Are self-perceptions of ageing modifiable? Examination of an exercise programme with vs. without a self-perceptions of ageing-intervention for older adults

Development, feasibility, and acceptability of a process based intervention to decrease internalized ageism

A lifetime of exposure to ageism may be internalized in older adults, and these ageist beliefs that are directed inwards can have severe consequences. However, research on reducing internalized ageism is scarce. To address this, we designed and implemented a six-week online process-based intervention to reduce internalized ageism and to assess its feasibility. The intervention utilized a process-based therapy approach targeting psychological, behavioral, and physiological pathways through which internalized ageism negatively impacts health, as specified by stereotype embodiment theory. Intervention components included education, acceptance and commitment therapy techniques, and attributional retraining. A total of 81 older adult participants participated in the feasibility study. Most participants rated each session and the overall program as very useful after each session (average program usefulness rating of 4.54/5). Participants also attributed a wide range of novel behaviors to this intervention and stated that they felt it changed their perspectives on ageism and/or internalized ageism. Results from this study provide a promising foundation from which to advance research on interventions that address internalized ageism - a problem that has severe consequences on the health and well-being of growing numbers of older adults globally.

Reimagine Aging: A Process-Based Intervention to Decrease Internalized Ageism

OBJECTIVES

Exposure to ageism may be internalized in older adults, and this can have severe consequences. However, little research has addressed reducing internalized ageism. Thus, Reimagine Aging, a 6-week process-based intervention to reduce internalized ageism, was designed and implemented, using education, acceptance and commitment therapy, and attributional retraining to target theoretically based mechanisms of change.

METHODS

Seventy-two older adults (M = 70.4 years, SD = 6.4 years) participated in Reimagine Aging, consented to participate in this robust single-sample pilot study, and provided valid data. Participants completed questionnaires prior to, immediately following, and 2 months after the intervention.

RESULTS

Participants' self-perceptions of aging (η p 2 =0.37, p < .001) and perceptions of older adults (η p 2 =0.27, p < .001) became significantly more positive, associated with large effect sizes. Furthermore, these positive gains were mediated by increases in psychological flexibility, mindfulness, and perceived control.

DISCUSSION

This study provides initial support for this process-based intervention targeting a reduction of internalized ageism.

CLINICAL IMPLICATIONS

This program has the potential to reduce the negative impact internalized ageism has on the health of older adults. Furthermore, it provides novel insights into intervention targets and tools that may be useful in achieving this reduction.

The Association of Self-Perception of Aging and Quality of Life in Older Adults: A Systematic Review

BACKGROUND AND OBJECTIVES

Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above.

RESEARCH DESIGN AND METHODS

A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being.

RESULTS

Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health.

DISCUSSION AND IMPLICATIONS

These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.

The Risks of Experiencing Severe Loneliness Across Middle and Late Adulthood

OBJECTIVES

From a theoretical point of view, older adults may not necessarily face a greater risk of becoming lonely than middle-aged adults but are more likely at a disadvantage in fighting loneliness. Therefore, in this study, we differentiate between the risk of becoming lonely and the risk of remaining lonely.

METHODS

A large longitudinal data set representative of the German noninstitutionalized population from 40 to 85 years of age (N = 15,408; 49% female participants) was used in the analysis. Lagged logistic regression models were estimated to investigate the effect of earlier experiences of severe loneliness on the risk of being lonely after three years across middle age and late adulthood. Individual differences in health, views on aging, and social activities were taken into account to explore their role in age differences in the risk of remaining lonely.

RESULTS

The analysis revealed marginal age differences in the risk of becoming lonely but a marked age gradient regarding the risk of remaining lonely. Lonely older adults who were older than 75 years of age were more likely to remain lonely after three years than lonely middle-aged adults. Controlling for individual differences in health, views on aging as social loss, and social activities accounted for this age difference.

DISCUSSION

Interventions against loneliness may prioritize older age groups because losses in capacities, shifts in motivations, and a degraded opportunity structure render it increasingly less likely that older adults leave a state of loneliness on their own accord.

Associations Between Everyday ICT Usage and (Self-)Ageism: A Systematic Literature Review

BACKGROUND AND OBJECTIVES

Both rapid technological changes and (self-)ageism are pervasive challenges of the 21st century, potentially affecting older adults' everyday functioning, health, and well-being. This systematic literature review aimed to synthesize scholarly evidence to determine the associations between everyday information and communication technology (EICT) usage and (self-)ageism as well as potential moderators.

