Awareness of age-related change: examination of a (mostly) unexplored concept

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.

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.

Urinary concerns among older adults: a qualitative analysis in the context of healthy aging

BACKGROUND

Urinary concerns increase with age impacting health and quality of life. The aims of this study were to describe: (1) urinary concerns as an age-related change (ARC); (2) the challenges of urinary concerns; (3) adaptation strategies used to manage urinary concerns; and (4) the value of engaging with aging (EWA) as a framework to promote self-management of urinary concerns.

METHODS

Data was used from semi-structured interviews with 29 older adults (mean age 77 years). An iterative coding process was used. A codebook was developed based on a-priori themes derived from the EWA framework, our previous publication, and a line-by-line coding of one of the transcripts. As the analysis progressed, additional codes emerged, enriching the codebook.

RESULTS

Six themes emerged: (1) the participants' experiences; (2) responses to urinary concerns, (3) adaptation and management strategies; (4) knowledge and understanding of urinary concerns; (5) available capacities and resources; and (6) the impact of the COVID-19 pandemic on urinary concerns. Participants tended to address their urinary concerns by adjusting routines, medication schedules, or diet patterns. They tried to secure restroom locations or use tools or reminders to resolve their urinary concerns. COVID-19 led to increased inconvenience for older adults to engage in outdoor activities due to the closure of public restrooms.

CONCLUSIONS

Our in-depth qualitative analysis found that participants developed personalized adjustments to address their needs and abilities to their urinary concerns. These findings offer insights into the individual aging experience, which will further enhance our understanding and advancement of person-centered care.

Purpose in Life Links Positive Aging Views to Life Satisfaction: A Within-Person Analysis Spanning 13 Years

This study aimed to examine the relationship between positive perceptions of aging, purpose in life, and life satisfaction in older adults. It was hypothesized that purpose in life mediates the relationship between positive perceptions of one's aging and life satisfaction. This hypothesis was tested in a sample of older American adults from four waves of the Health and Retirement Study collected at 4-year intervals between 2008 and 2020 (N = 11,546, mean age in 2008 = 62.772). The random intercept cross-lagged panel model was used to separate within-person and between-person sources of variance. Mediation was tested at the longitudinal within-person level and was supported. Results suggest that an increase in positive perceptions of aging is associated with a future increase in purpose in life, which in turn is associated with higher future levels of life satisfaction. The findings inform interventions promoting positive aging, purpose, and life satisfaction in older adults.

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.

To Be Frail or Not to Be Frail: This Is the Question-A Critical Narrative Review of Frailty

Many factors have contributed to rendering frailty an emerging, relevant, and very popular concept. First, many pandemics that have affected humanity in history, including COVID-19, most recently, have had more severe effects on frail people compared to non-frail ones. Second, the increase in human life expectancy observed in many developed countries, including Italy has led to a rise in the percentage of the older population that is more likely to be frail, which is why frailty is much a more common concern among geriatricians compared to other the various health-care professionals. Third, the stratification of people according to the occurrence and the degree of frailty allows healthcare decision makers to adequately plan for the allocation of available human professional and economic resources. Since frailty is considered to be fully preventable, there are relevant consequences in terms of potential benefits both in terms of the clinical outcome and healthcare costs. Frailty is becoming a popular, pervasive, and almost omnipresent concept in many different contexts, including clinical medicine, physical health, lifestyle behavior, mental health, health policy, and socio-economic planning sciences. The emergence of the new "science of frailty" has been recently acknowledged. However, there is still debate on the exact definition of frailty, the pathogenic mechanisms involved, the most appropriate method to assess frailty, and consequently, who should be considered frail. This narrative review aims to analyze frailty from many different aspects and points of view, with a special focus on the proposed pathogenic mechanisms, the various factors that have been considered in the assessment of frailty, and the emerging role of biomarkers in the early recognition of frailty, particularly on the role of mitochondria. According to the extensive literature on this topic, it is clear that frailty is a very complex syndrome, involving many different domains and affecting multiple physiological systems. Therefore, its management should be directed towards a comprehensive and multifaceted holistic approach and a personalized intervention strategy to slow down its progression or even to completely reverse the course of this condition.

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.

The Role of Awareness of Age-Related Change in the Longitudinal Association between Pain and Physical Activity

We examined how physical pain impacts the developmental construct of Awareness of Age-Related Change (AARC-gains and AARC-losses) and, in turn, how AARC mediates and moderates the association between pain and subsequent physical activity. We used longitudinal data from 434 participants of the UK PROTECT Study (mean age = 65.5 years; SD = 6.94 years). We found that pain in 2019 predicted higher AARC-losses (β = .07; p = .036) and less physical activity (β = -.13; p-value = .001) in 2020. Additionally, we found that AARC-losses partially mediated, but did not moderate, the association of pain in 2019 and physical activity in 2020. AARC-losses may explain physical inactivity in middle-aged and older adults experiencing pain. Incorporating developmental constructs such as AARC into theories and empirical studies on pain and pain management may be necessary to more fully capture people's responses to pain.

Cognitive trajectories: exploring the predictive role of subjective cognitive decline and awareness of age-related changes for cognitive functioning

Background

We investigated whether aspects of subjective cognitive aging, including awareness of age-related gains and losses in cognition (AARC-gains, AARC-losses) and subjective cognitive decline (SCD), predict change in objective cognitive function as measured by verbal reasoning (VR) and working memory (WM).

Methods

We used longitudinal data for 3,299 cognitively healthy UK residents aged 65+. We used data on AARC and SCD assessed in 2019, and cognitive tasks assessed in 2019, 2020, and 2021. We used latent growth curve modeling, latent class growth analysis, and growth mixture modeling.

Results

For VR, multiple growth trajectories were not evident. Mean VR at baseline was 37.45; this remained stable over time. Higher AARC-gains in cognition (mean intercept = -0.23; 95%CI: -0.31; -0.16), higher AARC-losses in cognition (mean intercept = -0.37; 95%CI: -0.46; -0.28), and lower SCD (mean intercept = 2.92; 95%CI: 2.58; 3.58) were associated with poorer VR at baseline. A three-class growth mixture model-class varying best represented trajectories of WM. In Class 1 (N = 182) mean WM at baseline was 31.20; this decreased by 2.48 points each year. In Class 2 (N = 119) mean WM at baseline was 23.12; this increased by 3.28 points each year. In Class 3 (N = 2,998) mean WM at baseline was 30.11; and it remained stable. Higher AARC-gains (Odds Ratio = 1.08; 95%CI: 1.03; 1.14) and AARC-losses (Odds Ratio = 1.10; 95%CI: 1.04; 1.16) in cognition predicted greater likelihood of being in Class 2 than Class 3.

Conclusion

Although both higher AARC-gains and AARC-losses indicate poorer concurrent cognition, higher AARC-gains may be a resource that facilitates future cognitive improvement.

