Longitudinal effects of subjective aging on health and longevity: An updated meta-analysis

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

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

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.

Psychometric Properties and Measurement Invariance of the Awareness of Age-Related Change Short Form in Older Adult Samples From Taiwan and Germany

BACKGROUND AND OBJECTIVES

This study examined the psychometric properties and measurement invariance of the 10-item Awareness of Age-Related Change Short Form (AARC-SF) questionnaire in a Chinese-speaking sample of older adults in Taiwan.

RESEARCH DESIGN AND METHODS

Data from 292 participants (Mage = 77.64 years) in the Healthy Aging Longitudinal Study in Taiwan cohort were used for Study 1, whereas data from young-old adult samples in Germany were used for Study 2.

RESULTS

Study 1 showed that the AARC-SF had satisfactory reliability and validity for assessing adults' AARC in Taiwan. Analyses confirmed the 2-factor structure of AARC-gains and AARC-losses. Study 2 demonstrated strong measurement invariance across men and women, whereas direct comparisons of the item scores between young-old adults and old-old adults need to be made with caution. Noninvariance of loadings indicated that certain items were more closely linked to AARC-gains and AARC-losses in Taiwan than in Germany. Noninvariance of intercepts suggested potential biases in comparing item scores between Taiwanese and German older adults.

DISCUSSION AND IMPLICATIONS

The AARC-SF emerged as a reliable and valid instrument for capturing positive and negative subjective aging experiences among Taiwanese older adults. However, it is noteworthy that some items on the AARC-SF may solicit different responses from individuals of different ages and different countries of origin, requiring caution with age group and cross-cultural comparisons.

'Does it matter how old I feel?' The role of subjective age in a psychosocial intervention for improving depressive symptomatology among older adults in Brazil (PROACTIVE)

OBJECTIVES

Depression is a prevalent mental health condition that also often affects older adults. The PROACTIVE psychosocial intervention was developed to reduce depressive symptomatology among older adults within primary care settings in Brazil. An important psychological marker that affects individuals' aging experience relates to how old people feel. Known as subjective age, this marker has been shown to be a risk factor for experiencing greater depressive symptoms if individuals report feeling older than their (chronological) age. In this study, we perform secondary analyses of the PROACTIVE cluster-randomized controlled trial to examine the role of subjective age.

METHOD

The sample included 715 Brazilian older adults (74% female, Mage 68.6, SD = 6.9, age range: 60-94 years) randomized to intervention (n = 360, 74% female, Mage 68.4, SD = 6.6, age range: 60-89 years) or control (n = 355, 74% female, Mage 68.9, SD = 7.2, age range: 60-94 years) arms. Here our primary outcome was depressive symptoms at the 8-month follow-up assessed with the 9-item Patient Health Questionnaire (PHQ-9) as a continuous variable. Our previous analyses demonstrated improved recovery from depression at follow-up in the intervention compared with the control arm.

RESULTS

Relevant main effects and interactions in regression models for PHQ-9 presented here found that those reporting older subjective age had worse depressive symptoms at follow-up but that they benefitted more from the intervention when initial levels of depression were high. For participants who reported younger subjective ages the intervention showed positive effects that were independent of initial levels of depression.

CONCLUSION

Our findings emphasize the importance of investigating possible underlying mechanisms that can help clarify the impact of mental health interventions.

Association between personality traits and concerns about falling among older patients: the mediating role of subjective age

Background

Older patients are at high risk of falling, and regular assessments of their concerns about falling (CaF) are often recommended. The present study aimed to investigate the association between CaF and personality traits among older patients as well as to elucidate the mediating role of subjective age.

Method

A cross-sectional study was conducted among 407 patients aged over 60 years in a tertiary hospital located in Chengdu, Sichuan Province, from March 2023 to May 2023. Predesigned electronic questionnaires were distributed to collect relevant data. Four different models (both crude and adjusted weighted linear regression models) were constructed based on the confounders. Confounders were gradually put into the models to control for bias and to examine the stability of the correlations. Bootstrap sampling was employed to examine the mediating role of subjective age.

