How does ageism influence frailty? A preliminary study using a structural equation model
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RESEARCH ARTICLE
Open Access
How does ageism influence frailty? A preliminary study using a structural equation model Bo Ye1, Junling Gao1*, Hua Fu2* , Hao Chen1, Wenjing Dong1 and Ming Gu1
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. Keywords: Ageism, Frailty, Experiences of ageism, Age stereotypes, Attitudes to ageing
Background Frailty is defined as a progressive age-related deterioration in physical systems that leads to extreme vulnerability to stressors and increases the risk of many adverse health outcomes or even death [1–3]. It is regarded as a modern geriatric giant and a major public health problem in the ageing population [3]. Frailty has been proved to be influenced by various of factors, which mostly in physical aspect; however, psychological factors may also play important roles in this process. * Correspondence: [email protected]; [email protected] 1 School of Public Health, Fudan University, PO Box 248, 138 Yixueyuan Road, Shanghai 200032, China 2 Fudan Health Communication Institute, School of Public Health, Fudan University, PO Box 248, 138 Yixueyuan Road, Shanghai 200032, China
Currently, a longitudinal study showed that older adults’ attitudes to ageing had a significant prediction on physical frailty status [4]. Importantly, it will increase the perceptions of older people as a burden, which may lead to a higher risk of ageism in current quick ageing world [5]. Older people who perceived ageism may have direct negative effects on their health and well-being [6–8]. Ageing process is widely assumed as an entirely physiological process of inevitable decline. Some of agebased
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