Dataset Information

Perceived Control Mediates Effects of Socioeconomic Status and Chronic Stress on Physical Frailty: Findings From the Health and Retirement Study.

ABSTRACT:

Objective

To investigate the psychosocial etiology of physical frailty by examining the influence of chronic stress and perceived control.

Method

Using population-based samples of older adults from the Health and Retirement Study, this study employed structural equation modeling in cross-sectional (N = 5,250) and longitudinal (N = 2,013) samples to estimate the effects of chronic stress and socioeconomic status (SES) on baseline frailty and change in frailty status over 4 years and the extent to which perceived control mediates or moderates effects of chronic stress.

Results

Perceived control fully mediated effects of chronic stress and partially mediated effects of SES on both baseline frailty and change in frailty. Multigroup analyses revealed that the mediating role of perceived control was consistent across age, gender, and racial/ethnic subgroups. There was no evidence to support a moderating role of perceived control in the chronic stress and frailty relationship.

Discussion

Findings provide novel evidence for a mediating role of perceived control in pathways linking SES and chronic stress to frailty, further underscoring the importance of psychosocial constructs to the development and progression of frailty in older adults.

SUBMITTER: Mooney CJ

PROVIDER: S-EPMC6146760 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Perceived Control Mediates Effects of Socioeconomic Status and Chronic Stress on Physical Frailty: Findings From the Health and Retirement Study.

Mooney Christopher J CJ Elliot Ari J AJ Douthit Kathryn Z KZ Marquis Andre A Seplaki Christopher L CL

The journals of gerontology. Series B, Psychological sciences and social sciences 20180901 7

<h4>Objective</h4>To investigate the psychosocial etiology of physical frailty by examining the influence of chronic stress and perceived control.<h4>Method</h4>Using population-based samples of older adults from the Health and Retirement Study, this study employed structural equation modeling in cross-sectional (N = 5,250) and longitudinal (N = 2,013) samples to estimate the effects of chronic stress and socioeconomic status (SES) on baseline frailty and change in frailty status over 4 years an ...[more]

PMID: 27522087

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Project description:BackgroundWith an aging population and growing number of patients with chronic kidney disease (CKD), integrating the latest risk factors when deciding on a treatment plan can result in better patient care. Frailty remains a prevalent syndrome in CKD resulting in adverse health outcomes. However, measures of frailty and functional status remain excluded from clinical decision making.ObjectiveTo examine the degree to which different measures of frailty and functional status are associated with mortality, hospitalization, and other clinical outcomes in patients with advanced CKD.DesignSystematic review.SettingObservation studies including cohort study, case-control study, or cross-sectional study examining frailty and functional status on clinical outcomes. There were no restrictions on type of setting or country of origin.PatientsAdults with advanced CKD, including both types of dialysis patients.MeasurementsData including demographic information (e.g., sample size, follow-up time, age, country), assessments of frailty or functional status and their domains, and outcomes including mortality, hospitalization, cardiovascular events, kidney function, and composite outcomes were extracted.MethodsA search was conducted using databases Medline, Embase, and Cochrane Central Register for Controlled Trials. Studies were included from inception to March 17, 2021. The eligibility of studies was screened by 2 independent reviewers. Data were presented by instrument and clinical outcome. Point estimates and 95% confidence intervals from the fully adjusted statistical model were reported or calculated from the raw data.ResultsA total of 117 unique instruments were found among 140 studies. The median sample size of studies was 319 (interquartile range, 161-893). Most studies focused on incident and chronic dialysis patient populations, with only 15% of studies examining non-dialysis CKD patients. Frailty and lower functional status were associated with an increased risk for adverse clinical outcomes such as mortality and hospitalization. The 5 individual domains of frailty were also found to be associated with poor health outcomes.LimitationsMeta-analysis could not be performed due to significant heterogeneity between studies and methods used to measure frailty and functional status. Many studies had issues with methodological rigor. Selection bias and the validity of data collection could not be ascertained for some studies.ConclusionFrailty and functional status measures should be integrated to help guide clinical care decision making for a comprehensive assessment of risk for adverse outcomes among patients with advanced CKD.Registration prosperoCRD42016045251.

