Department of Psychiatry, University of Rochester Medical Center.
School of Medicine and Dentistry, University of Rochester Medical Center.
Psychol Aging. 2018 May;33(3):473-481. doi: 10.1037/pag0000218. Epub 2018 Feb 15.
Mechanisms underlying prospective associations of perceived control with frailty and other health outcomes are not well understood. In the present study we used 3 waves of data from the Health and Retirement Study (N = 2,127) to test potential psychological and biological pathways linking perceived control with frailty over an 8-year period, and whether 4-year change in control predicts frailty independent of initial control. Lower odds of increasing frailty were associated with higher initial levels of perceived control (odds ratio [OR] = .74, p < .001, 95% confidence interval [CI] [.65, .83]) and a more positive change in perceived control (OR = .82, p = .006, 95% CI [.73, .92]), independent of the personality traits neuroticism and conscientiousness. In cross-lagged mediation models, the association of initial perceived control with frailty was partially mediated by positive affect, negative affect, and self-rated health, but not C-reactive protein or allostatic load. Associations of perceived control with positive and negative affect were bidirectional, with mediation in both directions. Initial frailty status was not related to 4-year change in perceived control. Perceived control may affect frailty risk through influences on affective states as well as perceived health. Findings also extend evidence that changes in perceived control may be prognostic of future health outcomes in older adults. (PsycINFO Database Record
目前尚不清楚感知控制与虚弱和其他健康结果之间的前瞻性关联的潜在机制。在本研究中，我们使用健康与退休研究（N=2127）的 3 波数据，检验了感知控制与虚弱之间的潜在心理和生物学途径，以及控制的 4 年变化是否独立于初始控制预测虚弱。与虚弱程度增加的几率较低相关的是感知控制的初始水平较高（优势比[OR]为.74，p<.001，95%置信区间[CI]为[.65，.83]）和感知控制的更积极变化（OR=.82，p=.006，95%置信区间[.73，.92]），这与神经质和尽责性这两种人格特质无关。在交叉滞后中介模型中，初始感知控制与虚弱的关联部分通过积极情绪、消极情绪和自我评估健康来介导，但 C 反应蛋白或全身负荷并不介导。感知控制与积极和消极情绪之间的关联是双向的，两个方向都存在中介作用。初始虚弱状态与感知控制的 4 年变化无关。感知控制可能会通过对情感状态和感知健康的影响来影响虚弱风险。研究结果还扩展了证据，即感知控制的变化可能对老年人未来的健康结果具有预后意义。
