Lower prevalence of psychiatric conditions when negative age stereotypes are resisted

Negative aging stereotypes in U.S. military veterans: results from the National Health and Resilience in Veterans Study

U.S. military veterans are an average 20 years older than non-veterans and have elevated rates of certain health conditions. While negative aging stereotypes have been linked to increased risk for various health conditions, little is known about the prevalence and correlates of these stereotypes in this population. Using data from a nationally representative sample of 4,069 U.S. veterans surveyed between 11/19 and 3/20, we examined (1) the current prevalence of negative aging stereotypes related to physical, mental, and cognitive health and (2) sociodemographic, health, and psychosocial factors associated with these stereotypes. Multivariable regression and relative weight analyses were conducted to identify independent correlates of negative aging stereotypes. Results revealed that 82.3%, 71.1%, and 30.0% of veterans endorsed negative aging stereotypes related to physical, cognitive, and emotional health, respectively. Older age (36.6% relative variance explained), grit (23.6%), and optimism (17.5%) explained the majority of the variance in negative age stereotypes related to physical aging; grit (46.6%), openness to experiences (31.5%), and older age (15.1%) in negative age stereotypes related to cognitive aging; and emotional stability (28.8%), purpose in life (28.8%), and grit (25.3%) in negative age stereotypes related to emotional aging. This study provides an up-to-date characterization of the prevalence and correlates of negative aging stereotypes in U.S. veterans. Results underscore the importance of targeting key correlates of negative aging stereotypes, such as lower grit, as part of efforts to promote health and functioning in this population.

What do we really know about age-related stereotypes and well-being of older adults? A commentary on the state of the art

There is a considerable body of literature on harmful consequences of age-related stereotypes-including consequences on physical and mental health. However, this commentary critically argues that the current state of the art disregards consequences of these stereotypes specifically for the well-being of older adults (i.e., outcome that is not to be confounded with mental health). To this end, the content of age-related stereotypes and the mechanisms through which they operate on physical and mental health are first outlined. The commentary then focuses on the very scarce evidence documenting how and when the well-being of older adults (as assessed directly and not as inferred from other indicators) is influenced by self-directed stereotypes. After setting out possible ways well-being may be involved in the relationship between self-directed stereotypes and physical and mental health of older adults, the present commentary argues that a better understanding of well-being would benefit strategies targeting the reduction of age-related stereotypes. Overall, this commentary on the state of the art highlights that future research is still needed to better understand both the direct and indirect relationships between age-related stereotypes and well-being that is not reducible to positive experiences of life (or hedonic well-being) but also comprises an eudaimonic component.

Intersections of Ageism and Homelessness Among Older Adults: Implications for Policy, Practice, and Research

Ageism remains a key issue in gerontological literature and has long been recognized as a deeply harmful form of discrimination. Despite advances in ageism scholarship related to education, advocacy, and prevention, there are calls for ongoing intersectional examinations of ageism among minority groups and across older people facing multiple exclusions. In particular, very little ageism research has considered the experiences of age-based discrimination and prejudice among older people experiencing homelessness. We problematize this gap in knowledge and provide recommendations for policy, practice, and research to address ageist discrimination toward older people experiencing homelessness. Intersections of ageism and homelessness are summarized at four levels: intrapersonal, interpersonal, institutional/community, and societal/structural. Building upon the limited research, we recommend key strategies for supporting and protecting older people experiencing homelessness through the reduction of ageism at each level. We present these insights and recommendations as a call to action for those working in both the aging and housing/homelessness spheres.

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

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

Comorbid Depressive and Anxiety Symptomatology in Older Adults: The Role of Aging Self-Stereotypes, Loneliness, and Feelings of Guilt Associated with Self-Perception as a Burden

The main objective of this study was to analyze the differences between older adults' symptom profiles (subclinical, anxiety, depressive, and comorbid) in negative aging self-stereotypes, loneliness, and feelings of guilt associated with self-perception as a burden. Participants were 310 community-dwelling people aged 60 years and over. The sample was grouped into four symptom profiles of older adults: anxiety, depressive, comorbid anxiety-depression, and subclinical symptoms. We carried out multinomial logistic regression analyses to analyze the role of assessed variables in the explanation of the four symptom profiles. Older adults who reported a comorbid symptomatology presented higher negative aging self-stereotypes and feelings of loneliness than the other three profiles. Compared with the subclinical profile, older adults who reported clinical symptomatology (anxiety, depressive, and comorbid profile) presented higher feelings of guilt associated with self-perception as a burden. The findings of this study suggest potential associations that may contribute to understanding and treating comorbid anxiety and depressive symptoms in older adults.

