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Den Ching Angel Lee is an Adjunct Research Fellow at the Department of Physiotherapy, Monash University and Specialist Advisor in Physiotherapy with ACH Group. Her research interests are prevention of accidental falls by older adults, evidence-based practice by health professionals, rehabilitation and gerontology. She has published nine peer reviewed journal articles during 2013 to 2017.

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Background & Aim: Clinical depression affects approximately 15% of community dwelling older adults, of which half of these cases are present in later life. Falls and depressive symptoms are thought to coexist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls and participation in physical activities amongst older adults recently discharged following extended hospitalization.

Methods: A prospective cohort study in which 311 older adults surveyed prior to hospital discharge were assessed monthly post discharge for six months. N=218 completed the six month follow up. Participants were recruited from hospitals in Melbourne, Australia. The survey instrument used was designed based on Fiske’s behavioral model depicting onset and maintenance of depression. The baseline survey collected data on self-reported falls, physical activity levels and depressive symptoms. The monthly follow up surveys repeated measurement of these outcomes.

Results: At any assessment point, falls were positively associated with depressive symptoms, depressive symptoms were negatively associated with physical activity levels and physical activity levels were negatively associated with falls. When compared with data in the subsequent assessment point, depressive symptoms were positively associated with falls reported over the next month [unadjusted OR: 1.20 (1.12, 1.28)] and physical activity levels were negatively associated with falls reported over the next month [unadjusted OR: 0.97 (0.96, 0.99) household and recreational], both indicating a temporal relationship.

Conclusion: Falls, physical activity and depressive symptoms were inter-associated and depressive symptoms and low physical activity levels preceded falls. Clear strategies for management of these inter connected problems remain elusive.

Recent publications

1 .Lee D C A (2016) Are older adults receiving evidence-based advice to prevent falls post-discharge. Hospital Health Education Journal; 75(4): 448-463.

  1. Lee D C A (2015) Investigation of Older Adults' Participation in Exercises Following Completion of a State-wide Survey Targeting Evidence based Falls Prevention Strategies, Journal of Aging and Physical Activity; 23(2): 256-263.

Lee D C A (2014) Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis. Health Education Journal; 73(5): 530-544


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