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Sebastiani C, Wong JYX, Litt A, Loewen J, Reece K, Conlin N, Dunand T, Montero Odasso M, D'Amore C, Saunders S, Beauchamp M. Mapping sex and gender differences in falls among older adults: A scoping review. J Am Geriatr Soc 2024; 72:903-915. [PMID: 38147460 DOI: 10.1111/jgs.18730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/02/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND There is growing recognition of the importance of sex and gender differences within falls literature, but the characterization of such literature is uncertain. The aim of this scoping review was to (1) map the nature and extent of falls literature examining sex or gender differences among older adults, and (2) identify gaps and opportunities for further research and practice. METHODS We used a scoping review methodology. Eligible studies included participants with a mean age of ≥ 60 years and study aims specifying falls and either sex or gender concepts. MEDLINE, Embase, CINAHL, Ageline, and Psychinfo databases were searched from inception to March 2, 2022. Records were screened and charted by six independent reviewers. Descriptive and narrative reports were generated. RESULTS A total of 15,266 records were screened and 74 studies were included. Most studies reported on sex and gender differences in fall risk factors (n = 52, 70%), incidence/prevalence (n = 26, 35%), fall consequences (n = 22, 30%), and fall characteristics (n = 15, 20%). The majority of studies (n = 70, 95%) found significant sex or gender differences in relation to falls, with 39 (53%) identifying significant sex differences and 31 (42%) identifying significant gender differences. However, only three (4%) studies defined sex or gender concepts and only nine (12%) studies used sex or gender terms appropriately. Fifty-six (76%) studies had more female participants than males. Four (5%) were intervention studies. Studies did not report falls in line with guidelines nor use common fall definitions. CONCLUSION Sex and gender differences are commonly reported in falls literature. It is critical for future research to use sex and gender terms appropriately and include similar sample sizes across all genders and sexes. In addition, there is a need to examine more gender-diverse populations and to develop interventions to prevent falls that address sex and gender differences among older adults.
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Affiliation(s)
- Crista Sebastiani
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jamie Yee Xin Wong
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Amandeep Litt
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julia Loewen
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Karly Reece
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Conlin
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tessa Dunand
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Manuel Montero Odasso
- Schulich School of Medicine and Dentistry, Department of Medicine, Western University, London, Ontario, Canada
| | - Cassandra D'Amore
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Saunders
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Heidel MMM, Robinovitch SN, Yang Y. Association Between Falls, Head Impacts, and Mortality Among Older Adults in Long-Term Care. J Am Med Dir Assoc 2023; 24:1990-1995.e1. [PMID: 37690460 DOI: 10.1016/j.jamda.2023.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/21/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Residents in long-term care (LTC) are at high risk for falls, and falls in LTC often result in impact to the head, with clinical consequences that may be challenging to detect. We examined whether the survival of LTC residents associates with falls and fall-related head impacts. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS This study was conducted in 2 Vancouver-area LTC homes where falls were captured on video from surveillance cameras. A total of 232 participants (133 females, 99 males) experienced at least 1 fall captured on video, among whom 84% (n = 194) died between January 2011 and January 2020. The mean age at death was 86.5 (SD = 8.5) years, and the mean survival time after enrollment to this study was 3.8 (SD = 2.1) years. METHODS Univariable and multivariable models were used to determine how survival time depended on the rate of falls (falls per 365 days), the percentage of falls on video involving head impact, sex, age at death, and baseline physical and cognitive status. RESULTS On average, participants experienced 6.2 (SD = 7.0) falls per 365 days, and 36.9% (SD = 36.3) of video-captured falls resulted in head impact. In multivariable analyses, an increase of 1 fall per 365 days resulted in a 4.2% higher risk of death [hazard ratio (HR) = 1.042, 95% CI 1.023-1.062, P < .001]. A 1% increase in falls involving head impact resulted in an 0.5% higher risk of death (HR 1.005, 95% CI 1.001-1.010, P = .015). Participants who experienced head impact in all video-captured falls had a 50% higher risk for death than those who always avoided head impact. CONCLUSIONS AND IMPLICATIONS Survival in LTC is associated with the rate of falls and percentage of falls involving head impact. Improved efforts are required to prevent falls in LTC, and reduce the frequency and consequences of head impacts during falls (eg, through compliant flooring).
