J Korean Acad Nurs.  2008 Oct;38(5):730-738. 10.4040/jkan.2008.38.5.730.

The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly

Affiliations
  • 1College of Nursing, Pusan National University, Busan, Korea.
  • 2Department of Nursing, Silla University, Busan, Korea. kypark@silla.ac.kr

Abstract

PURPOSE: The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly.
METHODS
Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program.
RESULTS
There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls.
CONCLUSION
For the effective management and prevention of community-dwelling older adults' falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

Keyword

Elderly; Extremities; Muscle strength; Falls; Depression

MeSH Terms

*Accidental Falls/prevention & control
Aged
Aged, 80 and over
*Depression
Extremities/physiology
Female
Geriatric Assessment
Homes for the Aged
Humans
Male
*Muscle Strength

Figure

  • Figure 1. Mediating effect of depression in the relationship between muscle strength of extremities and falls.


Reference

References

Arfken C. L.., Lach H. W.., Birge S. J.., Miller J.P. 1994. The prevalence and correlates of fear of falling in elderly persons living in the community. American Journal of Public Health. 84:565–570.
Article
Biderman A.., Cwikel J.., Fried A. V.., Galinsky, D. 2002. Depression and falls among community dwelling elderly people: A search for common risk factors. Journal of Epidemiology and Community Health. 56:631–636.
Article
Chang C. M.., Kang H.S. 2004. Physical function and physiological status in the elderly those who experienced a fall or not. Korean Journal of Rehabilitation Nursing. 7:48–57.
Chu L. W.., Chi I.., Chiu A.Y. 2005. Incidence and predictors of falls in the Chinese elderly. Annals of the Academy of Medicine, Singapore. 34:60–72.
Evans G. W.., Lepore S.J. 1997. Moderating and mediating processes in environment behavior research. Moore G.T., Marans R.W., editorsAdvances in environment, behavior, and design. 4. New York, NY: Plenum.
Ga mann, K. G., Rupprecht, R., Freiberger, E., & for the IZG Study Group. 2008. Predictors for occasional and recurrent falls in . community-dwelling older people. Zeitschrift fur Gerontologie und . Geriatrie: Organ der Deutschen Gesellschaft fur Gerontologie und Geriatrie. 41:1–8.
Gerety M. B.., Williams J. Jr.., Mulrow C. D.., Cornell J. E.., Kadri A. A.., Rosenberg J., et al1994. Performance of case-finding tools for depression in the nursing home: Influence of clinical and functional characteristics and selection of optimal threshold scores. Journal of the American Geriatrics Society. 42:1103–1109.
Article
Gu M. O.., Jeon M. Y.., Eun, Y. 2006. The development and effect of an tailed falls prevention exercise for older adults. Journal of Korean Academy of Nursing. 36:341–352.
Gu M. O.., Jeon M. Y.., Kim H. J.., Eun, Y. 2005. A review of exercise interventions for fall prevention in the elderly. Journal of Korean Academy of Nursing. 35:1101–1112.
Article
Hybels C. F.., Blazer D.G. 2003. Epidemiology of late-life men-taldisorders. Clinics in Geriatric Medicine. 19:663–696.
Jeon M. Y.., Jeong H. C.., Choe M.A. 2001. A study on the elderly patients hospitalized by the fracture from the fall. Journal of Korean Academy of Nursing. 31:443–453.
Article
Kannus P.., Sievanen H.., Palvanen M.., Jarvinen T.., Parkkari, J. 2005. Prevention of falls and consequent injuries in elderly people. Lancet. 26:1885–1893.
Article
Kim H.S. 2001. Senior fitness test manual. Seoul: Daehan Media.
Korea Centers for Disease Control and Prevention. 2005. Injury surveillance monthly report. 1:1–5. Retrieved July 9, 2008, from. http://www.cdc.go.kr/kcdchome.portal?_nfpb=true&_pageLa-bel=HPPUNI130&rootmenuid=20010&targetmenuid=20202&boardid=170&boardtype=BRDTYPE01&rootcmsid=&con-tentid=.
Lee H. J.., Park K. Y.., Park H.S. 2005. Self care activity, metabolic control, and cardiovascular risk factors in accordance with the levels of depression of clients with type 2 diabetes mellitus. Journal of Korean Academy of Nursing. 35:283–291.
Article
MacRae P. G.., Feltner M. E.., Reinsch, S. 1994. A 1-year exercise program for older women: Effects on falls, injuries, and physical performance. Journal of Aging and Physical Activity. 2:127–142.
Article
Min H.S. 1999. The Effects of personal characteristics and metamem-ory on the old adults’ memory performance. Unpublished doctoral dissertation. Seoul National University;Seoul:
Park E. Y.., Lee J.H. 2005. The effect of complex exercise program for prevention of falls on fitness in elderly. Exercise Science. 14:181–192.
Park S.W. 1997. Effect of reminiscence therapy on depression for elder-lypatient. Unpublished master’s thesis. Yonsei University;Seoul:
Robinson-Smith G.., Johnston M. V.., Allen, J. 2000. Self care, self-efficacy, quality of life, and depression after stroke. Archives of Physical Medicine and Rehabilitation. 81:460–464.
Rubenstein L. Z.., Josephson K.R. 2002. The epidemiology of falls and syncope. Clinics in Geriatric Medicine. 18:141–158.
Article
Schoenfelder D.P. 2000. A fall prevention for elderly individuals-Exercise in long term care settings. Journal of Gerontological Nursing. 26:43–51.
Sheikh J. I.., Yesavage J.A. 1986. Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist. 5:165–173.
Shin K. R.., Kang Y.., Jung D.., Choi K.A. 2007. A studyon the depression, somatic symptom, activities of daily living forthe elder-lywomen in an urban area. Journal of Korean Academy of Nursing. 37:1131–1138.
Stalenhoef P. A.., Diederiks J. P.., Knottnerus J. A.., Kester A. D.., Crebolder H.F. 2002. A risk model for the prediction of recurrent falls in community-dwelling elderly: A prospective cohort study. Journal of Clinical Epidemiology. 55:1088–1094.
Stel V. S.., Smit J. H.., Pluijm S. M.., Lips, P. 2004. Consequences of falling in older men and women and risk factors for health ser-viceuse and functional decline. Age Ageing. 33:58–65.
Tabachnick B. G.., Fidell L.S. 2001. Using multivariate statistics. 4th ed.Boston: Allyn & Bacon.
Tinetti M. E.., Speechley M.., Ginter S.F. 1988. Risk factors for falls among elderly persons living in the community. The New England Journal of Medicine. 319:1701–1707.
Article
Whooley M. A.., Kip K. E.., Cauley J. A.., Ensrud K. E.., Nevitt M. C.., Browner W.S. 1999. Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group. Archives of Internal Medicine. 159:484–490.
Full Text Links
  • JKAN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr