How old do you feel? The role of age discrimination and biological aging in subjective age

Self-Perceptions of Aging Predict Recovery After a Fall: Prospective Analysis From the English Longitudinal Study of Aging

OBJECTIVE

To investigate how mindsets around aging at baseline affect physical recovery following a subsequent fall.

DESIGN

Longitudinal observational study.

SETTING

English Longitudinal Study of Aging (ELSA).

PARTICIPANTS

We analyzed data for 694 individuals who had not fallen in the 2 years prior to baseline (Wave 4) but experienced a fall during follow-up (between Waves 4 and 5).

MEASUREMENTS

Self-perceptions of aging at baseline (Wave 4) and gait speed, activities of daily living (ADL) dependence, and physical (in)activity after a fall at a 2-year follow-up (Wave 5). Multivariable logistic regression analyses were used to determine to what extent aging-related mindset variables as measured at baseline predicted outcome measures at follow-up.

RESULTS

In a fully-adjusted model controlling for confounding baseline factors (including baseline gait speed, ADL dependence and physical inactivity), individuals with positive self-perceptions of aging at baseline had significantly lower odds of slow gait speed (OR = 0.729; 95% CI = 0.627-0.849), ADL dependence (OR = 0.667; 95% CI = 0.561-0.792) and physical inactivity (OR = 0.795; 95% CI = 0.700-0.904) following a fall at a 2-year follow-up.

CONCLUSIONS

These findings identify self-perceptions of aging as a strong predictor of physical recovery and disability following a fall, independent of other important factors such as age, gender, and pre-fall physical function. These novel observations advance our understanding of the psychological factors impacting physical recovery from a fall. Future work should explore if targeting such perceptions can directly improve physical recovery and outcomes following a fall.

Maintaining a young self-concept: Feeling young or shifting age thresholds?

In the face of prevailing negative views on old age, aging individuals try to maintain the self-concept of a young person. They may do so by feeling younger than they are or by shifting the threshold of old age. According to the dual-process theory of developmental regulation, the former represents an assimilative coping process, whereas the latter represents an accommodative coping process. In the present work, we investigated the usage of those two processes across various life domains (e.g., family, work, and leisure). We hypothesized that individuals try to maintain a young self-concept particularly in those domains they view as important for themselves. We furthermore expected older adults to rely more strongly on shifting the threshold of old age in personally important domains (= accommodative response) and younger adults to rely more strongly on feeling young in personally important domains (= assimilative response). We investigated these hypotheses in a cross-sectional sample of 768 individuals aged 30 to 80 years. Analyses were conducted in a multilevel framework with the life domains nested within individuals. Our hypotheses were confirmed. Participants protected a young self-concept selectively in domains that were important to them. Younger adults felt particularly young in self-relevant domains, whereas older adults selectively chose higher old age thresholds in self-relevant domains. Both processes may allow individuals to protect their self-concept and to dissociate themselves from the stigmatized identity of an old person. Results also shed light on the idealization of being young in our society.

Effects of Persistent Depression on Recall Memory are Moderated by Subjective Age Levels: Evidence From Community-Dwelling Older Adults

Results concerning memory performance in older adults with persistent-depression versus other depressive states (i.e., no-depression, past-depression and current-depression) are disparate. This study examined if persistent-depression is linked with impaired memory (measured by recall), and whether this link is moderated by one's feeling older or younger (subjective age). The study used data from waves 5 and 6 of SHARE-Israel (Survey of Health, Ageing and Retirement in Europe), collected in 2013 and 2015. This representative sample focuses on adults aged 50 and above (N = 1254, mean age = 68.4 ± 9.02). Each wave assessed depression, immediate and delayed recall, fluency and numeracy; subjective age was assessed only at 2015. The main moderation effect was analysed with a hierarchical regression analysis. Memory impairments in the persistent-depression group were evident only for those feeling older. There were no effects of subjective age on fluency and numeracy tasks. Limitations include usage of self-report measures to assess depression, as well as applying a minimal inter-wave duration (2 years) to assess persistent depression. Results are aligned with a resource-stress account of subjective which claims that one's subjective age refelcts a ratio of resoucres-to-stress. Implications suggest that challenges of ageing in the shadow of depression can be compounded by feeling older, that memory (vs. other cognitive tasks) may be uniquely linked with subjective age, and that feeling older is a potential risk factor for impaired memory in persistent-depression. The importance of possible interventions aimed at lowering subjective age are mentioned.

Disparities in depression and anxiety related to sexual orientation and gender identity among older adults: The role of age discrimination

Objectives

Sexual and gender minority (SGM) older adults report poorer mental health than their cisgender-heterosexual peers. Age discrimination may be a mechanism underlying these disparities. The current study examined whether SGM older adults reported more age discrimination and, in turn, higher depression and anxiety, compared to cisgender-heterosexual older adults.

Methods

As part of a larger study, 744 older adults (aged ≥ 50; M = 58.4, SD = 6.23) completed an online survey in September 2021. The survey included measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), and age discrimination (an adapted version of the Everyday Discrimination Scale). The sample included five sexual orientation and gender identity (SOGI) groups: cisgender sexual minority men (25.3%), cisgender sexual minority women (21.6%), cisgender-heterosexual men (19.8%), cisgender-heterosexual women (18.5%), and gender minorities (14.8%). We tested the indirect effects of SOGI group on depression and anxiety through age discrimination.

Results

Compared to cisgender-heterosexual men and women, all three SGM groups reported more age discrimination which, in turn, was associated with higher depression and anxiety. Further, compared to cisgender-heterosexual women, cisgender-heterosexual men reported more age discrimination which, in turn, was associated with higher depression and anxiety. All indirect effects were significant.

Conclusion

Age discrimination may be a mechanism underlying the mental health disparities affecting SGM older adults and a promising intervention target.

Association of stressful life events with subjective age and the mediating role of depression: A cross-sectional study of older adults in China

OBJECTIVE

While previous studies have examined the relationship between stressful life events (SLEs) and subjective age (SA), the results were inconclusive and the mechanisms linking the association were unclear. This study investigated whether the experience of SLEs was associated with an older SA and the potential mediating role of depression linking this association in a cross-sectional study of older adults in China.

METHODS

Data were drawn from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 7643 participants aged 60 and older. The association between SLEs and SA was examined using multivariate linear regression, and the mediation effect of depression was evaluated.

RESULTS

Experiencing SLEs over the past year was associated with a 0.018 increase in proportional felt age (95 % CI: 0.012, 0.024) and a 0.011 increase in proportional look age (95 % CI: 0.005, 0.016), respectively. Depression appeared to be a significant mediator, accounting for 22.2 % and 27.3 % of the association of SLEs with proportional felt age and proportional look age, respectively.

CONCLUSION

Findings revealed that having SLEs was associated with an older SA, partially through the pathway of depression. More attention and appropriate intervention should be given to the older adults incurring SLEs to prevent the adverse effect of older SA.

