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Psychological well-being and incident frailty in men and women: the English Longitudinal Study of Ageing

Published online by Cambridge University Press:  03 July 2013

C. R. Gale ,
C. Cooper ,
I. J. Deary  and
A. Aihie Sayer
C. R. Gale*
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, UK Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
C. Cooper
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, UK
I. J. Deary
Affiliation:
Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
A. Aihie Sayer
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, UK
*
* Address for correspondence: Dr C. R. Gale, MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK. (Email: crg@mrc.soton.ac.uk)
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Abstract

Background

Observations that older people who enjoy life more tend to live longer suggest that psychological well-being may be a potential resource for healthier ageing. We investigated whether psychological well-being was associated with incidence of physical frailty.

Method

We used multinomial logistic regression to examine the prospective relationship between psychological well-being, assessed using the CASP-19, a questionnaire that assesses perceptions of control, autonomy, self-realization and pleasure, and incidence of physical frailty or pre-frailty, defined according to the Fried criteria (unintentional weight loss, weakness, self-reported exhaustion, slow walking speed and low physical activity), in 2557 men and women aged 60 to ⩾90 years from the English Longitudinal Study of Ageing (ELSA).

Results

Men and women with higher levels of psychological well-being were less likely to become frail over the 4-year follow-up period. For a standard deviation higher score in psychological well-being at baseline, the relative risk ratio (RR) for incident frailty, adjusted for age, sex and baseline frailty status, was 0.46 [95% confidence interval (CI) 0.40–0.54]. There was a significant association between psychological well-being and risk of pre-frailty (RR 0.69, 95% CI 0.63–0.77). Examination of scores for hedonic (pleasure) and eudaimonic (control, autonomy and self-realization) well-being showed that higher scores on both were associated with decreased risk. Associations were partially attenuated by further adjustment for other potential confounding factors but persisted. Incidence of pre-frailty or frailty was associated with a decline in well-being, suggesting that the relationship is bidirectional.

Conclusions

Maintaining a stronger sense of psychological well-being in later life may protect against the development of physical frailty. Future research needs to establish the mechanisms underlying these findings.

Keywords

Ageingcohortfrailtylongitudinal studypsychological wellbeing
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 4 , March 2014 , pp. 697 - 706
Copyright
Copyright © Cambridge University Press 2013 

