The structure of the Philadelphia Geriatric Center Morale scale: a reinterpretation

Loneliness and low life satisfaction associated with older adults' poor oral health

Objective

To examine the association of older adults' loneliness, life satisfaction, and other psychological stressors and resources with oral health status.

Methods

This study merged 2018 data from the Health and Retirement Study (HRS) CORE survey with the HRS-Dental Module, and Psychosocial and Lifestyle Questionnaire-Panel A "Leave Behind" surveys (HRS-LB)(N = 418). Dental Module outcomes of interest were self-rated oral health status (SROH), and oral health-related quality of life (OHQOL). Older adults reported on loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors. Three distinct profiles based on the distribution of loneliness and life satisfaction were previously identified in the combined HRS and HRS-LB study population (N = 4,703) using latent class analysis (LCA). Class A:"Not Lonely/Satisfied" adults had the fewest psychosocial risk factors and most resources; Class C:"Lonely/Unsatisfied" adults exhibited the opposite profile (most risk factors, fewest resources); Class B:"Lonely/Satisfied" adults exhibited loneliness with favorable life satisfaction. Regression models examined associations between LCA classes and fair/poor SROH and the OHQOL scale score and individual items, after adjusting for socio-demographics.

Results

About 13% of older adults experienced loneliness, and about 16% reported low life satisfaction. About one-quarter (28%) of older adults reported fair/poor SROH, and they experienced more psychosocial risk factors than their counterparts with better oral health status. Nearly half the older adults were categorized in Class A:"Not Lonely/Satisfied" (n = 201), and about one-quarter each in Class B:"Lonely/Satisfied" (n = 103) and Class C:"Lonely/Unsatisfied" (n = 112). In fully adjusted models, Class B older adults had 1.81 (1.11-2.96) times greater odds of fair/poor SROH, and Class C had 4.64 (2.78-7.73) times greater odds of fair/poor SROH than Class A. Fully adjusted linear regression model results indicated a gradient by LCA class. OHQOL varied; Class A older adults had the best (lowest) OHQOL score (mean = 8.22, 4.37-12.10), Class B scored in the middle (mean = 12.00, 7.61-16.50), while Class C had the worst (highest) OHQOL score (mean = 16.20, 11.80-20.60).

Conclusion

Loneliness, as a defining characteristic distinguishing three latent classes of older adults, was associated with more risk factors and poorer oral health outcomes. Loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors vary widely for older adults and matter for oral health and OHQOL.

Needs and Challenges for Volunteering in Rural Areas: Lessons Learned From a Survey of a Service Organization in Rural Michigan

BACKGROUND AND OBJECTIVES

Volunteers are the foundation of social service agencies in rural communities, yet limited research exists on their needs and challenges. Motivated by the multidimensional older voluntarism sustainability framework, this study aims to understand (1) the characteristics of volunteers, (2) the relationships between volunteers' sense of community and their own aging and volunteer retention, and (3) the unique challenges faced by volunteers and volunteer-based agencies.

RESEARCH DESIGN AND METHODS

This study uses a mixed-methods design. Data were gathered via telephone interviews (n = 76) and in-person focus groups (n = 14) from the volunteer pool of a nonprofit organization in rural Michigan. Descriptive and regression analyses were conducted to understand the characteristics of the volunteers. Thematic analysis was conducted to identify unique challenges faced by rural agencies and volunteers.

RESULTS

Findings show that most volunteers were over 70, women, married, volunteered weekly or more, and were affiliated with multiple agencies. Volunteers with a stronger attachment to the community and higher self-perceptions of aging were likelier to continue and increase volunteering commitments. Due to the low population density in rural areas, volunteers were concerned about the heavy burden of volunteering, the lack of social connections with fellow volunteers, and the lack of active involvement in shaping the organization.

DISCUSSION AND IMPLICATIONS

Results from the study shed light on the urgent need for creative and engaging volunteer recruitment and retention strategies to sustain older adults, service agencies, and communities in rural areas.

Perceived ageism and psychosocial outcomes during the COVID-19 pandemic

BACKGROUND

In light of the existing knowledge gap in this research area (particularly based on representative samples and research conducted during the pandemic), the objective of this study was to explore the association between perceived ageism and psychosocial outcomes (i.e., in terms of life satisfaction, loneliness, social isolation, aging satisfaction and depressive symptoms) among middle-aged and older adults during the COVID-19 pandemic based on nationally representative data.

METHODS

We used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. Specifically, wave 7 of the German Ageing Survey (conducted from November 2020 to March 2021) was analyzed, consisting of a sample of 4,167 individuals with an average age of 68.7 years (SD: 10.1 years; ranging from 46 to 98 years). Established instruments were employed to measure psychosocial outcomes.

RESULTS

Regressions showed that the presence of perceived ageism was significantly associated with unfavorable psychometric outcomes (i.e., higher loneliness: β = 0.29, p < 0.001; higher perceived social isolation: β = 0.32, p < 0.001; more depressive symptoms: β = 2.68, p < 0.001; lower life satisfaction: β=-0.28, p < 0.001; higher negative affect: β = 0.21, p < 0.001; lower aging satisfaction: β=-0.19, p < 0.001), except for positive affect (β=-0.06, p = 0.10). Stratified by age group (i.e., individuals 40 to 64 years; individuals aged 65 years and over, see Tables 3 and 4), comparable results were obtained in terms of significance.

CONCLUSIONS

Perceived ageism was associated with unfavorable psychosocial outcomes. This knowledge can help reduce vulnerability to negative psychosocial factors in people in the middle and later years of life.

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.

Cognitive flexibility's role in shaping self-perception of aging, body appreciation, and self-efficacy among community-dwelling older women

BACKGROUND

Cognitive flexibility, the capacity to adjust to new information, affects how aging is perceived. In Egyptian culture, older women's views on aging are shaped by societal gender roles and expectations. These views influence their body image and belief in their abilities, all melded by cultural standards and values.

AIM

Investigate the mediating role of cognitive flexibility in the relationship between self-aging perception, body appreciation, and self-efficacy among community-dwelling older women.

METHODS

A correlational analytical design was used on 200 women aged 60 years or older using the Cognitive Flexibility Inventory, Self-Perceptions of Aging, General Self-Efficacy Scale, and Body Appreciation Scales. Structural equation modeling was used in the analysis.

RESULTS

The study found that cognitive flexibility is positively related to self-perception of aging and body appreciation and is also significantly related to general self-efficacy. However, no significant relationship was found between body appreciation and general self-efficacy. Additionally, the study found that cognitive flexibility partially mediates the relationship between self-perception of aging and body appreciation and fully mediates the relationship between body appreciation and self-efficacy.

CONCLUSION

Cognitive flexibility is vital in the relationships between self-perceptions of aging, body appreciation, and self-efficacy among older women. Therefore, nursing interventions targeting cognitive flexibility are recommended to promote positive self-aging perceptions, body appreciation, and self-efficacy in this population.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

DISCUSSION

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

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

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

Sexual satisfaction and aging satisfaction among middle-aged and older adults. Evidence from a nationally representative study

AIM

To examine the association between sexual satisfaction and aging satisfaction (also stratified by sex and age group).

METHODS

We used data from the German Ageing Survey (year 2008, n = 5,418 individuals). This is an established, nationally representative sample of individuals living in private households aged 40 years and over in Germany. The widely used "Attitudes Toward Own Ageing" (ATOA) subscale of the established Philadelphia Geriatric Morale Scale was used to quantify aging satisfaction. It was adjusted for several covariates in regression analysis.

