Abstract
Frailty is a core concept in understanding vulnerability and adjustment to stress in older adults. Adopting the perspective provided by the transactional model of stress and coping (Lazarus and Folkman in Stress, appraisal, and coping, Springer, New York, 1984), the present study examined three aspects of frailty in older adults: (1) the link between frailty and perceived stress exposure (PSE); (2) the link between frailty and stress-related symptoms (SRS); and (3) the role of frailty in the link between PSE and SRS. Participants were 2711 adults aged between 64 and 101 years who were taking part in the Swiss Vivre/Leben/Vivere study. As well as assessing frailty, we measured PSE and SRS during the 4 weeks preceding the administration of the questionnaires, together with the covariates age, sex, educational attainment, language of the canton, and type of canton (urban vs. rural). Regression analyses revealed higher levels of PSE in frail older adults than in non-frail older adults. In addition, frail older adults reported more SRS than non-frail older adults. As expected, the association between PSE and SRS differed as a function of the frailty status: The positive relation between PSE and SRS being stronger for frail older adults than for non-frail older adults. These results suggest that frailty is related to perceived discrepancy between resources and demands, and to ability to cope with PSE. Our findings have implications for interventions to help frail older adults manage stress.
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Notes
The main difference is that the score we used contains two extra items measuring physical disorders. Several items were also reworded.
Two additional analyses performed separately for different age groups (the continuous age variable was recoded by assigning the value of 0 to either the younger-old or older-old group) showed that the relationship between PSE and SRS was stronger for younger-old adults for somatic symptoms – younger-old adults: β = .323, t (2686) = 11.966, p < .001; older-old adults: β = .176, t (2686) = 7.017, p < .001) and for anxiety and insomnia – younger-old adults: β = .485, t (2674) = 18.205, p < .001; older-old: β = .257, t (2674) = 10.449, p < .001). This was not the case for social dysfunction – younger-old adults: β = − .171, t (2627) = − 6.062, p < .001; older-old: β = − .176, t (2627) = − 6.831, p < .001.
References
Avila-Funes JA, Helmer C, Amieva H, Barberger-Gateau P, Le Goff M, Ritchie K, Portet F, Carrière I, Tavernier B, Gutiérrez-Robledo LM, Dartigues JF (2008) Frailty among community-dwelling elderly people in France: the three-city study. J Gerontol A Biol Sci Med Sci 63:1089–1096
Bergman H, Ferrucci L, Guralnik J et al (2007) Frailty: an emerging research and clinical paradigm-issues and controversies. J Gerontol: Med Sci 62A:731–737
Beswick AD, Rees K, Dieppe P et al (2008) Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 371:725–735
Bortz WM (2002) A conceptual framework of frailty a review. J Gerontol A Biol Sci Med Sci 57:283–288
Buchner DM, Wagner EH (1992) Preventing frail health. Clin Geriatr Med 8:1–17
Cannon WB (1929) Bodily changes in pain, hunger, fear, and rage. Appleton-Century-Crofts, New York
Chaves PH, Varadhan R, Lipsitz LA et al (2008) Physiological complexity underlying heart rate dynamics and frailty status in community dwelling older women. J Am Geriatr Soc 56:1698–1703
Clegg A, Young J, Iliffe S, Olde Rikkert M, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762
Cohen S (1986) Contrasting the Hassles Scale and the Perceived Stress Scale: Who’s really measuring appraised stress? Am Psychol 41:716–718. https://doi.org/10.1037/0003-066X.41.6.716
Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396
Dasgupta M, Rolfson DB, Stolee P, Borrie MJ, Speechley M (2009) Frailty is associated with postoperative complications in older adults with medical problems. Arch Gerontol Geriatr 48:78–83
