Associação entre sintomas depressivos e risco fisiológico de quedas em idosos comunitários

Abstract

Falls and depressive symptoms are prevalent conditions in the older population and they are associated. However, there is still debate about the mechanisms underlying this relationship. The objective of this study is to investigate the relationship between depressive symptoms and falls in community-dwelling older people. This is a cross-sectional study, with 278 participants aged 60 or more, and recruited by convenience. Information on clinical and sociodemographic data were obtained in a structured interview, depressive symptoms were assessed with the Geriatric Depression Scale (GDS), falls in the previous year were self-reported and risk of falls was assessed with the Physiological Profile Assessment (PPA). Fallers and non-fallers were compared with Mann-Whitney and chi-square tests. A binary logistic model was used to investigate the association between falls and GDS score, followed by a Poisson regression model to analyze the association of GDS score and the number of falls. Finally, groups of individuals screened positive or negative for depression were compared for risk of falls and each individual PPA test. Participants were aged an average of 70.1 (±6.26) years, 188 were women (67.6%), 70 (25.2%) presented positive screening for depression e 98 (35.3%) reported at least one fall in the last year. Fallers presented more chronic conditions (p=0.013), polypharmacy (p=0.042), worse subjective health status (0.007) and higher GDS scores (p=0.039). Individuals with higher GDS scores presented higher chance of falling (OR: 1.10; p=0.02). The number of falls was not associated to GDS score in the adjusted Poisson model (IC95%: 0.69 -1.02), however there was an association between falls and number of morbidities (PR: 1.46; IC95%: 1.05-2.02). Positive screening for depression was associated to higher risk of falls according to the PPA (p=0.006), as well as to reaction time (p=0.001). In conclusion, fallers presented more depressive symptoms, morbidities, polypharmacy and worse subjective health status. Depressive symptoms did not act directly over the number of falls, nonetheless those with depressive symptoms presented a higher chance of falling, which may me associated to slower reaction time. Psychological symptoms play an important role in falls and should be considered when identifying older people at risk and developing prevention programs.