Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community

Background Older adults with apathy have a high risk of falls and are prone to repeated falls . Few interventions could achieve satisfactory effects on improving apathy, although improved apathy is associated with a reduced risk of falls. Improving frailty may be a new method for reducing the risk o...

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Main Author: TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2023-04-01
Series:Zhongguo quanke yixue
Subjects:
Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/zx20220620.pdf
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author TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei
author_facet TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei
author_sort TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei
collection DOAJ
description Background Older adults with apathy have a high risk of falls and are prone to repeated falls . Few interventions could achieve satisfactory effects on improving apathy, although improved apathy is associated with a reduced risk of falls. Improving frailty may be a new method for reducing the risk of falls in older adults with apathy. Objective To investigate the mediating effect of frailty between apathy and risk of falls in older adults in the community, so as to provide a new idea for reducing the fall risk in this group. Methods A total of 212 community-dwelling older adults were selected to attend a survey by convenience sampling from November 2021 to March 2022, including 128 from Dongshan Community Health Center, Nanjing, and 84 from Qinghu Town, Donghai County, Lianyungang. A self-developed Demographic Information Questionnaire, the Fried Frailty Phenotype (FFP) , Geriatric Depression Scale (GDS-3) , Stopping Elderly Accidents, Deaths & Injuries Tool Kit (STEADI) were used to collect demographics, frailty prevalence, apathy prevalence, and risk of falls, respectively. The intermediary role of frailty in apathy and fall risk was analyzed. Results One hundred and ninety-two cases (90.6%) who responded effectively to the survey were included for analysis. The average total STEADI score, average total GDS-3 score, and FFP score of the respondents were 2.0 (0, 4.0) , (1.6±0.9) , and 0 (0, 2.0) , respectively. Fifty-six (29.2%) and other 136 cases (70.8%) were assessed with and without fall risk, respectively. Spearman rank correlation analysis showed that apathy was positively correlated with frailty and fall risk, (rs=0.303, 0.388, P<0.05) , and frailty was positively correlated with fall risk (rs=0.424, P<0.05) . The analysis using intermediary Model 4 showed that apathy had a significant positive effect on fall risk (B=1.011, t=5.207, P<0.05) ; apathy significantly positively influenced frailty (B=0.324, t=3.800, P<0.05) ; frailty had a significant positive effect on fall risk (B=0.679, t=4.173, P<0.05) . Bootstrap test showed that the effect size of frailty in the path of "apathy→frailty→fall risk" was 0.22 〔95%CI (0.08, 0.40) 〕, indicating that frailty played a mediational role between apathy and risk of falls. Apathy could directly affect the fall risk, and could indirectly affect the fall risk through frailty. The total effect was 1.01, in which the size of direct effect was 0.79, the size of mediator effect was 0.22 (accounting for 21.78%) . Conclusion Frailty may be a mediator between apathy and fall risk in older adults in the community, and improving frailty is an important way to reduce risk of falling.
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spelling doaj.art-a76101b6474048afac1d103c1a16336c2024-04-09T07:47:28ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-04-0126121444144910.12114/j.issn.1007-9572.2022.0620Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the CommunityTAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei01School of Nursing, Nanjing Medical University, Nanjing 211166, China;2School of Nursing, Southern Medical University, Guangzhou 510515, ChinaBackground Older adults with apathy have a high risk of falls and are prone to repeated falls . Few interventions could achieve satisfactory effects on improving apathy, although improved apathy is associated with a reduced risk of falls. Improving frailty may be a new method for reducing the risk of falls in older adults with apathy. Objective To investigate the mediating effect of frailty between apathy and risk of falls in older adults in the community, so as to provide a new idea for reducing the fall risk in this group. Methods A total of 212 community-dwelling older adults were selected to attend a survey by convenience sampling from November 2021 to March 2022, including 128 from Dongshan Community Health Center, Nanjing, and 84 from Qinghu Town, Donghai County, Lianyungang. A self-developed Demographic Information Questionnaire, the Fried Frailty Phenotype (FFP) , Geriatric Depression Scale (GDS-3) , Stopping Elderly Accidents, Deaths & Injuries Tool Kit (STEADI) were used to collect demographics, frailty prevalence, apathy prevalence, and risk of falls, respectively. The intermediary role of frailty in apathy and fall risk was analyzed. Results One hundred and ninety-two cases (90.6%) who responded effectively to the survey were included for analysis. The average total STEADI score, average total GDS-3 score, and FFP score of the respondents were 2.0 (0, 4.0) , (1.6±0.9) , and 0 (0, 2.0) , respectively. Fifty-six (29.2%) and other 136 cases (70.8%) were assessed with and without fall risk, respectively. Spearman rank correlation analysis showed that apathy was positively correlated with frailty and fall risk, (rs=0.303, 0.388, P<0.05) , and frailty was positively correlated with fall risk (rs=0.424, P<0.05) . The analysis using intermediary Model 4 showed that apathy had a significant positive effect on fall risk (B=1.011, t=5.207, P<0.05) ; apathy significantly positively influenced frailty (B=0.324, t=3.800, P<0.05) ; frailty had a significant positive effect on fall risk (B=0.679, t=4.173, P<0.05) . Bootstrap test showed that the effect size of frailty in the path of "apathy→frailty→fall risk" was 0.22 〔95%CI (0.08, 0.40) 〕, indicating that frailty played a mediational role between apathy and risk of falls. Apathy could directly affect the fall risk, and could indirectly affect the fall risk through frailty. The total effect was 1.01, in which the size of direct effect was 0.79, the size of mediator effect was 0.22 (accounting for 21.78%) . Conclusion Frailty may be a mediator between apathy and fall risk in older adults in the community, and improving frailty is an important way to reduce risk of falling.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220620.pdfapathy|frailty|fall risk|aged|mediation analysis|risk assessment
spellingShingle TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei
Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
Zhongguo quanke yixue
apathy|frailty|fall risk|aged|mediation analysis|risk assessment
title Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
title_full Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
title_fullStr Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
title_full_unstemmed Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
title_short Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community
title_sort mediating effect of frailty on the association between apathy and fall risk in older adults in the community
topic apathy|frailty|fall risk|aged|mediation analysis|risk assessment
url https://www.chinagp.net/fileup/1007-9572/PDF/zx20220620.pdf
work_keys_str_mv AT taoluzengkainiezuotingzongqianxingchenlongwuyanyangrumei mediatingeffectoffrailtyontheassociationbetweenapathyandfallriskinolderadultsinthecommunity