Abstract
BACKGROUND: Falls among older adults significantly increase the risk of physical injuries, loss of independence, and social isolation, contributing to psychological conditions such as depression. OBJECTIVE: This study explores the association between falls and the risk of developing depression among older adults, comparing psychological outcomes between those with initial and recurrent falls. It also examines demographic factors such as age, sex, and race that may influence depression risk. METHODS: We retrospectively analyzed electronic health records from the TriNetX network at Virginia Commonwealth University Health System (VCUHS) during 2023. Older adults aged 65 to 89 were classified into two cohorts: initial falls (n = 2710) and recurrent falls (n = 1050). Statistical analyses, including risk ratios, survival analysis, and proportional hazards models, were used to evaluate associations between falls and depression risk. RESULTS: Recurrent fallers exhibited a higher prevalence of depression (25.7%) compared to initial fallers (16.6%), with a significant association (p < 0.000). Recurrent fallers were 48.8% more likely to develop depression (HR = 1.488). Among younger adults aged 65 to 69, females had a higher prevalence of depression than males (30.5% vs. 20.1%). Anxiety disorders tripled the risk of depression following falls (HR = 3.036). CONCLUSIONS: Recurrent falls are significantly associated with an increased likelihood of depression among older adults, highlighting the need for comprehensive interventions. Preventing falls not only reduces the risk of physical injuries but also alleviates associated mental health challenges, including depression and other comorbidities such as postoperative cognitive decline and dementia. Tailored prevention strategies, such as balance training, cognitive therapy, and home safety modifications, can foster better recovery and enhance the quality of life for this vulnerable population.