make judgements and coordinate
Falls & Falls Injury Prevention Service Newsletter │ December 2014/Januarymovements.
2015
Depression and Falls
With an estimated 15-20% of
people over 65 suffering from
some form of depression
(Biderman et al1 2002), the link
between depression and an
increased risk of falling should not
be overlooked.
According to Beyond Blue
(www.beyondblue.org.au)
depression is more than a feeling
of sadness or a low mood.
Depression is a serious illness
that affects you mentally and
physically. The symptoms of
depression which increase the
risk of falling include:
- fear of falling
- poor cognitive functioning,
mainly in executive function,
attention and processing
speed.
- poor appetite/ hydration and
weight loss
(Laboni et al2 2013)
It is often accompanied by
anxiety. Fearful people often walk
slowly (loss of stability), have
shorter strides (stiffening and
postural over adjustment), a wider
base, poor coordination and
higher gait variability (Laboni et al
2013).
These changes result in the
inability to pay attention to
environmental factors while
walking. Poor executive function
processes affect the ability to
compensate for age related motor
and sensory function changes
leading to postural instability,
impairment of activities of daily
living and falls3 .
Poor nutrition and weight loss put
individuals at risk of falling from
deconditioning and loss of muscle
mass with an inability to weight
bear. Falls result from a loss of
balance and coordination.
1
Continued weight loss and
inactivity can lead to postural
hypotension: a sudden drop in
blood pressure when changing
positions which leads to dizziness
and fainting. Poor nutrition also
impairs the brains ability to
function and process information,
2
3
Fear of Falling is described as an
excessive and disabling
emotional response to falling
resulting in avoidance of activity.
Biderman, A., Cwikel, J., Fried, A., and
Galinsky, D. (2002) Depression and falls
among community dweling elderly people: a
search for common risk factors. J Epidemol
Community Health, 56:631-636.
Laboni, A., Phil, D., and Flint, J. (2013). The
complex Interplay of Depression and Falls in
older Adults: A clinical review. Am J Geriatr
Psychiatry, 21:5, May 2013, pg 484. ProQuest
Central.
Dehydration is common in the
elderly as their thirst drive lessens
over time. However, this is
exacerbated with depression
especially with severe depression
where fluid consumption is
restricted by the individual due to
inactivity and forgetfulness.
Dehydration affects cognitive
ability and motor function.
TREATMENT
Biderman et al report that regular
exercise and leisure activities are
important for developing a sense
of positive well-being and can
lead to lower levels of depression
and anxiety in individuals. Better
nutrition (including supplements),
and medical intervention to treat
depressive symptoms all combine
to help decrease the falls risk for
individuals. Getting appropriate
treatment from mental health
professionals is important in
combination with input from the
General Practitioner.
Remember if you are concerned
about anyone who may be
depressed you can call Beyond
Blue on 1300 224 636 24 hours a
day, 7 days a week or they can
see their General Practitioner for
help.
Montero-Odasso, M., Verghese, J.,
Beauchet, O., and Hausdorff, J. (2012) Gait
and Cognition: A complementary approach to
understanding brain function and the risk of
falling. JAGS. 60:2127-2136.
To make a referral, contact Community Health Intake (CHI):
Phone: 02 6207 9977
Fax:
CHI referral form to 02 6205 2611
Email: CHI referral form to Chiintake@act.gov.au
CHI referral form can be located at www.health.act.gov.au/community health