Associations Between Changes in Depression/Anxiety Symptoms and Fall Worry Among Community-Dwelling Older Adults

Choi, Namkee G.; Zhou, Yuanjin; Marti, C. Nathan; Kunik, Mark E.

doi:10.1177/07334648221119464

Cited by 9 publications

(5 citation statements)

References 56 publications

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“…Frailty may predispose to worrying about falling and experiencing falling. Worrying about falling has been associated with depressive symptoms in aging adults [48]. In this sample (N=3,333 greater than 70-years-old), those with fall worry had more moderate/severe depressive symptoms in 2019 and an increase in fall worrying by 2020.…”

Section: Physical Healthmentioning

confidence: 77%

Late Life Depression: A Narrative Review

2023

Int J Geriatr Gerontol

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The recent literature (last five years) on late life depression is predominantly focused on risk factors/predictors of late life depression along with studies on effects, buffers, and interventions. Late life depression has typically been self-reported or diagnosed starting at age 60. The prevalence rates for late life depression were highly variable in this literature, ranging from a low of 7% in Italy to a high of 37% in Chile, a variability that may relate to the year or type of data collection and/or crosscultural variation. Negative effects have included loneliness, suicidal ideation, cognitive decline, frailty, functional limitations, low heart rate variability, biological aging (short telomere length and white matter lesions) and earlier mortality. Risk factors have included loneliness, aging anxiety, life stressors (marital discord and job strain), physical problems (activities of daily living), physical health (elevated blood pressure), physical weakness (handgrip, frailty, falls and disability) and unhealthy intake (poor diet, excessive alcohol and vitamin D deficiency). Buffers/protective factors have included positive views on aging, resilience, practicing religion, a Mediterranean diet, and remaining active. Interventions have included cognitive training, mindfulness, physical activity and ketamines. Multiple underlying mechanisms have been suggested including dysfunctional connectivity between different networks in the brain. Although the data highlight the severity of late life depression, the recent literature has been based on different measures appearing on self-report surveys that have yielded mixed results across samples. Prevalence of Late Life DepressionFirst, some myths about late life depression in a paper entitled "Depression among older adults: A 2-year update on common myths and misconceptions" are worth summarizing [1]. These authors concluded: 1) depression is not more common in older adults; 2) late life depression is not more often caused by psychological factors; 3) those who experience late life depression respond to psychological interventions as well as younger adults, but not to antidepressants; 4) late life depression follows a more chronic course (i.e. a greater rate of relapse); and 5) late life depression is frequently moderated by comorbidity.

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Section: Physical Healthmentioning

confidence: 77%

Late Life Depression: A Narrative Review

2023

Int J Geriatr Gerontol

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“…These findings suggest that a single fall over the 3 years could have been an accident (e.g., due to environmental hazards) and did not necessarily indicate health disadvantages among those who fell, while recurrent falls were likely indicators of significant health disadvantages. Previous research has shown reciprocal relationships among frailty, activity limitation, fall worry, depression/ anxiety, and falls (Choi et al, 2020(Choi et al, , 2022de Souza et al, 2022;Iaboni & Flint, 2013;Makino et al, 2021;Merchant et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay

et al. 2023

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We used the 2019–2021 U.S. National Health and Aging Trend Study ( N = 3,063, age 70+) and multinomial logistic regression and generalized linear models with Poisson and log link to identify correlates of (1) recurrent falls (2 + falls) over 3 years (2019–2021); and (2) any subsequent fall among those who had a fall in 2019. We also examined the associations between falls and hospitalization in 2021. Results show that those with recurrent falls had greater physical/functional and psychological health problems in 2019, while single fallers over the 3 years were not significantly different from those without a fall. Exercise was associated with a lower likelihood of a subsequent fall among those who fell in 2019. Both a single fall and recurrent falls over the 3 years were associated with a higher risk of hospitalization in 2021. Multifactorial fall preventions including exercise and depression/anxiety treatment are needed to mitigate recurrent fall risks.

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“…Existing studies have mainly examined the associations between pain in the lower extremity, hip, and back, and fall worry for older adults ( 43 , 57–59 ). We found that pain in the lower body (knee, foot, and leg) and the upper body (hand, wrist, shoulder, neck, and stomach) was associated with activity-limiting fall worry for older people with CI after adjusting covariates.…”

Section: Discussionmentioning

confidence: 99%

“…“Falling down” was defined as any fall, slip, or trip, which resulted in a loss of balance and landing on the floor or ground or at a lower level. Responses to these 2 items were used to generate a 3-level ordinal variable, “no fall worry,” “nonactivity-limiting fall worry,” and “activity-limiting fall worry.” This ordinal variable of fall worry has been used as a dependent variable in previous studies of older people with and without CI ( 11 , 43 ).…”

Section: Methodsmentioning

confidence: 99%

Association Between Pain and Fall Worry Among Community-Dwelling Older People With Cognitive Impairment in the United States

Zhou,

Choi,

Sadak

et al. 2023

Innovation in Aging

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Background and Objectives Previous studies have found that pain is associated with fall worry among community-dwelling older people. However, both pain and fall worry are poorly understood and under-addressed among community-dwelling older people with cognitive impairment (CI). It is essential to examine the association between pain and fall worry and how sociodemographic and health characteristics may shape fall worry among this subgroup. Research Design and Methods We used data from the 2015 National Health and Aging Trends Study (analytic sample: n=1150 community-dwelling older people with CI; were self-interviewed; mean age: 81; age range: 65-107). The number of pain sites in the prior month was assessed by presenting a card listing common pain sites (e.g., back, knees). Two questions assessed past-month fall worry, “did you worry about falling down” and “did this worry ever limit your activities”. Following descriptive statistics, we fit multinomial logistic regression models to examine the associations between different pain characteristics (number of sites, severity, location) and non-activity-limiting and activity-limiting fall worry. Results Non-activity-limiting fall worry was endorsed by 21.1% and activity-limiting fall worry by 13.6% of community-dwelling older people with CI. After adjusting for sociodemographic characteristics and fall-worry-related covariates, multinomial logistic regression analysis found that a greater number of pain sites (Relative Risk Ratio [RRR]=1.22, 95% Confidence Interval [95% CI] =1.12-1.33, p<0.001) and severe pain (RRR=2.05, 95% CI=1.12-3.75, p=0.020) was associated with activity-limiting fall worry. Both lower body (knee, foot, and leg) and upper body (hand, wrist, shoulder, neck, and stomach) pain were found to be associated with a high risk of activity-limiting fall worry. Discussion and Implications These findings suggest pain and fall worry are common among community-dwelling older people with CI and can be elicited directly from those who are communicative. Fall prevention for this population should prioritize pain management to mitigate activity-limiting fall worry since activity limitation increases the risk of falls.

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Associations Between Changes in Depression/Anxiety Symptoms and Fall Worry Among Community-Dwelling Older Adults

Cited by 9 publications

References 56 publications

Late Life Depression: A Narrative Review

Late Life Depression: A Narrative Review

Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay

Association Between Pain and Fall Worry Among Community-Dwelling Older People With Cognitive Impairment in the United States

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