Evans SJ, Sayers M, Mitnitski A, Rockwood K (2014) The risk of adverse outcomes in hospitalized older patients in relation to a frailty index based on a comprehensive geriatric assessment. Age Ageing 43:127–132
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:146–156
Goldberg D, Hillier VF (1979) A scaled version of the General Health Questionnaire. Psychol Med 9:139–145
Goldberg DP, Gater R, Sartorius N, Ustun T, Piccinelli M, Gureje O, Rutter C (1997) The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 27:191–197
Guilley E, Ghisletta P, Armi F, Berchtold A, Lalive d’Epinay C, Michel J-P, de Ribaupierre A (2008) Dynamics of frailty and ADL dependence in a five-year longitudinal study of octogenarians. Res Aging 30:299–317
Johar H, Emeny RT, Bidlingmaier M, Reincke M, Thorand B, Peters A, Heier M, Ladwig K-H (2014) Blunted diurnal cortisol pattern is associated with frailty: a cross-sectional study of 745 participants aged 65 to 90 years. J Clin Endocr Metab 99:464–468
Jopp DS, Schmitt M (2010) Dealing with negative life events: Differential effects of personal resources, coping strategies, and control beliefs. Eur J Ageing 7:167–180. https://doi.org/10.1007/s10433-010-0160-6
Katz S, Downs TD, Cash HR, Grotz RC (1970) Progress in development of the index of ADL. Gerontologist 10:20–30
Lalive d’Epinay C, Spini D (2008) Les années fragiles. La vie au-delà de quatre-vingts ans. Les Presses de l’Université Laval, Québec
Lazarus RS, Folkman S (1984) Stress, appraisal, and coping. Springer, New York
Lazarus RS, Folkman S (1987) Transactional theory and research on emotions and coping. Eur J Personal 1:141–169
Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM (2010) Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation 121:973–978
Ludwig C, Cavalli S, Oris M (2014) “Vivre/Leben/Vivere”: an interdisciplinary survey addressing progress and inequalities of aging over the past 30 years in Switzerland. Arch Gerontol Geriatr 59:240–248. https://doi.org/10.1016/j.archger.2014.04.004
Morley JE, Vellas B, van Kan GA et al (2013) Frailty consensus: a call to action. J Am Med Dir Assoc 14:392–397
Munz DC, Kohler JM, Greenberg CI (2001) Effectiveness of a comprehensive worksite stress management program: combining organizational and individual interventions. Int J Stress Manag 8:49–62. https://doi.org/10.1023/A:1009553413537
Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL (1994) Frailty in elderly people: an evolving concept. Can Med Assoc J 150:489–495
Rolland Y, Benetos A, Gentric A, Ankri J, Blanchard F, Bonnefoy M et al (2011) La fragilité de la personne âgée : un consensus bref de la Société française de gériatrie et gérontologie. Geriatr Psychol Neuropsychiatr Vieil 9:387–390
Selye H (1956) The stress of life. McGraw-Hill, New York. ISBN 978-0070562127
Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Mark Clarfield A (2011) The identification of frailty: a systematic literature review. J Am Geriatr Soc 59:2129–2138
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, Ershler WB, Harris T, Fried LP (2006) Research agenda for frailty in older adults: toward a better understanding of physiology and etiology—summary from the American Geriatrics Society/National Institute on Aging Research conference on frailty in older adults. J Am Geriatr Soc 54:991–1001
Acknowledgements
This publication benefited from the support of the Swiss National Centre of Competence in Research LIVES—Overcoming vulnerability: Life course perspectives, which is financed by the Swiss National Science Foundation (Grant Number: 51NF40-160590). The authors are grateful to the Swiss National Science Foundation for its financial assistance.
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Desrichard, O., Vallet, F., Agrigoroaei, S. et al. Frailty in aging and its influence on perceived stress exposure and stress-related symptoms: evidence from the Swiss Vivre/Leben/Vivere study. Eur J Ageing 15, 331–338 (2018). https://doi.org/10.1007/s10433-017-0451-2
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DOI: https://doi.org/10.1007/s10433-017-0451-2