Perceived age estimation from facial image and demographic data in young and middle-aged South Korean adults

Biological age is an indicator of whether an individual is experiencing rapid, slowing, or normal aging. Perceived age is highly correlated with biological age, which reflects health appraisal and is often used as a clinical marker of aging. Perceived age has been reported as an important indicator of biological age and general health status, not only in older adult populations but also in young and middle-aged adults. However, there is a lack of objective methods for quantifying perceived age in these younger age groups. Thus, this study aimed to propose a novel perceived age estimation algorithm to meet the need for an objective method to predict perceived age. This cross-sectional study included 609 healthy men and 1388 healthy women (29.02-57.91 years, average 44.4 years) from 2017 to 2019 using data from the Korean Medicine Daejeon Citizen Cohort Study. The proposed algorithm comprised two steps. First, the initial predicted perceived age was estimated from facial images using a convolutional neural network (CNN) ensemble model. Then, the final perceived age was estimated using regression from the chronological age, sex, BMI, and initial predicted perceived age obtained in the first step. Better performance results were obtained by model averaging and model stacking generated from various basic regression models. The averaging models of Lasso, XGBoost, and CatBoost showed a mean absolute error of 2.2944, indicating that this algorithm can be used as a screening method for general health status in the population.

Empathy mitigates the relationship between ageism and subjective age in late life

This study corresponds with a dispute in gerontology literature about whether a younger subjective age acts as a psychological defense for older adults by perceiving themselves as younger in order to dissociate from their age-group or as a marker of good physical health. This cross-sectional study presents a preliminary step to clarify this dispute. We examined the role of emotional empathy (measured by the Multifaceted Empathy Test) as a moderator in the ageism (measured implicitly by the Brief Implicit Association Test) and subjective age (measured on Likert scale) association on a convenience sample of 203 community-dwelling older adults (aged 65-90, M = 74.54, SD = 6.76). It was hypothesized that implicit ageism would be associated with younger subjective age and that this association would be only evident among older adults with lower emotional empathy. Implicit ageism was not associated with younger subjective age. As expected, hierarchical linear regression showed that the connection between higher implicit ageism and a younger subjective age remains significant (p = 0.012) only among participants with lower emotional empathy (∆R2 = 0.022, β = 0.156). Higher emotional empathy was associated with younger subjective age. For older adults who are equipped with the ability to feel others' emotions, the defensive dissociation between self and other perceptions of aging might be unnecessary. Theoretical and methodological implications are discussed.

The influence of ageism on the hallmarks of aging: Where age stigma and biology collide

Ageism encompasses the creation of negative stereotypes of aging that culminate in the development of prejudicial thoughts and discriminatory actions against people in advanced age. Stereotypes refer to major characteristics, overgeneralized, not supported by observations, that are created to categorize, simplify, and combine complex characteristics, attributes, and behaviors shared by members of a group into more simplistic categories. Negative aging stereotypes include the assumption that old people are weak, reminiscent, sick, and tired, to quote a few. In early age, these views may generate intergenerational conflicts between young and old people, but they seem to have little effect on other aspects of life. However, in middle-aged and older adults, the presence of negative-self stereotypes of aging are significantly associated with several health parameters, including walking speed, cognitive function, mental health problems, and accumulation of amyloid plaques and neurofibrillary tangles. Furthermore, observational studies found that ageism might be associated with cardiovascular events, obesity, dementia, and death. These harmful effects are possibly mediated by the interaction between ageism and fundamental mechanisms of aging, mainly inflammation. Given the clinical implications of this relationship, the present manuscript provides a critical review of the available literature that examined associations between ageism and health parameters. We also discuss the main possible mechanisms underlying this association, the main limitations of the current literature, candidate strategies to counteract ageism, and directions to future studies. Finally, we provide a critical opinion of the current scenario and its potential adaptability to the clinical practice.

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.

Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US

BACKGROUND

Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity.

METHODS

Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated.

RESULTS

Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age.

LIMITATIONS

The possibility of reciprocal effects cannot be excluded.

CONCLUSION

Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.

Cultural Differences in Daily Coupling of Subjective Views of Aging and Negative Affect

OBJECTIVES

The established link between subjective views of aging (VoA) and well-being shows variations across different cultures. Although VoA show daily fluctuations, little is known about cultural differences in such fluctuations and the daily coupling of VoA and well-being. We compared Israeli Arabs to Israeli Jews in the daily coupling of VoA and negative affect (NA).

METHODS

Community-dwelling older adults (N = 76, Mage = 66.71) completed measures of subjective age, subjective accelerated aging, ageist attitudes, and NA over 14 consecutive days.

RESULTS

Respondents reported higher daily NA when they felt older, reported to be aging faster, or had more ageist attitudes. The daily coupling between subjective age/subjective accelerated aging and NA was stronger among Israeli Arabs compared to Israeli Jews. There was no such interaction with ageist attitudes.

DISCUSSION

It is important to adopt a cultural perspective when investigating daily fluctuations in VoA and their correlates. In applied contexts, this might help to identify cultural groups that are particularly sensitive to the effects of VoA.

Psychological Well-Being and Self-Aging Attitudes Moderate the Association between Subjective Age and Age Discrimination in the Workplace

Views of aging include peoples' assessment of their own aging process and their subjective age. Positive views of aging relate to a improved psychological well-being which predicts better physical and mental health. While these relationships were substantially studied, the moderating roles of self-aging attitudes and psychological well-being in the subjective age-age discrimination connection have been much less explored. The current study used a convenience sample of 568 participants (mean = 66.21y, SD = 11.95, age range 50-95), 55.8% women, 67.1% employed. In line with the hypotheses, young subjective age and psychological well-being were connected to less age discrimination in the workplace, and higher psychological well-being mitigated the subjective age-age discrimination at work connection. When the perception of old age as a period of loss was added to the model, adults who perceived old age as a period of loss and reported lower levels of psychological well-being demonstrated the strongest relationship between an increase in subjective age and an increase in age-related discrimination at work. The findings emphasize the importance of the psychological well-being of older employees as a resource for improving their attitudes towards their last years at work.

Factors Associated with Subjective Aging Among Older Outpatients In Northern - India

Objectives

The objective of the study was to investigate factors associated with subjective aging among older patients visiting a geriatric medicine outpatient department in Northern-India.

Methods

The study is a cross-sectional study. Patients were categorized into three groups: whether they felt younger, equal, or older than their peers of same age. Factors such as fall, incontinence, anorexia, hand grip strength, cognition, depression, vision, hearing, cardiopulmonary function and immunization were assessed. Multinominal logistic regression was used to investigate the associated factors of subjective aging.

Results

We assessed 184 older patients with a median age of 66.5 years (IQR 63.0 -78.8). Chronological age and hand grip strength were the significant factors associated with subjective aging. With one year increase in age, odds of feeling older than peers of same age decreased by 8.9% (OR, 0.911; 95% CI, 0.831-0.999, p = 0.047). With one kilogram increase in hand grip strength, odds of feeling younger than peers of same age increased by 7.3% (OR, 1.073; 95% CI, 1.01-1.14, p = 0.032).

