Partner loss and its effect on frailty trajectories: results from the 13-year follow-up Survey of Health, Ageing and Retirement in Europe (SHARE)

2021 ◽  
pp. jech-2021-216637
Author(s):  
Moritz Oberndorfer ◽  
Christina Mogg ◽  
Sandra Haider ◽  
Igor Grabovac ◽  
Deborah Drgac ◽  
...  

BackgroundFrailty is a geriatric syndrome closely linked to a variety of adverse health outcomes. Thus, it is important to identify factors associated with the development of frailty. It was the aim of this study to examine, if, and to what extent partner loss, a highly stressful life event, affects frailty trajectories of community dwelling adults aged 50 or older.MethodsUsing six waves of panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigated the effect of partner loss on frailty trajectories estimating growth curve models. Our sample included 183 502 observations of 83 494 community-dwelling individuals aged 50 or older from 21 European countries collected between 2004 and 2017. Frailty was measured using the validated sex-specific SHARE-Frailty-Instrument including muscular weakness, unintended weight loss, decrease in walking capacity, low physical activity and exhaustion.ResultsOur sample contained 79 874 participants who lived in a partnership during their entire observational period and 3620 participants who lost their partner during their observational period. Both men (β=0.184 (95% CI: −0.017 to 0.386), p=0.073) and women (β=0.237 (95% CI: 0.106 to 0.369), p<0.001) showed initial effects of partner loss on frailty, but while only women gradually recovered over time (β=−0.023 (95% CI: −0.039 to −0.008), p=0.002), among men, the effect of partner loss persisted (β<0.001 (95% CI: −0.029 to 0.029), p=0.998).ConclusionThis study revealed that partner loss is followed by elevated frailty. However, while women’s frailty tended to recover from partner loss over time, men’s frailty remained elevated. Notable individual differences in the response of frailty trajectories to partner loss suggest the existence of effect modifiers.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 514-515
Author(s):  
Erfei Zhao ◽  
Eileen Crimmins ◽  
Jennifer Ailshire ◽  
Jung Ki Kim ◽  
Qiao Wu

Abstract Deterioration in kidney functioning is associated with aging and is a major risk factor for mortality and other poor health outcomes. Medicare expenses for poor kidney functioning are about 100 billion dollars every year. High Cystatin-C is an indicator of poor kidney functioning. We do not know if cystatin-C increases gradually as an individual ages. We use the Health and Retirement Study 2006/2008 Biomarker sample with follow-up for 8 years to examine this. Demographic and socioeconomic differences in trajectories of Cystatin-C trajectories were examined for 22,984 participants aged 50 and older. Growth curve models reveal that, although Cystatin-C increases with age (beta=0.025, p&lt;0.001), the annual increase varies by age (60-69 = 0.005, 70-79 = 0.013, 80+ = 0.017, p&lt;0.001), controlling for other socioeconomic variables. Cystatin-C increases faster for males than females. Cystatin-C of non-Hispanic Whites is lower than non-Hispanic Blacks but higher than Hispanics; there is no racial/ethnic difference in change over time. People who spent fewer years in school have higher Cystatin-C, and college graduates have slower growth in Cystatin-C compared to people who did not graduate from high school. These novel findings highlight the disparities in the process of kidney aging among older Americans.


2020 ◽  
Vol 4 (5) ◽  
Author(s):  
DeAnnah R Byrd ◽  
Roland J Thorpe ◽  
Keith E Whitfield

Abstract Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p &lt; .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.


2012 ◽  
Vol 25 (2) ◽  
pp. 275-285 ◽  
Author(s):  
Feng Lin ◽  
Ding-Geng Chen ◽  
David E. Vance ◽  
Karlene K. Ball ◽  
Mark Mapstone

ABSTRACTBackground: The present study examined the prospective relationships between subjective fatigue, cognitive function, and everyday functioning.Methods: A cohort study with secondary data analysis was conducted using data from 2,781 community-dwelling older adults without dementia who were enrolled to participate in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized intervention trial. Measures included demographic and health information at baseline, and annual assessments of subjective fatigue, cognitive function (i.e. speed of processing, memory, and reasoning), and everyday functioning (i.e. everyday speed and everyday problem-solving) over five years.Results: Four distinct classes of subjective fatigue were identified using growth mixture modeling: one group complaining fatigue “some of the time” at baseline but “most of the time” at five-year follow-up (increased fatigue), one complaining fatigue “a good bit of the time” constantly over time (persistent fatigue), one complaining fatigue “most of the time” at baseline but “some of the time” at five-year follow-up (decreased fatigue), and the fourth complaining fatigue “some of the time” constantly over time (persistent energy). All domains of cognitive function and everyday functioning declined significantly over five years; and the decline rates, but not the baseline levels, differed by the latent class of subjective fatigue. Except for the decreased fatigue class, there were different degrees of significant associations between the decline rates of subjective fatigue and all domains of cognitive function and everyday functioning in other classes of subjective fatigue.Conclusion: Future interventions should address subjective fatigue when managing cognitive and functional abilities in community-dwelling older adults.


