Factors associated with fall related injuries among the elderly with major depressive disorder in the emergency department: analysis from a us nationwide emergency department study

Introduction Depression is a leading cause of the global burden of disease and can be associated with an increased risk of fall-related injuries in the elderly. Major depressive disorder (MDD) can be associated with significant disability and reduced quality of life. Therefore, we sought to assess the factors associated with fall-related injuries among the elderly with MDD who present to the emergency department (ED). Methods We used the Nationwide Emergency Department Sample in 2018 and identified elderly patients (ages 65 years and above) with a history of MDD and fall-related injuries. We compared the clinical characteristics of ED visits of those with MDD who presented with and without fall-related injuries. Univariate and multivariate analyses were conducted to determine the factors associated with fall-related injuries among this population of the elderly with MDD. Results A total of 532,038 ED visits in 2018 involving elderly patients with MDD were analyzed and 12.6% had fall-related injuries. Elderly people with MDD diagnosed with fall-related injuries were more likely to be older (OR 1.04, 95%CI 1.03-1.04 p<0.001), females (OR 1.33, 95% CI 1.30-1.36, p<0.001), have dementia (OR 1.69 95% CI 1.65-1.74, p<0.001) or alcohol use disorder (OR 1.28 95% CI 1.21-1.34, p<0.001). These persisted after adjusting for other variables using Charlson comorbidity index, mental health conditions (schizophrenia, bipolar disorder, anxiety disorder), and other substance use disorders (opioid, cannabis, and cocaine). Conclusions Dementia and alcohol use disorder were associated with an increased risk of falls in this cross-sectional study among elders with MDD presenting to the ED Screening for falls among elderly patients with MDD in the ER may provide an important step in the care of patients with comorbid dementia or alcohol use disorder. Given the large number of patients in this group experiencing falls, the anticipated growth of the aging population, and the well-established risks associated with falls, future research should investigate prevention efforts integrated into the ED setting. This research was funded by None of the authors received funding in support of the research presented in this abstract, and all have declared no known financial conflicts of interest.