Depression, Antidepressants, and Falls Among Community-Dwelling Elderly People: The MOBILIZE Boston Study
Depression, Antidepressants, and Falls Among Community-Dwelling Elderly People: The MOBILIZE Boston Study
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DOI：
10.1093/gerona/glt084
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发表时间：
2013-12-01
影响因子：
5.1
通讯作者：
Lipsitz, Lewis A.
中科院分区：
文献类型：
--
作者：
Quach, Lien;Yang, Frances M.;Lipsitz, Lewis A.
跌倒和抑郁之间的联系机制仍不清楚。该研究的目的是检查抑郁症和抗抑郁药物与室内和室外跌倒之间的关系，并调查抗抑郁药物如何调节这种关系。该研究纳入了 763 名 70 岁及以上的男性和女性，抑郁症和抗抑郁药物使用的基线测量数据是通过老年人保持平衡、独立生活、智力和热情 (MOBILIZE) 波士顿研究的跌倒前瞻性数据获取的，该研究是一项基于人群的纵向研究（从 2005 年到 2005 年） 2009）。总体而言，跌倒率为 26 次跌倒/100 人年。 17% 的参与者有临床上显着的抑郁症状 (CSDS)，12% 的参与者使用抗抑郁药物。 CSDS 增加了室内和室外跌倒的风险（发生率比 [IRR] 1.6，95% 置信区间 [CI] 1.22.3，p < .01；IRR 1.6，95% CI 1.22.2，p < .01）。使用抗抑郁药使户外跌倒的风险增加 70%，并部分调节 CSDS 与户外跌倒之间的关联（IRR 1.7，95% CI 1.22.5，p < .05）。抗抑郁药物的使用与室内跌倒之间没有关系。当抑郁症被视为连续变量时，也观察到类似的结果。抑郁症会增加室内和室外跌倒的风险。患有 CSDS 的老年人使用抗抑郁药物会增加户外跌倒的风险，但不会增加室内跌倒的风险。临床医生应仔细考虑抗抑郁药在患有 CSDS 的老年人中的作用及其可能增加户外跌倒风险的可能性。
The mechanisms linking falls and depression are still unknown. The aim of the study is to examine the association between depression and antidepressants, with indoor and outdoor falls, and to investigate how antidepressants mediate this relationship.The study included 763 men and women aged 70 and older with baseline measures for depression and antidepressant use are captured with prospective data on falls from the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly (MOBILIZE) Boston study, which is a population-based longitudinal study (from 2005 to 2009).Overall, the rate of falls was 26 falls/100 person-years. Seventeen percent of participants had clinically significant depressive symptoms (CSDS), and 12% used antidepressants. CSDS increased the risk of indoor and outdoor falls (incidence rate ratio [IRR] 1.6, 95% confidence interval [CI] 1.22.3, p < .01; IRR 1.6, 95% CI 1.22.2, p < .01). Antidepressant use increased the risk of outdoor falls by 70% and partially mediated the association between CSDS and outdoor falls (IRR 1.7, 95% CI 1.22.5, p < .05). There was no relationship between antidepressant use and indoor falls. Similar results were observed when depression was considered as a continuous variable.Depression increased the risk of indoor and outdoor falls. Antidepressant use among older adults with CSDS increased the risk of outdoor, but not indoor falls. Clinicians should carefully consider the role of antidepressants among older adults with CSDS and their potential increase for the risk of outdoor falls.