Result

According to the fully adjusted model, neuroticism (β = 0.17, 95% CI: 0.02 to 0.31, p for trend = 0.02), extraversion (β = -0.07, 95% CI: -0.15 to 0.001, p for trend = 0.05), and subjective age (β = 2.02, 95% CI: 1.28 to 2.78, p for trend <0.001) were consistently correlated with CaF. Mediating analysis revealed that extraversion was negatively related with CaF both directly and indirectly, via subjective age [23.2% partial effect, bootstrap 95%CI: -0.024(-0.080, -0.000)]. Higher neuroticism was consistently related to older subjective age (β = 0.002, 95% CI: 0.001 to 0.004, p for trend = 0.006), while higher levels of conscientiousness, openness, and extraversion were consistently correlated with younger subjective age(β = -0.002, p for trend = 0.04; β = -0.003, p for trend = 0.003; β = -0.002, p for trend = 0.0, respectively).

Conclusion

Extraversion and neuroticism were significantly correlated with CaF. Moreover, subjective age partially mediated the relationship between extraversion and CaF. Furthermore, subjective age was found to be associated with both CaF and personality traits. These findings highlighted the important roles of personality traits and subjective age in assessments of CaF and in the development of strategies for preventing falls among older patients.

Felt Age and Its Psychological Correlates in Dementia Spousal Caregiving Dyads: Findings From the IDEAL Programme

OBJECTIVES

Evidence suggests spouses influence each other's subjective views on aging. Aligned with the Theory of Dyadic Illness Management, we investigated for the first time similarities in felt age (how old people feel relative to their chronological age) between people with dementia and their spousal caregivers, and how each partner's felt age was related to psychological correlates in the other partner.

METHODS

We used baseline (2014-2016) data from 1,001 people with dementia and their spousal caregivers who participated in the British Improving the experience of Dementia and Enhancing Active Life study. We ran linear regressions to analyze the extent to which the felt age of people with dementia and their caregivers were similar, and whether relationship quality was associated with the similarity. We utilized actor-partner interdependence models to analyze whether the felt age of people with dementia and their caregivers were associated with each other's well-being, satisfaction with life, and self-efficacy.

RESULTS

The felt age of people with dementia was associated with the felt age of their caregivers (β = 0.10; p = .001). Caregivers and people with dementia reported a more similar felt age when caregivers rated the caregiving relationship more positively (β = 0.07; p = .04). Caregivers' felt age was associated with well-being (β = 0.07; p = .02) and satisfaction with life (β = 0.06; p = .04), but not with self-efficacy, in people with dementia.

DISCUSSION

Felt age in caregivers and people with dementia may be interwoven, and important psychological variables in people with dementia are related to caregivers' felt age. Findings offer empirical evidence on dementia caregiving dynamics and how family relationships are related to views on aging.

Older adults' subjective aging perceptions, mentalization, and social relationships: a micro-longitudinal study

OBJECTIVES

Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link.

METHOD

Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days.

RESULTS

Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships.

CONCLUSION

The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

Feeling Younger on Active Summer Days? On the Interplay of Behavioral and Environmental Factors With Day-to-Day Variability in Subjective Age

Background and Objectives

Subjective age, that is, how old people feel in relation to their chronological age, has mostly been investigated from a macro-longitudinal, lifespan point of view and in relation to major developmental outcomes. Recent evidence also shows considerable intraindividual variations in micro-longitudinal studies as well as relations to everyday psychological correlates such as stress or affect, but findings on the interplay with physical activity or sleep as behavioral factors and environmental factors such as weather conditions are scarce.

Research Design and Methods

We examined data from 80 recently retired individuals aged 59-76 years (M = 67.03 years, 59% women) observed across 21 days. Daily diary-based assessments of subjective age, stress, affect, and sleep quality alongside physical activity measurement via Fitbit (steps, moderate-to-vigorous physical activity) and daily hours of sunshine were collected and analyzed using multilevel modeling.

