Associations of neuroticism with falls in older adults: do psychological factors mediate the association?

OBJECTIVES: Neuroticism predicts falls in older people. In addition, concern about falling and depressive symptoms are associated with fall risk. This study examined whether concern about falling and depressive symptoms mediate the association between neuroticism and falls. METHOD: Cross-sectional data on 314 community-dwelling people aged 70-85 years were utilized. Neuroticism was assessed with a short modified form of the Eysenck Personality Inventory. Indoor and outdoor falls during the past year were self-reported. Concern about falling was assessed with the Falls Efficacy Scale-International and depressive symptoms with the Geriatric Depression Scale-15. Path modeling was used to examine the associations between variables. RESULTS: Mediating pathways linking neuroticism and falls were found: neuroticism was positively associated with concern about falling, which was subsequently linked to indoor falls (indirect effect ß = 0.34, p = 0.002) and recurrent outdoor falls (ß = 0.19, p = 0.045). Moreover, a pathway from neuroticism to indoor falls through depressive symptoms was also found (ß = 0.21, p = 0.054). In other words, higher neuroticism was associated with higher concern about falling and depressive symptoms, both of which were linked to falls. The associations were independent of age, sex, use of psychotropic, chronic diseases, persistent pain, physical performance, physical activity, and executive functioning that are known risk factors for falls. DISCUSSION: The results indicate that concern about falling and depressive symptoms mediate the association between neuroticism and falling. Longitudinal studies are needed to confirm the causality of the findings and to examine the potential to reduce falls by targeting concern about falling and depressive symptoms among older adults higher in neuroticism.

The ecosystem of human capital in care homes.

Introduction: This qualitative study addresses the essential yet often overlooked experiences of knowledge transfer within care homes (CH). Conducted in a Slovenian CH in 2020 and 2023, participants, including CH management, staff, and residents with their relatives, shared perceptions of knowledge transfer at various levels. The study aims to explore barriers and facilitators for knowledge transfer crucial for creating new knowledge, services, and enhancing care quality for older individuals. Methods: Structured focus group interviews were conducted, and data were collected within the CH. The participants' insights into knowledge transfer were probed, covering various dimensions such as between individuals, groups, organizations, and the community. Transcriptions of recorded interviews were analyzed using content analysis. Results: Knowledge transfer within the CH was facilitated through continuous training, diverse communication channels, and mentoring. Collaboration with relatives improved understanding of resident preferences, habits, and overall enhanced the quality of care. This collaborative effort allowed mutual learning and knowledge transfer from the CH to the broader community. Despite potential benefits, there is an underutilization of information and communication technology, e-care, and untapped potential for partnerships, partly due to the scarcity of care. Barriers were identified in the form of stereotypical attitudes towards aging and care, further reinforced by negative news coverage on older people's care. Conclusion: The multidimensional nature of knowledge in CH centers on resident well-being, emphasizing three key aspects of knowledge transfer: between staff and residents, staff and residents' families, and between the CH and the community. In the context of age management, creating opportunities for knowledge transfer is crucial, emphasizing a transition from traditional institutional care to an approach prioritizing knowledge about quality care. and involving experts from experiences in care process.