Falling and Depression among Older Adults: Explanations, Conditions and Implications

Primary author: Kyle Murphy
Co-author(s): Shane McFarland; Myah Houghten; Marie Gray; Garrett Jenkins
Faculty sponsor: Brittany Cooper

Primary college/unit: Agricultural, Human and Natural Resource Sciences
Campus: Pullman

Introduction: The present study, presented at the Society for Prevention Research (SPR) 2019 conference as part of the SPR Cup, an academic competition for early-career prevention scientists, is an award-winning study, making WSU the winner of this competition for two consecutive years. With SPR-intentions to broaden prevention science in older adults (a critically understudied population with growing needs), all teams worked with the Medicare Health Outcomes Survey Data, a longitudinal, population-level dataset 1.5 months prior to presenting. Using Anderson’s Behavioral Health Model, the goal of the present study was to assess the relationships of needs-based, enabling and environmental mechanisms/processes by which falling predicts depression in older adults. Experiencing a fall increases risk for depression, which increases risk for suicidality and nursing home admission, and is related to mobility, physical health, physical activity, and health policy.

Sample: N>50,000 adults aged 65+, cohorts 2007-2014.

Method: We employed multiple group structural equation modeling to evaluate the following: 1. Mediation of falling predicting depression through mobility and general physical health; 2. Moderated-mediation by physical activity promotion; 3. Moderated-mediation by implementation of the affordable care act (ACA; designed to enhance Medicare).

Findings/conclusions: Reduced mobility and physical health explained the relationship between falling and increased depression. This relationship was consistent, however, the associative magnitude changed by condition; individuals who reported physical activity promotion with medical professionals, and individuals post-ACA implementation, were at significantly less risk. Implications for older adults, include continued prevention research and medical practices that promote physical activity. Furthermore, ACA evaluation is warranted.