Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people

Lloyd L Y Chan; Kim Delbaere; Katya Numbers; Ben Lam; Jasmine Menant; Daina L Sturnieks; Julian N Trollor; Matthew A Brodie; Stephen R Lord

doi:10.1111/ajag.13273

Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people

Australas J Ageing. 2024 Jun;43(2):333-342. doi: 10.1111/ajag.13273. Epub 2024 Jan 13.

Authors

Lloyd L Y Chan^{1

2}, Kim Delbaere^{1

2}, Katya Numbers³, Ben Lam³, Jasmine Menant^{1

2}, Daina L Sturnieks^{1

4}, Julian N Trollor⁵, Matthew A Brodie^{1

6}, Stephen R Lord^{1

2}

Affiliations

¹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia.
² School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
³ Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
⁴ School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales, Sydney, New South Wales, Australia.
⁶ Graduate School of Biomedical Engineering, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 38217882
DOI: 10.1111/ajag.13273

Abstract

Objectives: Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults.

Methods: Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments. Group-based trajectory analysis was used to identify patterns of depressive symptom development over 6 years of follow-up. Strengths of associations between baseline functional test performances and depressive symptom trajectories were evaluated with univariable ordinal models. Subsequently, the adjusted cumulative odds ratio for the association between identified risk factors, demographic factors and baseline anti-depressant use were measured using multivariable ordinal logistic regression.

Results: Three distinct depressive symptom trajectories were identified: a low-and-stable course (10% of participants), a low-and-increasing course (81%) and a moderate-and-increasing course (9%). Timed Up and Go test time was the strongest risk factor of depressive symptom trajectory, followed by Five Times Sit-to-Stand test performance, planned physical activity levels, and knee extension strength (adjusted standardised ORs 1.65, 95% CI 1.34-2.04; 1.44, 95% CI 1.16-1.77; 1.44, 95% CI 1.17-1.76 and 1.41, 95% CI 1.15-1.73 respectively). After adjusting for age, sex, body mass index and baseline anti-depressant use, Timed Up and Go test performance and knee extension strength were independently and significantly associated with depressive trajectories.

Conclusions: Timed Up and Go test times, Five Times Sit-to-Stand test performance, planned physical activity levels and knee extension strength are associated with three discrete depressive symptom trajectories. These clinical tests may help identify older adults aged 70-90 years at risk of developing depressive symptoms and help guide subsequent strength and mobility interventions.

Keywords: aging; depression; longitudinal studies; psychomotor disorders; sarcopenia.

MeSH terms

Age Factors
Aged
Aged, 80 and over
Aging / psychology
Antidepressive Agents / therapeutic use
Depression* / diagnosis
Depression* / epidemiology
Depression* / psychology
Female
Functional Status
Geriatric Assessment*
Humans
Independent Living
Life Style
Lower Extremity*
Male
Mobility Limitation*
Muscle Weakness* / diagnosis
Muscle Weakness* / physiopathology
Muscle Weakness* / psychology
Risk Assessment
Risk Factors
Time Factors

Substances

Antidepressive Agents

Grants and funding

Australian Government