Reliability and validity of the Attitudes to Ageing Questionnaire (AAQ) in older people in Spain

The relationship between square dance exercise and quality of life in middle-aged and older adults: chain mediated effects of negative emotions and attitudes toward aging

Background

With the continuous development of society and the economy, population aging has become an inevitable global development trend, triggering a series of social problems and having a more serious impact on the physical and mental health of middle-aged and older adults. Physical exercise is one of the key factors for improving the overall health and quality of life of individuals, but the role of square dance exercise and the quality of life of middle-aged and older adults have not yet been clarified.

Purpose

This study aimed to investigate the associations between square dance exercise and the quality of life of middle-aged and older adults and its mechanism of action, including its effects on physical health and mental health, with negative emotions and attitudes towards aging as mediating variables.

Method

This study adopted a cross-sectional research method, using the Physical Activity Rating Scale (PARS-3), Depression-Anxiety-Stress Scale in Simplified Chinese (DASS-21), Attitudes toward Aging Questionnaire (AAQ), and 12-item Short Form of the Health Survey (SF-12), and launched an online survey on the QuestionStar platform from August-September 2023 for 4,636 middle and older adults aged 45-74 years. The survey results were analyzed via Pearson correlation analysis via SPSS 27.0 and structural equation modeling analysis via Mplus 8.3 to test the model fit and mediation effects.

Results

Square dance exercise was significantly correlated with negative emotions, attitudes towards aging, and quality of life (r = -0.042-0.878, p < 0.01). Square dance exercise significantly and positively predicted quality of life (β = 0. 202, p < 0.001). Negative emotions and attitudes towards aging are chain mediators of square dance exercise and quality of life, and the mediation consists of three pathways: separate mediation of negative emotions, separate mediation of attitudes towards aging, and chain mediation of negative emotions-attitudes towards aging.

Conclusion

This study is dedicated to deepening the scientific role of how square dancing, as a health-promoting activity, can optimize the quality of life of middle-aged and older adults through the mediating mechanism of negative emotion alleviation and positive attitudes towards aging and then optimize the quality of life of middle-aged and older adults. This process not only enriches the theoretical framework of the complex interactions between psychosocial factors and healthy aging but also provides a solid empirical foundation for the development of health intervention strategies aimed at enhancing the overall well-being and quality of life of the middle-aged and older adults.

A brief version of the Attitudes to Ageing Questionnaire for older Chinese adults: development and psychometric evaluation

BACKGROUND

Positive attitudes toward aging are considered essential for achieving psychological well-being in later life. However, there is currently a lack of a concise and comprehensive measurement tool specifically designed to assess attitudes toward aging among the elderly population in China. To address this gap, the present study aimed to develop a brief version of the Attitudes to Ageing Questionnaire tailored to older Chinese individuals and evaluate its psychometric properties.

METHODS

Initially, a sample of community-dwelling older adults (Sample 1: n = 442, aged 60-88) was utilized to establish a new scale format. Subsequently, two convenience samples (Sample 2: n = 311, aged 60-90; Sample 3: n = 164, aged 60-89) were employed to evaluate the psychometric properties of this scale, including factor structure, internal consistency, test-retest reliability, convergent validity, and discriminant validity.

RESULTS

We selected 12 items from the original questionnaire to create the brief scale. The brief scale maintained the three-factor structure of the full-format version, encompassing psychosocial loss, physical change, and psychological growth, and demonstrated adequate psychometric properties.

CONCLUSIONS

This development process shortens the administration time of the questionnaire while avoiding excessive loss of information. The newly developed scale serves as a reliable and valid assessment tool for measuring attitudes toward aging among older Chinese individuals and is well-suited for implementation in large-scale surveys that utilize an extensive array of questionnaires. This tool can be applied to assessing the effectiveness of interventions aimed at eliminating ageism.

Predictors of attitudes towards aging in elderly living in community care

BACKGROUND

Due to the aging of the population, the promotion of healthy aging is an important part of public health. Healthy aging of the population can be influenced by the attitudes of the elderly themselves towards old age and aging. The aim of this cross-sectional study was to find out the attitudes of older people living in a community environment toward old age and the predictors that influence these attitudes.

METHODS

The evaluation of attitudes towards old age using the WHO AAQ (Attitudes to Aging Questionnaire) questionnaire involved 1,174 elderly people living in the community. Age, sex, marital status, education, subjective health assessment, social support, depression (GDS-15), anxiety (GAI), sense of coherence (SOC-13) and self-esteem (RSES) were used to evaluate related factors.