Conclusion

Chronological age and hand grip strength are the factors associated with subjective aging in Northern-Indian older adults. Further longitudinal multi-center studies are needed to confirm our findings.

War-Related Life Course Stress and Late-Life Subjective Age in Northern Vietnam

Background and Objectives

The role of early life stressors in subjective aging is weakly understood, especially in low- to middle-income countries. This paper investigated how early life stressors encountered in armed conflict influence subjective age among Vietnamese older adults who experienced war over decades of their early life.

Research Design and Methods

We analyzed survey data from the 2018 Vietnam Health and Aging Study involving 2,447 Vietnamese older adults who encountered diverse war-related stressors in early adulthood. The analytical sample (N = 2,341) included 50.9% women and 49.1% men, with an average age of 69.8. 41.1% are military veterans. We conducted survey-adjusted multinomial logistic regression analyses with mediation to predict the probability of feeling younger or older than one's chronological age. We examined how childhood adversity (i.e., childhood hunger and low parental SES) and wartime stressors (i.e., war-related violence, malevolent environment, and military service) influenced late-life subjective age, both directly and as mediated by late-life mental, functional, and physical health.

Results

We found significant associations between early adulthood war-related stressors and subjective age. Formal military service significantly lessened the relative risk of feeling subjectively old, and more plentiful wartime violence exposures significantly increased the risk of feeling younger than one's chronological age. Violence exposure's effects were both direct and indirect through functional and mental health. Conversely, greater exposure to wartime malevolent conditions (e.g., shortages of clean water and evacuations) and multiple episodes of severe hunger in childhood increased the risk of feeling older, effects both direct and mediated by late-life functional and mental health.

Discussion and Implications

Results suggest wartime stressors, especially war's malevolent environments and severe childhood hunger, experienced in many conflict-affected populations globally, have the potential to subjectively "age" survivors. Yet, not all war exposures are equal, and some may yield psychological and socioeconomic resources that support healthy aging.

Heterogeneity of aging and mortality risk among individuals with hypertension: Insights from phenotypic age and phenotypic age acceleration

OBJECTIVES

Hypertension, a key contributor to mortality, is impacted by biological aging. We investigated the relationship between novel biological aging metrics - Phenotypic Age (PA) and Phenotypic Age Acceleration (PAA) - and mortality in individuals with hypertension, exploring the mediating effects of arterial stiffness (estimated Pulse Wave Velocity, ePWV), and Heart/Vascular Age (HVA).

METHODS

Using data from 62,160 National Health and Nutrition Examination Survey (NHANES) participants (1999-2010), we selected 4,228 individuals with hypertension and computed PA, PAA, HVA, and ePWV. Weighted, multivariable Cox regression analysis yielded Hazard Ratios (HRs) relating PA, PAA to mortality, and mediation roles of ePWV, PAA, HVA were evaluated. Mendelian randomization (MR) analysis was employed to investigate causality between genetically inferred PAA and hypertension.

RESULTS

Over a 12-year median follow-up, PA and PAA were tied to increased mortality risks in individuals with hypertension. All-cause mortality hazard ratios per 10-year PA and PAA increments were 1.96 (95% CI, 1.81-2.11) and 1.67 (95% CI, 1.52-1.85), respectively. Cardiovascular mortality HRs were 2.32 (95% CI, 1.97-2.73) and 1.93 (95% CI, 1.65-2.26) for PA and PAA, respectively. ePWV, PAA, and HVA mediated 42%, 30.3%, and 6.9% of PA's impact on mortality, respectively. Mendelian randomization highlighted a causal link between PAA genetics and hypertension (OR = 1.002; 95% CI, 1.000-1.003).

CONCLUSION

PA and PAA, enhancing cardiovascular risk scores by integrating diverse biomarkers, offer vital insights for aging and mortality evaluation in individuals with hypertension, suggesting avenues for intensified aging mitigation and cardiovascular issue prevention. Validations in varied populations and explorations of underlying mechanisms are warranted.

The experience of feeling old after a fragility fracture

BACKGROUND

There has been little exploration of the effect of fragility fractures on patient perceptions of their age. The common assumption is that fractures "happen to old people". In individuals with a fragility fracture, our objective was to explore the experience of feeling old after sustaining a fragility fracture.

METHODS

A secondary analysis of data from 145 community-dwelling women and men participating in six qualitative primary studies was conducted relying on a phenomenological approach. Participants were English-speaking, 45 years and older, who had sustained a recent fragility fracture or reported a history of previous fragility fractures. Data for the analysis included direct statements about feeling old as well any discussions relevant to age post-fracture.

RESULTS

We highlight two interpretations based on how individuals with a history of fragility fracture talked about age: (1) Participants described feeling old post-fracture. Several participants made explicit statements about being "old". However, the majority of participants discussed experiences post-fracture that implied that they felt old and had resigned themselves to being old. This appeared to entail a shift in thinking and perception of self that was permanent and had become a part of their identity; and (2) Perceptions of increasing age after sustaining a fracture were reinforced by health care providers, family, and friends.

CONCLUSIONS

Our findings challenge the notion that fractures "happen to old people" and suggest that fractures can make people feel old. Careful consideration of how bone health messages are communicated to patients post-fracture by health care providers is warranted. (Word Count: 248).

Self-perceptions of aging: A conceptual and empirical overview

This article defines self-perceptions of aging (SPA) as individuals' perceptions, expectations, and experiences regarding their own process of growing old(er). As such, SPA are considered a critically important element of the aging self. Furthermore, the authors present a heuristic model that positions adults' SPA within a lifespan developmental and cultural-societal context and elaborates distal and proximal antecedents, process modes, and developmental outcomes. The remainder of the article summarizes recent empirical findings and discusses future challenges and directions.

To Be Frail or Not to Be Frail: This Is the Question-A Critical Narrative Review of Frailty

Many factors have contributed to rendering frailty an emerging, relevant, and very popular concept. First, many pandemics that have affected humanity in history, including COVID-19, most recently, have had more severe effects on frail people compared to non-frail ones. Second, the increase in human life expectancy observed in many developed countries, including Italy has led to a rise in the percentage of the older population that is more likely to be frail, which is why frailty is much a more common concern among geriatricians compared to other the various health-care professionals. Third, the stratification of people according to the occurrence and the degree of frailty allows healthcare decision makers to adequately plan for the allocation of available human professional and economic resources. Since frailty is considered to be fully preventable, there are relevant consequences in terms of potential benefits both in terms of the clinical outcome and healthcare costs. Frailty is becoming a popular, pervasive, and almost omnipresent concept in many different contexts, including clinical medicine, physical health, lifestyle behavior, mental health, health policy, and socio-economic planning sciences. The emergence of the new "science of frailty" has been recently acknowledged. However, there is still debate on the exact definition of frailty, the pathogenic mechanisms involved, the most appropriate method to assess frailty, and consequently, who should be considered frail. This narrative review aims to analyze frailty from many different aspects and points of view, with a special focus on the proposed pathogenic mechanisms, the various factors that have been considered in the assessment of frailty, and the emerging role of biomarkers in the early recognition of frailty, particularly on the role of mitochondria. According to the extensive literature on this topic, it is clear that frailty is a very complex syndrome, involving many different domains and affecting multiple physiological systems. Therefore, its management should be directed towards a comprehensive and multifaceted holistic approach and a personalized intervention strategy to slow down its progression or even to completely reverse the course of this condition.