RESULTS

After adjusting for sociodemographic and health-related covariates, multiple linear regressions still showed that higher sexual satisfaction was associated with higher aging satisfaction in the total sample (β = 0.06, p < .001). This association was also present among both sexes (men, β = 0.07, p < .001; women, β = 0.06, p < .001) as well as among both age groups (middle-aged adults: β = 0.07, p < .001; older adults: β = 0.06, p < .001).

CONCLUSIONS

Even after adjusting for several covariates, there is a clear link between sexual satisfaction and aging satisfaction. Such knowledge may assist in maintaining satisfaction with aging and may thus contribute to successful aging.

Internalization of negative societal views on old age into self-perceptions of aging: exploring factors associated with self-directed ageism

Introduction

A growing number of research has provided evidence for the negative impact of ageism on older people's health and well-being. Among the three different manifestations of ageism, namely institutional, interpersonal and self-directed ageism, significant ageism-health associations have been proved to be strongest for self-directed ageism. This supports stereotype embodiment theory, which maintains that lifetime exposure to negative age stereotypes leads to the internalization of ageism as a form of negative attitudes towards own aging and it adversely affects health and well-being in old age. However, little is known about how people internalize negative age stereotypes held in the society into self-perceptions of aging.

Methods

This study aimed to explore how socially shared beliefs about old age are internalized into self-perceptions of aging focusing on uncovering factors related to self-directed ageism. Data were derived from the survey that had examined citizen's attitudes towards old age and aging in Finland. Multinominal logistic regression models were performed to examine the association of sociodemographic and contextual factors with different combinations of societal age stereotypes and two indicators of self-perceptions of aging: subjective views on old age and personal feelings of own old age.

Results

The analyses showed that being female, attaining tertiary education, evaluating poor quality of life and awareness of institutional old age discrimination were related to holding negative views on aging towards both society and oneself.

Discussion

The findings from univariate and multivariate models suggest that it is not age per se, but structural and cultural circumstances shaped with growing older that turns socially shared negative age stereotypes into negative self-perceptions of aging. Even though the study addressed situations in one country, the findings have an important implication for other rapidly aging societies regarding how social and cultural contexts are closely linked to the formation of self-directed ageism.

The Impact of Caregiving History on Later-Life Self-Perceptions of Aging

OBJECTIVES

Theories suggest that self-perceptions of aging (SPA) reflect structural and cultural ageism together with an individual's personal life experiences. We examine the impact of an individual's history of informal caregiving on their SPA.

METHODS

Using data from the Health and Retirement Study (HRS, N = 8,372, age range 50-102 years), we investigated caregiving history as a determinant of later-life SPA. HRS participants provided reports of up to 5 episodes of caregiving, the life-course timing of each episode (start/end year), and their relationship with the care recipients. SPA was measured by the HRS Attitudes Toward Own Aging Scale. We conducted linear regressions to examine associations between specific caregiving histories and later-life SPA. Models included controls for current sociodemographic and health status.

RESULTS

Individuals who were ever a caregiver reported more negative SPA than noncaregivers. Variations in the impact of histories of caregiving were also revealed. Specifically, compared to people who had cared for adult(s) only, HRS participants who cared for both a child with special needs and an adult reported more negative SPA later in life.

DISCUSSION

The study provides insight into potential life-course precursors of SPA and highlights the importance of conceptualizing caregiving history as a complex life experience that might affect an individual's SPA later in life.

The Conceptual and Methodological Characteristics of Ageism During COVID-19: A Scoping Review of Empirical Studies

BACKGROUND AND OBJECTIVES

Printed and social media, as well as professional and scholarly platforms, have extensively discussed the proliferation of ageism during the coronavirus disease 2019 (COVID-19) pandemic. However, no study has systematically examined the body of knowledge on the topic. Framed around the characteristics of ageism in general, the aim of this review was to identify and characterize the conceptual and methodological underpinnings of the global, peer-reviewed, and empirical literature on ageism during COVID-19.

RESEARCH DESIGN AND METHODS

We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using PubMed, CINAHL, AgeLine, and PsycINFO. Quantitative and/or qualitative, English-language, and peer-reviewed articles were included. Data were tabulated and synthesized.

RESULTS

Thirty six articles examining ageism during the COVID-19 pandemic met inclusion criteria. Most were quantitative (64%) and cross-sectional (81%). The level, correlates, and consequences of ageism during the pandemic were similar to the ones reported before it. Studies about ageism during COVID-19 had similar conceptualization and measurement problems to those before the pandemic.

DISCUSSION AND IMPLICATIONS

Empirical studies did not find ageism during COVID-19 to be a unique phenomenon, as suggested by the media. More theoretically sound and methodologically rigorous studies, using longitudinal designs and validated unique measures are needed to examine this unique phenomenon.

Dance to Prosper: Benefits of Chinese Square Dance in QOL and the Moderating Roles of Aging Stereotypes

BACKGROUND

By examining the effect of Chinese square dance duration through a positive activity model and discussing the impact of aging stereotype internalization, this study examined the relationships between dance duration, attitudes toward own aging (ATOA), aging stereotypes, and quality of life.

METHODS

403 Chinese square dance participants were recruited to complete a 7-day diary survey in a cross-sectional design. Participants reported on their ATOA, aging stereotypes, perceived quality of life, and everyday dance participation during the week. Data were analyzed using latent variable structural equation modeling.

RESULTS

Increased dance participation improved quality of life, and the mediation by ATOA was determined. Positive and negative aging stereotypes separately moderated the mediating process. In general, people who had relatively stronger negative stereotypes benefited more from dancing duration, while people with stronger positive stereotypes felt no such dose effect.

CONCLUSIONS

The results suggest that an attitudinal pathway explains the positive activity dose effect, and people with more negative aging stereotypes are encouraged to practice Chinese square dance to benefit from certain effects.

Ageism from a cross-cultural perspective: results from a national survey of Israelis over the age of 50

OBJECTIVES

We examined differences across three groups in Israel to test the double jeopardy versus the intersection escape hypotheses-which evaluate whether being older and belonging to an underrepresented group serves as a double burden, exposing older minorities to higher levels of perceived ageism or on the contrary, older age serves as a protective factor, especially for underrepresented groups.

DESIGN

A cross-sectional, nationally representative sample, consisting of three groups: Veteran Israelis, Israeli Arabs and immigrants from the Former Soviet Union. The latter two groups represent underrepresented (minority) populations in Israel.

SETTING

Community-dwelling Israelis over the age of 50.

PARTICIPANTS

The sample was composed of 1570 participants.

MEASUREMENT

To examine the double jeopardy versus the intersectional escape hypothesis, self-perceptions of aging (SPA) and perceived age-based discrimination in the healthcare system were examined as outcome variables.

RESULTS

Among Israeli Arabs, being older was related to better SPA, whereas among the immigrants being older was related to worse SPA. As immigrants became older, they were more likely to report ageist experiences. Israeli Arabs reported higher levels of ageist experiences, regardless of their age.

CONCLUSIONS

The findings point to certain groups that require education about ageism and the aging processes and might require further protection from the experiences of ageism. The findings also point to the relevance of different theoretical paradigms that advocate for the consideration of culture and group membership in the understanding of the experiences of ageism.

C-Reactive Protein, Subjective Aging, and Incident Cardiovascular Disease: A Mediation Model

OBJECTIVES

Negative self-perceptions of aging (SPA) and an older subjective age are associated with a greater likelihood of cardiovascular disease. We predicted that C-reactive protein (CRP), a marker of stress-related inflammation, would mediate this relation.

