# Longitudinal Association Between Falls and Depressive Symptoms Among Community-Dwelling Older Adults in China

## TL;DR

This study finds that falls in older adults are linked to increased depressive symptoms, with social adaptation and urban residence playing key roles.

## Contribution

The study identifies a longitudinal link between falls and depression in older adults and explores mediating and moderating factors in China.

## Key findings

- Falls are positively associated with depressive symptoms in older adults (β = 0.625, p < 0.001).
- Social adaptation partially mediates the relationship, accounting for 8.91% of the effect.
- Urban older adults experience stronger effects of falls on depression compared to rural residents (β = 0.320, p < 0.01).

## Abstract

Purpose: Falls and depression in later life are both public health concerns. The current study aimed to establish the longitudinal link between falls and depressive symptoms among community-dwelling older adults in China. Moreover, the potential mediating role of social adaptation and moderating role of hukou (i.e., household registration system) were explored. Methods: Data were from four consecutive waves of a nationwide, longitudinal survey of community-dwelling older adults in China, encompassing a total of 31,526 person-year observations from 11,092 individual older adults. Both falls and depressive symptoms were self-reported. Random effects regression models were used to estimate the longitudinal association between falls and depressive symptoms. Mediation analysis and moderation were further employed to investigate the mediating role of social adaptation and moderating role of hukou, respectively. Results: We observed a positive longitudinal association between falls and depressive symptoms (β = 0.625 p < 0.001). Social adaptation played a partial mediating role, accounting for 8.91% (95% CI [0.037, 0.075]) of the association. Compared with their rural counterparts, urban older adults experienced significantly higher effects of falls on depression (β = 0.320, p < 0.01). Conclusions: These findings underscore the benefits of fall prevention interventions for elderly depression and advance our understanding of the psychosocial pathways linking falls to psychological outcomes in older adults.