RESULTS

As part of the exploratory factor analysis, a three-factor model (Psychosocial Loss, Physical Change, and Psychological Growth) was confirmed. The Cronbach alpha was found to be acceptable (α = 0.835). The predictors of better AAQ in the Psychological Loss domain were: subjective health, age, quality of life, self-esteem, sense of coherence, life satisfaction, anxiety, and social support; in the Physical Change domain: subjective health, quality of life, self-esteem, life satisfaction, cohabitation, and depression; and in the Psychological Growth domain: age, self-esteem, sense of coherence, life satisfaction, and social support.

CONCLUSION

Preventive and policy measures should aim to increase the satisfaction and self-assessment of the elderly, which can help them evaluate the period of old age more positively. It is also important to create a positive perspective of ageing and elderly in society.

Suitability of the Attitudes to Aging Questionnaire Short Form for Use among Adults in Their 50s: A Cross-Sectional e-Survey Study

This cross-sectional e-survey study examines the suitability (reliability and validity) of the 12-item Attitudes to Aging Questionnaire Short Form (AAQ-SF) for use among adults in their 50s. The AAQ-SF instrument was originally designed to capture subjective perceptions of physical change, psychosocial loss, and psychological growth by asking people aged 60 and beyond how they feel about growing older. Our sample comprised 517 people residing in three Canadian provinces. Respondents completed the Attitudes to Aging Questionnaire Short Form, the Rosenberg Self-Esteem Scale, and a short sociodemographic profile. Our findings replicate the original AAQ-SF structure for physical change, psychosocial loss, and psychological growth, with a promising internal consistency range for the third subscale. In our sample, psychological growth is best represented as 'Self' and 'Generativity', with a particularly greater capacity to explain variations in scores for item 18 and item 21. Physical change and psychosocial loss scores strongly differed based on perceived health and chronic illness presence. Psychosocial loss and psychological growth were moderately correlated with two aspects of self-esteem. We relate these patterns of findings within the context of prevailing growth and development theory and their perceived implications within the context of COVID-19 and post-pandemic life.

Portuguese Version of the Ageing Attitudes Questionnaire (AAQ): Validation of the Psychometric Properties

The Ageing Attitudes Questionnaire-AAQ was validated for the Portuguese population to understand the importance of attitudes towards old age and their impact on the subjective well-being of older adults. A sample of 400 subjects (from 18 to 93 years) answered a socio-demographic questionnaire, and the AAQ, composed of three subscales (psychosocial losses, physical change, and psychological growth). The CFA confirmed the tri-factorial structure with very good adjustment of the model to the data, with the Cronbach alpha of the total scale scoring 0.84 and ranging from 0.65 to 0.77 for each factor. A total of nine items were omitted for poor factor loadings (<0.50), namely in factor 1 items 9-17-20, in factor 2 items 7 and 24 and, finally, in factor 3 we omitted items 4-18-19-21. Notwithstanding, three items below the criteria were maintained, as they conceptually fit into the factor. Of the final 15 AAQ items, 5 belong to the Psychosocial Loss Factor, 6 to Physical Change Factor, and 4 to Psychosocial Growth Factor. This tree factor model explained 50.1% of the total variance. In conclusion, this study supports that AAQ has acceptable validity, confirming the composite reliability and the discriminant validity, but not the convergent validity. Through multi-group analysis, the invariance of the scale was confirmed. This validation is of pivotal importance once it allows measuring attitudes towards ageing in the Portuguese population, thus facilitating the prevention of ageism and the promotion of well-being across the lifespan.

A Malay Version of the Attitude to Ageing Questionnaire: Its Adaptation, Validation, and Reliability in the Malaysian Older Adult Population

Background

The Attitude to Ageing Questionnaire (AAQ) was developed to assess perceptions of the aging process among older adults. The 24 items were framed into three factors. This study aimed to translate the AAQ from English to the Malay language (AAQ-M) and determine its factorial structure and validity in a Malaysian population.

Methods

The original AAQ underwent a standard translation process, as well as content and face validation, to produce the AAQ-M. The construct validity of the AAQ-M was then assessed in 254 older adults aged 60 years and above attending a public primary care clinic in Seremban, Malaysia.

