Physical frailty, disability, and dynamics in health perceptions: a preliminary mediation model

Abstract

Purpose

Frailty is a condition characterized by loss of functional reserve and altered homeostatic capacity. The aging process is related with complex indicators of physiological state. This study aims, with a preliminary mediation model, to reveal the possible role of mediator of health perceptions variability in the relationship between frailty and disability.

Patients and methods

A longitudinal study (100 days) was performed. Data from 92 institutionalized older adults were used in the analysis. Frailty was assessed in baseline using the Italian version of the Survey of Health, Ageing and Retirement in Europe – Frailty Instrument; health perceptions were assessed on a daily basis by three visual analog scale questions; and disability was measured in baseline and post-test using the Katz Activities of Daily Living questionnaire. The product-of-coefficient mediation approach was used to test direct and indirect effects of frailty.

Results

Results showed that daily variability of health perceptions plays the role of mediator between frailty and disability. In all the steps, statistically significant results were found.

Conclusion

This preliminary result may indicate that physical frailty increases the variability in health perceptions contributing to disability.

Keywords:

• functional decline
• loss of autonomy
• variability
• health outcomes
• dynamic systems

Acknowledgments

For the publication of this article funding has been received from the project “Sistema di allerta integrato delle fragilità emergenti” within the Regional call “Bando Regionale a sostegno di progetti di ricerca industriale e/o sviluppo sperimentale di applicazioni integrate e innovative in ambito Internet of Data” funded by Regione Piemonte and the “Fondo Europeo di Sviluppo Regionale (POR-FESR).” The funding bodies were not involved in the study design, data collection, and analysis or in writing the report.

Disclosure

Anna Mulasso and Mattia Roppolo received a research fellowship from the Department of Psychology, University of Torino (reference number 17/2015, protocol n. 320) funded by “Regione Piemonte” and the “Fondo Europeo di Sviluppo Regionale (POR-FESR)” for the project “Sistema di allerta integrato delle fragilità emergenti.” The authors report no other conflicts of interest in this work.