Neurology and Psychiatry
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Chronic disorders such as Parkinson’s disease, transient ischaemic attacks, stroke, Alzheimer’s disease, epilepsy, multiple sclerosis, amyotrophic lateral sclerosis and diabetic neuropathy increase the risk of falling and correlate with lower bone mass, caused by immobility and drugs. The same is true for depressive states in which physical activity is reduced and nutrition may be inadequate. Depression has also been associated with disorders of the cardiovascular and many other systems, with osteoporosis and with increased serum levels of various cytokines, e.g. of the TNF-alpha system, which may even contribute to the development of the depressive disorder. There also appears to be a link between depression and cognitive function which further complicates the condition. And, unfortunately, some studies have indicated that antidepressant drugs such as the tricyclic antidepressants have an increased risk of falls and fractures.