Role of physical activity in the relationship between mastery and functional health

Effects of declines in personal mastery on self-perceived mobility, physical function, cognitive function, and depressive symptoms: a 6-year follow-up study from the Social Environment and Biomarkers of Aging Study

OBJECTIVES

As the psychosocial competence, personal mastery helps individuals to cope with stressful life events, and this study aims to examine impacts of declines in personal mastery on healthy aging among community-dwelling middle-aged and older adults using a nationally representative cohort.

METHODS

Data from 648 study participants in the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis. All participants were divided into four groups based on their baseline and changes of personal mastery (measured by the Pearlin mastery score) during the 6-year follow-up. Multivariate logistic regression models were adopted to examine associations between declines in personal mastery and indicators for healthy aging (declines in self-perceived mobility, physical function (activities of daily living (ADLs) and instrumental activities of daily living (IADLs)), cognitive function and depressive symptoms).

RESULTS

After adjustments for demographics and comorbidities, those with declines in personal mastery were associated with greater risks of declines in self-perceived mobility (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.01-2.22], p < 0.05). Although the point estimate in the unadjusted models indicated similar associations between declines in personal mastery and declines in ADLs, IADLs, cognitive function or depressive symptoms, these outcomes did not reach statistical significance in the adjusted model.

CONCLUSIONS

Declines in personal mastery were negatively associated with indicators related to healthy aging (particularly locomotion) in a 6-year follow-up. Further investigations are needed to explore the effects of preventing declines in personal mastery in promoting healthy aging over time.

Agency and Subjective Health from Early Adulthood to Mid-Life: Evidence from the Prospective Youth Development Study

Understanding the determinants of subjective or self-rated health (SRH) is of central importance because SRH is a significant correlate of actual health as well as mortality. A large body of research has examined the correlates, antecedents, or presumed determinants of SRH, usually measured at a given time or endpoint. In the present study, we investigate whether individual mastery, a prominent indicator of agency, has a positive effect on SRH over a broad span of the life course. Drawing on longitudinal data from the Youth Development Study (n=741), we examine the impacts of mastery on SRH over a 24-year period (from ages 21-22 to 45-46). The findings of a fixed effects analysis, controlling time-varying educational attainment, unemployment, age, obesity, serious health diagnoses, and time-constant individual differences, lead us to conclude that mastery is a stable predictor of SRH from early adulthood to mid-life. This study provides evidence that psychological resources influence individuals' subjective assessment of their health, even when objective physical health variables and socioeconomic indicators are taken into account.

Longitudinal Association of Physical Activity, Mastery and Psychological Distress in Mid-Aged Adults over 9-Years

Psychological distress is highly prevalent and associated with significant adverse health outcomes and economic burden. Mastery and physical activity are potential resources to reduce distress and promote wellbeing; however, previous research has not examined their potential interactive relationship over time. The purpose of this study was to explore associations between mastery, physical activity, and distress in mid-aged adults over nine years. Data from a longitudinal mail survey study including the Kessler 6, Pearlin Mastery Scale, and items assessing time spent in physical activity were examined in a sample of 4404 adults aged 40 to 54 years at baseline. Group-Based Trajectory Models identified two distinct trajectories of psychological distress (elevated and low). Generalized Estimating Equations were used to assess mastery and physical activity, adjusting for sociodemographic and health variables, as predictors for the probability of distress group membership. The odds of elevated distress over time were significantly reduced in people with higher mastery (OR = 0.13; 95% 0.11-0.15) and doing at least 150 min/week of physical activity (OR = 0.81; 95% 0.68-0.96). There was no significant interaction between mastery and physical activity. Mastery and physical activity may be important resources to mitigate distress and further research is needed to evaluate interventions promoting these resources and the impact on mid-aged adults experiencing psychological distress.

Key Determinants of Physical and Psychological Health-Related Quality of Life over Time among Midlife and Older LGBTQ and Sexual and Gender Diverse Caregivers

Background and Objectives

Prior research has shown informal caregiving among older adults can negatively impact the caregiver’s physical and psychological health. However, little is known about protective and risk factors associated with the health-related quality of life (HRQOL) of lesbian, gay, bisexual, transgender, and queer (LGBTQ) caregivers.