METHOD

Data from up to 6 602 participants ages 50-101 in the Health and Retirement Study (2008-2018) were analyzed using logistic regressions with mediation. Subjective aging was assessed in 2008 or 2010, CRP was assessed 2 years later, and diagnosis of heart disease or stroke was assessed in the years from CRP measurement to 2018.

RESULTS

Significant indirect effects occurred in all models, indicating that negative SPA and older subjective age are associated with a greater likelihood of heart disease and stroke through elevated levels of the inflammatory marker CRP.

DISCUSSION

These findings suggest that psychological factors such as subjective aging impact cardiovascular health through physiological mechanisms, specifically markers of inflammation.

Self-perceptions of aging and depressive symptoms: the mediating role of loneliness

Objectives: Depression is a major health concern for both individuals and societies. Hence, understanding the risk factors for depression is of importance. As individuals grow older, the way in which they perceive the aging process may have a significant influence on their physical and mental health. More negative perceptions of aging could put individuals at risk for social withdrawal, causing loneliness and resulting in higher levels of depressive symptoms.Methods: We use the Health and Retirement Survey, a large and longitudinal dataset spanning over a period of 8 years, to examine a model in which loneliness mediates the relationship between self-perceptions of aging and depressive symptoms.Results: Our findings suggest that loneliness indeed mediates the relationship between self-perceptions of aging and depressive symptoms.Conclusions: The results highlight to the importance of the way people view the aging process in shaping their social and mental well-being. Practitioners may want to address self-perceptions of aging when helping older adults cope with loneliness and depressive symptoms.

Social Disconnectedness and Loneliness: Do Self-Perceptions of Aging Play a Role?

OBJECTIVES

Research suggests that self-perceptions of aging (SPA) have effects on physical, mental, cognitive, and emotional well-being among older adults. Few studies have examined the effects of SPA on social well-being. This study investigates the association of SPA with trajectories of social disconnectedness and loneliness in older Americans and explores mechanisms linking SPA and the 2 forms of social isolation.

METHODS

We conducted Latent Growth Curve Modeling and path analysis using 3-wave data spanning 8 years (2008/2010-2016/2018) from the Health and Retirement Study. The sample included respondents aged 65 and older (N = 3,597) at baseline (2008/2010). SPA was measured by the Attitudes Toward Own Aging Scale. Social disconnectedness was an index including 6 indicators of social networks and social engagement. Loneliness was measured using the 11-item UCLA Loneliness Scale.

RESULTS

Older adults with more negative SPA at baseline were more lonely but had slower rates of increase in loneliness during the 8-year study period. More negative SPA also predicted greater social disconnectedness but was not significantly related to the rate of change in social disconnectedness over time. The effects of SPA on social disconnectedness were primarily indirect through loneliness, whereas SPA had direct effects on loneliness. Overall, SPA had a stronger association with loneliness than with social disconnectedness.

DISCUSSION

The results suggest that older adults with negative SPA are at risk of loneliness which then leads to social disconnectedness. Asking about SPA during individual assessment with older adults may help to discern issues with loneliness.

American Older Adults in COVID-19 Times: Vulnerability Types, Aging Attitudes, and Emotional Responses

The Coronavirus Disease (COVID) pandemic has aroused challenges to emotional well-being of the individuals. With 1,582 respondents from the Health and Retirement Survey (HRS), this study investigates the heterogeneity in older adults' vulnerability and examines the relationship between vulnerability types, aging attitudes, and emotional responses. International Positive and Negative Affect Schedule Short-form (I-PANAS-SF) and Attitudes toward own aging (ATOT) were used to assess the emotional experiences and aging attitudes, and 14 kinds of pandemic-related deprivations evaluated vulnerability of individuals. Latent class analysis (LCA) was used to explore the vulnerability types, and weighted linear regressions examined the relationship between vulnerability, aging attitudes, and emotional responses. The results showed that the proportion for individuals with mild vulnerability (MV), healthcare use vulnerability (HV), and dual vulnerability in healthcare use and financial sustainment (DVs) was 67, 22, and 11%, respectively. Older adults aged below 65, Hispanics and non-Hispanic Blacks, and those not eligible for Medicaid were more likely to have HV or DVs. The relationship between vulnerability and positive emotions (PAs) was non-significant, yet individuals with HV (beta = 0.10, standard error [SE] = 0.16) or DVs (beta = 0.09, SE = 0.28) were likely to have more negative emotions (NAs) than their mildly vulnerable counterparts. Furthermore, aging attitudes moderated the relationship between vulnerability and emotions. The salutary effect of positive aging attitudes on emotional well-being was more significant among people with DVs than those with MV (beta = 0.20, SE = 0.04 for positive responses; beta = −0.15, SE = 0.04 for negative responses). Thus, we urge more attention for vulnerable older adults in a pandemic context. Meanwhile, encouraging positive aging attitudes might be helpful for older adults to have better emotional well-being, especially for those with DVs.

“Old age scares me”: Exploring young adults' feelings about aging before and during COVID-19

Negative messages about aging dominate public discourse about the COVID-19 pandemic as older adults have been classified as members of a “vulnerable” population due to their chronological age. To explore young adults' feelings about aging before and after the emergence of COVID-19, we collected 794 qualitative questionnaires during the fall of 2017 and another 463 responses during the fall of 2020. We drew on the concepts of age-based stereotypes and future selves to guide our thematic analysis of the data. Findings captured young adults' feelings about aging at two distinct points in time and demonstrate the complex ways the communication contributed to shifting feelings about aging. In doing so, we highlight the role that portrayals of aging play in shaping young adults' feelings about aging and their perception of their future selves. These findings offer conceptual contributions about communication, context, and aging.

Subjective Wellbeing and Related Factors of Older Adults Nine and a Half Years after the Great East Japan Earthquake: A Cross-Sectional Study in the Coastal Area of Soma City

This study examined older adults’ subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton’s Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member’s health. Older adults’ subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.

Associations Between Satisfaction With Aging and Health and Well-being Outcomes Among Older US Adults

IMPORTANCE

Researchers and policy makers are expanding the focus from risk factors of disease to seek potentially modifiable health factors that enhance people's health and well-being. Understanding if and to what degree aging satisfaction (one's beliefs about their own aging) is associated with a range of health and well-being outcomes aligns with the interests of older adults, researchers, health systems, and politicians.

OBJECTIVES

To evaluate associations between changes in aging satisfaction and 35 subsequent health and well-being outcomes.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used data from the Health and Retirement Study, a national, diverse, and longitudinal sample of 13 752 US adults older than 50 years, to evaluate if changes in aging satisfaction (between combined cohorts from 2008 and 2010 and 4 years later, in 2012 and 2014) were subsequently associated with 35 indicators of physical, behavioral, and psychosocial health and well-being in 2016 and 2018. Statistical analysis was conducted from July 24, 2020, to November 6, 2021.

EXPOSURE

Aging satisfaction.

MAIN OUTCOMES AND MEASURES

A total of 35 physical (eg, stroke), behavioral (eg, sleep problems), and psychosocial (eg, depression) outcomes were evaluated using multiple linear and generalized linear regression models. Data from all participants, irrespective of how their levels of aging satisfaction changed from the prebaseline to baseline waves, were incorporated into the overall estimate, which was conditional on prior satisfaction.