Results

Exploratory factor analysis showed a three-factor model for the AAQ-M with acceptable reliability and Cronbach α values ranging from 0.71 to 0.82 for each factor. A total of five items were omitted for poor factor loadings (<0.32) or because they did not conceptually fit into the factor they were loaded onto. Of the final 19 AAQ-M items, seven were physical change factors, eight were psychosocial loss factors, and four were psychological growth factors. This three-factor model explained 37.9% of the total variance.

Conclusion

The AAQ-M version confirmed that the three-factor model, namely physical change, psychosocial loss, and psychological growth, was similar to that of the original AAQ. The AAQ-M is a valid and reliable instrument for assessing the three aspects of attitudes toward aging in the Malaysian older adult population.

Attitude towards ageing and perceived health status of community-dwelling older persons in a low resource setting: a rural-urban comparison

BACKGROUND

Older person's attitude to ageing is critical for their adjustment, acceptance of health-related behaviour, survival and choices. Their attitude influences how they cope with the challenges experienced while ageing, which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing process.

METHODS

A descriptive cross-sectional study among older persons aged 60 years and above was carried out in a selected rural and an urban community in Oyo State, south-western Nigeria. The study participants were selected using a multi-stage sampling technique. Trained research assistants collected data with the aid of an interviewer-administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants' perception of ageing in three domains (psychosocial loss, physical changes and psychological growth). Data were analysed using Stata version 14 at a level of significance p < 0.05.

RESULTS

A total of 1,180 participants (588 rural vs. 592 urban) were recruited for the study. The mean age was 73.2 ± 9.3 years. The majority (69.7 %) were females and still working (50.5 %). Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5 ± 3.4 vs. 32.4 ± 3.3, p = 0.30; physical change 27.5 ± 5.1 vs. 26.9 ± 5.0, p = 0.03; and psychosocial loss 25.3 ± 5.7 vs. 25.0 ± 5.3, p = 0.60). Among the rural and urban-dwelling participants, good self-rated health was significantly associated with a positive attitude to ageing across the domains.

CONCLUSIONS

Older persons residing in urban communities had higher positivity to ageing than their rural older counterparts. The common factor significantly associated with a positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries.

Attitude toward Aging Mediates the Relationship between Personality and Mental Health in Older Adults

This study aimed to examine attitude toward aging as a potential mediator of the relationship between personality factors and mental health in terms of depression and life satisfaction among older adults. A cross-sectional study was conducted with 438 Ethiopian elderly individuals aged 60 to 69. The results of the regression-based path analysis showed that after adjusting for demographic data, the relationship between agreeableness and depression in older adults was partially mediated by attitude toward aging. Likewise, attitude toward physical change due to aging and psychological growth subscales jointly mediated the correlation between neuroticism and depression. However, a significant direct path between neuroticism and depression persisted. On the contrary, openness had no significant direct association with depression apart from an indirect through psychosocial loss. The link between life satisfaction and agreeableness as well as openness to experience were partially mediated by psychosocial loss. Therefore, a person’s attitude toward aging and personality characteristics should be taken into consideration while designing interventions for managing mental health issues among older adults.

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.

A systematic review of existing ageism scales

Ageism has been shown to have a negative impact on older people's health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the 'Expectations Regarding Aging' met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the 'stereotype' dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing.

Psychometric properties of the Farsi version of Attitudes to Aging Questionnaire in Iranian older adults

BACKGROUND

Attitudes to the aging process are affected by the individual's sociocultural background. The measurement of this important concept among older people in various societies requires the use of tools that are able to demonstrate both reliability and validity.

OBJECTIVE

The objectives of this study were to translate and validate the Attitudes to Aging Questionnaire (AAQ) and investigate its psychometric features among Iranian older people.

METHODS

In this methodological study, the Farsi version of the AAQ was validated among 400 Iranian older adults who were members of citizen clubs in an urban area of Iran. Content, face and construct (exploratory factor analysis) validities of the AAQ were assessed. In addition, its reliability was assessed in terms of internal consistency and stability. For discriminant validity, the discriminant power of the AAQ in terms of gender and education levels was evaluated. Criterion validity showed a significant correlation between the most subscales of the AAQ and the Short Form 36 (SF-36) and World Health Organization Quality of Life (WHOQOL) questionnaires. Descriptive and inferential statistics were used for data analysis.

