Pengpid Supa, Peltzer Karl
Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
Arch Gerontol Geriatr. 2023 Jun;109:104955. doi: 10.1016/j.archger.2023.104955. Epub 2023 Feb 5.
Depression is a major issue in the aging population, which may be related to fear of falling (FOF) and falls contributing to increased morbidity and mortality. The aim of the study was to assess the tridirectional associations between probable depression (PD), FOF and falls in a longitudinal study in Thailand.
Longitudinal data of participants (≥45 years; N = 3708) from two consecutive waves (in 2015 and 2017) of the Health, Aging and Retirement in Thailand (HART) study were analysed. PD was assessed with the Center for Epidemiologic Studies Depression Scale, self-reported FOF and history of falls.
Having no PD in 2015 and PD in 2017 (aOR: 2.35, 95% CI: 1.67 to 3.30), and having both PD in 2015 and 2017 (aOR: 3.46, 95% CI: 1.92 to 6.23) were positively associated with incident FOF with activity avoidance, and no FOF in 2015 and FOF in 2017 (aOR: 2.29, 95% CI: 1.77 to 2.95), and both FOF in 2015 and 2017 (aOR: 2.38, 95% CI: 1.69 to 3.36) were positively associated with incident PD. Two or more falls in 2015 (aOR: 2.03, 95% CI: 1.29 to 3.19) was positively associated with incident PD, and both PD in 2015 and 2017 (aOR: 3.10, 95% CI: 1.40 to 6.48) were positively associated with incident multiple (≥2) falls.
We found tridirectional associations between PD, FOF and falls. It is suggested to screen and manage older adults for PD, FOF and fall history simultaneously.
抑郁症是老年人群中的一个主要问题，这可能与跌倒恐惧（FOF）以及跌倒导致发病率和死亡率增加有关。本研究的目的是在泰国的一项纵向研究中评估可能的抑郁症（PD）、FOF和跌倒之间的三向关联。
分析了泰国健康、老龄化与退休研究（HART）连续两波（2015年和2017年）参与者（≥45岁；N = 3708）的纵向数据。使用流行病学研究中心抑郁量表评估PD、自我报告的FOF和跌倒史。
2015年无PD而2017年有PD（调整后比值比：2.35，95%置信区间：1.67至3.30），以及2015年和2017年都有PD（调整后比值比：3.46，95%置信区间：1.92至6.23）与因活动回避导致的新发FOF呈正相关，2015年无FOF而2017年有FOF（调整后比值比：2.29，95%置信区间：1.77至2.95），以及2015年和2017年都有FOF（调整后比值比：2.38，95%置信区间：1.69至3.36）与新发PD呈正相关。2015年发生两次或更多次跌倒（调整后比值比：2.03，95%置信区间：1.29至3.19）与新发PD呈正相关，2015年和2017年都有PD（调整后比值比：3.10，95%置信区间：1.40至6.48）与新发多次（≥2次）跌倒呈正相关。
我们发现了PD、FOF和跌倒之间的三向关联。建议同时对老年人进行PD、FOF和跌倒史的筛查与管理。
