Falls, depression and antidepressants in later life: a large primary care appraisal.
Falls, depression and antidepressants in later life: a large primary care appraisal.
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DOI：
10.1371/journal.pone.0002423
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发表时间：
2008-06-18
期刊：
影响因子：
3.7
通讯作者：
Almeida OP
中科院分区：
文献类型：
--
作者：
Kerse N;Flicker L;Pfaff JJ;Draper B;Lautenschlager NT;Sim M;Snowdon J;Almeida OP
抑郁症和福尔斯是常见的，并同时存在于老年人。安全管理这些疾病中的每一种对于生活质量都很重要。一项横断面调查被用来检查与伤害性和非伤害性福尔斯在21,900社区居住的成年人，年龄在60岁或以上，从383澳大利亚的一般做法招募的DEPS-GP项目相关的药物使用。在一项标准化调查中报告了福尔斯和福尔斯损伤、药物使用、抑郁症状（初级健康问卷（PHQ-9））、临床发病率、自杀意念和意图、健康状况（SF-12健康调查）、人口统计学和生活方式信息。受访者年龄为71.8岁（标准差7.7），58.4%为女性。分别有24%、11%和8%的人报告了福尔斯跌倒、跌倒相关损伤和就医。抗抑郁药使用（比值比，OR：1.46; 95%置信区间，95%CI：1.25，1.70），可疑抑郁症（PHQ OR：1.32，95%CI：1.13，1.53）和临床显著的抑郁症状（PHQ OR：1.70，95%CI：1.14，1.50）与多次福尔斯独立相关。在所有精神药物中，使用SSRI与多次福尔斯跌倒的风险最高（OR：1.66，95%CI：1.36，2.02）。对于伤害性福尔斯也观察到类似的关联。超过60%的有四个累积风险因素的人在前一年有多次福尔斯（OR：3.40，95%CI：1.79，6.45）;调整其他人口统计学和健康因素。无论是否存在抑郁症状，抗抑郁药（尤其是SSRIs）的使用与福尔斯跌倒密切相关。预防福尔斯跌倒的策略应该成为老年抑郁症患者管理的常规部分。
Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life. A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey. Respondents were 71.8 years (sd 7.7) of age and 58.4% were women. 24% 11% and 8% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95% confidence interval, 95%CI: 1.25, 1.70), questionable depression (5–14 on PHQ OR: 1.32, 95%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95%CI: 1.79, 6.45); adjusted for other demographic and health factors. Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression.
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DOI：
10.1111/j.1532-5415.1999.tb03843.x
发表时间：
1999-07-01
影响因子：
6.3
作者：
Campbell, AJ;Robertson, MC;Buchner, DM
通讯作者：
Buchner, DM
影响因子：
3.4
作者：
KOENIG, HG;WESTLUND, RE;HYBELS, C
通讯作者：
HYBELS, C
影响因子：
--
作者：
COBB, JS;MILES, DPB
通讯作者：
MILES, DPB
DOI：
10.1111/j.1532-5415.1999.tb01898.x
发表时间：
1999-01-01
影响因子：
6.3
作者：
Leipzig, RM;Cumming, RG;Tinetti, ME
通讯作者：
Tinetti, ME
影响因子：
4
作者：
Becker, C;Crow, S;Siris, E
通讯作者：
Siris, E