Bidirectional relationship between subjective age and frailty: a prospective cohort study

Abstract

Background Subjective age refers to how young or old individuals experience themselves to be and is associated with health status, behavioral, cognitive, and biological processes that influence frailty. However, little research has examined the relationship between subjective age and frailty among older adults. This study examined the bidirectional association between subjective age and frailty among community-dwelling older adults. Methods We used data from the 2011 to 2015 waves of the National Health and Aging Trends Study. Our sample consists of 2,592 community-dwelling older adults with complete data on main outcome variables. Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust = 0, pre-frailty = 1 or 2; frailty = 3 or more criteria met. Generalized estimating equation models were used to examine the concurrent and lagged association between subjective age and frailty. Results Participants were, on average, 75.2 ± 6.8 years old, non-Hispanic whites (76 %), female (58 %). 77 % of the participants felt younger, 18 % felt the same, and 5 % felt older than their chronological age. About 45 %, 46 %, and 9 % of the participants were robust, pre-frailty and frailty in the first wave, respectively. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95 % CI = 1.93, 1.45–2.56). Conclusions These findings suggest that people with older subjective age are more likely to be pre-frail/frail. Subjective age could be used as a quick and economical screening for those who are potentially frailty or at risk for frailty.

Is Subjective Age Associated with Physical Fitness in Community-Dwelling Older Adults?

“…In previous studies, although there was no direct evidence, indirect evidence could prove that subjective age is associated with body balance and muscle endurance. For instance, Li et al [ 11 ], using a large sample of community-dwelling older people, found that adults with older subjective age than their chronological age were more likely to develop pre-frailty and frailty. It has been reported that body balance and muscle endurance, together with age and chronic diseases, are key risk factors for pre-frailty and frailty in the older population [ 29 , 30 ].…”

“…Previous studies have documented that reduced cardiopulmonary endurance is related to an increased risk of developing functional decline and cognitive impairment in older people [ 34 , 35 , 36 ]. Functional decline and cognitive impairment have been reported to more or less be associated with subjective age [ 7 , 8 , 11 ]. This implies that there is a relationship between cardiopulmonary endurance and subjective age.…”

“…In the first phase, the subjective age was collected for each participant through a face-to-face interview by an experienced researcher. The measurements for the subjective age involved in our study have been detailed in previous studies [ 11 , 15 , 16 , 17 ]. In the second phase, the physical fitness was reflected by assessing the muscle strength, balance, muscle endurance, usual gait speed, and cardiopulmonary endurance.…”

“…Subjective age has attracted growing attention in the last decade since it is shown to be related to a range of health-related outcomes in older people [ 6 ]. A great number of studies have documented that older subjective age is consistently associated with worse mental and cognitive health [ 7 , 8 ], poor sleep quality [ 9 ], lower overall functioning [ 10 , 11 ], and higher morbidity and mortality [ 12 , 13 ]. Furthermore, subjective age has been found to mediate the association between aging and a range of health-related outcomes [ 14 , 15 ].…”

What Determines That Older Adults Feel Younger Than They Are? Results From a Nationally Representative Study in Germany

“…Subjective age is an important predictor of positive health outcomes (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In a representative sample of 4,665 older community-dwelling people in Germany, the majority reported feeling younger than their chronological age.…”