RESULTS

During the 4-year follow-up period, participants (N = 13 752; 8120 women [59%]; mean [SD] age, 65 [10] years; median age, 64 years [IQR, 56-72 years]; 7507 of 11 824 married [64%]) in the highest (vs lowest) quartile of aging satisfaction had improved physical health (eg, 43% reduced risk of mortality [risk ratio, 0.57; 95% CI, 0.46-0.71]), better health behaviors (eg, 23% increased likelihood of frequent physical activity [risk ratio, 1.23; 95% CI, 1.12-1.34]), and improved psychosocial well-being (eg, higher positive affect [β = 0.51; 95% CI, 0.44-0.58] and lower loneliness [β = -0.41; 95% CI, -0.48 to -0.33]), conditional on prebaseline aging satisfaction.

CONCLUSIONS AND RELEVANCE

This study suggests that higher aging satisfaction is associated with improved subsequent health and well-being. These findings highlight potential outcomes if scalable aging satisfaction interventions were developed and deployed at scale; they also inform the efforts of policy makers and interventionists who aim to enhance specific health and well-being outcomes. Aging satisfaction may be an important target for future interventions aiming to improve later-life health and well-being.

The Relationship Between Perceived Age Discrimination in the Healthcare System and Health: An Examination of a Multi-Path Model in a National Sample of Israelis Over the Age of 50

OBJECTIVES

The present study aims to examine possible pathways that potentially account for the relationship between perceived age discrimination in healthcare settings (as one form of ageism) and health outcomes.

METHODS

We relied on 1570 complete surveys, which constitute a representative national sample of adults aged 50 and above in Israel.

RESULTS

We found a direct link between perceived age discrimination and health outcomes. This link was partially mediated by self-perceptions of aging and subsequently by health behaviors (e.g., eating vegetables) and preventive health behaviors (e.g., medical check-ups). The link between perceived age discrimination and health behaviors was moderated by age, thus, particularly detrimental for older people over the age of 65 as compared with those between the ages of 50 and 65.

DISCUSSION

This study adds to the literature as it examines comprehensive mechanisms to account for the path between perceived age discrimination and health status. Our findings point to the unique aspects associated with perceived age discrimination, which potentially make older people more susceptible to its negative effects.

Cognitive Interference in the Context of Daily Stressors, Daily Awareness of Age-Related Change, and General Aging Attitudes

OBJECTIVES

Previous diary work indicates that older people experience more intrusive and unwanted thoughts (i.e., cognitive interference) on days with stressors. We examined additional predictors of daily cognitive interference to enhance understanding of the psychological context surrounding this link. We specifically focused on factors related to subjective experiences of aging based on studies that have related higher stress and impairments in cognition such as executive control processes (working memory) to negative age stereotypes. Consistent with these findings, we generally expected stronger stress effects on cognitive interference when daily self-perceptions of aging (i.e., within-person fluctuations in awareness of age-related losses [AARC losses]) and general aging attitudes (i.e., individual differences in attitudes toward own aging [ATOA]) were more negative.

METHODS

Participants (n = 91; aged 60-80) on Amazon's Mechanical Turk completed surveys on 9 consecutive days, reporting on their ATOA (Day 1) as well as their stressors, AARC losses, and cognitive interference (Days 2-9).

RESULTS

Multilevel models showed that people reported more cognitive interference on days with more AARC losses. Individuals with positive ATOA also experienced less cognitive interference on days with more stressors, whereas those with negative ATOA experienced more.

DISCUSSION

Both individual differences and fluctuating daily perceptions of aging appear to be important for older adults' cognitive interference. Consistent with other work, positive ATOA protected against daily stressor effects. Further elucidating these relationships can increase understanding of and facilitate efforts to improve (daily) cognitive experiences in older adults.

Longitudinal Dyadic Effects of Aging Self-Perceptions on Health

OBJECTIVES

Adults' perceptions of aging are known to affect their mental and physical health. However, not much is known about how perceptions of aging within the couple-unit affect each member of the unit. Therefore, the current study explores the effects of husbands' and wives' self-perceptions of aging (SPA) on each other's physical and mental health, both directly and indirectly, through impacting each other's SPA.

METHOD

The study used data from the Health and Retirement Study, focusing on couples aged 50 and older. Self-rated health and Center for Epidemiological Studies Depression scale (CES-D) were used as indicators of physical and mental health. SPA was measured using the "Attitudes toward aging" subscale of the "Philadelphia Geriatric Center Morale Scale." An actor-partner interdependence mediation model was used to examine the effects of the 2008 SPA of couples on each other's 2012 SPA and 2016 health.

RESULTS

The SPA of both husbands and wives was associated with their own future mental and physical health in 2016, but not with that of their partner. However, their SPA was associated with their partner's health indirectly, by influencing the SPA of the partner. That is, the SPA of both husbands and wives in 2008 impacted their partner's SPA in 2012, which was subsequently related to that partner's mental and physical health in 2016.

DISCUSSION

Older couples can influence each other's health indirectly, by affecting each other's SPA. This indicates that adults' SPA are interconnected, and thus, the entire couple-unit should be targeted to enhance positive SPA.

Changes in depressive symptoms from pre- to postretirement over a 20-year span: The role of self-perceptions of aging

BACKGROUND

Retirement-related changes in depressive symptoms are not clear. This research examined short- and long-term changes in older adults' depressive symptoms before, upon, and after retirement. It also tested if and how changes in depressive symptoms varied by different levels of negative self-perceptions of aging (nSPA) in men and women.

METHODS

We analyzed longitudinal data from individuals who retired between 1994 and 2016 in the Health and Retirement Study (N = 9027). Using fixed-effect regression models, we examined changes in depressive symptoms from the 10-year preretirement phase through the 10-year postretirement phase. We also examined how changes in depressive symptoms during the retirement transition varied across four groups: low nSPA men, low nSPA women, high nSPA men, and high nSPA women.

RESULTS

Both male and female retirees experienced increased short- and long-term depressive symptoms after retirement. However, the pattern of change varied by nSPA and gender. For both low nSPA men and women, there were no significant changes in depressive symptoms across different retirement phases. Adults with high nSPA showed important changes in depressive symptoms, but there were gender differences-High nSPA men experienced increases in depressive symptoms mainly in preretirement years and during the year of retirement; high nSPA women experienced symptoms increase during the year of retirement and the years after retirement.

LIMITATIONS

The use of self-report measures may lead to recall bias. Studies are needed to understand mechanisms behind the protective role of low nSPA.

CONCLUSIONS

The findings attest to the health benefits of low nSPA during later-life stages.

Self-perceptions of ageing, GP visits and frequent attendance. Longitudinal findings from the German Ageing Survey

OBJECTIVES

The aim of this study was to clarify the link between self-perceptions of ageing and the number of general practitioner (GP) visits, as well as frequent GP visits, longitudinally.

METHODS

In this study, longitudinal data with n = 7,062 observations from 2014 (wave 5) to 2017 (wave 6) were taken from the German Ageing Survey (representative sample of middle aged and older individuals residing in private households). The five-item Attitudes Toward Own Ageing subscale of the Philadelphia Geriatric Center Morale Scale (PGCMS) was used to quantify self-perceptions of ageing. The frequency of GP visits in the past 12 months served as outcome measure (first model: measured continuously; second model: top 10% were defined as frequent attenders). To exploit the features of panel data, and to mitigate the problem of unobserved heterogeneity, fixed effects regressions were used.

RESULTS

Adjusting for predisposing characteristics, enabling resources and need-factors, regressions showed that an increase in self-perceptions of ageing was associated with decreases in the number of GP visits (IRR= .83 (95% CI: .77-.91)), and a decreased likelihood of becoming a frequent attender (OR= .44 (95% CI: .29-.66)).

