Abstract / Summary
Aim: To examine whether depression and fatigue mediate the association between sarcopenia and fear of falling in middle-aged and older adults with visual impairment, based on the biopsychosocial model.
Design: Cross-sectional secondary data analysis.
Methods: Data from 211 community-dwelling adults aged 50 years and older with visual impairment in South Korea, collected between September 2024 and March 2025, were analysed. The risks of sarcopenia, depression, fatigue, and fear of falling were measured. Serial mediation was tested using Hayes' PROCESS macro (Model 6).
Results: Sarcopenia was positively associated with depression, fatigue, and fear of falling, and its direct effect on fear of falling was significant. Depression alone did not mediate the association, whereas fatigue showed a significant indirect effect, including a serial pathway through depression and fatigue.
Conclusions: Fatigue was a key pathway linking sarcopenia to fear of falling, whereas depression alone was not. Screening for sarcopenia risk, fatigue, and depression, along with tailored interventions, is warranted.
Implications for the profession and/or patient care: When assessing fall risk in middle-aged and older adults with visual impairment, nurses should screen not only for physical function but also for sarcopenia risk, fatigue, and depression. Nurse-led interventions combining strength and balance training with fatigue and mood management may help reduce fear of falling in this population.
Impact: This study addressed how, and why, sarcopenia relates to fear of falling in adults with visual impairment. Fatigue emerged as the key pathway. The findings can help nurses and other providers develop integrated fall-prevention care for this population.
Reporting method: To strengthen the validity of the research, it was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
Patient or public contribution: No patient or public contribution, as this study involved a secondary analysis of de-identified data.