Reducing cardiovascular stress with positive self-stereotypes of aging

Internalized stigma: Social support, coping, psychological distress, and mental well-being among older adults in Ghana

BACKGROUND

Older adults have been found to internalize stigma from society and this has been linked to several variables including social support, coping, psychological distress, and mental well-being. However, there is a dearth of research on how these variables interact with each other to impact the life of older adults.

AIMS

This study employed path analysis to explore social support and coping as boundary conditions and underlying mechanisms in the link between internalized stigma, psychological distress, and mental well-being, among older adults in Ghana.

METHOD

Using a cross-sectional design, the study recruited 167 older adults who responded to standardized questionnaires including The Internalized Stigma of Mental Illness scale, Multidimensional Perceived Social Support Scale, The Brief Coping Inventory, Kessler Distress Scale, and the Warwick-Edinburgh Mental Well-being Scale, to determine levels of internalized stigma, social support, coping strategies, psychological distress, and mental well-being, respectively.

RESULTS

The findings revealed that at low levels of social support, there is a significant and positive correlation between internalized stigma and mental well-being (β = -.36, SE = 0.17, p < .001). Path analysis showed that the relationship between internalized stigma and mental well-being was fully mediated by problem-focused coping (β = .11, p = . 001, 95% CI [0.04, 0.21]), but not psychological distress. Problem-focused coping was also found to have a significant positive correlation with mental well-being but no significant correlation with psychological distress. Conversely, avoidant-focused coping was found to have a significant positive correlation with psychological distress and a significant negative correlation with mental well-being.

CONCLUSIONS

This study revealed the importance of social support and coping to attaining mental well-being among older adults. This study provides insights into the development of tailored interventions aimed at improving social support and problem-focused coping among older Ghanaian adults facing internalized stigma, and it also establishes a base for future research.

Youth is Prized in Medicine, Old Age is Valued in Law: Analysis of Media Narratives Over 200 Years

BACKGROUND

This is the first study to explore how age has influenced depictions of doctors and lawyers in the media over the course of 210 years, from 1810 to 2019. The media represents a significant platform for examining age stereotypes and possesses tremendous power to shape public opinion. Insights could be used to improve depictions of older professionals in the media.

OBJECTIVE

This study aims to understand how age shapes the portrayals of doctors and lawyers. Specifically, it compares the difference in sentiments toward younger and older doctors as well as younger and older lawyers in the media over 210 years.

METHODS

Leveraging a 600-million-word corpus of American media publications spanning 210 years, we compiled top descriptors (N=478,452) of nouns related to youth × occupation (eg, younger doctor or physician) and old age × occupation (eg, older lawyer or attorney). These descriptors were selected using well-established criteria including co-occurrence frequency and context relevance, and were rated on a Likert scale from 1 (very negative) to 5 (very positive). Sentiment scores were generated for "doctor/physician," "young(er) doctor/physician," "old(er) doctor/physician," "lawyer/attorney," "young(er) lawyer/attorney," and "old(er) lawyer/attorney." The scores were calculated per decade for 21 decades from 1810 to 2019. Topic modeling was conducted on the descriptors of each occupation in both the 1800s and 1900s using latent Dirichlet allocation.

RESULTS

As hypothesized, the media placed a premium on youth in the medical profession, with portrayals of younger doctors becoming 10% more positive over 210 years, and those of older doctors becoming 1.4% more negative. Meanwhile, a premium was placed on old age in law. Positive portrayals of older lawyers increased by 22.6% over time, while those of younger lawyers experienced a 4.3% decrease. In the 1800s, narratives on younger doctors revolved around their participation in rural health care. In the 1900s, the focus shifted to their mastery of new medical technologies. There was no marked change in narratives surrounding older doctors from the 1800s to the 1900s, though less attention was paid to their skills in the 1900s. Narratives on younger lawyers in the 1800s referenced their limited experience. In the 1900s, there was more focus on courtroom affairs. In both the 1800s and 1900s, narratives on older lawyers emphasized their prestige, especially in the 1900s.

CONCLUSIONS

Depending on the occupation, one's age may either be seen as an asset or a liability. Efforts must be expended to ensure that older professionals are recognized for their wealth of knowledge and skills. Failing to capitalize on the merits of an older workforce could ultimately be a grave disservice not only to older adults but to society in general.

Do Internalized Age Stereotypes Mediate the Relationship Between Volunteering and Self-Efficacy for Adults 50+ Years of Age?

This cross-sectional study examined whether internalized age stereotypes mediate the relationship between volunteering and self-efficacy for adults 50+ years of age. A convenience sample of volunteers (n = 173) residing in the United States of America Mountain West completed a 15-min, online survey. The independent variable was number of volunteer hours per week (mean = 6.44, SD = 5.50). The dependent variable was self-efficacy measured by five, four-point items from the general self-efficacy scale (α = .83; mean = 3.57, SD = .38). The indirect effects of five internalized positive and five negative age stereotypes were tested. Results indicate that increased internalized positive, but not negative, age stereotypes partially mediated the relationship between volunteer hours and self-efficacy. Although positive age stereotypes have long been considered a form of ageism, the findings suggest that internalized positive age stereotypes may function as a form of esteem to enhance psychosocial well-being.

Innovations for an Aging Society through the Lens of Patent Data

BACKGROUND AND OBJECTIVES

An aging population creates fertile ground for devising innovations for older adults. By using patents as a proxy for inventive activity, this study sets the stage for understanding the latest innovations being designed for the older population. Insights will pave the way for a better understanding of inventions that could render society more age-friendly on the innovation front.

RESEARCH DESIGN AND METHODS

To identify the latest innovations targeted at the older population, we collected all patents (N = 326) issued in 2021, specifically those issued between January 5th and December 28th. Upon removing irrelevant data, 120 patents were retained in the data set. Both inductive and deductive modes of reasoning informed our content analysis of the data.