RESEARCH DESIGN AND METHODS

A systematic search was performed in 8 academic databases, covering the time frame from January 1995 to January 2021. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a total of 15 articles met the inclusion criteria and were involved in the analysis. The standardized National Heart, Lung, and Blood Institute's quality assessment tools were used for risk bias.

RESULTS

Several studies demonstrated significant associations between EICT usage and stereotype embodiment (n = 8), stereotype threat (n = 2), and age discrimination (n = 3). Age (group), gender, and motivation were examined as potential moderators.

DISCUSSION AND IMPLICATIONS

This review provides initial evidence on the associations between (self-)ageism and EICT usage. It highlights the importance of positive subjective aging perceptions for active EICT usage in older adults, but also emphasizes the detrimental consequences of ageism in EICT learning settings and technology design on older persons' willingness and ability to use EICT. Further ecologically valid and methodologically sound research is needed to better understand both the nature and direction of the association between EICT usage and (self-)ageism.

Awareness of Age-Related Gains and Losses in a National Sample of Adults Aged 80 Years and Older: Cross-Sectional Associations With Health Correlates

Background and Objectives

Advanced old age is a life stage with a high likelihood of age-related loss experiences. However, little is known about remaining gain experiences and their relation with perceived losses and health correlates in community-dwelling very old adults. Moreover, virtually nothing is known in this regard about the experiences of individuals in long-term care settings. First, we strived to establish the normative course of age-related gains and losses in advanced old age. Second, we examined whether such gain/loss perceptions in advanced aging moderated health correlates.

Research Design and Methods

Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021. The sample comprised 10 578 individuals aged 80-106 years, including 587 individuals in long-term care. We used the multidimensional Awareness of Age-Related Change (AARC) questionnaire and moderated regression to analyze associations with late-life health and functioning correlates.

Results

Levels of AARC-Gains were higher than those of AARC-Losses across most of the age range. Long-term care residents showed more AARC-Losses and fewer AARC-Gains compared with community-dwelling adults and contributed significantly to an overall negative balance of more losses than gains in those aged 90 years or older. Regarding functional health and autonomy, negative age effects were amplified by AARC-Losses, but buffered by AARC-Gains. A more positive ratio of gains-to-losses predicted better health and functioning.

Discussion and Implications

Findings suggest that the loss aspect of development in very late life might have been overstated in the existing literature. Perceived gains and losses are of critical importance for the understanding of health correlates in very old age.

Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study

BACKGROUND

Self-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components.

METHODS

A cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations.

RESULTS

The overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402-0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492-0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197-0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062-1.810, P = 0.016).

CONCLUSIONS

This study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.

What does feeling younger or older than one's chronological age mean to men and women? Qualitative and quantitative findings from the PROTECT study

OBJECTIVE

We explored which factors are associated with subjective age (SA), i.e. feeling younger, the same as, or older than one's chronological age, and whether these factors differ between men and women and between two age sub-groups.

DESIGN

Cross-sectional study using qualitative and quantitative data for 1457 individuals (mean age= 67.2 years).

MAIN OUTCOME MEASURES

Participants reported how old they feel they are and provided comments in relation to their SA judgments.

RESULTS

By using content analysis participants' comments were assigned to 13 categories, grouped into three higher-order categories (antecedents of age-related thoughts, mental processes, and issues when measuring subjective age). SA may result from the interaction between factors that increase or decrease age-related thoughts and mental processes that individuals use to interpret age-related changes. Chi-squared tests show that individuals reporting an older SA are more likely to experience significant negative changes and to engage in negative age-related thoughts than individuals reporting an age-congruent SA or a younger SA. Women experience a more negative SA and more age-salient events than men.

CONCLUSION

Individuals reporting an older SA may benefit from interventions promoting adaptation to negative age-related changes. There is the need to eradicate negative societal views of older women.

Cross-Sectional and Longitudinal Associations between Subjective Sleep Difficulties and Self-Perceptions of Aging

BACKGROUND

Only one study has explored the associations of subjective sleep difficulties with self-perceptions of aging. It focused on a global indicator of self-perceptions of aging (subjective age) despite individuals reporting different experiences of aging in relation to different life domains. The concept of awareness of negative age-related change, capturing perceived losses across five domains (e.g., physical health, cognition), may be more appropriate when relating subjective sleep difficulties to self-perceptions of aging. We examined whether nine different indicators of subjective sleep difficulties predict levels of awareness of negative age-related change and subjective age, measured concurrently and one year later, while controlling for covariates (mood and daily function).

