The cross-domain correlates of subjective age in Chinese oldest-old

War-Related Life Course Stress and Late-Life Subjective Age in Northern Vietnam

Background and Objectives

The role of early life stressors in subjective aging is weakly understood, especially in low- to middle-income countries. This paper investigated how early life stressors encountered in armed conflict influence subjective age among Vietnamese older adults who experienced war over decades of their early life.

Research Design and Methods

We analyzed survey data from the 2018 Vietnam Health and Aging Study involving 2,447 Vietnamese older adults who encountered diverse war-related stressors in early adulthood. The analytical sample (N = 2,341) included 50.9% women and 49.1% men, with an average age of 69.8. 41.1% are military veterans. We conducted survey-adjusted multinomial logistic regression analyses with mediation to predict the probability of feeling younger or older than one's chronological age. We examined how childhood adversity (i.e., childhood hunger and low parental SES) and wartime stressors (i.e., war-related violence, malevolent environment, and military service) influenced late-life subjective age, both directly and as mediated by late-life mental, functional, and physical health.

Results

We found significant associations between early adulthood war-related stressors and subjective age. Formal military service significantly lessened the relative risk of feeling subjectively old, and more plentiful wartime violence exposures significantly increased the risk of feeling younger than one's chronological age. Violence exposure's effects were both direct and indirect through functional and mental health. Conversely, greater exposure to wartime malevolent conditions (e.g., shortages of clean water and evacuations) and multiple episodes of severe hunger in childhood increased the risk of feeling older, effects both direct and mediated by late-life functional and mental health.

Discussion and Implications

Results suggest wartime stressors, especially war's malevolent environments and severe childhood hunger, experienced in many conflict-affected populations globally, have the potential to subjectively "age" survivors. Yet, not all war exposures are equal, and some may yield psychological and socioeconomic resources that support healthy aging.

Latent profile analysis of self-perceptions of ageing among Chinese community-dwelling older adults

BACKGROUND

Self-perceptions of ageing (SPA) is an important predictor for physical and mental health of older adults in successful ageing. SPA is mainly studied from negative or positive perspectives using variable-centred methodologies. The aim of the current study was to explore distinct profiles of SPA among Chinese community-dwelling older adults using a person-centred method and validate the SPA profiles by examining associations with psychological outcomes.

METHODS

Participants aged 65 and over were randomly divided into test and validation samples (n = 451, respectively). SPA was measured by the Brief Ageing Perceptions Questionnaire using latent profile analysis.

RESULTS

Three SPA profiles were identified. One adaptive subgroup was designated as 'Low ageing awareness and high positive control' (LAPC, 84.7% and 75% in both samples, respectively). Two maladaptive SPA subgroups were designated as 'Low positive consequences and control' (LPCC, 3.9% and 8.2% in both samples, respectively), and 'High ageing awareness and negative control' (HANC, 11.4% and 16.8% in both samples, respectively). Similar to negative/positive SPA, the HANC and LAPC subgroups showed the highest and lowest levels of depressive symptoms and cognitive decline. Low cognitive function was found in the LPCC subgroup.

CONCLUSIONS

These findings highlight the heterogeneity of older adults' SPA. SPA profiles may aid community healthcare providers in China to identify individuals with high risk of maladaptive SPA and to tailor targeted interventions for psychological health in later life. Distinct SPA profiles require different interventions targeting negative or positive control or both aspects. More positive control strategies might be beneficial for cognitive functioning in older adults from the LPCC subgroup.

Psychological risk and protective factors associated with depression among older adults in mainland China: A systematic review and meta-analysis

BACKGROUND

Although geriatric depression is a public health concern in mainland China, findings about its psychological risk and protective factors have been inconsistent, and its prevention programmes have been deficient. To improve interventions for geriatric depression, we designed a study to systematically estimate the effect size of those factors.

METHODS

To identify psychological risk and protective factors of geriatric depression, we conducted two independent literature searches in English- and Chinese-language databases, and we used a random effects model to analyse effect sizes.

RESULTS

We identified 15 psychological risk and protective factors in 66 studies. The pooled effect sizes between the factors and geriatric depression ranged from 0.129 to 0.567. Self-esteem displayed a large effect size with depression (r = -0.567), whereas medium-to-large effect sizes emerged between geriatric depression and negative perceptions of age (r = 0.452), resilience (r = -0.426), rumination (r = 0.432), neuroticism (r = 0.381), extraversion (r = -0.363), self-efficacy (r = -0.357), sense of control (r = -0.343), and negative coping strategies (r = 0.315). The sample's mean age, the percentage of women sampled, and the research quality of the studies significantly moderated certain associations.

