Fall risk in older adults mediates the association between depression, executive dysfunction and daily life

Introduction: The present study aimed to identify signs of frequent fall-related body dysfunction (depression/cognition) as exhibited in daily activities among older adults. The role of fall risk in mediating body dysfunction and daily activities was also explored. Method: Participants included 123 non-institutionalised older adults. Depression and cognitive status were measured by the Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA). Fall risk was determined by a questionnaire, supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Alternate Executive Function Performance Test medication management performance-based assessment. Daily life measures included the Barthel and Instrumental scale of activities of daily living, and World Health Organization Quality of Life questionnaire. Results: Based on a falls risk score, 39 out of 123 participants (32%) were high-risk fallers. High-risk fallers showed greater body dysfunction, as recognised in daily activities. Structural equation modelling (SEM) revealed that fall risk mediated the associations among depression, executive dysfunction and daily activities. Conclusion: Emotional and cognitive dysfunctions that affect people with high fall risk may manifest while older people perform daily activities. Community fall prevention programmes should screen for such fall-related dysfunction and provide strategies to minimise falls and enhance daily function.