Antidepressant Use Increases Fall Risk; Exercise May Be an Alternative Intervention in At-Risk Adults

Document Type

Conference Presentation

Department

Health, Exercise, and Sport Sciences Department

Conference Title

American College of Sports Medicine - Medicine & Science in Sports & Exercise conference

Organization

American College of Sports Medicine

Location

Virtual

Date of Presentation

8-1-2021

Journal Publication

Medicine & Science in Sports & Exercise

ISSN

0195-9131

DOI

10.1249/01.mss.0000761388.28792.4b

Volume

53

Issue

8S

First Page

200

Abstract

Approximately 19% of American adults age ≥ 65 years are taking an antidepressant medication. Prescriptions are more common among adults who do not engage in regular exercise and those who have experienced a fall. A sedentary lifestyle and antidepressant use may compound the risk of falling, but data are limited. PURPOSE: To examine the effect of antidepressant use on fall risk in older adults. METHODS: We analyzed patients from a Level 1 trauma center in an urban-suburban setting. Patients age ≥ 65 years who experienced a fall-related injury constituted the study sample (N = 615). We collected their demographic information, conducted a medical history, documented poor balance, lightheadedness, and cognitive struggles, recorded the use of antidepressants, and tabulated previous fall-related admissions. Holding all demographic and diagnostic variables constant, a logistic regression tested the effect of antidepressant use on the odds that patients had been admitted multiple times in the past for falls. We then tracked patients forward for 8 months, tabulated future falls, and repeated the logistic regression prospectively, holding the same predictors constant. Lastly, we conducted a Poisson regression to measure the effect of antidepressant use on the total number of falls (retrospective and prospective), using the same set of predictors. RESULTS: Subjects were 80.0 ± 9.1 years old; 31.1% were taking an antidepressant medication; the most common class was SSRIs (22.4%). In the retrospective logistic regression (pseudo R2 = 0.170; p < 0.001), the use of antidepressants associated with a 59% increase in the odds of sustaining multiple previous falls (p < 0.001; 95% CI of OR: 1.10 - 2.29). The prospective logistic regression (pseudo R2 = 0.111; p < 0.001) showed antidepressant use to predict a 104% increase in the odds of a future fall (p < 0.001; 95% CI of OR: 1.42 - 2.95). The Poisson regression (p < 0.001) predicted an 18% increase in the total number of falls when taking an antidepressant (p = 0.002; 95% CI of IRR: 1.06 - 1.31). CONCLUSION: The use of antidepressants appears to increase fall risk in this population. Physicians may consider advising at-risk patients to participate in controlled exercise to decrease the need for prescriptions while simultaneously lowering the likelihood of falls.

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