Does Awareness of Aging Matter? The Moderating Function of Awareness of Age-Related Change on the Relationships Between COVID-19 Disruption, Perceived Stress, and Affect

OBJECTIVES

How people reflect on their own age may influence their well-being in the face of disruptions associated with the coronavirus (COVID-19). Subjective aging was operationalized in terms of one's awareness of age-related change (AARC), specifically, the gains and losses associated with aging. We developed a measure assessing disruptions to daily life associated with the COVID-19 pandemic across 3 dimensions (i.e., Social and Lifestyle Disruption, Work and Health Disruption, and Others Contracting COVID-19). We hypothesized that COVID-19 disruption would be positively associated with both AARC-losses and AARC-gains. Greater COVID-19 disruption would also be associated with poorer psychosocial outcomes (higher perceived stress and negative affect [NA] and lower positive affect [PA]) and these associations would be stronger for those reporting greater AARC-losses and weaker for those reporting greater AARC-gains.

METHODS

Cross-sectional questionnaire data were collected from 263 participants from the United States (aged 40-83; mean age: 62.88 years, standard deviation = 9.00; 56.3% females).

RESULTS

After controlling for age, gender, education, employment, socioeconomic status, and physical functioning, greater Work and Health Disruption was associated with greater AARC-losses. Greater Social and Lifestyle Disruption was associated with both greater AARC-gains and AARC-losses. Moderation effects showed an exacerbating effect of AARC-losses on NA in the face of Work and Health Disruption and a protective effect of AARC-gains on PA in the context of Social and Lifestyle Disruption.

DISCUSSION

We extend research detailing antecedents of AARC and highlight the need for longitudinal research that considers the ever-changing nature of the pandemic.

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.

Multimorbidity and Depressive Symptoms in Older Adults: A Contextual Approach

BACKGROUND AND OBJECTIVES

Among older adults, depressive symptoms increase with each chronic illness; however, specific disease-related stressors (e.g., pain) and contextual moderators (interpersonal, sociocultural, temporal) of this relationship remain understudied. We explored disease-related stressors associated with depressive symptoms and moderating effects of contextual factors on this relationship, guided by a social ecological framework.

RESEARCH DESIGN AND METHODS

Adults ≥62 years with multimorbidity (n = 366) completed validated scales assessing diagnoses, disease-related stressors (pain intensity, subjective cognitive function, physical function, somatic symptoms), and depressive symptoms. Moderators included age, expectations regarding aging, perceived social support, and difficulty affording medications. Data were analyzed using structural equation modeling.

RESULTS

Participants were 62-88 years old, with several comorbidities (M = 3.5; range: 2-9). As hypothesized, disease-related stressors were associated with depressive symptoms (b = 0.64, SE = 0.04, p < .001). The effect of disease-related stressors on depressive symptoms was greater among those reporting low social support (B = 0.70, SE = 0.06, p < .001) than for those reporting high social support (B = 0.46, SE = 0.06, p < .001). The negative effect of disease-related stressors on depressive symptoms was stronger for those with poorer expectations of aging (B = 0.68, SE = 0.07, p < .001), compared to those with more positive expectations (B = 0.47, SE = 0.06, p < .001). Age and difficulties affording medications were not significant moderators.

DISCUSSION AND IMPLICATIONS

Garnering social support and addressing low expectations for aging may prevent the detrimental effect of multimorbidity on mental health.

Rumination moderates the longitudinal associations of awareness of age-related change with depressive and anxiety symptoms

OBJECTIVE

Lower awareness of age-related gains (AARC-gains) and higher awareness of age-related losses (AARC-losses) may be risk factors for depressive and anxiety symptoms. We explored whether: (1) Baseline AARC-gains and AARC-losses predict depressive and anxiety symptoms at one-year follow-up; (2) age and rumination moderate these associations; (3) levels of AARC-gains and AARC-losses differ among individuals with different combinations of current and past depression and/or with different combinations of current and past anxiety.

METHODS

In this one-year longitudinal cohort study participants (N = 3386; mean age = 66.0; SD = 6.93) completed measures of AARC-gains, AARC-losses, rumination, depression, anxiety, and lifetime diagnosis of depression and anxiety in 2019 and 2020. Regression models with tests of interaction were used.

RESULTS

Higher AARC-losses, but not lower AARC-gains, predicted more depressive and anxiety symptoms. Age did not moderate these associations. Associations of lower AARC-gains and higher AARC-losses with more depressive symptoms and of higher AARC-losses with more anxiety symptoms were stronger in those with higher rumination. Individuals with both current and past depression reported highest AARC-losses and lowest AARC-gains. Those with current, but not past anxiety, reported highest AARC-losses.

CONCLUSION

Perceiving many age-related losses may place individuals at risk of depressive and anxiety symptoms, especially those who frequently ruminate.

Awareness of age-related change and its relationship with cognitive functioning and ageism

 .Given ageism's negative impacts on older adults, the theoretical model for awareness of age-related change (AARC) hypothesized that experiencing ageism may mediate the relationship of cognitive functioning to AARC. We tested this hypothesis and alternatively proposed that cognitive functioning mediated the relationship of ageism to AARC. Analyses were conducted using measures of memory and inductive reasoning for 215 older adults (66-90 years) recruited online. Significant direct effects of ageism, memory, and inductive reasoning and significant mediated effects were found in both models, with more support for cognition mediating the relationship between ageism and AARC than for ageism mediating the relationship between cognitive functioning and AARC. This study added to the literature by empirically investigating theoretically proposed antecedents of AARC. Policymakers should address ageism to support healthy aging. Findings may assist therapists working to help older adults gain insights regarding how ageism impacts cognitive functioning and awareness of age-related changes.

Physical and mental health conditions account for variability in awareness of age-related changes

Background

The concept of Awareness of Age-Related Changes captures people's perceptions of the positive (AARC-gains) and negative (AARC-losses) age-related changes they experience in several life domains, including their health. We investigated the cross-sectional associations of number and type of physical and mental health conditions with AARC-gains and AARC-losses.

Methods

The sample comprised 3,786 middle-aged and older adults (mean age = 67.04 years; SD = 6.88) participating to the UK PROTECT study. We used hierarchical regression models to analyze whether after having included sociodemographic variables (model 1), number of physical (model 2) and of mental (model 3) health conditions explained a significant additional amount of variance in AARC-gains and AARC-losses, and whether the association between number of conditions and AARC depended on participants' age. We used multiple regression models to analyze the associations of types of physical and mental health conditions with AARC-gains and AARC-losses.

Results

A higher number of physical health conditions was associated with higher AARC-gains and higher AARC-losses, but the association did not depend on participant age. After controlling for the number of physical health conditions, a higher number of mental health conditions was associated with higher AARC-losses but not with AARC-gains, and the association was stronger among older participants. Small effects were found between greater AARC-gains and current cancer and between greater AARC-losses and diagnoses of mild cognitive impairment, Parkinson's disease, arthritic condition, cancer in full remission, osteoporosis, depression, anxiety disorders, and personality disorder. The remaining health conditions were either negligibly or non-statistically related to AARC-losses.

Conclusion

Middle-aged and older adults having more physical health conditions and more mental health conditions may be at higher risk of negative views on their own aging. However, specific physical health conditions, such as arthritis, and certain mental health conditions, such as depression, may make adults particularly vulnerable to negative age-related perceptions.