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Affiliation(s)
- Mackenzie M M Heidel
- Injury Prevention and Mobility Lab, Simon Fraser University, Burnaby, BC, Canada
| | | | - Yijian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China; CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.
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Miró Ò, Gil-Rodrigo A, García-Martínez A, Aguiló S, Alemany X, Nickel CH, Jacob J, Llorens P, Herrero P, Torres-Machado V, Cenjor R, Coll-Vinent B, Martínez-Nadal G, Del Nogal ML, Peacock F, Martín-Sánchez FJ. Sex differences in mortality of older adults with falls after emergency department consultation: FALL-ER registry. J Am Geriatr Soc 2023; 71:2715-2725. [PMID: 37224385 DOI: 10.1111/jgs.18401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/07/2023] [Accepted: 04/19/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND To investigate if sex is a risk factor for mortality in patients consulting at the emergency department (ED) for an unintentional fall. METHODS This was a secondary analysis of the FALL-ER registry, a cohort of patients ≥65 years with an unintentional fall presenting to one of 5 Spanish EDs during 52 predefined days (one per week during one year). We collected 18 independent patient baseline and fall-related variables. Patients were followed for 6 months and all-cause mortality recorded. The association between biological sex and mortality was expressed as unadjusted and adjusted hazard ratios (HR) with the 95% confidence interval (95% CI), and subgroup analyses were performed by assessing the interaction of sex with all baseline and fall-related mortality risk variables. RESULTS Of 1315 enrolled patients (median age 81 years), 411 were men (31%) and 904 women (69%). The 6-month mortality was higher in men (12.4% vs. 5.2%, HR = 2.48, 95% CI = 1.65-3.71), although age was similar between sexes. Men had more comorbidity, previous hospitalizations, loss of consciousness, and an intrinsic cause for falling. Women more frequently lived alone, with self-reported depression, and the fall results in a fracture and immobilization. Nonetheless, after adjustment for age and these eight divergent variables, older men aged 65 and over still showed a significantly higher mortality (HR = 2.19, 95% CI = 1.39-3.45), with the highest risk observed during the first month after ED presentation (HR = 4.18, 95% CI = 1.31-13.3). We found no interaction between sex and any patient-related or fall-related variables with respect to mortality (p > 0.05 in all comparisons). CONCLUSIONS Male sex is a risk factor for death following ED presentation for a fall in the older population adults aged 65 and over. The causes for this risk should be investigated in future studies.
