Longitudinal Associations of Falls and Depressive Symptoms in Older Adults

Gerontologist. 2019 Nov 16;59(6):1141-1151. doi: 10.1093/geront/gny179.


Background and objectives: Fall incidents and associated medical costs are increasing among older adults. This study examined longitudinal associations between older adults' falls status and depression at 2 time periods to further clarify bidirectional relationships.

Methods: We used the National Health and Aging Trends Study (NHATS) Waves 5 and 6 data and included sample persons (N = 6,299) who resided in the community or residential care facilities (not nursing homes) at both waves (T1 and T2). We employed multinomial logistic regression analysis to examine the association of T2 falls status with T1 depressive symptoms, and negative binomial regression and logistic regression analyses to examine the association of T2 depressive symptoms with stability/change in T1-T2 falls status.

Results: Over the study period, 46% of older adults (18 million Medicare beneficiaries) who lived in the community or residential care facilities reported a fall. T1 depressive symptoms were significantly associated with greater odds of T2 multiple falls, and increasing falls or continuing incidents of multiple falls between T1 and T2 were significantly associated with higher depressive symptoms and probable major depression at T2.

Discussion and implications: The significant bidirectional relationships between T1 depression and T2 multiple falls point to the importance of incorporating depression treatment in fall prevention programs for older adults at high risk of increasing/multiple falls.

Keywords: Chronic illnesses; Depression; Fall worry; Falls; Functional impairments.

MeSH terms

  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Depression / complications
  • Depression / epidemiology*
  • Depression / etiology
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Risk Factors
  • United States / epidemiology