Research Design and Methods

Informed by the Health Equity Promotion Model and Caregiver Stress Process Model and utilizing longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this analysis examined modifiable risk and protective factors associated with psychological and physical HRQOL over time among 754 LGBTQ caregivers aged 50-98.

Results

Psychological and physical HRQOL declined over a three-year period. After controlling for background characteristics, mastery, social support, socialization, LGBTQ community engagement, and physical activity were positively associated with psychological HRQOL while day-to-day discrimination, identity stigma, and insufficient food intake were negatively associated. Steeper declines were observed for older and with no physical activity. Mastery, social support, socialization, and physical activity were positively associated with physical HRQOL while day-to-day discrimination and insufficient food intake were negatively associated. Steeper declines were found for those with high mastery and no physical activity.

Discussion and Implications

Although generalized factors including mastery, socialization, and social support, are protective for HRQOL among LGBTQ caregivers, factors including day-to-day discrimination and identity stigma are more unique to historically disadvantaged populations and should be considered in future research and practice. Caregiving interventions incorporating physical activity are promising given its buffering effect for decreased physical and psychological HRQOL over time.

Physical activity related to mastery and vitality in a Swedish adult population with economic difficulties

Background

People with low socio-economic status report lower levels of physical activity (PA). There is insufficient knowledge about the availability of psychological resources for those who are physically active despite having a low socio-economic status. The aim of this study is to investigate the association between PA level and mastery and vitality, respectively, within an adult population with self-reported economic difficulties.

Method

Data from a cross-sectional, population-based study (n = 817) were used. Linear regression was used to estimate the unstandardised regression coefficient (β) with 95% confidence intervals (95% CI), describing associations between PA levels (independent variable) and scale scores of psychological resources in terms of mastery and vitality (outcome variables). Three models were constructed: Model I unadjusted; Model II adjusted for sex and age; and Model III adjusted for sex, age, smoking and food quality.

Result

After adjusting for sex, age, smoking and food quality and using low-level PA as the reference, high-level PA, but not intermediate-level PA, was related to higher scale scores of mastery (β = 0.72 [95% CI 0.08 to 1.37]). For vitality, both high-level PA and intermediate-level PA were related to higher scale scores (β = 9.30 [95% CI 5.20 to 13.40] and β = 6.70 [95% CI 1.40 to 12.00] respectively).

Conclusion

In an adult population with self-reported economic difficulties, higher levels of physical activity were related to higher mastery and vitality. Our results support that the association between physical activity and psychological resources in terms of mastery and vitality should be considered in the context of targeted health dialogues.

Trial registration number

Not applicable.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12194-6.

Longitudinal Associations Between Perceived Control and Health for American and Japanese Aging Adults

BACKGROUND AND OBJECTIVES

Research suggests longitudinal and reciprocal relationships between perceived control over life circumstances and health for Western populations; yet, such associations have not been fully understood for non-Western populations. The present study addresses cultural differences in these associations for American and Japanese aging adults.

RESEARCH DESIGN AND METHODS

For respondents aged 40 and older at 2 waves (Time 1 [T1] and Time 2 [T2]) of Midlife in the United States (N = 4,455) and Midlife in Japan (N = 827), cross-lagged path models were analyzed for T1 perceived control predicting change in each health measure (i.e., self-rated health, number of chronic health conditions, and functional limitations) from T1 to T2; and the matched T1 health measure predicting change in perceived control from T1 and T2. In these analyses, the effects of T1 age, T1 perceived control, and each T1 health measure were compared cross-nationally.

RESULTS

A cross-national difference emerged in that T1 perceived control predicted change in chronic health conditions only for Americans. Similar tendencies were found between the 2 nationalities for T1 perceived control predicting changes in self-rated health and functional limitations. Reciprocal relationships between perceived control and health measures were found for Americans, but neither age nor any of the T1 health measures predicted change in perceived control for the Japanese respondents.

