Associations of Awareness of Age-Related Change With Emotional and Physical Well-being: A Systematic Review and Meta-analysis

Examining the structural relations of awareness of age-related change, inductive reasoning, and psychological well-being in older adults

OBJECTIVES

. The current study compared four conceptualizations of the structural relations of awareness of age-related change (AARC), inductive reasoning (IR), and psychological well-being (PWB), given their shared connections with successful aging and mixed empirical and theoretical support for their interrelations.

METHOD

. Data were collected online for 199 older adults (60-80 years). Four structural equation models, with latent variables for AARC gains, AARC losses, IR, and PWB, were estimated: (1) IR to AARC to PWB, (2) AARC to IR to PWB, (3) PWB to AARC to IR, and (4) PWB to IR to AARC.

RESULTS

. More support was found for higher IR as a predictor of less AARC losses and AARC gains than the converse relationships. Similarly, AARC gains and AARC losses related more strongly to PWB than the converse relationships. Significant indirect pathways from IR to PWB through AARC suggested that AARC gains and losses may explain the relation of IR with PWB.

CONCLUSION

. These findings expanded the literature regarding the relationships between AARC, IR, and PWB, highlight the importance of each variable in the lives of older adults, and can be used to inform psychological interventions used by clinicians working with older adults to promote successful aging.

Associations between Attitudes to Aging with concurrent and twelve-year change in cognitive functioning in very old individuals

OBJECTIVES

This study investigated the cross-sectional associations between participants' scores on five cognitive domains and global cognition and their scores on a multidimensional measure of self-perceptions of aging. This study also investigated whether 12-year change in the same cognitive domains and global cognition was associated with self-perceptions of aging.

DESIGN

Cross-sectional and longitudinal secondary analyses of a cohort study.

PARTICIPANTS

Participants were 103 individuals (mean age at 12-year follow-up = 87.43 years; SD = 3.60; 60.2 % women) enrolled in the Sydney Memory and Aging Study (MAS) with 12-years of follow-up data.

MEASUREMENTS

Cognitive domains assessed over 7 waves were attention processing speed, language, executive function, visuospatial abilities, and memory. Self-perceptions of aging were assessed only at wave 7 using the three subscales of the Laidlaw' Attitudes to Aging Questionnaire: psychological growth, psychosocial loss, and (positive) physical change.

RESULTS

After having adjusted for age, sex, marital status, occupation when working, depressive symptoms, and numbers of physical health conditions and for multiple comparisons there were no significant cross-sectional associations between cognitive abilities and global cognition and the subscales of the Attitudes to Aging Questionnaire. After having adjusted for baseline cognition, age, sex, marital status, occupation when working, depressive symptoms, and numbers of physical health conditions there were no significant longitudinal associations between change in cognitive abilities and in general cognition and the subscales of the Attitudes to Aging Questionnaire.

CONCLUSIONS

Cross-sectional and change scores on cognitive tasks and global cognition do not have an effect on Attitudes to Aging after having controlled for depressive symptoms.

Self-Perceptions of Aging and Physical Activity in Older Adults with Arthritis: Impact of General Health

How negative self-perceptions of aging relate to physical activity (PA) in older adults with arthritis is unclear. We examined whether general health mediated the relationship between Awareness of Age-Related change (AARC) losses and PA. We analyzed baseline data from a randomized controlled trial of a PA intervention for adults ≥60 years who self-reported PA, AARC, general health, pain, and social support. We evaluated point-biserial correlations between PA and other factors in participants with self-reported arthritis and developed a mediation model incorporating AARC losses, general health, and PA. We observed significant correlations between PA and general health, social support, and AARC losses in this physically active sample. General health mediated the effect of AARC losses on PA. While negative self-perceptions of aging were associated with less PA in older adults with arthritis, their impact was attenuated by general health. PA interventions for this population may benefit by targeting perceived general health.

Personal views of aging in midlife and older age: the role of personality

Introduction

Personal views of aging (VoA) reflect individuals' perceptions, attitudes, and expectations regarding their aging selves. The present cross-sectional study was aimed at examining whether personality traits, as defined by the Big Five model, are associated with different VoA concepts related to both subjective age and awareness of age-related gains and losses in midlife and older age.

Materials and methods

A sample of 224 participants aged 46-85 years reported their felt age and completed the Awareness of Age-Related Change (AARC) questionnaire, assessing perceptions of age-related gains (AARC-Gains) and losses (AARC-Losses) in various functioning domains, as well as the short version of the Big Five Inventory.

Results

Linear regression models showed that Openness contributed to explain youthful subjective age. Extraversion explained higher AARC-Gains scores, whereas Emotional Stability, along with younger chronological age and perceiving better self-rated health, contributed to explaining lower AARC-Losses scores.

Discussion

These findings confirm the relationship between personality traits and personal VoA. They further suggest that such an association varies depending on the VoA measure considered. They underscore the importance of considering personality among those individual characteristics capable of shaping personal VoA, with implications for the development of tailored interventions and the understanding of the underlying mechanisms linking personal VoA to health and longevity outcomes in midlife and older age.