CONCLUSIONS

Using data from a longitudinal study and exploiting the longitudinal data structure, the current study adds to our current knowledge by demonstrating that self-perceptions of ageing contribute to the frequency of GP visits as well as frequent attendance. Since self-perceptions of ageing are modifiable, this may help to manage health care use.

Exploring Lifestyle Activities to Reduce Internalized Ageism: Self-Efficacy as a Mediator Between Exercise, Volunteering, Computer Use, and Self-Perceptions of Aging

The objective of this study is to test self-efficacy as a mediator in the relationship between three lifestyle activities (exercise, volunteering, and computer use) and self-perceptions of aging (SPA) among older adults. We hypothesize that increased self-efficacy will mediate the relationship between lifestyle activities and more positive SPA. This is a cross-sectional, secondary data analysis drawn from the 2016 wave of the Health and Retirement Study (HRS; n = 4,561). Bootstrapping procedures were applied to test the significance of the indirect effects of self-efficacy in the relationship between lifestyle activities and SPA. Results indicate significant direct effects between exercise, computer use, and self-efficacy. Direct effects were observed between exercise, volunteering, computer use, and SPA. Self-efficacy partially mediated the relationship between exercise, volunteering, computer use, and SPA. Implications for practitioners working with older adults are discussed. Future research should test formal intervention programs aimed at reducing internalized ageism through additional pathways.

Measures of self- and other-directed ageism and worries concerning COVID-19 health consequences: Results from a nationally representative sample of Israelis over the age of 50

Worries associated with COVID-19 health consequences are well-justified. They may motivate people to take safety precautions, but may hinder if they become too intense. Current research has examined mainly age and gender as potential correlates associated with worries. This study instead, is focused on self-perceptions of aging (SPA) and perceived age discrimination as potential predictors of worry, in the light of the ageism pandemic which has co-occurred with the COVID-19 outbreak. The study is based on a national sample of 1,092 adults aged 50 and above in Israel. Phone interviews were conducted between March 29 2020 and May 3 2020, when Israel gradually moved from strict to partial lockdown. Respondents were queried about their worries related to COVID-19 health consequences, demographic characteristics, known-risk factors, SPA and perceived age-based discrimination in the healthcare system. Our findings show that in addition, to sex, financial status and chronic illness, SPA and age-based discrimination in the healthcare were significant predictors of worries and explained additional 8% of the variance. The findings point to the potentially negative impact of the ageism pandemic in an area that has not received much attention, thus far, namely people’s worries. Interventions that address ageism directed by self or others might alleviate worries in the midst of the COVID-19 pandemic.

Relationship between personality and physical capacities in older adults: The mediating role of subjective age, aging attitudes and physical self-perceptions

Walking speed and muscular strength are two main markers of health in adulthood. Previous studies have shown that personality traits may predict these two outcomes. However, little is known about the mechanisms underlying these relationships. Thus, the present study examined whether personality traits are associated with walking speed and muscular strength through the mediating role of subjective age (how young or old individuals experience themselves to be), attitudes toward aging and physical self-perceptions. Community-dwelling older women (N = 243; M_age = 73.0; SD_age = 6.5) were recruited. For reasons of recruitment feasibility, participants were only older women. They were requested to complete a questionnaire measuring personality, subjective age, attitudes toward aging and physical self-perceptions. Following this, their walking speed and their muscular strength were investigated. Data were analyzed using structural equation modeling. In line with the literature, we extended the associations between extraversion, neuroticism, conscientiousness and walking speed and between conscientiousness, neuroticism, openness and muscular strength. Physical self-perceptions appear to be a robust mediator between personality traits and walking speed whereas attitudes toward aging and subjective age mediated the personality traits/muscular strength relationship. This study provides evidence, for the first time, that the associations between personality traits and physical capacities are different according to the physical capacities investigated. Based on these results, it could be interesting to adapt physical activity interventions to the psychological profile of older adults.

"We Are Staying at Home." Association of Self-perceptions of Aging, Personal and Family Resources, and Loneliness With Psychological Distress During the Lock-Down Period of COVID-19

Objectives

Families are going through a very stressful time because of the COVID-19 outbreak, with age being a risk factor for this illness. Negative self-perceptions of aging, among other personal and relational variables may be associated with loneliness and distress caused by the pandemic crisis.

Method

Participants are 1310 Spanish people (age range: 18-88 years) during a lock-down period at home. In addition to specific questions about risk for COVID-19, self-perceptions of aging, family and personal resources, loneliness and psychological distress were measured. Hierarchical regression analyses were done for assessing the correlates of loneliness and psychological distress.

Results

The measured variables allow for an explanation of 48% and 33% of the variance of distress and loneliness, respectively. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, more contact with relatives different to those that co-reside, fewer positive emotions, less perceived self-efficacy, lower quality of sleep, higher expressed emotion and higher loneliness were associated with higher distress. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, lower contact with relatives, higher self-perception as a burden, fewer positive emotions, lower resources for entertaining oneself, lower quality of sleep and higher expressed emotion were associated with higher loneliness.

Childhood self-control forecasts the pace of midlife aging and preparedness for old age

The ability to control one's own emotions, thoughts, and behaviors in early life predicts a range of positive outcomes in later life, including longevity. Does it also predict how well people age? We studied the association between self-control and midlife aging in a population-representative cohort of children followed from birth to age 45 y, the Dunedin Study. We measured children's self-control across their first decade of life using a multi-occasion/multi-informant strategy. We measured their pace of aging and aging preparedness in midlife using measures derived from biological and physiological assessments, structural brain-imaging scans, observer ratings, self-reports, informant reports, and administrative records. As adults, children with better self-control aged more slowly in their bodies and showed fewer signs of aging in their brains. By midlife, these children were also better equipped to manage a range of later-life health, financial, and social demands. Associations with children's self-control could be separated from their social class origins and intelligence, indicating that self-control might be an active ingredient in healthy aging. Children also shifted naturally in their level of self-control across adult life, suggesting the possibility that self-control may be a malleable target for intervention. Furthermore, individuals' self-control in adulthood was associated with their aging outcomes after accounting for their self-control in childhood, indicating that midlife might offer another window of opportunity to promote healthy aging.

Psychometric Properties of a New Simplified Scale to Assess the Quality of Workers' Rest and Recreation on Their Days Off

Background

In this study, we developed and tested the validity and reliability of the 12-item Rest and Recreation Quality Scale (RRQ-Scale) for Workers as a new scale capable of conveniently assessing the quality of workers' days off, that is, their rest and recreation.

Methods

Participants included 756 employees (694 men, 62 women, mean age ± SD= 44.7 ± 13.5, age range = 18-81) of 26 manufacturing-related companies located in Oita Prefecture, Japan. We analyzed the factorial validity of the scale's score distribution and its criterion-related validity and reliability (Cronbach's coefficient α), compared to MOS 36-Item Short-Form Health Survey version 2.0 (SF-36v2) and the generalized self-efficacy scale. Participants responded to the 12 questions on 4-point scales; these were summed to calculate the total score (score range: 12-48 points).

Results

The smallest and largest mean ± SD of the questions were 2.53 ± 0.89 and 3.21 ± 0.74, respectively, which are within the possible score range (1-4, implying the absence of floor and ceiling effects). A confirmatory factor analysis indicated that the goodness of fit of the higher-order factor analysis model was satisfactory (GFI = 0.955), confirming factorial validity. In addition, consistent with the theoretical predictions, the total score exhibited statistically significant positive correlations with the components of the SF-36v2; physical component summary (PCS): rs = 0.193, P < 0.001, mental component summary (MCS): rs = 0.369, P < 0.001, and role/social Component Summary (RCS): rs = 0.115, P = 0.002. This confirmed criterion-related validity. Further, the overall reliability of the scale was high; α = 0.877.

