MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Gerontology. 2018;64(1):58-66. doi: 10.1159/000477169. Epub 2017 Aug 23.
Older people with more negative attitudes to ageing are at increased risk of several adverse outcomes, including decline in physical function and increased difficulties with activities of daily living.
We investigated whether negative attitudes to ageing increase the risk of the onset or progression of frailty.
Participants were 3,505 men and women aged 60 years and over from the English Longitudinal Study of Ageing. They completed a 12-item questionnaire on attitudes to ageing. Exploratory factor analysis was used to examine the structure of these items, and a single factor was derived which we labelled "physical and psychological loss." Frailty was assessed by the Fried phenotype of physical frailty at waves 2 and 4, and by a frailty index at waves 2-5.
Having a more positive attitude to ageing as regards "physical and psychological loss" was associated with a decreased risk of becoming physically frail or pre-frail at follow-up. For a standard deviation increment in score, the relative risk ratios (95% confidence interval), adjusted for age, sex and baseline level of physical frailty, were 0.86 (0.79, 0.94) for pre-frailty and 0.72 (0.63, 0.83) for frailty. Further adjustment for other potential confounding variables had only slight attenuating effects on these associations: multivariable-adjusted relative risk ratios were 0.89 (0.81, 0.98) for pre-frailty and 0.78 (0.68, 0.91) for frailty. Attitude to ageing was not associated with change in the frailty index over time after adjustment for potential confounding variables.
Older people who have a more positive attitude to ageing are at reduced risk of becoming physically frail or pre-frail. Future research needs to replicate this finding and discover the underlying mechanisms. Attitude to ageing was not a risk factor for change in the more broadly defined frailty index.
对衰老持更消极态度的老年人面临多种不良后果的风险增加，包括身体功能下降和日常生活活动困难增加。
我们研究了对衰老的消极态度是否会增加虚弱的发生或进展的风险。
参与者为年龄在 60 岁及以上的 3505 名男性和女性，来自英国老龄化纵向研究。他们完成了一份关于对衰老态度的 12 项问卷。使用探索性因素分析来检验这些项目的结构，并得出一个我们称之为“身体和心理丧失”的单一因素。在第 2 波和第 4 波时通过 Fried 表型的身体虚弱来评估虚弱，在第 2 波-5 波时通过虚弱指数来评估。
对“身体和心理丧失”方面的衰老持有更积极的态度与随访时身体虚弱或虚弱前状态的风险降低相关。对于得分的标准偏差增量，调整年龄、性别和基线身体虚弱程度后的相对风险比（95%置信区间）分别为 0.86（0.79，0.94）的虚弱前状态和 0.72（0.63，0.83）的虚弱状态。对其他潜在混杂变量的进一步调整对这些关联仅有轻微的减弱作用：多变量调整后的相对风险比分别为 0.89（0.81，0.98）的虚弱前状态和 0.78（0.68，0.91）的虚弱状态。在调整潜在混杂因素后，对衰老的态度与时间流逝时虚弱指数的变化无关。
对衰老持更积极态度的老年人身体虚弱或虚弱前状态的风险降低。未来的研究需要复制这一发现并发现潜在的机制。对衰老的态度不是更广泛定义的虚弱指数变化的危险因素。