RESULTS

The exploratory factor analysis confirmed the construct validity of the AAQ. The result of the test-retest reliability with a 2-week interval was satisfactory and reported as r=0.90 (p<0.001). The Cronbach's alpha coefficient was reported as 0.75 for the whole instrument and 0.85-0.93 for its dimensions. There were associations between the AAQ subscales, SF-36 quality of life (r=0.56, p<0.001) and WHOQOL-BREF (r=0.78, p<0.001), indicating an appropriate convergent validity. The ability to discriminate between male and female participants and those with lower and higher education levels was demonstrated, thus lending support to claims for adequate known-group validity.

CONCLUSION

The Farsi version of the AAQ showed favorable validity and reliability. Therefore, it can be used for assessing attitudes toward aging among older adults.

Attitudes of elderly persons and professionals towards intergenerational exchanges

Abstract Objective: to describe and compare the responses of elderly persons and professionals involved in permanent education programs in the state of São Paulo, Brazil, using the Intergenerational Exchanges Attitude Scale (IEAS), considering the variables living with children, for the elderly persons, and work with intergenerational groups or only with the elderly, for the professionals. Method: The convenience sample consisted of 148 elderly persons and 52 professionals. The participants responded to the IEAS and a questionnaire to delineate their profile in terms of age, gender and educational level. Comparative analysis, using the Mann-Whitney test, weighted each factor of the IEAS and the averages by items and by factors. Results: Compared to the professionals, the elderly had more negative perceptions of the attitudes of children towards the elderly (p<0.001) and more positive perceptions of the attitudes of the elderly towards children (p<0.001). Elderly persons who did not live with children had more negative perceptions of the interaction between children and the elderly than those who lived with children (p=0.003). Professionals working with intergenerational groups had more positive perceptions of the interaction between children and the elderly than professionals who worked only with older age groups (p=0.015). Conclusion: Intergenerational activities can be an important mediator of attitudes regarding the interaction between children and the elderly, as well as a form of training and professional renewal for those who work or intend to work in intergenerational activities.

Factors associated with attitudes toward the elderly in a sample of elderly caregivers

BACKGROUND

The number of elderly caregivers is increasing in the world. It is important to know the attitudes toward the elderly, because they can influence a range of behaviors. Our aim was to determine factors associated with attitudes toward the elderly in a sample of older carers.

METHODS

Three hundred and thirteen elderly caregivers (75.4% women, mean age 69.7 ± 7.1) who cared for a dependent older person at home completed a cross-sectional household interview. In addition to the four domains of the Neri Scale to Assess Attitudes Toward the Elderly, participants were evaluated regarding the demographics, care recipient (CR) characteristics, functional and cognitive status, general health, life satisfaction, perceived stress, and depressive symptoms.

RESULTS

Overall, attitudes toward the elderly were neutral in this sample. More negative attitudes in some Neri Scale domains were associated with being older, living in an urban setting, taking more medications per day, caring for an elderly dependent in basic Activities of Daily Living (ADLs), being "more or less" satisfied with life, and having higher levels of perceived stress. There was a negative association between positive attitudes and educational level.

CONCLUSIONS

The results highlight the need for public policies to promote more positive attitudes toward aging and change negative stereotypes usually used to designate older people. These public policies can try to modify some predictors of negative attitudes, such as perceived stress, which was associated with all four domains of Neri Scale.

A Validation of the French Version of the Attitudes to Aging Questionnaire (AAQ): Factor Structure, Reliability and Validity

Introduction: The Attitudes to Aging Questionnaire (AAQ) was developed to measure attitudes toward the aging process as a personal experience from the perspective of older people. The present study aimed to validate the French version of the AAQ. Participants and methods: This study examined factor structure, acceptability, reliability and validity of the AAQ's French version in 238 Belgian adults aged 60 years or older. In addition, participants provided information on demographics, self-perception of their mental and physical health (single items), quality of life (WHOQOL-OLD) and social desirability (DS-36). Results: Exploratory Factor Analysis produced a three-factor solution accounting for 36.9% of the variance. No floor or ceiling effects were found. The internal consistency, measured by Cronbach's alpha coefficients for the AAQ subscales were 0.62 (Physical Change), 0.74 (Psychological Growth), and 0.75 (Psychosocial Loss). A priori expected associations were found between AAQ subscales, self-reported health and quality of life, indicating good convergent validity. The scale also showed a good ability to discriminate between people with lower and higher education levels, supporting adequate known-groups validity. Finally, we confirmed the need to control for social desirability biases when assessing self-reported attitudes toward one's own aging. Conclusion: The data support the usefulness of the French version of the AAQ for the assessment of attitudes toward their own aging in older people.

