Negative Perception of Aging Is Associated With Frailty Transitions Within a Cohort of Sexual Minority Men

Abstract

Background and Objectives Older people have increased risk of developing frailty, an age-related clinical syndrome associated with worse health outcomes. This study examined the effect of self-perception of aging (i.e., age discrepancy - individuals feel younger/older than their chronological age, and aging satisfaction) on frailty transitions. Research Design and Methods We use longitudinal data from 549 HIV-/499 HIV+ sexual minority men (SMM) aged 50 years or older enrolled in the Multicenter AIDS Cohort Study (MACS). To test the association of self-perception of aging on transitions between states of frailty (non-frail/frail), defined using Fried Frailty Phenotype, a multinomial modeling was used. Results With remaining non-frail as the referent group, participants reporting low aging satisfaction (vs moderate aging satisfaction) had increased odds of transitioning from Non-Frail to Frail (OR: 2.72; 95% CI:1.56-4.74), Frail to Non-Frail (OR: 3.40; 95% CI: 1.62-7.12) or remaining frail (Frail to Frail) (OR: 6.64; 95% CI: 3.88-11.38). Participants reporting older subjective age (vs no age discrepancy) had increased odds of transitioning from Non-Frail to Frail (OR: 2.50; 95% CI: 1.11-5.64), Frail to Non-Frail (OR: 4.47; 95% CI: 1.85-10.81) or remaining frail (Frail to Frail) (OR: 5.68; 95% CI: 3.06-10.56). High aging satisfaction and younger subjective age were not statistically associated with frailty transitions. Discussion and Implications Our findings show that negative self-perception of aging (i.e., older subjective age and low aging satisfaction) is associated with frailty transitions (non-frail to frail, frail to non-frail, frail to frail) when compared to remaining non-frail. Translational significance Frailty is associated with increased risk of adverse health outcomes and poor quality of life. Independent of HIV-status, negative self-perception of aging (i.e., low aging satisfaction and older subjective age) is associated with frailty transitions among a cohort of sexual minority men aged 50 years or older. Given functional limitations are a core component of the definition of frailty, promoting efforts that would mitigate the impact of negative self-perceptions of aging on functional limitations is important. The impact of this individual level factor will intersect with other dyadic, community and structural factors, all of which foster healthy aging.

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“…19 Frailty was defined as the presence of 3 of more of the following: (1) weakness; (2) slowness; (3) unintentional weight loss of at least 10 LBS; (4) reported exhaustion during work or other activities; and (5) low physical activity due to health limitation. [19][20][21]…”