Middle-aged and older adults' psychosocial functioning trajectories before and during the COVID-19 pandemic: Evidence for multidirectional trends

So far little is known with regard to the impact of the COVID-19 pandemic on changes in psychosocial functioning of middle-aged and older adults across multiple indicators, interindividual differences in these changes, as well as the extent to which pandemic-related changes are temporary or not. We investigate different domains of psychosocial functioning (views on aging: attitude toward own aging [ATOA] and subjective age; subjective well-being: life satisfaction and depressive symptoms; health: self-rated health) across up to 7 years (prepandemic measurement occasions: 2014 and 2017; peri-pandemic measurement occasions: Summer 2020 and Winter 2020/2021) among middle-aged and older adults (n = 10,856; Mage in 2014 = 64.3 years, SD = 11.58), based on data of the German Ageing Survey. Longitudinal multilevel regression models revealed that mean-level change toward more negative ATOA over time was aggravated by an additional shift toward more pessimistic ATOA in Summer 2020. In contrast, the mean-level change toward older subjective ages over time was interrupted by a shift toward younger subjective ages in Summer 2020. This shift was more pronounced among chronologically younger individuals. Depressive symptoms remained on average stable over time, but there was a temporary increase in Summer 2020. No pandemic-related change was observed for life satisfaction and self-rated health. Our findings suggest that different psychosocial functioning indicators reveal a different susceptibility to "COVID-19 effects," but all changes were temporary, potentially reflecting processes of adaptation. We discuss our results in the context of established theories, such as socioemotional selectivity theory or set-point theory of well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prevalence of loneliness among older adults in Germany

Background

Loneliness refers to the subjective perception of a mismatch between a person's social needs and their actual personal relationships. In this paper, the prevalence of loneliness in the older population was examined based on current data.

Methods

The German Ageing Survey is an ongoing, population-representative study. A total of 4,261 people 50 years of age and older were surveyed in 2020/2021 with regard to their experience of loneliness.

Results

Overall, 8.3 % of the population 50 years of age and older feel lonely. The findings showed no differences between different age groups over 50 years of age, nor are there gender or educational differences.

Conclusions

There was no evidence that older individuals living in private households experience loneliness more commonly than middle-aged individuals. Data from nursing home residents indicate that there may be a higher risk of loneliness.

Prevalence of living wills among older adults in Germany

Background

Living wills regulate medical decisions in emergency situations. Those who create a living will can have it registered voluntarily in the Central Register of Lasting Powers of Attorney. Little is known about the general prevalence of living wills.

Methods

The German Ageing Survey is an ongoing, population-representative study. 4,185 people aged 50 and older were surveyed about living wills in 2020/2021.

Results

44.8 % of people aged 50 and older have a living will, women more often than men (50.1 % vs. 39.2 %), older people more often than middle-aged people. Educational differences do not exist.

Conclusions

Living wills increase the autonomy in medical emergency situations because the patient's wishes are specified in written form. People of all age groups should inform themselves about the significance of living wills and should seek advice about the contents, for example from the general practitioner or one's own health insurance.

[Older adults in the first year of the COVID-19 pandemic: health-related findings of the German Ageing Survey (DEAS)]

This narrative review brings together findings from the German Ageing Survey (DEAS) on the health situation of people in the second half of life during the first year of the COVID-19 pandemic. In doing so, this review answers the question of whether older adults (i.e., people in late adulthood) were indeed more vulnerable in the early days of the pandemic than younger adults (i.e., people in middle adulthood). Findings on the following health indicators are presented: perceived threat of the COVID-19 pandemic, perceived age discrimination, self-reported changes in physical activity, loneliness, and self-rated health.The results show that a higher age should not be considered as a universal risk factor for particularly severe indirect health consequences due to the COVID-19 pandemic. Most older adults did not perceive the COVID-19 pandemic as very threatening and rarely experienced discrimination based on their age. By contrast, many younger and older adults reported to be less physically active and they showed an increase in loneliness that was equally distributed across age groups. Moreover, self-rated health deteriorated compared to pre-pandemic levels-but only among older adults. This deterioration, however, seems to be associated with individual ageing rather than the pandemic situation.It can be concluded that older people in private households did not show a particularly unfavorable health situation in the first year of the COVID-19 pandemic.

