{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:23:33Z","timestamp":1775705013115,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background: Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. Objective: To evaluate the association between falls, FOF, and depressive symptoms in community-dwelling older adults. Methods: This cross-sectional study, conducted in 2018, included 400 older adults from a Basic Health Unit in S\u00e3o Paulo, Brazil. The Geriatric Depression Scale (GDS-15) and the International Falls Efficacy Scale (FES-I) were used, along with self-report questionnaires on fall history. Linear and logistic regression were used to analyze the relationships between variables. Results: The mean age was 75.2 (SD = 8.53) years, with 63.2% being female. Depressive symptoms were observed in 18.3% of the participants, while 90.5% reported a fear of falling (FOF). More than half (63.0%) experienced falls, with 49.5% occurring in the last year. Factors such as the female gender, negative health perceptions, and functional dependence were associated with depressive symptoms. Adjusted analyses indicated that both a fear of falling (FOF) (B = 0.043; p = 0.012) and a history of falls (B = 0.725; p = 0.015) were associated with depressive symptoms. Conclusions: Falls, FOF, and depressive symptoms are interlinked among older adults, underscoring the need for targeted interventions to improve their mental and physical health.<\/jats:p>","DOI":"10.3390\/healthcare12161638","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T12:40:07Z","timestamp":1723812007000},"page":"1638","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association between Falls, Fear of Falling and Depressive Symptoms in Community-Dwelling Older Adults"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria Eduarda Armando","family":"Pereira","sequence":"first","affiliation":[{"name":"Faculty of Medicine of Itajub\u00e1, Itajub\u00e1 37502-138, MG, Brazil"}]},{"given":"Gerson de Souza","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Centro Universit\u00e1rio Ages, Paripiranga 48430-000, BA, Brazil"}]},{"given":"Clara Rabite de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil"}]},{"given":"Kethlyn Cristina Santos","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil"}]},{"given":"Monalisa Claudia Maria da","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2626-8561","authenticated-orcid":false,"given":"Helena","family":"Jos\u00e9","sequence":"additional","affiliation":[{"name":"Atl\u00e2ntica School of Health, 2730-036 Barcarena, Portugal"},{"name":"Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, 3004-011 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9708-5690","authenticated-orcid":false,"given":"Lu\u00eds","family":"Sousa","sequence":"additional","affiliation":[{"name":"Atl\u00e2ntica School of Health, 2730-036 Barcarena, Portugal"},{"name":"Comprehensive Health Research Centre, University of \u00c9vora, 7000-801 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-8488","authenticated-orcid":false,"given":"Luciano Magalh\u00e3es","family":"Vitorino","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Itajub\u00e1, Itajub\u00e1 37502-138, MG, Brazil"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0140-6736(14)61347-7","article-title":"The burden of disease in older people and implications for health policy and practice","volume":"385","author":"Prince","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"eAPE0237345","DOI":"10.37689\/acta-ape\/2022AO0237345","article-title":"Atividades de vida di\u00e1ria, sintomas depressivos e qualidade de vida de idosos","volume":"35","author":"Scherrer","year":"2022","journal-title":"Acta Paul. Enferm."},{"key":"ref_3","first-page":"e210225","article-title":"Fragilidade, depress\u00e3o e mortalidade em uma coorte de pessoas idosas residentes na comunidade","volume":"25","author":"Nascimento","year":"2022","journal-title":"Rev. Bras. Geriatr. Gerontol."},{"key":"ref_4","first-page":"144","article-title":"Depressive Symptoms, Falls, and Fear of Falling in Old Korean Adults: The Korean Longitudinal Study on Health and Aging (KLoSHA)","volume":"6","author":"Park","year":"2017","journal-title":"J. Frailty Aging"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhang, Q., Zhao, X., Liu, H., and Ding, H. (2020). Frailty as a predictor of future falls and disability: A four-year follow-up study of Chinese older adults. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01798-z"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101532","DOI":"10.1016\/j.arr.2021.101532","article-title":"The complex associations between late life depression, fear of falling and risk of falls. A systematic review and meta-analysis","volume":"73","author":"Gambaro","year":"2022","journal-title":"Ageing Res. Rev."