Conclusion

In sum, the score distribution, validity, and reliability of the RRQ-Scale for workers were good, indicating a high degree of practicality.

Longitudinal correlates of loneliness and psychological distress during the lockdown situation due to COVID-19. Effects of age and self-perceptions of aging

Objectives

To longitudinally analyze the correlates of loneliness and psychological distress in people exposed to the coronavirus disease 2019 (COVID-19) lockdown, exploring the effects of age and self-perceptions of aging (SPA).

Methods

A longitudinal follow-up of 1,549 participants was carried out at four different time points during the lockdown in Spain. Questions about the risk of COVID-19, age, SPA, family and personal resources, loneliness, and psychological distress were measured.

Results

Changes in loneliness showed a linear longitudinal trajectory through time, but changes in psychological distress showed a U-shaped relationship with time. Age was a relevant predictor of differences in distress, with older people reporting less psychological distress. Change in both dependent variables was related to change in different predictors like family and personal variables and also to negative SPA.

Discussion

In a stressful situation such as the COVID-19 pandemic, older adults may be more resilient to adverse mental health outcomes by using more adaptive resources that strengthen their resilience. Support is provided for the importance of stereotyped views of the aging process that, independently of chronological age, may put people at risk of suffering adverse mental health outcomes such as loneliness and psychological distress in times of crisis.

Scaling Down the PGCM Scale to Assess Views on Ageing More Efficiently: Finding a New Alternative

The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale Scale (PGCM), originally consisting of 22 items. The growing numbers and proportions of older people among European populations has increased the need to obtain more reliable data on their needs, values, life experiences and overall quality of life. Using data from six surveys conducted in the Czech Republic, we have formulated a three-item positive outlook on life and ageing (POLA) scale. Our analyses are divided into three steps: (1) constructing the scale and testing its internal consistency; (2) testing the scale's external validity using mean comparisons and correlation coefficients; and (3) determining the factors affecting a positive outlook on later life, such as gender and education. We have confirmed that the three-item approach to measuring positive outlook on ageing as a part of morale is highly applicable to surveys, producing compelling results in assessing important quality-of-life sub-concepts, such as subjective health, subjective age, and loneliness.

The uniqueness of subjective ageing: convergent and discriminant validity

Although a large body of research has demonstrated the predictive power of subjective ageing for several decisive developmental outcomes, there remains some controversy about whether subjective ageing truly represents a unique construct. Thus, information about the convergent and discriminant validity of different approaches to measuring subjective ageing is still critically needed. Using data from the 2014 wave of the German Ageing Survey, we examined how three established subjective ageing measures (subjective age, global attitude toward own ageing, multidimensional ageing-related cognitions) were inter-related as well as distinct from general dispositions (optimism, self-efficacy) and well-being (negative affect, depressive symptoms, self-rated health). Using correlational and multivariate regression analysis, we found that the three subjective ageing measures were significantly inter-related (r = |.09| to |.30|), and that each measure was distinct from general dispositions and well-being. The overlap with dispositional and well-being measures was lowest for subjective age and highest for global attitudes towards own ageing. The correlation between global attitudes towards own ageing and optimism was particularly striking. Despite the high convergent validity of the different dimensions of ageing cognitions, we nevertheless observed stronger associations between specific dimensions of ageing cognitions with negative affect and self-rated health. We conclude that researchers should be aware of the multidimensional nature of subjective ageing. Furthermore, subjective age appears to be a highly aggregated construct and future work is needed to clarify its correlates and reference points.

The assessment of views on ageing: a review of self-report measures and innovative extensions

This is a review of existing self-report measures for assessing views on ageing. It provides an overview of instruments, for which basic psychometric properties are available and describes them according to the purposes for which they are suitable. Literature search resulted in the inclusion of 89 instruments which were categorised along eight dimensions. The majority of measures focus on explicit cognitions about people's own age and ageing or other (older) people. A substantial amount of tools account for the multidimensionality and multidirectionality of views on ageing, i.e. the idea that ageing is accompanied by both gains and losses in several different domains. To some extent, measures reflect that ageing is a long-term process and that views on ageing are malleable, rather than just stable traits. Cluster analysis revealed heterogeneity in instruments regarding the dimensions of Ecosystem, Balance, Stability, Dynamics, and Complexity. It becomes apparent, however, that approaches to measure views on ageing should be extended to more specifically target the implicit level as well as affective, physiological, and behavioural manifestations. Additionally, means for capturing views on ageing on the societal level and tools with a distinct time reference are needed. This is particularly important when one wants to account for the lifelong dynamics of views on ageing.

Ageism Amplifies Cost and Prevalence of Health Conditions

Background and Objectives

The persistent status of ageism as one of the least acknowledged forms of prejudice may be due in part to an absence of quantifying its costs in economic terms. In this study, we calculated the costs of ageism on health conditions for all persons aged 60 years or older in the United States during 1 year.

Research Design and Materials

The ageism predictors were discrimination aimed at older persons, negative age stereotypes, and negative self-perceptions of aging. Health care costs of ageism were computed by combining analyses of the impact of the predictors with comprehensive health care spending data in 1 year for the eight most-expensive health conditions, among all Americans aged 60 years or older. As a secondary analysis, we computed the number of these health conditions experienced due to ageism.

Results

It was found that the 1-year cost of ageism was $63 billion, or one of every seven dollars spent on the 8 health conditions (15.4%), after adjusting for age and sex as well as removing overlapping costs from the three predictors. Also according to our model, ageism resulted in 17.04 million cases of these health conditions.

Discussion and Implications

This is the first study to identify the economic cost that ageism imposes on health. The findings suggest that a reduction of ageism would not only have a monetary benefit for society, but also have a health benefit for older persons.

Self-perceptions of aging and domain-specific health outcomes among midlife and later-life couples

Objectives: This study places the self-perceptions of aging (SPA)-health link in the couple context and examines how changes in one’s own and spouse’s SPA influence multiple health domains and how such associations differ by gender. Methods: Fixed-effects regression models were estimated. Data were drawn from the Health and Retirement Survey ( N = 5972). Results: For both husbands and wives, almost all health domains declined when their own SPA became more negative. The spouse’s SPA were associated with one’s self-rated health, regardless of gender. Gender differences existed in some cross-spousal health effects; while the husband’s SPA were associated with his wife’s depressive symptoms, the wife’s SPA were associated with her husband’s physical disability, functional limitations, and chronic diseases. Discussion: The SPA–health association extends beyond the individual in married persons, demonstrating intertwined health trajectories in older couples. The detrimental effects of ageism might be underestimated if the spillover effects were not considered.

When Culture Influences Genes: Positive Age Beliefs Amplify the Cognitive-Aging Benefit of APOE ε2

OBJECTIVES

Most studies of aging cognition have focused on risk factors for worse performance and on either genetic or environmental factors. In contrast, we examined whether 2 factors known to individually benefit aging cognition may interact to produce better cognition: environment-based positive age beliefs and the APOE ε2 gene.

METHOD

The sample consisted of 3,895 Health and Retirement Study participants who were 60 years or older at baseline and completed as many as 5 assessments of cognition over 8 years.

RESULTS

As predicted, positive age beliefs amplified the cognitive benefit of APOE ε2. In contrast, negative age beliefs suppressed the cognitive benefit of APOE ε2. We also found that positive age beliefs contributed nearly 15 times more than APOE ε2 to better cognition.

