Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China.
Department of Rehabilitation, Affiliated Hospital of Qingdao University, Qingdao, China.
Arch Gerontol Geriatr. 2023 Aug;111:105006. doi: 10.1016/j.archger.2023.105006. Epub 2023 Mar 22.
Evidence on the temporal sequences between balance and depressive symptoms is limited, and no studies have compared the strength of each direction. This study aimed to assess the association between balance performance and depressive symptoms among community-dwelling older adults, and further to explore the driving factors in the dynamic association.
Data were obtained from the English Longitudinal Study of Aging (ELSA). Overall, 3971 community-residing adults aged 50 years or older were assessed at 2004/05, 2008/09, and 2012/13. Balance was measured using three progressively more difficult tasks (side-by-side, semi-tandem, and full-tandem). Depressive symptoms were determined with a dichotomous eight-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Cross-lagged panel models were used to test the reciprocal relationships between balance and depressive symptoms.
Our analyses revealed that earlier poorer balance predicted later worse depressive symptoms consistently across waves (β = -0.058, P < .05, β = -0.067, P < .001). Conversely, the higher scores of depressive symptoms at wave 4 predicted lower level of balance at wave 6 (β = -0.038, P = .018). The cross-lagged effects of balance on depressive symptoms were over all stronger than the reverse effects.
These findings add novel insights into the temporal directionality of balance and depressive symptoms among community-dwelling older adults, and suggest that a predominance of balance disorder effects. Interventional strategy should aim to increase balance ability from earlier stages to promote successful aging.
关于平衡和抑郁症状之间时间顺序的证据有限，且尚无研究比较过两者的关联强度。本研究旨在评估社区居住的老年人的平衡表现与抑郁症状之间的相关性，并进一步探讨动态关联中的驱动因素。
数据来自英国老龄化纵向研究（ELSA）。共有 3971 名年龄在 50 岁及以上的社区居住成年人在 2004/05、2008/09 和 2012/13 年接受评估。平衡通过三个逐渐困难的任务（并排、半并脚和全并脚）进行测量。抑郁症状采用中心流行病学研究抑郁量表（CES-D）的二分类八条目版本进行确定。交叉滞后面板模型用于测试平衡和抑郁症状之间的相互关系。
我们的分析表明，早期较差的平衡状态始终在各波次中预示着之后更严重的抑郁症状（β=-0.058，P<.05，β=-0.067，P<.001）。相反，第 4 波次较高的抑郁症状评分预示着第 6 波次较低的平衡水平（β=-0.038，P=0.018）。平衡对抑郁症状的交叉滞后效应总体上强于相反的效应。
这些发现为社区居住的老年人中平衡和抑郁症状的时间方向性提供了新的见解，并表明以平衡障碍为主导。干预策略应旨在从早期开始提高平衡能力，以促进成功老龄化。
