ABSTRACT

Slowed gait is one of the strongest predictors of fall risk in older adults. The present study investigated whether gait speed mediated the relationship between depression and fall history in 147 older adults presenting to a memory clinic for cognitive complaints. Depression, cognitive status, gait speed, and number of falls within the last year were the primary measures. Results revealed fallers, relative to non-fallers, had slower gait speed and higher depression scores. As hypothesized, analyses using the PROCESS macro found that gait mediated the relationship between depression and fall history. Additionally, the combination of depression and mild cognitive impairments (MCI) associated with a significantly greater likelihood of falling. Our findings indicate that combined depression and MCI have additive effects on fall risk, likely through the destabilizing effect of slowed gait on balance. Better understanding the underlying pathophysiology involved in MCI and depression-related gait disturbances may lead to improved intervention targets for fall risk prevention.

摘要

步态缓慢是老年人跌倒风险的最强预测因素之一。本研究调查了 147 名因认知问题而到记忆诊所就诊的老年人，步态速度是否介导了抑郁症和跌倒史之间的关系。去年的抑郁、认知状态、步态速度和跌倒次数是主要测量指标。结果显示，相对于非跌倒者，跌倒者的步态速度较慢，抑郁评分较高。正如假设的那样，使用 PROCESS 宏的分析发现，步态调节了抑郁症和跌倒史之间的关系。此外，抑郁症和轻度认知障碍 (MCI) 的组合与跌倒的可能性显着增加有关。我们的研究结果表明，合并抑郁症和 MCI 对跌倒风险具有累加效应，可能是由于步态缓慢对平衡造成的不稳定影响。更好地了解 MCI 和抑郁相关步态障碍所涉及的潜在病理生理学可能会导致改善跌倒风险预防的干预目标。