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. Carola 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.
Original languageEnglish
Pages (from-to)1491-1499
Number of pages9
JournalAging Clinical and Experimental Research
Volume31
Issue number10
Early online date2019
DOIs
Publication statusPublished - 1 Oct 2019

Cite this

@article{995c26e943f640a7abad1d6a5e2bb8ed,
title = "The association between apathy, decline in physical performance, and falls in older persons",
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.",
keywords = "Apathy, Community-dwelling, Fall risk factor, Older persons, Physical performance",
author = "Henstra, {Marieke J.} and Didi Rhebergen and Stek, {Max L.} and Swart, {Karin M. A.} and {van Dijk}, {Suzanne C.} and Zillikens, {M. Carola} and {Oliai Araghi}, Sadaf and {de Groot}, {Lisette C. M. G. M.} and {van Schoor}, {Natasja M.} and {van der Velde}, Nathalie",
year = "2019",
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doi = "10.1007/s40520-018-1096-5",
language = "English",
volume = "31",
pages = "1491--1499",
journal = "Aging - Clinical and Experimental Research",
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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. Carola; 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, 01.10.2019, p. 1491-1499.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

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. Carola

AU - Oliai Araghi, Sadaf

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

AU - van Schoor, Natasja M.

AU - van der Velde, Nathalie

PY - 2019/10/1

Y1 - 2019/10/1

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

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UR - https://www.ncbi.nlm.nih.gov/pubmed/30600489

U2 - 10.1007/s40520-018-1096-5

DO - 10.1007/s40520-018-1096-5

M3 - Article

VL - 31

SP - 1491

EP - 1499

JO - Aging - Clinical and Experimental Research

JF - Aging - Clinical and Experimental Research

SN - 1594-0667

IS - 10

ER -