Attitudes to ageing and change in frailty status: The English longitudinal study of ageing

Catharine Gale, Cyrus Cooper

Research output: Contribution to journalArticlepeer-review


Background: Older people with more negative attitudes to ageing are at increased risk of several adverse outcomes, including decline in physical function and increased difficulties with activities of daily living.
Objective: We investigated whether negative attitudes to ageing increase the risk of the onset or progression of frailty.
Method: Participants were 3505 men and women aged 60 and over from the English Longitudinal Study of Ageing. They completed a 12-item questionnaire on attitudes to ageing. Exploratory factor analysis was used to examine the structure of these items and a single factor was derived which we labelled ‘Physical &Psychological Loss’. Frailty was assessed by the Fried phenotype of physical frailty at Waves 2 and Wave 4, and by a frailty index at Waves 2-5.
Results: Having a more positive attitude to ageing as regards ‘Physical and Psychological Loss’ was associated with a decreased risk of becoming physically frail or pre-frail at follow-up. For a standard deviation increment in score, the relative risk ratios (95% CI), adjusted for age, sex and baseline level of physical frailty, were 0.86 (0.79, 0.94) for pre-frailty, and 0.72 (0.63, 0.83) for frailty. Further adjustment for other potential confounding variables had only slight attenuating effects on these associations: multi variable-adjusted relative risk ratios were 0.89(0.81, 0.98) for pre-frailty, and 0.78 (0.68, 0.91) for frailty. Attitude to ageing was not associated with change in the frailty index over time after adjustment for potential confounding variables.
Conclusion: Older people who have a more positive attitude to ageing are at reduced risk of becoming physically frail or pre-frail. Future research needs to 3 replicate this finding and discover the underlying mechanisms. Attitude to ageing was not a risk factor for change in the more broadly-defined frailty index.
Original languageEnglish
Pages (from-to)1-9
Early online date23 Aug 2017
Publication statusE-pub ahead of print - 23 Aug 2017


  • frailty
  • attitudes to ageing
  • cohort
  • longitudinal


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