Factors associated with depression in older carers

OBJECTIVE

Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated.

METHODS

We conducted a cross-sectional analysis of 202 older carers using the Geriatric Depression scale, demographics, personality traits, attitudes to ageing and other carer characteristics.

RESULTS

Increased hours spent caring and higher levels of neuroticism were all factors associated with depression. The care-recipient diagnosis, other personality traits, attitudes to ageing, leisure-physical activity (PA) and domestic-PA were not significantly associated with depression.

CONCLUSIONS

These findings have important implications for interventions to target at-risk carers.

Attitudes to aging in older carers - do they have a role in their well-being?

BACKGROUND

Attitudes to aging have been investigated in non-carer populations and found to have important relationships with physical and mental health. However, these have not been explored in an older carer sample, although it is becoming increasingly important to clarify variables which are linked with positive carer outcomes. This is one of the first studies to report on older carers, their attitudes to aging, and the relationship with carer-related factors.

METHODS

A cross-sectional study of 202 carers with a mean age of 70.8 years was conducted in Victoria, Australia, using carer demographic data, carer factors such as depression (using the Geriatric Depression Scale), burden (using the Zarit Burden Inventory, ZBI), physical health, personality, and attitudes to aging (using the Attitudes to Aging Questionnaire, AAQ). Spearman rank correlation and hierarchical regression analyses were used.

RESULTS

This study showed that carers had overall positive attitudes to aging inspite of their caring role. It also identified that carer factors including depression and burden contributed a significant amount of the variance to attitudes to aging in terms of physical change and psychosocial loss. Personality traits, specifically neuroticism, and extraversion, were also important contributors to attitudes to aging.

CONCLUSIONS

Results from this study demonstrated that inspite of moderate levels of depression and spending significant time caring, carers reported positive attitudes to aging. Treating depression, decreasing burden, and investigating the benefits of caring may assist older carers maintain their well-being.

Quality of life and comorbidity among older home care clients: role of positive attitudes toward aging

PURPOSE

Comorbidity has a negative impact on quality of life (QoL). This study aimed to investigate whether the impact of comorbidity on QoL is lower in older home care clients with positive attitudes toward aging.

METHODS

Totally, 361 older adults aged 50-91 years who were clients of 14 home care agencies in two regions in the Czech Republic gave an in-person interview to research nurses and completed the WHOQOL-BREF, the WHOQOL-OLD, and the Attitudes to Aging Questionnaire. The Charlson comorbidity index was calculated using ICD-10 codes. To address possible interaction between comorbidity and attitudes toward aging for QoL, the presence of additive interaction between comorbidity and attitudes toward aging on QoL was examined by synergy index. All analyses were adjusted by age, gender, education, and living arrangement.

RESULTS

A higher comorbidity index was significantly associated with lower scores of both QoL measures; one index increase was associated with 3.7 [95 % confidence interval (CI) 1.5: 5.9] decreases in generic QoL and 3.6 (95 % CI 1.3: 5.9) decreases in older-specific QoL. In stratified analyses by attitudes toward aging, comorbidity showed no association with QoL among those with positive attitudes, while it was significantly associated with low QoL in those without positive attitudes. The presence of additive interactions between comorbidity and less than positive attitudes on falling in low QoL was clearly suggested.

CONCLUSIONS

The negative impact of comorbidity on QoL might be mitigated by promoting a positive self-perception of aging in older people.

Attitudes to aging in midlife are related to health conditions and mood

BACKGROUND

Health is an important aspect of individuals' lives as they age. The aim of this study was to examine the relationship of sociodemographic factors, diagnosed chronic health conditions, and current depression with attitudes to aging in midlife.

METHODS

A cross-sectional baseline analysis was conducted on the first 300 participants from the Canterbury Health, Ageing and Life Course study in New Zealand, a stratified randomized community longitudinal study of adults recruited between 49 and 51 years. Attitudes were measured using the Attitudes to Aging Questionnaire (AAQ) and analyzed with a range of prevalent diagnosed chronic conditions, current depression, and sociodemographic variables.

