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Fernández-Ballbé Ó, Martin-Moratinos M, Saiz J, Gallardo-Peralta L, Barrón López de Roda A. The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review. Healthcare (Basel) 2023; 11:3115. [PMID: 38132005 PMCID: PMC10743019 DOI: 10.3390/healthcare11243115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.
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Affiliation(s)
- Óscar Fernández-Ballbé
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | | | - Jesus Saiz
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | - Lorena Gallardo-Peralta
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | - Ana Barrón López de Roda
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
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Sabatini S, Wahl HW, Diehl M, Clare L, Ballard C, Brooker H, Corbett A, Hampshire A, Stephan BCM. 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. J Gerontol B Psychol Sci Soc Sci 2023; 78:2026-2036. [PMID: 37801677 PMCID: PMC10699739 DOI: 10.1093/geronb/gbad150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Indexed: 10/08/2023] Open
Abstract
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.
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Affiliation(s)
- Serena Sabatini
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Hans-Werner Wahl
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Manfred Diehl
- Department of Human Development and Family Studies, Colorado State University, Forth Collins, Colorado, USA
| | - Linda Clare
- Medical School, University of Exeter, Exeter, UK
| | | | - Helen Brooker
- Medical School, University of Exeter, Exeter, UK
- Ecog Pro Ltd, Bristol, UK
| | - Anne Corbett
- Medical School, University of Exeter, Exeter, UK
| | - Adam Hampshire
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Blossom C M Stephan
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Bentley, Australia
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Turner SG, Brooker H, Ballard C, Corbett A, Hampshire A, Sabatini S. The Role of Awareness of Age-Related Change in the Longitudinal Association between Pain and Physical Activity. Int J Aging Hum Dev 2023:914150231208686. [PMID: 37899713 PMCID: PMC11058115 DOI: 10.1177/00914150231208686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
We examined how physical pain impacts the developmental construct of Awareness of Age-Related Change (AARC-gains and AARC-losses) and, in turn, how AARC mediates and moderates the association between pain and subsequent physical activity. We used longitudinal data from 434 participants of the UK PROTECT Study (mean age = 65.5 years; SD = 6.94 years). We found that pain in 2019 predicted higher AARC-losses (β = .07; p = .036) and less physical activity (β = -.13; p-value = .001) in 2020. Additionally, we found that AARC-losses partially mediated, but did not moderate, the association of pain in 2019 and physical activity in 2020. AARC-losses may explain physical inactivity in middle-aged and older adults experiencing pain. Incorporating developmental constructs such as AARC into theories and empirical studies on pain and pain management may be necessary to more fully capture people's responses to pain.
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Affiliation(s)
- Shelbie G. Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York City, NY, USA
| | | | | | | | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, UK
| | - Serena Sabatini
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
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Sabatini S, Cosentino S, Chapman S, Ballard C, Brooker H, Corbett A, Stephan BCM. Cognitive trajectories: exploring the predictive role of subjective cognitive decline and awareness of age-related changes for cognitive functioning. Front Psychiatry 2023; 14:1270798. [PMID: 37928917 PMCID: PMC10620507 DOI: 10.3389/fpsyt.2023.1270798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background We investigated whether aspects of subjective cognitive aging, including awareness of age-related gains and losses in cognition (AARC-gains, AARC-losses) and subjective cognitive decline (SCD), predict change in objective cognitive function as measured by verbal reasoning (VR) and working memory (WM). Methods We used longitudinal data for 3,299 cognitively healthy UK residents aged 65+. We used data on AARC and SCD assessed in 2019, and cognitive tasks assessed in 2019, 2020, and 2021. We used latent growth curve modeling, latent class growth analysis, and growth mixture modeling. Results For VR, multiple growth trajectories were not evident. Mean VR at baseline was 37.45; this remained stable over time. Higher AARC-gains in cognition (mean intercept = -0.23; 95%CI: -0.31; -0.16), higher AARC-losses in cognition (mean intercept = -0.37; 95%CI: -0.46; -0.28), and lower SCD (mean intercept = 2.92; 95%CI: 2.58; 3.58) were associated with poorer VR at baseline. A three-class growth mixture model-class varying best represented trajectories of WM. In Class 1 (N = 182) mean WM at baseline was 31.20; this decreased by 2.48 points each year. In Class 2 (N = 119) mean WM at baseline was 23.12; this increased by 3.28 points each year. In Class 3 (N = 2,998) mean WM at baseline was 30.11; and it remained stable. Higher AARC-gains (Odds Ratio = 1.08; 95%CI: 1.03; 1.14) and AARC-losses (Odds Ratio = 1.10; 95%CI: 1.04; 1.16) in cognition predicted greater likelihood of being in Class 2 than Class 3. Conclusion Although both higher AARC-gains and AARC-losses indicate poorer concurrent cognition, higher AARC-gains may be a resource that facilitates future cognitive improvement.
