Contribution of gait speed, grip strength, and depression on the risk of serious falls among older adults

• We evaluated the independent and combined associations of slow gait speed, weak grip strength, and depressive symptoms with serious falls in a large prospective community-dwelling aging population. • Slow gait speed, weak grip strength, and depressive symptoms were associated with the risk of serious falls in later life, and the risk was the highest among those with all three conditions. • These finding suggests that integrating assessments of gait speed and grip strength along with depression into routine clinical evaluations may help in identifying older adults at a higher risk of serious falls. This study assessed the individual and combined associations of slow gait speed, weak grip strength, and depressive symptoms with the risk of serious falls in an aging population. This study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) trial, which collected adjudicated events on serious falls from Australian community-dwelling older adults (≥70 years). Cox proportional hazard models were employed to estimate adjusted hazard ratios (AHR). Of 16,357 participants, 1505 (9.2 %) had serious falls over the median (IQR) follow-up of 4.4 (3.3–5.5) years. Slow gait, weak grip, and depressive symptoms at baseline were associated with serious falls (AHR = 1.38, 95 %CI: 1.22–1.56; AHR = 1.22, 95 %CI: 1.07–1.38, and AHR=1.28, 95 %CI:1.10–1.50, respectively). Combined slow gait, weak grip, and depressive symptoms were associated with a more than two-fold increase in the risk of serious falls (AHR=2.15, 95 %CI: 1.56–2.97). The presence of slow gait and weak grip were associated with a 66 % increase in the risk of serious falls (AHR=1.66, 95 %CI:1.40–1.97). Depressive symptoms worsened the risk of falls among individuals with chronic conditions such as diabetes. Combined gait speed, grip strength, and depressive symptoms have a strong association with serious falls in an aging population. Therefore, incorporating strength and mobility training interventions to improve physical functions and addressing depression through timely diagnosis and effective treatment may help to prevent the risk of falls among older adults.