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Depression and activity-limiting fall worry among older adults: longitudinal reciprocal relationships

Published online by Cambridge University Press:  18 July 2019

Namkee G. Choi ,
Nancy M. Gell ,
Diana M. DiNitto ,
C. Nathan Marti  and
Mark E. Kunik
Namkee G. Choi*
Affiliation:
Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
Nancy M. Gell
Affiliation:
Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
Diana M. DiNitto
Affiliation:
Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
C. Nathan Marti
Affiliation:
Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
Mark E. Kunik
Affiliation:
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. Debakey VA Medical Center, Houston, TX, USA South Central Mental Illness Research, Education and Clinical Center, and Baylor College of Medicine, Houston, TX, USA
*
Correspondence should be addressed to: Namkee G. Choi, 1925 San Jacinto Blvd, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA. Phone: 512-232-9590. Email: [email protected].
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Abstract

Objectives:

Late-life depression, falls, and fall worry are public health problems. While previous research confirms the cross-sectional relationship between depression and fall worry, few longitudinal studies have examined whether changes in fall worry are associated with changes in depressive illness and vice versa. This study examined longitudinal relationships between probable major depression (PMD) and activity-limiting fall worry (ALW).

Design, Setting, Participants, Measurements:

This longitudinal panel observational study used data from the National Health and Aging Trends Study (NHATS) waves 5 (referred to as T1 in this study) and 6 (T2), conducted in 2015 and 2016, respectively (N = 6,299, aged 65 and older). We examined associations of new and continued ALW between T1 and T2 with T2 PMD, controlling for T1 PMD; and associations of new and continued PMD between T1 and T2 with T2 ALW, controlling for T1 ALW. We used χ2 and t tests for descriptive statistics and logistic regression for multivariable analysis.

Results:

Those with new ALW at T2 had significantly greater odds of T2 PMD compared to those without ALW at both time points (AOR = 2.64, 95% CI = 1.98−3.51), and those with new PMD at T2 had significantly greater odds of T2 ALW (AOR = 2.42, 95% CI = 1.66−3.52). Those with continued PMD also had greater odds of T2 ALW compared to those without PMD at either time point (AOR = 2.31, 95% CI = 1.62−3.29).

Conclusions:

The findings add to knowledge about bidirectional (mutually reinforcing) relationships between depression and activity-limiting fall worry. Innovative interventions are needed to reduce both late-life depression and activity-limiting fall worry.

Keywords

depressionfall worryfallsactivity limitationhealth conditions
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 4: Issue Theme: Serious Mental Illnesses in Older Adults , April 2020 , pp. 495 - 504
Copyright
© International Psychogeriatric Association 2019

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