DISCUSSION

This study provides the first known evidence that self-perceptions can influence the impact of a gene on cognition. The results underscore the importance of combined psychosocial and biological approaches to understanding cognitive function in older adults.

How Far Have we Come? An Integrative Review of the Current Literature on Sense of Community and Well-being

Sense of community and well-being are considered core tenets in the field of community psychology, acting as focal points for theory, research, and action. This integrative review synthesizes the empirical literature on sense of community and well-being with respect to four research questions focused on the relationships between these variables, the methodologies used to study those relationships, and how future research might expand upon the current literature. A search of the available literature produced 30 articles that met the search criteria, based primarily on conceptualizations and measurement of both sense of community and hedonic and eudaimonic well-being. This review suggests a general consensus across the literature of a positive relationship between sense of community and well-being among both youth and adults in a variety of settings, and discusses the strengths and limitations of this area of research, pointing to the need for more nuanced, ecologically valid research that incorporates more qualitative and critical methodologies. We hope that this review can promote a more thorough understanding of how sense of community and individual well-being relate to each other, and that ongoing research in this area can be a catalyst for action research and interventions that are applied to pressing contemporary issues as well as strengths-based approaches focused on how to foster and support the well-being of individuals within their community contexts.

[Differences in anxiety, sadness, loneliness and comorbid anxiety and sadness as a function of age and self-perceptions of aging during the lock-out period due to COVID-19]

OBJECTIVES

To analyze differences by age group in anxiety, depression, loneliness and comorbid anxiety and depression in young people, middle aged adults and older adults during the lock-down period at home due to the COVID-19 pandemic, and to explore the association between negative self-perceptions of aging and psychological symptoms controlling by age group.

METHOD

Participants are 1501 people (age range 18 to 88 years). Anxiety, sadness, loneliness and self-perceptions of aging were assessed. The sample was divided according to the age group and quartiles (lower, intermediate levels, and higher) of anxiety, sadness, loneliness and self-perceptions of aging.

RESULTS

Older adults reported lower levels of anxiety and sadness than middle aged adults, and middle aged adults reported lower levels than younger participants. Middle aged adults reported the lowest loneliness, followed by older adults and younger participants. For each age group, those with more negative self-perceptions of aging reported higher anxiety, sadness and loneliness. More comorbid anxiety and sadness was found in younger adults and less in older adults; more depressed participants in the middle aged group, and more older adults and less younger participants were found in the group with the lowest levels of anxiety and sadness. For all the age groups, participants with high levels of comorbid anxiety and sadness are those who report the highest scores in negative self-perceptions of aging.

CONCLUSIONS

Older adults reported lower psychological anxiety, sadness and loneliness than the other age groups. Having negative self-perceptions of aging damage psychological health irrespective of the chronological age.

Measuring Self-Perceptions of Aging: Differences Between Measures When Predicting Health Outcomes

Objectives

The majority of self-perceptions of aging (SPA) research uses either a combination of the Aging-related Cognitions (AgeCog) scales of Ongoing Development and Physical Loss, or the Attitudes Towards Own Aging (ATOA) subscale to assess views on aging. Although these scales are used interchangeably, the valence (positive/negative) and the specificity of the view on aging (domain-based/general) being assessed are not consistent. This study investigates how different measures of SPA relate to one another and whether they differentially predict various types of health outcomes (psychological/physiological; well-being/ill-being).

Method

Data from the 2008 and 2014 waves of the German Aging Survey (DEAS; N = 3,745), a population-based representative survey of adults aged 40–95, was used to examine the relationship between the AgeCog scales and the ATOA subscale, as well as the differences in the types of health outcomes each predicts.

Results

The correlations between the AgeCog scales and the ATOA were higher than the correlation between the AgeCog scales (p &lt; .001). The AgeCog scale of Ongoing Development significantly predicted psychological health outcomes across a 6-year period, while the AgeCog scale of Physical Loss and the ATOA subscale predicted both physiological and psychological health outcomes.

Discussion

Evidence supports using the AgeCog scale of Ongoing Development to predict domain-relevant, psychological health outcomes. However, the multidimensionality of SPA is best measured by the ATOA subscale or a combination of the two AgeCog scales. Both forms of measurement were found to maximize the amount of explained variance for psychological and physiological indicators of well-being and ill-being.

Reductions in cognitive functioning are associated with decreases in satisfaction with aging. Longitudinal findings based on a nationally representative sample

OBJECTIVE

The objective of this study was to investigate the link between cognitive functioning and satisfaction with aging.

METHODS

Data were drawn from a population-based sample, the German Ageing Survey (wave 5 and wave 6 with n = 6,384 in the analytical sample). The validated Philadelphia Geriatric Center Morale Scale was used to quantify satisfaction with aging. Cognitive functioning was measured using the digit symbol test. Linear fixed effects regressions were used.

RESULTS

Adjusting for socioeconomics and various health-related covariates, regressions showed that decreases in cognitive functioning were associated with decreases in satisfaction with aging (β = .002, p = .02). Furthermore, regressions showed that decreases in satisfaction with aging were associated with increases in age (β=-.01, p < .001), decreases in physical functioning (β = .002, p < .01), worsening self-rated health (β=-.12, p < .001) and they were inversely associated with changes from employment to retirement (β = .11, p < .001).

CONCLUSION

Study findings stress the importance of maintaining cognitive functioning for sustaining satisfaction with ageing. Strategies to postpone cognitive decline among middle-aged and older adults may contribute to aging satisfaction and ultimately to successful aging.

[Will to live as an expression of the well-being of older people]

INTRODUCTION

Will-to-live, a central concept in well-being theories, represents a positive attitudinal component towards one's own life. It has been identified as a mediator between the self-perception of aging and longevity and health. The objective of this study is to characterise elderly people with high levels of will-to-live in the main dimensions of positive psychology.

METHOD

The study included the voluntary participation of 165 adults, aged between 54-89 years, users of senior centres in the Community of Madrid. Will-to-live and other dimensions of well-being and health were evaluated. The correlations between the different evaluated dimensions were analysed, and comparisons made in terms of different levels of will-to-live, as well as an analysis of the dimensions that contribute most to the will-to-live.

RESULTS

Correlations among the majority of variables were statistically significant, with a decrease in the coefficients being observed when controlling the effect of the will-to-live. When groups with different levels of will-to-live are compared with well-being and health, there are statistically significant differences in practically all of the dimensions. Gratitude, positive affect, and depression are the dimensions that best predict will-to-live.

CONCLUSION

Older adults that make up the group with high will-to-live are characterised by higher levels of optimism, gratitude, positive affect, sense of life, psychological prosperity, resilience, happiness, and satisfaction with life, as well as lower levels of depression and negative self-perception of aging. The implications of these results point towards the relevance of will-to-live in successful aging.

Attitude Toward Own Aging Among Older Adults: Implications for Cancer Prevention

BACKGROUND AND OBJECTIVES

Negative age stereotypes can become internalized and contribute to lower levels of physical and mental well-being in older adults, including those with serious illnesses. The main objective of this study was to examine the relationships of attitude toward own aging (ATOA) with health outcomes after controlling for resilience among older cancer survivors and comparison subjects without cancer, aged 50 years or older.

METHODS

We examined data in 1,140 adults from the Successful Aging Evaluation (SAGE) study, a structured multi-cohort investigation of community-based adults selected using random digit dialing. There were 219 participants with cancer (excluding skin cancer) and 912 without cancer. ATOA was assessed with the Philadelphia Geriatric Morale Scale, and its relationship with measures of physical, cognitive, and mental health, as well as resilience was evaluated.

