Frailty & Depression: Mediators of Fear of Falling and Quality of Life in Older Adults
Bibliographic record
Abstract
Abstract Fear of falling is a known predictor for decreased health-related quality of life (QoL) in older adults, including among high risk frail community-dwelling older adults with multiple comorbidities including depression. The study aimed to examine the sequential explanatory roles of frailty and depressive symptoms in the relationship between fear of falling (FoF) and QoL in a program for all-inclusive care for the elderly (PACE). This was a retrospective single cohort study that included 84 older adults in a PACE program located in the Northeastern United States. Participants were cognitively intact older adults ≥55 years (M=70.33; SD=6.46). FoF was assessed with the Falls Efficacy Scale-International; frailty was measured with the Edmonton Frail Scale; QoL was measured with the Short Form 12v2 which includes both physical and mental domains. Using the Process Macro (model 6) in SPSS, path models were constructed hypothesizing frailty and depressive symptoms as serial mediators of the relationship between FoF and QoL while controlling for race, gender, age and comorbidities. Frailty and depressive symptoms serially mediated the FoF and mental QoL relationship (Indirect Effect = -0.10; 95% CI= -0.19, -0.03). Serial mediation effects of frailty and depressive symptoms were not replicated for the association between FoF and physical QoL (Indirect Effect = 0.00; 95% CI= -0.04, 0.05). Understanding the roles of frailty and depressive symptoms in explaining the association between FoF and mental health-related QoL can delineate targeted areas for intervention development not typically considered when attempting to reduce the influence of FoF on QoL in older adults.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".