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Original Article
- The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly
- Hyoung-Sook Park1, Kyung-Yeon Park2
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Journal of Korean Academy of Nursing 2008;38(5):730-738.
DOI: https://doi.org/10.4040/jkan.2008.38.5.730
Published online: October 12, 2008
1Professor, College of Nursing, Pusan National University, Busan, Korea
2Full-time Lecturer, Department of Nursing, Silla University, Busan, Korea
1Professor, College of Nursing, Pusan National University, Busan, Korea
2Full-time Lecturer, Department of Nursing, Silla University, Busan, Korea
- Address reprint requests to : Park, Kyung-Yeon Department of Nursing, Silla University, San 1-1 Gwaebeop-dong, Sasang-gu, Busan 617-736, Korea Tel: 82-51-999-5461 Fax: 82-51-999-5470 E-mail: kypark@silla.ac.kr
• Received: August 14, 2008 • Revised: August 16, 2008 • Accepted: October 7, 2008
Copyright © 2008 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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Purpose
- The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly.
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Methods
- Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program.
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Results
- There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls.
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Conclusion
- For the effective management and prevention of community-dwelling older adults’ falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.
Figure 1.Mediating effect of depression in the relationship between muscle strength of extremities and falls.
Table 1.General Characteristics of Participants (N=247)
Table 2.Descriptive Statistics of Research Variables (N=247
Table 3.Correlations among Study Variables (N=247)
Table 4.Mediating Effects of Depression in the Relationship between Muscle Strength of Extremities and Falls (N=247)
| Predictors | F | β | R2 | Additional R2 | Mediating effect |
|---|---|---|---|---|---|
| Muscle strength of lower extremity (MSLE) | |||||
| Equation 1. MSLE → depression | 16.877*** | -.254*** | .064 | - | |
| Equation 2. MSLE → falls | 4.914* | -.140* | .020 | - | |
| Equation 3. Depression → falls | 9.941*** | .244*** | .075 | - | |
| MSLE → falls | -.078 | .006 | Yes | ||
| Muscle strength of left upper extremity (MSLUE) | |||||
| Equation 1. MSLUE → depression | 24.161*** | -.300*** | .090 | - | |
| Equation 2. MSLUE → falls | 7.294** | -.170** | .029 | - | |
| Equation 3. Depression → falls | 10.422*** | .234*** | .079 | - | |
| MSLUE → falls | -.100 | .009 | Yes | ||
| Muscle strength of right upper extremity (MSRUE) | |||||
| Equation 1. MSRUE → depression | 23.800*** | -.298*** | .089 | - | |
| Equation 2. MSRUE → falls | 7.966** | -.177** | .031 | - | |
| Equation 3. Depression → falls | 10.659*** | .232*** | .080 | - | |
| MSRUE → falls | -.109 | .011 | Yes |
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REFERENCES
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REFERENCES
Citations
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XML DownloadThe Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly
Figure 1. Mediating effect of depression in the relationship between muscle strength of extremities and falls.
Figure 1.
The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly
General Characteristics of Participants (N=247)
| Characteristics | n | % |
|---|---|---|
| Gender | ||
| Male | 38 | 15.4 |
| Female | 209 | 84.6 |
| Age (yr) | ||
| 65-69 | 16 | 6.5 |
| 70-79 | 138 | 55.8 |
| 80 or more | 93 | 37.7 |
| Mean±SD | 77.9±5.4 | |
| Education | ||
| None | 133 | 53.9 |
| Elementary school | 65 | 26.3 |
| Middle school or higher | 49 | 19.8 |
| Spouse | ||
