Depressive Symptoms and Orthostatic Hypotension Are Risk Factors for Unexplained Falls in Community-Living Older People

Jasmine C. Menant, Alfred K W Wong, Julian N. Trollor, Jacqueline C T Close, Stephen R. Lord*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Objectives: To investigate risk factors for unexplained falls in older community-dwelling individuals. Design: Prospective cohort study. Setting: Community population, Sydney, Australia. Participants: Older adults (N = 529; mean age 79.8 ± 4.4, 52.2% female). Measurements: Participants provided information demographic, medical, and medication characteristics and completed cardiovascular (tilt table test, pulse wave velocity), cognitive, and sensorimotor assessments at baseline. Falls were then recorded in monthly fall diaries for 12 months. Unexplained fallers (UFs) were those who reported falls due to a blackout, dizziness, feeling faint, or “found themselves suddenly on the ground.”. Results: Of the 523 participants available at follow-up, 238 (45.5%) reported one or more falls; 35 participants fulfilled the definition of UFs. UFs were more likely than balance-related fallers (BFs) (n = 203) and nonfallers (n = 291) to have orthostatic hypotension (39.4%, 20.5% and 22.4%, respectively) and depressive symptoms (24.2%, 10.1%, and 7.9% respectively). More UFs (88.6%) than BFs (70.9%) had injurious falls. A multivariate logistic regression model revealed that depressive symptoms and orthostatic hypotension were significant and independent determinants of UF status. Conclusion: Approximately 15% of fallers had unexplained falls, which were more likely to result in injuries. Depressive symptoms and orthostatic hypotension increased the risk of unexplained falls, whereas cognitive deficits and sensorimotor and balance impairments did not. Future research should investigate whether psychotherapy and physical exercise to improve mood and medication reviews and nonpharmacological therapies for the treatment of orthostatic hypotension and depression are effective at reducing the risk of unexplained falls in older people.

Original languageEnglish
Pages (from-to)1073-1078
Number of pages6
JournalJournal of the American Geriatrics Society
Volume64
Issue number5
DOIs
Publication statusPublished - 1 May 2016
Externally publishedYes

Keywords

  • accidental falls
  • aged
  • depression
  • orthostatic hypotension
  • unexplained falls

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