'I feel old and have aging stereotypes'. Internalized aging stereotypes and older adults' mental health: the mediational role of loneliness

OBJECTIVES

The main objective of this study was to analyze the role of aging stereotype activation (when older adults with aging stereotypes begin to consider themselves as older persons) in the relationship between ageist stereotypes, depressive, anxiety, loneliness, and comorbid anxiety-depressive symptoms.

METHODS

Participants were 182 autonomous community-dwelling people between 60 and 88 (mean age = 72.30; SD = 5.53). Three path models were tested exploring the role of considering oneself as an older person as a moderator variable. Ageist stereotypes were included as the independent variable, loneliness as the mediating variable, and anxiety symptoms, depressive symptoms, and comorbid anxiety-depressive symptoms as dependent variables for each model.

RESULTS

The results suggest an influence of ageist stereotypes on anxiety, depressive, and comorbid anxiety-depressive symptoms only in older adults who consider themselves as older persons, and mediated by loneliness.

CONCLUSION

This study suggests that, when someone considers him or herself as an older person, ageist stereotypes activate loneliness feelings, and this activation is associated with psychological distress, including anxiety, depressive, and comorbid anxiety-depressive symptoms.

[Age images of older patients with psychiatric diseases -The importance of attachment and mentalization]

Objectives: The emergence and effects of self-perception of ageing (SPA) are central gerontological research topics. SPA has an influence on numerous psychological, cognitive and physical parameters.The question of its significance for mental illness in old age, which was investigated in the present study, has so far remained in the background. Of particular interest was the connection to attachment and mentalization. Method: A clinical sample (N = 150) was compared with a non-clinical sample (N = 153). Both were divided into three age groups (40-54, 55-69 and over 70 years).The survey instruments used were the Attitude to Own Ageing subscale of the Philadelphia Geriatric Center Moral Scale (PGCMS) and a mentalizing and an attachment questionnaire (MZQ and ECR). Results:The clinical sample showed significantly lower scores in all age groups (more negative SWA), but only the non-clinical sample showed a decrease in age across the three age groups, thus the SPA became more negative. In the regression analytic evaluation, a more negative SPA was associated with an avoidant attachment orientation as well as reduced mentalizing skills. Conclusions: The results highlight the importance of SWA as a clinically and therapeutically significant variable. Finally, therapeutic implications are discussed.

A Paucity of Data on Veterans 65 and Older and Risk of Suicide: A Systematic Review

Older veterans are vastly underrepresented in studies that shape national suicide prevention strategies. This is of great concern because factors that impact younger veterans may not be as robust in later life. Although younger veterans have higher rate of suicide, the highest counts of death by suicide are in older veterans. However, it remains unclear from the extant literature what factors may influence increased or decreased risk of late-life suicide in veterans. The objective of this systematic review was to identify risk and protective factors related to suicide outcomes (i.e., ideation, attempt, death, or suicide-related behavior [SRB]) among older veterans. Furthermore, it offers data regarding future study directions and hypothesis generation for late-life suicide research and for informing potential intervention and prevention efforts in this area. We searched 4 databases from inception up to May 5, 2022. We screened 2,388 abstracts for inclusion and 508 articles required full text review. The final sample included 19 studies published between 2006 and 2022. We found five domains of factors studied (i.e., neuropsychiatric, social determinants of health, aging stereotypes, residential and supportive housing settings, and multifactorial-neuropsychiatric/mental health and physical health) with more risk factors than protective factors reported. Across the three suicide outcomes only neuropsychiatric factors were consistently identified as risk factors. Neuropsychiatric factors also comprised the largest group of risk factors studied. More innovative targets to consider for intervention and more innovative methods to predict suicide in late-life are needed. There is also continued necessity to design suicide prevention interventions for older veterans given lethality trends.

Effects of physical and mental health factors and family function on the self-perception of aging in the elderly of Chinese community

BACKGROUND

To examine the effects of physical and mental health factors and family functioning on the self-perception of ageing in elderly people.