Caregiving intensity and its association with subjective views of ageing among informal caregivers with different sociodemographic background: a longitudinal analysis from Germany

We analysed whether care time, burden and range of caregiving tasks were associated with informal caregivers' subjective views of ageing (measured as attitudes towards own age (ATOA), subjective age (SA), and onset of old age (OOA)), and whether these associations differed as a function of the caregivers' age and gender. Adjusted cluster-robust fixed effects regression analyses were conducted with gender and age as moderators using data of informal caregivers (≥ 40 years) of the population-based German Ageing Survey (2014, 2017). All three aspect of care intensity were associated with changes in subjective views of ageing and this pattern was a function of the caregiver's age and gender. Care time was significantly associated with higher SA. Care tasks were significantly associated with more positive ATOA and earlier OOA. Age moderated the association between burden and ATOA, with older adults reporting more positive ATOA. Gender moderated the association between care time and ATOA; women reported less positive ATOA than men with increasing care time, but also felt subjectively younger than men with a broader range of care tasks. Age- and gender-stratified analysis indicated further differences. Our findings suggest to reduce care time, especially among older and female caregivers, to prevent a worsening of views of ageing, while being involved in a broad range of care tasks seems to (only) benefit female caregivers.

Changing trends in health orientation among older adults: A scoping review

Older people's health condition is not uniform, and the components of their health are interrelated. Concepts regarding the health of older people have emerged and changed over time. However, the transition of concepts and influencing factors are not well examined through research. We have conducted a scoping review of the changes over time in the concept of health for older people and the factors influencing these changes. The public websites of international organizations and academic societies related to older people's health and research paper database were searched, and the extracted data were summarized in a chronological table. Consequently, this study revealed changing trends in health orientation after health had been defined by WHO, namely, successful aging, productive aging, active aging, and healthy aging, and their components, not the concept of health. The emergence and changes of health orientation among older people may have accompanied proposals and measures of international organizations and academic societies developed in response to changes in the demographic structure, and changes in how society perceives and supports older people. With the changing eras that bring about advances in health technology, prolongation of life expectancy, and changes in lifestyles, the needs of older people, society's perceptions of aging and older people, and how to support them will also change. Our findings may provide a valuable basis for understanding aging and older people, reconsidering their health orientation based on the health issues of older people and their significance, and formulating policies for older people in the future. Geriatr Gerontol Int 2024; 24: 5-17.

Dental anxiety and ageing anxiety: Moderated mediation roles of Oral Health-Related Quality of Life and subjective accelerated ageing

BACKGROUND

Oral health and its relation to ageing is an important topic often neglected among geriatric populations. Proper oral rehabilitation may aid in alleviating mental health burdens in such populations.

OBJECTIVES

The present study aimed to explore the association between dental anxiety and ageing anxiety, with regard to the interplay of Oral Health-Related Quality of Life (OHRQoL) as mediator and subjective accelerated ageing as a moderator.

METHODS

A total of 577 participants with mean age 72.78 years (SD = 3.832, range = 68-87) were recruited via a survey company in Israel. They completed a self-report battery of questionnaires about dental anxiety, OHRQoL, subjective accelerated ageing and ageing anxiety, along with their informed consent.

RESULTS

The findings revealed that dental anxiety was positively associated with ageing anxiety (direct effect), and that OHRQoL mediated the link between dental anxiety and ageing anxiety (indirect effect). Additionally, subjective accelerated ageing moderated the positive link between dental anxiety and OHRQoL, as well as the positive link between OHRQoL and ageing anxiety.

CONCLUSIONS

The results provide insight for the roles of OHRQoL and subjective accelerated ageing among older adults between dental anxiety and ageing anxiety. Tailoring oral rehabilitation interventions that focus on these factors are warranted to improve older adults' dental health.

A cross-sectional study on resilience, anxiety, depression, and psychoactive substance use among heterosexual and sexual minority adolescents in Nigeria

BACKGROUND

Mental health-related problems predispose alcohol and other psychoactive substances use as coping strategies. We assessed associations between resilience and anxiety symptoms, depressive symptoms, problematic alcohol, and multiple psychoactive substance use among sexual minority and heterosexual adolescents in Nigeria.

METHODS

This was a secondary analysis of a subset of data generated through an online cross-sectional study conducted between 16th and 31st of October 2020. Data extracted for adolescents in Nigeria age 13-19 years were: dependent variables (alcohol use using the CAGE test, multiple psychoactive substance use, depressive symptoms using the Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7 measure); independent variables (resilience using the Connor-Davidson resilience scale and sexual identity), and confounding factors (age and sex). Associations between dependent and independent variables were determined using multivariable logistic regression analyses after controlling for confounders.

RESULTS

Of the 1419 adolescent participants, 593 (42%) were sexual minority individuals, 533 (37.6%) had high depressive symptoms, 381 (26.8%) had high anxiety symptoms, 177 (12.5%) had problematic alcohol use and 389 (27.4%) used multiple psychoactive substances. Resilience was significantly associated with lower odds of anxiety (AOR:0.96, 95% CI: 0.94-0.97, p < 0.001) and depressive (AOR:0.94, 95% CI: 0.92-0.96, p < 0.001) symptoms, problematic alcohol use (AOR:0.97, 95% CI: 0.95-0.99, p = 0.002), and multiple psychoactive substance use (AOR:0.95, 95% CI: 0.93-0.96, p < 0.001). Sexual minority adolescents had significantly higher odds of anxiety (AOR:4.14, 95% CI: 3.16-5.40, p < 0.001) and depressive symptoms (AOR:4.79; 95% CI: 3.73-6.15, p < 0.001), problematic alcohol use (AOR:2.48, 95% CI: 1.76-3.49, p < 0.001), and multiple psychoactive substance use (AOR:5.69, 95% CI: 4.34-7.47, p < 0.001).

CONCLUSION

Sexual minority adolescents and adolescents with low resilience have a higher need for interventions to reduce the risk of anxiety, depression, and the use of alcohol and other psychoactive substances.

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.

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.

The association of functional limitations and diseases with multidimensional subjective age: Does chronological age matter?

OBJECTIVE

As the longstanding culture of respecting for older adults and filial piety norms is diminishing in China, how older Chinese perceive their health loss becomes a significant question. Based on the biological-psycho-social model of successful aging, the present study combines physiological and subjective indicators into a complete framework of successful aging, and examines the influence of disease and disability situation on multidimensional perceptions of senescence during the aging process among Chinese older adults.

METHODS

In a representative sample of Chinese older adults aged 60-89 from the China Longitudinal Aging Social Survey (CLASS) (n = 7,668 respondents), we use multiple linear regression model to analyze the heterogeneous association of suffering from various disease types and activity restrictions with 3 facets of subjective age (SA): felt age, look age and self-defined aging standard with the increasing chronological age.