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Affiliation(s)
- Serena Sabatini
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York, NY, United States
- Department of Neurology, Columbia University, New York, NY, United States
| | - Silvia Chapman
- Department of Neurology, Columbia University, New York, NY, United States
| | - Clive Ballard
- Faculty of Health and Life Science, University of Exeter, Exeter, United Kingdom
| | - Helen Brooker
- Faculty of Health and Life Science, University of Exeter, Exeter, United Kingdom
- Ecog Pro Ltd., Bristol, United Kingdom
| | - Anne Corbett
- Faculty of Health and Life Science, University of Exeter, Exeter, United Kingdom
| | - Blossom C. M. Stephan
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Bentley, WA, Australia
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Kolovos E, Windsor TD. 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. J Gerontol B Psychol Sci Soc Sci 2023; 78:1691-1699. [PMID: 37338812 PMCID: PMC10561889 DOI: 10.1093/geronb/gbad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 06/21/2023] Open
Abstract
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.
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Affiliation(s)
- Elli Kolovos
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Tim D Windsor
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
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Sabatini S, Dritschel B, Rupprecht FS, Ukoumunne OC, Ballard C, Brooker H, Corbett A, Clare L. Rumination moderates the longitudinal associations of awareness of age-related change with depressive and anxiety symptoms. Aging Ment Health 2023; 27:1711-1719. [PMID: 36762688 DOI: 10.1080/13607863.2023.2176820] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
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.
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Affiliation(s)
- S Sabatini
- School of Medicine, University of Nottingham, Nottingham, UK
| | - B Dritschel
- School of Psychology and Neuroscience, University of St Andrews, St Andrews, UK
| | - F S Rupprecht
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria
| | - O C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC), Exeter, UK
- University of Exeter Medical School, Exeter, UK
| | - C Ballard
- University of Exeter Medical School, Exeter, UK
| | - H Brooker
- University of Exeter Medical School, Exeter, UK
- Ecog Pro Ltd, Bristol, UK
| | - A Corbett
- University of Exeter Medical School, Exeter, UK
| | - L Clare
- NIHR Applied Research Collaboration South West Peninsula (PenARC), Exeter, UK
- University of Exeter Medical School, Exeter, UK
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Sabatini S, Turner S, Brooker H, Ballard C, Corbett A, Hampshire A. Physical and mental health conditions account for variability in awareness of age-related changes. Front Psychiatry 2023; 14:1152177. [PMID: 37539325 PMCID: PMC10394239 DOI: 10.3389/fpsyt.2023.1152177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
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.
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Affiliation(s)
- Serena Sabatini
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Shelbie Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York City, NY, United States
| | - Helen Brooker
- University of Exeter Medical School, Exeter, United Kingdom
- Ecog Pro Ltd, Bristol, United Kingdom
| | - Clive Ballard
- University of Exeter Medical School, Exeter, United Kingdom
| | - Anne Corbett
- University of Exeter Medical School, Exeter, United Kingdom
| | - Adam Hampshire
- Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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Testad I, Ushakova A, Aakre JA, Sabatini S, Gjestsen MT. Awareness of age-related changes in Norwegian individuals 50+. Short form questionnaire validation. Front Psychiatry 2022; 13:929249. [PMID: 36440418 PMCID: PMC9696323 DOI: 10.3389/fpsyt.2022.929249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
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.
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Affiliation(s)
- Ingelin Testad
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway.,College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Anastasia Ushakova
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
| | - Jon Arild Aakre
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway.,College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Serena Sabatini
- Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
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