Poster Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

Falls in community-dwelling women with bipolar disorder (#154)

Kara Anderson 1 , Amanda L Stuart 2 , Julie A Pasco 2 3 4 , Michael Berk 2 5 6 , Stephanie P Cowdery 2 , Vinoomika Chandrasekaran 2 , Lana J Williams 2 4
  1. Barwon Health, Geelong, VIC, Australia
  2. Deakin University, IMPACT SRC, Geelong, VIC, Australia
  3. Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia
  4. Barwon Health, Geelong, Victoria, Australia
  5. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
  6. Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia

Introduction: Mood disorders have been linked to increased falls in both clinical and community samples. However, data specifically investigating bipolar disorder and falls, is sparse outside an inpatient setting. Thus, we aimed to investigate falls in a community-dwelling sample of women with bipolar disorder.

Method: Women with a history of bipolar disorder (n=123) were recruited and non-bipolar disorder controls were drawn from Geelong Osteoporosis Study (n=779). Lifetime history of mood disorder was identified using a semi structured clinical interview (SCID-I/NP). Participants were classified as fallers if they had fallen to the ground at least twice during the previous 12-months. Medication use (antidepressants, anticonvulsants, antipsychotics, anxiolytics, benzodiazepines, sedatives/hypnotics), alcohol consumption, mobility, health status and use of a walking aid were self-reported. Anthropometry, blood pressure and the timed up-and-go test (TUG) were measured, and area-based socioeconomic status determined. Binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (95% CI) to determine the likelihood of falling among those with bipolar disorder compared to controls.

Results: Fallers [n=70 (7.8%)] and non-fallers differed in weight, the TUG, antidepressant use, mobility, health status and history of bipolar disorder. Bipolar disorder cases had an increased odds of falling compared to controls [OR 3.3, (95%CI 1.9-5.7), p<0.001]. This relationship was attenuated following adjustment for mobility and antidepressant use, however, the odds of falling remained two-fold greater for bipolar disorder cases compared to controls [OR 2.1, (1.2-3.9), p=0.019]. No other confounders were identified.

Conclusion: Falls risk was greater among women with a history of bipolar disorder compared to non-bipolar disorder controls. Underlying mechanisms, including confidence, balance and gait disturbances, contributing to the increased risk of falls among those with bipolar disorder need to be investigated.