Den-Ching A Lee1, Aislinn F Lalor2, Grant Russell3, Rene Stolwyk4, Ted Brown2, Fiona McDermott5, Terry P Haines6. 1. Department of Physiotherapy,School of Primary and Allied Health Care,Faculty of Medicine, Nursing, and Health Sciences,Monash University (Peninsula Campus),McMahons Road,Frankston,Victoria 3199,Australia. 2. Department of Occupational Therapy,School of Primary and Allied Health Care,Faculty of Medicine, Nursing, and Health Sciences,Monash University (Peninsula Campus),McMahons Road,Frankston,Victoria 3199,Australia. 3. Head of School of Primary and Allied Health Care and Director of Southern Academic Primary Health Care Research Unit,Department of General Practice,Faculty of Medicine, Nursing, and Health Sciences,Monash University (Notting Hill Campus),Building 1,270 Ferntree Gully Road,Notting Hill Victoria 3168,Australia. 4. Monash Institute of Cognitive and Clinical Neurosciences,School of Psychological Sciences,Faculty of Medicine, Nursing, and Health Sciences,Monash University (Clayton Campus),Wellington Road,Clayton,Victoria 3800,Australia. 5. Department of Social Work,School of Primary and Allied Health Care,Faculty of Medicine, Nursing and Health Sciences,Monash University (Caulfield Campus),900 Dandenong Road,Caulfield East,Victoria 3145,Australia. 6. Director of Allied Health Research Unit,Monash Health and Director of Research,Southern Physiotherapy Clinical School,Physiotherapy Department,Monash University (Peninsula Campus),McMahons Road,Frankston,Victoria 3199,Australia.
Abstract
BACKGROUND: Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization. METHODS: A prospective cohort study in which 311 older adults surveyed prior to hospital discharge were assessed monthly post-discharge for six months. N = 218 completed the six-month follow-up. Participants were recruited from hospitals in Melbourne, Australia. The survey instrument used was designed based on Fiske's behavioral model depicting onset and maintenance of depression. The baseline survey collected data on self-reported falls, physical activity levels, and depressive symptoms. The monthly follow-up surveys repeated measurement of these outcomes. RESULTS: At any assessment point, falls were positively associated with depressive symptoms; depressive symptoms were negatively associated with physical activity levels; and, physical activity levels were negatively associated with falls. When compared with data in the subsequent assessment point, depressive symptoms were positively associated with falls reported over the next month (unadjusted OR: 1.20 (1.12, 1.28)), and physical activity levels were negatively associated with falls reported over the next month (unadjusted OR: 0.97 (0.96, 0.99) household and recreational), both indicating a temporal relationship. CONCLUSION: Falls, physical activity, and depressive symptoms were inter-associated, and depressive symptoms and low physical activity levels preceded falls. Clear strategies for management of these interconnected problems remain elusive.
BACKGROUND: Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization. METHODS: A prospective cohort study in which 311 older adults surveyed prior to hospital discharge were assessed monthly post-discharge for six months. N = 218 completed the six-month follow-up. Participants were recruited from hospitals in Melbourne, Australia. The survey instrument used was designed based on Fiske's behavioral model depicting onset and maintenance of depression. The baseline survey collected data on self-reported falls, physical activity levels, and depressive symptoms. The monthly follow-up surveys repeated measurement of these outcomes. RESULTS: At any assessment point, falls were positively associated with depressive symptoms; depressive symptoms were negatively associated with physical activity levels; and, physical activity levels were negatively associated with falls. When compared with data in the subsequent assessment point, depressive symptoms were positively associated with falls reported over the next month (unadjusted OR: 1.20 (1.12, 1.28)), and physical activity levels were negatively associated with falls reported over the next month (unadjusted OR: 0.97 (0.96, 0.99) household and recreational), both indicating a temporal relationship. CONCLUSION: Falls, physical activity, and depressive symptoms were inter-associated, and depressive symptoms and low physical activity levels preceded falls. Clear strategies for management of these interconnected problems remain elusive.
Authors: Barbara Resnick; Elizabeth Galik; Marie Boltz; Erin Vigne; Sarah Holmes; Steven Fix; Shijun Zhu Journal: West J Nurs Res Date: 2018-03-21 Impact factor: 1.967