The role of frailty in the association between depression and fall risk among older adults.
The role of frailty in the association between depression and fall risk among older adults.
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DOI：
10.1080/13607863.2021.1950616
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发表时间：
2022-09
影响因子：
3.4
通讯作者：
Merchant, Anwar T.
中科院分区：
文献类型：
--
作者：
Lohman, Matthew C.;Mezuk, Briana;Fairchild, Amanda J.;Resciniti, Nicholas, V;Merchant, Anwar T.
尽管在老年人中，抑郁症和更大的跌倒风险之间存在公认的关联，但解释这种关联的机制尚不清楚。这项研究评估了虚弱这一常见的老年综合征在确定患有抑郁症的老年人摔倒的更大风险方面的作用。我们使用了健康和退休研究(HRS；2010-2014)三次两年一次的纵向数据。样本包括社区居住调查的受访者，年龄65岁，参加了客观的生理测量。采用抑郁综合国际诊断访谈简表测量重度抑郁(MD)。使用脆弱表型模型中概述的标准来衡量脆弱程度。使用因果中介分析区分抑郁对跌倒、跌伤和多次跌倒的直接影响和虚弱对跌倒的间接影响。在两年的时间里，重度抑郁症与经历跌倒(OR：1.91；95%CI：1.31，2.77)、跌伤(OR：1.86；95%CI：1.17，2.95)和多次跌倒(OR：2.26；95%CI：1.52，3.37)的几率显著增加。虚弱是抑郁对跌倒和多次跌倒影响的显著中介变量，分别约占总效应的18.9%和21.3%。我们没有发现抑郁和脆弱相互作用的证据。敏感度分析表明，结果对抑郁症的未测量混杂和替代操作是稳健的。虚弱解释了患有抑郁症的老年人跌倒可能性增加的很大一部分原因。虚弱症状的治疗和管理可能是老年抑郁症患者预防跌倒的重要组成部分。
Although there is a recognized association between depression and greater fall risk among older adults, the mechanisms explaining this association are unclear. This study evaluated the role of frailty, a common geriatric syndrome, in determining greater risk of falls among older adults with depression. We used longitudinal data from three biennial waves of the Health and Retirement Study (HRS; 2010–2014). The sample included community-dwelling survey respondents age ≥ 65 who participated in objective physiological measures. Major Depression (MD) was measured using Composite International Diagnostic Interview for depression short form. Frailty was measured using criteria outlined in the frailty phenotype model. Causal mediation analysis was used to differentiate the direct effect of depression and indirect effect mediated by frailty on falls, fall injuries, and multiple falls. Major depression was associated with significantly greater odds of experiencing a fall (OR: 1.91; 95% CI: 1.31, 2.77), fall injury (OR:1.86; 95% CI: 1.17, 2.95), and multiple falls (OR: 2.26; 95% CI: 1.52, 3.37) over a two-year period. Frailty was a significant mediator of the effects of depression on falls and multiple falls, accounting for approximately 18.9% and 21.3% of the total effects, respectively. We found no evidence of depression-frailty interaction. Sensitivity analyses showed that results were robust to unmeasured confounding and alternative operationalizations of depression. Frailty explains a significant proportion of increased likelihood of falls among older adults with depression. Treatment and management of frailty symptoms may be an important components of fall prevention among older adults with depression.
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影响因子：
6.3
作者：
Florence CS;Bergen G;Atherly A;Burns E;Stevens J;Drake C
通讯作者：
Drake C
DOI：
10.1093/gerona/61.3.262
发表时间：
2006-03-01
影响因子：
5.1
作者：
Bandeen-Roche, K;Xue, QL;Fried, LP
通讯作者：
Fried, LP
影响因子：
6.7
作者：
Boyd, Rebecca;Stevens, Judy A.
通讯作者：
Stevens, Judy A.
影响因子：
18.4
作者：
Fiske A;Wetherell JL;Gatz M
通讯作者：
Gatz M
影响因子：
3.7
作者：
Kerse N;Flicker L;Pfaff JJ;Draper B;Lautenschlager NT;Sim M;Snowdon J;Almeida OP
通讯作者：
Almeida OP