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Affiliation(s)
- Òscar Miró
- Emergency Department, Hospital Clínic, Barcelona, Catalonia, Spain
- University of Barcelona, Catalonia, Spain
| | - Adriana Gil-Rodrigo
- Emergency Department, Short Stay Unit and Hospitalization at Home, Dr. Balmis General University Hospital, Alicante, Spain
- Institute for Health and Biomedical Research, Alicante, Spain
| | | | - Sira Aguiló
- Emergency Department, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Xavier Alemany
- Emergency Department, Hospital Clínic, Barcelona, Catalonia, Spain
| | | | - Javier Jacob
- Emergency Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | - Pere Llorens
- Emergency Department, Short Stay Unit and Hospitalization at Home, Dr. Balmis General University Hospital, Alicante, Spain
- Institute for Health and Biomedical Research, Alicante, Spain
- Miguel Hernández University, Elche, Alicante, Spain
| | - Pablo Herrero
- Emergency Department, Hospital Central de Asturias, Oviedo, Spain
| | - Victoria Torres-Machado
- Emergency Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | - Raquel Cenjor
- Emergency Department, Hospital Central de Asturias, Oviedo, Spain
| | | | | | | | - Frank Peacock
- Henry JN Taub Emergency Department, Baylor College of Medicine, Houston, Texas, USA
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Yoo TK, Lee S, Park SJ, Lee JY. Arterial stiffness expressed as brachial-ankle pulse wave velocity and gait assessment independent of lower extremity strength: a cross-sectional study in the older men population. J Geriatr Cardiol 2023; 20:91-99. [PMID: 36910247 PMCID: PMC9992948 DOI: 10.26599/1671-5411.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Older men are more vulnerable to fatal falls than women, and gait disturbances contribute to the risk of falls. Studies have assessed the association between arterial stiffness and gait dysfunction, but the results have been inconclusive. This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and gait assessment in older men. METHODS Data from the 2014-2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis. The inclusion criteria were men aged > 65 years with gait assessment [the 30-s chair stand test (30s-CST), the timed up and go (TUG) test, the figure-of-8 walk (F8W) test, the 2-min step test (2MST), and the 6-min walk test (6MWT)] and baPWV measurement data. Generalized linear regression analysis was conducted with multiple confounding factor adjustments, including lower extremity isometric strength. RESULTS A total of 291 participants were included in the analysis. The mean age was 71.38 ± 4.40 years. The mean values were as follows: (1) 30s-CST, 17.48 ± 5.00; (2) TUG test, 6.01 ± 1.10 s; (3) F8W test, 25.65 ± 4.71 s; (4) 2MST, 102.40 ± 18.83 per 2 min; and (5) 6MWT, 500.02 ± 85.65 m. After multivariable adjustment, baPWV was associated with the 6MWT (β = -0.037, 95% CI: -0.072--0.002), TUG test (β = 0, 95% CI: 0.000-0.001), and F8W test (β = 0.002, 95% CI: 0.000-0.004). baPWV was not associated with the 30s-CST and 2MST. CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness, independent of lower extremity strength. However, this association was modest. Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.
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Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center, Framingham, USA
| | - Seunghee Lee
- Department of Physical Education, Korea University, Seoul, South Korea
| | - Sae-Jong Park
- Division of Sports Science, Korea Institute of Sport Science, Seoul, South Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Pandya S, Le T, Demissie S, Zaky A, Arjmand S, Patel N, Moko L, Garces J, Rivera P, Singer K, Fedoriv I, Garcia Z, Kennedy J, Makkapati B, Mukherjee I, Szerszen A, Gross J, Glinik G, Younan D. The Association of Gender and Mortality in Geriatric Trauma Patients. Healthcare (Basel) 2022; 10:healthcare10081472. [PMID: 36011129 PMCID: PMC9407800 DOI: 10.3390/healthcare10081472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
The association of gender with mortality in trauma remains a subject of debate. Geriatric trauma patients have a higher risk of mortality compared to younger patients. We sought to evaluate the association of gender with mortality in a group of geriatric trauma patients presenting to an academic level 1 trauma center (trauma center designated by New York State capable of handling the most severe injuries and most complex cases). Methods: We performed a retrospective review of geriatric trauma patients who were admitted to our trauma center between January 2018 and December 2020. Data collected included vital signs, demographics, injury, and clinical characteristics, laboratory data and outcome measures. The study controlled for co-morbidities, injury severity score (ISS), and systolic blood pressure (SBP) in the ED. Multivariable logistic regression analysis was performed to evaluate the association of gender and mortality. Results: 4432 geriatric patients were admitted during the study period, there were 1635 (36.9%) men and 3859 (87.2%) were White with an average age of 81 ± 8.5 years. The mean ISS was 6.7 ± 5.4 and average length of stay was 6 ± 6.3 days. There were 165 deaths. Male gender (OR 1.94, 95% CI 1.38 to 2.73), ISS (OR 1.12, 95% CI 1.09 to 1.14), Emergency Department SBP less than 90 mmHg (OR 6.17, 95% CI 3.17 to 12.01), and having more than one co-morbidity (OR 2.28, 95% CI 1.55 to 3.35) were independently predictive of death on multivariable logistic regression analysis. Conclusion: Male gender, Emergency Department systolic blood pressure less than 90 mmHg, having more than one co-morbidity, and injury severity are independent predictors of mortality among geriatric trauma patients.
