MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK.
J Gerontol B Psychol Sci Soc Sci. 2011 Jul;66(4):468-77. doi: 10.1093/geronb/gbr049.
To investigate whether 3 positive psychological characteristics, related to sense of control, modify the associations of physical performance levels with subsequent functional decline and institutionalization.
One thousand five hundred and thirty-two men and women participating in the Longitudinal Aging Study Amsterdam and not living in an institution in 2005-2006 were included. Mastery, self-efficacy, investment in independence, and objective physical performance scores were ascertained in 2005-2006. Functional decline and institutionalization were assessed after 3 years of follow-up.
The association between lower physical performance levels and increased odds of functional decline was modified by investment in independence, with a weaker association found among people with higher investment in independence scores than in people with lower scores even after adjustment for covariates. The association between lower physical performance levels and higher odds of institutionalization was marginally weaker among those people with above median levels of mastery (test of interaction p = .08). In men, an association between general self-efficacy and functional decline was found and maintained after adjustments.
Positive psychological characteristics, related to sense of control, play a role in the transition between stages in the disablement process. Specific psychological characteristics may be associated with different stages of the disablement process and may in turn be affected by disablement.
探讨与控制感相关的 3 种积极心理特征是否能改变身体机能水平与随后的功能下降和住院之间的关联。
本研究纳入了 1532 名男性和女性，他们参加了阿姆斯特丹纵向老龄化研究，且在 2005-2006 年期间没有住在养老院里。2005-2006 年期间确定了掌握能力、自我效能感、独立投资和客观身体机能评分。在 3 年的随访后评估了功能下降和住院情况。
较低的身体机能水平与功能下降风险增加之间的关联，因独立投资而发生改变，在独立投资得分较高的人群中，这种关联比得分较低的人群更弱，即使在调整了协变量后也是如此。在那些掌握能力处于中值以上的人群中，较低的身体机能水平与更高的住院风险之间的关联则略有减弱（交互作用检验 p =.08）。在男性中，一般自我效能感与功能下降之间存在关联，且在调整后仍然存在。
与控制感相关的积极心理特征在失能过程的不同阶段之间的转变中起着作用。特定的心理特征可能与失能过程的不同阶段相关联，并可能反过来受到失能的影响。