Nine-year changes in self-reported problems with vision and hearing among older adults: do subjective age views matter?

OBJECTIVES

So far, little is known about linkages between subjective age views and long-term changes in vision and hearing.

METHOD

We examined the predictive role of two key measures of subjective age views (attitude toward own aging [ATOA]; aging-related cognitions comprising continuous growth, social loss, and physical decline) for changes in self-reported problems with vision and hearing over a period of up to 9 years. A subsample of the German Ageing Survey was used, consisting of 2,499 older adults.

RESULTS

Controlling for socio-demographic characteristics, self-rated health, and depressive symptoms, we found that with increasing age, more favorable ATOA scores, as well as higher scores on continuous growth and lower scores on physical decline, were associated with fewer self-reported vision problems at baseline. With advancing age, more favorable ATOA scores were also related with fewer hearing problems at baseline. However, among individuals with an older baseline age, more favorable ATOA scores were associated with a steeper increase in vision problems. Higher scores on continuous growth were related with less increase in hearing problems, independent of age.

CONCLUSION

Our findings suggest that subjective age views predict individuals' self-reported vision and hearing problems.

Do neuroticism and conscientiousness interact with health conditions in predicting 4-year changes in self-rated health among Swedish older adults?

Health conditions such as higher disease burden, pain, or lower functional health are associated with poorer self-rated health (SRH) in older age. Poorer SRH, in turn, is a predictor of morbidity and mortality. Personality traits are associated with SRH as well, but little is known about the interaction of personality and health conditions. In the present preregistered analyses, we used five annual waves of the Health, Aging and Retirement Transitions in Sweden (HEARTS) study (N = 5,823, M age = 63.09, SD = 2.01) to investigate the associations of personality (neuroticism and conscientiousness) and physical health indices (disease burden, pain, and functional limitations) with levels and change in SRH. In addition, we tested Personality × Health interaction effects. We found that higher neuroticism and lower conscientiousness were related to lower levels of SRH, but not to change in SRH after controlling for the health indices. Personality did not moderate the effect of health indices on levels and change in SRH. Exploratory analyses showed that high scores of neuroticism may augment the association of increased pain and functional limitations with declines in SRH. Additional studies with other samples are needed to test if this result can be replicated. Taken together, our findings provide only weak evidence for interaction effects of personality and physical health factors on SRH. More research is needed to understand the interplay of physical and psychological factors in shaping individual SRH. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Feeling younger as a stress buffer: Subjective age moderates the effect of perceived stress on change in functional health

Feeling younger than one's chronological age is associated with various beneficial health outcomes. However, apart from these direct health effects, little is known about the role of subjective age as a potential "buffer" and compensatory resource that might counteract the detrimental effect of health risk factors. We investigated whether the effect of perceived stress as a major health risk factor on change in functional health is smaller among individuals who feel younger. Additionally, we analyzed whether this "stress buffer effect" of subjective age varies by chronological age. Longitudinal data from the German Ageing Survey comprising 3 years (2014-2017) were used (N = 5,039; mean age at baseline: M = 63.91 years, SD = 10.80 years, range 40-95 years). Latent change score models revealed that, controlling for baseline functional health as well as for sociodemographic variables, greater perceived stress was associated with a steeper decline in functional health. This effect increased in size with advancing chronological age. Moreover, a younger subjective age was associated with a less steep decline in functional health. Subjective age additionally exhibited a stress buffer effect: Among individuals who felt younger, the association of greater perceived stress with steeper functional health decline was weaker. This stress buffer effect of subjective age became larger with increasing age. Our findings thus suggest that, particularly among older adults, a younger subjective age might help to buffer functional health decline, not only by directly affecting functional health, but also by compensating and counteracting the detrimental effect of stress on functional health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Age-related change in self-perceptions of aging: Longitudinal trajectories and predictors of change