RESULTS

The negative association of limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) with perception of senescence is stabilized with chronological age. Respondents with non-life-shortening disease (type N) and chronic disease (type C) are associated with older felt age and look age and the discrepancy increases with age, while the negative association between acute and chronic disease (type AC) and self-defined aging standard becomes weaker with age.

DISCUSSION

Our results highlight the match between physiological indicators and different dimensions of aging perception, and how these factors map subjective senescence experience across aging process. Our identification of physical conditions in individuals with negative aging perceptions could help form effective interventions to achieve a more positive overall image of old age.

The Mediating Role of Biomarkers in the Association Between Subjective Aging and Episodic Memory

OBJECTIVES

Subjective aging, indexed by subjective age and self-perceptions of aging (SPA), is consistently related to cognition in adulthood. The present study examined whether blood biomarkers mediate the longitudinal associations between subjective aging indices and memory.

METHODS

Data of 5,369 individuals aged 50-94 years (mean = 66.89 years, SD = 9.22; 60% women) were drawn from the Health and Retirement Study (HRS). Subjective age, SPA, and demographic factors were assessed in 2012/2014. Interleukin-6, C-reactive protein, albumin, cystatin C, N-terminal pro B-type natriuretic peptide (NT-proBNP), fasting glucose, Vitamin D, hemoglobin, red cells distribution width, and epigenetic aging were assessed as part of the HRS Venuous Blood Study in 2016. Memory was measured in 2018. The mediators (except for epigenetic aging, which was assessed in a subsample) were tested simultaneously in models that accounted for demographic covariates.

RESULTS

An older subjective age was related to worse memory partially through higher fasting glucose, higher cystatin C, higher NT-proBNP, and accelerated epigenetic aging. Negative SPA was related to worse memory through lower Vitamin D3, higher fasting glucose, higher cystatin C, higher NT-proBNP, and accelerated epigenetic aging. The biomarkers explained between 2% and 10% of subjective age and between 1% and 8% of SPA associations with memory. Additional analysis revealed that biomarkers continued to be significant mediators when physical inactivity and depressive symptoms were included as additional mediators.

CONCLUSION

The present study adds to existing research on the association between subjective aging and memory by providing new evidence on the biological mediators of this association.

Attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning

OBJECTIVE

To understand if attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning among older adults with medical conditions. We examined: (1) if these effects are reciprocal; (2) if attitudes to aging (psychological loss, psychological growth, physical change) play a mediating role in these effects.

DESIGN

A sample of 226 community-dwelling older adults (T1 age range = 65-94, mean age = 73.59, SD = 6.29) reporting at least one chronic medical condition completed two phone interviews across six months.

MAIN OUTCOME MEASURES

Background measures, health anxiety, physical functioning, and attitudes to aging at T1 and T2.

RESULTS

T2 attitudes to aging served as a mediator controlling for T1 attitudes. There was a direct effect of worse physical functioning at T1 on increased health anxieties at T2. Negative (but not positive) attitudes to aging mediated that effect. The reversed temporal sequencing (T1 health anxiety leading to T2 physical functioning) was significant only when mediated by negative attitudes to aging.

CONCLUSIONS

Findings suggest that viewing aging as mostly a time of losses (but not as a time of gains) serves as an important mechanism through which health anxieties and physical functioning affect each other among older adults having chronic medical conditions.

Association of Chronic Diseases and Functional Limitations with Subjective Age: The Mediating Role of Sense of Control

OBJECTIVES

This study examined the relationships between chronic diseases, functional limitations, sense of control, and subjective age. Older adults may evaluate their subjective age by reference to their younger healthier selves and thus health and functional status are likely to be determinants of subjective age. Although sense of control is also a potential predictor of subjective age, stress-inducing factors associated with disease and functional limitations may reduce older adults' sense of control, making them feel older.

METHODS

Using the 2010 and 2014 waves of the Health and Retirement Study, structural equation modeling was performed on a sample of 6,329 respondents older than 50 years to determine whether sense of control mediated the relationship between chronic diseases, limitations in instrumental/basic activities of daily living (ADLs, IADLs), and subjective age.

RESULTS

Chronic diseases and limitations in ADLs had a positive, direct association with subjective age (β = 0.037, p = .005; β = 0.068, p = .001, respectively). In addition, chronic diseases and limitations in ADLs and IADLs were positively, indirectly associated with subjective age via a diminished sense of control (β = 0.006, p = .000; β = 0.007, p = .003; β = 0.019, p = .000, respectively).

DISCUSSION

As predicted by the Deterioration model, the findings showed that chronic diseases and functional impairment are associated with older adults feeling older by challenging the psychological resource of sense of control. Appropriate interventions for dealing with health challenges and preserving sense of control may help prevent the adverse downstream effects of older subjective age.

Subjective age, worry and risk-related perceptions in older adults in times of a pandemic

During the Covid-19 pandemic, older people have been in the spotlight of the public debate. Given their higher risk of severe outcomes of the disease, they have been described as especially vulnerable and as a burden to others and society. We thus wanted to investigate how older people’s perception of their own age, that is their subjective age, as well as their Covid-19 related risks and worries were related during the pandemic and whether these relationships varied according to participants’ subjective health. We used data from the longitudinal CRISIS study which was conducted in the Grand-Duchy of Luxembourg in June and October 2020. Participants were aged 60–98 and responded on questionnaires regarding their subjective age, worry of falling ill with Covid-19, perceived risk of contracting the virus, perceived risk of falling seriously ill if they contracted Covid-19, as well as their subjective health and covariates. Three cross-lagged panel models were constructed to explore the longitudinal, bidirectional relationships between the variables. Cross-sectionally, a higher subjective age was related to more perceived risk of a serious course of disease. Longitudinally, subjective age and worry did not show any significant association over time, and neither did subjective age and perceived risk of contracting the virus. However, subjective health significantly moderated the relationship of worry and subjective age, showing different trajectories in the relationship depending on whether subjective health was good or bad. Higher perceived risk of falling seriously ill increased subjective age over time. Again, subjective health moderated this relationship: the perceived risk of falling seriously ill affected subjective age only for those with better subjective health. Our findings show the interactive relationship between subjective age and Covid-19 related cognitions and emotions and provide guidance for identifying older people that are most susceptible for negative age-related communication during the pandemic.

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).

