Self-efficacy proxy predicts frailty incidence over time in non-institutionalized older adults.


Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
12 2021
Historique:
revised: 22 07 2021
received: 26 02 2021
accepted: 24 07 2021
pubmed: 22 8 2021
medline: 22 12 2021
entrez: 21 8 2021
Statut: ppublish

Résumé

Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable. Self-efficacy is associated with improved health behavior and decreased chronic disease burden. Its relationship to frailty is unknown. The purpose of this study was to evaluate whether a general self-efficacy proxy predicts incident frailty. A nationally representative sample of 4825 U.S. older adults aged 65 and older living in the community or non-nursing home care setting enrolled in the National Health and Aging Trends Study from 2011 to 2018 was used. Self-efficacy was dichotomized into low and high groups using the one-item self-efficacy proxy measure. The Physical Frailty Phenotype was used to categorize participants as frail and non-frail. A discrete time hazard model using data from eight rounds was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education, and income. Model 2 contained Model 1 covariates and added disability and comorbidities. Among people without frailty at baseline, risk of developing frailty over 7 years was increased by 41% among those with low versus high self-efficacy after adjustment for sociodemographics (P = 0.002), and by 27% after further adjustment for disability and comorbidities (P = 0.032). This study generates a rationale to further explore self-efficacy in frailty research. Self-efficacy may be a key modifiable element to incorporate into multimodal physical frailty interventions.

Sections du résumé

BACKGROUND
Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable. Self-efficacy is associated with improved health behavior and decreased chronic disease burden. Its relationship to frailty is unknown. The purpose of this study was to evaluate whether a general self-efficacy proxy predicts incident frailty.
METHODS
A nationally representative sample of 4825 U.S. older adults aged 65 and older living in the community or non-nursing home care setting enrolled in the National Health and Aging Trends Study from 2011 to 2018 was used. Self-efficacy was dichotomized into low and high groups using the one-item self-efficacy proxy measure. The Physical Frailty Phenotype was used to categorize participants as frail and non-frail. A discrete time hazard model using data from eight rounds was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education, and income. Model 2 contained Model 1 covariates and added disability and comorbidities.
RESULTS
Among people without frailty at baseline, risk of developing frailty over 7 years was increased by 41% among those with low versus high self-efficacy after adjustment for sociodemographics (P = 0.002), and by 27% after further adjustment for disability and comorbidities (P = 0.032).
CONCLUSION
This study generates a rationale to further explore self-efficacy in frailty research. Self-efficacy may be a key modifiable element to incorporate into multimodal physical frailty interventions.

Identifiants

pubmed: 34418062
doi: 10.1111/jgs.17417
pmc: PMC8648965
mid: NIHMS1732043
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

3507-3518

Subventions

Organisme : NIA NIH HHS
ID : UH2UH3 AG056933-02
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG032947
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG021334
Pays : United States
Organisme : NINR NIH HHS
ID : P30 NR018093
Pays : United States
Organisme : NIA NIH HHS
ID : UH3 AG056933
Pays : United States
Organisme : NINR NIH HHS
ID : 3P30NR018093
Pays : United States

Informations de copyright

© 2021 The American Geriatrics Society.

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Auteurs

Melissa D Hladek (MD)

Johns Hopkins School of Nursing, Baltimore, Maryland, USA.

Jiafeng Zhu (J)

Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Brian J Buta (BJ)

Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Sarah L Szanton (SL)

Johns Hopkins School of Nursing, Baltimore, Maryland, USA.

Karen Bandeen-Roche (K)

Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Jeremy D Walston (JD)

Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

Qian-Li Xue (QL)

Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

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Classifications MeSH