RESULTS

Individuals with cancer reported slightly more pessimistic ATOA than individuals without cancer. ATOA correlated with physical and mental health in individuals with and without cancer. Hierarchical linear multiple regression revealed that ATOA contributed significantly to the prediction of physical and mental health after controlling for socio-demographic variables and resilience.

DISCUSSION AND IMPLICATIONS

Higher levels of positive ATOA appear to be a protective factor for health in older adults, including those with cancer. Interventions that provide education about positive aspects of aging, modify negative automatic thoughts, and promote optimism may be useful for increasing ATOA and thereby improving physical and mental health in older adults, especially those with cancer.

Global reach of ageism on older persons' health: A systematic review

OBJECTIVE

Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time.

METHOD

A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857).

RESULTS

Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism).

CONCLUSION

The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

Design and protocol of Estrogenic Regulation of Muscle Apoptosis (ERMA) study with 47 to 55-year-old women's cohort: novel results show menopause-related differences in blood count

Supplemental Digital Content is available in the text

Objective:

The multidisciplinary Estrogenic Regulation of Muscle Apoptosis (ERMA) study was designed to reveal how hormonal differences over the menopausal stages affect the physiological and psychological functioning of middle-aged women. This paper describes the protocol and nonrespondent analysis of ERMA and novel findings on menopausal differences in blood count variables and their association with female sex hormones.

Methods:

Women aged 47 to 55 years were assigned to pre, early peri, late peri, and postmenopausal groups based on follicle-stimulating hormone (FSH) and bleeding diary. Multivariate linear regression models were constructed to estimate the association of 17β-estradiol (E₂) and FSH with the blood count variables.

Results:

In all, 3,064 women returned the prequestionnaire (ERMA phase one), 1,393 donated blood samples and were assigned to the relevant menopausal group (phase two), and 914 completed phase three, which included physiological and psychological measurements. Nonrespondents were more likely than respondents to be obese, whereas the menopausal groups showed no mean differences in body mass index. Blood count variables, while being within clinical reference values, showed significant differences between groups. E₂ and FSH were associated with the white blood cell (WBC) count and neutrophil-to-lymphocyte ratio.

Conclusions:

The ERMA study was successful in recruiting and characterizing the menopausal status of a cohort sample of middle-aged women. The significant group differences found in the blood count variables and their associations with E₂ and FSH verifies menopause-associated changes in WBC composition potentially being an early sign of low-grade inflammation that may develop later in life.

Are Self-perceptions of Aging Associated With Health Trajectories Among Middle-Aged and Older Adults?

Background and Objectives

Older adults’ health trajectory is often pictured as loss and decline. Recent literature has questioned this assumption. Conceptualizing health as a multidimensional construct, encompassing physical disabilities, functional limitations, chronic diseases, depressive symptoms, memory problems, and self-rated health, we investigated patterns of health trajectories among middle-aged and older adults in the United States. Moreover, we investigated the relationship between self-perceptions of aging (SPAs) and health trajectory patterns.

Research Design and Methods

We used latent class growth modeling to examine health trajectory patterns, based on longitudinal data with 4 measurement points over a 7-year period from a national sample of 10,212 middle-aged and older adults (aged 51 and older). Multinomial logit models were used to examine how health trajectory patterns were associated with baseline SPA.

Results

We identified 4 health trajectory patterns: accelerated aging, usual aging, depressed aging, and healthy aging. The full model shows that with each one-unit increase in negative SPA, the odds of belonging to an accelerated aging group, depressed aging group, and usual aging group (vs healthy aging group) increased by 26%, 17%, and 9%, respectively.

Discussion and Implications

The combination of health changes across different domains results in health trajectories that cannot be understood as simply a declining process. SPAs are associated with individuals’ trajectories of health.

Survival Advantage Mechanism: Inflammation as a Mediator of Positive Self-Perceptions of Aging on Longevity

Objective

Previous studies have found that positive self-perceptions of aging (SPA) are associated with longer survival; however, a biological mechanism was unknown. We examined whether C-reactive protein (CRP), a marker of cumulative stress-related inflammation, mediates the relationship between SPA and survival.

Method

The SPA of participants aged 50 and older in the Health and Retirement Study (N = 4,149) were assessed at baseline. Inflammation was measured by the level of CRP 4 years later. Survival was followed for up to 6 years.

Results

As hypothesized, CRP mediated the impact of SPA on survival. Following the steps of a mediation analysis, positive SPA at baseline predicted lower CRP after 4 years (β = -.29, p = .03) and longer survival in the 2 years following the CRP measurement (β = .20, p =.003); additionally, lower CRP predicted longer survival, after adjusting for positive SPA (β = -.02, p = .0001). All models adjusted for baseline age, CRP, health, sex, race, and education.

Discussion

It was found that lower CRP partially mediates the relationship between positive SPA and longer survival. Hence, this study presents a novel pathway to explain the process by which positive SPA extend longevity.

Future Time Perspective and Well-Being in Chinese Older Adults: Moderating Role of Age Stereotypes

Through this cross-sectional study, we aimed to examine the association between future time perspective (FTP) and well-being among older adults, with age stereotypes as a moderator. The participants, 333 Chinese older adults (60-88 years), completed measures related to FTP, age stereotypes, and well-being. The results showed that opportunity and limitation emerged as two subcomponents of FTP, and their effects on well-being depended on older adults' negative age stereotypes. Specifically, for older adults holding less negative age stereotypes, FTP-opportunity and FTP-limitation had a positive effect on well-being, whereas for older adults holding more negative age stereotypes, FTP-opportunity's positive effect became stronger and FTP-limitation's positive effect became weaker and even detrimental. These results indicate that certain qualifiers should be taken into account when considering the relationship between FTP and well-being. These findings contribute to the theoretical understanding of the role of FTP in older adults' well-being.

The Fountain of Health: effective health promotion knowledge transfer in individual primary care and group community-based formats

ABSTRACTBackground:The Fountain of Health (FoH) initiative is a knowledge transfer (KT) project on the science of brain health and resilience promotion, in alignment with positive psychiatry.

OBJECTIVES

Assess the effectiveness of FoH KT delivered in individual and group-based formats.

DESIGN

Pre- and post-intervention quality assurance survey of FoH KT.

SETTING

Interventions occurred in Nova Scotia, Canada.

PARTICIPANTS

Adults over age 50 years without pre-existing dementia were targeted. A total of 92 participants received FoH KT in individualized (n = 41) and group-based (n = 51) formats.

INTERVENTION

FoH KT (e.g. sharing evidence, lifestyle coaching, and goal setting) using a range of KT supports (e.g. FoH website, paper materials) was delivered to (1) individual patients by primary care clinicians and (2) community-based groups by lay leaders.

MEASUREMENTS

The main outcome measure was participant pre- and post-quality assurance self-reports.

RESULTS

Improvements were found in participant awareness of FoH, knowledge of evidence-based mental health promotion initiatives, and in application of this information in daily life in both individual and group-based settings. Improvements in participant knowledge about epigenetic factors that impact health and confidence with health behavior goal setting were reported in both contexts. Changes in self-perceptions of aging scores reached significance in the group intervention.

CONCLUSIONS

FoH KT produced short-term positive self-reported changes in participants in both individual and group formats. Larger control studies with long-term follow up are needed to better assess effects of both individual and group formats of FoH KT and longer term impacts on health behaviors and outcomes.