The moderating role of psychological resilience in the relationship between falls, anxiety and depressive symptoms

Background: There is a greater likelihood of anxiety and depression among older adults who suffer falls. This study examined the relationships of falls and severe falls with anxiety and depressive symptoms, and the moderating role of psychological resilience on these associations. Methods: Our study recruited participants from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative cohort study. A total of 11,857 participants included in the analysis. We used a linear regression model to investigate the relationship between falls/severe falls and anxiety/depressive symptoms, adjusting for a range of potential covariates and a bootstrapping sample test to examine the potential moderating role of psychological resilience in these relationships. Results: Older adults who suffered the falls have higher anxiety/depressive symptoms (beta = 0.28 [0.23, 0.32] for anxiety symptoms, p < 0.001; beta= 0.21 [0.16, 0.25] for depressive symptoms, p < 0.001), and those who suffered the severe falls have higher anxiety/depressive symptoms (beta = 0.30 [0.24, 0.37] for anxiety symptoms, p < 0.001; beta = 0.21 [0.15, 0.27] for depressive symptoms, p < 0.001), in the fully adjusted model. The relationship between falls/severe falls and anxiety/depressive symptoms was mitigated in participants with higher levels of psychological resilience. Limitations: The present study is based on cross-sectional data, which limits the ability to infer causal relationships. Conclusions: Falls/severe falls were positively associated with anxiety and depression, and that psychological resilience could moderate this association. Our findings suggest that psychological resilience may be an effective target for intervention and prevention of fall-related symptoms of anxiety and depression.