| Yes | 58 | 23.5 |
| No | 189 | 76.5 |
| Living arrangement | ||
| Children offspring | 117 | 47.4 |
| Spouse | 43 | 17.4 |
| Solitude | 86 | 34.8 |
| Others | 1 | 0.4 |
| Perceived economic status | ||
| High | 6 | 2.4 |
| Middle | 120 | 48.6 |
| Low | 121 | 49.0 |
| Perceived health status | ||
| Good | 47 | 19.0 |
| Moderate | 81 | 32.8 |
| Poor | 119 | 48.2 |
| Regular exercise | ||
| Yes | 119 | 48.2 |
| No | 128 | 51.8 |
| Pre-existing chronic disease | ||
| Yes | 168 | 68.0 |
| No | 79 | 32.0 |
Descriptive Statistics of Research Variables (N=247
| Variables | Mean | SD | Actual range | Reference range |
|---|---|---|---|---|
| M. strength of lower ext. (Frequency) | 12.67 | 4.46 | 0-28 | |
| Male | 14.45 | 4.22 | 4-26 | 8-18 |
| Female | 12.35 | 4.43 | 0-28 | 8-16 |
| M. strength of upper ext. (Hand grip) | ||||
| Left hand (kg) | 14.89 | 5.66 | 0-35 | |
| Male | 21.91 | 6.58 | 0-35 | 30-40 |
| Female | 13.61 | 4.42 | 0-24 | 17-24 |
| Right hand (kg) | 15.20 | 5.50 | 0-36 | |
| Male | 21.94 | 6.21 | 0-36 | 30-40 |
| Female | 13.98 | 4.36 | 0-33 | 17-24 |
| Depression | 7.30 | 3.82 | 0-15 | 0-5 |
| Falls | ||||
| Frequency | 0.68 | 1.13 | 0-4 | |
| n | % | |||
| Yes | 84 | 34.01 | ||
| 1 | 38 | 45.24 | ||
| 2 | 20 | 23.81 | ||
| 3 | 15 | 17.86 | ||
| 4 or more | 11 | 13.10 | ||
| No | 163 | 65.99 |
M.=Muscle; Ext.=Extremities.
Correlations among Study Variables (N=247)
| M. strength. of lower ext. r (p) | M. strength of left upper ext. r (p) | M. strength of right upper ext. r (p) | Depression r (p) | Falls r (p) | |
|---|---|---|---|---|---|
| M. strength of lower ext. | |||||
| M. strength of left upper ext. | .412 (<.001) | ||||
| M. strength of right upper ext. | .444 (<.001) | .781 (<.001) | |||
| Depression | -.254 (<.001) | -.300 (<.001) | -.298 (<.001) | ||
| Falls | -.140 (.028) | -.170 (.007) | -.177 (.005) | .264 (<.001) |
M.=Muscle; Ext.=Extremities.
Mediating Effects of Depression in the Relationship between Muscle Strength of Extremities and Falls (N=247)
| Predictors | F | β | R2 | Additional R2 | Mediating effect |
|---|---|---|---|---|---|
| Muscle strength of lower extremity (MSLE) | |||||
| Equation 1. MSLE → depression | 16.877 |
-.254 |
.064 | - | |
| Equation 2. MSLE → falls | 4.914 |
-.140 |
.020 | - | |
| Equation 3. Depression → falls | 9.941 |
.244 |
.075 | - | |
| MSLE → falls | -.078 | .006 | Yes | ||
| Muscle strength of left upper extremity (MSLUE) | |||||
| Equation 1. MSLUE → depression | 24.161 |
-.300 |
.090 | - | |
| Equation 2. MSLUE → falls | 7.294 |
-.170 |
.029 | - | |
| Equation 3. Depression → falls | 10.422 |
.234 |
.079 | - | |
| MSLUE → falls | -.100 | .009 | Yes | ||
| Muscle strength of right upper extremity (MSRUE) | |||||
| Equation 1. MSRUE → depression | 23.800 |
-.298 |
.089 | - | |
| Equation 2. MSRUE → falls | 7.966 |
-.177 |
.031 | - | |
| Equation 3. Depression → falls | 10.659 |
.232 |
.080 | - | |
| MSRUE → falls | -.109 | .011 | Yes |
*p<.05
**p<.01
***p<.001.
Equation 1. IV → mediator to check beta and R2; Equation 2. IV → DV to check beta and R2 (it should be significant to test mediator effect); Equation 3. Step 1: mediator → DV to check beta and R2; Step 2: IV → DV to check beta and R2.
Table 1. General Characteristics of Participants (N=247)
Table 2. Descriptive Statistics of Research Variables (N=247
M.=Muscle; Ext.=Extremities.
Table 3. Correlations among Study Variables (N=247)
M.=Muscle; Ext.=Extremities.
Table 4. Mediating Effects of Depression in the Relationship between Muscle Strength of Extremities and Falls (N=247)
p<.05 p<.01 p<.001. Equation 1. IV → mediator to check beta and R2; Equation 2. IV → DV to check beta and R2 (it should be significant to test mediator effect); Equation 3. Step 1: mediator → DV to check beta and R2; Step 2: IV → DV to check beta and R2.