DISCUSSION AND IMPLICATIONS

The findings suggest cultural differences and similarities between the 2 nationalities, which have implications for potential health benefits of enhancing perceived control among American and Japanese aging adults. Building on these findings, the present study also indicates future directions of research.

Physical Activity and Health Among Native Hawaiian and other Pacific Islander Older Adults

Objectives: Native Hawaiian and other Pacific Islander (NHPI) older adults often experience social disadvantages and poor health outcomes. Physical activity has been associated with better health in other racial groups, but limited studies have examined these associations in NHPI older adults. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n = 1,045), logistic regression models examined associations between physical activity and memory/psychological distress/self-rated health. Results: Sufficient levels of physical activity were associated with lower odds of memory problems, serious psychological distress, and poor/fair self-rated health. Unfortunately, only half of the sample reported sufficient physical activity and approximately 30% reported none. Also, 78% of the sample was estimated to be overweight/obese, and 29% had diabetes. Discussion: Culturally-appropriate interventions are recommended to increase physical activity in this population, which could also help reduce high rates of overweight/obesity and diabetes.

Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women?

Aim

This study aimed to determine the association of handgrip strength with isometric and isokinetic strength (hip, knee and ankle extensor/flexor muscles), and functional capacity in older women.

Methods

The handgrip strength and lower limb strength of 199 older women (60–86 years) were measured using JAMAR and BIODEX dynamometers, respectively. Time Up and Go, Five-times-sit-to-stand and 6m-walk functional tests were evaluated. Pearson correlations were used to determine the relationship between variables. Regression analysis was applied to identify if HS was able to predict TUG performance. The effect of age was analyzed by splitting the participants in a group of older women (OLD; from 60 to 70 years old) and very old women (from 71 to 86 years old).

Results

The HS and isometric/isokinetic strength correlations were negligible/low and, in most cases, were non-significant. The correlation between handgrip strength and functional tests also ranged predominantly from negligible (r=0.0 to 0.3) to low (r=0.3 to 0.5), irrespective of the group age. The handgrip strength was not able to explain the variance of the TUG performance.

Conclusion

Generalizing handgrip strength as a practical and straightforward measure to determine lower limbs and overall strength, and functional capacity in older women must be viewed with caution. Handgrip strength and standard strength measures of the lower limbs and functional tests present a negligible/low correlation.

Getting Old Well in Sub Saharan Africa: Exploring the Social and Structural Drivers of Subjective Wellbeing among Elderly Men and Women in Uganda

While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (β = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men’s SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women’s SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.

Evaluation of self-efficacy determinants in community-dwelling older adults with chronic musculoskeletal pain

INTRODUCTION: Self-efficacy is defined as the strength of a person’s convictions in being able to perform a given activity and obtain the expected result. It may act as a potent mediator between chronic musculoskeletal pain and how older adults cope with their disabilities. OBJECTIVE: To evaluate the determinants of self-efficacy beliefs and fear of physical exercise in community-dwelling older adults with chronic musculoskeletal pain. METHODS: This cross-sectional study recruited older adults with chronic musculoskeletal pain. Only individuals living in an urban area in southern Brazil and who reported pain for more than 3 months were included. A convenience sample was selected in a nonprobabilistic fashion. The study variables consisted of sociodemographic data; pain based on the Brief Pain Inventory and the Leeds Assessment of Neuropathic Symptoms and Signs for Patients with Chronic Pain; and self-efficacy based on the Chronic Pain Self-Efficacy Scale. Also, simple questions were created for physical exercise beliefs. For statistical analysis, absolute and relative frequency, χ2 test, and Mann-Whitney U test were used as appropriate. RESULTS: The sample consisted of 193 older adults, mostly women with low level of education. Self-efficacy was best rated by older adults living alone and by those who were classified as exclusively nociceptive pain. CONCLUSION: Despite having chronic pain, older adults with higher self-efficacy feel confident in performing their tasks and have greater ability to cope with changes related to aging and to engage in self-care.

