Resumen de Depressive Symptomatology as a Risk Factor for Falls in Older People:: Systematic Review and Meta-Analysis
Tasha Kvelde, Catherine McVeigh, Barbara Toson, Mark Greenaway, Stephen R. Lord, Kim Delbaere, Jacqueline C.T. Close
Objectives: To conduct a systematic literature review and meta-analysis to evaluate studies that have addressed depressive symptoms as a risk factor for falls in older people.
Design: Systematic review with meta-analysis.
Setting: Community and residential care.
Participants: Individuals aged 60 and older.
Measurements: Depressive symptoms, incidence of falls.
Results: Twenty-five prospective studies with a total of 21,455 participants met inclusion criteria for the systematic review. Twenty studies met criteria for the meta-analyses. Recruitment of participants was conducted randomly or by approaching groups with identified healthcare needs. Eleven measures were used to assess depressive symptoms, and length of follow-up for falls ranged from 90 days to 8 years. Reporting of antidepressant use was variable across studies. The pooled effect of 14 studies reporting odds ratios (ORs) indicated that a higher level of depressive symptoms at baseline resulted in a greater likelihood of falling during follow-up (OR = 1.46, 95% confidence interval (CI) = 1.27�1.67, P < .001, I2 = 77.2%). In six studies reporting relative risks (RRs) or hazard ratios, a higher level of depressive symptoms at baseline resulted in a greater likelihood of falling during follow-up (RR = 1.52, 95% CI = 1.19�1.84, P < .001). There was no difference between community samples and those with identified healthcare needs with respect to depressive symptoms being a risk factor for falls.
Conclusion: Depressive symptoms were found to be consistently associated with falls in older people, despite the use of different measures of depressive symptoms and falls and varying length of follow-up and statistical methods. Clinicians should consider management of depression when implementing fall prevention initiatives, and further research on factors mediating depressive symptoms and fall risk in older people is needed.