Testing Bidirectionality in Associations of Awareness of Age-Related Gains and Losses With Physical, Mental, and Cognitive Functioning Across 1 Year: The Role of Age

OBJECTIVES

The bidirectionality between self-perceptions of aging and health-related outcomes may depend on age group. Therefore, we tested such bidirectionality among individuals in late midlife (50-64 years), young-old age (65-74 years), and old-old age (75+ years), taking advantage of the construct of Awareness of Age-Related Change (AARC) and its 2-dimensionality in terms of AARC-gains and AARC-losses. Various conceptualizations of physical, mental, and cognitive functioning were used as outcomes.

METHODS

Data from 2 measurement occasions (2019 and 2020) from the UK PROTECT study for individuals in late midlife (N = 2,385), young-old age (N = 2,430), and old-old age (N = 539) were used. Data on self-reported functional difficulties, depression, anxiety, and performance on four computerized cognitive tasks (i.e., verbal reasoning, paired associate learning, self-ordered search, and digit span) providing a score for verbal reasoning and a score for working memory were analyzed using cross-lagged panel models.

RESULTS

Across all 3 age groups, the bidirectional associations of AARC-gains with indicators of functioning were not significant, whereas higher AARC-losses significantly predicted slightly greater functional difficulties and higher depression and anxiety levels. Higher AARC-losses predicted slightly poorer Verbal Reasoning only in old-old age and poorer Working Memory predicted slightly higher AARC-losses only in young-old age. The remaining associations of AARC-losses with cognitive tasks were not statistically significant.

DISCUSSION

In accordance with previous research targeting other indicators of self-perceptions of aging, this study supported a stronger impact of AARC-losses on indicators of physical functioning and mental health than vice versa from midlife to old-old age.

Does Awareness of Aging Matter? The Moderating Function of Awareness of Age-Related Change on the Relationships Between COVID-19 Disruption, Perceived Stress, and Affect

OBJECTIVES

How people reflect on their own age may influence their well-being in the face of disruptions associated with the coronavirus (COVID-19). Subjective aging was operationalized in terms of one's awareness of age-related change (AARC), specifically, the gains and losses associated with aging. We developed a measure assessing disruptions to daily life associated with the COVID-19 pandemic across 3 dimensions (i.e., Social and Lifestyle Disruption, Work and Health Disruption, and Others Contracting COVID-19). We hypothesized that COVID-19 disruption would be positively associated with both AARC-losses and AARC-gains. Greater COVID-19 disruption would also be associated with poorer psychosocial outcomes (higher perceived stress and negative affect [NA] and lower positive affect [PA]) and these associations would be stronger for those reporting greater AARC-losses and weaker for those reporting greater AARC-gains.

METHODS

Cross-sectional questionnaire data were collected from 263 participants from the United States (aged 40-83; mean age: 62.88 years, standard deviation = 9.00; 56.3% females).

RESULTS

After controlling for age, gender, education, employment, socioeconomic status, and physical functioning, greater Work and Health Disruption was associated with greater AARC-losses. Greater Social and Lifestyle Disruption was associated with both greater AARC-gains and AARC-losses. Moderation effects showed an exacerbating effect of AARC-losses on NA in the face of Work and Health Disruption and a protective effect of AARC-gains on PA in the context of Social and Lifestyle Disruption.

DISCUSSION

We extend research detailing antecedents of AARC and highlight the need for longitudinal research that considers the ever-changing nature of the pandemic.

Rumination moderates the longitudinal associations of awareness of age-related change with depressive and anxiety symptoms

OBJECTIVE

Lower awareness of age-related gains (AARC-gains) and higher awareness of age-related losses (AARC-losses) may be risk factors for depressive and anxiety symptoms. We explored whether: (1) Baseline AARC-gains and AARC-losses predict depressive and anxiety symptoms at one-year follow-up; (2) age and rumination moderate these associations; (3) levels of AARC-gains and AARC-losses differ among individuals with different combinations of current and past depression and/or with different combinations of current and past anxiety.

METHODS

In this one-year longitudinal cohort study participants (N = 3386; mean age = 66.0; SD = 6.93) completed measures of AARC-gains, AARC-losses, rumination, depression, anxiety, and lifetime diagnosis of depression and anxiety in 2019 and 2020. Regression models with tests of interaction were used.

RESULTS

Higher AARC-losses, but not lower AARC-gains, predicted more depressive and anxiety symptoms. Age did not moderate these associations. Associations of lower AARC-gains and higher AARC-losses with more depressive symptoms and of higher AARC-losses with more anxiety symptoms were stronger in those with higher rumination. Individuals with both current and past depression reported highest AARC-losses and lowest AARC-gains. Those with current, but not past anxiety, reported highest AARC-losses.

CONCLUSION

Perceiving many age-related losses may place individuals at risk of depressive and anxiety symptoms, especially those who frequently ruminate.

Awareness of age-related change and its relationship with cognitive functioning and ageism

 .Given ageism's negative impacts on older adults, the theoretical model for awareness of age-related change (AARC) hypothesized that experiencing ageism may mediate the relationship of cognitive functioning to AARC. We tested this hypothesis and alternatively proposed that cognitive functioning mediated the relationship of ageism to AARC. Analyses were conducted using measures of memory and inductive reasoning for 215 older adults (66-90 years) recruited online. Significant direct effects of ageism, memory, and inductive reasoning and significant mediated effects were found in both models, with more support for cognition mediating the relationship between ageism and AARC than for ageism mediating the relationship between cognitive functioning and AARC. This study added to the literature by empirically investigating theoretically proposed antecedents of AARC. Policymakers should address ageism to support healthy aging. Findings may assist therapists working to help older adults gain insights regarding how ageism impacts cognitive functioning and awareness of age-related changes.

Physical and mental health conditions account for variability in awareness of age-related changes

Background

The concept of Awareness of Age-Related Changes captures people's perceptions of the positive (AARC-gains) and negative (AARC-losses) age-related changes they experience in several life domains, including their health. We investigated the cross-sectional associations of number and type of physical and mental health conditions with AARC-gains and AARC-losses.

Methods

The sample comprised 3,786 middle-aged and older adults (mean age = 67.04 years; SD = 6.88) participating to the UK PROTECT study. We used hierarchical regression models to analyze whether after having included sociodemographic variables (model 1), number of physical (model 2) and of mental (model 3) health conditions explained a significant additional amount of variance in AARC-gains and AARC-losses, and whether the association between number of conditions and AARC depended on participants' age. We used multiple regression models to analyze the associations of types of physical and mental health conditions with AARC-gains and AARC-losses.

Results

A higher number of physical health conditions was associated with higher AARC-gains and higher AARC-losses, but the association did not depend on participant age. After controlling for the number of physical health conditions, a higher number of mental health conditions was associated with higher AARC-losses but not with AARC-gains, and the association was stronger among older participants. Small effects were found between greater AARC-gains and current cancer and between greater AARC-losses and diagnoses of mild cognitive impairment, Parkinson's disease, arthritic condition, cancer in full remission, osteoporosis, depression, anxiety disorders, and personality disorder. The remaining health conditions were either negligibly or non-statistically related to AARC-losses.

Conclusion

Middle-aged and older adults having more physical health conditions and more mental health conditions may be at higher risk of negative views on their own aging. However, specific physical health conditions, such as arthritis, and certain mental health conditions, such as depression, may make adults particularly vulnerable to negative age-related perceptions.

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.

Longitudinal effects of subjective aging on health and longevity: An updated meta-analysis

This article updates and extends an earlier meta-analysis (Westerhof et al., 2014) on the longitudinal effects of subjective aging (SA) on health outcomes. A systematic search in different databases (APA PsycInfo, PubMed, Web of Science, and Scopus) resulted in 99 articles, reporting on 107 studies. Participants: Studies had a median sample size of 1,863 adults with a median age of 66 years. A randomized effect meta-analysis showed a significant, small effect (likelihood ratio = 1.347; 95% confidence interval [1.300, 1.396]; p < .001), similar in magnitude to the previous meta-analysis of 19 studies. Although the results showed high heterogeneity in the longitudinal link between SA and health outcomes, there were no differences in effects according to chronological age of participants, welfare state status (more or less developed social security system), length of follow-up, type of health-related outcome, or quality of the study. Effects were stronger for multiitem measures of self-perceptions of aging than for the frequently used single-item measures assessing subjective age, especially for indicators of physical health. Based on this meta-analysis, building on five times more studies than the 2014 review, we consider the associations of measures of SA with health and longevity across time as robust, albeit small in size. Future research should concentrate on the clarification of pathways mediating the relation between SA and health outcomes, as well as potential bidirectional effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

Awareness of age-related changes in Norwegian individuals 50+. Short form questionnaire validation

Background

A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany, and validated for the UK and Brazilian populations. In this study, we validated the short-form measure (AARC-10 SF) in the Norwegian population aged 50 and over. In addition, the relationship between cognitive variables and AARC was examined.

Methods

Cross-sectional analyses of data from 1,510 participants in the ongoing online PROTECT Norge study were used to explore and confirm the two-factor structure of AARC gains and AARC losses; reliability; measurement invariance across different population groups defined by sex, education level, employment, and in middle age, early old age, and advanced old age. We explored the relationship between AARC and demographic variables (defined in the same way as the population groups).

Results

We confirmed the two-factor structure (gains and losses) of the Norwegian translation of the AARC-10 SF. We did not find mutual correlations between related items in gains and losses, except for the physical health item from the gains dimension, which was positively correlated with all items of the losses dimension. Age, sex, marital status, employment, and university education predicted AARC gains and losses.

Conclusion

The Norwegian translation of the AARC-10 SF captures individuals' positive and negative self-perceptions of age-related changes in their mental, physical, and cognitive health.

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.

Exploring awareness of age-related changes among over 50s in the UK: findings from the PROTECT study

OBJECTIVES

Older people describe positive and negative age-related changes, but we do not know much about what contributes to make them aware of these changes. We used content analysis to categorize participants' written comments and explored the extent to which the identified categories mapped onto theoretical conceptualizations of influences on awareness of age-related change (AARC).

DESIGN

Cross-sectional observational study.

PARTICIPANTS

The study sample comprised 609 UK individuals aged 50 years or over (mean (SD) age = 67.9 (7.6) years), enrolled in the PROTECT study.

MEASUREMENTS

Between January and March 2019, participants provided demographic information, completed a questionnaire assessing awareness of age-related change (AARC-10 SF), and responded to an open-ended question asking them to comment on their responses.

