The mediating role of self-directed ageism on frailty and quality of life in community-dwelling older people

Abstract

Abstract Purpose The purpose of this study was to explore the role of self-directed ageism in the relationship between frailty and quality of life in community-dwelling older adults. Methods Secondary data-analysis on data from the Belgian Ageing Studies. A stratified sample of 1895 participants, based on census data by gender and age, was drawn between 2017 and 2019. Frailty, quality of life and self-directed ageism were assessed by the Comprehensive Frailty Assessment Instrument, a numeric rating scale and a newly developed self-directed ageism scale, respectively. The validity of this new scale was assessed by exploratory factor analysis, while mediation analysis was used to explore if self-directed ageism mediates the relationship between frailty and quality of life. Results The self-directed ageism scale proved highly reliable (Cronbach’s α = 0.898, Spearman-Brown = 0.906), explaining 58.86% of the variance in self-directed ageism. Respondents scored an average of 23.6 on 40 for self-directed ageism, 26.94 on 100 for frailty, and a median of 8 on 10 for quality of life. Mediation analysis showed that frailty negatively correlates with quality of life, and that this relationship is partially mediated by self-directed ageism. Conclusion Most respondents were identified as mild frail, experienced self-directed ageism, and those 80 or older rated their quality of life lower. The present study showed that frailty negatively correlates with quality of life and this relationship is partially mediated by self-directed ageism. We conclude that every effort should be made to prevent frailty, ageism and self-directed ageism as they impact community-dwelling older people’s quality of life.

Keywords

• Quality of life
• Frailty
• Self-directed ageism
• Community-dwelling older people
• Mediation analysis