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References

Andrew, MK, Fisk, JD, Rockwood, K (2012). Psychological well-being in relation to frailty: a frailty identity crisis? International Psychogeriatrics 24, 1347–1353.CrossRefGoogle ScholarPubMed
Avila-Funes, JA, Helmer, C, Amieva, H, Barberger-Gateau, P, Le Goff, M, Ritchie, K, Portet, F, Carriere, I, Tavernier, B, Gutierrez-Robledo, LM, Dartigues, JF (2008). Frailty among community-dwelling elderly people in France: the three-city study. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 63, 1089–1096.Google Scholar
Baltes, PB, Baltes, MM (1990). Successful Aging: Perspectives from the Behavioral Sciences. Cambridge University Press: New York.Google Scholar
Bandeen-Roche, K, Xue, QL, Ferrucci, L, Walston, J, Guralnik, JM, Chaves, P, Zeger, SL, Fried, LP (2006). Phenotype of frailty: characterization in the Women's Health and Aging Studies. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 61, 262–266.CrossRefGoogle ScholarPubMed
Banks, J, Karlsen, S, Oldfield, Z (2003). Socio-economic position. In Health, Wealth and Lifestyles of the Older Population in England (ed. Marmot, M., Banks, J., Blundell, R., Lessof, C. and Nazroo, J.), pp. 71–125. Institute for Fiscal Studies: London.Google Scholar
Barzilay, JI, Blaum, C, Moore, T, Xue, QL, Hirsch, CH, Walston, JD, Fried, LP (2007). Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. Archives of Internal Medicine 167, 635–641.Google Scholar
Baylis, D, Bartlett, DB, Syddall, HE, Ntani, G, Gale, CR, Cooper, C, Lord, JM, Sayer, AA (2013). Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people. Age (Dordrecht, Netherlands) 35, 963–971.Google Scholar
Bergman, H, Ferrucci, L, Guralnik, J, Hogan, DB, Hummel, S, Karunananthan, S, Wolfson, C (2007). Frailty: an emerging research and clinical paradigm – issues and controversies. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 62, 731–737.CrossRefGoogle ScholarPubMed
Bouillon, K, Sabia, S, Jokela, M, Gale, CR, Singh-Manoux, A, Shipley, MJ, Kivimaki, M, Batty, GD (2012). Validating a widely used measure of frailty: are all sub-components necessary? Evidence from the Whitehall II cohort study. Age (Dordrecht, Netherlands). Published online 8 July 2012 . doi:10.1007/s11357–012–9446–2.Google Scholar
Boyle, PA, Buchman, AS, Bennett, DA (2010). Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons. American Journal of Geriatric Psychiatry 18, 1093–1102.Google Scholar
Brayne, C, Nickson, J, McCracken, C, Gill, C, Johnson, AL (1998). Cognitive function and dementia in six areas of England and Wales: the distribution of MMSE and prevalence of GMS organicity level in the MRC CFA study. Psychological Medicine 28, 319–335.Google Scholar
Chida, Y, Steptoe, A (2008). Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosomatic Medicine 70, 741–756.Google Scholar
Collins, AL, Goldman, N, Rodriguez, G (2008). Is positive well-being protective of mobility limitations among older adults? Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 63, 321–327.Google Scholar
Cooper, R, Stafford, M, Hardy, R, Aihie Sayer, A, Ben-Shlomo, Y, Cooper, C, Craig, L, Deary, IJ, Gallacher, J, McNeill, G, Starr, JM, Kuh, D, Gale, CR, on behalf of the HALCyon study team (in press). Physical capability and subsequent positive mental wellbeing in older people: findings from five HALCyon cohorts. Age (Dordrecht, Netherlands).Google Scholar
Espinoza, SE, Jung, I, Hazuda, H (2012). Frailty transitions in the San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society 60, 652–660.Google Scholar
Fillit, H, Butler, RN, Fillit, H, Butler, RN (2009). The frailty identity crisis. Journal of the American Geriatrics Society 57, 348–352.Google Scholar
Fried, LP, Tangen, CM, Walston, J, Newman, AB, Hirsch, C, Gottdiener, J, Seeman, T, Tracy, R, Kop, WJ, Burke, G, McBurnie, MA (2001). Frailty in older adults: evidence for a phenotype. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 56, M146–M156.Google Scholar
Gale, CR, Baylis, D, Cooper, C, Sayer, AA (2013). Inflammatory markers and incident frailty in men and women: the English Longitudinal Study of Ageing. Age (Dordrecht, Netherlands). Published online 2 April 2013 . doi:10.1007/s11357–013–9528–9/.CrossRefGoogle ScholarPubMed
Gerstorf, D, Lovden, M, Rocke, C, Smith, J, Lindenberger, U (2007). Well-being affects changes in perceptual speed in advanced old age: longitudinal evidence for a dynamic link. Developmental Psychology 43, 705–718.Google Scholar
Gill, TM, Gahbauer, EA, Allore, HG, Han, L (2006). Transitions between frailty states among community-living older persons. Archives of Internal Medicine 166, 418–423.Google Scholar
Graig, R, Deverill, C, Pickering, K (2006). Quality control of blood, saliva and urine analytes. In Health Survey for England 2004, Methodology and Documentation, vol. 2 (ed. Spronston, K. and Mindell, J.), pp. 34–41. The Information Centre: London.Google Scholar
Hyde, M, Wiggins, RD, Higgs, P, Blane, DB (2003). A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Aging and Mental Health 7, 186–194.Google Scholar
Joint Health Surveys Unit (2007). Health Survey for England Physical Activity Validation Study: Substantive Report. Information Centre for Health and Social Care: Leeds.Google Scholar