METHODS

A random cluster sampling method was used to select elderly people aged over 60 from three communities in Handan City. Subjects were evaluated via face-to-face interviews using the Chinese version of the Ageing Perception Questionnaire, the Family Function Scale, the SF-36 Short-Form Health Survey, and a self-compiled general questionnaire. A single factor and stepwise multiple regression analysis were evaluated using SPSS 17.0 software.

RESULTS

Among the 1815 elderly people surveyed, the total negative dimension score was 91.67 ± 16.58 with an index of 73.34%, which is higher than the positive dimension score (6.01 ± 0.52, 60.10%). Elderly people with varying degrees of family dysfunction accounted for 11.63%, and the score for self-perceived ageing in elderly participants with good family function was 95.74 ± 12.63. The proportions with poor physical and mental health factors were 45.40% and 28.10%, respectively, and the scores for ageing self-perception in elderly participants with good or moderate mental health were 89.11 ± 12.65 and 86.22 ± 12.58, respectively. A stepwise multiple regression analysis showed that age, presence of a spouse, and family function were positive protective factors for ageing self-perception, while physical health factors were risk factors for the positive dimension of self-perceived ageing. Age and family function were risk factors for the negative dimension of ageing self-perception, while physical and mental health factors were protective factors for the negative dimension of self-perceived ageing.

CONCLUSIONS

Younger elderly and elderly people with good family function have positive self-perceptions of ageing, while elderly participants with poor physical and mental health have a negative perception of ageing.

Relationship between negative stereotypes toward aging and multidimensional variables in older people living in two different social environments

BACKGROUND

Ageism is studied extensively in community-dwelling older adults, but remains poorly understood in institutionalized older adults. Here, we compared the physical, psychological, and social variables associated with self-reported age-based biases in community-dwelling older adults and in those living in nursing homes (NHs).

MATERIAL AND METHODS

Participants (n = 272) in this descriptive cross-sectional study lived in NHs (n = 126) or in their homes (n = 146), were 60 years or older, and had no cognitive or serious functional impairments. Those in NHs had been institutionalized for at least six months. The dependent variable was negative stereotypes toward aging (CENVE). We developed generalized linear models (GLMs) by place of residence and sex following the Comprehensive Geriatric Assessment´s (CGA) methodology.

RESULTS

There is a statistically significant relationship between negative stereotypes of aging and different multidimensional variables. These variables differ between institutionalized and non-institutionalized adults and between men and women. While some variables are non-modifiable (age and sex) others are potentially modifiable (educational level, participation in activities, length of NH stay, hand strength, autonomy, and depression).

CONCLUSIONS

This study compared, for the first time, levels of ageism in older people living in two different social environments. Because most of the significant variables are modifiable in both environments, our results provide a framework to combat this type of discrimination. Promising strategies include anti-ageism policies and laws, educational interventions, and increased intergenerational contact.

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

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

The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions

United States (U.S.) veterans are substantially older than their non-veteran counterparts. However, nationally representative, population-based data on the unique health needs of this population are lacking. Such data are critical to informing the design of large-scale outreach initiatives, and to ensure the effectiveness of service care delivery both within and outside of the Veterans Affairs healthcare system. The National Health and Resilience in Veterans Study (NHRVS) is a contemporary, nationally representative, prospective study of two independent cohorts (n = 3,157 and n = 1,484) of U.S. veterans, which is examining longitudinal changes, and key risk and protective factors for several health outcomes. In this narrative review, we summarize the main findings of all NHRVS studies (n = 82) published as of June 2020, and discuss the clinical implications, limitations, and future directions of this study. Review of these articles was organized into six major topic areas: post-traumatic stress disorder, suicidality, aging, resilience and post-traumatic growth, special topics relevant to veterans, and genetics and epigenetics. Collectively, results of these studies suggest that while a significant minority of veterans screen positive for mental disorders, the majority are psychologically resilient. They further suggest that prevention and treatment efforts designed to promote protective psychosocial characteristics (i.e., resilience, gratitude, purpose in life), and social connectedness (i.e., secure attachment, community integration, social engagement) help mitigate risk for mental disorders, and promote psychological resilience and post-traumatic growth in this population.