Using data from the German Ageing Survey (Deutscher Alterssurvey, DEAS; N = 4,712), this study examined age-related change in three dimensions of self-perceptions of aging (SPA): perceptions of physical losses, social losses, and ongoing development. Participants ranged in age from 40 to 85 years at study entry (1996, 2002, or 2008) and were followed for up to 21 years. Time-invariant, context-specific and time-varying, person-specific predictors of the observed age-related changes were examined. Findings from longitudinal multilevel regression analyses showed significant nonlinear age-related change for all three dimensions. Specifically, starting at about age 65, participants showed age-related increases in perceptions of physical and social losses, with increases getting steeper in old age. Starting at about age 55, participants reported increasingly fewer perceptions related to ongoing development. The decline in perceptions of ongoing development also became increasingly steeper after age 70. Region of residence was a significant context-specific predictor of the intercepts of the three SPA dimensions. Health-related variables (i.e., number of chronic diseases, self-rated health), affective well-being (i.e., positive and negative affect), and measures of social integration (i.e., loneliness) were significant person-specific predictors. Health-related variables had their strongest association with perceptions of physical losses, whereas negative affect and loneliness had their strongest association with perceptions of social losses. Positive affect had its strongest association with perceptions of ongoing development. This study is the first one to describe age-related change trajectories in multiple dimensions of SPA and significant predictors of these change trajectories. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Young people feel wise and older people feel energetic: comparing age stereotypes and self-evaluations across adulthood

We use questionnaire data from the MIDUS study (N = 6325 and a subsample n = 2120) to examine the extent to which people in their late 20s, late 40s and late 60s think that positive characteristics apply to themselves, their age peers and other age groups. Results based on factor analysis confirmed the existence of age stereotypes, such that one constellation of characteristics (wise, caring, calm, knowledgeable, generative; "wise") was seen as more descriptive of older adults, while another constellation of characteristics (energetic, healthy, willing to learn; "energetic") was seen as more descriptive of younger adults. Self-evaluations were, however, highly positive and largely independent of age. As a group, younger adults saw themselves as being as "energetic" but "wiser" than their age peers, while older adults saw themselves as being more "energetic" but less "wise" than their age peers. In sum, the results suggest that self-views are relatively independent of existing age stereotypes but also indicate that the "better-than-average effect" depends on age and whether the considered characteristics represent a relative strength or weakness of one's own age group. The results also indicate that, at the aggregate level, older adults' tendency to use stereotypes about their age group's weaknesses as a frame of reference for making flattering self-evaluations seems to outweigh the effects of stereotype internalization.

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.

Changes in views on aging in later adulthood: the role of cardiovascular events

A number of longitudinal studies have pointed to the long-term impact of different views on aging (VoA) on health in later life, whereas the reverse relationship has rarely been examined. Serious cardiovascular events such as myocardial infarction or stroke are life-threatening events which might in turn lead to changes in VoA. The present longitudinal study examined the effect of a cardiovascular event (CVE) on VoA over a three-year period using pooled data from three waves of the German Ageing Survey (2008, 2011, 2014, age range: 40-95 years). In order to account for alternative explanations for changes in VoA, individuals without CVE (n = 200) were matched to individuals who experienced a CVE (n = 202) using a propensity score matching procedure. Compared to individuals without CVE, individuals who experienced a CVE showed adverse changes in three VoA indicators (self-perceptions of aging as associated with physical losses/with ongoing development; subjective age). These results suggest that CVE can in fact change how individuals view their own aging. According to previous studies, this can lead to future health changes and thus become a health-related downward spiral. Health promotion programs could, therefore, profit by adding specific VoA interventions for individuals who experienced a CVE.

Associations of Age and Pain With 9-Year Functional Health Trajectories

Abstract. We investigated whether information-processing speed and accommodative coping moderate associations of age and pain with 9-year functional health trajectories. Our sample consisted of 5,254 participants of the German Ageing Survey aged 40 years and older ( M = 62.33 years) who participated in up to four measurement occasions. After controlling for sex, chronic diseases, and education, our longitudinal multilevel regression models revealed that the association of older age and higher pain severity with lower functional health was weaker in individuals with higher processing speed. The relationship between pain and functional health was weaker in individuals with higher scores on accommodative coping. Our findings suggest that processing speed and accommodative coping may be important compensatory resources buffering negative associations of age and pain with functional health.

