The complex associations between late life depression, fear of falling and risk of falls. A systematic review and meta-analysis

Gambaro, Eleonora; Gramaglia, Carla; Azzolina, Danila; Campani, Daiana; Molin, Alberto Dal; Zeppegno, Patrizia

doi:10.1016/j.arr.2021.101532

Cited by 70 publications

(44 citation statements)

References 54 publications

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“…The fear-of-falling is a common and serious problem among older adults [ 8 ] which is considered as a complex phenomenon, affected by physical, physiological, psychological and functional factors [ 9 ]. Research has shown that fear-of-falling has been linked to increased risk of future falls through restriction in activities of daily living, cautious gait pattern and reductions in the walking speed, increased level of anxiety and depression, poor quality of life, and all-cause mortality [ 10 – 14 ]. The effect of balance and resistance training programs on reducing the fear-of-falling is, however, less clear [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial

et al. 2022

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Background Engaging in multimodal exercise program helps mitigate age-related decrements by improving muscle size, muscle strength, balance, and physical function. The addition of trunk-strengthening within the exercise program has been shown to significantly improve physical functioning outcomes. Whether these improvements result in improved psychological outcomes associated with increased physical activity levels requires further investigation. We sought to explore whether the inclusion of trunk-strengthening exercises to a multimodal exercise program improves objectively measured physical activity levels and self-reported psychological functioning in older adults. Method We conducted a secondary analysis within a single-blinded parallel-group randomized controlled trial. Sixty-four healthy older (≥ 60 years) adults were randomly allocated to a 12-week walking and balance exercise program with (n = 32) or without (n = 32) inclusion of trunk strengthening exercises. Each program involved 12 weeks of exercise training, followed by a 6-week walking-only program (identified as detraining). Primary outcome measures for this secondary analysis were physical activity (accelerometry), perceived fear-of-falling, and symptoms of anxiety and depression. Results Following the 12-week exercise program, no significant between-group differences were observed for physical activity, sedentary behaviour, fear-of-falling, or symptoms of anxiety or depression. Significant within-group improvements (adjusted mean difference [95%CI]; percentage) were observed in moderate-intensity physical activity (6.29 [1.58, 11.00] min/day; + 26.3%) and total number of steps per min/day (0.81 [0.29 to 1.33] numbers or + 16.3%) in trunk-strengthening exercise group by week 12. With respect to within-group changes, participants in the walking-balance exercise group increased their moderate-to-vigorous physical activity (MVPA) (4.81 [0.06 to 9.56] min/day; + 23.5%) and reported reduction in symptoms of depression (-0.26 [-0.49 to -0.04] points or -49%) after 12 weeks of the exercise program. The exercise-induced increases in physical activity levels in the trunk-strengthening exercise group were abolished 6-weeks post-program completion. While improvements in physical activity levels were sustained in the walking-balance exercise group after detraining phase (walking only). Conclusions The inclusion of trunk strengthening to a walking-balance exercise program did not lead to statistically significant between-group improvements in physical activity levels or psychological outcomes in this cohort following completion of the 12-week exercise program. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12613001176752), registered on 28/10/2013.

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Section: Introductionmentioning

confidence: 99%

The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial

et al. 2022

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“…They are typically measured by validated rating scales with established cutoffs such as the Epidemiologic Studies Depression scale (6). Depressive symptoms are consistently associated with falls (7)(8)(9)(10)(11). Two studies conducted in the United States and Canada demonstrated significant associations between baseline depressive symptoms and subsequent falls in community-dwelling older populations (7,9).…”

Section: Introductionmentioning

confidence: 99%

“…Two studies conducted in the United States and Canada demonstrated significant associations between baseline depressive symptoms and subsequent falls in community-dwelling older populations (7,9). Systematic reviews (10,11) also indicate a relationship between high depressive symptoms and an increased risk of falls in older adults. Notably, previous studies (7)(8)(9)(10)(11) have considered depressive symptoms as a dichotomous factor (e.g., present or not), or have used a total depression score.…”

Section: Introductionmentioning

confidence: 99%

“…Systematic reviews (10,11) also indicate a relationship between high depressive symptoms and an increased risk of falls in older adults. Notably, previous studies (7)(8)(9)(10)(11) have considered depressive symptoms as a dichotomous factor (e.g., present or not), or have used a total depression score. Such studies assumed that depressive symptoms are a single condition, and that all specific symptoms are fungible and equally valid indicators.…”

Section: Introductionmentioning

confidence: 99%

“…Specific depressive symptoms such as sadness, sleep disorders, inattention, and suicidal ideation are distinct conditions, and they differ in significant respects such as potential biology, effect on injury, and risk factors (12). Moreover, most prior studies have concentrated on the role of depressive symptoms only on the occurrence of falls, while ignoring resulting injuries that required medical care (8)(9)(10)(11), or they have only examined these relationships in older people (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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Depressive symptoms increase the risk of falls and injurious falls in Chinese adults aged ≥ 45 years: A 3-year cohort study

Wang

et al. 2022

Front. Public Health

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BackgroundFalls and depressive symptoms are both public health concerns in China, but the effects of depressive symptoms on falls and injurious falls have not been thoroughly investigated.MethodsThis population-based prospective cohort study used data derived from adults aged ≥45 years acquired from the 2015 and 2018 China Health and Retirement Longitudinal Study. Data were analyzed from August 2021 to December 2021. Self-reported depressive symptoms were determined using a 10-item Center for Epidemiologic Studies Depression scale (CESD-10) with a total score range of 0–30. Item responses of 3–4 or 5–7 days were deemed indicative of specific depressive symptoms. The outcome variables were self-reported accidental falls and injurious falls.ResultsOf the 12,392 participants included in the study, 3,671 (29.6%) had high baseline depressive symptoms (CESD-10 scores ≥ 10), 1,892 (15.3%) experienced falls, and 805 (6.5%) experienced injurious falls during 2015–2018 follow-up. High depressive symptoms increased the risk of falls [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19–1.50] and injurious falls (OR 1.28, 95% CI 1.09–1.51) in a multivariable logistic regression model adjusted for major demographic, health-related, and anthropometric covariates. All of the 10 specific depressive symptoms except “felt hopeless” were associated with falls, and four specific symptoms significantly increased the risk of injurious falls; “had trouble concentrating” (OR 1.32, 95% CI 1.13–1.55); “felt depressed” (OR 1.32, 95% CI 1.12–1.55); “everything was an effort” (OR 1.23, 95% CI 1.04–1.45); and “restless sleep” (OR 1.18, 95% CI 1.02–1.40).ConclusionHigh depressive symptoms are significantly related to risk of falls and injurious falls. Four specific symptoms (had trouble concentrating, felt depressed, everything was an effort, and restless sleep) increase the risk of injurious falls in Chinese adults aged ≥ 45 years.

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Wohnen mit Pflegebedürftigkeit: Ergebnisse zur Wohnsituation aus der ZQP-Befragung pflegender Angehöriger, Handlungsbedarf und Lösungsansätze

Eggert,

Suhr,

Teubner

2024

Pflege-Report 2024

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The complex associations between late life depression, fear of falling and risk of falls. A systematic review and meta-analysis

Cited by 70 publications

References 54 publications

The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial

The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial

Depressive symptoms increase the risk of falls and injurious falls in Chinese adults aged ≥ 45 years: A 3-year cohort study

Wohnen mit Pflegebedürftigkeit: Ergebnisse zur Wohnsituation aus der ZQP-Befragung pflegender Angehöriger, Handlungsbedarf und Lösungsansätze

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