Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Research article

How does ageism influence frailty? A preliminary study using a structural equation model

Authors: Bo Ye, Junling Gao, Hua Fu, Hao Chen, Wenjing Dong, Ming Gu

Published in: BMC Geriatrics | Issue 1/2020

Login to get access

Abstract

Background

Based on the Stereotype Embodiment Theory (SET), this study aims to examine the mechanism of ageism on frailty through the proposed framework of “Experiences of Ageism (EA) → Age Stereotypes (AS) → Attitudes to Ageing (AA) → Frailty” using a structural equation model (SEM).

Methods

A community-based study involving 630 participants aged 60 years and older was conducted in Shanghai. EA, AS, AA and frailty status were assessed by validated scales. In particular, EA included three parts in this study, as the first part was the experiences of explicit prejudice or discrimination because of age, another two parts were the experiences of witnessed and encountered implicit negative age-based stereotypes. A SEM was performed to examine whether the proposed paths from EA to frailty were supported.

Results

EA had a significant indirect effect (β’ = .360*-.456*-.576 = .095, p < .001) on frailty through the path of “EA → AS → AA → Frailty” after controlling for covariates. AA had a direct effect (β = −.576, p < .001) on frailty; AS fully mediated the association between EA and AA (indirect effect = .360*-.456 = −.164, p < .001), and AA fully mediated the association between AS and frailty (indirect effect = −.456*-.576 = .263, p < .001).