Awareness of Age-Related Gains and Losses in a National Sample of Adults Aged 80 Years and Older: Cross-Sectional Associations With Health Correlates

Background and Objectives

Advanced old age is a life stage with a high likelihood of age-related loss experiences. However, little is known about remaining gain experiences and their relation with perceived losses and health correlates in community-dwelling very old adults. Moreover, virtually nothing is known in this regard about the experiences of individuals in long-term care settings. First, we strived to establish the normative course of age-related gains and losses in advanced old age. Second, we examined whether such gain/loss perceptions in advanced aging moderated health correlates.

Research Design and Methods

Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021. The sample comprised 10 578 individuals aged 80-106 years, including 587 individuals in long-term care. We used the multidimensional Awareness of Age-Related Change (AARC) questionnaire and moderated regression to analyze associations with late-life health and functioning correlates.

Results

Levels of AARC-Gains were higher than those of AARC-Losses across most of the age range. Long-term care residents showed more AARC-Losses and fewer AARC-Gains compared with community-dwelling adults and contributed significantly to an overall negative balance of more losses than gains in those aged 90 years or older. Regarding functional health and autonomy, negative age effects were amplified by AARC-Losses, but buffered by AARC-Gains. A more positive ratio of gains-to-losses predicted better health and functioning.

Discussion and Implications

Findings suggest that the loss aspect of development in very late life might have been overstated in the existing literature. Perceived gains and losses are of critical importance for the understanding of health correlates in very old age.

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

This article updates and extends an earlier meta-analysis (Westerhof et al., 2014) on the longitudinal effects of subjective aging (SA) on health outcomes. A systematic search in different databases (APA PsycInfo, PubMed, Web of Science, and Scopus) resulted in 99 articles, reporting on 107 studies. Participants: Studies had a median sample size of 1,863 adults with a median age of 66 years. A randomized effect meta-analysis showed a significant, small effect (likelihood ratio = 1.347; 95% confidence interval [1.300, 1.396]; p < .001), similar in magnitude to the previous meta-analysis of 19 studies. Although the results showed high heterogeneity in the longitudinal link between SA and health outcomes, there were no differences in effects according to chronological age of participants, welfare state status (more or less developed social security system), length of follow-up, type of health-related outcome, or quality of the study. Effects were stronger for multiitem measures of self-perceptions of aging than for the frequently used single-item measures assessing subjective age, especially for indicators of physical health. Based on this meta-analysis, building on five times more studies than the 2014 review, we consider the associations of measures of SA with health and longevity across time as robust, albeit small in size. Future research should concentrate on the clarification of pathways mediating the relation between SA and health outcomes, as well as potential bidirectional effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-reported hearing and awareness of age-related change : A domain-specific perspective

BACKGROUND

Impaired hearing is associated with disadvantages in developmental outcomes, such as compromised everyday social communication or reduced well-being. Hearing impairment might also have an impact on how individuals evaluate their own aging as deterioration in hearing can be interpreted as being age-related and as a phenomenon individuals attribute to getting older.

OBJECTIVE

This study investigated how self-reported hearing is related to awareness of age-related change (AARC).

MATERIAL AND METHODS

AARC is a multidimensional construct comprising perceived age-related gains and losses in general as well as across five functional domains (health and physical functioning, cognitive functioning, interpersonal relations, social cognitive and social emotional functioning, lifestyle and engagement). A sample of 423 individuals (age range 40-98 years; mean age, M = 62.9 years; standard deviation (SD) = 11.8 years) was assessed up to 3 times over approximately 5 years.

RESULTS

Based on longitudinal multilevel regression models, controlling for age, gender, subjective health and education, it was found that poorer self-reported hearing was associated with more perceived general AARC losses as well as with more AARC losses in health and physical functioning and in cognitive functioning at baseline. With an older age at baseline, poorer self-reported hearing was associated with a steeper decline in AARC gains regarding interpersonal relations over time, whereas in those who were younger at baseline poorer hearing was related to fewer gains in social cognitive and social emotional functioning at baseline.

DISCUSSION

Self-reported hearing reveals differential associations with AARC domains; however, changes in most AARC domains of gains and losses seem to be only weakly related to subjective hearing.

Elderly Users’ Emotional and Behavioral Responses to Self-Service Technology in Fast-Food Restaurants

While COVID-19 has accelerated digital transformation, increasing labor costs and 52-h workweek rules are replacing human labor with self-service technologies (SSTs). Self-service technology is increasingly being implemented in restaurant settings. However, the elderly, who have relatively lower levels of digital literacy, are being excluded from services that can alleviate the economic and social difficulties of their daily lives. This study thus aims to explain how elderly users feel about and respond to SST in fast-food restaurants. An off-site survey was conducted with individuals who had experience using SST. We analyzed the data using the partial least squares structural equation modeling method by SmartPLS 3.0. The results showed that SST’s reduction, perceived ease of use of SST, and perceived time pressure significantly influenced users’ negative emotions toward the SST. However, perceived physical condition and perceived crowding did not have significant influences on users’ emotions. In empirically investigating individuals’ negative emotions toward and coping strategies for challenges posed by SST, this study emphasizes the development of a nationwide digital inclusion policy that can help bridge the digital divide.

How Do Marital Transitions Affect Self-Perceptions of Aging?

OBJECTIVES

We analyzed whether marital status and experiences of marital loss or gain were associated with self-perceptions of aging (SPA), a major psychosocial mechanism of healthy aging.

METHOD

We used data from 7028 participants of the Health and Retirement Study. Participants reported their marital status and their positive and negative SPA on two occasions 4 years apart. We ran general linear models to analyze differences in SPA between men and women who remained married, became divorced or widowed, or remarried following divorce or widowhood.

RESULTS

Participants who experienced marital loss had lower positive SPA than participants who remained marred. Participants who experienced marital gain had lower negative SPA than participants who remained married. None of the associations differed between men and women.

DISCUSSION

Results suggest that it may not be marital status itself, but rather the transition into or out of marriage, that impacts how people appraise their own aging.

Community-dwelling older adults' experiences and perceptions of needs for home modification in Shanghai

Home environment is essential to older adults. While existing studies have investigated the positive implications of home modification strategies for older adults and proposed relevant policies and programmes, literature has remained relatively silent on how older adults perceive their needs for their home environment and its modification, especially during and after they go through home modification projects. This study investigated community-dwelling older adults' perceptions of needs for home modification in Shanghai. Informed by theories in environmental gerontology and tenets of awareness of age-related change, we conceptualised two intertwined, evolving processes of person–environment (P-E) interactions: older adults' interactions with their home environment, and the interactions between their perceptions of needs for home modification and the ageing process. Taking a qualitative approach, we interviewed community-dwelling older adults who were among the first to have received a pilot government-sponsored home modification project in Shanghai (N = 15). Our findings suggest that older adults' P-E dynamics evolved in response to their perception of their home environment and ageing process. Most participants initially were unaware of their underlying needs for home modification even when they had encountered challenges in their apartments. As the home modification project took place, participants gradually gained knowledge of their home environment and the following modification, which enabled them to better identify and articulate their needs to improve their daily living. After the project, participants' understandings of their home environments continued to evolve, expanding to their neighbourhood. This study informs policy and practice to focus on recognising the evolving aspects of older adults' needs in their home environment and better engaging older adults in the process of home modification.