PARTICIPANTS/METHODS

We used data from the PROTECT cohort study; 4,482 UK residents (mean age = 66.1; SD = 6.9) completed measures of awareness of age-related change, subjective age, mood, daily function, and subjective sleep difficulties.

RESULTS

Based on linear regression analyses, poorer quality of sleep, lower alertness after awakening, satisfaction with sleep, depth of sleep, more frequent early awakening, difficulty falling asleep, more times awake during a night, fewer hours of sleep during the night and more hours of sleep during the day predicted higher awareness of negative age-related change at baseline and follow-up (p< .001). Associations were small in size. Associations between subjective sleep difficulties and subjective age were either negligible or statistically non-significant.

CONCLUSIONS

Although subjective sleep difficulties are one of the many factors associated with awareness of negative age-related change, addressing sleep difficulties, alongside negative mood, and poor daily functioning, may promote a small additional increase in positive self-perceptions of aging.

Awareness of age-related gains and losses as moderators of daily stress reactivity in middle- and older-adulthood

Objectives

Associations between awareness of one's own aging and wellbeing have received increasing attention in the field of gerontology over the last decade. The current study examines how between-person differences and within-person fluctuations of awareness of age-related change (AARC) relate to daily negative affect and vitality. Of key interest was the extent to which fluctuations in AARC moderated reactivity to stressor exposure. We predicted that higher positive perceptions of aging (AARC-gains) would buffer the relationship between daily stressors and negative affect/vitality. Conversely, we expected that higher negative perceptions (AARC-losses) may exacerbate the relationship between daily stressors and the outcome variables.

Methods

Data were collected from a community-based sample of 152 Australian adults aged 53-86 (M = 69.18, SD = 5.73). For 10 consecutive days, participants completed surveys on their smartphones measuring daily stressors, AARC, and affect (positive and negative). Bayesian hierarchical linear models were used to examine whether AARC-gains and AARC-losses moderated within-person associations of daily stressors and affect (i.e., stress reactivity).

Results

At the between-person level, higher AARC-gains was associated with lower negative affect and higher vitality, whereas those reporting higher AARC-losses scored higher on negative affect and lower on vitality. Within-person variables revealed that on days when AARC-gains was higher and AARC-losses was lower, this corresponded with lower negative affect and higher vitality. There was no evidence in support of individual moderating effects of within-person AARC-losses or within-person AARC-gains on stress reactivity. A trend was evident in support of a three-way WP Stress severity × WP AARC-gains × WP AARC-losses interaction in the prediction of negative affect, indicating that on days when AARC-losses was higher, the association of stress severity with negative affect was weaker if AARC-gains was higher. Follow-up analyses modeling quadratic stress severity revealed a trend suggesting an interaction of within-person stress severity and within-person AARC-losses.

Discussion

Results indicate that both individual differences and short-term fluctuations in AARC are associated with daily negative affect and vitality. The results provided qualified support for a possible protective role of AARC-gains in the context of stress reactivity.

Regulatory focus and perceptions of ageing: exploring the connections

Objectives:Perceptions of ageing can become a self-fulfilling prophecy for older adults, with those who hold more negative views of ageing experiencing more negative consequences of the ageing process, including poorer health and cognitive declines. Exposure to negative stereotypes about their group can also affect older adults performance in cognitive tests, as they are more likely to adopt a prevention focus to avoid mistakes, therefore, performing poorly in tasks requiring them to adopt a gains-oriented focus. Based on regulatory focus theory, we hypothesised that negative perceptions of ageing and stereotype threat may be connected, specifically we hypothesised that those with more negative perceptions of ageing would also have a stronger trait prevention focus.Method: Two hundred adults aged 60+ took part in an online questionnaire examining their perceptions of ageing and their trait regulatory focus.Results and Conclusion: Results indicated that negative perceptions of ageing were predictive of a stronger trait prevention focus in a hierarchical multiple regression model. This provides evidence that older adults with more negative perceptions of ageing may adopt a stronger prevention focus, potentially influencing psychological attitudes to everyday tasks and behaviours. Perceptions of ageing and regulatory focus can have implications for the efficacy of health messaging for older adults.

