Fall Risk Increase Associated With Depression in NH Residents

Nursing home (NH) residents receiving psychosocial treatments for depression are six times more susceptible to falls compared with residents not receiving depression treatments, according to a recent study (Contemporary Clinical Trials Communications. 2016;3:139-141). 

The research team, led by Suzanne Meeks, PhD, professor at the University of Louisville, (Louisville, KY), compared data from 82 eligible residents (mean age 75.16) with depression at 23 facilities from a cluster-randomized controlled trial of a 10-week psychosocial treatment for depression. Residents were divided into two groups: the experimental group (n = 42), who received psychosocial depression treatments such as group and cognitive behavioral therapies; and the control group (n = 40).

During a 2-week baseline assessment and the 10-week intervention phase, research staff met with participants for at least one visit per week. Each time a research staff member was in contact with a participant they completed a checklist of possible adverse events, which included the following: participant complaint of fatigue related to the intervention, confidentiality breach, increased depression severity, suicidal ideation, severe medical set-back (eg, hospitalization, pneumonia), resident died, falls, or “other.”

No adverse event other than falls was significantly different between the two groups; there were 13 falls reported over 20,739 person-days of follow-up. Seven participants fell once, and three participants fell twice. Most participants did not fall, but 11 falls were experienced by members of the treatment group, as compared to only 2 falls in the control group.

Ultimately, Dr Meeks and her team found that members of the experimental group were almost 6 times more likely to fall than those in the control group. Although residents in both groups shared risk factors such as chronic illnesses, the psychosocial treatment group still had “a significantly higher rate of falls,” Dr Meeks said.

In terms of clinical practice, Dr Meeks concluded, it may be important for mental health practitioners to consider risk of falls during any treatment for depression, to assess regularly for safety, and to consider whether treatment for depression should be augmented by fall prevention practices. —Amanda Del Signore