The Effects of Gait Speed and Psychomotor Speed on Risk for Depression and Anxiety in Older Adults with Medical Comorbidities.
Aged
Aged, 80 and over
Anxiety
/ epidemiology
Cognitive Dysfunction
/ physiopathology
Comorbidity
Depression
/ epidemiology
Disabled Persons
/ psychology
Female
Follow-Up Studies
Geriatric Assessment
/ methods
Humans
Incidence
Male
Middle Aged
Osteoarthritis, Knee
/ physiopathology
Predictive Value of Tests
Psychomotor Performance
Walking Speed
aging
cognitive function
mental illness
motor function
prevention
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
11
12
2020
received:
08
09
2020
accepted:
13
12
2020
pubmed:
3
1
2021
medline:
29
9
2021
entrez:
2
1
2021
Statut:
ppublish
Résumé
Gait speed and psychomotor speed slow with age and may predict neuropsychiatric disease such as depression and anxiety. We explored the relative predictive values of gait speed, psychomotor slowing, and a composite index of these two measures on time to new episode depression or anxiety in older adults at risk for these common psychiatric conditions. Randomized controlled prevention trial with 15-month follow-up. University-based late-life mental health research clinic. Two hundred thirteen individuals, age 60+ years, with subsyndromal symptoms of depression or anxiety and one of the following risk factors for these common conditions: mild cognitive impairment, knee osteoarthritis, or disabilities requiring home-based care. Participants in each of the risk factor groups were randomized to a depression-specific preventive intervention or usual care. Gait speed: 4-m walk test from the Short Physical Performance Battery. Psychomotor speed: Coding task of the Repeatable Battery for the Assessment of Neuropsychological Status. We created a composite index of slowing by determining whether participants exceeded established cut-offs for slow performance in both gait speed (≤0.8 m/s) and psychomotor speed (<7 on the coding task). Time to new onset syndromal depression/anxiety was measured using research diagnostic criteria. Fifty-four participants developed syndromal depression/anxiety (19.5%) over the course of 15 months. Participants with slowing in both areas were over twice as likely to experience new onset depression/anxiety (hazard ratio (HR) = 2.11; 95% confidence interval (CI) = 1.02-4.40, P = .046) compared to participants with no slowing in either area. Slowed gait (HR = 1.88; 95% CI = 0.992-3.55; P = .052) or slowed psychomotor speed (HR = 0.60; 95% CI = 0.14-2.58; P = .488) alone did not increase risk for depression/anxiety. Evaluating both gait and psychomotor speed in older adults with medical comorbidities and sub-syndromal depression may predict incident mental illness and inform prevention planning. Future research is needed to validate our observations and explore shared neurobiological mechanisms that explain this elevated risk.
Sections du résumé
BACKGROUND/OBJECTIVES
Gait speed and psychomotor speed slow with age and may predict neuropsychiatric disease such as depression and anxiety. We explored the relative predictive values of gait speed, psychomotor slowing, and a composite index of these two measures on time to new episode depression or anxiety in older adults at risk for these common psychiatric conditions.
DESIGN
Randomized controlled prevention trial with 15-month follow-up.
SETTING
University-based late-life mental health research clinic.
PARTICIPANTS
Two hundred thirteen individuals, age 60+ years, with subsyndromal symptoms of depression or anxiety and one of the following risk factors for these common conditions: mild cognitive impairment, knee osteoarthritis, or disabilities requiring home-based care.
INTERVENTION
Participants in each of the risk factor groups were randomized to a depression-specific preventive intervention or usual care.
MEASUREMENTS
Gait speed: 4-m walk test from the Short Physical Performance Battery. Psychomotor speed: Coding task of the Repeatable Battery for the Assessment of Neuropsychological Status. We created a composite index of slowing by determining whether participants exceeded established cut-offs for slow performance in both gait speed (≤0.8 m/s) and psychomotor speed (<7 on the coding task). Time to new onset syndromal depression/anxiety was measured using research diagnostic criteria.
RESULTS
Fifty-four participants developed syndromal depression/anxiety (19.5%) over the course of 15 months. Participants with slowing in both areas were over twice as likely to experience new onset depression/anxiety (hazard ratio (HR) = 2.11; 95% confidence interval (CI) = 1.02-4.40, P = .046) compared to participants with no slowing in either area. Slowed gait (HR = 1.88; 95% CI = 0.992-3.55; P = .052) or slowed psychomotor speed (HR = 0.60; 95% CI = 0.14-2.58; P = .488) alone did not increase risk for depression/anxiety.
CONCLUSION
Evaluating both gait and psychomotor speed in older adults with medical comorbidities and sub-syndromal depression may predict incident mental illness and inform prevention planning. Future research is needed to validate our observations and explore shared neurobiological mechanisms that explain this elevated risk.
Identifiants
pubmed: 33387385
doi: 10.1111/jgs.17024
pmc: PMC8279258
mid: NIHMS1714745
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1265-1271Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000005
Pays : United States
Organisme : NIMH NIH HHS
ID : P30 MH090333
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR024153
Pays : United States
Organisme : NIH HHS
ID : UL1TR000005
Pays : United States
Organisme : NIMH NIH HHS
ID : MH118270
Pays : United States
Organisme : NIMH NIH HHS
ID : MH090333
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH118270
Pays : United States
Organisme : NIH HHS
ID : UL1RR024153
Pays : United States
Informations de copyright
© 2021 The American Geriatrics Society.
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