Awareness of age-related change, future time perspective, and implications for goal adjustment in older adulthood

OBJECTIVES

How people adjust their goals is central to adaptation across the lifespan. However, little is known about individual difference characteristics that predict how and why people use different self-regulatory strategies. The present study investigated associations of perceived age-related gains and losses, and their interaction, as predictors of goal adjustment in older adulthood. Furthermore, we examined whether future time perspective (FTP) mediated relationships between awareness of age-related change (AARC) and goal adjustment.

METHOD

A community-based sample of 408 adults (aged 60-88 years) was recruited via an internet-based research platform. Participants completed questionnaire measures of AARC, FTP, goal disengagement, and goal re-engagement. A flexibility index reflecting tendencies toward use of both goal disengagement and goal re-engagement strategies was also analyzed.

RESULTS

Although AARC-losses was associated with lower goal re-engagement and goal flexibility, this association was weaker among those with higher AARC-gains, indicating AARC-gains may be protective in the relationship between AARC-losses and goal adjustment. The association between AARC and goal adjustment was also shown to be mediated by FTP. Higher AARC-gains was associated with more expansive FTP, which was associated with lower goal disengagement and higher goal re-engagement. On the other hand, higher AARC-losses was associated with more restricted FTP, which was associated with higher goal disengagement and lower goal re-engagement.

DISCUSSION

Results have implications for how we conceptualize the combined effects of age-related gains and losses on developmental outcomes relevant to adaptive aging. Furthermore, perceptions of future time with advancing age may be implicated in processes linking AARC with goal adjustment.

Nine-year changes in self-reported problems with vision and hearing among older adults: do subjective age views matter?

OBJECTIVES

So far, little is known about linkages between subjective age views and long-term changes in vision and hearing.

METHOD

We examined the predictive role of two key measures of subjective age views (attitude toward own aging [ATOA]; aging-related cognitions comprising continuous growth, social loss, and physical decline) for changes in self-reported problems with vision and hearing over a period of up to 9 years. A subsample of the German Ageing Survey was used, consisting of 2,499 older adults.

RESULTS

Controlling for socio-demographic characteristics, self-rated health, and depressive symptoms, we found that with increasing age, more favorable ATOA scores, as well as higher scores on continuous growth and lower scores on physical decline, were associated with fewer self-reported vision problems at baseline. With advancing age, more favorable ATOA scores were also related with fewer hearing problems at baseline. However, among individuals with an older baseline age, more favorable ATOA scores were associated with a steeper increase in vision problems. Higher scores on continuous growth were related with less increase in hearing problems, independent of age.

CONCLUSION

Our findings suggest that subjective age views predict individuals' self-reported vision and hearing problems.

Awareness of Age-Related Change as a Behavioral Determinant of Survival Time in Very Old Age

Although research on the association between subjective views of aging (VOA) and survival is scarce, more negative VOA have been found to be associated with increased all-cause mortality, even after controlling for possible confounders. Longitudinal studies on the predictive association of VOA with survival in individuals aged 80 years or older are, however, very limited. Thus, the aim of this study was to link adults' awareness of age-related change (AARC), a multidimensional measure of adults' subjective VOA, to survival time across a 3.5-year observation interval in advanced old age. To put the AARC construct in context, the study also considered related psychosocial concepts (i.e., perceived control and appraisal of life) essential for coping with late-life challenges as potential behavioral predictors of longevity. Data came from a representative panel study that included persons living in community and institutional settings. A total of 1,863 interviews were conducted at wave 1. This study used meta-data from wave 2 fieldwork 2 years after the initial assessment and death records obtained during panel maintenance after 3.5 years to estimate determinants of survival. Results showed that loss-related VOA indicated increased risk to survival, whereas gain-related VOA were predictive of longer survival. Both perceived age-related losses and perceived age-related gains exerted a significant independent effect on late-life mortality over and above socio-demographic background characteristics, perceived control, engagement with life, as well as health status. These findings suggest that the multidimensional examination of very old adults' VOA may help to better understand successful longevity in the Fourth Age.

Age Discrimination in the Context of Motivation and Healthy Aging

Age discrimination can undermine older people's motivation to stay engaged with their lives and poses a major challenge to healthy aging. In this article, we review research on age discrimination in different life domains, including health and work. Motivation and health constitute potential antecedents as well as outcomes of age discrimination, with reduced motivation and impaired health increasing the likelihood of becoming a victim of age discrimination, but also resulting from age discrimination. Furthermore, high levels of motivation and health can also serve as buffers against the negative effects of age discrimination. Based on our literature review, we discuss possible strategies aimed at reducing age discrimination. Understanding and combating age discrimination can foster older people's motivation to participate in meaningful activities and promote healthy aging.