Results

Forty-four percent of the overall variance in subjective age was due to intraindividual variation, demonstrating considerable fluctuation. Affect explained the largest share in day-to-day fluctuations of subjective age, followed by stress and steps, whereas sunshine duration explained the largest share of variance in interindividual differences.

Discussion and Implications

In our daily diary design, subjective age was most strongly related to self-reported affect as a psychological correlate. We, however, also found clear associations with objective data on daily steps and weather. Hence, our study contributes to contextualizing and understanding variations in subjective age in everyday life.

The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study

Background

Prolonged confinement can lead to personal deterioration at various levels. We studied this phenomenon during the nationwide COVID-19 lockdown in a functionally dependent population of the Orcasitas neighborhood of Madrid, Spain, by measuring their ability to perform basic activities of daily living and their mortality rate.

Methods

A total of 127 patients were included in the Orcasitas cohort. Of this cohort, 78.7% were female, 21.3% were male, and their mean age was 86 years. All participants had a Barthel index of ≤ 60. Changes from pre- to post-confinement and 3 years afterward were analyzed, and the effect of these changes on survival was assessed (2020-2023).

Results

The post-confinement functional assessment showed significant improvement in independence over pre-confinement for both the Barthel score (t = -5.823; p < 0.001) and the classification level (z = -2.988; p < 0.003). This improvement progressively disappeared in the following 3 years, and 40.9% of the patients in this cohort died during this period. These outcomes were associated with the Barthel index (z = -3.646; p < 0.001) and the level of dependence (hazard ratio 2.227; CI 1.514-3.276). Higher mortality was observed among men (HR 1.745; CI 1.045-2.915) and those with severe dependence (HR 2.169; CI 1.469-3.201). Setting the cutoff point of the Barthel index at 40 provided the best detection of the risk of death associated with dependence.

Conclusions

Home confinement and the risk of death due to the COVID-19 pandemic awakened a form of resilience in the face of adversity among the population of functionally dependent adults. The Barthel index is a good predictor of medium- and long-term mortality and is a useful method for detecting populations at risk in health planning. A cutoff score of 40 is useful for this purpose. To a certain extent, the non-institutionalized dependent population is an invisible population. Future studies should analyze the causes of the high mortality observed.

Subjective Age and Loneliness in Older Adults: The Moderating Role of Attachment Patterns

Loneliness in older adults has been associated with a myriad of undesirable physical and psychological consequences, as well as with negative age and aging perceptions. However, little is known regarding the effect of individual differences in the ability to seek, maintain, and benefit from close relationships in this context. Accordingly, we examined the associations between subjective age (i.e., how old/young one feels vis-à-vis his/her chronological age; SA), attachment patterns, and loneliness. Data were collected from 840 older adults in Israel (Mage = 74.75, SD = 5.50, range = 67-94), who provided information pertaining to SA, attachment anxiety/avoidance, and loneliness. Loneliness was associated with an older SA, as well as with high levels of attachment anxiety/avoidance. Moreover, the association between SA and loneliness was nullified for individuals with low levels of attachment anxiety/avoidance. The discussion highlights the importance of both age perceptions and attachment patterns for understanding the underlying mechanisms of late-life loneliness.

The role of social network diversity in self-perceptions of aging in later life

While the link between self-perceptions of aging (SPA) and healthy aging is well established, less is known about the association between social factors and SPA. The present study investigated whether higher social network diversity is associated with more positive and less negative SPA and whether this association is moderated by age. We examined cross-sectional data from the German Ageing Survey of 2008 (DEAS; N = 6205, 40-85 years, 49.5% female). Network diversity was assessed as the number of social roles in an individual's network (such as spouse, friend and colleague). Three domains of SPA were measured using the Aging-Related Cognitions Scale (AgeCog): ongoing development (positive SPA), social losses (negative SPA) and physical losses (negative SPA). We conducted multiple linear regression models and tested for a moderator effect of age using an interaction term of age and network diversity. Results showed that at higher ages older adults with higher network diversity reported more positive SPA related to ongoing development and more negative SPA related to social losses than those with less diverse networks, indicating that age has a moderating effect. We found no association between network diversity and negative SPA related to physical losses and no indication that age was relevant to this relationship. The present study adds to evidence on the role of social networks in SPA. Our findings suggest that in certain SPA domains and depending on age, network diversity is related to both more positive and more negative SPA, which emphasizes the importance of considering domain-specific SPA.

