The association between apathy, decline in physical performance, and falls in older persons

Marieke J. Henstra, Didi Rhebergen, Max L. Stek, Karin M.A. Swart, Suzanne C. van Dijk, M.C. Zillikens, Sadaf Oliai Araghi, Lisette C.M.G.M. de Groot, Natasja M. van Schoor, Nathalie van der Velde

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: 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. Aim: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. Methods: 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. Results: 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. Conclusion: 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.

LanguageEnglish
Pages1491-1499
Number of pages9
JournalAging clinical and experimental research
Volume31
Issue number10
Early online date2 Jan 2019
DOIs
Publication statusPublished - Oct 2019

Fingerprint

Apathy
Incidence
Odds Ratio
Independent Living
Vitamin B Complex
Osteoporotic Fractures
Geriatrics
Confidence Intervals
Depression

Keywords

  • Apathy
  • Community-dwelling
  • Fall risk factor
  • Older persons
  • Physical performance

Cite this

Henstra, M. J., Rhebergen, D., Stek, M. L., Swart, K. M. A., van Dijk, S. C., Zillikens, M. C., ... van der Velde, N. (2019). The association between apathy, decline in physical performance, and falls in older persons. Aging clinical and experimental research, 31(10), 1491-1499. https://doi.org/10.1007/s40520-018-1096-5
Henstra, Marieke J. ; Rhebergen, Didi ; Stek, Max L. ; Swart, Karin M.A. ; van Dijk, Suzanne C. ; Zillikens, M.C. ; Oliai Araghi, Sadaf ; de Groot, Lisette C.M.G.M. ; van Schoor, Natasja M. ; van der Velde, Nathalie. / The association between apathy, decline in physical performance, and falls in older persons. In: Aging clinical and experimental research. 2019 ; Vol. 31, No. 10. pp. 1491-1499.
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abstract = "Background: 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. Aim: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. Methods: 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. Results: 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. Conclusion: 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.",
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Henstra, MJ, Rhebergen, D, Stek, ML, Swart, KMA, van Dijk, SC, Zillikens, MC, Oliai Araghi, S, de Groot, LCMGM, van Schoor, NM & van der Velde, N 2019, 'The association between apathy, decline in physical performance, and falls in older persons', Aging clinical and experimental research, vol. 31, no. 10, pp. 1491-1499. https://doi.org/10.1007/s40520-018-1096-5

The association between apathy, decline in physical performance, and falls in older persons. / Henstra, Marieke J.; Rhebergen, Didi; Stek, Max L.; Swart, Karin M.A.; van Dijk, Suzanne C.; Zillikens, M.C.; Oliai Araghi, Sadaf; de Groot, Lisette C.M.G.M.; van Schoor, Natasja M.; van der Velde, Nathalie.

In: Aging clinical and experimental research, Vol. 31, No. 10, 10.2019, p. 1491-1499.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - The association between apathy, decline in physical performance, and falls in older persons

AU - Henstra, Marieke J.

AU - Rhebergen, Didi

AU - Stek, Max L.

AU - Swart, Karin M.A.

AU - van Dijk, Suzanne C.

AU - Zillikens, M.C.

AU - Oliai Araghi, Sadaf

AU - de Groot, Lisette C.M.G.M.

AU - van Schoor, Natasja M.

AU - van der Velde, Nathalie

PY - 2019/10

Y1 - 2019/10

N2 - Background: 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. Aim: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. Methods: 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. Results: 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. Conclusion: 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.

AB - Background: 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. Aim: To longitudinally assess the association between apathy and (1) decline of physical performance and (2) the number of falls in older community-dwelling persons. Methods: 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. Results: 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. Conclusion: 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.

KW - Apathy

KW - Community-dwelling

KW - Fall risk factor

KW - Older persons

KW - Physical performance

U2 - 10.1007/s40520-018-1096-5

DO - 10.1007/s40520-018-1096-5

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SN - 1594-0667

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ER -