Media Release: University of Auckland - New Zealand

Older people who have depression or are taking anti-depressants have an increased risk of falls, New Zealand and Australian researchers have found.

Research published this week in PLoS ONE suggests people with depression and those taking antidepressants, especially SSRI’s, are 50% more likely to fall than other older people

In a study of 21,900 Australians aged over 60, who responded to a survey sent out by their GP, 24 percent reported at least one fall during the last 12 months, 11% had injured themselves with falling and 8% had needed to see a doctor because of a fall. About one quarter of the group reported symptoms of depression and 12% were taking some form of antidepressant. While using antidepressants was a significant risk for falls, the highest risk (66% increase in falls) was seen when older people used SSRI’s, the most frequently prescribed antidepressant (6% of people took this medication).

"Falls are very common and risk factors for falls are easy to identify," says Associate Professor Ngaire Kerse of The University of Auckland’s School of Population Health and lead author of the study. "The risk associated with SSRIs has been reported before but not in such a large group of older people living in the community. More than 60% of women aged over 80 with depression and taking an SSRI fell in the last year. This means fall prevention strategies must really be thought of when prescribing antidepressants for older people."

Researchers also found:

• Women were more likely to sustain injury than men. 
• Those with any degree of depression were up to 70% more likely to have multiple falls and injury than those who weren’t. 
• Depression, taking antidepressants, ever having thought about suicide, having had a stroke, arthritis or suffering from more than 3 medical problems were associated with having more than one fall.

Researchers suggest effective prevention programmes include lower leg strengthening and balance retraining, as well as home assessment and modification programs to reduce hazards. Home hazard assessment and modification should include appropriate lighting, removing obstacles and installing transfer rails. Family members also need to be involved in making modifications and taking action that will help prevent falls.

"We need to increase the awareness among family members on fall prevention," Kerse said. "More than one-third of patients with depression will fall and the consequences can be disastrous, adding to the consequences of depression. There is an opportunity to offer fall prevention strategies as part of the initial treatment for depression in patients and as part of ongoing treatment."

Co-authors of the research include Leon Flicker, Jon J Pfaff, Osvaldo P Almeida and Nicola T Lautenschlager from the University of Western Australia; Brian Draper at the University of New South Wales; Moira Sim from Edith Cowan University in Perth; and John Snowdon from the University of Sydney in Sydney. The research was funded by the Australian National Health and Medical Research Council and beyondblue.