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

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

The possibility of reciprocal effects cannot be excluded.

CONCLUSION

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

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

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

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.

Associations of Agency and Communion With Domain-Specific Self-Perceptions of Aging: A Cross-Sectional Study In Old-Old Adults in Poor Health

A large body of research indicates that self-perceptions of aging (SPA) play an important role for health in later life. Hence, more research on SPA and correlates is needed, especially in old age and poor health, where negative SPA tend to prevail. Recent studies identified personality as an important correlate of SPA in young-old and relatively healthy samples. Thus, we investigated cross-sectional associations of agency and communion with two SPA domains in a sample of old-old adults in poor health (n  =  154; M_age  =  81.55, SD  =  4.56, 58.4% women). In multiple regression analyses, agency and communion were associated with SPA related to ongoing development beyond health. In contrast, only health as a covariate was significantly associated with SPA related to physical losses. Thus, personality may be a resource associated with gain-related SPA, at least for those in poor health and old age.

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.

Shifting self-perceptions of ageing: differential effects of value priorities on self-perceptions of ageing beyond age stereotypes

Self-perceptions of ageing (SPA) are important predictors of health in later life. However, research on antecedents of SPA other than age stereotypes is scarce. To address this gap, this study investigates the impact of personal value priorities beyond age stereotypes on SPA. Can values as the motivational basis of attitudes and evaluations predict gain- and loss-related SPA? To answer this question, we conducted multiple regression analyses of longitudinal data from two waves (2008, 2011) of the German Ageing Survey (DEAS; N = 6089, age range in 2008: 40–93 years). Gain- and loss-related SPA as well as age stereotypes were assessed with two AgeCog scales and personal values with the 21-item Portrait Values Questionnaire. Results indicate that value priorities relate to SPA longitudinally in domain-specific ways: People with a value priority of openness to change and self-transcendence reported more gain-related SPA at follow-up, whereas those who prioritized conservation reported less gain-related SPA. In the domain of loss-related SPA, those people with a value priority of self-enhancement reported more and those prioritizing self-transcendence reported less loss-related SPA at follow-up. These results complement and extend recent findings on the role of personality for SPA. They suggest that whether people focus on the gains or losses that occur with age, whether they perceive ageing as a threat or chance, is not only shaped by their age stereotypes, but also by what they find important—their values.

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.

Ageism in informal care network members of older women

OBJECTIVES

Negative attitudes toward aging are common among formal healthcare providers, but have been infrequently assessed among informal caregivers providing assistance to older adults. The current study sought to identify factors associated with ageism toward older women.

DESIGN

Multivariate hierarchical linear regression model.

SETTING

Lower-income neighborhoods in an urban setting in the Midwestern USA.

PARTICIPANTS

144 care network members of White and African American women aged ≥ 65 years.

MEASUREMENTS

Age Group Evaluation and Description (AGED) Inventory assessed attitudes toward older women; CES-D scale measured depressive symptoms; Intergenerational Affectional Solidarity Scale assessed relationship closeness.

RESULTS

In bivariate analyses, African American caregivers endorsed more positive attitudes toward older women. In the multivariate regression model, attitudes toward older women were associated with care recipient health (β = 0.18, p < 0.05) and relationship closeness with the care recipient (β = 0.23, p < 0.05). However, these associations were fully mediated by care recipient-specific attitude ratings by the care network member. The association between person-specific attitudes and general attitudes was uniquely directional.

CONCLUSIONS

Findings from the present study are consistent with past research suggesting that 'ageism' may, at least in part, derive from bias against perceived poor health. Further, our findings of an association between attitude toward the care recipient and attitudes toward older women in general provide support for cognitive psychology theory which emphasizes the role of personal experience in stereotype formation through the availability heuristic. The current study underlines the necessity for development of interventions to address ageism in informal caregivers.

The Role of Personality in Becoming Aware of Age-Related Changes

Awareness of age-related change (AARC) refers to an individual's conscious knowledge about the gains and losses resulting from growing older. Personality traits reflect dispositional patterns of behavior, perception, and evaluation and should therefore influence the experience of AARC. The 4.5-year longitudinal study examines this association between personality traits and AARC in a sample of 423 individuals aged 40 to 98 years (M = 62.9 years) using latent change analyses. After controlling for sex, health, and education, a different pattern of associations for cross-sectional vs. longitudinal relations. Cross-sectionally, neuroticism was positively related to AARC losses, whereas openness, conscientiousness, and neuroticism were positively related to AARC gains. Longitudinally, the impact of personality traits on change in AARC was rather limited with only higher conscientiousness acting as a predictor of decreases in AARC losses over time. Overall, the findings add to the existing literature on associations between personality traits and subjective aging. Specifically, the results indicate that personality traits are differentially related to awareness of age-related gains in comparison to awareness of age-related losses.

Health status of people who have provided informal care or support to an adult with chronic disease in the last 5 years: results from a population-based cross-sectional survey in South Australia

Objective The aim of the present study was to compare the health status of South Australians with recent experience of caring for an adult with chronic disease with non-carers drawn from the same population. Methods Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Respondents were asked whether they had provided care or support in the last 5 years to someone with cancer, heart disease, respiratory disease, mental illness, neurological disease or dementia. Health status was measured using the Short Form-12 version 1 (SF-12) physical and mental component scale summary scores (PCS and MCS respectively), with poor health status defined as ≥0.5 standard deviation below the normative mean. Logistic regression explored characteristics associated with poor health status. Results Of 3033 respondents analysed, 987 (32.5%) reported caring experience. Poor PCS and MCS were associated with carer status, lower-than-degree-level education, employment status other than employed and annual household income less than A$60000. Being Australian born was a protective factor for PCS, whereas factors protective for MCS were being married or in a de facto relationship and age ≥65 years. Conclusions Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers. What is known about the topic? Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers. What does this paper add? Including recent as well as current carers in a population-based sample was associated with less effect on health status compared with studies focused on current carers only. This finding is consistent with the possibility that health status recovers during the 5 years after caring. What are the implications for practitioners? Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.