Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 69, Issue 12, Pages 3507-3518Publisher
WILEY
DOI: 10.1111/jgs.17417
Keywords
behavior change; healthy aging; personal mastery; stress response
Categories
Funding
- NIH/NIA [UH2UH3 AG056933-02]
- NIH/NINR [3P30NR018093]
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This study found that older adults with low self-efficacy have a higher risk of developing frailty over a 7-year period, suggesting that self-efficacy may be a key factor to consider in frailty research and interventions.
Background Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable. Self-efficacy is associated with improved health behavior and decreased chronic disease burden. Its relationship to frailty is unknown. The purpose of this study was to evaluate whether a general self-efficacy proxy predicts incident frailty. Methods A nationally representative sample of 4825 U.S. older adults aged 65 and older living in the community or non-nursing home care setting enrolled in the National Health and Aging Trends Study from 2011 to 2018 was used. Self-efficacy was dichotomized into low and high groups using the one-item self-efficacy proxy measure. The Physical Frailty Phenotype was used to categorize participants as frail and non-frail. A discrete time hazard model using data from eight rounds was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education, and income. Model 2 contained Model 1 covariates and added disability and comorbidities. Results Among people without frailty at baseline, risk of developing frailty over 7 years was increased by 41% among those with low versus high self-efficacy after adjustment for sociodemographics (P = 0.002), and by 27% after further adjustment for disability and comorbidities (P = 0.032). Conclusion This study generates a rationale to further explore self-efficacy in frailty research. Self-efficacy may be a key modifiable element to incorporate into multimodal physical frailty interventions.
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