Psychiatric disorders, psychotropic medication use and falls among women: an observational study

BMC Psychiatry

Michael Berk¹  Päivi H Rauma⁵  Heli Koivumaa-Honkanen⁶  Risto Honkanen⁷  Amelia G Dobbins³  Sharon L Brennan²  Felice N Jacka¹  Amanda L Stuart³  Julie A Pasco⁴  Lana J Williams³ 

[1] Department of Psychiatry, The University of Melbourne, Parkville, Australia;Australian Institute for Musculoskeletal Sciences, Melbourne, Australia;IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong 3220, Australia;NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia;Bone and Cartilage Research Unit, Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland;Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland;Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Joensuu, Finland

关键词: Benzodiazepine;    Antidepressants;    Psychotropic medication;    Falls;    Anxiety;    Depression;   

Others  :  1171026
DOI  :  10.1186/s12888-015-0439-4

 received in 2013-08-06, accepted in 2015-03-12,  发布年份 2015

【 摘 要 】

Background

Psychotropic agents known to cause sedation are associated with an increased risk of falls, but the role of psychiatric illness as an independent risk factor for falls is not clear. Thus, this study aimed to investigate the association between psychiatric disorders, psychotropic medication use and falls risk.

Methods

This study examined data collected from 1062 women aged 20-93 yr (median 50 yr) participating in the Geelong Osteoporosis Study, a large, ongoing, population-based study. Depressive and anxiety disorders for the preceding 12-month period were ascertained by clinical interview. Current medication use and falls history were self-reported. Participants were classified as fallers if they had fallen to the ground at least twice during the same 12-month period. Anthropometry, demographic, medical and lifestyle factors were determined. Logistic regression was used to test the associations, after adjusting for potential confounders.

Results

Fifty-six women (5.3%) were classified as fallers. Those meeting criteria for depression within the past 12 months had a 2.4-fold increased odds of falling (unadjusted OR = 2.4, 95% CI 1.2-4.5). Adjustment for age and mobility strengthened the relationship (adjusted OR = 2.7, 95% CI 1.4-5.2) between depression and falling, with results remaining unchanged following further adjustment for psychotropic medication use (adjusted OR = 2.7, 95% CI 1.3-5.6). In contrast, past (prior to 12-month) depression were not associated with falls. No association was observed between anxiety and falls risk. Falling was associated with psychotropic medication use (unadjusted OR = 2.8, 95% CI 1.5-5.2), as well as antidepressant (unadjusted OR = 2.4, 95% CI 1.2-4.8) and benzodiazepine use (unadjusted OR = 3.4, 95% CI 1.6-7.3); associations remained unchanged following adjustment for potential confounders.

Conclusion

The likelihood of falls was increased among those with depression within the past 12 months, independent of psychotropic medication use and other recognised confounders, suggesting an independent effect of depression on falls risk. Psychotropic drug use was also confirmed as an independent risk factor for falls, but anxiety disorders were not. Further research into the underlying mechanisms is warranted.

【 授权许可】

   
2015 Williams et al.; licensee BioMed Central.

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