Steve Hicks School of Social Work, The University of Texas at Austin, Houston VA HSR&D Center for Innovations in Quality, Texas.
Effectiveness and Safety, Michael E. Debakey VA Medical Center, Houston VA HSR&D Center for Innovations in Quality, Texas.
Gerontologist. 2019 Nov 16;59(6):1141-1151. doi: 10.1093/geront/gny179.
Fall incidents and associated medical costs are increasing among older adults. This study examined longitudinal associations between older adults' falls status and depression at 2 time periods to further clarify bidirectional relationships.
We used the National Health and Aging Trends Study (NHATS) Waves 5 and 6 data and included sample persons (N = 6,299) who resided in the community or residential care facilities (not nursing homes) at both waves (T1 and T2). We employed multinomial logistic regression analysis to examine the association of T2 falls status with T1 depressive symptoms, and negative binomial regression and logistic regression analyses to examine the association of T2 depressive symptoms with stability/change in T1-T2 falls status.
Over the study period, 46% of older adults (18 million Medicare beneficiaries) who lived in the community or residential care facilities reported a fall. T1 depressive symptoms were significantly associated with greater odds of T2 multiple falls, and increasing falls or continuing incidents of multiple falls between T1 and T2 were significantly associated with higher depressive symptoms and probable major depression at T2.
The significant bidirectional relationships between T1 depression and T2 multiple falls point to the importance of incorporating depression treatment in fall prevention programs for older adults at high risk of increasing/multiple falls.
老年人跌倒事件及其相关医疗费用不断增加。本研究通过两次随访(T1 和 T2),考察了老年人跌倒状态与抑郁之间的纵向关联,以进一步阐明两者之间的双向关系。
我们使用了全国健康老龄化趋势研究(NHATS)第五波和第六波的数据,纳入了两次随访(T1 和 T2)均居住在社区或养老院(非疗养院)的样本人群(N=6299)。我们采用多项逻辑回归分析来检验 T2 跌倒状态与 T1 抑郁症状之间的关联,采用负二项回归和逻辑回归分析来检验 T2 抑郁症状与 T1-T2 跌倒状态的稳定性/变化之间的关联。
在研究期间,居住在社区或养老院的 46%(1800 万 Medicare 受益人)的老年人报告了跌倒。T1 抑郁症状与 T2 多次跌倒的几率显著相关,T1 和 T2 之间增加的跌倒次数或持续发生多次跌倒与 T2 时更高的抑郁症状和可能的重度抑郁显著相关。
T1 抑郁与 T2 多次跌倒之间的显著双向关系表明,对于有增加/多次跌倒风险的老年人,将抑郁治疗纳入跌倒预防计划至关重要。