Positive Affect and Incidence of Frailty in Elderly Women Caregivers and Noncaregivers: Results of Caregiver–Study of Osteoporotic Fractures

Autor: Eunice Park-Lee, Kimberly A. Faulkner, Marc C. Hochberg, Lisa Fredman
Rok vydání: 2009
Předmět:
Zdroj: Journal of the American Geriatrics Society. 57:627-633
ISSN: 1532-5415
0002-8614
DOI: 10.1111/j.1532-5415.2009.02183.x
Popis: There is mounting evidence that positive affect, defined as emotional contentment and happiness,1 has benefits for physical and psychological health. It is associated with greater independence in activities of daily living (ADLs);2–4 faster walking speed;3,4 and lower incidence of mortality,3,5 stroke,6 and frailty7 in community-dwelling elderly adults. Older adults with high positive affect also have better recovery in ADLs, walking pace, and chair stand speed after hospitalization for stroke, heart attack, and hip fracture than those with low positive affect or depressive symptoms.2,8 With respect to psychological health, adults with high positive affect report greater psychological resilience than those with low positive affect or depressive symptoms.9,10 Laboratory studies suggest that positive emotions may help people endure stress and have better health outcomes.10 Because caregivers are generally under chronic stress,11 studies comparing caregivers and noncaregivers can shed light on whether positive affect influences physical health differently in stressed and nonstressed adults. To the authors’ knowledge, no study has addressed this question under real-life circumstances. This study evaluated whether the association between positive affect and incidence of frailty differed in caregivers and noncaregivers in a multisite sample of community-dwelling elderly women. The stress-buffering model12 and “broaden and build” theory13 propose two ways that positive affect may operate in caregivers and noncaregivers. The stress-buffering model hypothesizes that positive affect serves as a buffer against the negative effects of stress. According to this model, it would be expected that a stronger benefit of positive affect would be observed in caregivers because of their higher levels of stress. The “broaden and build” theory states that positive emotions enable individuals to broaden their behavioral repertoires and draw on a wider array of physical, psychological, intellectual, and social resources in response to stress. This theory would predict that persons with high positive affect, regardless of caregiver status, would have a lower risk of health decline than those without high positive affect. Frailty is generally defined as a decline in homeostatic reserves in multiple physiological systems, resulting in greater vulnerability.14–16 Its prevalence increases from 2.5% to 4.8% in adults aged 65 to 75 to more than 30% (32–56.3%) in those aged 90 and older.17,18 Frail older adults have a greater risk of falls, disability, hospitalization, institutionalization, and death.16,19,20 Although several studies have evaluated whether depression influences the development of frailty,21,22 only one study has found that it was inversely associated with positive affect, and that study was conducted over a 7-year period.7 Thus, the short-term influence of positive affect on frailty is relatively unknown. In the present study, the hypothesis was tested that older women with high positive affect would have a lower risk of frailty over 2 years than those with low positive affect or high depressive symptoms and that high positive affect would have a greater protective effect on caregivers than on noncaregivers. A previously developed measure of positive affect 2,8 and a modified version of a previously developed index to measure frailty16 were used.
Databáze: OpenAIRE
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