Subjective age and attitudes toward own aging across two decades of historical time

A large body of empirical evidence has accumulated showing that the experience of old age is "younger," more "agentic," and "happier" than ever before. However, it is not yet known whether historical improvements in well-being, control beliefs, cognitive functioning, and other outcomes generalize to individuals' views on their own aging process. To examine historical changes in such views on aging, we compared matched cohorts of older adults within two independent studies that assessed differences across a two-decade interval, the Berlin Aging Studies (BASE; 1990/1993 vs. 2017/2018, each n = 256, Mage = 77) and the Midlife in the United States Study (MIDUS; 1995/1996 vs. 2013/14, each n = 848, Mage = 67). Consistent across four different dimensions of individuals' subjective views on aging (age felt, age appeared, desired age, and attitudes toward own aging) in the BASE and corroborated with subjective age felt and subjective age desired in the MIDUS, there was no evidence whatsoever that older adults of today have more favorable views on how they age than older adults did two decades ago. Further, heterogeneity in views on aging increased across two decades in the MIDUS but decreased in BASE. Also consistent across studies, associations of views on aging with sociodemographic, health, cognitive, and psychosocial correlates did not change across historical times. We discuss possible reasons for our findings, including the possibility that individual age views may have become increasingly decoupled from societal age views. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Personality and subjective age: Evidence from six samples

Subjective age is associated with health-related outcomes across adulthood. The present study examined the cross-sectional and longitudinal associations between personality traits and subjective age. Participants (N > 31,000) were from the Midlife in the United States Study (MIDUS), the Health and Retirement Study (HRS), the National Health and Aging Study (NHATS), the Wisconsin Longitudinal Study Graduate (WLSG) and Siblings (WLSS) samples, and the English Longitudinal Study of Aging (ELSA). Demographic factors, personality traits, and subjective age were assessed at baseline. Subjective age was assessed again in the MIDUS, the HRS, and the NHATS, 4 to almost 20 years later. Across the samples and a meta-analysis, higher neuroticism was related to an older subjective age, whereas higher extraversion, openness, agreeableness, and conscientiousness were associated with a younger subjective age. Self-rated health, physical activity, chronic conditions, and depressive symptoms partially mediated these relationships. There was little evidence that chronological age moderated these associations. Multilevel longitudinal analyses found similar associations with the intercept and weak evidence for an association with the slope in the opposite of the expected direction: Lower neuroticism and higher extraversion, agreeableness, and conscientiousness were related to feeling relatively older over time. The present study provides replicable evidence that personality is related to subjective age. It extends existing conceptualization of subjective age as a biopsychosocial marker of aging by showing that how old or young individuals feel partly reflects personality traits. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Association Between Views of Aging and Subjective Cognitive Complaints in Older Adults: Findings From Two Samples

This cross-sectional study examined whether views of aging (VoA) relate to subjective cognitive complaints in two separate cohorts of older adults. Ageist attitudes, attitudes to aging (psychological loss, physical change, and psychological growth), subjective age, and subjective successful aging were examined. A moderating effect of chronological age was also examined. Samples included 572 adults aged 50 or older (Sample 1; mean age = 67.63, SD = 11.39, 49.4% female) and 224 adults aged 65 or older (Sample 2; mean age = 81.50, SD = 6.61, 75.3% female). More negative VoA (higher ageist attitudes, lower psychological growth, lower physical change, older subjective age, and less successful aging) were associated with more subjective cognitive complaints after controlling for covariates. An increase in chronological age strengthened some of these associations. Findings suggest that improving dimensions of VoA may have a complementary positive effect on subjective cognitive complaints in older adults.

Applied Artificial Intelligence and user satisfaction: Smartwatch usage for healthcare in Bangladesh during COVID-19

The evolution of Artificial Intelligence (AI) has revolutionized many aspects of human life, including healthcare. Amidst the Covid-19 pandemic, AI-enabled smartwatches are being used to help users to self-monitor and self-manage their health. Using a framework based on Stimulus-Organism-Response (S-O-R) theory, this present study aimed to explore the use of AI-enabled smartwatches for health purposes, in particular the effects of product quality, service quality, perceived convenience, and perceived ease of use on user experience, trust and user satisfaction. Based on a purposive survey sample of 486 smartphone users in Bangladesh, data collected was analyzed using SPSS software for elementary analyses and PLS-SEM for hypotheses testing. The findings showed that the predictors, namely product quality, service quality, perceived convenience, and perceived ease of use, significantly affected user experience and trust. Similarly, user experience and trust were influential on user satisfaction and played partial mediating roles between predictors and user satisfaction. Besides, gender and age moderate the relationships of experience and trust with customer satisfaction. These findings support the S-O-R theoretical framework and have practical implications for brand and marketing managers of smartwatches in developing product features and understanding users' attitudes and behaviours.

Subjective age and multiple cognitive domains in two longitudinal samples

OBJECTIVE

Subjective age is consistently related to memory performance and global cognitive function among older adults. The present study examines whether subjective age is prospectively related to specific domains of cognitive function.

METHOD

Participants were drawn from the Health and Retirement Study (HRS, N = 2549, Mean Age = 69.66, SD = 7.36) and the Midlife in the United States Survey (MIDUS, N = 2499, Mean Age = 46.24, SD = 11.25). In both samples, subjective age, depressive symptoms, chronic conditions, and demographic factors were assessed at baseline. Four domains of cognition were assessed 8 years later in the HRS and almost 20 years later in the MIDUS: episodic memory, speed-attention-executive, verbal fluency, and numeric reasoning. HRS also assessed visuospatial ability.

RESULTS

Regression analysis revealed that an older subjective age was related to worse performance in the domains of episodic memory and speed-attention-executive in both samples. The effect size for the difference between a younger and an older subjective age was d = 0.14 (MIDUS) and d = 0.24 (HRS) for episodic memory and d = 0.25 (MIDUS) and d = 0.33 (HRS) for speed-attention-executive. Feeling older was related to lower verbal fluency in HRS (d = 0.30) but not in MIDUS, whereas no association was found with numeric reasoning in either sample. An older subjective age was related to lower visuospatial ability in HRS (d = 0.25).

CONCLUSION

Subjective age is prospectively related to performance in different cognitive domains. The associations between subjective age and both episodic memory and speed-attention-executive functions were replicable and robust over up to 20 years of follow-up.

Subjective Age and Late-Life Functional Status: Mediating and Moderating Effects

OBJECTIVES

The present study examined the longitudinal relationships between subjective age (SA) and future functional status in later life, via depressive symptoms. Additionally, we assessed the role of subjective nearness to death (SNtD) as a potential moderator within these pathways.

METHODS

Older adults (average age 81.14 at T1) were interviewed once a year for three consecutive years (N=224 at T1, N=178 at T2, and N=164 at T3), Participants reported their SA, SNtD, depressive symptoms, and functional status. Additionally, grip strength was employed as an objective measure of functional status.

RESULTS

Data analysis revealed distinct pathways leading from T1 SA to T3 functional status through T2 depressive symptoms. Moreover, T1 SNtD was found to significantly moderate most of these indirect pathways, so that the mediation model of T1 SA-T2 depressive symptoms-T3 functional status was mostly significant among those who felt closer to death.

DISCUSSION

The findings contribute to our understanding of the underlying mechanism through which SA predicts long-term functioning sequelae by underscoring the indirect effect of depressive symptoms. They further indicate the importance of gauging the effects of SNtD on these longitudinal relationships. Present results may further contribute to establishing an integrative model for predicting long-term functional outcomes based on older adults' earlier subjective views of aging.