Associations of self-reported vision problems with health and psychosocial functioning: A 9-year longitudinal perspective

Impaired vision often results in restrictions across diverse key indicators of successful aging. However, little is known about how impaired vision affects the long-term trajectories of these outcomes, whether effects are moderated by age, and whether psychosocial resources beyond well-being such as subjective age views are also affected by vision loss. We analyzed how self-reported vision problems as a time-varying predictor are related to long-term changes in health and cognitive ability (functional health, number of chronic diseases, self-rated health, information processing speed), well-being (life satisfaction, positive and negative affect, depressive symptoms, loneliness), and subjective age views (subjective age; aging-related cognitions: social loss, physical decline, continuous growth). Our sample was derived from the German Ageing Survey, comprising 6,378 individuals (40–89 years) who provided up to four observations over a 9-year period. Controlling for gender, age, education, and functional as well as self-rated health, we observed that both on a between- and a within-person level, indicators of successful aging were consistently less favorable among individuals with more vision problems. Associations between vision problems and functional health became stronger with advancing age. In contrast, with increasing age, vision problems were less closely associated with change in several indicators of psychosocial functioning. Our findings suggest that self-reported visual impairment is associated with restrictions across a broad range of developmental domains. Some detrimental effects of vision problems are augmented in later life, whereas several effects on well-being and subjective age views were attenuated with advancing age, which might indicate processes of late-life adaptation to vision loss.

DO SERIOUS HEALTH EVENTS CHANGE HOW WE VIEW OUR OWN AGING? ON THE ROLE OF CARDIOVASCULAR EVENTS

Several studies have demonstrated beneficial effects of views on aging (VoA) on health, while the reverse relationship is seldom in focus. Serious health events (e.g., myocardial infarction) are life-threatening and remind individuals of the finitude of life possibly changing their VoA. The present study investigates the effect of cardiovascular events (CVE) on longitudinal changes in VoA using pooled data of three waves of the German Ageing Survey (2008, 2011, 2014, age-range: 40-95 years). To account for alternative explanations, individuals without CVE were matched to the individuals with CVE (n = 202) using a propensity-score-matching approach. Individuals who experienced a CVE showed more adverse changes in three VoA indicators (aging associated with physical losses, ongoing development, felt age) than individuals without CVE. Results show that CVE can change how we view our own aging which in turn affects future health changes. Following a CVE people may benefit from promoting positive VoA.

YOUNG PEOPLE FEEL WISE, OLD PEOPLE FEEL ENERGETIC: COMPARING AGE STEREOTYPES AND SELF-EVALUATIONS ACROSS ADULTHOOD

Using questionnaire data from the MIDUS study (N=6.325) we examined the extent to which people in their late 20s, 40s, and 60s think that positive stereotypic “old” and “young” characteristics describe themselves, their age peers, and other age groups. A constellation of “old” characteristics (e.g., wise, caring, calm) was seen as more descriptive of older adults, while a constellation of “young” characteristics (e.g., healthy, energetic) was seen as more descriptive of younger adults. Self-evaluations were highly positive and largely consistent across age groups. Compared to their age peers, younger adults saw themselves as having as many positive “young” characteristics but more positive “old” characteristics whereas older adults saw themselves as having more positive “young” characteristics but fewer positive “old” characteristics. The results support the stability of the aging self despite the existence of age stereotypes and the role of negative age stereotypes as a frame of reference for making self-evaluations.

SUBJECTIVE AGING: SOMETHING UNIQUE OR JUST ANOTHER EXPRESSION OF GENERAL SELF-BELIEFS?

Using data from the German Ageing Survey (adults aged 40‒85), this study tested the convergent and discriminant validity of subjective aging measures by comparing three different measures of subjective aging with one another and relating them to established measures of general self-beliefs (optimism, self-efficacy, subjective health) and subjective well-being (depression, affect). Correlations between subjective aging measures ranged from ‒.61 (amongst general self-perceptions of aging measures) to ‒.09, with subjective age being least related to the other measures. The highest overlap was observed between optimism and global self-perceptions of aging (.69) and it was for these global self-perceptions that the highest amount of variance could be explained by correlates in a regression analysis (R-square=.55). In contrast, only 10% of variance could be explained for subjective age. Our results underline the merit of taking the multidimensional nature of subjective aging into account since global measures appear less distinct from general personality traits.