Development, feasibility, and acceptability of a process based intervention to decrease internalized ageism

A lifetime of exposure to ageism may be internalized in older adults, and these ageist beliefs that are directed inwards can have severe consequences. However, research on reducing internalized ageism is scarce. To address this, we designed and implemented a six-week online process-based intervention to reduce internalized ageism and to assess its feasibility. The intervention utilized a process-based therapy approach targeting psychological, behavioral, and physiological pathways through which internalized ageism negatively impacts health, as specified by stereotype embodiment theory. Intervention components included education, acceptance and commitment therapy techniques, and attributional retraining. A total of 81 older adult participants participated in the feasibility study. Most participants rated each session and the overall program as very useful after each session (average program usefulness rating of 4.54/5). Participants also attributed a wide range of novel behaviors to this intervention and stated that they felt it changed their perspectives on ageism and/or internalized ageism. Results from this study provide a promising foundation from which to advance research on interventions that address internalized ageism - a problem that has severe consequences on the health and well-being of growing numbers of older adults globally.

Understanding Health, Subjective Aging, and Participation in Social Activities in Later Life: A Regional Finnish Survey

To understand health and well-being in later life, it is vital to consider the meaning of subjective aging. This study aimed to explore how perceived health, self-perceptions of aging, and participation in social activities relate to each other among older persons in the Bothnia region and Åland islands in Finland. Data were analyzed using Spearman's and polychoric correlation and multinomial logistic regression analyses. The perceived good health and the younger physical, psychological, and social dimensions of subjective age were found to be associated with each other and with participation in social activities outside one's home.

Fear of Falling Carries Over into Overprotection in Old Age: A Cross-Lagged Panel Analysis

Fear of falling might result in overprotection by one's social environment. In turn, feeling dependent could increase fear of falling. However, the association between fear of falling and perceived overprotection and its temporal order is unknown. This longitudinal study explores this potential mutual longitudinal association. This study presents secondary analyses from a larger trial. We tested the association between fear of falling and perceived overprotection in a cross-lagged path model controlled for falls, health-related quality of life, age, gender, and trial condition. N = 310 participants (M = 70 years, range: 64-92) completed self-reports at Time 1, 7 (Time 2), and 11 weeks (Time 3) after baseline assessment. We found a positive association from fear of falling to perceived overprotection (β = .12, 95% CI[0.02, 0.21], p = .02; β = .10; [0.01, 0.18], p = .03). The reversed cross-lagged paths were not significant. Findings suggest higher fear of falling translates into perceived overprotection, which may in turn increase loss of independence in old age.

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.

Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in Macao: a cross-sectional study

BACKGROUND

Societal attitudes toward ageing play a significant role in shaping one's ageing experience, and an age-friendly environment can potentially enhance the life satisfaction of older individuals. The objective of this study is to examine the role of attitudes to ageing as mediators in the association between the perception of an age-friendly city and life satisfaction among middle-aged and older adults.

METHODS

Using the tools of Age-Friendly City (AFC) criteria, Attitudes to Ageing Questionnaire (AAQ) to measure psychosocial loss, psychological growth, and physical change, and Satisfaction with Life Scale (SWLS) to assess the level of life satisfaction among community-dwelling middle-aged and older people in Macao. Multiple mediation analysis was performed to test the mediation effect.

