Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA.
Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA.
Int Psychogeriatr. 2020 Apr;32(4):495-504. doi: 10.1017/S1041610219000838. Epub 2019 Jul 18.
Late-life depression, falls, and fall worry are public health problems. While previous research confirms the cross-sectional relationship between depression and fall worry, few longitudinal studies have examined whether changes in fall worry are associated with changes in depressive illness and vice versa. This study examined longitudinal relationships between probable major depression (PMD) and activity-limiting fall worry (ALW).
DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: This longitudinal panel observational study used data from the National Health and Aging Trends Study (NHATS) waves 5 (referred to as T1 in this study) and 6 (T2), conducted in 2015 and 2016, respectively (N = 6,299, aged 65 and older). We examined associations of new and continued ALW between T1 and T2 with T2 PMD, controlling for T1 PMD; and associations of new and continued PMD between T1 and T2 with T2 ALW, controlling for T1 ALW. We used χ2 and t tests for descriptive statistics and logistic regression for multivariable analysis.
Those with new ALW at T2 had significantly greater odds of T2 PMD compared to those without ALW at both time points (AOR = 2.64, 95% CI = 1.98-3.51), and those with new PMD at T2 had significantly greater odds of T2 ALW (AOR = 2.42, 95% CI = 1.66-3.52). Those with continued PMD also had greater odds of T2 ALW compared to those without PMD at either time point (AOR = 2.31, 95% CI = 1.62-3.29).
The findings add to knowledge about bidirectional (mutually reinforcing) relationships between depression and activity-limiting fall worry. Innovative interventions are needed to reduce both late-life depression and activity-limiting fall worry.
老年期抑郁、跌倒和跌倒担忧是公共卫生问题。尽管先前的研究证实了抑郁与跌倒担忧之间存在横断面关系，但很少有纵向研究检验跌倒担忧的变化是否与抑郁疾病的变化有关，反之亦然。本研究检验了可能的重度抑郁症（PMD）和活动受限性跌倒担忧（ALW）之间的纵向关系。
设计、地点、参与者、测量：这项纵向面板观察性研究使用了国家健康老龄化趋势研究（NHATS）第 5 波（本研究中称为 T1）和第 6 波（T2）的数据，分别于 2015 年和 2016 年进行（N=6299，年龄在 65 岁及以上）。我们检验了 T1 至 T2 期间新出现和持续的 ALW 与 T2 时 PMD 的关联，同时控制了 T1 时 PMD；以及 T1 至 T2 期间新出现和持续的 PMD 与 T2 时 ALW 的关联，同时控制了 T1 时 ALW。我们使用 χ2 和 t 检验进行描述性统计，使用逻辑回归进行多变量分析。
与两个时间点均无 ALW 的人相比，T2 时出现新的 ALW 的人 T2 时 PMD 的可能性显著更高（AOR=2.64，95%CI=1.98-3.51），T2 时出现新的 PMD 的人 T2 时 ALW 的可能性显著更高（AOR=2.42，95%CI=1.66-3.52）。与两个时间点均无 PMD 的人相比，持续存在 PMD 的人 T2 时 ALW 的可能性也更高（AOR=2.31，95%CI=1.62-3.29）。
这些发现增加了关于抑郁和活动受限性跌倒担忧之间双向（相互加强）关系的知识。需要创新的干预措施来降低老年期抑郁和活动受限性跌倒担忧。
