The association between apathy, decline in physical performance, and falls in older persons
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Symptoms of apathy are common in older persons. Negative effects on physical performance and fall risk are plausible, considering the pathophysiology of apathy. However, literature is scarce.
To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons.
The ‘B vitamins for the PRevention Of Osteoporotic Fractures’ study provided data on 2919 older persons over a period of 2 years. Apathy was assessed using the Geriatric Depression Scale 3. A physical performance score (PPS) was calculated using three performance tests. Falls were registered prospectively. We calculated adjusted odds ratios (ORs), Incidence Rate Ratios (IRRs), and their 95% confidence intervals. Effect modification by age and gender was investigated. We also investigated mediation by baseline PPS for the association between apathy and the number of falls.
Apathy and decline of PPS were independently associated. After stratification, the effect only remained in men. Age was an effect modifier; higher ORs for decreasing age. Apathy was also independently associated with the number of falls. After stratification, women had higher IRRs than men. Age modified the association in the opposite direction: higher IRRs for increasing age. Baseline PPS was a mediator in the association.
The impact of apathy on physical performance and fall incidents varied with age and gender. Potentially, in older individuals with apathy, fall risk is preceded by a decline in physical performance. In clinical practice, identifying apathy in older persons might be useful to target mobility preserving interventions.
KeywordsApathy Fall risk factor Physical performance Older persons Community-dwelling
Paul Lips, Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam, The Netherlands, firstname.lastname@example.org.
The B-PROOF study is supported and funded by The Netherlands Organization for Health Research and Development (ZonMw, Grant 6130.0031), the Hague; unrestricted grant from NZO (Dutch Dairy Association), Zoetermeer; Orthica, Almere; NCHA (Netherlands Consortium Healthy Ageing) Leiden/Rotterdam; Ministry of Economic Affairs, Agriculture and Innovation (project KB-15-004-003), the Hague; Wageningen University, Wageningen; VUmc, Amsterdam; Erasmus Medical Center, Rotterdam.
Compliance with ethical standards
Conflict of interest
The author declares that there is no competing interest.
Statement of human and animal rights
The study protocol was approved by the Wageningen University Medical Ethics Committee and the Medical Ethics committees of the two other participating centres gave approval for local feasibility.
All participating individuals gave written informed consent
- 4.Gillespie LD et al (2012) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 9:CD007146Google Scholar
- 16.Tierney SM et al (2018) Real-world implications of apathy among older adults: independent associations with activities of daily living and quality of life. J Clin Exp Neuropsychol 11:1–9Google Scholar
- 24.http://www.lasa-vu.nl/themes/physical/physical-performance.htm. Accessed 2 July 2017
- 28.Garretsen HFL (1983) Probleemdrinken: Prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden: theoretische overwegingen en onderzoek in Rotterdam. Swets & Zeitlinger, RotterdamGoogle Scholar
- 31.Nur H, Sertkaya BS, Tuncer T (2017) Determinants of physical functioning in women with knee osteoarthritis. Aging Clin Exp Res 30:299–306Google Scholar
- 33.Addison O et al (2017) Sarcopenia in peripheral arterial disease: prevalence and impact on functional status. Arch Phys Med Rehabil 99:623–628Google Scholar
- 39.Bertens AS et al (2016) Validity of the three apathy items of the geriatric depression scale (GDS-3A) in measuring apathy in older persons. Int J Geriatr Psychiatry 32:421–428Google Scholar