Marieke J Henstra1,2, Didi Rhebergen3, Max L Stek3, Karin M A Swart4, Suzanne C van Dijk5, M Carola Zillikens6, Sadaf Oliai Araghi7, Lisette C M G M de Groot8, Natasja M van Schoor9, Nathalie van der Velde10,11. 1. Department of Internal Medicine, Geriatrics, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.j.henstra@amc.nl. 2. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.j.henstra@amc.nl. 3. Department of Psychiatry, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, The Netherlands. 4. Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 5. Department of Geriatric Medicine, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands. 6. Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. 7. Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 8. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. 9. Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 10. Department of Internal Medicine, Geriatrics, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. 11. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Symptoms of apathy are common in older persons. Negative effects on physical performance and fall risk are plausible, considering the pathophysiology of apathy. However, literature is scarce. AIM: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. METHODS: The 'B vitamins for the PRevention Of Osteoporotic Fractures' study provided data on 2919 older persons over a period of 2 years. Apathy was assessed using the Geriatric Depression Scale 3. A physical performance score (PPS) was calculated using three performance tests. Falls were registered prospectively. We calculated adjusted odds ratios (ORs), Incidence Rate Ratios (IRRs), and their 95% confidence intervals. Effect modification by age and gender was investigated. We also investigated mediation by baseline PPS for the association between apathy and the number of falls. RESULTS: Apathy and decline of PPS were independently associated. After stratification, the effect only remained in men. Age was an effect modifier; higher ORs for decreasing age. Apathy was also independently associated with the number of falls. After stratification, women had higher IRRs than men. Age modified the association in the opposite direction: higher IRRs for increasing age. Baseline PPS was a mediator in the association. CONCLUSION: The impact of apathy on physical performance and fall incidents varied with age and gender. Potentially, in older individuals with apathy, fall risk is preceded by a decline in physical performance. In clinical practice, identifying apathy in older persons might be useful to target mobility preserving interventions.
BACKGROUND: Symptoms of apathy are common in older persons. Negative effects on physical performance and fall risk are plausible, considering the pathophysiology of apathy. However, literature is scarce. AIM: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. METHODS: The 'B vitamins for the PRevention Of Osteoporotic Fractures' study provided data on 2919 older persons over a period of 2 years. Apathy was assessed using the Geriatric Depression Scale 3. A physical performance score (PPS) was calculated using three performance tests. Falls were registered prospectively. We calculated adjusted odds ratios (ORs), Incidence Rate Ratios (IRRs), and their 95% confidence intervals. Effect modification by age and gender was investigated. We also investigated mediation by baseline PPS for the association between apathy and the number of falls. RESULTS: Apathy and decline of PPS were independently associated. After stratification, the effect only remained in men. Age was an effect modifier; higher ORs for decreasing age. Apathy was also independently associated with the number of falls. After stratification, women had higher IRRs than men. Age modified the association in the opposite direction: higher IRRs for increasing age. Baseline PPS was a mediator in the association. CONCLUSION: The impact of apathy on physical performance and fall incidents varied with age and gender. Potentially, in older individuals with apathy, fall risk is preceded by a decline in physical performance. In clinical practice, identifying apathy in older persons might be useful to target mobility preserving interventions.
Entities:
Keywords:
Apathy; Community-dwelling; Fall risk factor; Older persons; Physical performance
Authors: P L Bernard; G Ninot; N Raffort; B Aliaga; L Gamon; M Faucanie; M C Picot; O Maurelli; S Pla; L Soriteau; J Bousquet; H Blain Journal: Aging Clin Exp Res Date: 2020-06-20 Impact factor: 3.636