Conclusions

These findings demonstrated a mechanism from ageism to frailty, and highlighted the potential threat of negative AS on health. Ageism and frailty are both great challenges for the process of healthy ageing.
Appendix
Available only for authorised users
Literature
1.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMedCrossRef
2.
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, Ershler WB, Harris T, Fried LP. 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. 2006;54(6):991–1001.PubMedCrossRef
3.
Morley JE, Vellas B, Abellan Van Kan G, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.PubMedPubMedCentralCrossRef
4.
Gale CR, Cooper C. Attitudes to ageing and change in frailty status: the English longitudinal study of ageing. Gerontology. 2018;64(1):58–66.PubMedCrossRef
5.
North MS, Fiske ST. An inconvenienced youth? Ageism and its potential intergenerational roots. Psychol Bull. 2012;138(5):982–97.PubMedCrossRef
6.
Lyons A, Alba B, Heywood W, Fileborn B, Minichiello V, Barrett C, Hinchliff S, Malta S, Dow B. Experiences of ageism and the mental health of older adults. Aging Ment Health. 2018;22(11):1456–64.PubMedCrossRef
7.
Sabik NJ. Ageism and body esteem: associations with psychological well-being among late middle-aged African American and European American women. J Gerontol B Psychol Sci Soc Sci. 2015;70(2):191–201.PubMedCrossRef
8.
9.
10.
Levy BR, Pilver C, Chung PH, Slade MD. Subliminal strengthening: improving older individuals’ physical function over time with an implicit-age-stereotype intervention. Psychol Sci. 2014;25(12):2127–35.PubMedPubMedCentralCrossRef
11.
Lamont RA, Swift HJ, Abrams D. A review and meta-analysis of age-based stereotype threat: negative stereotypes, not facts, do the damage. Psychol Aging. 2015;30(1):180–93.PubMedPubMedCentralCrossRef
12.
Fiske ST, Cuddy AJC, Glick P, Xu J. A model of (often mixed) stereotype content: competence and warmth respectively follow from perceived status and competition. J Pers Soc Psychol. 2002;82(6):878–902.PubMedCrossRef
13.
14.
Hehman JA, Bugental DB. Responses to patronizing communication and factors that attenuate those responses. Psychol Aging. 2015;30(3):552–60.PubMedCrossRef
15.
Huang YF, Liang J, Shyu YIL. Ageism perceived by the elderly in Taiwan following hip fracture. Arch Gerontol Geriat. 2014;58(1):30–6.CrossRef
16.
17.
18.
19.
Officer A, Schneiders ML, Wu D, Nash P, Thiyagarajan JA, Beard JR. Valuing older people: time for a global campaign to combat ageism. B World Health Organ. 2016;94(10):710.CrossRef
20.
Officer A, de la Fuente-Núñez V. A global campaign to combat ageism. B World Health Organ. 2018;96(4):295–6.CrossRef
21.
22.
Bugental DB, Hehman JA. Ageism: a review of research and policy implications. Soc Issues Policy Rev. 2007;1(1):173–216.CrossRef
23.
Vauclair C, Marques S, Lima ML, Abrams D, Swift H, Bratt C. Perceived age discrimination as a mediator of the association between income inequality and older people’s self-rated health in the European region. J Gerontol Ser B Psychol Sci Soc Sci. 2015;70(6):901–12.
24.
Vauclair C, Lima ML, Abrams D, Swift HJ, Bratt C. What do older people think that others think of them, and does it matter? The role of meta-perceptions and social norms in the prediction of perceived age discrimination. Psychol Aging. 2016;31(7):699–710.PubMedPubMedCentralCrossRef
25.
Kim I, Noh S, Chun H. Mediating and moderating effects in ageism and depression among the Korean elderly: the roles of emotional reactions and coping reponses. Osong Public Health Res Perspect. 2016;7(1):3–11.PubMedCrossRef
26.
Minichiello V, Browne J, Kendig H. Perceptions and consequences of ageism: views of older people. Ageing Soc. 2000;20(3):253–78.CrossRef
27.
Levy BR, Leffheit-Limson E. The stereotype-matching effect: greater influence on functioning when age stereotypes correspond to outcomes. Psychol Aging. 2009;24(1):230–3.PubMedPubMedCentralCrossRef
28.
Cuddy AJC, Norton MI, Fiske ST. This old stereotype: the pervasiveness and persistence of the elderly stereotype. J Soc Issues. 2005;61(2):267–85.CrossRef
29.
Whitbourne SK, Sneed JR. The paradox of well-being, identity processes, and stereotype threat: ageism and its potential relationships to the self in later life. In: Nelson T, editor. Ageism: stereotyping and prejudice against older persons. Cambridge: MIT; 2004. p. 247–73.
30.
Cuddy AJC, Fiske ST. Doddering, but dear: process, content, and function in stereotyping of older persons. In: Nelson TD, editor. Ageism: Stereotyping and prejudice against older persons. Massachusetts: MIT Press; 2002. p. 3–26.
31.
32.
Kornadt AE, Rothermund K. Internalization of age stereotypes into the self-concept via future self-views: a general model and domain-specific differences. Psychol Aging. 2012;27(1):164–72.PubMedCrossRef
33.
Clement RW, Krueger J. Social categorization moderates social projection. J Exp Soc Psychol. 2002;38(3):219–31.CrossRef
34.
Rothermund K. Effects of age stereotypes on self-views and adaptation. In: Greve W, Rothermund K, Wentura D, editors. The adaptive self: personal continuity and intentional self-development. Ashland: Hogrefe & Huber Publishers; 2005. p. 223–42.
35.