RESULTS

Individuals perceived their physical aging more negatively after a diagnosis of hypertension, arthritis or asthma. Diagnosed lifetime depression and anxiety, and current depression, showed strong relationships with attitudes to aging across domains. After controlling for sociodemographic factors and current depression, individuals with diagnosed hypertension, arthritis, asthma, lifetime depression or anxiety continued to report significantly more negative attitudes to aging. Current depression showed the strongest associations with attitudes to aging and mediated relationships of health on attitudes to aging.

CONCLUSIONS

Physical and mental health are related to attitudes to aging. Most chronic conditions examined are significantly associated with attitudes toward aging in the physical change domain. Diagnosed lifetime depression and anxiety, and current depression, are negatively related across attitudinal domains. Individuals can feel positive about aging while experiencing poorer health, but this is more difficult in the presence of low mood.

The attitudes to ageing questionnaire: Mokken scaling analysis

Background

Hierarchical scales are useful in understanding the structure of underlying latent traits in many questionnaires. The Attitudes to Ageing Questionnaire (AAQ) explored the attitudes to ageing of older people themselves, and originally described three distinct subscales: (1) Psychosocial Loss (2) Physical Change and (3) Psychological Growth. This study aimed to use Mokken analysis, a method of Item Response Theory, to test for hierarchies within the AAQ and to explore how these relate to underlying latent traits.

Methods

Participants in a longitudinal cohort study, the Lothian Birth Cohort 1936, completed a cross-sectional postal survey. Data from 802 participants were analysed using Mokken Scaling analysis. These results were compared with factor analysis using exploratory structural equation modelling.

Results

Participants were 51.6% male, mean age 74.0 years (SD 0.28). Three scales were identified from 18 of the 24 items: two weak Mokken scales and one moderate Mokken scale. (1) ‘Vitality’ contained a combination of items from all three previously determined factors of the AAQ, with a hierarchy from physical to psychosocial; (2) ‘Legacy’ contained items exclusively from the Psychological Growth scale, with a hierarchy from individual contributions to passing things on; (3) ‘Exclusion’ contained items from the Psychosocial Loss scale, with a hierarchy from general to specific instances. All of the scales were reliable and statistically significant with ‘Legacy’ showing invariant item ordering. The scales correlate as expected with personality, anxiety and depression. Exploratory SEM mostly confirmed the original factor structure.

Conclusions

The concurrent use of factor analysis and Mokken scaling provides additional information about the AAQ. The previously-described factor structure is mostly confirmed. Mokken scaling identifies a new factor relating to vitality, and a hierarchy of responses within three separate scales, referring to vitality, legacy and exclusion. This shows what older people themselves consider important regarding their own ageing.

Life course influences of physical and cognitive function and personality on attitudes to aging in the Lothian Birth Cohort 1936

ABSTRACT Background: Reports of attitudes to aging from older people themselves are scarce. Which life course factors predict differences in these attitudes is unknown. Methods: We investigated life course influences on attitudes to aging in healthy, community-dwelling people in the UK. Participants in the Lothian Birth Cohort 1936 completed a self-report questionnaire (Attitudes to Aging Questionnaire, AAQ) at around age 75 (n = 792, 51.4% male). Demographic, social, physical, cognitive, and personality/mood predictors were assessed, around age 70. Cognitive ability data were available at age 11. Results: Generally positive attitudes were reported in all three domains: low Psychosocial Loss, high Physical Change, and high Psychological Growth. Hierarchical multiple regression found that demographic, cognitive, and physical variables each explained a relatively small proportion of the variance in attitudes to aging, with the addition of personality/mood variables contributing most significantly. Predictors of attitudes to Psychosocial Loss were high neuroticism; low extraversion, openness, agreeableness, and conscientiousness; high anxiety and depression; and more physical disability. Predictors of attitudes to Physical Change were: high extraversion, openness, agreeableness, and conscientiousness; female sex; social class; and less physical disability. Personality predictors of attitudes to Psychological Growth were similar. In contrast, less affluent environment, living alone, lower vocabulary scores, and slower walking speed predicted more positive attitudes in this domain. Conclusions: Older people's attitudes to aging are generally positive. The main predictors of attitude are personality traits. Influencing social circumstances, physical well-being, or mood may result in more positive attitudes. Alternatively, interventions to influence attitudes may have a positive impact on associated physical and affective changes.