Positive affect and incidence of frailty in elderly women caregivers and noncaregivers: results of Caregiver-Study of Osteoporotic Fractures.
OBJECTIVE
To determine whether positive affect is associated with a lower incidence of frailty over 2 years in elderly community-dwelling women and to test the stress-buffering hypothesis by evaluating whether these associations differed in caregivers and noncaregivers.


METHODS
Prospective cohort study with three annual interviews conducted in four U.S. communities between 1999 and 2004.


METHODS
Home-based interviews.


METHODS
Three hundred thirty-seven caregiver and 617 noncaregiver participants from the Caregiver-Study of Osteoporotic Fractures (Caregiver-SOF) who were not frail at the baseline Caregiver-SOF interview.


METHODS
High and low positive affect and depressive symptoms were derived from the baseline 20-item Center for Epidemiologic Studies Depression Scale. Frailty was the development of three or more indicators (weight loss, exhaustion, slow walking speed, or weak grip strength) at the first or second follow-up interview.


RESULTS
Respondents' mean age was 81.2. Caregivers and noncaregivers had similar levels of positive affect (56.3% vs 58.3%) and frailty incidence (15.4% vs 15.9%) but differed in perceived stress (mean Perceived Stress Scale score 16.7 vs 14.8, P<.001). Frailty risk was lower in respondents with high positive affect than in those with low positive affect in the total sample (adjusted hazard ratio (HR)=0.49, 95% confidence interval (CI)=0.35-0.70), caregivers (adjusted HR=0.44, 95% CI=0.24-0.80) and noncaregivers (adjusted HR=0.50, 95% CI=0.32-0.77).


CONCLUSIONS
These findings add to the evidence that positive affect protects against health decline in older adults, although it had no additional stress-buffering effect on health in elderly caregivers.
Park-Lee
Eunice
E
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Fredman
Lisa
L
Hochberg
Marc
M
Faulkner
Kimberly
K
D000203:Activities of Daily Living; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D016330:Frail Elderly; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology