Do Positive Psychological Characteristics Modify the Associations of Physical Performance With Functional Decline and Institutionalization? Findings From the Longitudinal Aging Study Amsterdam

OBJECTIVES. To investigate whether 3 positive psychological characteristics, related to sense of control, modify the associations of physical performance levels with subsequent functional decline and institutionalization. METHOD. One thousand five hundred and thirty-two men and women participating in the Longitudinal Aging Study Amsterdam and not living in an institution in 2005–2006 were included. Mastery, self-efficacy, investment in independence, and objective physical performance scores were ascertained in 2005–2006. Functional decline and institutionalization were assessed after 3 years of follow-up. RESULTS. The association between lower physical performance levels and increased odds of functional decline was modified by investment in independence, with a weaker association found among people with higher investment in independence scores than in people with lower scores even after adjustment for covariates. The association between lower physical performance levels and higher odds of institutionalization was marginally weaker among those people with above median levels of mastery (test of interaction p = .08). In men, an association between general self-efficacy and functional decline was found and maintained after adjustments. CONCLUSIONS. Positive psychological characteristics, related to sense of control, play a role in the transition between stages in the disablement process. Specific psychological characteristics may be associated with different stages of the disablement process and may in turn be affected by disablement.