RESULTS

A total of 543 participants were included in this study. The average score of AFC was 4.25, the total scores of psychosocial loss, physical change, and psychological growth were 24.06, 29.00, and 26.94 respectively. The total score of SWLS was 24.06. There was a partial mediation of attitudes to ageing in the relationship between perception of age-friendly city and life satisfaction. The mediation effect explained 56.1% of the total effect of AFC to life satisfaction.

CONCLUSION

The development of an age-friendly city can help improve the public's view on ageing, and thus improve their life satisfaction. It is important for government to consider the improvement of people's attitudes to ageing when developing policies regarding AFC.

The Social Construction of Aging Among a Clinic-Based Population and Their Healthcare Workers in Zambia

Objectives

We sought to understand the social construction of aging in a clinic-based population, with and without HIV, to address gaps in care for older individuals living with HIV in Zambia.

Methods

Our exploratory qualitative study included 36 in-depth interviews with clinic clients and four focus group discussions with 36 professional and lay healthcare workers providing services to the clients. We identified themes based on social construction theory.

Results

At the individual level, aging was multidimensional, perceived both as an achievement in the HIV era and as a period of cognitive, physical, and economic decline. In social interactions, older individuals were often stereotyped and treated as helpless, poor, and "witches." Those living with HIV faced the additional stigma of being labeled as promiscuous. Some of the participants living without HIV refused to take daily medication for non-communicable diseases to avoid being mistaken for taking antiretroviral therapy for HIV. Older individuals wanted quality healthcare and family support to address the intersectional stigma of aging, poverty, and chronic illness.

Conclusion

Multifaceted interventions are required to combat age-related prejudice, intersectional stigma, and discriminatory practices, particularly for people living with HIV.

Associations between self-perceptions of aging and social functioning in older adults: An analysis based on health and retirement study data

OBJECTIVES

Self-perception of aging (SPA) and social functioning are two important variables in the process of healthy aging, but the relationship between them is still unclear. This study aimed to explore the association between SPA and social functioning in older adults.

METHODS

We conducted a longitudinal study utilizing data from the Health and Retirement Study. The sample comprised individuals aged 50 and above. Socio-demographic, psychosocial, and lifestyle information of study participants was systematically collected at baseline (2012 and 2014) and during follow-up four years later (2016 and 2018). SPA was measured using a scale assessing individuals' attitudes toward their aging process. Social functioning was evaluated through 22 questions, reflecting individuals' abilities to engage in and perform various roles and tasks in their daily lives. Multilevel modeling was employed to analyze the relationship between SPA and social functioning. Differences in social functioning changes among various SPA groups were assessed through the Generalized Estimating Equations methodology.

RESULTS

The study included 8,454 participants with an average age of 68.3 years (SD = 9.92). The multilevel model revealed a significant correlation between SPA and social functioning (β = 0.131; P < 0.001). This relationship persisted after adjusting the model (β = 0.088; P < 0.001). Generalized Estimating Equations indicated noteworthy differences in social functioning changes among distinct SPA groups (P = 0.034).

DISCUSSION

Positive SPA is associated with the healthy social functioning of older adults. Healthcare providers could target modifiable aspects of SPA to enhance the social function of older adults and promote successful aging.

Breaking the links between ageism and health: An integrated perspective

Ageism refers to prejudice, stereotypes or discrimination based on a person's actual or perceived chronological age. While ageism can affect people at all stages of the human lifespan, ageism against older adults has emerged as the most pervasive and potentially harmful. Much is now understood about how ageism can impact older people's health and wellbeing via structural, organisational, and provider level biases that threaten the provision of equitable and ethical healthcare. Negative attitudes about age and ageing also contribute to workforce shortages in aged care sectors, such as residential aged care and nursing. However, often underappreciated is how self-directed ageism, which refers to ageism turned against oneself, can also be an important determinant of health and wellbeing. Relative to external sources of ageism, negative internalised ageist beliefs are not only experienced more frequently in older adults' everyday lives, but are also more strongly linked to their health and wellbeing. Here we highlight how this understanding means that eliminating ageism requires a multifaceted approach that targets not only health care systems and aged care professionals, but older people themselves. Because normal age-related cognitive changes in how we think, perceive and reason increase the risk of older people viewing themselves through a negative and ageist lens, we provide a novel discussion of how broader insights from cognitive ageing literature must play a central role in any agenda focused on breaking the links between ageism and health.