RESULTS

While some of the emerging categories were in line with the existing conceptual framework of AARC (e.g. experiencing negative changes and attitudes toward aging), others were novel (e.g. engagement in purposeful activities or in activities that distract from age-related thoughts). Analysis revealed some of the thought processes involved in selecting responses to the questionnaire items, demonstrating different ways in which people make sense of specific items.

CONCLUSIONS

Results support the ability of the AARC questionnaire to capture perceived age-related changes in cognitive functioning, physical and mental health, and engagement in social activities and in healthy and adaptive behaviors. However, findings also suggest ways of enriching the theoretical conceptualization of how AARC develops and offer insights into interpretation of responses to measures of AARC.

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.

Attitudes toward own aging and cognition among individuals living with and without dementia: findings from the IDEAL programme and the PROTECT study

Background

It is unclear whether people with dementia (PwD) have more negative attitudes toward own aging (ATOA) than people without dementia and what factors influence ATOA among PwD. We investigated whether PwD have more negative ATOA than individuals without dementia and whether cognition and dementia subtype are associated with ATOA in PwD.

Methods

Data from the IDEAL and PROTECT studies were used to compare ATOA between 1502 PwD (mean (SD) age = 76.3 (8.5)) and 6377 individuals without dementia (mean (SD) age = 66.1 (7.1)). Linear regressions and ANOVA were used.

Results

PwD reported slightly more negative ATOA than people without dementia; this relationship disappeared after controlling for depression and self-rated health. In PwD more positive ATOA showed negligible associations with better general cognition, memory performance, verbal fluency, and visuospatial ability. However, after adjusting for covariates only better visuospatial ability predicted more positive ATOA. Additional analyses showed that before and after controlling for covariates, individuals with poorer self-reported visual acuity have more negative ATOA. Amongst dementia subtypes, people with Parkinson’s disease dementia and dementia with Lewy bodies reported most negative ATOA.

Conclusions

ATOA between PwD and people without dementia do not differ. ATOA in PwD appear to be affected not by cognitive impairment but by other characteristics that vary across dementia subtypes. Among PwD, those with Parkinson’s disease dementia and dementia with Lewy bodies may have higher risk of experiencing negative ATOA due to the motor and visual impairments that they experience.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03336-5.

No Pain, No Gain? Personality Associations With Awareness of Aging Depend on Arthritis

Background

Awareness of aging brings to light one’s own perceived behavioral, physical, and cognitive changes associated with getting older. Personality and physical illness are each related to two components of awareness of aging: attitudes toward own aging (ATOA), and awareness of age-related changes (AARC). Here, we move beyond main effects to examine how personality and arthritis interact with respect to awareness of aging.

Materials and Methods

296 participants (M age = 64.67, SD = 4.36, Range = 60–90 years, 49.7% women) completed online self-report questionnaires of personality, arthritis, ATOA, and AARC gains and losses.

Results

We ran three hierarchical multiple regression models to test how personality traits and arthritis interacted to predict ATOA, AARC gains, and AARC losses, respectively. Higher extraversion was related to positive ATOA, and higher openness was related to positive ATOA and more AARC gains. Higher neuroticism was related to negative ATOA, more AARC losses, and less AARC gains. We found a main effect for arthritis, where those with arthritis reported more AARC losses. Lastly, we found a significant interaction between arthritis and agreeableness when predicting AARC gains. Among those with low agreeableness, people with arthritis reported significantly more AARC gains compared to those without arthritis.

Conclusion

Personality and arthritis are each important for awareness of aging. Overall, our study suggests that for those with arthritis, it is especially important to consider behavioral and cognitive factors related to agreeableness, as they may be important means of promoting positive views on aging.

Subjective views of aging in very old age: Predictors of 2-year change in gains and losses

This study examined trajectories of awareness of age-related change (AARC; Diehl & Wahl, 2010) across 2 years in a large representative sample of very old adults. We also examined the predictive role of health, functional status, cognitive functioning, and engagement with life for AARC change. The initial sample comprised 1,863 individuals aged 80 years or older. Of the 1,612 individuals recontacted 2 years later, 912 took part in the follow-up. Measures included the AARC-Short Form, assessing perceived AARC Gains and AARC Losses. Measures of multimorbidity and functional health, a cognitive screening test, and indicators of engagement with life (e.g., leisure activity) were examined as predictors of AARC change, using semi-cross-lagged fixed effects modeling. Higher overall levels of AARC Gains were observed compared to AARC Losses for all but respondents aged 90 years or older. Intra-individual levels of AARC Gains decreased significantly over the 2-year period, whereas a significant increase was found for AARC Losses. AARC Losses across time were predicted by loss of instrumental activities of daily living (IADL) independence, but not by change in multimorbidity, cognitive performance, or engagement with life. One indicator of engagement with life, reduced leisure activity, predicted smaller AARC Gains at wave 2. These results were robust in models controlling for potential reverse causation. These findings suggest that a significant increase in perceived AARC Losses appears to be an inherent characteristic of very old age. Very old age may be a stage in life in which changes in multimorbidity and cognitive performance no longer impact individuals' views on aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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.