2019 ◽  
Vol 30 (2) ◽  
pp. 340-346
Author(s):  
Sandra Haider ◽  
Igor Grabovac ◽  
Deborah Drgac ◽  
Christine Mogg ◽  
Moritz Oberndorfer ◽  
...  

Abstract Background Frailty is a geriatric condition associated with adverse health outcomes. As physical inactivity, low protein intake and poor social network are known risk factors, we aimed to assess the influence of these parameters and their interaction in an 11-year follow-up study on a Europe-wide level. Methods Data from the Study on Health, Ageing and Retirement in Europe were used, including 22 226 community-dwelling robust and prefrail persons aged ≥50 years, from 11 countries. Frailty was assessed with the ‘Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe’. Additionally, self-reported physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using multivariate cox regressions. Results Performing no regular PA, was associated with higher hazards ratio (HRs) for frailty compared with performing regular PA [men: 1.90 (95%CI: 1.50–2.42); women: 1.65 (95%CI: 1.25–2.18)]; HRs for low protein intake were 1.16 (95%CI: 0.93–1.46) for men and 1.05 (95%CI: 0.80–1.37) for women. And HR for poor social network were 0.92 (95%CI: 0.74–1.15) for men and 1.72 (95%CI: 1.31–2.27)] for women. In general, persons with a combination of two of the assessed risk factors had a higher risk for frailty compared with those with no or only one of the risk factors. However, no significant synergy index could be found. Conclusion The results illustrate the importance of PA, but also of nutritional and social network to prevent frailty.


Medicines ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 48
Author(s):  
Chiaki Uehara ◽  
Nobuyuki Miyatake ◽  
Shuhei Hishii ◽  
Hiromi Suzuki ◽  
Akihiko Katayama

Background: Sedentary behavior (SB) is associated with adverse health outcomes. The aim of this study was to clarify seasonal changes in SB including continuous SB (CSB) in community-dwelling Japanese adults. Methods: In this secondary analysis, a total of 65 community-dwelling Japanese adults (7 men and 58 women, 69 (50–78) years) were enrolled. SB (%), including CSB (≥30 min) as well as physical activity, were evaluated using a tri-accelerometer. The differences in these parameters between baseline (summer) and follow-up (winter) were examined. Results: %CSB and %SB at baseline were 20.5 (4.0–60.9) and 54.0 ± 11.5, respectively. CSB was significantly increased (6.6%), and SB was also increased (5.1%) at follow-up compared with baseline. In addition, there were positive relationships between changes in CSB and SB, and body weight and body mass index. Conclusions: These results suggest that there were significant seasonal changes in CSB and SB in community-dwelling Japanese adults.


2022 ◽  
Author(s):  
Thi Lien To ◽  
Ching-Pyng Kuo ◽  
Chih-Jung Yeh ◽  
Wen-Chun Liao ◽  
Meng-Chih Lee

