Depressive symptoms, balance, and gait in older adults: Mediation and moderation analysis

This study aimed to investigate the relationship between depressive symptoms and balance/gait in older adults while accounting for potential mediators and moderators, including cognitive function, nutritional status, and fear of falling.

This retrospective cross-sectional study included 566 community-dwelling older adults aged 65 and above who underwent a comprehensive geriatric assessment at a geriatric outpatient clinic. Balance and gait were assessed using the Tinetti Assessment Battery (TAB), depressive symptoms were measured with the Geriatric Depression Scale (GDS), and cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Mediation and moderation analyses were conducted to assess the direct and indirect effects of depression on balance and gait.

Advanced age, female sex, fear of falling, lower MMSE and Mini-Nutritional Assessment (MNA) scores, and higher GDS scores were independent risk factors for impaired balance and gait. Mediation analysis revealed that MNA (36.8 %), fear of falling (17 %), and MMSE (15.5 %) partially mediated the relationship between depressive symptoms and balance/gait impairment. However, moderation analysis indicated that none of the examined factors significantly altered the strength of this relationship.

Depressive symptoms were independently associated with impaired balance and gait in older adults, with nutritional status, cognitive function, and fear of falling acting as partial mediators. These findings highlight the need for a multidimensional approach in assessing and managing mobility impairments in depressed older adults. Addressing nutritional deficiencies, cognitive decline, and fear of falling may serve as potential intervention targets to mitigate the negative impact of depression on balance and gait.