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Pereira MEA, Santos GDS, de Almeida CR, Nunes KCS, da Silva MCM, José H, Sousa L, Vitorino LM. Association between Falls, Fear of Falling and Depressive Symptoms in Community-Dwelling Older Adults. Healthcare (Basel) 2024; 12:1638. [PMID: 39201196 PMCID: PMC11353576 DOI: 10.3390/healthcare12161638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/02/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. OBJECTIVE To evaluate the association between falls, FOF, and depressive symptoms in community-dwelling older adults. METHODS This cross-sectional study, conducted in 2018, included 400 older adults from a Basic Health Unit in São Paulo, Brazil. The Geriatric Depression Scale (GDS-15) and the International Falls Efficacy Scale (FES-I) were used, along with self-report questionnaires on fall history. Linear and logistic regression were used to analyze the relationships between variables. RESULTS The mean age was 75.2 (SD = 8.53) years, with 63.2% being female. Depressive symptoms were observed in 18.3% of the participants, while 90.5% reported a fear of falling (FOF). More than half (63.0%) experienced falls, with 49.5% occurring in the last year. Factors such as the female gender, negative health perceptions, and functional dependence were associated with depressive symptoms. Adjusted analyses indicated that both a fear of falling (FOF) (B = 0.043; p = 0.012) and a history of falls (B = 0.725; p = 0.015) were associated with depressive symptoms. CONCLUSIONS Falls, FOF, and depressive symptoms are interlinked among older adults, underscoring the need for targeted interventions to improve their mental and physical health.
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Affiliation(s)
| | | | - Clara Rabite de Almeida
- Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (C.R.d.A.); (K.C.S.N.); (M.C.M.d.S.)
| | - Kethlyn Cristina Santos Nunes
- Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (C.R.d.A.); (K.C.S.N.); (M.C.M.d.S.)
| | - Monalisa Claudia Maria da Silva
- Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (C.R.d.A.); (K.C.S.N.); (M.C.M.d.S.)
| | - Helena José
- Atlântica School of Health, 2730-036 Barcarena, Portugal; (H.J.); (L.S.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, 3004-011 Coimbra, Portugal
| | - Luís Sousa
- Atlântica School of Health, 2730-036 Barcarena, Portugal; (H.J.); (L.S.)
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal
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Brasileiro LEE, Dantas AAG, Linhares DB, Vale HA, Terradas-Monllor M, Ochandorena-Acha M, Paiva ALDM, de Medeiros MYD, Jerez-Roig J, de Souza DLB. Incidence of depression among community-dwelling older adults: A systematic review. Psychogeriatrics 2024; 24:496-512. [PMID: 38263357 DOI: 10.1111/psyg.13081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/11/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
We aimed to synthesise information related to the incidence of depression and depressive symptoms (DDS) in a community-dwelling older adult population at a global level. In this systematic review, we included articles with a cohort study design that evaluated the incidence of depression or depressive symptoms in older adults aged 60 years or more in a community-dwelling environment. Six databases were used: Web of Science, PubMed, Scopus, LILACS, SciELO, and Cochrane, and the entire selection process was independently performed by peers. We divided the included articles into subgroups according to the DDS assessment instrument: (i) Geriatric Depression Scale; (ii) Center for Epidemiologic Studies Depression Scale; (iii) miscellaneous scales; and (iv) diagnostic interviews. Each cumulative incidence value obtained per item was adjusted for a 1-year follow-up period, which generated an annual cumulative incidence (AcI). From 46 articles, 42 used scales to evaluate the depressive variable, with an AcI estimate of around 4.5%. The articles that assessed depression categorically observed a variation in AcI between 0.2% and 7.0%. Among all the materials included, the group that used the Geriatric Depression Scale observed the lowest and the highest AcI, 1.3% and 26.6% respectively. Most of the productions were from countries in the Asian continent (52.2%), followed by Europe (30.4%), the Americas (13%), and Oceania (4.4%). Despite the variation of AcI, we found a frequent occurrence of DDS in older adults in the community-dwelling environment, which highlights the need for preventive actions and better-targeted early care, especially in terms of primary health care.
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Affiliation(s)
- L E E Brasileiro
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Amanda Almeida Gomes Dantas
- Department of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dorothy Bezerra Linhares
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Heron Alves Vale
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte (UFRN), Caicó, Brazil
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | | | | | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health, and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Dyego Leandro Bezerra de Souza
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
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