Furtado Guilherme Eustáquio, Caldo Adriana, Vieira-Pedrosa Ana, Letieri Rubens Vinícius, Hogervorst Eef, Teixeira Ana Maria, Ferreira José Pedro
University of Coimbra - Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Science and Physical Education (FCDEF-UC), Coimbra, Portugal.
Multidisciplinary Research Nucleus in Physical Education (NIMEF), Physical Education Department, Federal University of Tocantins (UFT), Tocantinópolis, Brazil.
Front Psychol. 2020 Jul 16;11:1568. doi: 10.3389/fpsyg.2020.01568. eCollection 2020.
Frailty associated to core dimensions of psychological well-being (PwB) has appeared as a possible new frailty phenotype named psychological frailty, implying a parallel to physical frailty (PF). Very little is known about the associations between mental well-being, especially emotional, mood, and self-perception dimensions, and the frailty syndrome in institutionalized older populations. The present study aims to examine the interlink between the PF phenotype and the core dimensions of PwB in Portuguese institution-dwelling older women.
Cross-sectional data were collected. A total of 358 older women, aged 75 years or more, were recruited from four nursing homes within the city of Coimbra and asked to complete a sociodemographic and a general health assessment survey. The main PwB dimensions were assessed in all participants: (i) global cognitive status was assessed using The Montreal Cognitive Assessment (MoCA) Neuropsychology Test, (ii) self-perception was screened using the General Self-Efficacy Scale (GSES) and Global Self-Esteem Scale, (iii) CES-D of depression and Perceived Stress Scale (PSS) were used to screen mood states, and (iv) subjective happiness, satisfaction with life, and attitudes to aging psychometric rating scales were used to screen for emotional well-being. The syndrome of PF was assessed using Fried's PF phenotype that includes weight loss, weakness, slowness, exhaustion, and low physical activity (PA) level assessments.
Frail older women had a poor score in all PwB outcomes, except for global self-esteem and satisfaction with life. A hierarchical regression model analysis showed that global cognitive status and emotional well-being of subjective happiness and attitude to aging showed a significant negative relationship with PF in both unadjusted and adjusted models (explaining 34 and 40% of variance, respectively).
Emotional well-being and global cognitive performance are strongly associated with PF. Implementing active lifestyle interventions to improve positive psychological outcomes using geriatric assessments could assist in the older institutionalized patients' physical and mental health care.
与心理健康核心维度相关的脆弱性已表现为一种可能的新的脆弱性表型，称为心理脆弱，这意味着它与身体脆弱（PF）并行。关于心理健康，尤其是情绪、心境和自我认知维度与机构化老年人群体中的脆弱综合征之间的关联，我们知之甚少。本研究旨在探讨葡萄牙机构养老老年女性中PF表型与心理健康核心维度之间的相互联系。
收集横断面数据。从科英布拉市的四家养老院招募了总共358名75岁及以上的老年女性，并要求她们完成一份社会人口统计学和一般健康评估调查。对所有参与者评估主要的心理健康维度：（i）使用蒙特利尔认知评估（MoCA）神经心理学测试评估整体认知状态，（ii）使用一般自我效能感量表（GSES）和全球自尊量表筛查自我认知，（iii）使用抑郁自评量表（CES-D）和感知压力量表（PSS）筛查情绪状态，（iv）使用主观幸福感量表、生活满意度量表和对衰老的态度心理测量评定量表筛查情绪健康。使用Fried的PF表型评估PF综合征，该表型包括体重减轻、虚弱、行动迟缓、疲惫和低体力活动（PA）水平评估。
除了全球自尊和生活满意度外，脆弱的老年女性在所有心理健康结果方面得分都很低。分层回归模型分析表明，在未调整和调整模型中，整体认知状态以及主观幸福感和对衰老的态度方面的情绪健康与PF均呈现显著负相关（分别解释34%和40%的方差）。
情绪健康和整体认知表现与PF密切相关。通过老年评估实施积极的生活方式干预以改善积极的心理结果，可能有助于机构养老老年患者的身心健康护理。
