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

  • C. R. Gale (a1) (a2), C. Cooper (a1), I. J. Deary (a2) and A. Aihie Sayer (a1)
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.

Copyright
Corresponding author
* Address for correspondence: Dr C. R. Gale, MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK. (Email: crg@mrc.soton.ac.uk)
References
Hide All
Andrew MK, Fisk JD, Rockwood K (2012). Psychological well-being in relation to frailty: a frailty identity crisis? International Psychogeriatrics 24, 13471353.
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, 10891096.
Baltes PB, Baltes MM (1990). Successful Aging: Perspectives from the Behavioral Sciences. Cambridge University Press: New York.
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, 262266.
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. 71125. Institute for Fiscal Studies: London.
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, 635641.
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, 963971.
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, 731737.
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.
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, 10931102.
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, 319335.
Chida Y, Steptoe A (2008). Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosomatic Medicine 70, 741756.
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, 321327.
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).
Espinoza SE, Jung I, Hazuda H (2012). Frailty transitions in the San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society 60, 652660.
Fillit H, Butler RN, Fillit H, Butler RN (2009). The frailty identity crisis. Journal of the American Geriatrics Society 57, 348352.
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, M146M156.
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/.
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, 705718.
Gill TM, Gahbauer EA, Allore HG, Han L (2006). Transitions between frailty states among community-living older persons. Archives of Internal Medicine 166, 418423.
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. 3441. The Information Centre: London.
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, 186194.
Joint Health Surveys Unit (2007). Health Survey for England Physical Activity Validation Study: Substantive Report. Information Centre for Health and Social Care: Leeds.
Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R (2002). Emotions, morbidity, and mortality: new perspectives from psychoneuroimmunology. Annual Review of Psychology 53, 83107.
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, 409417.
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.
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, 404409.
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, 473478.
Ostir GV, Ottenbacher KJ, Markides KS (2004). Onset of frailty in older adults and the protective role of positive affect. Psychology and Aging 19, 402408.
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, 627633.
Puts MT, Visser M, Twisk JW, Deeg DJ, Lips P (2005). Endocrine and inflammatory markers as predictors of frailty. Clinical Endocrinology (Oxford) 63, 403411.
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, 947954.
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, 3136.
Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL (1994). Frailty in elderly people: an evolving concept. Canadian Medical Association Journal 150, 489495.
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, 6267.
Roth M, Huppert FA, Mountjoy CQ, Tym E (1999). The Revised Cambridge Examination for Mental Disorders of the Elderly. Cambridge University Press: Cambridge.
Rowe JW, Kahn RL (1998). Successful Aging: The MacArthur Foundation Study. Pantheon Books: New York.
Royston P (2004). Multiple imputation of missing values. Stata Journal 4, 227241.
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. 249300. Institute for Fiscal Studies: London.
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.
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.
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, 501508.
Steptoe A, Dockray S, Wardle J (2009). Positive affect and psychobiological processes relevant to health. Journal of Personality 77, 17471776.
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, 197203.
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. 357374. Institute for Fiscal Studies: London.
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, 9911001.
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Psychological Medicine
  • ISSN: 0033-2917
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