Using Theories of Behavior Change to Develop Interventions for Healthy Aging

Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.

Self-perceptions of ageing, GP visits and frequent attendance. Longitudinal findings from the German Ageing Survey

OBJECTIVES

The aim of this study was to clarify the link between self-perceptions of ageing and the number of general practitioner (GP) visits, as well as frequent GP visits, longitudinally.

METHODS

In this study, longitudinal data with n = 7,062 observations from 2014 (wave 5) to 2017 (wave 6) were taken from the German Ageing Survey (representative sample of middle aged and older individuals residing in private households). The five-item Attitudes Toward Own Ageing subscale of the Philadelphia Geriatric Center Morale Scale (PGCMS) was used to quantify self-perceptions of ageing. The frequency of GP visits in the past 12 months served as outcome measure (first model: measured continuously; second model: top 10% were defined as frequent attenders). To exploit the features of panel data, and to mitigate the problem of unobserved heterogeneity, fixed effects regressions were used.

RESULTS

Adjusting for predisposing characteristics, enabling resources and need-factors, regressions showed that an increase in self-perceptions of ageing was associated with decreases in the number of GP visits (IRR= .83 (95% CI: .77-.91)), and a decreased likelihood of becoming a frequent attender (OR= .44 (95% CI: .29-.66)).

CONCLUSIONS

Using data from a longitudinal study and exploiting the longitudinal data structure, the current study adds to our current knowledge by demonstrating that self-perceptions of ageing contribute to the frequency of GP visits as well as frequent attendance. Since self-perceptions of ageing are modifiable, this may help to manage health care use.

Do age stereotype-based interventions affect health-related outcomes in older adults? A systematic review and future directions

PURPOSE

Developing interventions that target population-specific motivational barriers to promote health behaviours is crucial, especially for older adults who are confronted with negative age stereotypes. This systematic review evaluates randomized and non-randomized field studies that tested the effects of age stereotype-based interventions on health outcomes in adults aged 50 years and over.

METHODS

MEDLINE, SPORTDiscus, Scopus, Web of Science Core Collection and PsychINFO were searched to identify articles published up until May 2019. Data were extracted from all articles independently and assessed for risk-of-bias using Cochrane Collaboration tools.

RESULTS

Ten articles met the inclusion criteria. Health-related outcome measures were identified across three domains: physical, psychological/psychosocial well-being, and quality of life/subjective health, with age stereotypes reported as an additional outcome. Intervention structure varied substantially between studies regarding content, duration, frequency, and length of follow-up.

CONCLUSIONS

Most studies showed that age stereotype-based interventions significantly improved physical function or physical activity as well as self-perceptions of ageing. However, more rigorous studies are needed. Indeed, given the detrimental health effects of age stereotypes, the potential for impact of interventions designed to challenge them is important. Future research should explore the implications of intervening on different stereotype mechanisms, whether intervention effects are comparable across health domains, and whether age stereotype-based interventions are more effective than non-age-specific interventions. PROSPERO Registration CRD42018094006.

Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

INTRODUCTION

Stroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.

METHODS AND ANALYSIS

The study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1-5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.

ETHICS AND DISSEMINATION

The study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.

TRIAL REGISTRATION NUMBER

NCT04704635.

Ageist Attitudes Are Associated with Will-to-Live and Moderated by Age, Medical Conditions and Attitudes toward Aging

The extent to which older adults’ ageist attitudes associate with their will-to-live has barely been studied. Moreover, whether this effect is moderated by older adults’ age, medical conditions, and attitudes toward their own aging has not been investigated. These associations were examined by two studies. Study 1 examined the relationship between ageist attitudes and will-to-live among individuals aged 48–97, and the moderating roles of age and medical conditions on this connection. Study 2 reassessed this connection in a new sample of older adults (people aged 60–94 years) and examined the moderating role of their attitudes toward aging in this regard. In line with the hypothesis of the first study, ageist attitudes and will-to-live were negatively associated among older adults with more medical conditions. In accordance with the hypotheses of study 2, the ageist attitudes and will-to-live connection was reconstructed, and when regressed on the ageist attitudes × attitudes toward aging interaction, it remained significant only among those with increased ageist attitudes. These findings demonstrate the negative effect that ageist attitudes may have on will-to-live, especially among the very old, and particularly when their health deteriorates, and support the utility of interventions aimed at increasing their will-to-live.

