Psychological resources as modifiers of the association between mobility decline and activity in old age

Abstract

Activity refers to everything a person does. Staying active in later life is important for wellbeing but may be restricted due to age-related mobility decline. This study explored whether cognition, resilience, and coping as psychological resources, i.e., personal reserves that may intervene the stressor-wellbeing relationship, modify the negative associations between mobility decline and activity. In addition, this study investigated whether an active aging counseling intervention affects mobility, physical activity and resilience. Two different datasets were utilized for the current study: Life-Space Mo-bility in Old Age (n=848) and its sub-study Life-Space Mobility and Active Ageing (n=206); and Active Ageing – Resilience and External Support as Modifiers of the Disablement Outcome, which consisted of two separate studies: co-hort (n=1021) and intervention (n=204). The participants were community-dwelling people aged 75 to 93. Study variables were assessed based on validated self-reports, objective observations and activity monitoring. Mobility was observed from multiple aspects including ability, autonomy and extent. Those with impaired physical performance and impaired cognition had the greatest odds for walking difficulty compared to those with intact function or deficits in only one or the other. Those with high tenacity and high flexibility scored the highest in life-space mobility and perceived autonomy in outdoor mobility, whereas those with low tenacity and flexibility scored the lowest. High resilience was associated with greater active aging among persons with or without walking difficulty but not among persons reporting the inability to walk 2 km. An individualized active aging counseling intervention improved physical performance, lowered perceived autonomy in outdoor mobility and had no systematic effects on other outcomes. In conclusion, physical and cognitive decline may have additive negative effects on mobility disability in later life, whereas persistence and mental flexibility may help older people to compensate for functional losses and maintain a higher level of activity. The counseling intervention had inconsistent effects on activity and mobility, and hence it remained unclear whether, and if so, how activity can be promoted in old age.