Anxiety, Depression, and Fall-Related Psychological Concerns in Community-Dwelling Older People

Surrey Community Health, University of Surrey, Surrey, United Kingdom (IIK)
The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry (Impact Factor: 4.24). 08/2012; 21(12). DOI: 10.1097/JGP.0b013e318266b373
Source: PubMed


Establish the association between affect and fall-related psychological concerns (fear of falling, fall-related self-efficacy, balance confidence, and outcome expectancy).

A total of 205 community-dwelling older people (mean age 81, SD 7.5 years) completed the Geriatric Depression Scale-15, Geriatric Anxiety Inventory, Modified Survey of Activities and Fear of Falling, Falls-Efficacy Scale- International, Activity-Specific Balance Confidence Scale, and the Consequences of Falling Scale.

Hierarchical regression models showed that anxiety was independently associated with all fall-related psychological concerns; depression was only associated with falls efficacy. Associations between fall-related psychological concerns and age, gender, accommodation,medications, self-rated physical health, falls history, mobility, and sensory aids are also discussed.

This is the first study that investigates the association between affect and the four fall-related psychological concerns. Anxiety was a significant factor associated with all four, whereas depression was only associated with activity avoidance. Implications for healthcare providers are discussed.

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    • "xi - ety at each assessment . Overall , the findings suggest that TJR is associated with a modest improvement in the levels of depression and anxiety over time , although it is unclear whether this was uniform across all persons . If symptoms of depression and anxiety were closely linked to pain ( Denkinger et al . , 2014 ) and physical function ( Hull et al . , 2013 ) , then a greater improvement may have been expected at long term follow - up . Therefore , it is possible that the symp - toms of depression and anxiety increased in some patients , while other patients improved or remained the same . Although it would be clinically useful to identify these subgroups , this requires data for individua"
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    ABSTRACT: Patients usually experience good physical recovery after total joint replacement (TJR); however, it is unclear whether mood also improves. The current meta-analysis examined changes in depression and anxiety following TJR in older (≥50 years) patients in order to address this gap in the literature. Data from 26 studies (4045 TJR, 55 controls) that assessed depression and/or anxiety pre- and post-surgery in TJR patients, with or without a control group, were analyzed. Prevalence rates and Cohen's d effect sizes were used to evaluate changes in the prevalence and severity of depression/anxiety, respectively. Approximately 23% of TJR patients had clinically significant levels of depression prior to surgery, which decreased to 13% one year later. The prevalence of anxiety could not be evaluated due to the limited available data. TJR patients did not show any clinically meaningful reductions in symptoms of depression or anxiety, following surgery. Compared to controls, there was no difference in symptom progression over time; although only one study examined this. TJR patients appear to have higher rates of clinically significant symptoms of depression before and after surgery, compared to the general population, however more research with adequate control groups is needed to confirm this. Only a modest improvement in the severity of depression and anxiety symptoms was noted post-surgery. However, existing research is limited; preventing definite conclusions regarding the impact of TJR on mood.
    No preview · Article · Aug 2015 · Aging and Mental Health
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    • "ARTICLE IN PRESS PHYST-829; No. of Pages 7 2 B. Stubbs et al. / Physiotherapy xxx (2015) xxx–xxx can consequently increase sensorimotor deconditioning and subsequently increase the older person's risk of falls [8] [9] [10] [11]. Furthermore, reduced balance confidence is, in its own right, disabling and detrimental to the wellbeing of older adults [7] [12]. Among the few measures of balance confidence, one measure, the Activities and Balance Confidence (ABC) scale [13], is favoured among clinicians and has excellent test–retest reliability (r = 0.92, P < 0.001) [13] and internal consistency (Cronbach's alpha = 0.96) [14]. "
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    ABSTRACT: To determine whether musculoskeletal pain (pain severity and number of chronic pain sites; single or multisite) is associated with balance confidence over and above previously established risk factors. Cross-sectional study. Ten community sites (five day centres, two sheltered housing schemes and three community 'clubs') in the UK. Two hundred and eighty-nine community-dwelling older adults [response rate 72%, mean age 78 (standard deviation 8) years, 67% female] completed the study assessment. Eligibility criteria were as follows: living in the community; aged ≥60 years; able to walk ≥10m; able to communicate in English; and no cognitive (e.g. dementia), neurological or mental health conditions. Not applicable. Balance confidence as measured by the 16-item Activities Balance Confidence (ABC) scale (lower scores indicate less confidence). One hundred and fifty participants had at least one site of chronic musculoskeletal pain (52%), and the remaining 139 (48%) participants did not report chronic musculoskeletal pain. Older people with chronic musculoskeletal pain had significantly lower scores on the ABC scale compared with those without chronic musculoskeletal pain (mean 48.3 vs 71.3, P<0.001). After adjustment for established risk factors, two separate hierarchical regression models demonstrated that both pain severity (β=-0.106, P=0.029) and number of chronic musculoskeletal pain sites (β=-0.98, P=0.023) were significantly associated with lower balance confidence. Both pain severity and number of chronic pain sites (particularly multisite pain) are associated with lower balance confidence in community-dwelling older adults. Further research is needed to target pain symptoms and balance confidence in relation to fall risk in older adults with chronic musculoskeletal pain. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · May 2015 · Physiotherapy
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    Full-text · Article · Dec 2014 · The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry
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