LIMITATIONS

Large heterogeneity, the inexplicability of causal relationships between the factors and geriatric depression, and the lack of generalisability to special groups limit our findings.

CONCLUSIONS

Self-esteem and perceptions of age are potential targets for improving interventions for geriatric depression in mainland China, which should continue to be developed and assessed for their effectiveness.

Bidirectional relationship between subjective age and frailty: a prospective cohort study

Background

Subjective age refers to how young or old individuals experience themselves to be and is associated with health status, behavioral, cognitive, and biological processes that influence frailty. However, little research has examined the relationship between subjective age and frailty among older adults. This study examined the bidirectional association between subjective age and frailty among community-dwelling older adults.

Methods

We used data from the 2011 to 2015 waves of the National Health and Aging Trends Study. Our sample consists of 2,592 community-dwelling older adults with complete data on main outcome variables. Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust = 0, pre-frailty = 1 or 2; frailty = 3 or more criteria met. Generalized estimating equation models were used to examine the concurrent and lagged association between subjective age and frailty.

Results

Participants were, on average, 75.2 ± 6.8 years old, non-Hispanic whites (76 %), female (58 %). 77 % of the participants felt younger, 18 % felt the same, and 5 % felt older than their chronological age. About 45 %, 46 %, and 9 % of the participants were robust, pre-frailty and frailty in the first wave, respectively. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95 % CI = 1.93, 1.45–2.56).

Conclusions

These findings suggest that people with older subjective age are more likely to be pre-frail/frail. Subjective age could be used as a quick and economical screening for those who are potentially frailty or at risk for frailty.

Aging in Context: Incorporating Everyday Experiences Into the Study of Subjective Age

The age that a person feels is a strong predictor of their well-being and long-term health, beyond chronological age, showing that people have a self-awareness that provides insight into their aging process. It appears this insight has broad implications for a person's everyday life and functioning. One's subjective age is shaped by metacognitive beliefs about aging, including both expectations about typical changes but most notably the awareness and interpretation of personal experiences. Subjective age has been described as multidimensional, aligning with life domains such as cognitive, social, and physical functioning. This perspective, coupled with laboratory studies that manipulate subjective age, suggests that situational context has an important role in determining the age a person feels. Here we review literature on subjective age with a focus on how research and theoretical perspectives should be adapted to integrate momentary experiences. We propose a contextual model that will help discriminate the links between situational influences and subjective age, as well as resulting behaviors that impact health and well-being. While most research has considered subjective age to be a relatively stable variable, we provide a novel account of how daily life offers a variety of situational contexts and experiences that directly impact the age a person feels at a given moment. We propose that studying moment-to-moment context is a critical next step in understanding the associations between subjective age, lifestyle choices, and health outcomes.

Loneliness, Malnutrition and Change in Subjective Age among Older Adults during COVID-19 Pandemic

Objectives: We examined the effect of loneliness and the role of two mediating factors, depressive symptoms and malnutrition on subjective age among older adults during the 2020 COVID-19 pandemic, and explored how the pandemic is affecting subjective age. Design: A convenience sample of 201 older adults aged 65 and over was interviewed. Using bootstrapping, we tested the strength and significance of the indirect effect of depressive symptoms and malnutrition (mediators) on the relationship between feelings of loneliness and subjective age. Results: The relationship between feelings of loneliness and subjective age during the COVID-19 pandemic was mediated by malnutrition, but not by depressive symptoms. In addition, the participants felt older during the COVID-19 pandemic compared with the preceding period. Conclusions: An association was found among feelings of loneliness, malnutrition, and subjective age. To overcome these feelings in times of crisis like the pandemic, it is essential to develop new communication methods (technologies for managing and addressing the needs of the older population; technologies to encourage social engagement, and technologies for managing and providing remote medical services) for and with older adults that are effective in reducing loneliness, and to promote good nutrition. Possible practical solutions include new social network technologies for reducing loneliness combined with continued reliance on phone communication as an intervention of psychological support to promote a healthy lifestyle and prevent malnutrition.