Kiecolt-Glaser, JK, McGuire, L, Robles, TF, Glaser, R (2002). Emotions, morbidity, and mortality: new perspectives from psychoneuroimmunology. Annual Review of Psychology 53, 83–107.Google Scholar
Levy, BR, Slade, MD, Kasl, SV (2002). Longitudinal benefit of positive self-perceptions of aging on functional health. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 57, 409–417.Google Scholar
Marmot, M, Nazroo, J, Banks, J, Blundell, R, Erens, B, Lessof, C, Huppert, FA (2011). English Longitudinal Study of Ageing: Wave 0 (1998, 1999 and 2001) and Waves 1–4 (2002–2009) [computer file]. 15th Edition. SN: 5050. UK Data Archive [distributor]: Colchester, Essex.Google Scholar
Ostir, GV, Berges, IM, Ottenbacher, ME, Clow, A, Ottenbacher, KJ (2008). Associations between positive emotion and recovery of functional status following stroke. Psychosomatic Medicine 70, 404–409.Google Scholar
Ostir, GV, Markides, KS, Black, SA, Goodwin, JS (2000). Emotional well-being predicts subsequent functional independence and survival. Journal of the American Geriatrics Society 48, 473–478.Google Scholar
Ostir, GV, Ottenbacher, KJ, Markides, KS (2004). Onset of frailty in older adults and the protective role of positive affect. Psychology and Aging 19, 402–408.Google Scholar
Park-Lee, E, Fredman, L, Hochberg, M, Faulkner, K (2009). Positive affect and incidence of frailty in elderly women caregivers and noncaregivers: results of Caregiver-Study of Osteoporotic Fractures. Journal of the American Geriatrics Society 57, 627–633.CrossRefGoogle ScholarPubMed
Puts, MT, Visser, M, Twisk, JW, Deeg, DJ, Lips, P (2005). Endocrine and inflammatory markers as predictors of frailty. Clinical Endocrinology (Oxford) 63, 403–411.Google Scholar
Reiner, AP, Aragaki, AK, Gray, SL, Wactawski-Wende, J, Cauley, JA, Cochrane, BB, Kooperberg, CL, Woods, NF, Lacroix, AZ (2009). Inflammation and thrombosis biomarkers and incident frailty in postmenopausal women. American Journal of Medicine 122, 947–954.CrossRefGoogle ScholarPubMed
Rockwood, K, Bergman, H (2012). FRAILTY: A Report from the 3(rd) Joint Workshop of IAGG/WHO/SFGG, Athens, January 2012. Canadian Geriatrics Journal 15, 31–36.Google Scholar
Rockwood, K, Fox, RA, Stolee, P, Robertson, D, Beattie, BL (1994). Frailty in elderly people: an evolving concept. Canadian Medical Association Journal 150, 489–495.Google Scholar
Rodríguez-Mañas, L, Féart, C, Mann, G, Viña, J, Chatterji, S, Chodzko-Zajko, W, Gonzalez-Colaço Harmand, M, Bergman, H, Carcaillon, L, Nicholson, C, Scuteri, A, Sinclair, A, Pelaez, M, Van der Cammen, T, Beland, F, Bickenbach, J, Delamarche, P, Ferrucci, L, Fried, LP, Gutiérrez-Robledo, LM, Rockwood, K, Rodríguez Artalejo, F, Serviddio, G, Vega, E; FOD-CC group (Appendix 1) (2013). Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 68, 62–67.CrossRefGoogle ScholarPubMed
Roth, M, Huppert, FA, Mountjoy, CQ, Tym, E (1999). The Revised Cambridge Examination for Mental Disorders of the Elderly. Cambridge University Press: Cambridge.Google Scholar
Rowe, JW, Kahn, RL (1998). Successful Aging: The MacArthur Foundation Study. Pantheon Books: New York.Google Scholar
Royston, P (2004). Multiple imputation of missing values. Stata Journal 4, 227–241.Google Scholar
Steel, N, Huppert, FA, McWilliams, BMD (2003). Physical and cognitive function. In Health, Wealth and Lifestyles of the Older Population in England: The 2002 English Longitudinal Study of Ageing (ed. Marmot, M., Banks, J., Blundell, R., Lessof, C. and Nazroo, J.), pp. 249–300. Institute for Fiscal Studies: London.Google Scholar
Steffick, DE and the HRS Health Working Group (2000). Documentation of Affective Functioning Measures in the Health and Retirement Study. HRS/AHEAD Documentation Report DR-005 (hrsonline.isr.umich.edu/sitesdocs/userg/dr_005.pdf). Accessed 5 November 2012.Google Scholar
Steptoe, A, Breeze, E, Banks, J, Nazroo, J (2012 a). Cohort Profile: The English Longitudinal Study of Ageing. International Journal Epidemiology. Published online 9 November 2012 . doi:10.1093/ije/dys168.Google Scholar
Steptoe, A, Demakakos, P, de Oliviera, C, Wardle, J (2012 b). Distinctive biological correlates of positive psychological well-being in older men and women. Psychosomatic Medicine 74, 501–508.Google Scholar
Steptoe, A, Dockray, S, Wardle, J (2009). Positive affect and psychobiological processes relevant to health. Journal of Personality 77, 1747–1776.Google Scholar
Syddall, H, Roberts, HC, Evandrou, M, Cooper, C, Bergman, H, Aihie, SA (2010). Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study. Age and Ageing 39, 197–203.Google Scholar
Taylor, R, Conway, L, Calderwood, L, Lessof, C (2003). Methodology. In Health, Wealth and Lifestyles of the Older Population in England: The 2002 English Longitudinal Study of Ageing (ed. Marmot, M., Banks, J., Blundell, R., Lessof, C. and Nazroo, J.), pp. 357–374. Institute for Fiscal Studies: London.Google Scholar
Walston, J, Hadley, EC, Ferrucci, L, Guralnik, JM, Newman, AB, Studenski, SA, Ershler, WB, Harris, T, Fried, LP (2006). Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society 54, 991–1001.Google Scholar