Understanding Temporal Relationships Between Depression, Falls And Physical Activity In A Cohort Of Post Hospitalized Older Adults: A Breakthrough Or A Conundrum? | 70689
Journal of Novel Physiotherapies
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Background & Aim: Clinical depression affects approximately 15% of community dwelling older adults, of which half of these
cases are present in later life. Falls and depressive symptoms are thought to coexist, 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 inter connected problems remain elusive.
Den Ching Angel Lee is an Adjunct Research Fellow at the Department of Physiotherapy, Monash University and Specialist Advisor in Physiotherapy with ACH Group. Her research interests are prevention of accidental falls by older adults, evidence-based practice by health professionals, rehabilitation and gerontology. She has published nine peer reviewed journal articles during 2013 to 2017.