Linked Lives: Dyadic Associations of Mastery Beliefs With Health (Behavior) and Health (Behavior) Change Among Older Partners

Objectives

Mastery beliefs are known to contribute to healthy aging. However, it is an open question whether individual mastery-health associations impact the health of close long-term partners.

Method

We applied actor-partner interdependence models to 4-wave, 6-year longitudinal dyadic data from married and cohabitating partners in the Health and Retirement Study (N = 1,981 partners; age at baseline: M = 67 years, SD = 8.93, range 50-94 years).

Results

Higher individual mastery beliefs were associated with better individual physical health and health behaviors. Higher mastery beliefs were associated with subsequent increases in light physical activity. Having a partner with higher levels of mastery was uniquely associated with fewer functional limitations, better self-rated health, and more physical activity. Actor × Partner interaction effects for functional limitations indicated multiplicative associations of actor and partner mastery with health. Of note, mastery-health associations for individuals and their partners were invariant across age, gender, education, employment status, perceived stress over one's own and partner's health, and cognition.

Discussion

Findings suggest that partner mastery beliefs matter for the health (behaviors) of older adults. We discuss possible mechanisms underlying partner interrelations in mastery and health, their age invariance, and consider implications arising from our results.

Functional mastery of health ownership: A model for optimum health

The aim of this paper is to introduce the Functional Mastery of Health Ownership (FMHO) model and to develop an operational definition of functional mastery as it applies to a positive health outcome for patients with chronic illness or an altered life situation. Daily functioning within the negative disease burden of chronic illness is the goal of individuals living within the constraints of morbidity. Functional mastery fosters health ownership and helps to predict successful control over life circumstances for optimum wellness within the parameters of the limitations of the effects of illness. Significant to nursing, the FMHO conceptual framework uses four foundational influences to assess a patient's ability to not only master function within the disease process, but also to sustain function and best health over time. The FMHO model provides a tool for practitioners to enable individualized care as patients move through the disease process and adapt to changes over time.

The reciprocal relationship between physical activity and depression: Does age matter?

BACKGROUND

The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is moderated by age. As sense of mastery and functional limitations have been previously associated with low PA and depression in older adults, we also examined whether these are determinants of the differential effect of age on PA and depression.

METHODS

1079 patients with major depressive disorder (aged 18-88 years) were followed-up after two-years; depression diagnosis and severity as well as PA were re-assessed. Linear and logistic regression analyses were used to test reciprocal prospective associations between PA and depression outcomes. In all models the interaction with age was tested.

RESULTS

PA at baseline predicted remission of depressive disorder at follow-up (OR = 1.43 [95% CI: 1.07-1.93], p = .018). This effect was not moderated by age. PA predicted improvement of depression symptom severity in younger (B = -2.03; SE = .88; p = .022), but not in older adults (B = 2.24; SE = 1.48; p = .128) (p = .015 for the interaction PA by age in the whole sample). The level of PA was relatively stable over time. Depression, sense of mastery and functional limitation were for all ages not associated with PA at follow-up.

CONCLUSIONS

Age did not moderate the impact of PA on depressive disorder remission. Only in younger adults, sufficient PA independently predicts improvement of depressive symptom severity after two-year follow-up. Level of PA rarely changed over time, and none of the determinants tested predicted change in PA, independent of age.

The effect of perceived control on self-reported cardiovascular disease incidence across adulthood and old age

OBJECTIVE

To examine whether rates of change in perceived control are predictive of cardiovascular disease (CVD) incidence across adulthood and old age.

DESIGN

We used the PATH Through Life Project (n = 7103, M = 40, SD = 16; 52% women), a longitudinal panel survey that encompasses three cohorts at Time 1, ages 20-24, 40-44 and 60-64, who have been assessed three times at four-year intervals.

METHOD

We examined whether rates of change in perceived control were associated with CVD incidence over 8 years of time, over and above that of baseline levels of perceived control and known risk factors for CVD.

MAIN OUTCOME MEASURES

Self-reported CVD incidence.

