Emotional Well-Being and Cognitive Function Have Robust Relationship With Physical Frailty in Institutionalized Older Women

Abstract

Introduction: Frailty associated to core dimensions of psychological well-being (PwB) has appeared as a possible new frailty phenotype named psychological frailty, implying a parallel to physical frailty (PF). Very little is known about the associations between mental well-being, especially emotional, mood, and self-perception dimensions, and the frailty syndrome in institutionalized older populations. The present study aims to examine the interlink between the PF phenotype and the core dimensions of PwB in Portuguese institution-dwelling older women. Methods: Cross-sectional data were collected. A total of 358 older women, aged 75 years or more, were recruited from four nursing homes within the city of Coimbra and asked to complete a sociodemographic and a general health assessment survey. The main PwB dimensions were assessed in all participants: (i) global cognitive status was assessed using The Montreal Cognitive Assessment (MoCA) Neuropsychology Test, (ii) self-perception was screened using the General Self-Efficacy Scale (GSES) and Global Self-Esteem Scale, (iii) CES-D of depression and Perceived Stress Scale (PSS) were used to screen mood states, and (iv) subjective happiness, satisfaction with life, and attitudes to aging psychometric rating scales were used to screen for emotional well-being. The syndrome of PF was assessed using Fried's PF phenotype that includes weight loss, weakness, slowness, exhaustion, and low physical activity (PA) level assessments. Results: Frail older women had a poor score in all PwB outcomes, except for global selfesteem and satisfaction with life. A hierarchical regression model analysis showed that global cognitive status and emotional well-being of subjective happiness and attitude to aging showed a significant negative relationship with PF in both unadjusted and adjusted models (explaining 34 and 40% of variance, respectively).

Prevalência E Fatores Associados À Síndrome Da Fragilidade Em Idosos Institucionalizados: Revisão Integrativa Da Literatura

“…Os estudos apontaram maior frequência de associação da fragilidade com o aumento da idade, especialmente entre os mais longevos, com idade ≥ 80 anos (DE LA RICA-ESCUIN et al, 2014;BORGES et al, 2015;DEN UIJL et al, 2015;LUO et al, 2015;TABUE-TEGUO et al, 2015;BUCKINX et al, 2016;2018a;2018b;CESARI et al, 2016;FERREIRA et al, 2016;KAEHR et al, 2016;THEOU et al, 2016;HASAN et al, 2017;LAWRENCE et al, 2017;MARTÍNEZ-VELILLA et al, 2017;OVERBEEK et al, 2018;GE et al, 2019;FURTADO et al, 2020;LIU et al, 2020). Estima-se que, para cada ano a mais de vida, haja aumento médio de 0,8% na pontuação da fragilidade (FHON et al, 2018).…”

“…Os resultados apontaram predomínio de fragilidade no sexo feminino (DE LA RICA-ESCUIN et al, 2014;DEN UIJL et al, 2015;LUO et al, 2015;TABUE-TEGUO et al, 2015;BUCKINX et al, 2016;2018a;2018b;CESARI et al, 2016;FERREIRA et al, 2016;KAEHR et al, 2016;THEOU et al, 2016;HASAN et al, 2017;LAWRENCE et al, 2017;MARTÍNEZ-VELILLA et al, 2017;OVERBEEK et al, 2018;MURUKESU et al, 2019;FURTADO et al, 2020;LIU et al, 2020). Essa condição é verificada tanto em idosas institucionalizadas, quanto entre as residentes na comunidade, apresentando prevalência de 69,6% e 60%, respectivamente (AUGUSTI et al, 2017;MELO et al, 2018).…”

“…A polifarmácia esteve significativamente associada à fragilidade em vários estudos (BORGES et al, 2015;LUO et al, 2015;BUCKINX et al, 2016;2018a;2018b;FERREIRA et al, 2016;KAEHR et al, 2016;HASAN et al, 2017;FURTADO et al, 2020). Idosos que vivem em Instituições de Longa Permanência apresentam maior número de comorbidades e, por consequência, fazem uso simultâneo de diversos fármacos (SANTIAGO et al, 2016); ambas as situações convergem para a fragilidade.…”

“…Em relação ao estado civil, os idosos que vivem sem companheiro apresentam maior vulnerabilidade de se tornarem frágeis quando comparados àqueles que possuem um parceiro (BORGES et al, 2015;BUCKINX et al, 2016;2018a;KAEHR et al, 2016;OVERBEEK et al, 2018;GE et al, 2019;FURTADO et al, 2020;LIU et al, 2020). Em um estudo realizado por Fhon et al (2018), os idosos que não possuíam companheiro obtiveram escore médio de fragilidade de 10,4% maior do que os idosos com companheiro.…”

Dispositional Optimism and Context Sensitivity: Psychological Contributors to Frailty Status Among Elderly Outpatients

“…Moreover, loneliness, depression, and social isolation appear to be involved in the interaction between physical frailty and daily autonomy in community-dwelling older adults ( Mulasso et al, 2016 ). Psychological factors, such as social and emotional support, resilience, and emotional well-being, have been suggested as potential protective factors for physical frailty in older subjects suffering from chronic medical conditions ( Rubtsova et al, 2019 ; Yuan et al, 2020 ) and institutionalized older women ( Furtado et al, 2020 ).…”