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Affiliation(s)
- Shreya Pandya
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Timothy Le
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Seleshi Demissie
- Biostatistics Unit, Feinstein Institutes for Medical Research, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Ahmed Zaky
- Department of Anesthesia, The University of Alabama in Birmingham, Birmingham, AL 35294, USA
| | - Shadi Arjmand
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Nikhil Patel
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Lilamarie Moko
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Juan Garces
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Paula Rivera
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Kiara Singer
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Ivan Fedoriv
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Zachery Garcia
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - James Kennedy
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Bhavana Makkapati
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Indraneil Mukherjee
- Department of Surgery, Division of Minimally Invasive Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Anita Szerszen
- Department of Medicine, Division of Geriatric Medicine, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Jonathan Gross
- Department of Orthopedics, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Galina Glinik
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
| | - Duraid Younan
- The Department of Surgery, Division of Acute Care Surgery, Staten Island University Hospital, Staten Island, New York, NY 10305, USA
- Correspondence:
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A retrospective cohort study of factors associated with severity of falls in hospital patients. Sci Rep 2022; 12:12266. [PMID: 35851400 PMCID: PMC9293967 DOI: 10.1038/s41598-022-16403-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/11/2022] [Indexed: 11/26/2022] Open
Abstract
Severity of falls in hospital patients are threat to patient safety which can result in a financial burden on the patient’s family and health care services. Both patient specific and environmental and organisational factors are associated with severity of falls in hospital. It is important to continuously analyse the factors associated with severity of fall which can inform the implementation of any fall preventive strategies. This study aims to identify factors associated with the severity of falls in hospitalised adult patients in Western Australia. This study involved a retrospective cohort analysis of inpatient falls records extracted from the hospital’s Clinical Incident Database from May 2014 to April 2019. Severity of falls were classified as three Severity Assessment Code (SAC): SAC 1 was “high” causing serious harm or death; SAC 2 was “medium” causing moderate or minor harm; and SAC 3 was “low” indicating no harm. Univariable and multivariable generalised ordinal logistic regression models were used to quantify the magnitude of effects of the potential risk factors on severity of falls at 5% level of significance and reported the crude odds and adjusted odds ratio of falling at a higher severity level. There were 3705 complete reported cases of falls with the average age of the patients was 68.5 ± 17.0 years, with 40.2% identified as female. The risk of falling at a higher level of severity increased by patient age over 50 years. Females were 15.1% more likely to fall at higher severity level compared to females. Fall incidents occurred during toileting and showering activities and incidents in a communal area were 14.5% and 26% more likely to occur at a higher severity respectively. Similarly, depression (167%), influence of alcohol or illicit drugs (more than 300%), use of medications (86%) and fragile skin (75%) significantly increased the odds of falling at higher level of severity. Identification of underlying risk factors associated with fall severity provides information which can guide nurses and clinicians to design and implement effective interventional strategies that mitigate the risk of serious fall injuries. The results suggest that fall prevention strategies should target patients with these risk factors to avoid severity of falls.