Profiles of Expectations Regarding Aging After Relocation to Assisted Living

This study classified assisted living (AL) residents by expectations for future physical, cognitive, and socioemotional health in later life. The authors analyzed cross-sectional data from 202 AL residents. Study participants completed the 12-item expectations regarding aging survey. A K-means cluster analysis identified three subgroups: "lower expectations" (n = 55), "higher expectations" (n = 70), and "expecting adaptiveness" (n = 77). Subgroups varied by select demographic, health, and relocation-related factors. Results suggest that, despite similarities in physical and cognitive functioning, AL residents reported different expectations for health. Socioemotional functioning may help explain observed discrepancies between current health and future health-related expectations.

Questionnaire measures of self-directed ageing stereotype in older adults: a systematic review of measurement properties

The population is ageing, but while average life expectancy continues to increase, healthy life expectancy has not necessarily matched this and negative ageing stereotypes remain prevalent. Self-directed ageing stereotypes are hypothesised to play an important role in older adults' health and well-being; however, a wide variety of terms and measures are used to explore this construct meaning there is a lack of clarity within the literature. A review was conducted to identify tools used to measure self-directed ageing stereotype in older adults and evaluate their quality. Searches identified 109 papers incorporating 40 different measures. Most common were the Philadelphia Geriatric Centre Morale Scale Attitude Towards Own Ageing (ATOA) subscale, Ageing Perceptions Questionnaire (APQ) and Attitudes to Ageing Questionnaire. Despite being most frequently used, the ATOA was developed to measure morale in older adults rather than self-directed ageing stereotypes. Over 25 terms were used to describe the concept, and it is suggested that for consistency the term "self-directed ageing stereotype" be adopted universally. Across measures, poor reporting of psychometric properties made it difficult to assess scale quality and more research is needed to fully assess measures before conclusions can be drawn as to the best tool; however, the Brief-APQ appears to hold most promise. Future research must address this issue before interventions to reduce negative self-directed ageing stereotypes can be developed and fully evaluated.

Global reach of ageism on older persons' health: A systematic review

OBJECTIVE

Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time.

METHOD

A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857).

RESULTS

Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism).

CONCLUSION

The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

Benevolent ageism: Attitudes of overaccommodative behavior toward older women

Stereotypes of older adults fit a paternalistic pattern, including elevated warmth and lowered competence, yet little effort has been made to elucidate this in an everyday context. This phenomenon was examined with an experimental vignette, in which a woman was offered unnecessary help; specifically, the age (young vs. old) and the independence (accepting vs. declining assistance) of the woman were manipulated. Attributions from a college-age sample toward the woman were examined. In the older conditions, hypotheses were confirmed that participants approved overaccommodative behaviors, endorsed higher warmth and lower competence, and attitudes were modified when the older women contradicted the paternalistic stereotype by declining assistance. That is, competence was modifiable for older women, whereas warmth was not. Implications of these findings as possible evidence of benevolent ageism and the malleability of the Stereotype Content Model are discussed.

The missing link: Finding space for gerontology content into university curricula in South Africa

The rapid increase in the global elderly population has been widely documented in both demographic and popular literature in recent decades. Population estimates produced by the national statistical service of South Africa in 2017 show that the proportion of elderly (60 years and older) in South Africa is growing fast, reaching 8.1% of the total population in 2017. The country is set to experience a doubling of the population over the age of 65 by the year 2020. Similar to their counterparts in the developed world, tertiary institutions throughout Africa too are faced with the challenge of training professionals capable of understanding and responding to the socioeconomic consequences, social priorities, and complex needs of an increasing aging population. The right set of policies can equip individuals, families, and societies to address the challenges of an aging population. After conducting an extensive literature review, we recommend that policy-makers in South Africa should look into ways that will enable them to meet the many challenges of an aging population in the coming decades. One way to address this issue would be to include gerontology content into the curricula of programs in the humanities and social sciences.

