Psychological Distress and Fall Risk in Patients with Diabetes

  • Research type

    Research Study

  • Full title

    Does Psychological Distress Predispose Fall Risk in Patients with Diabetes?

  • IRAS ID

    217980

  • Contact name

    Neil Reeves

  • Contact email

    n.reeves@mmu.ac.uk

  • Sponsor organisation

    Manchester Metropolitan University

  • Duration of Study in the UK

    0 years, 5 months, 31 days

  • Research summary

    Research Summary

    People with diabetes may be less active than individual’s without diabetes. This may be due to various additional complications that some people develop, which impact upon an individual’s ability to remain active as well as having psychological implications which may also reduce a person’s activity levels. Lower activity levels are associated with a deterioration of physical capabilities, as well as quality of life. Therefore, we want to investigate some of the factors that may or may not impact upon activity levels, in order to better understand why people may reduce their activity levels in certain conditions. Specifically, we want to investigate the relationship between: depressive symptoms, history of falling and fear of sustaining falls upon daily activity. These factors will be assessed through the use of questionnaires and activity monitors. By doing this we aim to identify factors that are directly linked to activity levels in people with diabetes resulting in better understanding of the condition and more effective, targeted treatment, ultimately leading to better physical and emotional functioning and quality of life.

    Summary of Results

    This cross-sectional study explored relationships between physical and psychosocial variables. Physical variables were Diabetic Peripheral Neuropathy (DPN) related-unsteadiness and physical activity (PA) levels. Psychosocial variables were depression, fear of falling (FoF), and QoL outcomes. The results indicate that quality of life (NeuroQoL) and depression (Hospital Anxiety and Depression Scale) are strongly associated with objective DPN-related unsteadiness (Berg Balance test: r=-.64, p=.01 & r=.63, p=.01; respectively) and FoF (Falls Self-Efficacy Scale: r=.61, p=.02 & r=-.55 p=.03; respectively). Moreover, DPN related-unsteadiness (Berg balance score: 47 ±6) and FoF were associated with reduced vigorous exercise PA levels (r=.53, p=.04 and r=-.51, p=.05; respectively), as well as total moderate PA levels (r=-.45, p=.09 and r=.45, p=.09; respectively); measured by the General Practice Assessment Questionnaire. Finally, FoF correlated strongly with DPN-unsteadiness (r=-0.79, p<0.001), demonstrating a potential reason why balance impairment may have the negative impact upon PA and QoL. These results support the strong links between the biomechanical impact of DPN and psychosocial outcomes, including depression and fear of falling, and reduced QoL. These data indicate that there is an unmet need for the development of multifaceted interventions that address both psychological distress and biomechanical challenges experienced by patients with this debilitating complication of diabetes.

  • REC name

    East of Scotland Research Ethics Service REC 2

  • REC reference

    17/ES/0020

  • Date of REC Opinion

    7 Apr 2017

  • REC opinion

    Further Information Favourable Opinion