},{"key":"ref_7","first-page":"e30","article-title":"The excess costs of depression: A systematic review and meta-analysis","volume":"29","author":"Konnopka","year":"2019","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"103417","DOI":"10.1016\/j.ajp.2022.103417","article-title":"Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys","volume":"80","author":"Cai","year":"2023","journal-title":"Asian J. Psychiatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1590\/0047-2085000000250","article-title":"Preval\u00eancia de sintomatologia depressiva em idosos brasileiros: Uma revis\u00e3o sistem\u00e1tica com metan\u00e1lise","volume":"68","author":"Meneguci","year":"2019","journal-title":"J. Bras. Psiquiatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100391","DOI":"10.1016\/j.lanepe.2022.100391","article-title":"Predictors of depression among middle-aged and older men and women in Europe: A machine learning approach","volume":"18","author":"Handing","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1017\/S1041610210000463","article-title":"Depressive morbidity and gender in community-dwelling Brazilian elderly: Systematic review and meta-analysis","volume":"22","author":"Izbicki","year":"2010","journal-title":"Int. Psychogeriatr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Laved\u00e1n, A., Viladrosa, M., J\u00fcrschik, P., Botigu\u00e9, T., Nu\u00edn, C., Masot, O., and Laved\u00e1n, R. (2018). Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both?. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197792"},{"key":"ref_13","first-page":"303","article-title":"Fear of falling and its association with anxiety and depression disorders among community-dwelling older adults","volume":"57","author":"Rakhshani","year":"2019","journal-title":"Int. J. Health Promot. Educ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/psyg.12664","article-title":"Is fear of falling and the associated restrictions in daily activity related to depressive symptoms in older adults?","volume":"21","author":"Lee","year":"2021","journal-title":"Psychogeriatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.jsr.2020.11.008","article-title":"Special Report from the CDC Antidepressant subclass use and fall risk in community-dwelling older Americans","volume":"76","author":"Haddad","year":"2021","journal-title":"J. Saf. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s41999-021-00475-7","article-title":"Depression, antidepressants and fall risk: Therapeutic dilemmas-a clinical review","volume":"12","author":"Pronk","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e210013","DOI":"10.1590\/1981-22562021024.210013","article-title":"Sintomas depressivos e fragilidade f\u00edsica em pessoas idosas: Revis\u00e3o integrativa","volume":"24","author":"Lenardt","year":"2021","journal-title":"Rev. Bras. Geriatr. Gerontol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/jgs.15219","article-title":"Falls in Cognitively Impaired Older Adults: Implications for Risk Assessment and Prevention","volume":"66","author":"Speechley","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gao, Q., Hu, K., Yan, C., Zhao, B., Mei, F., Chen, F., Zhao, L., Shang, Y., Ma, Y., and Ma, B. (2021). Associated Factors of Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Nutrients, 13.","DOI":"10.3390\/nu13124291"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Xiong, W., Wang, D., Ren, W., Liu, X., Wen, R., and Luo, Y. (2024). The global prevalence of and risk factors for fear of falling among older adults: A systematic review and meta-analysis. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-04882-w"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1186\/s13018-022-03222-1","article-title":"Global prevalence of falls in the older adults: A comprehensive systematic review and meta-analysis","volume":"17","author":"Salari","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1093\/geront\/gny179","article-title":"Longitudinal Associations of Falls and Depressive Symptoms in Older Adults","volume":"59","author":"Choi","year":"2019","journal-title":"Gerontologist"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e052147","DOI":"10.1136\/bmjopen-2021-052147","article-title":"Incidence of depression and depressive symptoms and their predictive factors in community-dwelling older adults: A systematic review and meta-analysis protocol","volume":"11","author":"Brasileiro","year":"2021","journal-title":"BMJ Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1017\/S204579602000058X","article-title":"The course of depression in late life: A longitudinal perspective","volume":"29","year":"2020","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Li, Y., Hou, L., Zhao, H., Xie, R., Yi, Y., and Ding, X. (2022). Risk factors for falls among community-dwelling older adults: A systematic review and meta-analysis. Front. Med., 9.","DOI":"10.3389\/fmed.2022.1019094"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105098","DOI":"10.1016\/j.archger.2023.105098","article-title":"Falls increase the risk for incident anxiety and depressive symptoms among adults aged \u226550 years: An analysis of the Irish longitudinal study on ageing","volume":"114","author":"Jacob","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1080\/13607863.2020.1856775","article-title":"Prospective associations between subjective age and fear of falling in older adults","volume":"26","author":"Fundenberger","year":"2022","journal-title":"Aging Ment. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100631","DOI":"10.1016\/j.jadr.2023.100631","article-title":"The social cost of depression: Investigating the impact of impaired social emotion regulation, social cognition, and interpersonal behavior on social functioning","volume":"14","author":"Kupferberg","year":"2023","journal-title":"J. Affect. Disord. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/08982643231152276","article-title":"Social Mediators of the Association Between Depression and Falls Among Older Adults","volume":"35","author":"Lohman","year":"2023","journal-title":"J. Aging Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"dos Santos, E.P.R., Ohara, D.G., Patrizzi, L.J., de Walsh, I.A.P., Silva, C.d.F.R., da Silva Neto, J.R., Oliveira, N.G.N., Matos, A.P., Iosimuta, N.C.R., and Pinto, A.C.P.N. (2023). Investigating Factors Associated with Fear of Falling in Community-Dwelling Older Adults through Structural Equation Modeling Analysis: A Cross-Sectional Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020545"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2522\/ptj.20140461","article-title":"What Works to Prevent Falls in Community-Dwelling Older Adults? Umbrella Review of Meta-analyses of Randomized Controlled Trials","volume":"95","author":"Stubbs","year":"2015","journal-title":"Phys. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"105177","DOI":"10.1016\/j.archger.2023.105177","article-title":"The association between depressive symptoms with fear of falling and cognitive decline in older adults in the Korean community: An analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006\u20132020","volume":"117","author":"Yao","year":"2024","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"379","DOI":"10.5770\/cgj.24.521","article-title":"Fear of Falling in Older Adults: A Scoping Review of Recent Literature","volume":"24","author":"MacKay","year":"2021","journal-title":"Can. Geriatr. J."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Xu, Q., Ou, X., and Li, J. (2022). The risk of falls among the aging population: A systematic review and meta-analysis. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.902599"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.56294\/saludcyt20241000","article-title":"Preventing falls in the aged: A challenge in patient safety","volume":"4","author":"Sousa","year":"2024","journal-title":"Salud Cienc. Tecnol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2147\/CIA.S448196","article-title":"Evaluation of a Fall Prevention Program to Reduce Fall Risk and Fear of Falling Among Community-Dwelling Older Adults and Adults with Disabilities","volume":"19","author":"Hawkins","year":"2024","journal-title":"Clin. Interv. Aging"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"430","DOI":"10.3390\/nursrep11020041","article-title":"Fall Risk Assessment Scales: A Systematic Literature Review","volume":"11","author":"Strini","year":"2021","journal-title":"Nurs. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.gerinurse.2017.08.005","article-title":"Fear of falling among community-dwelling older adults: A scoping review to identify effective evidence-based interventions","volume":"39","author":"Whipple","year":"2018","journal-title":"Geriatr. Nurs."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ferreira, R., Pedrosa, A.R., Reis, N., Sousa, L., Nicolau, C., Ferreira, B., Rocha, B., and Baixinho, C.L. (2024). Transitional care for older persons with need of geriatric rehabilitation nursing interventions. BMC Nurs., 23.","DOI":"10.1186\/s12912-024-02050-4"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Gemito, L., Alves, E., Moreira, J., Marques, M.F., Caldeira, E., Ferreira, R., Bico, I., Pinho, L., Fonseca, C., and Sousa, L. (2024). Programmes Addressed to Informal Caregivers\u2019 Needs: A Systematic Literature Review. Geriatrics, 9.","DOI":"10.3390\/geriatrics9030071"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Sadaqa, M., N\u00e9meth, Z., Makai, A., Pr\u00e9musz, V., and Hock, M. (2023). Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: A systematic review with narrative synthesis. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1209319"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"104235","DOI":"10.1016\/j.archger.2020.104235","article-title":"Systematic Review and Meta-Analysis of Fear of Falling and Fall-Related Efficacy in a Widely Disseminated Community-Based Fall Prevention Program","volume":"91","author":"Yoshikawa","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_43","unstructured":"(2020). WHO\u2019s Work on the UN Decade of Healthy Ageing: Plan of Action (2021\u20132030)."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/12\/16\/1638\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:37:52Z","timestamp":1760110672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/12\/16\/1638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":43,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["healthcare12161638"],"URL":"https:\/\/doi.org\/10.3390\/healthcare12161638","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,16]]}}}