Subjective age and verbal fluency among middle aged and older adults: A meta-analysis of five cohorts

OBJECTIVES

This study aimed to examine the relation between subjective age and verbal fluency in five large samples of older adults to advance knowledge on the role of subjective age in a complex cognitive function that is an intermediate marker of cognitive impairment and dementia risk.

METHODS

Participants (N > 27,000), aged 32 to 99 years old, predominantly white, were from the Wisconsin Longitudinal Study Graduate (WLSG) and Siblings (WLSS) samples, the Health and Retirement Study (HRS), the Midlife in the United States Study (MIDUS), and the English Longitudinal Study of Ageing (ELSA). They provided complete data on subjective age, demographic factors and verbal fluency. Estimates from each sample were combined in a meta-analysis.

RESULTS

Across each of the five samples and in the meta-analysis, an older subjective age was related to lower performance on the verbal fluency task. This association was independent of chronological age and was not moderated by age, sex, nor education. The difference in fluency between individuals with an older and younger subjective age ranged from d = 0.09 to d = 0.37 across the five samples.

CONCLUSIONS

This study found replicable evidence for an association between an older subjective age and lower verbal fluency, extending knowledge about an intermediate marker of cognitive function.

A Systematic Review and Meta-Analysis of Subjective Age and the Association With Cognition, Subjective Well-Being, and Depression

OBJECTIVES

A systematic review and meta-analysis were conducted to quantify the degree to which subjective age is associated with cognition, subjective well-being, and depression.

METHOD

A systematic search was performed in three electronic social scientific databases, PsycINFO, Scopus, and Web of Science in May 2018. A manual forward and backward citation search of articles meeting the criteria for inclusion, including a mean participant age of 40+ years, was conducted in November 2019. Twenty-four independent data sets were included in the meta-analysis.

RESULTS

Overall, a younger subjective age was related to enhanced subjective well-being and cognitive performance, and reduced depressive symptoms (r = .18). This association was stronger among collectivist (r = .24) than individualist (r = .16) cultures. Mean chronological age across samples (ranging from 55 to 83 years), type of subjective age scoring, and gender did not influence the strength of the overall association. Further analysis revealed that subjective age was individually associated with depressive symptoms (r = .20), subjective well-being (r = .17), and cognition (r = .14), and none had a stronger association with subjective age than the other.

DISCUSSION

The results indicate a small yet significant association between subjective age and important developmental outcomes.

Health and Subjective Views on Aging: Longitudinal Findings From the ActiFE Ulm Study

Objectives

Previous research supports that subjective views on aging (VoA), such as older subjective age (SA) and negative attitudes toward own aging (ATOA), go along with negative outcomes. A differentiated treatment of health and disease as antecedents of VoA is largely lacking. Therefore, our objective was to estimate the relationship between generally framed physical, affective, and cognitive health as well as specific diseases and VoA, operationalized both as SA and ATOA.

Methods

Data were drawn from the ActiFE Ulm study for which a representative sample of community-dwelling older people (65–90 years) was recruited at baseline. Follow-ups were conducted 7.7 years (median) after recruitment (N = 526). Health- and disease-related data at baseline, based on established assessment procedures for epidemiological studies, were regressed on VoA (1-item SA indicator, 5-item ATOA scale) measures at follow-up.

Results

Reported severity of affective health problems such as depression was the strongest general risk factor for both older SA and negative ATOA. Also, some but not all major diseases considered were associated with VoA. Notably, back pain predicted negative ATOA, while cancer was associated with older SA. Rheumatism was linked with more negative ATOA along with higher SA. Throughout analyses, explained variance in ATOA was considerably higher than in SA.

Discussion

Affective health problems, such as depression, should be regarded as a major correlate of subjective aging views. Interestingly, diseases do not have to be life-threatening to be associated with older SA or negative ATOA.

Perceived Ageism During the Covid-19-Crisis Is Longitudinally Related to Subjective Perceptions of Aging

Ageism in media and society has increased sharply during the Covid-19-crisis, with expected negative consequences for the health and well-being of older adults. The current study investigates whether perceived ageism during the crisis longitudinally affects how people perceive their own aging. In June 2020, N = 611 older adults from Luxembourg [aged 60–98 years, M_age(SD) = 69.92(6.97)] participated in a survey on their perception of the crisis. In October 2020, N = 523 participated in a second measurement occasion. Participants reported on perceived ageism during the crisis in different domains, their self-perceptions of aging and subjective age. In latent longitudinal regression models, we predicted views on aging at T2 with perceived ageism at T1, while controlling for baseline views on aging and covariates. Perceived ageism at T1 increased self-perceptions of aging as social loss and yielded a trend for physical decline, while there were no effects on subjective age and self-perceptions of aging as continued growth. Views on aging are powerful predictors of well-being and health outcomes in later life. Our data suggest that being the target of ageism during the crisis negatively affects older adults' self-perceptions of aging and this impact may be felt beyond the current crisis.

Bidirectional relationship between subjective age and frailty: a prospective cohort study

Background

Subjective age refers to how young or old individuals experience themselves to be and is associated with health status, behavioral, cognitive, and biological processes that influence frailty. However, little research has examined the relationship between subjective age and frailty among older adults. This study examined the bidirectional association between subjective age and frailty among community-dwelling older adults.

Methods

We used data from the 2011 to 2015 waves of the National Health and Aging Trends Study. Our sample consists of 2,592 community-dwelling older adults with complete data on main outcome variables. Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust = 0, pre-frailty = 1 or 2; frailty = 3 or more criteria met. Generalized estimating equation models were used to examine the concurrent and lagged association between subjective age and frailty.

Results

Participants were, on average, 75.2 ± 6.8 years old, non-Hispanic whites (76 %), female (58 %). 77 % of the participants felt younger, 18 % felt the same, and 5 % felt older than their chronological age. About 45 %, 46 %, and 9 % of the participants were robust, pre-frailty and frailty in the first wave, respectively. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95 % CI = 1.93, 1.45–2.56).

Conclusions

These findings suggest that people with older subjective age are more likely to be pre-frail/frail. Subjective age could be used as a quick and economical screening for those who are potentially frailty or at risk for frailty.

Subjective age, depressive symptoms, and cognitive functioning across five domains

Objective: Younger subjective age predicts better episodic memory and executive functioning performance independent of chronological age. This study examined whether subjective age is associated with performance in five cognitive domains, quantified the extent to which these relationships are mediated by depressive symptoms, and tested whether these associations are moderated by chronological age.Method: Participants in this cross-sectional study included 993 adults aged 65 and older from the Health and Retirement Study's 2016 Harmonized Cognitive Assessment Protocol. Moderated mediation models estimated direct and indirect effects of subjective age on factor scores representing episodic memory, executive functioning, language, visuoconstruction, and speed through depressive symptoms and tested whether associations differed according to chronological age.Results: Depressive symptoms explained 21-32% of the associations between subjective age and language, speed, episodic memory, and executive functioning. Chronological age moderated the indirect effect involving language, such that depressive symptoms were more strongly related to worse language performance at older chronological ages. After accounting for indirect effects, direct effects of younger subjective age remained for language and speed domains.Conclusions: This study extends research on the cognitive correlates of subjective age and demonstrates that depressive symptoms partly mediate these relationships. Subjective age may bemost strongly associated with language among individuals at older chronological ages not because they are more sensitive to the negative mental health impact of feeling older than they are but because they may be particularly vulnerable to the negative effects of depressive symptoms on language ability. Additional longitudinal research is needed to determine whether links between subjective age and cognition are causal versus predictive.