RESULTS

Three themes surfaced. About half (49.2%) of the patents focused on "Preventive Health, Safety, and Independence" (Theme 1). About 38.3% pertained to "Anti-Aging" (Theme 2) and 12.5% were about the "Pathologization of Old Age" (Theme 3).

DISCUSSION AND IMPLICATIONS

This is the first study that evaluates the state of innovations for an aging population. While there are inventions aimed at optimizing the well-being of older adults, there are also those designed due to beliefs that see old age as a problem to solve. As the world experiences a demographic shift, it is imperative that collective ingenuity be harnessed to build a society conducive to all facets of the aging experience.

Ageism in the Nursing Care of Older Adults: A Concept Analysis

Despite the high prevalence of ageism worldwide, it is still underestimated and unrecognized by many nurses. Concept clarification is required to delineate the meaning of the word "ageism" in nursing. The purpose of this concept analysis is to clearly define the concept of ageism relative to nursing discipline using the Walker and Avant method. Defining the concept of ageism will provide nurses with a better understanding of its causes and consequences. It will aid policy makers in developing policies and interventions to help decrease ageism in health care environments.

Perceptions of older adults and generativity among older citizens in Japan: a descriptive cross-sectional study

BACKGROUND

As the population ages worldwide, including in Japan, there is a growing expectation for older adults to remain active participants in society. The act of sharing one's experiences and knowledge with younger generations through social engagement not only enriches the lives of older individuals, but also holds significant value for our society. In this study, we examined both positive and negative perceptions of older adults and investigated the correlation between these perceptions and generativity among older citizens. Additionally, we evaluated the impact of life satisfaction on these factors.

METHODS

We conducted a survey of 100 older adults in Japan (mean age, 71.68 years) and utilized multiple regression analyses, using positive and negative perceptions of older adults, life satisfaction, and demographic factors as independent variables. The sub-categories of generativity-namely, generative action, concern, and accomplishment-were used as dependent variables.

RESULTS

Participants who held a more positive perception of older adults demonstrated a higher level of generative actions and concerns. Additionally, participants who reported higher levels of life satisfaction also exhibited more generative actions, concerns, and accomplishments. Conversely, those who held a more negative perception of older adults were found to have higher levels of generative actions.

CONCLUSION

Enhancing positive perceptions of older adults among them can boost the sub-categories of generativity. This study, which was conducted from an exploratory perspective, has several limitations, including a potential sampling bias. A more comprehensive examination of the relationship between perceptions of older adults and generativity is anticipated in future research.

Change in Views of Aging, Physical Activity, and Physical Health Over 8 Weeks: Results From a Randomized Study

The AgingPLUS program targets motivational barriers, including negative views of aging, as mechanisms to increase adult physical activity. A pilot study was conducted to test the efficacy of this new program against a generic successful aging program. Fifty-six participants were randomly assigned to the AgingPLUS group, and 60 participants were assigned to the active control group. Repeated-measures multivariate analyses of variance assessed changes in views of aging, physical activity, blood pressure, and hand-grip strength from pretest (Week 0) to delayed posttest (Week 8). The Condition × Occasion interactions were nonsignificant; however, significant main effects for condition and occasion were found. Follow-up tests showed that views of aging were more positive, and physical activity had significantly increased at Week 8 for all participants. In addition, in the treatment group, elevated blood pressure had significantly decreased and hand-grip strength had significantly increased at Week 8. Despite the nonsignificant multivariate findings, the main effect findings provided partial support for the efficacy of the AgingPLUS program.

Self-Perception of Aging and Hypertension in a Cohort of Sexual Minority

Objectives To determine whether self-perception of aging is an important marker of health and hypertension among older sexual minority men. Methods We evaluated associations between self-perception of aging (chronologic-subjective age discrepancy and aging satisfaction) and hypertension among 1,180 sexual minority men (51.6% with HIV/48.4% without HIV) from the Multicenter AIDS Cohort Study using a manifest Markov chain model adjusted for HIV status, age, race/ethnicity, education, smoking status, inhaled nitrite use, diabetes, dyslipidemia, kidney and liver disease. Results The overall prevalence of hypertension increased from 73.1% to 82.6% over three years of follow-up. Older age discrepancy (aOR (adjusted odds ratio): 1.13 95% CI: 0.35-3.69) and low aging satisfaction (aOR: 0.88; 95% CI: 0.31-2.52) were not associated with an increased prevalence of hypertension, regardless of HIV status. Discussion More than 80% of sexual minority men had a diagnosis of hypertension but self-perception of aging was not predictive of incident hypertension.

Association between older subjective age and poor sleep quality: a population-based study

OBJECTIVE

To examine the association of subjective age (SA) with sleep quality in an adult population.

METHODS

In the Korean Sleep and Headache Study, 2,349 participants (49.2% men; 48.1 ± 16.4 years old) were interviewed face-to-face using structured questionnaires between September and December 2018. SA was assessed by asking participants their perceived age in years and then compared with their chronological age (CA). Participants were assigned to three groups: feeling younger, feeling their age, and feeling older. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Association between SA and sleep quality was analyzed with multiple linear regression controlling for demographics, psychosocial, and sleep characteristics.

RESULTS

The group feeling older (n = 404, 17.2%; men, 58.2%; age, 46.5 ± 16.2 years) had worse sleep quality than the groups feeling younger and feeling their age (PSQI score, 4.3 ± 2.7, 3.8 ± 2.4, 3.4 ± 2.1, respectively, p <.001; prevalence of poor sleep quality, 29.0%, 18.4%, 13.5% respectively, p <.001). The association between SA and the PSQI score remained significant after adjusting for confounders (β = 1.05, 95% confidence interval 0.26, 1.83; p <.001). Stratified analyses by sex and CA showed that the association between SA and the PSQI score was significant only in women and in middle-aged and older group (aged 50-79), suggesting that sex and CA modified the association.

CONCLUSION

Age perception was associated with self-reported sleep quality, independent of CA. SA may be a useful marker that complements the conventional assessment of subjective sleep quality.

A cross sectional survey on UK older adult’s attitudes to ageing, dementia and positive psychology attributes

Background

With an increasingly ageing population worldwide, the predominant attitude towards ageing is still negative. Negative stereotypes have detrimental effects on individuals’ physical and mental health. Evidence is required about factors that may predict and change these views. This study aimed to investigate if an older person’s attitude towards dementia, their belief in a just world and sense of coherence is associated with their attitudes to ageing.

Methods

A 25-min online survey was completed by 2,675 participants aged 50 or over who were current residents of the United Kingdom (UK). Questions included demographics, overall health, dementia carer, dementia relative status and retirement status. Standardised scales used were the Attitudes to Ageing Questionnaire (AAQ), Dementia Attitudes Scale (DAS), Just World Scale (JWS) and Sense of Coherence Scale-13 (SOC). Data was analysed with descriptive, two-tailed bivariate Pearson’s correlations, simple, and hierarchical regression analyses.

Results

Attitudes to dementia, just world beliefs, and sense of coherence were all significantly positively correlated with AAQ-Total, with SOC sub-scale “Meaningfulness” showing the strongest correlation. In a hierarchical regression model, higher scores on SOC-Meaningfulness, DAS-Total and belief in a just world for oneself all predicted more positive attitudes to ageing.

Conclusions

The more positive an individual’s attitude to dementia and the stronger they hold the belief that the world is just and coherent, the more likely they are to display positive attitudes to ageing. This initial evidence helps create a greater understanding of the factors that drive attitudes and stigma and may have implications for public health messaging.

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.

Ageism on Twitter during the COVID-19 pandemic

The COVID-19 crisis has sparked a resurgence of scholarly interest in the issue of ageism. Whether the outbreak thwarts or facilitates efforts to combat ageism hinges upon public sentiments toward the older demographic. This study aims to explore discourse surrounding older adults by analyzing 183,179 related tweets posted during the COVID-19 pandemic from February to December 2020. Overall, sentiments toward older adults became significantly less negative over time, being the least negative in April, August, and October, though the score remained below the neutral value throughout the 11 months. Our topic modelling analysis generated four themes: "The Need to Protect Older Adults" (41%), "Vulnerability and Mortality" (36%), "Failure of Political Leadership" (12%), and "Resilience" (11%). These findings indicate nascent support for older adults, though attempts to show solidarity may well worsen benevolent ageism.

Identifying and Addressing Implicit Ageism in the Co-Design of Services for Aging People

In a world with an increasingly aging population, design researchers and practitioners can play an essential role in shaping better future societies, by designing environments, tools, and services that positively influence older adults’ everyday experiences. The World Health Organization (WHO) has proposed a framework called Healthy Ageing, which can be adopted as the basis for designing for an aging society. There are, however, many challenges in achieving this goal. This article addresses one of these challenges identified by WHO, which is overcoming ageism as a form of discrimination based on age. In contrast with most other types of discrimination, ageism is not always easy to detect and overcome because of its generally implicit nature. This paper investigates adopting storytelling as a method for detecting implicit ageism and proposes a co-design process that utilizes this method to better address older adults’ needs and requirements. The use of this method is discussed through two example case studies aimed at improving the design of assistive services and technologies for aging people. The findings from these case studies indicate that the proposed method can help co-design teams better identify possible implicit ageist biases and, by doing so, try to overcome them in the design process.

Younger and Older Adults’ Cognitive and Physical Functioning in a Virtual Reality Age Manipulation

Objectives: Age group stereotypes (AGS), especially those targeting old age, affect an individual’s behavior and long-term cognitive and physiological functioning. Conventional paradigms investigating the related mechanisms lack validity and stability. Our novel approach for the activation of self-relevant AGS uses a virtual reality (VR) ageing experience, measuring relevant effects on performance parameters.

Methods: In a between-subjects experimental design, young participants embodied either a younger or older avatar in a 3D virtual environment to capture the effects on physical (Study 1; N = 68) and cognitive performance (Study 2; N = 45). In Study 3 (N = 117), the paradigm was applied to older participants.

Results: For the younger participants, embodying older avatars was associated with declines in memory and physical performance when compared to the younger avatar age group. Furthermore, the manipulations’ main effects were moderated by negative explicit AGS that matched the respective performance domains. For the older participants, we found no significant performance differences in the two domains investigated.

Discussion: The experimental manipulation demonstrated an impact on relevant performance parameters on a motivational and strategic level, especially for strong performance-related AS, but for young participants only. Possible reasons and mechanisms for the differences in younger and older samples’ results are discussed.

Anti-old and anti-youth attitudes among older adults: focusing on middle-aged and old age identity

There is currently a lack of comprehensive scholarly information concerning the attitudes older people hold toward both older adults and the young. Using the social identity theory framework, this study investigated older identity issues including middle-aged identity and old age identity. We conducted an online survey of Japanese older participants (N = 301) and then implemented a Bayesian structural equation modeling to examine whether age and gender predicted middle-aged/old age identity in addition to whether middle-aged/old age identity predicted anti-old/anti-youth attitudes. Results showed the more strongly participants identified with being middle-aged the more positive their attitudes were toward old/young people, while they showed no significant relationship between old age identity and the attitudes. Regarding participant ages, the results found no significant relationship with middle-aged identity but a positive relationship with old age identity. These findings will contribute to psychological research aimed at reducing anti-old/anti-youth attitudes among older adults.¹1 A part of this study was presented at the 85th Annual Convention of the Japanese Psychological Association.

Self-Perceptions of Aging Moderate Associations of Within- and Between-Persons Perceived Stress and Physical Health Symptoms

OBJECTIVES

To examine how self-perceptions of aging (SPA) moderated within- and between-persons perceived stress associations with physical health symptoms.

METHODS

A community-dwelling sample of 103 adults (Meanage = 63, range = 52-88) participated in an online microlongitudinal study for 100 days (Noccasions = 7,064). Participants completed baseline surveys consisting of SPA, social connections, and demographics followed by 100 daily surveys including information about daily stress perceptions and physical health. Utilizing generalized multilevel models, we examined whether daily fluctuations and average levels of perceived stress over 100 days affected physical health symptoms and whether these associations varied by SPA.

RESULTS

Adults who had higher perceived stress, on average across 100 days, reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p < .05). On days when individuals reported higher perceived stress than their own average, they had a higher likelihood of reporting more physical health symptoms compared to days when their perceived stress was lower than their own average (p < .05). Further, SPA significantly moderated associations between both within- and between-persons perceived stress and physical health symptoms (ps < .05). Individuals with more positive SPA were less affected by high levels of perceived stress-both on average and on days when perceived stress was higher than their own average.

DISCUSSION

More positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.

Impact of Media-Based Negative and Positive Age Stereotypes on Older Individuals' Mental Health

OBJECTIVES

During the COVID-19 pandemic, stigmatization of older persons increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health.

METHOD

To address these gaps, we designed age-stereotype interventions based on actual news stories that appeared during the pandemic, and divided them into negative and positive versions of what we term personified (i.e., individual-based) and enumerative (i.e., number-based) age-stereotype messaging. The negative versions of the 2 types of messaging reflected the age stereotype of decline, whereas the positive versions of the 2 types of messaging reflected the age stereotype of resilience.

RESULTS

As expected, the exposure of older individuals to the negative-age-stereotype-messaging interventions led to significantly worse mental health (i.e., more anxiety and less peacefulness), compared to a neutral condition; in contrast, the positive-age-stereotype-messaging interventions led to significantly better mental health (i.e., less anxiety and more peacefulness), compared to a neutral condition. The findings were equally strong for the personified and enumerative conditions. Also as expected, the interventions, which were self-irrelevant to the younger participants, did not significantly impact their mental health.

DISCUSSION

This is the first-known study to experimentally demonstrate that institutional ageism, and statistics that reflect stereotypes about older individuals, can impact mental health. The results demonstrate the need for media messaging aimed at empowering older individuals during the pandemic and beyond.

Associations Between Satisfaction With Aging and Health and Well-being Outcomes Among Older US Adults

IMPORTANCE

Researchers and policy makers are expanding the focus from risk factors of disease to seek potentially modifiable health factors that enhance people's health and well-being. Understanding if and to what degree aging satisfaction (one's beliefs about their own aging) is associated with a range of health and well-being outcomes aligns with the interests of older adults, researchers, health systems, and politicians.

OBJECTIVES

To evaluate associations between changes in aging satisfaction and 35 subsequent health and well-being outcomes.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used data from the Health and Retirement Study, a national, diverse, and longitudinal sample of 13 752 US adults older than 50 years, to evaluate if changes in aging satisfaction (between combined cohorts from 2008 and 2010 and 4 years later, in 2012 and 2014) were subsequently associated with 35 indicators of physical, behavioral, and psychosocial health and well-being in 2016 and 2018. Statistical analysis was conducted from July 24, 2020, to November 6, 2021.

EXPOSURE

Aging satisfaction.

MAIN OUTCOMES AND MEASURES

A total of 35 physical (eg, stroke), behavioral (eg, sleep problems), and psychosocial (eg, depression) outcomes were evaluated using multiple linear and generalized linear regression models. Data from all participants, irrespective of how their levels of aging satisfaction changed from the prebaseline to baseline waves, were incorporated into the overall estimate, which was conditional on prior satisfaction.

RESULTS

During the 4-year follow-up period, participants (N = 13 752; 8120 women [59%]; mean [SD] age, 65 [10] years; median age, 64 years [IQR, 56-72 years]; 7507 of 11 824 married [64%]) in the highest (vs lowest) quartile of aging satisfaction had improved physical health (eg, 43% reduced risk of mortality [risk ratio, 0.57; 95% CI, 0.46-0.71]), better health behaviors (eg, 23% increased likelihood of frequent physical activity [risk ratio, 1.23; 95% CI, 1.12-1.34]), and improved psychosocial well-being (eg, higher positive affect [β = 0.51; 95% CI, 0.44-0.58] and lower loneliness [β = -0.41; 95% CI, -0.48 to -0.33]), conditional on prebaseline aging satisfaction.

CONCLUSIONS AND RELEVANCE

This study suggests that higher aging satisfaction is associated with improved subsequent health and well-being. These findings highlight potential outcomes if scalable aging satisfaction interventions were developed and deployed at scale; they also inform the efforts of policy makers and interventionists who aim to enhance specific health and well-being outcomes. Aging satisfaction may be an important target for future interventions aiming to improve later-life health and well-being.

Predicting others' knowledge in younger and older adulthood

Our beliefs about aging affect how we interact with others. For example, people know that episodic memory declines with age, and as a result, older adults' memories are less likely to be trusted. However, not all aspects of remembering decline with age; semantic memory (knowledge) increases across adulthood and is relatively unaffected in healthy aging. In the current work, we examined people's awareness of this pattern. Participants estimated the knowledge of hypothetical younger and older adults; in some studies, they also predicted and demonstrated their own knowledge on the same measures. Across studies, both younger and older adults estimated that older adults would perform better on a knowledge test, demonstrating awareness that knowledge is not impaired with aging. Furthermore, people's beliefs about their own knowledge influenced the predictions they made about others' knowledge. We discuss how this work informs theories of metacognition and contributes to positive self-perceptions in older adulthood.

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.

"Better be dead than grow older:" A qualitative study on subjective aging among older Koreans

While a large body of evidence suggests potential cultural variations in the experiences of subjective aging, very little is known about how members of Asian cultures feel about their aging. This study aims to acquire an in-depth understanding of subjective aging and its cultural/societal contexts among older Korean adults. In-depth face-to-face interviews were conducted with 20 community-dwelling Korean adults over age 65. Guided by the Stereotype Embodiment Theory, open-ended questions were asked to address how exposure to cultural/societal views about older adults relate to individuals' subjective aging. Data were analyzed using the constant comparative method. Seven categories were identified, which were grouped into three primary themes: 1) exposure to negative views on aging/older persons; 2) salience gain from self-relevance; and 3) influence on older adults' subjective aging. Most participants were generally not satisfied with their aging, felt they were a burden, and were prone to experience intergenerational conflicts. This may be attributed in part to their exposure to widespread negative age stereotypes and disrespect for older adults. Awareness of age-related changes and experience of age discrimination appear to be triggers through which the negative cultural/societal views on aging/older persons influence one's subjective perceptions and experience of aging. This in-depth data from an understudied population contributes to the existing literature by suggesting that the dominant-negative experience of aging among older Koreans may be better understood from socio-cultural contexts. Our findings can inform culture-specific intervention strategies to promote positive subjective aging.

The Need for a Paradigm Shift in Approaching Ageing-Related Design Research and Practice

Despite a rapidly ageing world population, ageism – particularly in its implicit form – is widespread in society. In this article, we propose that a paradigm shift is needed in how we approach ageing-related design research and practice in areas such as assistive technologies. We also put forward the idea of using the Healthy Ageing (HA) framework of the WHO as the basis for new lines actions that can be taken by design researchers and practitioners to address implicit ageism in society through their work.

Effects of Counter-Stereotypes Cognitive Training on Aging Stereotypes in 12- to 13-Year Olds

The purpose of this study was to investigate the effect of counter-stereotypes cognitive training on adolescents' aging stereotypes and to further investigate the best training method to intervene in aging stereotypes by comparing the effect of single and multiple intervention training methods on aging stereotypes and their retention effects. Three experiments examined the different intervention outcomes of different counter-stereotypes cognitive training on adolescent aging stereotypes. The study used a randomized block group experimental design and recruited a total of 183 middle school students for testing. Experiment 1 verified the effect of counter-stereotypes cognitive training by taking a single training task (evaluative conditioning technique), randomly assigning subjects to different conditions (training task or unrelated drawing task), and administering a follow-up test 24h after the posttest. Experiment 2a compared the effects of multiple versus single cognitive training, where we took multiple (adding the counter-stereotypes situational storytelling method) versus single training tasks and administered a follow-up test 72h after the posttest. Experiment 2b increased the number of training sessions based on Experiment 2a, with a second intervention training 72h after the end of the posttest and a follow-up test 72h after the second training. Experimental results suggest that evaluative conditioning techniques are effective in weakening subjects' aging stereotypes, but are less effective in maintaining them. Compared to a single training task, multi-tasking is more effective and the effects of the intervention are maintained for up to a week by increasing the number of training sessions.

Cognitive Interference in the Context of Daily Stressors, Daily Awareness of Age-Related Change, and General Aging Attitudes

OBJECTIVES

Previous diary work indicates that older people experience more intrusive and unwanted thoughts (i.e., cognitive interference) on days with stressors. We examined additional predictors of daily cognitive interference to enhance understanding of the psychological context surrounding this link. We specifically focused on factors related to subjective experiences of aging based on studies that have related higher stress and impairments in cognition such as executive control processes (working memory) to negative age stereotypes. Consistent with these findings, we generally expected stronger stress effects on cognitive interference when daily self-perceptions of aging (i.e., within-person fluctuations in awareness of age-related losses [AARC losses]) and general aging attitudes (i.e., individual differences in attitudes toward own aging [ATOA]) were more negative.

METHODS

Participants (n = 91; aged 60-80) on Amazon's Mechanical Turk completed surveys on 9 consecutive days, reporting on their ATOA (Day 1) as well as their stressors, AARC losses, and cognitive interference (Days 2-9).

RESULTS

Multilevel models showed that people reported more cognitive interference on days with more AARC losses. Individuals with positive ATOA also experienced less cognitive interference on days with more stressors, whereas those with negative ATOA experienced more.

DISCUSSION

Both individual differences and fluctuating daily perceptions of aging appear to be important for older adults' cognitive interference. Consistent with other work, positive ATOA protected against daily stressor effects. Further elucidating these relationships can increase understanding of and facilitate efforts to improve (daily) cognitive experiences in older adults.

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.

Societal Age Stereotypes in the U.S. and U.K. from a Media Database of 1.1 Billion Words

Recently, 194 World Health Organization member states called on the international organization to develop a global campaign to combat ageism, citing its alarming ubiquity, insidious threat to health, and prevalence in the media. Existing media studies of age stereotypes have mostly been single-sourced. This study harnesses a 1.1-billion-word media database comprising the British National Corpus and Corpus of Contemporary American English-with genres including spoken/television, fiction, magazines, newspapers-to provide a comprehensive view of ageism in the United Kingdom and United States. The US and UK were chosen as they are home to the largest media conglomerates with tremendous power to shape public opinion. The most commonly used synonym of older adults was identified, and its most frequently used descriptors were analyzed for valence. Such computational linguistics techniques represent a new advance in studying aging narratives. The key finding is consistent, though no less alarming: Negative descriptions of older adults outnumber positive ones by six times. Negative descriptions tend to be physical, while positive ones tend to be behavioral. Magazines contain the highest levels of ageism, followed by the spoken genre, newspapers, and fiction. Findings underscore the need to increase public awareness of ageism and lay the groundwork to design targeted societal campaigns to tackle ageism-one of our generation's most pernicious threats.

Generativity and Social Well-Being in Older Women: Expectations Regarding Aging Matter

OBJECTIVES

Beliefs about aging can contribute to health and well-being in older adults. Feeling generative, or that one is caring for and contributing to the well-being of others, can also impact health and well-being. In this study, we hypothesized that those with more positive expectations regarding aging (ERA) in the mental health domain would report greater levels of perceived social support (PSS) and lower levels of loneliness in response to a generativity intervention (vs control condition).

METHOD

Participants in this study (n = 73, 100% female) were randomly assigned to a 6-week generativity condition, which involved writing about life experiences and sharing advice with others, or to a control condition, which involved writing about neutral topics. Pre- and postintervention, PSS, and feelings of loneliness were measured.

RESULTS

Those in the generativity condition with more positive ERA in the mental health domain reported greater PSS and lower loneliness postintervention.

DISCUSSION

These results highlight the importance of psychological factors, such as ERA, in moderating the efficacy of interventions to promote social well-being in older adults.

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.

Perceived Stress Predicts Subsequent Self-Reported Problems With Vision and Hearing: Longitudinal Findings From the German Ageing Survey

Although stress is a risk factor for various diseases in later life, its role for sensory abilities in the second half of life has rarely been empirically addressed. We examined if perceived stress at baseline predicts self-reported difficulties with vision and hearing 3 years later. We also explored whether chronological age is a moderator of associations between stress and sensory difficulties. Our sample was derived from the German Ageing Survey and consisted of n = 5,085 individuals aged 40-95 years (M = 64.01 years, SD = 10.84 years). Controlling for baseline self-reported sensory functioning, socio-demographic indicators, self-rated health and chronic diseases, greater perceived stress at baseline predicted greater self-reported difficulties with vision and hearing 3 years later. The effect of stress did not vary by age. Our findings suggest that, from middle adulthood to advanced old age, stress is a risk factor for increases in self-perceived problems with vision and hearing.

Exploring Lifestyle Activities to Reduce Internalized Ageism: Self-Efficacy as a Mediator Between Exercise, Volunteering, Computer Use, and Self-Perceptions of Aging

The objective of this study is to test self-efficacy as a mediator in the relationship between three lifestyle activities (exercise, volunteering, and computer use) and self-perceptions of aging (SPA) among older adults. We hypothesize that increased self-efficacy will mediate the relationship between lifestyle activities and more positive SPA. This is a cross-sectional, secondary data analysis drawn from the 2016 wave of the Health and Retirement Study (HRS; n = 4,561). Bootstrapping procedures were applied to test the significance of the indirect effects of self-efficacy in the relationship between lifestyle activities and SPA. Results indicate significant direct effects between exercise, computer use, and self-efficacy. Direct effects were observed between exercise, volunteering, computer use, and SPA. Self-efficacy partially mediated the relationship between exercise, volunteering, computer use, and SPA. Implications for practitioners working with older adults are discussed. Future research should test formal intervention programs aimed at reducing internalized ageism through additional pathways.

Relationship between self-perceptions of aging and 'living well' among people with mild-to-moderate dementia: Findings from the ideal programme

OBJECTIVE

A primary goal for dementia research is to understand how to best support people to live well with dementia. Among cognitively healthy older individuals, more positive attitudes toward their own aging (ATOA) and/or feeling younger than their chronological age (i.e. having a younger subjective age: SA) are associated with better quality of life (QoL), satisfaction with life (SwL), and well-being (which are indicators of capability to live well), and fewer depressive symptoms. We tested whether people with dementia (PwD) with more positive ATOA and/or with a younger SA report better QoL, SwL, and well-being, and are less likely to experience depression.

METHODS

We used cross-sectional data from the IDEAL cohort baseline assessment (conducted between 2014 and 2016), comprising 1541 PwD residing in Great Britain [mean (range) age= 76.3 (43 to 98); 43.6% women].

RESULTS

More positive ATOA was associated with better QoL, SwL, well-being, and less likelihood of depression. Younger SA was associated with better QoL, SwL, well-being, and less likelihood of depression.

CONCLUSIONS

More positive ATOA and younger SA may be beneficial psychological resources that enhance capability to live well with dementia. Promoting more positive perceptions of aging at the societal level may help to equip people with the resilience needed to cope well after a diagnosis of dementia, and enhance the support available to people with dementia. Focusing on retained abilities and achievable goals may help to counteract the impact of negative age-related stereotypes on people with dementia, and enhance person-centered care.

Negative Self-perception of Aging and Mortality in Very Old Chinese Adults: The Mediation Role of Healthy Lifestyle

OBJECTIVES

Previous literature has consistently shown a positive association between negative self-perception of aging and mortality in middle-aged and older adults. However, two questions remain unsolved: (a) whether such association holds among very old people (i.e., the fourth age) and (b) the potential mediators that could contribute to the positive association. This study sought to fill in the research gap by examining the association between self-perception of aging and mortality in a group of very old Chinese participants (i.e., aged over 78 years).

METHODS

Four waves of data across a span of 8 years (2000-2008) were obtained from the Chinese Longitudinal Healthy Longevity Survey, which measured a total of 9,683 participants' negative self-perception of aging, survival status, cognitive functioning, diet, as well as other demographic information.

RESULTS

Latent growth models with survival analysis were conducted, and the results replicated previous findings indicating an association between negative self-perceptions of aging and reduced survival. Moreover and more importantly, a potential mediator-healthy lifestyle (e.g., eating fresh vegetables and fruits, exercising regularly, and no smoking)-was identified, such that older adults with more negative self-perception of aging tended to engage in less healthy lifestyle, which could lead to increased risk of mortality.

DISCUSSION

The findings provided support for a longitudinal behavioral pathway of health, linking negative perceptions of aging to mortality, and also yielded important practical implications for older adults to reach longevity.

Ageism and psychosocial variables during the COVID-19 pandemic: a scoping review protocol

OBJECTIVE: To map studies that focused on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the mental health, well-being, self-perception of aging, and intergenerational relationships of older adults, and how ageism affected these psychosocial variables in this population during the pandemic. METHODS: We will use the Joanna Brings Institute (JBI) methodology and search for indexed literature published in English, Portuguese, and Spanish in 12 databases. Two authors will independently screen titles, abstracts, and full texts according to the following eligibility criteria: studies that focused on samples of older adults (minimum age 60 years old), considering community-dwelling older adults, and studies using (quantitative designs, whether cross-sectional or longitudinal). In addition, at least one variable and its relationship with the COVID-19 pandemic must be presented in the study. RESULTS: The results will be presented in a tabular format with a narrative summary.

Ageism Amplifies Cost and Prevalence of Health Conditions

Background and Objectives

The persistent status of ageism as one of the least acknowledged forms of prejudice may be due in part to an absence of quantifying its costs in economic terms. In this study, we calculated the costs of ageism on health conditions for all persons aged 60 years or older in the United States during 1 year.

Research Design and Materials

The ageism predictors were discrimination aimed at older persons, negative age stereotypes, and negative self-perceptions of aging. Health care costs of ageism were computed by combining analyses of the impact of the predictors with comprehensive health care spending data in 1 year for the eight most-expensive health conditions, among all Americans aged 60 years or older. As a secondary analysis, we computed the number of these health conditions experienced due to ageism.

Results

It was found that the 1-year cost of ageism was $63 billion, or one of every seven dollars spent on the 8 health conditions (15.4%), after adjusting for age and sex as well as removing overlapping costs from the three predictors. Also according to our model, ageism resulted in 17.04 million cases of these health conditions.

Discussion and Implications

This is the first study to identify the economic cost that ageism imposes on health. The findings suggest that a reduction of ageism would not only have a monetary benefit for society, but also have a health benefit for older persons.

Intergenerational communities: A systematic literature review of intergenerational interactions and older adults' health-related outcomes

RATIONALE

Population aging is a major societal challenge that the US and many other countries are facing. The roles of intergenerational interactions are being increasingly recognized as important factors influencing health and well-being of older adults and other generations.

OBJECTIVE

This systematic review paper provides a critical assessment of the current state of knowledge about the impacts of intergenerational activities on older adults' health-related outcomes.

METHODS

Literature searches were conducted in October 2019 within MEDLINE, SocIndex, APA PsycInfo, and CINAHL Complete, using a pre-developed list of relevant keywords. Identified papers were reviewed and selected based on the following eligibility criteria: (1) older adults aged 50 or over as the study population, (2) nonfamily member intergenerational interactions as independent variables, (3) older adults' health-related outcomes as dependent variables, and (4) empirical and quantitative studies performed in the US and written in English. A total of 24 out of 22,674 identified articles met these eligibility criteria.

RESULTS

All of the 24 studies focused on evaluating intergenerational programs and their intervention effects. No studies addressed community or environmental interventions/effects. Program-based intergenerational interactions showed positive associations with older adults' physical health, psychosocial health (e.g. reduced depression), cognitive function, social relationships, and well-being/quality of life. Moreover, engagement in intergenerational activities was linked with increased physical and social activities.

CONCLUSIONS

This review showed solid evidence supporting the significance of program-based interventions in promoting intergenerational activities and associated health benefits. Significant knowledge gaps are also found resulting from the lack of studies examining the roles of physical environmental interventions/factors, diverse types of intergenerational interactions, and location-driven activities. Such studies can contribute to a better understanding of the specific attributes, both program-based and place-based supports, of the community environment that can promote intergenerational interactions and healthy aging in place.

When Culture Influences Genes: Positive Age Beliefs Amplify the Cognitive-Aging Benefit of APOE ε2

OBJECTIVES

Most studies of aging cognition have focused on risk factors for worse performance and on either genetic or environmental factors. In contrast, we examined whether 2 factors known to individually benefit aging cognition may interact to produce better cognition: environment-based positive age beliefs and the APOE ε2 gene.

METHOD

The sample consisted of 3,895 Health and Retirement Study participants who were 60 years or older at baseline and completed as many as 5 assessments of cognition over 8 years.

RESULTS

As predicted, positive age beliefs amplified the cognitive benefit of APOE ε2. In contrast, negative age beliefs suppressed the cognitive benefit of APOE ε2. We also found that positive age beliefs contributed nearly 15 times more than APOE ε2 to better cognition.

DISCUSSION

This study provides the first known evidence that self-perceptions can influence the impact of a gene on cognition. The results underscore the importance of combined psychosocial and biological approaches to understanding cognitive function in older adults.

Self-Acceptance and Interdependence Promote Longevity: Evidence From a 20-year Prospective Cohort Study

We explored psychosocial pathways to longevity, specifically, the association between psychological well-being and mortality in a 20-year prospective cohort study of 7626 participants. As hypothesized, high self-acceptance and interdependence were associated with decreased mortality risk, controlling for other psychological components (purpose, positive relations, growth, mastery) and potential confounders: personality, depression, self-rated health, smoking status, body mass index (BMI), illness, and demographics. Self-acceptance decreased mortality risk by 19% and added three years of life. Longevity expectation fully mediated the relationship between self-acceptance and mortality. Interdependence decreased mortality risk by 17% and added two years of life. Serenity towards death fully mediated the relationship between interdependence and mortality. This is the first known study to investigate self-acceptance, interdependence, and serenity toward death as promoters of longevity, and distilled the relative contributions of these factors, controlling for covariates-all of which were measured over multiple time points. Theoretically, this study suggests that components of well-being may make meaningful contributions to longevity, and practically recommend that self-acceptance and interdependence could be added to interventions to promote aging health.