Social isolation and loneliness among Chinese older adults: Examining aging attitudes as mediators and moderators

Due to labor migration and social changes, the Chinese elderly are facing significant social isolation, along with changes in aging attitudes. However, whether social isolation affects loneliness among the Chinese elderly and whether this relationship is moderated and mediated by aging attitudes is unclear. This empirical study aimed to respond to the above questions in the Chinese context, Based on the data from the 2014 China Longitudinal Aging Social Survey (N = 6,645), the results showed that social isolation is a positive predictor of loneliness; aging attitudes mediate the relationship between social isolation and loneliness. Social isolation affects the loneliness of the elderly partially by weakening positive aging attitudes and strengthening negative aging attitudes; aging attitudes moderate the effect of social isolation on loneliness. For those older adults with higher positive aging attitudes, social isolation has a much smaller effect on loneliness. While for those older adults with higher negative aging attitudes, social isolation has a more substantial effect on their feelings of loneliness. Our results indicate that less social isolation is an effective way to relieve loneliness, and maintaining higher positive aging attitudes and lower negative aging attitudes, is important for the Chinese elderly to prevent loneliness when facing social isolation.

Association between older subjective age and poor sleep quality: a population-based study

OBJECTIVE

To examine the association of subjective age (SA) with sleep quality in an adult population.

METHODS

In the Korean Sleep and Headache Study, 2,349 participants (49.2% men; 48.1 ± 16.4 years old) were interviewed face-to-face using structured questionnaires between September and December 2018. SA was assessed by asking participants their perceived age in years and then compared with their chronological age (CA). Participants were assigned to three groups: feeling younger, feeling their age, and feeling older. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Association between SA and sleep quality was analyzed with multiple linear regression controlling for demographics, psychosocial, and sleep characteristics.

RESULTS

The group feeling older (n = 404, 17.2%; men, 58.2%; age, 46.5 ± 16.2 years) had worse sleep quality than the groups feeling younger and feeling their age (PSQI score, 4.3 ± 2.7, 3.8 ± 2.4, 3.4 ± 2.1, respectively, p <.001; prevalence of poor sleep quality, 29.0%, 18.4%, 13.5% respectively, p <.001). The association between SA and the PSQI score remained significant after adjusting for confounders (β = 1.05, 95% confidence interval 0.26, 1.83; p <.001). Stratified analyses by sex and CA showed that the association between SA and the PSQI score was significant only in women and in middle-aged and older group (aged 50-79), suggesting that sex and CA modified the association.

CONCLUSION

Age perception was associated with self-reported sleep quality, independent of CA. SA may be a useful marker that complements the conventional assessment of subjective sleep quality.

Cross-Sectional and Longitudinal Associations between Subjective Sleep Difficulties and Self-Perceptions of Aging

BACKGROUND

Only one study has explored the associations of subjective sleep difficulties with self-perceptions of aging. It focused on a global indicator of self-perceptions of aging (subjective age) despite individuals reporting different experiences of aging in relation to different life domains. The concept of awareness of negative age-related change, capturing perceived losses across five domains (e.g., physical health, cognition), may be more appropriate when relating subjective sleep difficulties to self-perceptions of aging. We examined whether nine different indicators of subjective sleep difficulties predict levels of awareness of negative age-related change and subjective age, measured concurrently and one year later, while controlling for covariates (mood and daily function).

PARTICIPANTS/METHODS

We used data from the PROTECT cohort study; 4,482 UK residents (mean age = 66.1; SD = 6.9) completed measures of awareness of age-related change, subjective age, mood, daily function, and subjective sleep difficulties.

RESULTS

Based on linear regression analyses, poorer quality of sleep, lower alertness after awakening, satisfaction with sleep, depth of sleep, more frequent early awakening, difficulty falling asleep, more times awake during a night, fewer hours of sleep during the night and more hours of sleep during the day predicted higher awareness of negative age-related change at baseline and follow-up (p< .001). Associations were small in size. Associations between subjective sleep difficulties and subjective age were either negligible or statistically non-significant.

CONCLUSIONS

Although subjective sleep difficulties are one of the many factors associated with awareness of negative age-related change, addressing sleep difficulties, alongside negative mood, and poor daily functioning, may promote a small additional increase in positive self-perceptions of aging.

Effects of age simulation suits on psychological and physical outcomes: a systematic review

Age simulation suits (ASS) are widely used to simulate sensory and physical restrictions that typically occur as people age. This review has two objectives: first, we synthesize the current research on ASS in terms of the observed psychological and physical effects associated with ASS. Second, we analyze indicators able to estimate the validity of ASS in simulating "true" ageing processes. Following the PRISMA guidelines, eight electronic databases were searched (BASE, Cinhal, Cochrane, Google Scholar, ProQuest, PsychINFO, Pubmed, and Web of Science). Qualitative and quantitative studies addressing effects of ASS interventions regarding psychological outcomes (i.e., empathy, attitudes) or physical parameters (i.e., gait, balance) were included. The Mixed Methods Appraisal Tool was applied for quality assessment. Of 1890 identified citations, we included 94 for full-text screening and finally 26 studies were examined. Publication years ranged from 2001 to 2021. Study populations were predominantly based on students in health-related disciplines. Results suggest that ASS can initiate positive effects on attitudes toward (d_weighted = 0.33) and empathy for older adults (d_weighted = 0.54). Physical performance was significantly reduced; however, there is only little evidence of a realistic simulation of typical ageing processes. Although positive effects of ASS are supported to some extent, more diverse study populations and high-quality controlled designs are needed. Further, validation studies examining whether the simulation indeed reflects "real" ageing are needed and should build on reference data generated by standardized geriatric assessments or adequate comparison groups of older adults.Prospero registration: 232686.

Awareness of age-related change is associated with attitudes toward technology and technology skills among older adults

Despite much research in the context of aging and technology, the role of Views on aging (VoA) for differences in technology use and attitudes among older adults has rarely been studied so far. This study focuses on the associations between a multidimensional measure of VoA and technology use, technology skills, and attitudes toward technology in a sample of older adults (n = 369, age range: 65–93 years, 48.2% male). We apply the concept of Awareness of age-related change (AARC) to examine the role of positive (AARC-Gains) and negative (AARC-Losses) self-perceptions of aging. Bivariate and multivariate regression analyses were conducted. The results showed positive associations of AARC-Gains with technology skills and technology attitudes. For AARC-Losses, we identified negative associations with technology skills, technology attitudes as well as general technology use. In contrast, associations between subjective age (SA) and all technology-related measures were non-significant. The results stress the importance to consider multidimensional measures of VoA to gain a better understanding of the associations between an individuals’ experiencing of own aging processes and technology adoption. More research is needed to determine the stability of these findings in other samples and for other kinds of technology use and attitudes.