Self-perceptions of aging: A conceptual and empirical overview

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

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.

Correlates of felt age in caregivers of people with dementia: findings from the IDEAL study

Objective

Family relationships influence how people appraise their own aging and how their appraisals impact their health. We analyzed felt age (FA) among family caregivers of people with dementia.

Methods and measures

We used a stratified sample of 1,020 spousal and 202 adult-child caregivers from the IDEAL study. We estimated cross-sectional associations and bidirectional influences between caregivers' FA and their health and wellbeing (depression, number of health conditions, stress, positive aspects of caregiving) over 2 years.

Results

Among spousal caregivers, 25% had a younger FA and 36% had an older FA. Among adult-child caregivers, 21.8% had a younger FA and 36.1% had an older FA. In spousal and adult-child caregivers an older FA was cross-sectionally associated with higher depression, number of health conditions, and stress, and fewer positive aspects of caregiving. In spousal caregivers, hours of care per day moderated the association between FA and depression, and FA was associated with stress 1 year later.

Conclusion

Caregiving may impact FA and its relationship with health. We urge continued research on the connections between caregiving and FA, and how interventions might support caregivers' positive views on their own aging, which will translate views on aging scholarship to meaningfully improve caregivers' lives.

Testing Bidirectionality in Associations of Awareness of Age-Related Gains and Losses With Physical, Mental, and Cognitive Functioning Across 1 Year: The Role of Age

OBJECTIVES

The bidirectionality between self-perceptions of aging and health-related outcomes may depend on age group. Therefore, we tested such bidirectionality among individuals in late midlife (50-64 years), young-old age (65-74 years), and old-old age (75+ years), taking advantage of the construct of Awareness of Age-Related Change (AARC) and its 2-dimensionality in terms of AARC-gains and AARC-losses. Various conceptualizations of physical, mental, and cognitive functioning were used as outcomes.

METHODS

Data from 2 measurement occasions (2019 and 2020) from the UK PROTECT study for individuals in late midlife (N = 2,385), young-old age (N = 2,430), and old-old age (N = 539) were used. Data on self-reported functional difficulties, depression, anxiety, and performance on four computerized cognitive tasks (i.e., verbal reasoning, paired associate learning, self-ordered search, and digit span) providing a score for verbal reasoning and a score for working memory were analyzed using cross-lagged panel models.

RESULTS

Across all 3 age groups, the bidirectional associations of AARC-gains with indicators of functioning were not significant, whereas higher AARC-losses significantly predicted slightly greater functional difficulties and higher depression and anxiety levels. Higher AARC-losses predicted slightly poorer Verbal Reasoning only in old-old age and poorer Working Memory predicted slightly higher AARC-losses only in young-old age. The remaining associations of AARC-losses with cognitive tasks were not statistically significant.

DISCUSSION

In accordance with previous research targeting other indicators of self-perceptions of aging, this study supported a stronger impact of AARC-losses on indicators of physical functioning and mental health than vice versa from midlife to old-old age.

