Association between Depression and Postural Balance in Older Adults with Knee Osteoarthritis in Saudi Arabia: A Cross-Sectional Study

Background: Several studies examined the reciprocal relationship between knee osteoarthritis (KOA), depression, and postural balance separately; however, few studies have investigated the relationship between them. Therefore, this study aimed to identify the relationship between postural balance and depression among patients with KOA in Saudi Arabia. Methods and Results: A total of 71 patients with KOA were recruited (36 males, 35 females) with a mean age of 55.0 +/- 8.6 years, mean knee pain of 7.2 +/- 1.0, and mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) of 44.9 +/- 11.6. Depression was measured using the Hospital Anxiety and Depression Scale (HADS). The participants were asked to complete the HADS, rate their pain in both knees using the Visual Analogue Scale (VAS) and the WOMAC, and undergo the Berg Balance Scale (BBS) to assess the postural balance. A significantly strong negative correlation was observed between postural balance and anxiety and depression in all the participants (BBS and HADS: r=-0.920, P<0.001), as well as a significant negative correlation between knee pain and postural balance (VAS and BBS: r=-0.26, P=0.029) Conclusion: Decrease in postural balance was associated with a higher level of anxiety and depression in addition to knee pain among patients with KOA.