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身体损伤与心理影响:了解反复跌倒的老年人患抑郁症的高风险。

Physical Injury and Psychological Impact: Understanding the High Risk of Depression on Older Adults with Recurrent Falls.

作者信息

Namoos Asmaa, Thomson Nicholas, Olson Carol, Aboutanos Michel

机构信息

Department of Surgery, Medical Center West Hospital, Injury and Violence Prevention Program, School of Medicine, Virginia Commonwealth University, Richmond, VA 23219, USA.

出版信息

Adv Geriatr Med Res. 2024;6(4). doi: 10.20900/agmr20240008. Epub 2024 Dec 18.

Abstract

BACKGROUND

Falls among older adults significantly increase the risk of physical injuries, loss of independence, and social isolation, contributing to psychological conditions such as depression.

OBJECTIVE

This study explores the association between falls and the risk of developing depression among older adults, comparing psychological outcomes between those with initial and recurrent falls. It also examines demographic factors such as age, sex, and race that may influence depression risk.

METHODS

We retrospectively analyzed electronic health records from the TriNetX network at Virginia Commonwealth University Health System (VCUHS) during 2023. Older adults aged 65 to 89 were classified into two cohorts: initial falls ( = 2710) and recurrent falls ( = 1050). Statistical analyses, including risk ratios, survival analysis, and proportional hazards models, were used to evaluate associations between falls and depression risk.

RESULTS

Recurrent fallers exhibited a higher prevalence of depression (25.7%) compared to initial fallers (16.6%), with a significant association ( < 0.000). Recurrent fallers were 48.8% more likely to develop depression (HR = 1.488). Among younger adults aged 65 to 69, females had a higher prevalence of depression than males (30.5% vs. 20.1%). Anxiety disorders tripled the risk of depression following falls (HR = 3.036).

CONCLUSIONS

Recurrent falls are significantly associated with an increased likelihood of depression among older adults, highlighting the need for comprehensive interventions. Preventing falls not only reduces the risk of physical injuries but also alleviates associated mental health challenges, including depression and other comorbidities such as postoperative cognitive decline and dementia. Tailored prevention strategies, such as balance training, cognitive therapy, and home safety modifications, can foster better recovery and enhance the quality of life for this vulnerable population.

摘要

背景

老年人跌倒会显著增加身体受伤、失去独立能力和社会孤立的风险,进而导致抑郁等心理问题。

目的

本研究探讨老年人跌倒与患抑郁症风险之间的关联,比较初次跌倒者和反复跌倒者的心理结局。同时研究年龄、性别和种族等人口统计学因素对抑郁症风险的影响。

方法

我们回顾性分析了弗吉尼亚联邦大学健康系统(VCUHS)TriNetX网络2023年期间的电子健康记录。65至89岁的老年人被分为两个队列:初次跌倒者(n = 2710)和反复跌倒者(n = 1050)。采用风险比、生存分析和比例风险模型等统计分析方法来评估跌倒与抑郁症风险之间的关联。

结果

与初次跌倒者(16.6%)相比,反复跌倒者的抑郁症患病率更高(25.7%),二者存在显著关联(P < 0.000)。反复跌倒者患抑郁症的可能性高出48.8%(风险比 = 1.488)。在65至69岁的年轻人中,女性的抑郁症患病率高于男性(30.5%对20.1%)。跌倒后焦虑症会使患抑郁症的风险增加两倍(风险比 = 3.036)。

结论

反复跌倒与老年人患抑郁症的可能性增加显著相关,这凸显了采取综合干预措施的必要性。预防跌倒不仅能降低身体受伤的风险,还能缓解相关的心理健康挑战,包括抑郁症以及术后认知功能下降和痴呆等其他合并症。量身定制的预防策略,如平衡训练、认知疗法和家庭安全改造等,可以促进更好的康复并提高这一弱势群体的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6801/12333890/94212e06156c/nihms-2045945-f0001.jpg

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