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Kidney Week

Abstract: FR-PO568

Depressive Disorders Are a Risk Factor for Falls and Fall-Related Injuries Among Adults with Kidney Disease

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Kistler, Brandon, Ball State University, Muncie, Indiana, United States
  • Khubchandani, Jagdish, Ball State University, Muncie, Indiana, United States
  • Bennett, Paul N., Satellite Healthcare, San Jose, California, United States
  • Wilund, Ken, University of Illinois, Urbana, Illinois, United States
  • Sosnoff, Jacob J., University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
Background

Depressive disorders are common among patients with chronic kidney disease (CKD) and especially those who have advanced to end stage kidney disease (ESKD). In addition, depression and pharmacotherapy for depression have been associated with impaired gait and increased propensity for falls in older adults. Therefore, the purpose of this study was to determine the relationship between depressive disorders, falls, and fall-related injuries in a large cohort of US adults with CKD.

Methods

We analyzed the 2016 US Behavioral Risk Factor Surveillance System data using complex sample survey data analysis procedures in STATA software accounting for the multistage cluster study design.

Results

Among 354,829 adults, 16,675 (4.5%) reported CKD, 61,543 (16.8%) reported a history of a depressive disorder, 102,456 (28.5%) reported a fall, and 38.7% of those who fell reported a fall-related injury. Compared to adults without CKD or depression, adults with depression (OR=2.88, 95% CI=2.76-2.99), adults with CKD (OR=1.74, 95%CI=1.60-1.90), and adults with both CKD and depression (OR=4.17, 95%CI=3.69-4.71) had increased odds of suffering a fall. These results remained significant after accounting for demographic characteristics and comorbidities commonly associated with falls such as diabetes, arthritis, asthma, and cardiovascular conditions. Similarly, adults with depression (OR=2.02, 95%CI=1.90-2.14), CKD (OR=1.37, 95%CI=1.19-1.57), and CKD with depression (OR=2.89, 95%CI=2.47-3.38) had a higher risk of suffering an injury from a fall. Among only CKD patients, those who had been diagnosed with depression had higher odds of falling (OR=2.39, 95%CI=2.08-2.76) and suffering an injury (OR=2.11, 95%CI=1.72-2.59) even after adjusting for demographics and comorbidities commonly associated with falls.

Conclusion

Among adults with a self-reported diagnosis of CKD, depression is a risk factor for suffering a fall and fall-related injury. It is unknown if this increased propensity for falling is related to medications, depression, or an interplay of these and other factors. Given the high prevalence of depression within the CKD population, this relationship warrants further examination in order to prevent and decrease fall-related injuries in this population.