Self-management abilities and frailty are important for healthy aging among community-dwelling older people; a cross-sectional study.

Jane M Cramm,Jos Twisk,Anna P Nieboer

doi:10.1186/1471-2318-14-28

Jane M Cramm, Jos Twisk + Show 1 more

Open Access

https://doi.org/10.1186/1471-2318-14-28

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Abstract

BackgroundThis study aimed to identify the relationships of self-management abilities and frailty to perceived poor health among community-dwelling older people in the Netherlands while controlling for important individual characteristics such as education, age, marital status, and gender.MethodsThe cross-sectional study sample consisted of 869/2212 (39% response rate) independently living older adults (aged ≥70 years) in 92 neighborhoods of Rotterdam. In the questionnaires we assessed self-rated health, frailty using the Tilburg Frailty Indicator (TFI) and self-management abilities with the short version of the Self-Management Ability Scale (SMAS-S). We first used descriptive analysis to identify those in poor and good health. Differences between groups were established using chi-squared and t-tests. Relationships between individual characteristics, frailty, self-management abilities and poor health were investigated with correlation analyses. Multilevel logistic regression analyses were than performed to investigate the relationships of self-management abilities and frailty to health while controlling for age, gender, education, and marital status. The results of the multilevel regression analyses are reported as odd ratios.ResultsRespondents in poor health were older than those in good health (78.8 vs. 77.2; p ≤ .001). A significantly larger proportion of older people in poor health were poorly educated (38.4% vs. 19.0%; p ≤ .001) and fewer were married (33.6% vs. 46.3%; p ≤ .001). Furthermore, older people in poor health reported significantly lower self-management abilities (3.5 vs. 4.1; p ≤ .001) and higher levels of frailty (6.9 vs. 3.3; p ≤ .001). Correlation analyses showed significant relationships between frailty, self-management abilities and poor health. Multilevel analyses showed that, after controlling for background characteristics, self-management abilities were negatively associated with poor health (p ≤ .05) and a positive relationship was found between frailty and poor health (p ≤ .05) among older people in the community.ConclusionsSelf-management abilities and frailty are important for healthy aging among community-dwelling older people in the Netherlands. Particularly vulnerable are the lower educated older adults. Interventions to improve self-management abilities may help older people age healthfully and prevent losses as they age further.

Highlights

This study aimed to identify the relationships of self-management abilities and frailty to perceived poor health among community-dwelling older people in the Netherlands while controlling for important individual characteristics such as education, age, marital status, and gender
Gender did not differ between these two groups, but significant differences were found in age, educational level, marital status, self-management abilities, and frailty
These results clearly show significant relationships between frailty, self-management abilities and poor health

Summary

Introduction

This study aimed to identify the relationships of self-management abilities and frailty to perceived poor health among community-dwelling older people in the Netherlands while controlling for important individual characteristics such as education, age, marital status, and gender. Healthy aging is expected to depend on older peoples’ abilities to selfregulate or self-manage their lives and aging processes. These abilities depend on the physical health aspects of aging (e.g., regular exercise and healthy eating) [3,4,5], and on the social and psychological aspects of life, such as regularly socializing with friends/ family [6]. The self-management of well-being (SMW) theory [7] describes how older individuals can achieve well-being and is based on the notion that healthy aging is a lifelong process of realizing and sustaining wellbeing, even in the face of declining resources. It includes the ability to look ahead and invest in resources (e.g., good health, good social relationships) that may contribute to health in the long term

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