RESULTS

Increases in perceived control over time were associated with decreased likelihood of 8-year incidence of CVD and these effects were independent of socio-demographics, covariates and baseline levels of perceived control. The effects were consistent across young adulthood, midlife and old age and for men and women.

CONCLUSIONS

Findings demonstrate the importance of changes in perceived control as a predictor of CVD incidence across adulthood and old age. We suggest future research using mediation analysis to test reverse causality and mechanisms underlying the effects of perceived control on CVD incidence.

Trajectories of ageing well among older Australians: a 16-year longitudinal study

In this study we used individual differences concepts and analyses to examine whether older people achieve different ageing-well states universally or whether there are identifiable key groups that achieve them to different extents. The data used in the modelling were from a prospective 16-year longitudinal study of 1,000 older Australians. We examined predictors of trajectories for ageing well using self-rated health, psychological wellbeing and independence in daily living as joint indicators of ageing well in people aged over 65 years at baseline. We used group-trajectory modelling and multivariate regression to identify characteristics predicting ‘ageing well’. The results showed three distinct and sizeable ageing trajectory groups: (a) ‘stable-good ageing well’ (classified as ageing well in all longitudinal study waves; which was achieved by 30.2% of women and 28.0% of men); (b) ‘initially ageing well then deteriorating’ (50.5% women and 47.6% men); and (c) ‘stable-poor’ (not ageing well in any wave; 19.3% women and 24.4% men). Significant gender differences were found in membership in different ageing-well states. In the stable-poor groups there were 103/533 females which was significantly lower than 114/467 men (z-statistic = −2.6, p = 0.005); women had a ‘zero’ probability of progressing to a better ageing-well classification in later years, whilst males had a one-in-five probability of actually improving. Robust final state outcome predictors at baseline were lower age and fewer medical conditions for both genders; restful sleep and Australian-born for women; and good nutrition, decreased strain, non-smoker and good social support for men. These results support that ageing-well trajectories are influenced by modifiable factors. Findings will assist better targeting of health-promoting activities for older people.

The conceptualization of a Just-In-Time Adaptive Intervention (JITAI) for the reduction of sedentary behavior in older adults

Low physical activity and high sedentary behavior in older adults can be addressed with interventions that are delivered through modern technology. Just-In-Time Adaptive Interventions (JITAIs) are an emerging technology-driven behavior-change intervention type and capitalize on data that is collected via mobile sensing technology (e.g., smartphones) to trigger appropriate support in real-life. In this paper we integrated behavior change and aging theory and research as well as knowledge around older adult's technology use to conceptualize a JITAI targeting the reduction of sedentary behavior in older adults. The JITAIs ultimate goal is to encourage older adults to take regular activity breaks from prolonged sitting. As a proximal outcome, we suggest the number of daily activity breaks from sitting. Support provided to interrupt sitting time can be based on tailoring variables: (I) the current accumulated sitting time; (II) the location of the individual; (III) the time of the day; (IV) the frequency of daily support prompts; and (V) the response to previous support prompts. Data on these variables can be collected using sensors that are commonly inbuilt into smartphones (e.g., accelerometer, GPS). Support prompts might be best delivered via traditional text messages as older adults are usually familiar and comfortable with this function. The content of the prompts should encourage breaks from prolonged sitting by highlighting immediate benefits of sitting time interruptions. Additionally, light physical activities that could be done during the breaks should also be presented (e.g., walking into the kitchen to prepare a cup of tea). Although the conceptualized JITAI can be developed and implemented to test its efficacy, more work is required to identify ways to collect, aggregate, organize and immediately use dense data on the proposed and other potentially important tailoring variables. Machine learning and other computational modelling techniques commonly used by computer scientists and engineers appear promising. With this, to develop powerful JITAIs and to actualize the full potential of modern sensing technologies transdisciplinary approaches are required.