Age-related change in self-perceptions of aging: Longitudinal trajectories and predictors of change

Using data from the German Ageing Survey (Deutscher Alterssurvey, DEAS; N = 4,712), this study examined age-related change in three dimensions of self-perceptions of aging (SPA): perceptions of physical losses, social losses, and ongoing development. Participants ranged in age from 40 to 85 years at study entry (1996, 2002, or 2008) and were followed for up to 21 years. Time-invariant, context-specific and time-varying, person-specific predictors of the observed age-related changes were examined. Findings from longitudinal multilevel regression analyses showed significant nonlinear age-related change for all three dimensions. Specifically, starting at about age 65, participants showed age-related increases in perceptions of physical and social losses, with increases getting steeper in old age. Starting at about age 55, participants reported increasingly fewer perceptions related to ongoing development. The decline in perceptions of ongoing development also became increasingly steeper after age 70. Region of residence was a significant context-specific predictor of the intercepts of the three SPA dimensions. Health-related variables (i.e., number of chronic diseases, self-rated health), affective well-being (i.e., positive and negative affect), and measures of social integration (i.e., loneliness) were significant person-specific predictors. Health-related variables had their strongest association with perceptions of physical losses, whereas negative affect and loneliness had their strongest association with perceptions of social losses. Positive affect had its strongest association with perceptions of ongoing development. This study is the first one to describe age-related change trajectories in multiple dimensions of SPA and significant predictors of these change trajectories. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of the COVID-19 Pandemic on Self-Perception of Aging Among Older Adults

The COVID-19 pandemic has created a pattern of physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of negative self-perception of aging (SPA) among older adults, but how this pandemic has influenced such SPA is not yet known. This study, therefore, explored SPA at different time phases of the COVID-19 pandemic to explain the pandemic's impact on SPA among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65 to 95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection from different older adults within one study occurred both before and after Switzerland's first confirmed COVID-19 case. The descriptive analysis revealed that negative SPA increased, and positive SPA decreased, after the Swiss government recommended physical distancing. After the Federal Council decided to ease these measures, negative SPA slightly decreased and positive SPA increased. According to the multivariate analysis, individuals interviewed after the lockdown were more likely to report greater levels of negative SPA and lower levels of positive SPA. Age, income, and living alone also correlated with SPA. The results suggest that the pandemic has affected older adults' subjective views of their own aging, and these findings help illustrate the pandemic's outcomes.

Views on aging: older adults' self-perceptions of age and of health

Perceptions of age and perceptions of health have each been found to predict future health and well-being, yet surprisingly, studies typically focused on one or the other. Studies on perceived age suggested that its effects on longevity may be mediated by perceived health. Within each of these lines of research, the constructs have not been consistently operationalized, making it difficult to generalize across studies. We aimed to investigate the associations of different measures of perceptions of age and of health with one another and with longevity. Data collected at baseline from the 851 participants of the Rutgers Aging and Health longitudinal study (mean age 73) included perceptions of age and health, each assessed with four different single-item measures, sociodemographic, and health measures. Mortality was followed-up for 10 years. All four health perceptions and two of the age perceptions (Age-group identity and nearness-to-death) were associated with survival time. Age and health perceptions had similar independent effects in models that included measures of both types, controlling for demographics and chronic conditions, though not after controlling for age. In contrast with our hypothesis, health perceptions did not mediate the association between age perceptions and mortality. Findings regarding health perceptions were generally consistent across measures, whereas age perception measures differed in their associations with various outcomes, indicating that they assess different subjective age constructs. The findings correspond with proposed explanations for the predictive effect of age and health perceptions and support the significant though weaker independent effects of age perceptions compared with health perceptions.

