Anxiety disorders and falls among older adults

Abstract

Background:Falls are common among older adults and can lead to serious injuries, including fractures. We aimed to determine associations between anxiety disorders and falls in older adults. Methods:Participants were 487 men and 376 women aged ≥60 years enrolled in the Geelong Osteoporosis Study, Australia. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient edition (SCID-I/NP), lifetime history of anxiety disorders was determined. Falls were determined by self-report. In men, a falls-risk score (Elderly Falls Screening Test (EFST)) was also calculated. Results:Among fallers, 24 of 299 (8.0%) had a lifetime history of anxiety disorder compared to 36 of 634 (5.7%) non-fallers (p=0.014). Examination of the association between anxiety and falls suggested differential relationships for men and women. In men, following adjustment for 2 psychotropic medications, mobility and blood pressure, lifetime anxiety disorder was associated with falling (OR 2.96; 95%CI 1.07-8.21) and with EFST score (OR 3.46; 95%CI 1.13-10.6). In women, an association between lifetime anxiety disorder and falls was explained by psychotropic medication use, poor mobility and socioeconomic status. Limitations:Sub-group analyses involving types of anxiety and anxiety disorders over the past 12-months were not performed due to power limitations. Conclusion:Although anxiety disorders were independently associated with a 3-fold increase in likelihood of reported falls and high falls risk among men, an independent association was not detected among women. These results may aid in prevention of falls through specific interventions aimed at reducing anxiety, particularly in men.

Psychological correlates of fear of falling: Findings from the German Aging Survey

“…This might be fruitful, because the majority of aged individuals have regular GP visits in Germany. 50 In addition, it has been shown that the general psychological factors used in the present study are potentially modifiable, which might be essential for creating interventions. 48 For example, a recent study (randomized controlled trial) examined the effectiveness of an intervention (series of cognitive-behavioral sessions) targeting to reduce FOF.…”

“…48 However, further research is required due to some methodological constraints in existing studies. 50 In addition, it has been shown that the general psychological factors used in the present study are potentially modifiable, which might be essential for creating interventions. [25][26][27][28][29] Longitudinal studies are required to reveal insights into the temporal relationship between psychological factors and FOF.…”

The Factors Associated With Anxiety Symptom Severity in Older Adults Living in Nursing Homes and Other Residential Aged Care Facilities

“…For instance, to date very little or no research has examined the association between anxiety and global attachment style, residents’ sense of mastery (i.e., personal control and sense of competence in mastering one’s day-to-day activities and environment), level of social engagement (i.e., having connections with others and being involved in group activities), or experience of a fall. Previous late-life research examining these variables have found significant associations between depression and lower levels of mastery (Davison, McCabe, Knight, & Mellor, 2012) and social engagement (Kang, 2012; Resnick, Fries, & Verbrugge, 1997) among RACF residents, whereas community-based studies have found an association between anxiety and the experience of a fall (Holloway et al, 2016; Menant et al, 2013) and an anxious attachment style (Kafetsios & Sideridis, 2006). Given that attachment behavior continues throughout the life span and impacts on well-being (Bowlby, 1980), and RACF residents are at particular risk of low social engagement, low perceived mastery, and increased risk of falls, research examining these factors and their association with anxiety is warranted.…”

Astrocytes in the Ventromedial Hypothalamus Involve Chronic Stress-Induced Anxiety and Bone Loss in Mice

“…In particular, abnormal bone metabolism is a common symptom of stress and anxiety [10,11]. Clinical studies have shown that the probability of osteoporosis and fractures in patients with anxiety and depression is significantly higher than that in normal controls [12][13][14], suggesting that an individual's anxiety state is closely related to bone metabolism. Although evidence indicates that anxiety can affect bone loss, the underlying neural mechanism is still unclear.…”