title: Do psychosocial resources modify the effects of frailty on functional decline and mortality?
abstract: OBJECTIVE
  Little is known about factors that may prevent or delay adverse health outcomes in frail older adults. Previous studies have demonstrated beneficial effects of psychosocial resources on health outcomes in older adults. The aim of this study was to investigate whether psychosocial resources modify the effects of frailty on functional decline and mortality.
  
  
  METHODS
  The study sample consisted of 1665 men and women aged 58 and over from two waves of the Longitudinal Aging Study Amsterdam (LASA), a population based study. Frailty and psychosocial resources were assessed at T1 (2005/2006). Frailty was assessed using the criteria of Fried's phenotype. Psychosocial resources included sense of mastery, self-efficacy, instrumental support and emotional support. Functional decline and mortality were assessed at T2 (2008/2009).
  
  
  RESULTS
  Results of logistic regression analyses demonstrated that frail older adults had higher odds of both functional decline (OR=2.63, 95% CI=1.61-4.27) and 3-year mortality (OR=3.17, 95% CI=1.95-5.15). After adjustment for covariates, higher levels of mastery and self-efficacy were associated with decreased odds of functional decline, but not mortality. No statistically significant interaction effects between frailty and psychosocial resources were found for either functional decline or mortality.
  
  
  CONCLUSIONS
  This study found no evidence that psychosocial resources buffer against functional decline and mortality in frail older adults.
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: e.hoogendijk@vumc.nl.
authors.forename: Emiel O
authors.initials: EO
authors.lastname: Hoogendijk
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hein P J
authors.initials: HP
authors.lastname: van Hout
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriëtte E
authors.initials: HE
authors.lastname: van der Horst
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dinnus H M
authors.initials: DH
authors.lastname: Frijters
authors.affiliation: School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Elsa
authors.initials: E
authors.lastname: Dent
authors.affiliation: Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.affiliation: Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Sociology, VU University, Amsterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Huisman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D020377:Self Efficacy; D012944:Social Support; D012959:Socioeconomic Factors
keywords: Frail elderly; Functional decline; Mastery; Mortality; Self-efficacy