Identifying predictors of self-perceptions of aging based on a range of cognitive, physical, and mental health indicators: Twenty-year longitudinal findings from the ILSE study

Research exploring whether health predicts self-perceptions of aging (SPA) has mostly focused on single predictors and has been hampered by short observational intervals. We examined whether 20-year changes in cognitive functioning, physical and mental health predict SPA. We used data of 103 German participants who remained of a sample of 500 participants born in 1930-1932 enrolled in the Interdisciplinary Longitudinal Study of Adult Development (ILSE) in 1993/1996 (mean age at fourth measurement wave = 82.5 years). Health indicators included six cognitive tests, objective and subjective physical health, and self-reported depression. We used a new and multidimensional (awareness of age-related gains and losses) and a well-established (attitudes toward own aging) measure of SPA. Linear regression analyses showed that, among the cognitive tests, decline in information processing speed (Digit Symbol) predicted less awareness of age-related gains and more awareness of age-related losses but not attitudes toward own aging. Decline in subjective but not objective physical health, predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. Increase in depressive symptoms predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. The size of associations suggests that objective cognitive decline has limited influence on older adults' SPA and, if so, only when the decline is related to mental slowing. Similarly, perceived physical and mental health, but not objective health, have a small-to-moderate influence on awareness of age-related losses and attitudes toward own aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Awareness of Age-Related Changes Among Middle-Aged and Older Adults: Longitudinal Trajectories, and the Role of Age Stereotypes and Personality Traits

Awareness of Age-Related Change (AARC) describes to what extent people become aware of changes which they attribute to getting older. So far little is known regarding how different AARC dimensions change over time, to what extent these changes in different domains of AARC gains and losses are interrelated, and which predictors account for inter-individual differences in within-person longitudinal trajectories. Specifically, the extent to which individuals perceive age-related gains and losses might be shaped by their chronological age, their personality as well as by their general views on aging (i.e., their age stereotypes). We investigated changes in global and domain-specific AARC gains and losses over about five years in a sample of originally N = 423 participants aged 40 to 98 years at baseline. We analyzed the role of personality traits and age stereotypes for levels and changes of AARC, taking into account participants' age at baseline and controlling for gender, education, and subjective health. Based on longitudinal multilevel regression models, we observed mean-level declines in most AARC gain domains. In contrast, perceived general AARC losses, as well as AARC losses in health and physical functioning, in cognitive functioning and in social-cognitive/socio-emotional functioning remained, on average, stable over time. Baseline scores on AARC gains (global scale) were higher among individuals with higher neuroticism, openness, conscientiousness and more positive age stereotypes. Additionally, the association of higher neuroticism with higher AARC gain scores was stronger among individuals with more positive age stereotypes. Higher neuroticism and more negative age stereotypes also predicted higher baseline scores on AARC losses (global scale). At the same time, higher neuroticism was associated with a steeper decrease in AARC loss perceptions over time. Most of the intercorrelations within the intercepts and within the intra-individual trajectories of the different AARC domains were positive, but small in size. Our findings show the importance of considering trajectories of age-related gains and losses in parallel and across multiple developmental domains when investigating the subjective perception of the aging process. They also suggest that personality traits and general age stereotypes are related with individual experiences of aging.

Differences in awareness of positive and negative age-related changes accounting for variability in health outcomes

Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N = 6192; mean (SD) age = 66.1 (7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-squared tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one's ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.

Awareness of age-related change in the context of major life events

Although gains and losses are an integral part of human development, the experience of change and readjustment that often comes with major life events may be particularly influential for an individual's subjective aging experience and awareness of age-related change (AARC). Thus, this study focused on the role of life events in the domains of family and health for an individual's awareness of age-related gains and losses. Specifically, we differentiated between the experience of specific life events (e.g., entering a new romantic relationship; hospital stay) and the cumulative experience of multiple life events. Furthermore, we differentiated between life events experienced at an expected time in life and life events experienced relatively early or relatively late compared to established social norms. Data came from the Innovation Sample of the German Socio-Economic Panel (SOEP-IS) and consisted of 1,612 participants aged 16 to 93 years (M = 54.1; SD = 18.2). Life events were assessed annually and retrospectively for the last 2 years. Propensity score matching provided evidence for an association of specific family life events and a higher awareness of age-related gains, as well as specific health life events and a higher awareness of age-related losses. Results furthermore indicated that the cumulative experience of family life events was associated with a higher awareness of age-related gains. Conversely, the cumulative experience of health events was associated with higher awareness of both age-related losses and age-related gains. Moreover, it was not only life events happening at an expected age, but also those happening relatively early and particularly those happening late in life, which were associated with AARC. In summary, life events and the change they may bring seem to be reflected in individuals' awareness of age-related losses and awareness of age-related gains.

Awareness of age-related change, chronological age, subjective age and proactivity: An empirical study in China

An aging workforce and the increasing value placed on employees' proactivity are two important features of current workplaces. We address the extent to which this proactivity is affected by age and aging. The study has two objectives. First, it aims to validate the concept of awareness of age-related change (AARC) in the Chinese context. Second, it compares the explanatory power of AARC with that of chronological age and subjective age in predicting three types of proactivity: task proactivity, development proactivity and organization proactivity. We used the ten-item AARC instrument in a survey of teachers (n = 421, mean age = 41.0) in China, and validated its content by comparing the responses of a subsample of these teachers (n = 33, mean age = 42.5) to questions asked in a semi-structured interview. This confirmed the validity of the instrument's content, and its applicability beyond North America and Europe, in a Chinese context. We then show that awareness of positive and negative age-related changes (AARC-Gains and AARC-Losses) are, respectively, positively and negatively associated with the three types of proactivity, and that they are better predictors than chronological age and subjective age. The research adds weight to challenges to negative age stereotyping--that older employees are set in their ways and less proactive--and to claims about the value of AARC for measuring aging, by showing that this factor can predict outcomes beyond health and the concerns of older adults.

Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study

BACKGROUND

Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative.

OBJECTIVES

This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms.

METHODS

A qualitative descriptive design was used to examine our research questions. Community-dwelling older adults without dementia (n = 49, M_age  = 74.5[10.1], 63% women) completed a cognitive assessment, questionnaires and two semi-structured interviews. Content analysis was used to code and categorise the transcribed interview data, then identify themes within and across participant groups.

RESULTS

Five themes described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalising Problems and Adjusting Thinking. Memory problems' impact on emotional well-being varied by current anxiety symptoms, characteristics of the problem and personal experience with dementia.

CONCLUSION

The emotional impact of memory problems tended to differ by affective symptoms, not cognitive status. Older adults who report memory concerns without objective evidence of impairment may be at risk for negative impacts to mental health and well-being.

IMPLICATIONS FOR PRACTICE

Cognitive screening guidelines should consider best practices for responding to memory concerns when cognitive testing results are normal.

Impact on Mental Well-Being and Resilience of Patients with Multiple Chronic Conditions in Different Periods during the Coronavirus Disease 2019 Outbreak in Taiwan

Concerns over the coronavirus disease 2019 (COVID-19) pandemic and control measures have affected the routine outpatient visits of individuals with comorbidities and their mental well-being. From October 2019 to August 2020, this cross-sectional study enrolled 135 patients who sought medical attention at a medical center in Taiwan. This period covered the early (October to December 2019), peak (January to April 2020), and late (May to August 2020) periods of the COVID-19 outbreak in Taiwan. The demographic data, social support data, activities of daily living (ADL), resilience scale scores, and mental well-being scale scores of the participants were compared. There were no statistically significant differences in the participation rate, demographic data, and social support data between the three periods. The correlation analysis confirmed significant negative relationships between the number of COVID-19 cases and outpatient department visits per month (r = −0.764, p < 0.001), emergency department visits per month (r = −0.023, p < 0.001), ADL (r = −0.257, p = 0.03), resilience scale (r = −0.390, p < 0.001), and mental well-being scale (r = −0.475, p < 0.001). In conclusion, the severity of the COVID-19 outbreak in Taiwan was associated with declines in the ADL, mental well-being, and resilience of patients who sought medical attention.

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.

Subjective perceptions of age-related gains buffer negative associations of perceived age-related losses with health, well-being, and engagement

People reflect on their own aging, and this subjective awareness has an influence on developmental outcomes. Scholars have recently operationalized subjective aging in terms of awareness of age-related change (AARC), which captures awareness of both gains and losses. We examined associations of AARC-gains and AARC-losses with physical functioning, subjective well-being, and engagement with life (enjoyable activities and sense of purpose). Importantly, we extended previous research by not only assessing main effects of gains and losses but also testing their interaction. We hypothesized that awareness of losses would be more weakly negatively associated with health and well-being among those who possessed higher awareness of gains. A total of 399 older participants aged 65 to 91 (235 women and 164 men) were recruited via Prime Panels crowd-sourcing platform to complete an online questionnaire. Greater AARC-losses was associated with poorer health, lower subjective well-being, and lower sense of purpose. AARC-gains was associated with better outcomes in general, and moderated associations of AARC-losses with physical functioning, subjective well-being, and sense of purpose (but not engagement in leisure activities). Consistent with predictions, moderation effects showed that negative associations of AARC-losses with the outcomes were weaker among those who reported higher AARC-gains. Results provided some support for a role of AARC-gains in buffering negative effects of AARC-losses on developmental outcomes.

Awareness of age-related gains and losses and their associations with psychological well-being: A longitudinal examination

OBJECTIVES

How people experience their own aging is more strongly linked to well-being than chronological age. This study examined associations of awareness of age-related change (AARC) with between-person differences and longitudinal changes in psychological well-being (PWB). We expected that higher AARC-gains would be associated with higher PWB and increases in PWB over time. Conversely, we expected higher AARC-losses would be associated with lower PWB, and steeper decline in PWB over time. Furthermore, we tested the interaction of AARC-gains and AARC-losses to examine whether negative associations between AARC-losses and PWB would be weaker among those reporting higher AARC-gains.

METHOD

Data were collected in three waves from a 12-month longitudinal study of 408 community-dwelling older adults (aged 60+). Multilevel growth models were used to analyze associations between AARC and a composite measure of PWB which included key components of PWB identified in self-determination theory (satisfaction and frustration of basic psychological needs), as well as vitality, and life engagement.

RESULTS

At the between-person level, higher AARC-gains and lower AARC-losses were consistently associated with higher PWB. Furthermore, associations between AARC-losses and lower PWB were weaker among those with higher AARC-gains. There was no evidence to suggest the interplay of AARC-gains and AARC-losses had implications for change in PWB over time.

DISCUSSION

Appreciation of age-related gains may buffer the impact of AARC-losses on PWB. However, longitudinal studies conducted over varying macro- and micro-time scales are needed to better understand the developmental significance of AARC for later life.

The cross-sectional relationship between pain and awareness of age-related changes

BACKGROUND

Awareness of positive and negative age-related changes (AARC gains and losses) captures the perceived changes that older individuals experience in several domains of their lives including physical, cognitive and social functioning; interpersonal relationships; and lifestyle. Exploring antecedents of AARC is important to identify those individuals that could benefit the most from interventions promoting positive experiences of ageing and/or adaptation to age-related changes. This study investigates the experience of pain as a predictor of lower AARC gains and higher AARC losses.

METHODS

Analyses are based on cross-sectional data from the PROTECT cohort (2019); 1013 UK residents (mean (SD; range) age: 65.3 (7.1; 51.4-92) years, 84.4% women) completed measures of AARC and pain and provided demographic information. Linear regression models were fitted to examine pain as a predictor of AARC gains and AARC losses.

RESULTS

Higher levels of pain predicted more AARC losses both before (regression coefficient, B = 0.36; 95% confidence interval (CI): 0.29 to 0.42, p-value < 0.001; R 2 = 0.11) and after adjusting for demographic covariates (B = 0.34; 95% CI: 0.27 to 0.40; p-value < 0.001; Partial R 2 = 0.11). Pain was not significantly associated with AARC gains (unadjusted B = 0.05; 95% CI: -0.03 to 0.12, p-value = 0.21; Partial R 2 = 0.01).

CONCLUSION

Individuals experiencing pain may perceive more AARC losses. Interventions aiming to decrease levels of pain could include a component targeting self-perceptions of ageing and/or promoting acceptance of the negative changes that can happen with ageing.

STATEMENT OF SIGNIFICANCE

The predictive role of greater levels of pain for more negative perceptions of age-related changes extends the literature on the negative psychological outcomes of pain and on predictors of perceived awareness of age-related changes (AARC). As individuals experiencing pain may be more at risk of perceiving their own ageing in a more negative way, they may benefit from interventions that combine strategies to reduce levels of pain and the interference that pain exerts on their daily activities with an educational component enhancing positive self-perceptions of ageing and promoting acceptance of negative age-related changes.

Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition

OBJECTIVES

Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training.

DESIGN

Cross-sectional observational study.

PARTICIPANTS

The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age.

MEASUREMENTS

We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH).

RESULTS

Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training.

CONCLUSIONS

Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables - alongside psychological variables - related to perceived cognitive losses.

Associations of subjective cognitive and memory decline with depression, anxiety, and two-year change in objectively-assessed global cognition and memory

Research studies exploring the association of cognitive complaints with objectively assessed cognitive decline report inconsistent results. However, many of these have methodological limitations. We investigated whether 1) more severe subjective cognitive decline (SCD) and subjective memory decline (SMD) predict change in objectively assessed global cognition, remote memory, recent memory, learning; 2) the predictive value of more severe SMD over change in objectively assessed remote memory, recent memory, and learning is stronger for individuals that report an SMD that started within the past five years than for those that report an SMD that started five or more years previously and/or stronger for those that experienced SMD within the past two years than for those who had not; and 3) greater depression and anxiety are associated with more severe SCD and SMD. We used two-year longitudinal data from the CFAS-Wales study (N = 1,531; mean (SD) age = 73.0 (6.0) years). We fitted linear regression models. More severe SCD and SMD did not predict change in objectively assessed global cognition, remote memory, and recent memory but predicted lower scores in learning. The prediction of SMD over change in learning was not stronger when individuals reported an SMD that started within the past five years compared to when they reported an SMD that started five or more years previously nor when individuals reported an SMD that started within the past two years than those who did not. Greater depression and anxiety were associated with more severe SCD and SMD. More severe SMD may be useful for predicting lower learning ability and for identifying individuals experiencing depression and anxiety.

Network-Exposure Severity and Self-Protective Behaviors: The Case of COVID-19

BACKGROUND AND OBJECTIVES

To clarify whether awareness of the extent and severity of exposure to the coronavirus disease 2019 (COVID-19) in the social networks of older adults is related to the engagement by the latter in self-protective behaviors. The inquiry is guided by the Health Belief Model and by concepts from the domain of social networks.

RESEARCH DESIGN AND METHODS

Data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, including the SHARE COVID-19 Survey executed in the summer of 2020. The study sample numbered 33,053 persons aged 50 and older in 26 countries. We regressed a logged count of self-protective behaviors on network-exposure severity, controlling for sociodemographic background, country, personality traits, and self-exposure severity. Age and network-exposure interaction terms were examined, as were "close family" and "other" network ties.

RESULTS

Network-exposure severity was positively associated with the extent of engagement in self-protective behaviors among older adults, but mainly among the oldest group, aged 70 and older. Awareness of exposure severity in "close family" and "other" networks were similarly associated with self-protection. Respondents from countries with the lowest rates of COVID-19 infection at the time (Latvia, Finland, and Denmark) engaged in fewer self-protective behaviors, while those from countries with high infection rates (Spain, Italy, and Portugal) self-protected to a greater degree.