Engaging With Aging: A Qualitative Study of Age-Related Changes and Adaptations

Background and Objectives

In the context of global aging, there is a need to better understand how older adults adapt to their changing health status. Engaging with aging (EWA) is an emerging framework proposed by Carnevali, which provides a new lens to understand an active, conscious daily-living process of managing age-related changes (ARCs) taken on by older adults. Study aims were to (a) describe the ARCs experienced by community-dwelling older adults and (b) identify the strategies and resources used by older adults to accommodate the daily-living challenges caused by the associated ARCs.

Research Design and Methods

We conducted semistructured interviews using a virtual card sort to gather qualitative data about ARCs and strategies to manage ARCs. Interviews were conducted virtually due to coronavirus disease 2019 (COVID-19) restrictions.

Results

Participants included 19 females and 10 males. The mean age was 77.45 years old (range from 64 to 98). Sixteen ARCs (e.g., changes in hearing, changes in stability, changes in sleep, etc.) were mentioned by participants, and their corresponding adaptations were discussed. Participants linked their adaptations to their ARCs based on their changing capacities and needs. Examples of commonly used adaptations included, for example, conserving energy, utilizing tools or technology, and being more conscious before and while taking actions. The challenges caused by COVID-19 in implementing the adaptations were also discussed.

Discussion and Implications

Findings from this study demonstrate how older adults explore, generate, and utilize adaptive behaviors to address their ARCS. This study substantiates the EWA framework by showing common patterns among older adults in linking ARCs with adaptations. Implications for clinicians include using EWA to help older adults identify personalized health solutions that fit their capacities. Researchers may use EWA to design and test interventions by considering the specific ARCs older adults encounter and the attitudes they hold towards the ARCs.

Daily fluctuations in subjective age and depressive symptoms: the roles of attitudes to ageing and chronological age

Studies indicate that both subjective age-individuals' perception of their own age as older or younger than their chronological age, and attitudes to ageing are related to physical and mental health. Less is known about the possible dual effect of these two constructs of subjective views of ageing. In the current study, 334 participants (aged 30-90, M = 58.15) reported their daily subjective age and mental health along 14 consecutive days. Attitudes to ageing were measured at baseline. Results indicated that daily variation in subjective age was related to daily variation in depressive symptoms, such that people experienced more depressive symptoms at days they felt older. Furthermore, we found that attitudes to ageing (perceptions of losses, physical change, and psychological growth) moderated this relationship. The covariation between daily subjective age and daily depressive symptoms was stronger when attitudes to ageing were less favorable (e.g., high perceptions of losses and low psychological growth). The moderating effect of losses was especially prominent among older participants. This indicates that attitudes to ageing moderate the toll that feeling old takes on mental health, especially in older age. The results also emphasize the need to understand how different subjective views on ageing, measured in different time frames, operate interactively to shape individual's daily experiences.

Exploring awareness of age-related changes among over 50s in the UK: findings from the PROTECT study

OBJECTIVES

Older people describe positive and negative age-related changes, but we do not know much about what contributes to make them aware of these changes. We used content analysis to categorize participants' written comments and explored the extent to which the identified categories mapped onto theoretical conceptualizations of influences on awareness of age-related change (AARC).

DESIGN

Cross-sectional observational study.

PARTICIPANTS

The study sample comprised 609 UK individuals aged 50 years or over (mean (SD) age = 67.9 (7.6) years), enrolled in the PROTECT study.

MEASUREMENTS

Between January and March 2019, participants provided demographic information, completed a questionnaire assessing awareness of age-related change (AARC-10 SF), and responded to an open-ended question asking them to comment on their responses.

RESULTS

While some of the emerging categories were in line with the existing conceptual framework of AARC (e.g. experiencing negative changes and attitudes toward aging), others were novel (e.g. engagement in purposeful activities or in activities that distract from age-related thoughts). Analysis revealed some of the thought processes involved in selecting responses to the questionnaire items, demonstrating different ways in which people make sense of specific items.

CONCLUSIONS

Results support the ability of the AARC questionnaire to capture perceived age-related changes in cognitive functioning, physical and mental health, and engagement in social activities and in healthy and adaptive behaviors. However, findings also suggest ways of enriching the theoretical conceptualization of how AARC develops and offer insights into interpretation of responses to measures of AARC.

Awareness of age-related gains and losses as moderators of daily stress reactivity in middle- and older-adulthood

Objectives

Associations between awareness of one's own aging and wellbeing have received increasing attention in the field of gerontology over the last decade. The current study examines how between-person differences and within-person fluctuations of awareness of age-related change (AARC) relate to daily negative affect and vitality. Of key interest was the extent to which fluctuations in AARC moderated reactivity to stressor exposure. We predicted that higher positive perceptions of aging (AARC-gains) would buffer the relationship between daily stressors and negative affect/vitality. Conversely, we expected that higher negative perceptions (AARC-losses) may exacerbate the relationship between daily stressors and the outcome variables.

Methods

Data were collected from a community-based sample of 152 Australian adults aged 53-86 (M = 69.18, SD = 5.73). For 10 consecutive days, participants completed surveys on their smartphones measuring daily stressors, AARC, and affect (positive and negative). Bayesian hierarchical linear models were used to examine whether AARC-gains and AARC-losses moderated within-person associations of daily stressors and affect (i.e., stress reactivity).

Results

At the between-person level, higher AARC-gains was associated with lower negative affect and higher vitality, whereas those reporting higher AARC-losses scored higher on negative affect and lower on vitality. Within-person variables revealed that on days when AARC-gains was higher and AARC-losses was lower, this corresponded with lower negative affect and higher vitality. There was no evidence in support of individual moderating effects of within-person AARC-losses or within-person AARC-gains on stress reactivity. A trend was evident in support of a three-way WP Stress severity × WP AARC-gains × WP AARC-losses interaction in the prediction of negative affect, indicating that on days when AARC-losses was higher, the association of stress severity with negative affect was weaker if AARC-gains was higher. Follow-up analyses modeling quadratic stress severity revealed a trend suggesting an interaction of within-person stress severity and within-person AARC-losses.

Discussion

Results indicate that both individual differences and short-term fluctuations in AARC are associated with daily negative affect and vitality. The results provided qualified support for a possible protective role of AARC-gains in the context of stress reactivity.

No Pain, No Gain? Personality Associations With Awareness of Aging Depend on Arthritis

Background

Awareness of aging brings to light one’s own perceived behavioral, physical, and cognitive changes associated with getting older. Personality and physical illness are each related to two components of awareness of aging: attitudes toward own aging (ATOA), and awareness of age-related changes (AARC). Here, we move beyond main effects to examine how personality and arthritis interact with respect to awareness of aging.

Materials and Methods

296 participants (M age = 64.67, SD = 4.36, Range = 60–90 years, 49.7% women) completed online self-report questionnaires of personality, arthritis, ATOA, and AARC gains and losses.