Age-related loss of resources and perceived old age in China

Life expectancy in China has increased. This paper explores the age when older adults (aged 60 and above) consider themselves to be an ‘older person’ and how age-related loss of resources (five dimensions: early cumulative factors, decline and loss of health resources, reduction and loss of economic resources, weakening and loss of social support resources, and personal role transition and experiences of losing family members) could impact their perceived old age. Using two waves of data from the China Longitudinal Ageing Social Survey (CLASS) in 2014 and 2016 (6,244 participants in 2014 and 2,989 participants in both 2014 and 2016), we found that the mean perceived old age is around 70 years at baseline (2014). Higher level of educational attainment and occupational types (early cumulative factors), better health condition, receiving support from friends and taking care of grandchildren are significantly associated with the perception that old age begins at an older age at baseline, while being Han-Chinese, being an urban resident (early cumulative factors) and reporting better health condition have significant positive effects on the perception that old age begins at an older age in the later wave. Our findings suggest that the age standard of older adults should be adjusted dynamically in response to social development and longevity, and also highlight the importance of early cumulative factors in shaping the ageing process besides age-related factors.

Differential associations between subjective age and depressive symptoms among urban and rural Chinese older adults

Objectives: Little research has investigated the prospective association between subjective-aging-perception and depressive symptoms in Chinese older adults. The aim of this study is to evaluate the differential associations of feeling old with depressive symptoms among urban and rural community-dwelling Chinese older adults using panel data drawn from two waves of nationally representative surveys.Method: We conducted secondary data analysis and utilized the data of 5,685 urban and 5,612 rural community-dwelling older adults aged 60 years and above who participated in both the 2006 and the 2010 Sample Survey on the Aged Population in Urban/Rural China (SSAPUR). A single-item measure of subjective age was used to distinguish between feeling old and feeling not old.Results: Ordinary least regression analyses indicated that the longitudinal effect of subjective age on depressive symptoms existed only in the urban sample (p<.001) but not in the rural sample and that feeling not old was related to less depressive symptoms in the urban sample, after controlling for baseline measures of depressive symptoms and sociodemographic and health factors.Conclusion: This study provides new longitudinal evidence of the impact of subjective age on depression among Chinese older individuals. The findings provide useful information for depression interventions among urban older Chinese individuals.

'Feeling younger, remembering better': the effect of experimentally induced subjective age on memory performance among Chinese older adults

Objectives: This study aimed to explore whether experimentally induced younger subjective age can lead to better memory performance among Chinese older adults.Method: A total of 203 participants aged 60-84 years were randomly assigned to three groups. In the positive and neutral feedback groups, participants were told that their memory performance was better than and equivalent to the same-aged peers after an initial memory task, respectively, in contrast to no feedback in the control group. Participants then completed a second memory measure.Results: The results revealed that participants in the positive feedback group felt younger and showed a significant increase in memory performance, whereas participants in the neutral feedback group felt older but also showed a significant increase in memory performance. For participants in the control group, no significant changes in memory performance were observed.Conclusion: It seems that experimentally induced younger subjective age can lead to better memory performance among older adults, providing a promising strategy to maintain memory functioning in old age.

Subjective age and depressive symptoms among Chinese older adults: A moderated mediation model of perceived control and self-perceptions of aging

Although subjective age has been shown to play an important role in older adults' experiences of depressive symptoms, the mediating and moderating mechanisms underlying this relationship have not been adequately examined. The present study aimed to investigate the mediating role perceived control plays between subjective age and depressive symptoms, as well as the moderating role self-perceptions of aging plays in this indirect relationship. To examine this, a cross-sectional study was conducted with 609 Chinese older adults, who completed measures of subjective age, perceived control, self-perceptions of aging, and depressive symptoms. The results indicated that: (1) possessing a younger subjective age is significantly associated with less depressive symptoms; (2) perceived control partially mediates the relationship between subjective age and depressive symptoms; and (3) the indirect effect of subjective age on depressive symptoms, through perceived control, is moderated by self-perceptions of aging, while the mediated path is stronger for older adults with less favorable self-perceptions of aging. The findings underscore the importance of identifying the mechanisms that moderate the mediated paths between subjective age and depressive symptoms.

The Longitudinal Association Between Age Identity and Physical Functioning Among Urban Chinese Older Adults

The aim of this study is to determine the longitudinal association between age identity and physical functioning among urban Chinese older adults. We conducted secondary data analyses based on a sample of older adults aged 60 years and above who participated in both the 2006 and the 2010 Sample Survey on Aged Population in Urban/Rural China, which consisted of 5,788 urban community-dwelling older adults. A single-item measure of age identity was used to distinguish between old and youthful age identities (or the feeling of being old or not). Ordinary least regression analyses revealed that youthful age identity was significantly associated with better physical functioning, even when controlling for baseline sociodemographic and health variables as well as baseline physical functioning. This study provides new cross-cultural and longitudinal evidence of the protective function of youthful age identity in later life.