Trajectories of functional health and its associations with information processing speed and subjective well-being: The role of age versus time to death

Functional health declines with advancing age, which is supposedly the consequence of both normal, "primary aging" as well as of mortality-related, "tertiary aging" processes. To better understand the independent effects of both processes, we investigated how age and time to death relate to changes in functional health over up to 12 years. Additionally, adopting the disablement process model for an end-of-life perspective, we investigated if both age and time to death moderate associations of information processing speed and subjective well-being with functional health. Data from the German Ageing Survey were used. Our sample consisted of 578 participants who had died between 2002 and 2016 (mean age at death: 76.59 years, range 45-95 years). Information processing speed was measured by the Digit Symbol Substitution Test. The well-being indicators assessed were positive affect and depressive symptoms. Based on longitudinal multilevel regression models, we found that functional health significantly decreased over time in study. Approaching death was a stronger predictor of functional health decline than was chronological age. Regarding moderation effects, controlling for gender, education, and multimorbidity, individuals closer to death at baseline revealed stronger associations of both depressive symptoms and information processing speed with baseline functional health, whereas these associations were not moderated by chronological age. Our findings suggest that change in functional health is more strongly affected by time to death than by chronological age. Moreover, there may be a growing importance of cognitive resources and well-being for functional health with advanced "tertiary aging," but not with progression of "primary aging." (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Response shift in self-rated health after serious health events in old age

OBJECTIVE

Although health generally deteriorates with advancing age, how older adults evaluate their health status (i.e., their self-rated health, SRH) remains rather positive. So far, however, little is known about how SRH in old age may change in the face of an abrupt health decline. Because change/stability in SRH may reflect not only change/stability in health but also changes in the meaning people assign to the concept of "health", response shift effects in SRH for people with and without a serious health event are investigated in the present study in the older general population.

METHOD

Longitudinal data from 1764 participants of the German Ageing Survey aged 65 + assessed at two occasions three years apart was used to investigate changes in SRH and three types of response shift: recalibration (change in standards for good health), reprioritization (change in the importance of different factors for health), and reconceptualization (omission/inclusion of new factors). The so-called "then-test" was used to examine recalibration response shift and path analyses, to examine reprioritization and reconceptualization response shift.

RESULTS

SRH declined between the two measurement occasions. As expected, people who experienced a serious health event indicated stronger declines in SRH. The study found evidence of two types of response shift. Regardless of whether they experienced a serious health event or not, individuals on average retrospectively overestimated their baseline health relative to the concurrent rating (recalibration). Furthermore, the predictive importance of depressive symptoms and optimism for SRH increased for individuals who experienced a serious health event (reprioritization).

CONCLUSION

The results indicate that older adults maintain stable SRH by using two types of response shift: recalibration and, when faced with a serious health event, reprioritization response shift.

Perceived somatic and affective barriers for self-efficacy and physical activity

According to Bandura's social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults' physical activity levels.

Predictors of Self-Rated Health: Does Education Play a Role Above and Beyond Age?

Objectives

Previous studies have demonstrated that while health factors lose importance for the individual conceptualization of self-rated health (SRH) with advancing age, subjective well-being (SWB) factors gain in importance. The present study examined whether this age-related pattern differs between educational groups.

Method

Longitudinal data of adults aged 40 years and older of the German Ageing Survey was used (N = 6,812). The role of education in age-related changes in the predictive value of different health and SWB facets for SRH was investigated with a cross-lagged panel regression model.

Results

Physical conditions were a stronger predictor in lower than in higher educated individuals while the association did not change with age. In contrast, positive affect and life satisfaction only gained in importance with advancing age for higher educated individuals. Negative affect was an equally strong predictor independent of education, and loneliness had a stronger association with SRH in people with lower education compared to those with high education while the associations did not change with age.

Discussion

The findings highlight the importance of considering the multidimensionality of SWB and the educational background of individuals for the study of SRH and indicate possible limits to adjustment to age-related declines in health.

Exploring the Causal Interplay of Subjective Age and Health Dimensions in the Second Half of Life

Numerous studies have emphasized a stable relationship between subjective age and health. However, few longitudinal studies exist and these have normally tested only one causal pathway. The present study investigated the direction of effects between subjective age and different health dimensions in 3,038 participants of the German Ageing Survey, aged 40 years and older. Cross-sectionally, subjective age correlated with all health dimensions studied. Longitudinally, subjective age predicted physical, mental, and self-rated health, whereas the reverse effect was found only for self-rated health. Subjective age thus seems to be an important resource for preserving health in the second half of life.