Associations between age discrimination and health and wellbeing: cross-sectional and prospective analysis of the English Longitudinal Study of Ageing

BACKGROUND

Age discrimination (or ageism) is pervasive in society. Other forms of discrimination (such as racism) have been linked with adverse health outcomes, but age discrimination has not been well studied in public health. We aimed to examine associations between perceived age discrimination and health and wellbeing in England.

METHODS

We did a longitudinal observational population study with data from the English Longitudinal Study of Ageing, a nationally representative sample of older men and women. Participants were aged 50 years or older and reported experiences of age discrimination via a face-to-face computer-assisted personal interview and a self-completed questionnaire between July, 2010, and June, 2011. Self-rated health, chronic health conditions, and depressive symptoms were assessed between July, 2010, and June, 2011, and between May, 2016, and June, 2017. We used logistic regression to test cross-sectional associations between perceived age discrimination and baseline health status and prospective associations between perceived age discrimination and incident ill health over 6 years. Analyses were adjusted for age, sex, and wealth.

FINDINGS

Our sample for cross-sectional analyses of 2010-11 data comprised 7731 people who took part in the face-to-face interview, returned the self-completion questionnaire, and had available data for age discrimination. Perceived age discrimination was reported by 1943 (25·1%) participants. Patients who perceived age discrimination were more likely to self-report fair or poor health (odds ratio [OR] 1·32 [95% CI 1·17-1·48]) and to have coronary heart disease (1·33 [1·14-1·54]), chronic lung disease (1·37 [1·11-1·69]), arthritis (1·27 [1·14-1·41]), limiting long-standing illness (1·35 [1·21-1·51]), and depressive symptoms (1·81 [1·57-2·08]) than those who did not perceive age discrimination. Follow-up data collected 6 years after the baseline assessment were available for 5595 participants. Longitudinally, perceived age discrimination was associated with the deterioration of self-rated health (OR 1·32 [95% CI 1·10-1·58]) and incident coronary heart disease (1·66 [1·18-2·35]), stroke (1·48 [1·08-2·10]), diabetes (1·33 [1·01-1·75]), chronic lung disease (1·50 [1·10-2·04]), limiting long-standing illness (1·32 [1·10-1·57]), and depressive symptoms (1·47 [1·16-1·86]) over 6 years.

INTERPRETATION

Among older adults living in England, perceived age discrimination was associated with increased odds of poor self-rated health and risk of incident serious health problems over a 6-year period. These findings underscore the need for effective interventions at the population level to combat age stigma and discrimination.

FUNDING

UK Economic and Social Research Council.

Six Propositions against Ageism in the COVID-19 Pandemic

The risk of developing severe illness from COVID-19 and of dying from it increases with age. This statistical association has led to numerous highly problematic policy suggestions and comments revealing underlying ageist attitudes and promoting age discrimination. Such attitudes are based on negative stereotypes on the health and functioning of older adults. As a result, the lives of older people are disvalued, including in possible triage situations and in the potential limitation of some measures against the spread of the pandemic to older adults. These outcomes are unjustified and unethical. We develop six propositions against the ageism underlying these suggestions to spur a more adequate response to the current pandemic in which the needs and dignity of older people are respected.

Attitudes Toward Retirement Drive the Effects of Retirement Preparation on Psychological and Physical Well-Being of Hong Kong Chinese Retirees Over Time

Recent findings on retirement preparation found a positive impact on the psychological and physical well-being of retirees. However, the types of mental resources that are driving the relationship, such as attitudes toward retirement, only received limited attention. Reasoning from previous findings, we posit that attitudes toward retirement would explain the relationship between retirement preparation and well-being over time after retirement. A three-wave study was conducted in a sample of 130 Hong Kong Chinese retirees over a period of 1.5 years. Data were collected 6 months prior to retirement (T1) and 6 and 12 months after retirement (T2 and T3, respectively), in which preretirement preparation, attitudes toward retirement, and psychological and physical well-being were measured. The positive effect of T1 retirement planning on T3 physical and psychological well-being was partially mediated by T2 attitudes toward retirement. These results remain significant even after controlling for gender, education level, preretirement occupation, and well-being at T1. These findings reveal the role of attitudes toward retirement in driving postretirement adjustment over time.

Impact of self-perception of aging on mortality of older patients in oncology

OBJECTIVE

Several studies show that self-perception of aging (SPA) is a significant predictor of mental and physical health. In this study, we analyze the effect of SPA on mortality in the specific context of geriatric oncology.

METHODS

The sample constituted of 140 individuals aged 65 years and older suffering from a recent nonmetastatic cancer (breast, lung, gynecological, or hematological), followed up to 6 years. We used Cox proportional hazards model to assess the effect of SPA at baseline on mortality. It was adjusted for age, gender, educational and cognitive level, oncological information (the site and kind of cancer), number of comorbidities, and physical and mental health at baseline.

RESULTS

Patients were aged 73 years at diagnosis and were more often women (85.7%). Individuals with more negative SPA were 3.62 times more likely to die than those with a more positive SPA, with control of gender, age, education and cognitive level, mental and physical health, the category (breast, lung, gynecological, or hematological), and kind (initial or recurrence) of cancer.

CONCLUSIONS

These findings suggest that SPA influence the mortality of older people in the particular context of oncology. Therefore, the need to change our attitudes toward aging and older people implied indirectly by these results is discussed.

Older adults' understandings and perspectives on frailty in community and residential aged care: an interpretive description

OBJECTIVES

Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive-descriptive qualitative study.

SETTING

Aged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia.

PARTICIPANTS

39 non-frail, prefrail, frail and very frail South Australian older adults.

METHODS

Seven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators.

RESULTS

Frailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail.

CONCLUSIONS

Aside from a disability model, views of frailty as unmodifiable permeated older persons' diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.