Matos Queirós Alcina, von Gunten Armin, Rosselet Amoussou Joëlle, Lima Andreia Maria, Martins Maria Manuela, Verloo Henk
Departement of Health and Social Welfare, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
Interact J Med Res. 2024 Nov 28;13:e57050. doi: 10.2196/57050.
Depression is a highly prevalent psychopathological condition among older adults, particularly those institutionalized in nursing homes (NHs). Unfortunately, it is poorly identified and diagnosed. NH residents are twice as likely to fall as community-dwelling older adults. There is a need for more knowledge about the mechanisms and relationships between depression and falls.
This study aims to identify, analyze, and synthesize research on the relationships between depression and falls among NH residents.
A literature search was conducted in October 2023 in the following bibliographic databases: MEDLINE ALL Ovid, Embase, CINAHL with Full Text EBSCO, APA PsycInfo Ovid, Web of Science Core Collection, the Cochrane Database of Systematic Reviews Wiley, and ProQuest Dissertations & Theses A&I. Clinical trials were searched for in the Cochrane Central Register of Controlled Trials Wiley, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. Additional searches were performed using Google Scholar, the DART-Europe E-theses Portal, and backward citation tracking. The Newcastle-Ottawa Scale and the Appraisal tool for Cross-Sectional Studies were used to evaluate study quality.
The review included 7 quantitative studies published in 7 different countries from 3 continents; of these, 6 (86%) were cross-sectional studies, and 1 (14%) was a prospective cohort study. Results suggested high frequencies of depressive symptoms and falls among older adults living in NHs, and depressive symptoms were considered a risk factor for falls. The 15-item and 10-item versions of the Geriatric Depression Scale were the most commonly used measurement tools, followed by the Cornell Scale for Depression in Dementia and the Resident Assessment Instrument-Minimum Data Set 2.0. The prevalence of depression was heterogeneous, varying from 21.5% to 47.7% of NH residents. The studies used heterogeneous descriptions of a fall, and some considered the risk of falls, recurrent fallers, and near falls in their data. The prevalence of fallers was disparate, varying from 17.2% to 63.1%. Of the 7 retained studies, 6 (86%) reported a relationship between depression and falls or the risk of falls. Among the 19 other risk factors identified in the review as being associated with falls among NH residents were a history of falls in the last 180 days, >1 fall in the past 12 months, and respiratory illnesses.
There is a paucity of research examining falls among older adults with depressive symptoms in NHs. These findings should alert nurses to the need to consider depression as a risk factor in their work to prevent falls. More research is needed to gain a comprehensive understanding of fall risk among NH residents with depressive symptoms.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/46995.
抑郁症是老年人中一种高度普遍的精神病理状况，尤其是那些住在养老院（NHs）的老年人。不幸的是，它很难被识别和诊断。养老院居民跌倒的可能性是居家老年人的两倍。有必要更多地了解抑郁症与跌倒之间的机制和关系。
本研究旨在识别、分析和综合有关养老院居民抑郁症与跌倒之间关系的研究。
2023年10月在以下书目数据库中进行了文献检索：MEDLINE ALL Ovid、Embase、CINAHL with Full Text EBSCO、APA PsycInfo Ovid、Web of Science核心合集、Cochrane系统评价数据库Wiley以及ProQuest学位论文与学术期刊数据库A&I。在Cochrane对照试验中央注册库Wiley、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台中搜索了临床试验。还使用谷歌学术、DART-Europe电子论文门户和反向引文跟踪进行了额外搜索。使用纽卡斯尔-渥太华量表和横断面研究评估工具来评估研究质量。
该综述纳入了来自三大洲7个不同国家发表的7项定量研究；其中，6项（86%）为横断面研究，1项（14%）为前瞻性队列研究。结果表明，住在养老院的老年人中抑郁症状和跌倒的发生率很高，抑郁症状被认为是跌倒的一个危险因素。老年抑郁量表的15项和10项版本是最常用的测量工具，其次是痴呆抑郁康奈尔量表和居民评估工具-最低数据集2.0。抑郁症的患病率各不相同，在养老院居民中从21.5%到47.7%不等。这些研究对跌倒的描述各不相同，有些在数据中考虑了跌倒风险、反复跌倒者和险些跌倒的情况。跌倒者的患病率也各不相同，从17.2%到63.1%不等。在保留的7项研究中，6项（86%）报告了抑郁症与跌倒或跌倒风险之间的关系。在该综述中确定的与养老院居民跌倒相关的其他19个危险因素包括过去180天内有跌倒史、过去12个月内跌倒超过1次以及呼吸系统疾病。
针对养老院中有抑郁症状的老年人跌倒情况的研究较少。这些发现应提醒护士在预防跌倒的工作中需要将抑郁症视为一个危险因素。需要更多研究来全面了解有抑郁症状的养老院居民的跌倒风险。
国际注册报告识别号（IRRID）：RR2-10.2196/46995。