Highlights From an Expert Meeting on Opportunities for Cancer Prevention Among Older Adults

This paper provides highlights from an expert meeting to explore opportunities to reduce cancer risk and promote health at older ages. Factors that increase cancer risk among older adults include exposure to carcinogens from multiple sources, chronic conditions such as obesity and diabetes, and unhealthy behaviors. Emerging research points to chronic social stressors - social isolation, loneliness, and financial hardship - as being linked to accelerated biological aging and increased cancer risk later in life. Older adults may disproportionately encounter these stressors as well as barriers to preventive health care services, accurate health information, and environments that promote health. Researchers can use existing cohort studies of older adults to deepen our understanding of the relative benefit of modifying specific behaviors and circumstances. The evidence points to the value of comprehensive, transdisciplinary approaches to promote health and reduce cancer risk across the entire lifespan, extending through older adulthood. Clinical encounters with older adults provide opportunities for psychosocial and behavioral screening and counseling. In the presence of multiple morbidities, preventive health services may offer greater health benefits than cancer-screening tests. Strategies that involve families and caregivers, promote positive attitudes about aging, and engage many different community sectors have the potential to prevent or delay the development of cancer at older ages.

Active coping shields against negative aging self-stereotypes contributing to psychiatric conditions

RATIONALE

Psychiatric conditions are often falsely considered inherent to aging. We examined whether negative age stereotypes, which older individuals tend to assimilate from the environment across their lifespan, contributed to an increased risk of developing four psychiatric conditions, and, if so, whether this risk was reduced through active coping.

METHOD

The sample consisted of participants aged 55 years and older, free of the psychiatric conditions at baseline, drawn from the National Health and Resilience in Veterans Study, a nationally representative sample. New cases of posttraumatic stress disorder, suicidal ideation, generalized anxiety disorder, and major depressive disorder were assessed during three waves spanning a four-year period.

RESULTS

As predicted, participants holding more-negative age stereotypes were more likely to develop the psychiatric conditions, and their engagement in active coping reduced the risk of their developing these conditions.

CONCLUSION

Our findings suggest that prevention and treatment efforts designed to reduce psychiatric conditions in later life may benefit from bolstering active coping as well as positive age stereotypes.

Is the relationship between subjective age, depressive symptoms and activities of daily living bidirectional?

OBJECTIVES

The aim of the current study was to investigate the prospective association between subjective age and depressive symptoms and activities of daily living (ADLs), and to test for reciprocal relationships.

METHODS

We used data from 9886 respondents aged 50 years and over who participated in the English Longitudinal Study of Ageing (ELSA). We fitted a series of multiple regression models to analyse the relationships between subjective age, depressive symptoms, and ADL limitations over a four-year period.

RESULTS

Following adjustment for demographic, social, cognitive, lifestyle, and health factors, we found that having an older subjective age independently predicted increased ADL limitations (B = -0.16, 95% CI -0.25, -0.07) and greater depressive symptoms (B = -0.40, 95% CI -0.57, -0.23). By contrast, we observed no significant associations between depressive symptoms and ADL limitations and future subjective age in the fully-adjusted model.

CONCLUSION

In conclusion, older subjective age is associated with future depression and functional health, but the reverse pattern is confounded by initial health and social factors. These findings indicate that an individual's age identity may have an important effect on both depressive symptoms and activities of daily living.

Holistic Wellness in Older Adulthood: Group Differences Based on Age and Mental Health

PURPOSE

To understand how demographic variables and depression symptoms relate to the prevalence of wellness, resilience, and age perception within a sample of community-dwelling older adults.

DESIGN

In all, 200 residents across 12 senior housing sites were surveyed. Research questions included the following: (1) Do group differences exist in wellness, resilience, and age perception based on age, sex, race, education, and depression symptoms? (2) Which profile of variables is most strongly associated with self-rated depression among older adults?

METHOD

Multivariate analyses of variance were used to examine group differences. A discriminant analysis demonstrated which variables comprised the profile of individuals who ascribed to depression symptoms.

FINDINGS

Younger respondents (i.e., age 55-70) had significantly lower levels of wellness (η² = .034) and resilience (η² = .052). Respondents suffering from depression symptoms had lower levels of wellness (η² = .155), resilience (η² = .163), and positive age perception (η² = .067) and higher rates of negative age perception (η² = .052). The discriminant analysis correctly categorized 75.3% of the cases related to depression symptoms, and resilience and certain forms of wellness were most relevant.

CONCLUSIONS

The current study sheds light into within-group differences in wellness, resilience, and age perception that depend on variables such as age and depression.

What are the keys to a longer, happier life? Answers from five decades of health psychology research

RATIONALE

It has long been known that factors of the mind and of interpersonal relationships influence health, but it is only in the last 50 years that an independent scientific field of health psychology appeared, dedicated to understanding psychological and behavioral processes in health, illness, and healthcare.