Koher-Gruhn D, Hess TM. The impact of age stereotypes on self-perceptions of aging across the adult lifespan. J Gerontol B Psychol. 2012;67(5):563–71.CrossRef
36.
Levy BR, Ryall AL, Pilver CE, Sheridan PL, Wei JY, Hausdorff JM. Influence of African American elders’ age stereotypes on their cardiovascular response to stress. Anxiety Stress Copin. 2008;21(1):85–93.CrossRef
37.
Hausdorff JM, Levy BR, Wei JY. The power of ageism on physical function of older persons: reversibility of age-related gait changes. J Am Geriatr Soc. 1999;47(11):1346–9.PubMedCrossRef
38.
Levy BR. Mind matters: cognitive and physical effects of aging self-stereotypes. J Gerontol B Psychol Sci Soc Sci. 2003;58(4):P203–11.PubMedCrossRef
39.
Laidlaw K, Power MJ, Schmidt S. The attitudes to ageing questionnaire (AAQ): development and psychometric properties. Int J Geriatr Psychiatry. 2007;22(4):367–79.PubMedCrossRef
40.
Kim SH. Older people’s expectations regarding ageing, health-promoting behaviour and health status. J Adv Nurs. 2009;65(1):84–91.PubMedCrossRef
41.
Sargent-Cox KA, Anstey KJ, Luszcz MA. The relationship between change in self-perceptions of aging and physical functioning in older adults. Psychol Aging. 2012;27(3):750–60.PubMedCrossRef
42.
Kotter-Gruhn D, Kleinspehn-Ammerlahn A, Gerstorf D, Smith J. Self-perceptions of aging predict mortality and change with approaching death: 16-year longitudinal results from the Berlin aging study. Psychol Aging. 2009;24(3):654–67.PubMedCrossRef
43.
Levy BR, Slade MD, Kasl SV. Longitudinal benefit of positive self-perceptions of aging on functional health. J Gerontol B-Psychol. 2002;57(5):P409–17.CrossRef
44.
Han JN, Richardson VE. The relationships among perceived discrimination, self-perceptions of aging, and depressive symptoms: a longitudinal examination of age discrimination. Aging Ment Health. 2015;19(8):747–55.PubMedCrossRef
45.
Kim H, Thyer BA, Munn JC. The relationship between perceived ageism and depressive symptoms in later life: understanding the mediating effects of self-perception of aging and purpose in life, using structural equation modeling. Educ Gerontol. 2019;45(2):105–19.CrossRef
46.
Laidlaw K, Wang D, Coelho C, Power M. Attitudes to ageing and expectations for filial piety across Chinese and British cultures: a pilot exploratory evaluation. Aging Ment Health. 2010;14(3):283–92.PubMedCrossRef
47.
Abellan Van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A. task force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008;12(1):29–37.PubMedCrossRef
48.
49.
Woo J, Leung J, Morley JE. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc. 2012;60(8):1478–86.PubMedCrossRef
50.
Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, Woo J, Dong B, de la Vega S, Hua Poi PJ, et al. The Asia-Pacific clinical practice guidelines for the management of frailty. J Am Med Dir Assoc. 2017;18(7):564–575.51.PubMedCrossRef
51.
Woo J, Yu R, Wong M, Yeung F, Wong M, Lum C. Frailty screening in the community using the FRAIL scale. J Am Med Dir Assoc. 2015;16(5):412–9.PubMedCrossRef
52.
Muthén LK, Muthén BO. Mplus user’s guide. 8th ed. Los Angeles: Author; 1998-2017.
53.
Chen D, Yang T. The pathways from perceived discrimination to self-rated health: an investigation of the roles of distrust, social capital, and health behaviors. Soc Sci Med. 2014;104:64–73.PubMedCrossRef
54.
Turner RJ. Understanding health disparities: the relevance of the stress process model. Soc Ment Health. 2013;3(3):170–86.CrossRef
55.
Warmoth K, Tarrant M, Abraham C, Lang IA. Relationship between perceptions of ageing and frailty in English older adults. Psychol Health Med. 2018;23(4):465–74.PubMedCrossRef
56.
Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: a multilevel analysis. BMC Geriatr. 2018;18(1):314.PubMedPubMedCentralCrossRef
57.
58.
Gale CR, Cooper C, Deary IJ, Aihie SA. Psychological well-being and incident frailty in men and women: the English longitudinal study of ageing. Psychol Med. 2014;44(4):697–706.PubMedCrossRef
59.
Metadata
Title
How does ageism influence frailty? A preliminary study using a structural equation model
Authors
Bo Ye
Junling Gao
Hua Fu
Hao Chen
Wenjing Dong
Ming Gu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01749-8

Other articles of this Issue 1/2020

BMC Geriatrics 1/2020 Go to the issue

Research article

A balance between meaningfulness and risk of harm – frail elderly patients’ perceptions of physical activity and exercise – an interview study

Research article

Feasibility and acceptability of commonly used screening instruments to identify frailty among community-dwelling older people: a mixed methods study

Research article

Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: a process evaluation of a cluster-randomised pilot trial

Research article

The associations of the number of medications and the use of anticholinergics with recovery from tubal feeding: a longitudinal hospital-based study

Research article

The influence of co-residential and non-co-residential living arrangements on sufficient fruit and vegetable consumption in the aging population in Thailand

Research article

Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits