Are Antidepressants Bringing You Down?

It is no secret that, as we age, the risk of falling dramatically increases.

It is perfectly normal for our body to have trouble adapting to the decrease in muscle mass and nerve sensation that takes a toll on our body as the years pass by. For older people, these physiological changes can make a normal everyday activity, such as walking to the kitchen, a possibly fatal hazard. 

As dangerous as the possibly of falling is, sometimes doctors are unintentionally making it even more dangerous.

A recent study in the American Journal of Geriatric Psychiatry found that antidepressant use can cause gait disturbances in older people.

The study focused on individuals over 60 years old and measured their gait during single and dual-task walking. With close to 2,000 individuals tested, the study showed that those individuals using antidepressants displayed shorter stride length and reduced gait speed, which can be associated with an increased risk in falling.

This information is not only valuable for podiatrists, but it is also valuable for caretakers of the elderly or anyone who may be worried that their loved one is susceptible to a fall.

Bringing this information up with your doctor and discussing different options for treatment could save your life or someone you care about. 

As part of physician quality reporting by podiatrists, now a falls-risk analysis and plan of care will be evaluated at your visit. Part of this analysis is to update and review your medications and dosing. There could be the possibility of an adverse drug side-effect causing a defective gait. 

The assessment will also include identifying your falls history and if any modifications in your home environment can be made. 

Your gait and balance will be analyzed and recommendations for mobility devices may be given such as a cane, walker or foot bracing. Lightweight braces that now fit into most shoes can give added ankle stability to prevent a fall.

Vitamin D supplementation may also be advised. Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight

It is also occurs naturally in a few foods including some fish, fish liver oils and egg yolks, and in fortified dairy and grain products.

Vitamin D is essential for strong bones because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn’t properly mineralize, leading to soft bones and skeletal deformities.

Increasingly, research is revealing the importance of vitamin D in protecting against a host of other health problems. One of these is cognitive impairment in older adults. If an adult has cognitive impairment then this puts them at risk for a fall since they are not aware of their surroundings as well.

Guidelines from the Institute of Medicine increased the recommended dietary allowance of vitamin D to 600 international units for everyone ages 1-70, and raised it to 800 units for adults older than age 70 to optimize bone health. The safe upper limit was also raised to 4,000 units.

If you don’t spend much time in the sun, an Ohio winter given, or always are careful to cover your skin, you should speak to your doctor about taking a vitamin D supplement, particularly if you have risk factors for vitamin D deficiency.

Since podiatrists regularly perform gait analysis, this would be a great place to start to make sure you or your loved one stays on their feet. A thorough gait analysis could help determine if there is a high or low risk for falls.

If you are determined to have a high risk for falls, your podiatrist can give you a plan of care to include home modification, assistive devices for mobility, proper shoes for control, vision acuity awareness and home exercises, and balance guidelines to help you stay safe. 

If you are worried that your geriatric friend or family member is growing more unstable on their feet, it may be well worth your time to make an appointment with your podiatrist.