OBJECTIVE AND METHOD

This article (a) reviews important research that answers the question of how human beings can have longer, happier lives; and (b) highlights trends in health psychology featuring articles in Social Science & Medicine as well as other related literature.

RESULTS

Since the 1970s, health psychology has embraced a biopsychosocial model such that biological factors interact and are affected by psychological and social elements. This model has illuminated all subjects of health, ranging from interventions to lower stress and/or to improve people's ability to cope with stressors, to mental and physical health. Importantly, a health psychology perspective is behavioral: The majority of chronic diseases of today can be avoided or reduced through healthy lifestyles (e.g., sufficient exercise, proper diet, sufficient sleep). Thus, behavior change is the key target to help reduce the immense public health burden of chronic lifestyle illnesses. Health psychology also focuses on how social patterns influence health behavior and outcomes, in the form of patient-provider interactions or as social forces in communities where people live, work, and play. Health psychology is congenial to other health sciences, especially when allied with ecological perspectives that incorporate factors upstream from individual behavior, such as networks linked to individuals (e.g., peer groups, communities). Over its history, health psychology research has been responsive to societal and medical needs and has routinely focused on understanding health disparities.

CONCLUSION

By relying on a strong interdisciplinary approach, research in health psychology provides a remarkably comprehensive perspective on how people can live healthier lives.

Effects of Aging Stereotype Threat on Working Self-Concepts: An Event-Related Potentials Approach

Although the influence of stereotype threat (ST) on working self-concepts has been highlighted in recent years, its neural underpinnings are unclear. Notably, the aging ST, which largely influences older adults' cognitive ability, mental and physical health, did not receive much attention. In order to investigate these issues, electroencephalogram (EEG) data were obtained from older adults during a modified Stroop task using neutral words, positive and negative self-concept words in aging ST vs. neutral control conditions. Results showed longer reaction times (RTs) for identifying colors of words under the aging ST compared to the neutral condition. More importantly, the negative self-concept elicited more positive late P300 amplitudes and enhanced theta band activities compared to the positive self-concept or neutral words under the aging ST condition, whereas no difference was found between these self-concepts and neutral words in the control condition. Furthermore, the aging ST induced smaller theta band synchronization and enhanced alpha band synchronization compared to the control condition. Moreover, we also observed valence differences in self-concepts where the negative self-concept words reduced early P150/N170 complex relative to neutral words. These findings suggest that priming ST could activate negative self-concepts as current working self-concept, and that this influence occurred during a late neural time course.

Social Support and Attitudes to Aging in Later Life

Negative attitudes to aging are a risk factor for poor health and well-being. The current study sought to examine satisfaction with social support as a potentially modifiable factor that might facilitate the development of more positive attitudes to aging. A convenience sample of 501 older respondents (M_age = 72.06) reported on frequency of social support and their satisfaction with it, as well as completing a rating of attachment (model of the self and others), a measure of attitudes to aging, and a number of background measures. Results indicated that better subjective health, younger age, and greater satisfaction with social support were all significant predictors of more positive attitudes to aging, while frequency of social support was not. Model of the self accounted for some variation in satisfaction with social support. Interventions to increase satisfaction with social support in later life, recognizing individual differences and attachment styles, may improve attitudes to aging and further support health and well-being.

Negative perceptions of ageing predict the onset and persistence of depression and anxiety: Findings from a prospective analysis of the Irish Longitudinal Study on Ageing (TILDA)

BACKGROUND

Although there is a growing literature on the adverse health outcomes related with negative ageing perceptions, studies on their association with mental disorders such as depression and anxiety are scarce. Thus, the aim of the current study was to prospectively assess the association between negative ageing perceptions and incident/persistent depression and anxiety using nationally representative data from Ireland.

METHODS

Data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) were analysed. The analytical sample consisted of 6095 adults aged ≥50 years. Validated scales for negative ageing perceptions, depression, and anxiety were used. Multivariable logistic regression analyses were used to assess the association between negative ageing perceptions at baseline and the onset and persistence of depression and anxiety at two-year follow up.

RESULTS

After adjusting for potential confounders, negative ageing perceptions at baseline predicted the new onset of depression and anxiety at follow-up. Among those with depression or anxiety at baseline, negative ageing perceptions also predicted the persistence of these conditions at follow-up.