Results

We ran three hierarchical multiple regression models to test how personality traits and arthritis interacted to predict ATOA, AARC gains, and AARC losses, respectively. Higher extraversion was related to positive ATOA, and higher openness was related to positive ATOA and more AARC gains. Higher neuroticism was related to negative ATOA, more AARC losses, and less AARC gains. We found a main effect for arthritis, where those with arthritis reported more AARC losses. Lastly, we found a significant interaction between arthritis and agreeableness when predicting AARC gains. Among those with low agreeableness, people with arthritis reported significantly more AARC gains compared to those without arthritis.

Conclusion

Personality and arthritis are each important for awareness of aging. Overall, our study suggests that for those with arthritis, it is especially important to consider behavioral and cognitive factors related to agreeableness, as they may be important means of promoting positive views on aging.

Subjective views of aging in very old age: Predictors of 2-year change in gains and losses

This study examined trajectories of awareness of age-related change (AARC; Diehl & Wahl, 2010) across 2 years in a large representative sample of very old adults. We also examined the predictive role of health, functional status, cognitive functioning, and engagement with life for AARC change. The initial sample comprised 1,863 individuals aged 80 years or older. Of the 1,612 individuals recontacted 2 years later, 912 took part in the follow-up. Measures included the AARC-Short Form, assessing perceived AARC Gains and AARC Losses. Measures of multimorbidity and functional health, a cognitive screening test, and indicators of engagement with life (e.g., leisure activity) were examined as predictors of AARC change, using semi-cross-lagged fixed effects modeling. Higher overall levels of AARC Gains were observed compared to AARC Losses for all but respondents aged 90 years or older. Intra-individual levels of AARC Gains decreased significantly over the 2-year period, whereas a significant increase was found for AARC Losses. AARC Losses across time were predicted by loss of instrumental activities of daily living (IADL) independence, but not by change in multimorbidity, cognitive performance, or engagement with life. One indicator of engagement with life, reduced leisure activity, predicted smaller AARC Gains at wave 2. These results were robust in models controlling for potential reverse causation. These findings suggest that a significant increase in perceived AARC Losses appears to be an inherent characteristic of very old age. Very old age may be a stage in life in which changes in multimorbidity and cognitive performance no longer impact individuals' views on aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Awareness of age-related change, future time perspective, and implications for goal adjustment in older adulthood

OBJECTIVES

How people adjust their goals is central to adaptation across the lifespan. However, little is known about individual difference characteristics that predict how and why people use different self-regulatory strategies. The present study investigated associations of perceived age-related gains and losses, and their interaction, as predictors of goal adjustment in older adulthood. Furthermore, we examined whether future time perspective (FTP) mediated relationships between awareness of age-related change (AARC) and goal adjustment.

METHOD

A community-based sample of 408 adults (aged 60-88 years) was recruited via an internet-based research platform. Participants completed questionnaire measures of AARC, FTP, goal disengagement, and goal re-engagement. A flexibility index reflecting tendencies toward use of both goal disengagement and goal re-engagement strategies was also analyzed.

RESULTS

Although AARC-losses was associated with lower goal re-engagement and goal flexibility, this association was weaker among those with higher AARC-gains, indicating AARC-gains may be protective in the relationship between AARC-losses and goal adjustment. The association between AARC and goal adjustment was also shown to be mediated by FTP. Higher AARC-gains was associated with more expansive FTP, which was associated with lower goal disengagement and higher goal re-engagement. On the other hand, higher AARC-losses was associated with more restricted FTP, which was associated with higher goal disengagement and lower goal re-engagement.

DISCUSSION

Results have implications for how we conceptualize the combined effects of age-related gains and losses on developmental outcomes relevant to adaptive aging. Furthermore, perceptions of future time with advancing age may be implicated in processes linking AARC with goal adjustment.

Identifying predictors of self-perceptions of aging based on a range of cognitive, physical, and mental health indicators: Twenty-year longitudinal findings from the ILSE study

Research exploring whether health predicts self-perceptions of aging (SPA) has mostly focused on single predictors and has been hampered by short observational intervals. We examined whether 20-year changes in cognitive functioning, physical and mental health predict SPA. We used data of 103 German participants who remained of a sample of 500 participants born in 1930-1932 enrolled in the Interdisciplinary Longitudinal Study of Adult Development (ILSE) in 1993/1996 (mean age at fourth measurement wave = 82.5 years). Health indicators included six cognitive tests, objective and subjective physical health, and self-reported depression. We used a new and multidimensional (awareness of age-related gains and losses) and a well-established (attitudes toward own aging) measure of SPA. Linear regression analyses showed that, among the cognitive tests, decline in information processing speed (Digit Symbol) predicted less awareness of age-related gains and more awareness of age-related losses but not attitudes toward own aging. Decline in subjective but not objective physical health, predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. Increase in depressive symptoms predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. The size of associations suggests that objective cognitive decline has limited influence on older adults' SPA and, if so, only when the decline is related to mental slowing. Similarly, perceived physical and mental health, but not objective health, have a small-to-moderate influence on awareness of age-related losses and attitudes toward own aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Widowhood and depression among Chinese older adults: examining coping styles and perceptions of aging as mediators and moderators

Objectives: Based on the stress-coping framework, this study examined the role of coping styles and perceptions of aging in the relationship between widowhood and depression through two alternative pathways-mediation and moderation-with a national probability sample of older adults in China.Method: The data came from the baseline wave of the China Longitudinal Aging Social Survey of 2014. Our final sample featured 8,404 older adults.Results: The results of structural equation modeling showed a good fit for the total sample (NFI = .909, IFI = .916, GFI = .963, RMSEA = .038) and indicated the significant direct impact of widowhood on depression among Chinese older adults. Moreover, the findings of mediating effects found compared with a married group, widowed older adults used less problem-focused coping and had more negative perceptions of aging, which in turn, predicted higher depression; they were also more likely to use emotion-focused coping, which in turn, predicted lower depression. The results of moderation analysis demonstrated that a higher level of negative perceptions of aging significantly worsened the adverse effects of widowhood on depression.Conclusion: Overall, our findings highlight the importance of a cognitive approach to targeting programs for widowed older adults in China, with a focus on strengthening their abilities to alter maladaptive copings styles and reauthor their life narratives.