Diagnoses of Chronic Health Conditions and Change in Subjective Age: The Moderating Role of Chronological Age

BACKGROUND AND OBJECTIVES

Health is a predictor of subjective age, and although inconclusive, the strength of this association is not uniform across different age groups. This study investigates if new diagnoses of chronic health conditions are associated with a change in subjective age and if chronological age moderates this relationship.

RESEARCH DESIGN AND METHODS

Using data from the Health and Retirement Study, residualized change regression analysis was performed for a sample of 5,158 respondents older than 50 years to examine their subjective age in 2014 relative to that reported in 2010. The main predictor was the number of chronic health conditions newly diagnosed between 2010 and 2014. Chronological age in 2010 was the moderator.

RESULTS

Results showed that each new diagnosis of a chronic health condition was significantly associated with a 0.68-year increase in subjective age reported in 2014, compared to subjective age reported in 2010. However, this increase in subjective age was attenuated by 0.05 years for each additional year in 2010 chronological age.

DISCUSSION AND IMPLICATIONS

According to Social and Temporal Comparison theories, people compare themselves to their age peers and earlier selves. Given expectations for better health at younger chronological ages, being diagnosed with chronic health conditions may have a stronger association with subjective age among middle-aged persons as compared to older persons. The findings suggest that subjective age may be used as a screening tool to predict how chronic disease diagnosis may influence peoples' sense of self, which in turn shapes future health.

Subjective Aging and Incident Cardiovascular Disease

OBJECTIVES

Subjective aging, including subjective age and self-perceptions of aging (SPA), predicts health-related outcomes in older adults. Despite its association with cardiovascular risk factors, little is known about the association between subjective aging and the incidence of cardiovascular disease. Therefore, the present study examined whether subjective age and SPA are related to the incidence of heart conditions and stroke.

METHODS

The sample comprises 10,695 participants aged 50-100 years from the Health and Retirement Study. Subjective age, SPA, demographic factors, and health-related behaviors, body mass index (BMI), hypertension, diabetes, and depressive symptoms were assessed at baseline. Self-reported physician diagnosis of heart conditions and stroke were assessed biennially over up to 9 years of follow-up.

RESULTS

Controlling for demographic factors, an older subjective age and more negative SPA were related to a higher risk of incident heart conditions and stroke. Feeling older and holding negative SPA were associated with around 40% higher risk of experiencing heart conditions over time. An older subjective age and negative SPA were related to almost twofold and 30% higher risk of incident stroke, respectively. Health risk behaviors, BMI, hypertension, diabetes, and depressive symptoms accounted for part of the associations between subjective aging and heart diseases and stroke.

CONCLUSIONS

Consistent with the literature on subjective aging and cardiovascular risk factors, this large prospective study indicates that an older subjective age and negative SPA increase the risk of incident stroke and other cardiovascular diseases.

Subjective accelerated aging moderates the association between COVID-19 health worries and peritraumatic distress among older adults

BACKGROUND

The present study examined whether subjective accelerated aging moderated the relationship between COVID-19 health worries and COVID-19 peritraumatic distress among older adults.

METHOD

The sample consisted of 277 older adults (M = 69.58, s.d. = 6.73, range 60-92) who answered an online questionnaire during the outbreak of COVID-19 pandemic in Israel. Participants completed the measures of background characteristics, exposure to COVID-19, COVID-19 health worries, subjective accelerated aging and COVID-19-based peritraumatic distress.

RESULTS

Higher levels of COVID-19 health worries were correlated with higher levels of peritraumatic distress symptoms among older adults. Moreover, those reporting accelerated aging also reported a higher level of peritraumatic distress. Finally, the interaction between COVID-19 health worries and subjective accelerated aging predicted peritraumatic distress, suggesting that COVID-19 worries were associated with peritraumatic distress to a stronger degree among older adults who felt they were aging faster.

CONCLUSIONS

These findings indicate that negative views of aging may serve as an amplifying factor for traumatic distress during the COVID-19 pandemic. Although preliminary, the findings provide insight for potential screening and interventions of older adults at risk of developing peritraumatic distress symptoms during the global pandemic.

Relationship between personality and physical capacities in older adults: The mediating role of subjective age, aging attitudes and physical self-perceptions

Walking speed and muscular strength are two main markers of health in adulthood. Previous studies have shown that personality traits may predict these two outcomes. However, little is known about the mechanisms underlying these relationships. Thus, the present study examined whether personality traits are associated with walking speed and muscular strength through the mediating role of subjective age (how young or old individuals experience themselves to be), attitudes toward aging and physical self-perceptions. Community-dwelling older women (N = 243; M_age = 73.0; SD_age = 6.5) were recruited. For reasons of recruitment feasibility, participants were only older women. They were requested to complete a questionnaire measuring personality, subjective age, attitudes toward aging and physical self-perceptions. Following this, their walking speed and their muscular strength were investigated. Data were analyzed using structural equation modeling. In line with the literature, we extended the associations between extraversion, neuroticism, conscientiousness and walking speed and between conscientiousness, neuroticism, openness and muscular strength. Physical self-perceptions appear to be a robust mediator between personality traits and walking speed whereas attitudes toward aging and subjective age mediated the personality traits/muscular strength relationship. This study provides evidence, for the first time, that the associations between personality traits and physical capacities are different according to the physical capacities investigated. Based on these results, it could be interesting to adapt physical activity interventions to the psychological profile of older adults.

Does older subjective age predict poorer cognitive function and higher risk of dementia in middle-aged and older adults?

As a biopsychosocial marker of aging, subjective age (i.e., the age individuals feel regardless of their actual age) was related to many health issues in the elderly. The purpose of this study is to investigate whether subjective age is associated with subsequent cognition and dementia risk in middle-aged and older adults. Samples were drawn from the English Longitudinal Study of Ageing (ELSA). Participants reported their subjective ages at the baseline (2004/2005), and their cognitive functions were measured after 10 years (2014/2015). Newly diagnosed dementias were recorded between 2006/2007 to 2014/2015. Overall, 6,475 adults aged 50 years or older were included in the current analyses. The relationship between subjective age reported at baseline and cognition assessed ten years later was modeled using multiple linear regression models. Compared to participants who reported a younger subjective age, those who reported an older subjective age were more likely to have poorer cognition after ten years (β = -0.705, P = .002 for memory, β = -1.567, P = .001 for executive function). A Cox proportional hazard regression model suggested that older subjective age was an independent risk factor for incident dementia (HR = 1.737, 95% CI =1.060-2.848). Other than chronological age, subjective age could also be considered as an important predictor for the development of cognitive dysfunction.