Abstract Background: Frailty in older adults is a common geriatric syndrome that can be reversed, thus coping strategies for the aging population are essential. Self-management behaviours may represent cost-effective strategies to reverse physical frailty in community-dwelling older adults. This study aimed to describe the changes in frailty status among community-dwelling older adults in Taiwan and investigate the association of self-management behaviours with changes in frailty status over a four-year follow-up period (2007 to 2011).Methods: This data was retrieved from the Taiwan Longitudinal Study of Aging (TLSA), which is a prospective cohort study of 1,283 community-dwelling older adults aged 65 years and older without cognitive impairment. Frailty was assessed based on Fried's frailty phenotype, in which ≥ three criteria indicate frail. Self-management behaviours (maintaining body weight, quitting smoking, drinking less, exercising, diet control, and maintaining a regular lifestyle) were assessed using a questionnaire. Multivariate logistic regression analyses were used to investigate the associations between self-management behaviours and changes in frailty status.Results: The prevalence of frailty was 8.7% at baseline and 8.1% after four years of follow-up, with 196 (15.3%) deaths. Overall, 74.6% of participants remained in the same state (non-frail or frail), 23.5% worsened (non-frail to frail, including missing data, and frail to death), and only 1.95% improved (frail to non-frail). Being aged ≥ 75-years-old, chronic diseases, and an absence of self-management behaviours were associated with higher risks of frailty at baseline and after follow-up. Exercise was significantly associated with a reversal of frailty in community-dwelling older adults (RR, 3.11; 95% CI, 1.95, 4.95) after adjusting for personal and disease covariates, regardless of whether death was coded as frail or not.Conclusions: Self-management behaviours beneficially reverse frailty status; maintaining regular exercise was especially associated with a reversal of frailty in community-dwelling older adults, even among individuals over 75-years-old and with chronic diseases. Older adults should be encouraged to perform adequate physical exercise to prevent the progression of frailty and ameliorate frailty status.


2016 ◽  
Vol 33 (2) ◽  
pp. 111-119 ◽  
Author(s):  
J. E. McHugh ◽  
M. Dowling ◽  
A. Butler ◽  
B. A. Lawlor

ObjectivesPhysical health and, in particular, frailty may be associated with psychological factors among older adults. We aimed to investigate the relationships between aspects of psychological distress and progression of frailty over time among older adults.MethodsWe used a longitudinal observational study design with 624 participants aged over 60 years (mean age=72.75, s.d.=7.21, 68% female) completing a baseline comprehensive biopsychosocial geriatric assessment, and 447 returning for a follow-up assessment 2 years later. Aspects of psychological distress, physical health, and frailty were analysed for the purposes of this study. We employed a series of logistic regression analyses to determine psychological predictors of changing states of aspects of frailty over time.ResultsWith individual components of frailty, neuroticism and age predicted negative transitions of exhaustion and grip strength, respectively, whereas age alone was a predictor of transitions in overall frailty scores based on four components.ConclusionWe conclude that neuroticism and age may impact upon physical frailty and its progression over time in an ageing population. These findings may reflect the tendency for those with high levels of neuroticism to endorse negative symptoms, or alternatively, neuroticism may result in exhaustion via worry in an older population. Further research is required to further elucidate this relationship.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 573-573
Author(s):  
DeAnnah Byrd ◽  
Roland Thorpe ◽  
Keith Whitfield

Abstract The established association between stress and depression is typically examined only in one direction and cross-sectionally. Data from the Baltimore Study of Black Aging-Patterns of Cognitive Aging was used to longitudinally examine the bi-directional relationships between (1) stress-depression and (2) depression-stress, and age as a modifier. The sample consisted of 602 community-dwelling Blacks, aged 48-92 years at baseline and 450 at follow-up 33 months later. While the stress-depression relationship was non-significant; the depression-stress was (b= 0.236, p&lt; 0.000) and this association varied by age with the impact of baseline depression on changes in stress greatest among Blacks in their 60’s versus those in their 50’s (b= 0.257, p= 0.002), controlling for model covariates. Findings highlight the importance of depression in shaping Blacks’ perception of stress over time. Future work should continue to identify stress and mental health risk factors that contribute to poor health and health disparities in older Blacks.


2018 ◽  
Vol 36 (6) ◽  
pp. 1872-1891 ◽  
Author(s):  
Kyle J. Bourassa ◽  
Karen Hasselmo ◽  
David A. Sbarra

Divorce is a stressful life event that is associated with increased risk for poor mental and physical health. A key goal for research in this area is to understand individual differences in who fares well or poorly over time, and whether behavioral markers of risk immediately after a separation predict longer term adjustment. This article investigates psychological distress in a sample of separated adults ( N = 134, 84 of whom completed all follow-up assessments) who participated in an initial study and a follow-up assessment approximately 4.5 years later. Using multiple regression we examined whether two linguistic behaviors—the use of words from categories such as first-person pronouns and present tense words (verbal immediacy) and first-person plural pronouns (we-talk; e.g., “we” or “our”)—predicted self-reported psychological distress at follow-up. Increased use of first-person plural pronouns predicted greater psychological distress 4.5 years after marital separation. Additional analyses revealed that this effect was driven largely by differences in self-concept disturbance over time. The extent to which people use first-person plural pronouns following marital separation predicts increased risk for psychological distress years later, and this behavioral indicator may identify people who are at greater risk for poor adjustment over time.


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