Awareness of Age-Related Changes Among Middle-Aged and Older Adults: Longitudinal Trajectories, and the Role of Age Stereotypes and Personality Traits

Awareness of Age-Related Change (AARC) describes to what extent people become aware of changes which they attribute to getting older. So far little is known regarding how different AARC dimensions change over time, to what extent these changes in different domains of AARC gains and losses are interrelated, and which predictors account for inter-individual differences in within-person longitudinal trajectories. Specifically, the extent to which individuals perceive age-related gains and losses might be shaped by their chronological age, their personality as well as by their general views on aging (i.e., their age stereotypes). We investigated changes in global and domain-specific AARC gains and losses over about five years in a sample of originally N = 423 participants aged 40 to 98 years at baseline. We analyzed the role of personality traits and age stereotypes for levels and changes of AARC, taking into account participants' age at baseline and controlling for gender, education, and subjective health. Based on longitudinal multilevel regression models, we observed mean-level declines in most AARC gain domains. In contrast, perceived general AARC losses, as well as AARC losses in health and physical functioning, in cognitive functioning and in social-cognitive/socio-emotional functioning remained, on average, stable over time. Baseline scores on AARC gains (global scale) were higher among individuals with higher neuroticism, openness, conscientiousness and more positive age stereotypes. Additionally, the association of higher neuroticism with higher AARC gain scores was stronger among individuals with more positive age stereotypes. Higher neuroticism and more negative age stereotypes also predicted higher baseline scores on AARC losses (global scale). At the same time, higher neuroticism was associated with a steeper decrease in AARC loss perceptions over time. Most of the intercorrelations within the intercepts and within the intra-individual trajectories of the different AARC domains were positive, but small in size. Our findings show the importance of considering trajectories of age-related gains and losses in parallel and across multiple developmental domains when investigating the subjective perception of the aging process. They also suggest that personality traits and general age stereotypes are related with individual experiences of aging.

The Association Between Views of Aging and Subjective Cognitive Complaints in Older Adults: Findings From Two Samples

This cross-sectional study examined whether views of aging (VoA) relate to subjective cognitive complaints in two separate cohorts of older adults. Ageist attitudes, attitudes to aging (psychological loss, physical change, and psychological growth), subjective age, and subjective successful aging were examined. A moderating effect of chronological age was also examined. Samples included 572 adults aged 50 or older (Sample 1; mean age = 67.63, SD = 11.39, 49.4% female) and 224 adults aged 65 or older (Sample 2; mean age = 81.50, SD = 6.61, 75.3% female). More negative VoA (higher ageist attitudes, lower psychological growth, lower physical change, older subjective age, and less successful aging) were associated with more subjective cognitive complaints after controlling for covariates. An increase in chronological age strengthened some of these associations. Findings suggest that improving dimensions of VoA may have a complementary positive effect on subjective cognitive complaints in older adults.

The subjective life course framework: Integrating life course sociology with gerontological perspectives on subjective aging

The expansion of life expectancy has precipitated a cultural transformation of the life course - altering the perceived temporal contours of middle and later life. However, our understanding of these perceptions is limited by the absence of a framework within which to examine them. This paper builds on the life course perspective - which emphasizes the objective patterning of lives - by focusing on the subjective side of the life course. Drawing on theoretically, methodologically, and substantively diverse studies, this paper develops the concept of the subjective life course - a term we use to denote individuals' perceptions of the life course, including its structure and timing and their advancing location in it. We outline two dimensions of the subjective life course - the target of the perception (i.e., generalized other versus self) and the temporal frame of reference (i.e., past, present, or future). Using the resulting framework as an organizational tool, we then discuss key constructs located at each intersection along these dimensions, providing examples, where possible, of empirical studies examining them. We close with a discussion of two broad directions for research: leveraging the framework to yield insight on the subjective life course and exploring links between objective and subjective dimensions of the life course.

“Aging Means to Me… That I Feel Lonely More Often”? An Experimental Study on the Effects of Age Simulation Regarding Views on Aging

Over the last decades, educational programs involving age simulation suits (ASS) emerged with the ambition to further the understanding of age-related loss experiences, enhance empathy and reduce negative attitudes toward older adults in healthcare settings and in younger age groups at large. However, the impact of such “instant aging” interventions on individuals’ personal views on aging have not been studied yet. The aim of the current study is to address possible effects of ASS interventions on multiple outcomes related to views on aging, i.e., aging-related cognitions (i.e., expectations regarding social losses), awareness of age-related change (AARC) and age stereotypes. Moreover, we explore effects on broader constructs with relevance to aging, i.e., perceived obsolescence, risk perceptions, as well as desired support through technology. In a within-subjects design, N = 40 participants (M = 61.4 years, SD = 6.16) went through a series of established geriatric assessments (i.e., Timed up and Go) with and without an ASS. Views on aging constructs were assessed in standardized questionnaires before and after the ASS intervention. Changes in aging-related cognitions were observed, with more negative expectations regarding social integration and continuous development after wearing the ASS. AARC and age stereotypes did not change from pre- to post-assessment, but participants reported an increased susceptibility to age-associated impairments and stronger feelings of obsolescence. Those participants who exhibited higher difficulties in geriatric assessments while wearing the suit reported higher openness to be supported by intelligent assistive devices or robots afterwards. We conclude that ASS interventions should only be combined with education on losses and gains during the aging process to prevent negative effects on individual views on aging. On the other hand, potentials regarding technology acceptance and formation of intentions to engage in prevention and health behaviors among middle-aged to young-old adults are discussed.

Differences in awareness of positive and negative age-related changes accounting for variability in health outcomes

Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N = 6192; mean (SD) age = 66.1 (7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-squared tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one's ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.

Antecedents and Consequences of Endorsing Prescriptive Views of Active Aging and Altruistic Disengagement

In this study, we investigated endorsement of two types of prescriptive views of aging, namely active aging (e.g., prescriptions for older adults to stay fit and healthy and to maintain an active and productive lifestyle) and altruistic disengagement (e.g., prescriptions for older adults to behave altruistically toward the younger generation by granting young people access to positions and resources). The study comprised a large international sample of middle-aged and older adults (N = 2,900), covering the age range from 40 to 90 years. Participants rated their personal endorsement of prescriptive views of active aging and altruistic disengagement targeting older adults in general (i.e., "In my personal opinion, older adults should…"). Findings showed that endorsement was higher for prescriptions for active aging than for prescriptions for altruistic disengagement. Age groups in the sample differed regarding their endorsement of both prescriptive views of active aging and altruistic disengagement with older adults showing higher endorsement than middle-aged adults did. Prescriptive views of active aging and altruistic disengagement related positively to each other and to the superordinate social belief that older adults should not become a burden, which attests to their functional similarity. In contrast, prescriptive views of active aging and altruistic disengagement were associated with psychological adjustment in opposite ways, with endorsement of active aging (vs. altruistic disengagement) being related to better (vs. worse) adjustment outcomes such as life satisfaction and subjective health. Our findings highlight the internalization of prescriptive views of aging in older people and their implications for their development and well-being.

Awareness of age-related change in the context of major life events

Although gains and losses are an integral part of human development, the experience of change and readjustment that often comes with major life events may be particularly influential for an individual's subjective aging experience and awareness of age-related change (AARC). Thus, this study focused on the role of life events in the domains of family and health for an individual's awareness of age-related gains and losses. Specifically, we differentiated between the experience of specific life events (e.g., entering a new romantic relationship; hospital stay) and the cumulative experience of multiple life events. Furthermore, we differentiated between life events experienced at an expected time in life and life events experienced relatively early or relatively late compared to established social norms. Data came from the Innovation Sample of the German Socio-Economic Panel (SOEP-IS) and consisted of 1,612 participants aged 16 to 93 years (M = 54.1; SD = 18.2). Life events were assessed annually and retrospectively for the last 2 years. Propensity score matching provided evidence for an association of specific family life events and a higher awareness of age-related gains, as well as specific health life events and a higher awareness of age-related losses. Results furthermore indicated that the cumulative experience of family life events was associated with a higher awareness of age-related gains. Conversely, the cumulative experience of health events was associated with higher awareness of both age-related losses and age-related gains. Moreover, it was not only life events happening at an expected age, but also those happening relatively early and particularly those happening late in life, which were associated with AARC. In summary, life events and the change they may bring seem to be reflected in individuals' awareness of age-related losses and awareness of age-related gains.