Context Influences on the Subjective Experience of Aging: The Impact of Culture and Domains of Functioning

Background and Objectives

Attitudes about aging influence how people feel about their aging and affect psychological and health outcomes in later life. Given cross-cultural variability in such attitudes, the subjective experience of aging (e.g., subjective age [SA]) may also vary, potentially accounting for culture-specific patterns of aging-related outcomes. Our study explored cultural variation in SA and its determinants.

Research Design and Methods

American (N = 569), Chinese (N = 492), and German (N = 827) adults aged 30-95 years completed a questionnaire that included instruments measuring basic demographic information, SA, beliefs about thresholds of old age, control over life changes, and age dependency of changes in eight different life domains (i.e., family, work).

Results

Analyses revealed consistency across cultures in the domain-specificity of SA, but differences in the amount of shared variance across domains (e.g., Chinese adults exhibited greater homogeneity across domains than did Americans and Germans). Cultural differences were also observed in levels of SA in some domains, which were attenuated by domain-specific beliefs (e.g., control). Interestingly, beliefs about aging accounted for more cultural variation in SA than did sociodemographic factors (e.g., education).

Discussion and Implications

Our results demonstrate that subjective perceptions of aging and everyday functioning may be best understood from a perspective focused on context (i.e., culture, life domain). Given its important relation to functioning, examination of cross-cultural differences in the subjective experience of aging may highlight factors that determine variations in aging-related outcomes that then could serve as targets of culture-specific interventions promoting well-being in later life.

Resilience in context: the special case of advanced age

OBJECTIVES

Advanced age is a time shaped by the current experience of physical, social and psychological characteristics associated with living into an eighth decade and beyond and also by reflection upon past experiences. Understanding the specific factors that contribute to ageing well is increasingly important as greater numbers of older people remain living independently in the community and may require targeted and sustainable support to do so. This paper offers a conceptualisation of resilience for advanced age (age 85+), a life stage currently under-researched.

METHOD

We utilise a developmental and socio-historical context to develop key arguments about adversity, resources and positive outcomes that affect the experience of resilient ageing.

RESULTS

Very late life is characterised by a unique balance between losses, associated with vulnerability and resource restrictions, and potential gains based upon wisdom, experience, autonomy and accumulated systems of support, providing a specific context for the expression of resilience. Post-adversity growth is possible, but maintenance of everyday abilities may be more relevant to resilience in advanced age.

CONCLUSION

An increasing life-span globally necessitates creative and conscientious thought about wellbeing, and resilience research has the important aim to focus health and wellness on success and what is possible despite potential limitations.

Self-perceived uselessness and associated factors among older adults in China

Background

Self-perceived uselessness is associated with poor health and high mortality among older adults in China. However, it is unclear which demographic, psychosocial, behavioral and health factors are associated with self-perceived uselessness.

Methods

Data came from four waves (2005, 2008, 2011 and 2014) of the largest nationwide longitudinal survey of the population aged 65 and older in China (26,624 individuals contributed 48,476 observations). This study aimed to systematically investigate factors associated with self-perceived uselessness based on the proposed REHAB framework that includes resources (R), environments (E), health (H), fixed attributes (A) and behaviors (B). Self-perceived uselessness was measured by a single item: “with age, do you feel more useless?” and coded by frequency: high (always and often), moderate (sometimes) and low (seldom and never). Multinomial logistic regression models with low frequency as the reference category were employed to identify REHAB risk factors associated with self-perceived uselessness.

Results

Most factors in the REHAB framework were associated with self-perceived uselessness, although some social environmental factors in the full model were not significant. Specifically, more socioeconomic resources were associated with reduced relative risk ratio (RRR) of high or moderate frequency of self-perceived uselessness relative to low frequency. More environmental family/social support was associated with lower RRR of high frequency of self-perceived uselessness. Cultural factors such as coresidence with children and intergenerational transfer were associated with reduced RRR of high frequency of self-perceived uselessness. Indicators of poor health status such as disability and loneliness were associated with greater RRR of high or moderate frequency of self-perceived uselessness. Fixed attributes of older age and Han ethnicity were associated with increased RRR of high frequency of self-perceived uselessness; whereas optimism and self-control were associated with reduced RRR. Behaviors including regular consumption of alcohol, regular exercise, social participation and leisure activities were associated with reduced RRR of high frequency of self-perceived uselessness.

Conclusions

Self-perceived uselessness was associated with a wide range of factors in the REHAB framework. The findings could have important implications for China to develop and target community health programs to improve self-perceived usefulness among older adults.