How does ageism influence frailty? A preliminary study using a structural equation model

Bo Ye,Hua Fu,Junling Gao,Ming Gu,Hao Chen,Wenjing Dong

doi:10.1186/s12877-020-01749-8

Abstract

BackgroundBased 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).MethodsA 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.ResultsEA 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).ConclusionsThese 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.

Highlights

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)
The risk of frailty increased with age, and the prevalence of frailty was more likely to be reported by those whose education were below junior high school, those who were unmarried, and those who lived alone
The Cronbach’s alpha of each sub/scale were greater than .80, and the model fit indices of confirmatory factor analysis (CFA) indicated good model fit of these two measurement models after linking the covariant residuals by double arrows according to their M.I

Summary

Introduction

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). 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 [1,2,3]. It is regarded as a modern geriatric giant and a major public health problem in the ageing population [3]. A longitudinal study showed that older adults’ attitudes to ageing had a significant prediction on physical frailty status [4] 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 [6,7,8]

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