DISCUSSION AND IMPLICATIONS

The study findings point to the role of the social network, even if indirect, in promoting self-protective behaviors among the oldest segment of society. Policymakers should collaborate with the social networks of older adults in order to promote the adoption of self-protective behaviors. Such intervention might help to reduce the threat of infection among the most vulnerable age group.

The Effects of Age Stereotypes on Physical and Mental Health Are Mediated by Self-perceptions of Aging

OBJECTIVES

Although the evidence linking views on aging (VoA) with aging outcomes is robust, little is known about how different types of VoA may interact to influence such outcomes. Therefore, this study examined two types of VoA, age stereotypes (AS), representing general VoA, and self-perceptions of aging (SPA), representing personal VoA. We operationalized SPA in terms of awareness of age-related change (AARC), distinguishing between gain- and loss-related SPA (e.g., awareness of positive and negative age-related changes, respectively). Based on theoretical reasoning, we hypothesized that AS would be an antecedent of SPA, and that the effect of AS on physical and mental health would be mediated by SPA.

METHOD

A total of 819 German and U.S. adults aged 40-98 completed a survey on VoA, physical health, and mental health at baseline and 2.5 years later. Structural equation modeling with latent variables was used to examine the effects of Time 1 AS (predictor) and Time 2 gain- and loss-related SPA (mediators) on physical and mental health outcomes.

RESULTS

As hypothesized, AS predicted later SPA. Loss-related SPA mediated the effect of AS on physical health; both gain- and loss-related SPA mediated the effect of AS on mental health.

DISCUSSION

Congruent with theoretical assumptions, our findings provide empirical support for a directional pathway by which AS shape later SPA. We conclude that AS and SPA may affect physical health outcomes more strongly than mental health outcomes. Studies that assess both types of VoA are needed to illuminate the pathways by which VoA influence aging outcomes.

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.

International relevance of two measures of awareness of age-related change (AARC)

BACKGROUND

A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany. We validated the short form of the measure (AARC-10 SF) and the cognitive functioning subscale from the 50-item version of the AARC (AARC-50) questionnaire in the UK population aged 50 and over.

METHODS

Data from 9410 participants (Mean (SD) age = 65.9 (7.1)) in the PROTECT cohort were used to explore and confirm the psychometric properties of the AARC measures including: validity of the factor structure; reliability; measurement invariance across men and women, individuals with and without a university degree, and in middle age, early old age, and advanced old age; and convergent validity with measures of self-perception of aging and mental, physical, and cognitive health. We explored the relationship between demographic variables (age, sex, marital status, employment, and university education) and AARC.

RESULTS

We confirmed the two-factor structure (gains and losses) of the AARC-10 SF and the AARC-50 cognitive functioning subscale. Both scales showed good reliability and good convergent validity for AARC losses, but weak convergent validity for AARC gains. For both scales metric invariance was held for the two subgroups defined by education level and age. For the AARC-50 subscale, but not for the AARC-10 SF, strong invariance was also held for the two subgroups defined by sex. Age, sex, marital status, employment, and university education predicted AARC gains and losses.

CONCLUSIONS

The AARC-10 SF and AARC-50 cognitive functioning subscale identify UK individuals who perceive age-related changes in their mental, physical, and cognitive health.

Dynamic awareness of age-related losses predict concurrent and subsequent changes in daily inductive reasoning performance

To address gaps in previous research, we examined daily within-person associations between awareness of age-related change (AARC) and cognitive performance in older adults. One hundred twelve adults aged 60-90 participated in an online daily diary study for nine consecutive days. On Day 1, they reported demographic information. On Days 2-9, they reported daily AARC, subjective age, and stressors and completed three tasks that gauged memory (word recall), perceptual speed (number comparison), and reasoning (letter series), respectively, once per day. Unconditional multilevel models revealed significant within-person fluctuations in daily cognitive performance and daily AARC. Controlling for age, education, health, and daily stressors, daily awareness of age-related losses was negatively associated with letter series scores of the same day and changes from one day to the next. The effects held over and above AARC gains and subjective age. Dynamic, naturally occurring perceptions of ageing may influence within-person concurrent and subsequent changes in reasoning performance on a daily basis and point to a promising avenue of intervention.

Associations of City-Level Active Aging and Age Friendliness with Well-Being among Older Adults Aged 55 and Over in Taiwan

This study aims to identify the typology of city-level active aging and age-friendliness across cities in Taiwan and examine their effects on well-being in terms of life satisfaction (aged 55 and over) and health-related quality of life (HRQoL) (aged 65 and over) among older adults. The data were from the 2017 Taiwan Senior Citizen Condition Survey. Available indicators of Taiwan’s Active Aging Index and city age-friendliness were selected, and mixed linear models were analyzed. Active aging cities were classified into four categories—content, developed, participatory, and pioneer—and age-friendly cities into insecure, infrastructural, and tranquil. Life satisfaction was rated higher in content and participatory cities compared with the pioneer city, and related to individuals’ active aging status. Physical HRQoL was rated higher in infrastructural and tranquil cities, compared with insecure cities. City types of active aging and age-friendliness have different effects on well-being, but the effects are weaker than those of individuals’ characteristics.