Associações entre significados de velhice e bem-estar subjetivo indicado por satisfação em idosos

Resumo Objetivos: Investigar os significados atribuídos por idosos aos conceitos de velhice saudável e de ser feliz na velhice, bem como as associações entre os significados e suas avaliações sobre satisfação global e referenciada a domínios. Método: Esta investigação foi realizada a partir dos dados de um estudo multicêntrico, de corte transversal. As emissões verbais provenientes de amostras representativas de idosos comunitários (N=1.242, com 65 anos e mais), registradas no banco de dados de duas cidades brasileiras, foram submetidas à análise de conteúdo e comparadas com indicadores de satisfação, considerando-se sexo, idade e renda familiar. Resultados: Quatro temas e 14 categorias explicaram os dois conceitos: saúde física e funcionalidade (42,1% das emissões), bem-estar psicológico (25,4%), relações interpessoais (23,5%) e recursos materiais e acesso a serviços de saúde (9,0%). Exceção feita à satisfação e prazer, não foram observadas diferenças quanto às razões de prevalência entre as categorias de significado e pontuação alta em satisfação global. Conclusão: Os dois conceitos suscitaram significados comuns associados a aspectos positivos da velhice e refletiram sobre as avaliações de satisfação, evidenciando que, envelhecer de forma saudável e feliz é mais do que ter saúde, pois envolve também bem-estar psicológico e relações interpessoais.

Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial

Background

Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones.

Objective

The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants’ exercise frequency and the effects of the intervention on secondary outcomes.

Methods

The Malaysian Physical Activity for Health Study (_myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity–related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24.

Results

In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study-unrelated injuries forced 4 participants to discontinue after a few weeks (they were not included in any analyses). Overall retention was 86% (37/43). After 12 weeks, SMS texting arm participants exercised significantly more than non-SMS texting arm participants (mean difference 1.21 times, bias-corrected and accelerated bootstrap [BCa] 95% CI 0.18-2.24). Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers. They described the SMS text messages as being encouraging, a push, and a reminder. After 24 weeks, there was no significant difference between the research arms (mean difference 0.74, BCa 95% CI –0.30 to 1.76). There were no significant effects for secondary outcomes.

Conclusions

This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country. Although the effects were not maintained when SMS text messaging ceased, the results are promising and warrant more research on behavioral mobile health interventions in other regions.

Trial Registration

Clinicaltrials.gov NCT02123342; http://clinicaltrials.gov/ct2/show/NCT02123342 (Archived by WebCite at http://www.webcitation.org/6eGSsu2EI).

The effects of constraints and mastery on mental and physical health: Conceptual and methodological considerations

Perceived control and health are closely interrelated in adulthood and old age. However, less is known regarding the differential implications of 2 facets of perceived control, constraints and mastery, for mental and physical health. Furthermore, a limitation of previous research testing the pathways linking perceived control to mental and physical health is that mediation was tested with cross-sectional designs and not in a longitudinal mediation design that accounts for temporal ordering and prior confounds. Using data from the Health and Retirement Study (HRS; n = 7,612, M age = 68, SD = 10.66; 59% women) we examined the effect of constraints and mastery on 4-year changes in mental and physical health and whether physical activity mediated such effects in a longitudinal mediation design. Using confirmatory factor analysis, we modeled the 2-factor structure of perceived control that consisted of constraints and mastery. In our longitudinal mediation model, where we accounted for possible confounders (e.g., age, gender, education, neuroticism, conscientiousness, memory, and health conditions), constraints showed a stronger total effect on mental and physical health, than mastery, such that more constraints were associated with 4-year declines in mental and physical health. Physical activity did not mediate the effect of constraints and mastery on mental and physical health (indirect effect). To demonstrate the importance of a longitudinal mediation model that accounts for confounders, we also estimated the mediated effect using 2 models commonly used in the literature: cross-sectional mediation model and longitudinal mediation model without accounting for confounders. These mediation models indicated a spurious indirect effect that cannot be causally interpreted. Our results showcase that constraints and mastery have differential implications for mental and physical health, as well as how a longitudinal mediation design can illustrate (or not) pathways in developmental processes. Our discussion focuses on the conceptual and methodological implications of a 2 facet model of perceived control and the strengths of longitudinal mediation designs for testing conceptual models of human development.