Fall risk in older adults mediates the association between depression, executive dysfunction and daily life

The present study aimed to identify signs of frequent fall-related body dysfunction (depression/cognition) as exhibited in daily activities among older adults. The role of fall risk in mediating body dysfunction and daily activities was also explored.

Participants included 123 non-institutionalised older adults. Depression and cognitive status were measured by the Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA). Fall risk was determined by a questionnaire, supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Alternate Executive Function Performance Test medication management performance-based assessment. Daily life measures included the Barthel and Instrumental scale of activities of daily living, and World Health Organization Quality of Life questionnaire.

Based on a falls risk score, 39 out of 123 participants (32%) were high-risk fallers. High-risk fallers showed greater body dysfunction, as recognised in daily activities. Structural equation modelling (SEM) revealed that fall risk mediated the associations among depression, executive dysfunction and daily activities.

Emotional and cognitive dysfunctions that affect people with high fall risk may manifest while older people perform daily activities. Community fall prevention programmes should screen for such fall-related dysfunction and provide strategies to minimise falls and enhance daily function.