The assessment of views on ageing: a review of self-report measures and innovative extensions

This is a review of existing self-report measures for assessing views on ageing. It provides an overview of instruments, for which basic psychometric properties are available and describes them according to the purposes for which they are suitable. Literature search resulted in the inclusion of 89 instruments which were categorised along eight dimensions. The majority of measures focus on explicit cognitions about people's own age and ageing or other (older) people. A substantial amount of tools account for the multidimensionality and multidirectionality of views on ageing, i.e. the idea that ageing is accompanied by both gains and losses in several different domains. To some extent, measures reflect that ageing is a long-term process and that views on ageing are malleable, rather than just stable traits. Cluster analysis revealed heterogeneity in instruments regarding the dimensions of Ecosystem, Balance, Stability, Dynamics, and Complexity. It becomes apparent, however, that approaches to measure views on ageing should be extended to more specifically target the implicit level as well as affective, physiological, and behavioural manifestations. Additionally, means for capturing views on ageing on the societal level and tools with a distinct time reference are needed. This is particularly important when one wants to account for the lifelong dynamics of views on ageing.

Changes in views on aging in later adulthood: the role of cardiovascular events

A number of longitudinal studies have pointed to the long-term impact of different views on aging (VoA) on health in later life, whereas the reverse relationship has rarely been examined. Serious cardiovascular events such as myocardial infarction or stroke are life-threatening events which might in turn lead to changes in VoA. The present longitudinal study examined the effect of a cardiovascular event (CVE) on VoA over a three-year period using pooled data from three waves of the German Ageing Survey (2008, 2011, 2014, age range: 40-95 years). In order to account for alternative explanations for changes in VoA, individuals without CVE (n = 200) were matched to individuals who experienced a CVE (n = 202) using a propensity score matching procedure. Compared to individuals without CVE, individuals who experienced a CVE showed adverse changes in three VoA indicators (self-perceptions of aging as associated with physical losses/with ongoing development; subjective age). These results suggest that CVE can in fact change how individuals view their own aging. According to previous studies, this can lead to future health changes and thus become a health-related downward spiral. Health promotion programs could, therefore, profit by adding specific VoA interventions for individuals who experienced a CVE.

Brief Anti-Ageism Messaging Effects on Physical Activity Motivation Among Older Adults

When people have more negative perceptions about aging or attribute health decline to old age, they engage in less health promotion behavior. We tested whether an intervention of brief anti-ageism messages addressing views of aging could motivate engagement in physical activities at senior centers. Attendees aged 50 and older ( n = 349; Mage = 72, SD = 9) at seven centers were randomly assigned to read one of three intervention messages (different approaches addressing views of aging) or to not read a message before rating their likelihood of attending a variety of center programs, including physical activities. Multilevel regression models indicated the intervention increased motivation to attend physical activities compared with the control group among participants aged 72 and older. The three anti-ageism messages were similarly effective suggesting some flexibility in framing. The results indicate anti-ageism messages may be a scalable, low-cost approach to promoting physical activity in older adults.

Mobility in Older Community-Dwelling Persons: A Narrative Review

Due to the demographic changes and the increasing awareness of the role of physical function, mobility in older age is becoming an important topic. Mobility limitations have been reported as increasingly prevalent in older persons affecting about 35% of persons aged 70 and the majority of persons over 85 years. Mobility limitations have been associated with increased fall risk, hospitalization, a decreased quality of life, and even mortality. As concepts of mobility are multifactorial and complex, in this narrative review, definitions, physical factors, and their age-related changes associated with mobility will be presented. Also, areas of cognitive decline and their impact on mobility, as well as neuromuscular factors related to mobility will be addressed. Another section will relate psychological factors such as Fall-related psychological concerns and sedentary behavior to mobility. Assessment of mobility as well as effective exercise interventions are only shortly addressed. In the last part, gaps and future work on mobility in older persons are discussed.

Perception of aging in the relation between sport activity and self-rated health in middle and older age - A longitudinal analysis

Background

This study aims to generate more comprehensive knowledge regarding underlying mechanisms of health production in middle and older age by focusing on perception of aging in the relation between sport activity and self-rated health. More differentiated information can be generated by using more age-specific data and applying advanced empirical methods.

Methods

Panel data from the German Ageing Survey (DEAS) (n = 1027) is used, whereby individuals are included, that participated at least in two waves. First, a blockwise fixed effects logistic regression model is carried out, which allows to investigate mediation as well as moderation effects and controls for time invariant unobserved heterogeneity. Additionally, two recursive bivariate probit models are conducted to identify further indirect pathways.

Findings

A mediating and moderating effect of perception of aging regarding self-rated health is found in the fixed effects model. Indirect pathways of perception of aging and retirement over sport activity (mediator) are confirmed in the recursive bivariate probit models.