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Niederer D, Engeroff T, Fleckenstein J, Vogel O, Vogt L. The age-related decline in spatiotemporal gait characteristics is moderated by concerns of falling, history of falls & diseases, and sociodemographic-anthropometric characteristics in 60-94 years old adults. Eur Rev Aging Phys Act 2021; 18:19. [PMID: 34610791 PMCID: PMC8493753 DOI: 10.1186/s11556-021-00275-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Associations between age, concerns or history of falling, and various gait parameters are evident. Limited research, however, exists on how such variables moderate the age-related decline in gait characteristics. The purpose of the present study was to investigate the moderating effects of concerns of falling (formerly referred to as fear of falling), history of falls & diseases, and sociodemographic characteristics on changes in gait characteristics with increasing age in the elderly. METHODS In this individual participant level data re-analysis, data from 198 participants (n = 125 females) from 60 to 94 years of age were analysed (mean 73.9, standard deviation 7.7 years). Dependent variables were major spatiotemporal gait characteristics, assessed using a capacitive force measurement platform (zebris FDM-T). Age (independent variable) and the moderating variables concerns of falling (FES-I), gender/sex, history of falls and fall-related medical records, number of drugs daily taken, and body mass index were used in the statistical analysis. Hierarchical linear mixed moderation models (multilevel analysis) with stepwise (forward) modelling were performed. RESULTS Decreases of gait speed (estimate = -.03, equals a decrease of 0.03 m/s per year of ageing), absolute (- 1.4) and gait speed-normalized (-.52) stride length, step width (-.08), as well as increases in speed normalized cadence (.65) and gait speed variability (.15) are all age-related (each p < .05). Overall and specific situation-related concerns of falling (estimates: -.0012 to -.07) were significant moderators. History of potentially gait- and/or falls-affecting diseases accelerated the age-related decline in gait speed (-.002) and its variability (.03). History of falls was, although non-significant, a relevant moderator (in view of increasing the model fit) for cadence (.058) and gait speed (-.0027). Sociodemographics and anthropometrics showed further moderating effects (sex moderated the ageing effect on stride length, .08; height moderated the effect on the normalised stride length, .26; BMI moderated the effects on step width, .003). . CONCLUSION Age-related decline in spatiotemporal gait characteristics is moderated by concerns of falling, (non-significantly) by history of falls, significantly by history of diseases, and sociodemographic characteristics in 60-94 years old adults. Knowing the interactive contributions to gait impairments could be helpful for tailoring interventions for the prevention of falls. TRIAL REGISTRATION Re-analysis of [21-24].
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
| | - Tobias Engeroff
- Division Health and Performance, Goethe University Frankfurt, Institute of Occupational, Social and Environmental Medicine, Frankfurt, Germany
| | - Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Oliver Vogel
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.,Institute of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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Rhee MK, Jang Y, Kim SY, Chang S. The moderating role of social factors in the relationship between an incident of fall and depressive symptoms: a study with a national sample of older adults in South Korea. Aging Ment Health 2021; 25:1086-1093. [PMID: 32426987 DOI: 10.1080/13607863.2020.1758911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The purpose of the study was to examine the effect of an incident of fall on depressive symptoms and the moderating role of social factors (marital status, living arrangement, family network, and friend network) in older adults in South Korea. We hypothesized that the adverse mental health effect of a fall would be pronounced among those who lack social resources (e.g., no spouse, living alone, and social disconnectedness). METHOD Using the 2017 National Survey of Older Koreans, data were drawn from 8,522 survey participants (aged 65 or older). Multivariate linear regression models of depressive symptoms were examined with an array of predictors: (1) demographic and health variables, (2) social factors, (3) an incident of fall, and (4) interactions between falls and social factors. RESULTS More than 15% of the sample had at least one fall in the past 12 months. Higher levels of depressive symptoms were associated with an incident of fall, not married and living alone, and lack of family and friend networks. Not married and living alone and family network significantly moderated the relationship between falls and depressive symptoms. The adverse mental health effect of a fall was more pronounced among those who were not married and living alone and who reported not having any close family members than their counterparts. CONCLUSION The findings highlight the critical role of family and social resources in protecting older Koreans from the negative mental health consequences of a fall. Findings also provide implications for developing fall prevention and management programs, suggesting prioritizing older adults with limited social resources.
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Affiliation(s)
- Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Soo Young Kim
- Department of Social Welfare, Kyungsung University, Busan, South Korea
| | - Sujie Chang
- Department of Social Welfare, Kyungsung University, Busan, South Korea
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