Supplementary Material for: Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults

<b><i>Background:</i></b> Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. <b><i>Objectives:</i></b> This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. <b><i>Methods:</i></b> This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. <b><i>Results:</i></b> The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for &lt;5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. <b><i>Conclusions:</i></b> Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls.

**背景**：在当前老龄化社会中，明确老年人群跌倒的风险因素无疑是最为紧迫的公共卫生议题之一。
**目的**：本研究旨在探究韩国老年人群中抑郁症状、主观认知下降（Subjective Cognitive Decline, SCD）以及主观睡眠质量不佳与滑倒/跌倒风险之间的关联。
**方法**：本项横断面研究共纳入228340名居住于韩国的老年人。研究采集的数据包括自我报告的抑郁症状、主观认知下降情况以及自我报告的睡眠质量。本研究以"过去12个月内是否发生过滑倒/跌倒"作为二分类指标划分跌倒风险，并探究了不同风险因素与滑倒/跌倒风险之间的关联。研究采用多重逻辑回归分析计算比值比（odds ratios, ORs）及95%置信区间（95% confidence intervals, CIs），并使用复杂抽样方法估算每名受试者的加权值。
**结果**：滑倒/跌倒风险与重度抑郁症状（校正后OR=1.06，95%CI：1.05~1.07）及主观认知下降（校正后OR=1.33，95%CI：1.19~1.50）存在显著关联。针对各项睡眠质量指标，与对应良好睡眠状态相比，滑倒/跌倒风险的校正后比值比如下：睡眠质量极差者为1.85，睡眠潜伏期（sleep latency）延长者为1.49，每日睡眠时长不足5小时者为1.04，睡眠效率（sleep efficiency）低下者为1.32，睡眠干扰（sleep disturbance）严重者为2.78，每周使用助眠药物≥3次者为1.52，因睡眠问题导致日间功能障碍（daytime dysfunction）严重者为1.82。
**结论**：本研究结果表明，抑郁症状、主观认知下降以及主观睡眠质量不佳均为影响滑倒/跌倒发生的独立危险因素。因此，早期干预抑郁症状与认知下降、改善睡眠质量的相关措施，可作为降低老年人跌倒风险的有效策略。