Conclusion

The results highlight the complexity of the underlying mechanisms as well as the importance of individual and needs-based designed health promotion. Here, public health policy should not solely focus on sport activity, rather it should include target group specific strategies to shape individual perceptions of aging towards a more positive view on aging, while considering the heterogeneity of middle and older age groups.

•

Sport activity and health-specific perception of aging are positively associated with self-rated health.

•

A mediating and moderating effect of perception of aging on sport activity regarding self-rated health is found.

•

Indirect pathways of perception of aging and retirement over sport activity are confirmed.

The differences in self-perceptions of aging, health-related quality of life and their association between urban and rural Chinese older hypertensive patients

Background

Most hypertensive clients are elderly, whose health-related quality of life (HRQL) may be associated with self-perceptions of aging (older individuals’ beliefs about their own aging). Meanwhile, culture and health disparities between rural and urban populations are substantial. Whether there are differences in self-perceptions of aging, HRQL, and their association among elderly hypertensive clients in urban and rural areas remains unknown. The objective of this study was to investigate and compare self-perceptions of aging and HRQL and their association among urban and rural older Chinese hypertensive clients.

Methods

A cross-sectional investigation was conducted in 15 urban community clinics and 22 village clinics from Suzhou, China. Older hypertensive adults were invited to complete a self-administered questionnaire addressing socio-demographic and clinical information, HRQL and self-perceptions of aging.

Results

There were 492 urban participants and 537 rural participants included in the analyses. The physical (40.0 ± 12.1 vs. 30.9 ± 8.9, P <  0.001) and mental (51.5 ± 8.3 vs. 46.0 ± 7.8, P <  0.001) HRQL scores of urban participants were all higher than those of rural ones. Urban participants’ scores on dimensions of “timeline cyclical”, “consequences negative”, and “control negative” of self-perceptions of aging questionnaire (APQ) were lower than those of rural participants (P <  0.001, respectively), while the scores on dimensions of “consequences positive” and “control positive” were higher (P <  0.001, respectively). Adjusted multivariate linear regression showed that participants who had worse self-perceptions of aging had poorer HRQL. Some APQ dimensions associated with urban or rural hypertensive elders’ HRQL were different.

Conclusions

Older hypertensive clients in rural areas have poorer self-perceptions of aging and HRQL than those in urban areas. Health care professionals should pay more attention to HRQL and self-perceptions of aging of older hypertensive clients in rural areas.

There Is Still Time to Be Active: Self-Perceptions of Aging, Physical Activity, and the Role of Perceived Residual Lifetime Among Older Adults

Self-perceptions of aging (SPA) are a resource in later life. As aging is accompanied with perceptions of the finitude of life, it is assumed that perceived residual lifetime may play a role in the relationship between SPA and health behavior. Among older adults aged 65 years and older, the present study tested whether the relationships between gain- and loss-related SPA and two kinds of physical activity are moderated by perceived residual lifetime. Data were based on 2.367 participants over a 3-year period. Participants with less gain-related SPA were less likely to walk on a regular basis; however, a longer residual lifetime compensated for this negative effect. In addition, participants did sports more often if they not only held less loss-related SPA but also perceived a longer residual lifetime. These results emphasize the importance of perceived residual lifetime in health promotion interventions targeting physical activity in older adults.

Profiles of physical activity biographies in relation to life and aging satisfaction in older adults: longitudinal findings

BACKGROUND

While there is substantial evidence on the relationship between life satisfaction and present physical activity (PA), less is known about which specific PA biographies are associated with a high quality of life and aging satisfaction. Our objective was to identify classes of PA biographies that may be associated with life and aging satisfaction.

METHODS

In this longitudinal study, PA biographies were assessed retrospectively as a baseline, followed by assessments of life and aging satisfaction at six and twelve months in 418 adults aged 60-95. Subgroups with different PA biographies were identified using latent class analysis.

RESULTS

Four distinct PA biographies emerged: increasingly active (35%; n = 147); consistently active (25%; n = 103); consistently inactive (18%; n = 75); and decreasingly active (22%; n = 94). Being consistently active was related to life satisfaction (β = .17) and consistent inactivity was associated with aging dissatisfaction (β = -.20) when accounting for current PA levels.

CONCLUSIONS

In addition to current PA, our findings emphasize the value of PA biographies for life and aging satisfaction, which could inform lifespan theories of PA and health promotion.