Take-Charge Attitude Offsets Frailty For Oldest Old

November 05, 1997

University Park, Pa. --- Even for those in their 80s and 90s, physical frailty can be offset, in part, by an undimmed sense of mastery, the feeling of actively being in charge of your own life, a Penn State study has shown.

Elia E. Femia, a Penn State doctoral candidate in human development and family studies; Dr. Steven Zarit, professor of human development and assistant director of Penn State's Gerontology Center; and Dr. Boo Johansson, Penn State adjunct professor of biobehavioral health and docent at the Institute of Gerontology, University College of Health Sciences, Jonkoping, Sweden, developed the study. Their results are detailed in the November issue of the Journal of Gerontology: Psychological Sciences in a paper, "Predicting Change in Activities of Daily Living: A Longitudinal Study of the Oldest Old."

Femia, whose master's thesis forms part of the report, says, "It's a misconception that the oldest old are all the same and that decline is inevitable. There is actually a great deal of variability."

"Mastery is one of many factors that may enable a person to compensate for increasing frailty. However, eventually, there may come a time when the physical problems just can't be compensated for. But, up to a point, mastery serves as a protective effect for an older individual where an assertive attitude compensates for increasing physical decline," she explains.

Zarit adds, "We think the findings can direct researchers towards interventions that maintain a sense of mastery and an individual's aggressive attitude toward challenging situations.

"For example, moving to the protected environment of a nursing home can sometimes reinforce disability. If you can improve a person's sense of mastery, or control, it may enable them to compensate for their physical disability," he says.

The subjects in the team's study were 142 men and women, 84 to 90 years old living in South Central Sweden. Respondents were interviewed at the beginning of the study and two more times over four years. The goal was to identify factors associated with high levels of functioning at these advanced ages.

After two years, the researchers found that people living in the community, those with more positive perceptions of their own health and with higher mastery were more likely to continue functioning at high levels in their activities of daily living. These activities include housework, laundry, making the bed, cooking, grocery shopping, and using the telephone, bank and post office.

Subjective health and mastery were also related to the participants' mobility or ability to get around outdoors and indoors, go up stairs, get in and out of bed, etc., after two years. Lung capacity, as measured by the ability to blow forcefully into a tube, was also related to stability after two years.

After four years, 43 percent of the participants remained stable in their activities of daily living. Stability was associated with housing status. Most of those who remained stable lived independently in the community, rather than in sheltered housing.

Mastery continued to be associated with mobility after four years. Sixty-two percent of the participants remained stable in mobility functions after four years with those displaying higher mastery more likely to be stable.

Zarit says, "These findings show that physical frailty late in life may be offset, in part, by psycho-social resources, such as mastery, that have not diminished in time. These resources represent protective factors that may be available to help people compensate for overall decline in health and vitality."

EDITORS: Dr. Zarit is at (814) 863-9980 or z67@psu.edu by email; Ms. Femia at (814) 865-3549 or exk12@psu.edu by email.

Penn State

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