This study aimed to investigate the role of self-directed ageism in shaping the relationship between frailty and quality of life among community-dwelling older adults. A secondary analysis was conducted using data from the Belgian Ageing Studies. Between 2017 and 2019, a stratified sample of 1895 participants, based on age and gender according to census data, was selected. Frailty, quality of life, and self-directed ageism were measured using the Comprehensive Frailty Assessment Instrument, a numeric rating scale, and a newly developed self-directed ageism scale, respectively. The new scale’s validity was evaluated through exploratory factor analysis, and mediation analysis assessed whether self-directed ageism mediated the association between frailty and quality of life.
The self-directed ageism scale demonstrated high reliability (Cronbach’s α = 0.898, Spearman-Brown = 0.906) and accounted for 58.86% of the variance in self-directed ageism. Participants had an average self-directed ageism score of 23.6/40, a mean frailty score of 26.94/100, and a median quality of life score of 8/10. Mediation analysis indicated that frailty was inversely related to quality of life and that this association was partially mediated by self-directed ageism. Most participants were mildly frail, experienced self-directed ageism, and those aged 80 or older reported a lower quality of life. The findings confirm that frailty negatively impacts quality of life, with self-directed ageism partially mediating this effect. Interventions targeting frailty, ageism, and self-directed ageism are essential to improve the quality of life for older adults living in the community.