Project description:IntroductionThe prevalence of frailty is increasing worldwide, emphasizing the importance of prioritizing healthy ageing. To address this, cost-effective and minimally supervised interventions are being sought. This study aimed to assess the impact of an educational program on frailty status, physical function, physical activity, sleep patterns, and nutritional status in community-dwelling older adults with at least 1 Fried's frailty criteria.MethodsA 6-month multicentre randomized controlled trial was conducted from March 2022 to February 2023 in 14 health centres located in Cadiz and Malaga, Spain. The educational intervention consisted of 4 group sessions and 6 follow-up phone calls spread over 6 months. The program focused on educating participants about frailty and its impact on health, providing guidelines for physical activity, healthy dietary habits, cognitive training, psychological well-being and social activities. A total of 163 participants, divided into control (n = 80) and educational groups (n = 83) were assessed before and after the intervention.ResultsThe results showed a significant group-time interaction in the physical function evaluated with a large effect on Short Physical Performance Battery score (η2p = 0.179, -0.1 [-1.2-1.0] points for control group vs. 1.0 [0.0-3.0] points for educational group, p < 0.001), and an effect on the 4-meter gait test ((η2p = 0.122, 0.5 [0.1-0.0] s for control group vs. -0.4 [-0.5- -0.3] s for educational group, p < 0.001), and the 5-repetition sit-to-stand test (η2p = 0.136, 1.0 [0.0-1.2] s for control group vs. -4.3 [-7.0- -2.3] for educational group, p < 0.001). Additionally, the use of accelerometers to assess physical activity, inactivity, and sleep patterns revealed a significant small effect in the number of awakenings at night ((η2p = 0.040, 1.1 [-0.5-3.4] awakenings for control group vs. 0.0 [-2.2-0.0] awakenings for educational group, p = 0.009). The findings also highlighted a significant medium effect regarding malnutrition risk, which was assessed using the Mini-Nutritional Assessment score (η2p = 0.088, -0.7 [-2.3-1.5] points for control group vs. 1.5 [-0.5-3.0] points for educational group, p < 0.001).DiscussionThus, the 6-month educational program effectively improved physical function, sleep patterns, and nutritional status compared to usual healthcare attendance in community-dwelling older adults with frailty or pre-frailty. These findings underscore the potential of minimally supervised interventions in promoting a healthy lifestyle in this vulnerable population.

Project description:BackgroundA frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ?50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries.MethodsSubjectsSHARE Wave 1 respondents (17,304 females and 13,811 males).Measuresfive SHARE variables approximating Fried's frailty definition. Analyses (for each gender): 1) estimation of a discreet factor (DFactor) model based on the frailty variables using LatentGOLD. A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail) was modelled; 2) the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3) the prospective mortality risk (unadjusted and age-adjusted) for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008) (11,384 females and 9,163 males); 4) two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements.ResultsFemales: the DFactor model included 15,578 cases (standard R2 = 0.61). All five frailty indicators discriminated well (p < 0.001) between the three classes: non-frail (N = 10,420; 66.9%), pre-frail (N = 4,025; 25.8%), and frail (N = 1,133; 7.3%). Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval) for mortality at Wave 2 was 2.1 (1.4 - 3.0) in the pre-frail and 4.8 (3.1 - 7.4) in the frail. Males: 12,783 cases (standard R2 = 0.61, all frailty indicators had p < 0.001): non-frail (N = 10,517; 82.3%), pre-frail (N = 1,871; 14.6%), and frail (N = 395; 3.1%); age-adjusted OR (95% CI) for mortality: 3.0 (2.3 - 4.0) in the pre-frail, 6.9 (4.7 - 10.2) in the frail.ConclusionsThe SHARE Frailty Instrument has sufficient construct and predictive validity, and is readily and freely accessible via web calculators. To our knowledge, SHARE-FI represents the first European research effort towards a common frailty language at the community level.

Project description:IntroductionNight sleep duration and total sleep duration are associated with frailty. However, the association between daytime nap duration and the risks of frailty has not been explored thoroughly.MethodsThis study used data from the China Health and Retirement Longitudinal Study (CHARLS). Participants aged 60 years and older at baseline were included in this study. Individuals with daytime nap duration were categorized into four groups: no napping, short napping (< 30 min), moderate napping (30-89 min), and extended napping (≥90 min). Frailty was assessed using a modified Physical Frailty Phenotype (PFP) scale. Non-frail participants at baseline were followed up for 4 years. The association between nap duration and risks of frailty at baseline and incident frailty was evaluated by logistic regression and discrete-time Cox regression analyses, respectively.ResultsIn total, 5,126 participants were included in this study. For individuals with night sleep duration of ≥9 h, short nappers showed higher odds [odds ratio (OR) = 4.08, 95% confidence interval (CI): 1.30-12.78] for frailty compared with non-habitual nappers at baseline, while moderate nappers were less likely to be frail (OR = 0.18, 95% CI: 0.04-0.73). In the follow-up study, short nappers showed higher risks for frailty compared with participants of the no napping group with night sleep duration of < 6 h [hazard ratio (HR) = 1.91, 95% CI: 1.07-3.43] or 6-9 h (HR = 1.97, 95% CI: 1.18-3.30). Compared with short nappers, older adults with extended napping (HR = 0.41, 95% CI: 0.22-0.77) showed lower risks for frailty in those with night sleep duration of 6-9 h. For individuals with night sleep duration of ≥9 h, moderate napping (HR = 0.20, 95% CI: 0.05-0.77) decreased the risks for frailty compared with short napping.ConclusionAmong older adults with night sleep duration of < 9 h, short nappers posed higher risks for frailty compared with non-habitual nappers. Extended naps for those with a night sleep duration of 6-9 h or moderate naps for those with night sleep duration of ≥9 h could lower the risk of frailty compared with short naps. Future studies on the timing, purpose, frequency, and quality of daytime napping and objectively measured nap duration are needed to explore the association between daytime napping and risks of frailty.

Dataset Information

Perceived Control Mediates Effects of Socioeconomic Status and Chronic Stress on Physical Frailty: Findings From the Health and Retirement Study.

Objective

Method

Results

Discussion

Publications

Perceived Control Mediates Effects of Socioeconomic Status and Chronic Stress on Physical Frailty: Findings From the Health and Retirement Study.

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