"If this is what it means to be old…": a mixed methods study on the effects of age simulation on views on aging and perceptions of age-related impairments

Age simulation suits are a promising tool to increase empathy and to promote positive attitudes toward older adults. However, studies have largely focused on (young) healthcare professionals, are probably biased by social desirability, and have not addressed participants' views of the aging process triggered by the simulation. The current work combines two studies addressing effects of aging suits on both general and personal views on aging among heterogeneous samples, and exploring spontaneous associations during the simulation. In study 1, N = 165 adults (M = 37.1 years, SD = 15.4, range 18-74 years) answered questionnaires containing general views regarding older adults ("old people are…") as well as personal perceptions ("aging means to me…") before and after wearing an aging suit. In study 2, young adults (N = 22; M = 24.8 years, SD = 4.3, range 20-38 years) and middle-aged adults (N = 41; M = 60.8 years, SD = 6.9, range 40-75 years) carried out established geriatric assessments with and without aging suit, and spontaneous impressions on the instant aging experience were recorded. Findings indicated negative shifts in both general and personal views on aging measures in both age groups (d = .30 to d = .44). Analyses of qualitative data resulted in seven main themes, e.g., "strain/coordination", "future me", "empathy/insight". Group comparisons revealed higher frequencies of future-self related thoughts among middle-aged adults, whereas younger adults mentioned predominantly physical effects of the suit. In conclusion, applying age simulation suits might evoke unintended negative views on aging. In comparison with young adults, middle-aged adults showed broader reflections including thoughts related to emotions, future-self, and potential struggles of older people.

Explaining Variation in Individual Aging, Its Sources, and Consequences: A Comprehensive Conceptual Model of Human Aging

We define aging as a characteristic deterioration in one (or more) observable attributes of an organism that typically occurs during later life. With this narrow functional definition, we gain the freedom to separate aging from other processes of age-related change (e.g., maturation, growth, illness, terminal decline). We introduce a structural model that distinguishes between (1) the phenomenon of aging, (2) the subjective experience of aging, (3) sources of aging, and (4) consequences of aging. A core focus of the model is on the role of buffering mechanisms of biological repair and personal adaptation that regulate the relations between sources of aging, aging proper, and its consequences. The quality and level of functioning of these buffering mechanisms also varies across the life span, which directly affects the sources of aging, resulting in either resilience against or accelerated aging, and thus can be considered to be a major source of the variation in aging processes among different individuals. External factors comprising attributes of the physical environment and sociocultural characteristics are considered as contexts in which aging occurs. These contextual factors are assumed to feed into the various components of the model. Our model provides an interdisciplinary account of human aging, its sources and consequences, and also its subjective experience, by integrating biological, psychological, lifestyle, and sociocultural factors, and by specifying their interrelations and interactions. The model provides a comprehensive understanding of individual human aging, its underlying processes, and modulating factors. It allows for the derivation of empirically testable hypotheses, and it helps practitioners to identify elements that lend themselves to targeted intervention efforts aimed at increasing the resilience of individuals against aging and buffering its negative consequences.

[Relationship between the subjective age, higher-life function, and new certification as needing long-term care in community-dwelling older adults: The KAGUYA project longitudinal survey of older adults]

AIM

To determine the relationship between the subjective age, higher-life function, and new certification for the need for long-term care among older adults in the community.

METHODS

A mail survey was conducted in 2016 among community-dwelling older adults, and the 2,323 participants who were available for follow-up in 2019 were included in the analysis. Subjective age was evaluated using the following three items in response to the question "Please answer how old you feel you are": "Same as actual age," "Feel younger," and "Feel older." Other assessments included an evaluation of the higher-life function, Geriatric Depression Scale scores, general self-efficacy, and exercise adherence. In addition, at follow-up, we investigated whether or not participants required new certification for the need for long-term care.

RESULTS

At baseline, participants who felt "older than their actual age" had a significantly lower life function and general self-efficacy and were less likely to exercise at least once a week than the other groups. Furthermore, those who felt "older than their actual age" was more likely than the other groups to be newly certified as needing long-term care, while those who felt "younger than their actual age" were less likely to receive new certification. A logistic regression analysis revealed that "feeling older" was a risk factor for being certified as needing long-term care, even after adjusting for other factors (odds ratio= 3.33, 95% confidence interval: 1.02-10.94, p=0.047).

CONCLUSIONS

Among community-dwelling older adults, those with a subjective age exceeding their chronological age were expected to show a decreased life function in the future and an increased risk of needing long-term care.