Dementia, depressive symptoms and activities of daily living as risk factors for falls among elderly

Objectives: Falls among elderly are a well-recognised public health problem . The purpose of the present study was to explore the relation between deme ntia, number of depressive symptoms, activities of daily living, setting, a nd risk of falling. Methods: Data for the analysis came from a cross-sectional study about: dem entia, depression, and disabilities, carried out 1995/96 in Zurich and Gene va. The random sample stratified, by age and gender consisted of 921 subjec ts aged 65 and more. The interview was conducted by means of the Canberra I nterview for the Elderly, extended by short questionnaire. The subject was classified as a faller if the subject and/or the informant had reported a f all within the last 12 months prior to the interview. Logistic-regression a nalysis was used to determine the independent impact of dementia, depressiv e symptoms, and ADL-score on risk of falling. Results: The stepwise logistic regression analysis has revealed a statistic ally significant association between dementia (OR 2.14, 95% Cl 1.15-3.96), two resp, three depressive symptoms (OR 1.64, 95% Cl 1.04-2.60) as well as four or more depressive symptoms (OR 2.64, 95% Cl 1.39-5.02) and the risk o f falling. There was no statistically significant relationship between stud ied risk factors and the risk of being one-time faller. However, we found a strong positive association between dementia (OR 3.92, 95% Cl 1.75-8.79), four or more depressive symptoms (OR 3.90, 35% Cl 1.55-9.83) and the risk o f being recurrent faller. Moreover residents of nursing homes (OR 8.50, 95% Cl 2.18-33.22) and elderly aged 85 or more (OR 2.29, 95% Cl 1.08-4.87) wer e under statistically significant higher risk of sustaining recurrent falls . Conclusions: The results of the present study confirm that dementia and dep ression substantially increase the risk of falling.