LIMITATIONS

Baseline data on negative ageing perceptions were used for the analysis and it is possible that scores could have changed over time.

CONCLUSIONS

Addressing negative perceptions towards ageing by developing interventions that activate positive ageing perceptions, and target societal attitudes by means of policy change, public campaigns, and community education programmes, may shift social perceptions and reduce the burden of depression and anxiety among the elderly.

Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study

Background

Decreased independence and loss of functional ability are issues regarded as inevitably connected to old age. This ageism may have negative influences on older adults’ beliefs about aging, making it difficult for them to focus on their current ability to maintain a good health. It is therefore important to change focus towards promoting Optimal Functionality (OF). OF is a concept putting the older adult’s perspective on health and function in focus, however, the concept is still under development. Hence, the aim was to extend the concept of optimal functionality in various groups of older adults.

Methods

A qualitative study was conducted based on focus group discussions (FGD). In total 6 FGDs were performed, including 37 older adults from three different groups: group 1) senior athletes, group 2) free living older adults, group 3) older adults living in senior living homes. All data was transcribed verbatim and analyzed following the process of deductive content analysis.

Results

The principal outcome of the analysis was “to function as optimally as you possibly can”, which was perceived as the core of the concept. Further, the concept of OF was described as multifactorial and several new factors could be added to the original model of OF. Additionally the findings of the study support that all three cornerstones comprising OF have to occur simultaneously in order for the older adult to function as optimal as possible.

Conclusions

OF is a multifaceted and subjective concept, which should be individually defined by the older adult. This study further makes evident that older adults as a group are heterogeneous in terms of their preferences and views on health and should thus be approached as such in the health care setting. Therefore it is important to promote an individualized approach as a base when caring for older adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12877-016-0244-z) contains supplementary material, which is available to authorized users.

A culture-brain link: Negative age stereotypes predict Alzheimer's disease biomarkers

Although negative age stereotypes have been found to predict adverse outcomes among older individuals, it was unknown whether the influence of stereotypes extends to brain changes associated with Alzheimer's disease. To consider this possibility, we drew on dementia-free participants, in the Baltimore Longitudinal Study of Aging, whose age stereotypes were assessed decades before yearly magnetic resonance images and brain autopsies were performed. Those holding more-negative age stereotypes earlier in life had significantly steeper hippocampal-volume loss and significantly greater accumulation of neurofibrillary tangles and amyloid plaques, adjusting for relevant covariates. These findings suggest a new pathway to identifying mechanisms and potential interventions related to the pathology of Alzheimer's disease.

Images of Aging in the Psychotherapeutic Context

Both psychotherapists and their clients have mental representations of old age and the aging process. In this conceptual review, we draw on available research from gerontology, social and developmental psychology, and communication science to consider how these “images of aging” may affect the psychotherapeutic process with older clients. On the basis of selected empirical findings we hypothesize that such images may affect the pathways to psychotherapy in later life, therapist-client communication, client performance on diagnostic tests as well as how therapists select and apply a therapeutic method. We posit that interventions to help both older clients and therapists to reflect on their own images of aging may increase the likelihood of successful treatment. We conclude by making suggestions for future research.

Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study

Background

Back pain, the most common type of pain reported by older adults, is often undertreated for reasons that are poorly understood, especially in minority populations. The objective of this study was to understand older adults’ beliefs and perspectives regarding care-seeking for restricting back pain (back pain that restricts activity).

Methods

We used data from a diverse sample of 93 older adults (median age 83) who reported restricting back pain during the past 3 months. A semi-structured discussion guide was used in 23 individual interviews and 16 focus groups to prompt participants to share experiences, beliefs, and attitudes about managing restricting back pain. Transcripts were analyzed in an iterative process to develop thematic categories.

Results

Three themes for why older adults may not seek care for restricting back pain were identified: (1) beliefs about the age-related inevitability of restricting back pain, (2) negative attitudes toward medication and/or surgery, and (3) perceived importance of restricting back pain relative to other comorbidities. No new themes emerged in the more diverse focus groups.

Conclusions

Illness perceptions (including pain-related beliefs), and interactions with providers may influence older adults’ willingness to seek care for restricting back pain. These results highlight opportunities to improve the care for older adults with restricting back pain.