André Hajek1, Christian Brettschneider1, Hendrik van den Bussche2, Dagmar Lühmann2, Anke Oey3, Birgitt Wiese3, Siegfried Weyerer4, Jochen Werle4, Angela Fuchs5, Michael Pentzek5, Janine Stein6, Tobias Luck6,7, Horst Bickel8, Edelgard Mösch8, Kathrin Heser9, Michael Wagner9,10, Martin Scherer2, Wolfgang Maier9,10, Steffi G Riedel-Heller6, Hans-Helmut König1. 1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Institute of General Practice, Hannover Medical School, Hannover, Germany. 4. Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. 5. Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. 6. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. 7. Department of Economic & Social Sciences, University of Applied Sciences Nordhausen, Nordhausen, Germany. 8. Department of Psychiatry, Technical University of Munich, Munich, Germany. 9. Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany. 10. DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany.
Abstract
OBJECTIVE: The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. METHODS: Data were used from 2 waves of the multicenter prospective cohort "Study on needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). This study covers primary care patients ≥85 years (at baseline: n = 547, average age of 88.9 ± 3.0 years; ranging from 85 to 100 years). General practitioner-diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure. RESULTS: Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms (β = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; β = -.04, P = .005). CONCLUSIONS: Based on a large, population-based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms.
OBJECTIVE: The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. METHODS: Data were used from 2 waves of the multicenter prospective cohort "Study on needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). This study covers primary care patients ≥85 years (at baseline: n = 547, average age of 88.9 ± 3.0 years; ranging from 85 to 100 years). General practitioner-diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure. RESULTS: Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms (β = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; β = -.04, P = .005). CONCLUSIONS: Based on a large, population-based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms.