Personality and Risk of Frailty: the English Longitudinal Study of Ageing

Galé, Catharine R.; Mõttus, René; Deary, Ian J.; Cooper, Cyrus; Sayer, Avan Aihie

doi:10.1007/s12160-016-9833-5

Cited by 32 publications

(31 citation statements)

References 59 publications

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“…Overall, the results of the phenotypic analyses are in line with previous studies examining the association between neuroticism and frailty, using both measures of physical frailty (i.e. the frailty phenotype) and the frailty index (10)(11)(12). Our study expanded the follow-up time up to 29 years, elucidating the stability of neuroticism in midlife as a predictor of late life frailty.…”

Section: Discussionsupporting

confidence: 85%

“…depressed mood, worry, fear), has been consistently associated with a wide range of physical and mental health problems such as cardiovascular disease, disrupted immune functioning, asthma, irritable bowel syndrome, atopic eczema, migraine, mood and anxiety disorders, and even increased risk of premature mortality (7)(8)(9), potentially also affecting frailty. The association between neuroticism and frailty has been investigated in three previous studies, all suggesting that high neuroticism is associated with higher frailty concurrently and longitudinally, over up to eight years (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Neuroticism as a predictor of frailty in old age: a genetically informative approach

Daníelsdóttir¹,

Jylhävä²,

Hägg³

et al. 2019

Preprint

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Objective: Neuroticism is associated with poor health outcomes, but its contribution to the accumulation of health deficits in old age, i.e. frailty, is largely unknown. We aimed to explore associations between neuroticism and frailty cross-sectionally and over up to 29 years, and to investigate the contribution of shared genetic influences.Method: Data were derived from the UK Biobank (UKB, n=502,631), the Australian Over 50's Study (AO50, n=3,011) and the Swedish Twin Registry (SALT n=23,744, SATSA n=1,637).Associations between neuroticism and the Frailty Index were investigated using regression analysis cross-sectionally in UKB, AO50 and SATSA, and longitudinally in SALT (25-29y follow-up) and SATSA (6 and 23y follow-up). The co-twin control method was applied to explore the contribution of underlying shared familial factors (SALT, SATSA, AO50). Genome-wide polygenic risk scores for neuroticism in all samples were used to further assess whether common genetic variants associated with neuroticism predict frailty. Results: High neuroticism was consistently associated with greater frailty cross-sectionally (adjusted β, 95% confidence intervals in UKB= 0.32, 0.32-0.33; AO50= 0.35, 0.31-0.39; SATSA= 0.33, 0.27-0.39) and longitudinally up to 29 years (SALT= 0.24; 0.22-0.25; SATSA 6y= 0.31, 0.24-0.38; SATSA 23y= 0.16, 0.07-0.25). When controlling for underlying shared genetic and environmental factors the neuroticism-frailty association remained significant, although decreased.Polygenic risk scores for neuroticism significantly predicted frailty in the two larger samples (metaanalyzed total β= 0.06, 0.05-0.06). Conclusion:High neuroticism is associated with the development and course of frailty. Both environmental and genetic influences, including neuroticism-associated genetic variants, contribute to this relationship.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Neuroticism as a predictor of frailty in old age: a genetically informative approach

Daníelsdóttir¹,

Jylhävä²,

Hägg³

et al. 2019

Preprint

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“…On the contrary, people who are higher in neuroticism, the tendency to experience negative emotion, may have an increased risk of cognitive decline [ 107 ] and dementia [ 108 ]. In a prospective study of people aged 60 to over 90 years, higher levels of neuroticism and lower levels of extraversion and conscientiousness were associated with greater frailty at follow-up around 2 years later [ 109 ]. There is evidence that personality may be associated with individual differences in physiological processes that have been hypothesized to underlie the onset of frailty, namely inflammation and the HPA dysregulation [ 110, 111 ].…”

Section: Possible Neurobiological Mechanisms Underlying Cognitive Framentioning

confidence: 99%

Different Cognitive Frailty Models and Health- and Cognitive-related Outcomes in Older Age: From Epidemiology to Prevention

Panza

Lozupone

Solfrizzi

et al. 2018

JAD

267

229

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Frailty, a critical intermediate status of the aging process that is at increased risk for negative health-related events, includes physical, cognitive, and psychosocial domains or phenotypes. Cognitive frailty is a condition recently defined by operationalized criteria describing coexisting physical frailty and mild cognitive impairment (MCI), with two proposed subtypes: potentially reversible cognitive frailty (physical frailty/MCI) and reversible cognitive frailty (physical frailty/pre-MCI subjective cognitive decline). In the present article, we reviewed the framework for the definition, different models, and the current epidemiology of cognitive frailty, also describing neurobiological mechanisms, and exploring the possible prevention of the cognitive frailty progression. Several studies suggested a relevant heterogeneity with prevalence estimates ranging 1.0–22.0% (10.7–22.0% in clinical-based settings and 1.0–4.4% in population-based settings). Cross-sectional and longitudinal population-based studies showed that different cognitive frailty models may be associated with increased risk of functional disability, worsened quality of life, hospitalization, mortality, incidence of dementia, vascular dementia, and neurocognitive disorders. The operationalization of clinical constructs based on cognitive impairment related to physical causes (physical frailty, motor function decline, or other physical factors) appears to be interesting for dementia secondary prevention given the increased risk for progression to dementia of these clinical entities. Multidomain interventions have the potential to be effective in preventing cognitive frailty. In the near future, we need to establish more reliable clinical and research criteria, using different operational definitions for frailty and cognitive impairment, and useful clinical, biological, and imaging markers to implement intervention programs targeted to improve frailty, so preventing also late-life cognitive disorders.

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“…This critique focuses, inter alia, on its failure to take into account the role played in precipitating frailty by domains outside the biological, including social disadvantage [3]; its overlooking of positive aspects of frail embodiment/resilience [4]; its incorporation of psycho-social aspects in a dualistic framework that posits the separation of mind and body [5]; its perpetuation of decline narratives; and ultimately its potentially (albeit unintentionally) harmful impact on older people who are labelled 'frail', which may in turn trigger frailty identity crises [6] precipitating a 'cycle of decline' [7]. The importance of subjectivity is also highlighted in clinical literature: for example, negative representations of ageing may underpin a decline in objective walking speed [8]; in addition, the English Longitudinal Study of Ageing suggested that older people who have a more positive attitude to ageing may be at reduced risk of becoming physically frail or pre-frail [9].…”

Section: The Disjunction Between Clinical Approaches and Lived Experimentioning

confidence: 99%

New horizons in frailty: the contingent, the existential and the clinical

et al. 2019

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In the past decade, frailty research has focused on refinement of biomedical tools and operationalisations, potentially introducing a reductionist approach. This article suggests that a new horizon in frailty lies in a more holistic approach to health and illness in old age. This would build on approaches that view healthy ageing in terms of functionality, in the sense of intrinsic capacity in interplay with social environment, whilst also emphasising positive attributes. Within this framework, frailty is conceptualised as originating as much in the social as in the biological domain; as co-existing with positive attributes and resilience, and as situated on a continuum with health and illness. Relatedly, social science-based studies involving interviews with, and observations of, frail, older people indicate that the social and biographical context in which frailty arises might be more impactful on the subsequent frailty trajectory than the health crisis which precipitates it. For these reasons, the article suggests that interpretive methodologies, derived from the social sciences and humanities, will be of particular use to the geriatrician in understanding health, illness and frailty from the perspective of the older person. These may be included in a toolkit with the purpose of identifying how biological and social factors jointly underpin the fluctuations of frailty and in designing interventions accordingly. Such an approach will bring clinical approaches closer to the views and experiences of older people who live with frailty, as well as to the holistic traditions of geriatric medicine itself.

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Personality and Risk of Frailty: the English Longitudinal Study of Ageing

Cited by 32 publications

References 59 publications

Neuroticism as a predictor of frailty in old age: a genetically informative approach

Neuroticism as a predictor of frailty in old age: a genetically informative approach

Different Cognitive Frailty Models and Health- and Cognitive-related Outcomes in Older Age: From Epidemiology to Prevention

New horizons in frailty: the contingent, the existential and the clinical

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