EMOTIONAL VITALITY AS A BUFFER FOR FRAILTY-ASSOCIATED RISK OF MORTALITY?

摘要

To examine whether emotional vitality is a buffer against the impact of frailty on mortality, we developed and validated a scale to measure emotional vitality among a subset of older females with mobility disability in the National Health and Aging Trends Study (NHATS; n=1262) modelled after an existing scale in the Women’s Health and Aging Study (WHAS; n=1002). We performed Cox models to examine how emotional vitality modifies the effect of frailty on mortality, adjusting for age, race, income, selfcare function, and chronic diseases. Our analysis showed that being not emotionally vital and frail were independently associated with increased risk of mortality. However, emotional vitality had no significant impact on the effect of frailty on mortality in both NHATS and WHAS. In NHATS, the hazard ratio of frailty in emotionally vital older females was 1.95 (95% CI 1.24 – 3.07) while that in not emotionally vital older females was 1.58 (95% CI 1.06 – 2.34). In WHAS, the hazard ratio of frailty in emotionally vital older females was 2.12 (95% CI 1.31– 3.44) while that in not emotionally vital older females was 1.53 (95% CI 1.17 – 2.01). Sensitivity analyses using i) a modified frailty phenotype excluding exhaustion and ii) different subpopulations in NHATS did not qualitatively change the outcome. In conclusion, emotional vitality did not attenuate the effect of frailty on mortality in both studies contrary to our hypothesis. Further studies will be needed to investigate potential differential measurement of frailty and competing risks influencing the results.