The Influence of Dementia Beliefs and Knowledge on Perceived Dementia Worry: An Empirical Study Among Adults in Rural China

Alzheimer's disease and related dementias are more prevalent in rural areas than in urban areas in China. This study aims to examine the role of dementia beliefs and knowledge in influencing dementia worry among rural adults in China. Data were generated in a cross-sectional survey of 577 participants. Hierarchical regression analyses found that both the beliefs and knowledge of dementia contributed to higher levels of dementia worry. The propensity score matching method affirmed the robustness of regression results. In addition, those aged 45-64 reported higher worry about dementia than those aged 65 or older, while being married was related to lower dementia worry. As one of the first kind studies that examined dementia worry in rural Chinese population, our findings suggest that policy and practice efforts should address cultural beliefs of dementia as they contributed to higher worry about dementia in rural areas.

Awareness of age-related changes in Norwegian individuals 50+. Short form questionnaire validation

BACKGROUND

A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany, and validated for the UK and Brazilian populations. In this study, we validated the short-form measure (AARC-10 SF) in the Norwegian population aged 50 and over. In addition, the relationship between cognitive variables and AARC was examined.

METHODS

Cross-sectional analyses of data from 1,510 participants in the ongoing online PROTECT Norge study were used to explore and confirm the two-factor structure of AARC gains and AARC losses; reliability; measurement invariance across different population groups defined by sex, education level, employment, and in middle age, early old age, and advanced old age. We explored the relationship between AARC and demographic variables (defined in the same way as the population groups).

RESULTS

We confirmed the two-factor structure (gains and losses) of the Norwegian translation of the AARC-10 SF. We did not find mutual correlations between related items in gains and losses, except for the physical health item from the gains dimension, which was positively correlated with all items of the losses dimension. Age, sex, marital status, employment, and university education predicted AARC gains and losses.

CONCLUSION

The Norwegian translation of the AARC-10 SF captures individuals' positive and negative self-perceptions of age-related changes in their mental, physical, and cognitive health.

Awareness of age-related change in very different cultural-political contexts: A cross-cultural examination of aging in Burkina Faso and Germany

Combining recent developments in research on personal views on aging (VoA) and a cross-country comparative approach, this study examined awareness of age-related change (AARC) in samples from rural Burkina Faso and Germany. The aims of this study were (1) to examine for an assumed proportional shift in the relationship between gains/losses toward more losses as predicted by life span psychology; (2) to estimate the association between AARC dimensions and subjective age; and (3) to examine the association between health variables and AARC. A cross-sectional method involving a large, representative sample from rural Burkina Faso that included participants aged 40 and older (N = 3,028) and a smaller convenience sample of German respondents aged 50 years and older (N = 541) were used to address these questions. A proportional shift toward more AARC-losses was more clearly observable in the sample from Burkina Faso as compared to the German reference. In both samples, subjective age was consistently more strongly related to AARC-losses than to AARC-gains. Within the sample from Burkina Faso, differential associations of AARC-gains and AARC-losses to health variables could be shown. In conclusion, the findings support key tenets of life span psychology including that age-related gains occur even late in life and that a shift toward more losses occurs with increasing age. Also, feeling subjectively younger may indeed be more strongly guided by lowered negative aging experiences than by increased positive ones.

Embedding the silver thread in all-age psychological services: training and supervising younger therapists to deliver CBT for anxiety or depression to older people with multi-morbidity

Providers of cognitive behavioural therapy (CBT) in adult mental health services in the UK are expected to deliver therapy suitable for adults of all ages. However, older people commonly present with co-morbidities that challenge delivery of single-diagnosis CBT protocols. Added to this, the difference in age between therapy-provider and service-user can compromise collaboration. In this paper, I consider two key areas of relevance for training and supervising CBT therapists for work with older people, namely multi-morbidities and intergenerational relations. The evolving evidence base for CBT with older people is summarised and a commentary provided on previous ‘old age’ case studies from the Cognitive Behaviour Therapist (tCBT). Strategies for collaborative relationships are discussed, as are strategies for ‘embedding the silver thread’. I conclude with recommendations for future directions for CBT training and supervision.

Key learning aims

(1)

Awareness of age-related change, chronological age, subjective age and proactivity: An empirical study in China

An aging workforce and the increasing value placed on employees' proactivity are two important features of current workplaces. We address the extent to which this proactivity is affected by age and aging. The study has two objectives. First, it aims to validate the concept of awareness of age-related change (AARC) in the Chinese context. Second, it compares the explanatory power of AARC with that of chronological age and subjective age in predicting three types of proactivity: task proactivity, development proactivity and organization proactivity. We used the ten-item AARC instrument in a survey of teachers (n = 421, mean age = 41.0) in China, and validated its content by comparing the responses of a subsample of these teachers (n = 33, mean age = 42.5) to questions asked in a semi-structured interview. This confirmed the validity of the instrument's content, and its applicability beyond North America and Europe, in a Chinese context. We then show that awareness of positive and negative age-related changes (AARC-Gains and AARC-Losses) are, respectively, positively and negatively associated with the three types of proactivity, and that they are better predictors than chronological age and subjective age. The research adds weight to challenges to negative age stereotyping--that older employees are set in their ways and less proactive--and to claims about the value of AARC for measuring aging, by showing that this factor can predict outcomes beyond health and the concerns of older adults.

Impacts of biophilic design on the development of gerotranscendence and the Profile of Mood States during the COVID-19 pandemic

To live in a good mood is not only a key consideration for future age-friendly communities, but also a critical necessity for positive ageing. Despite growing evidence of correlations between contact with nature and stress reduction, little is known about the effect of nature integration in indoor environments. Thus, this study aimed to answer the following research questions: (a) How do biophilic characteristics of home environments correlate with older adults’ experience of the multiple levels of the theory of gerotranscendence? and (b) What is the relationship between these experiences and the mood states of these older adults? The study was based on a comparative analysis to scrutinise the impact of the COVID-19 pandemic on these questions. The data were gathered through questionnaires with 450 older adults aged between 65 and 95 years, and stratified by the biophilic characteristics of their living environments: indoor biophilic, outdoor biophilic and non-biophilic. Two sets of data were collected with the same participants, respectively, before the COVID-19 pandemic (June to October 2018) and during the COVID-19 pandemic (June to October 2020). It found that the biophilic characteristics of home environments are correlated dynamically with older adults’ ageing experience and mood states. The study indicates that outdoor biophilic features facilitate the recovery of tension mood effects of the COVID-19 pandemic, whereas indoor biophilic features facilitate recovery from depression and anger.