Younger Than Ever? Subjective Age Is Becoming Younger and Remains More Stable in Middle-Age and Older Adults Today.

Little is known about historical shifts in subjective age (i.e., how old individuals feel). Moving beyond the very few time-lagged cross-sectional cohort comparisons, we examined historical shifts in within-person trajectories of subjective age from midlife to advanced old age. We used cohort-comparative longitudinal data from middle-age and older adults in the German Ageing Survey (N = 14,928; ~50% female) who lived in Germany and were between 40 and 85 years old when entering the study. They provided up to seven observations over 24 years. Results revealed that being born later in historical time is associated with feeling younger by 2% every birth-year decade and with less intraindividual change toward an older subjective age. Women reported feeling younger than men; this gender gap widened across cohorts. The association of higher education with younger subjective age became weaker across cohorts. Potential reasons for the subjective-rejuvenation effect across cohorts are discussed.

Aging in 10 Minutes: Do Age Simulation Suits Mimic Physical Decline in Old Age? Comparing Experimental Data with Established Reference Data.

INTRODUCTION: Age simulation suits are increasingly used in health care education. However, empirical evidence that quantifies the simulated performance losses in established geriatric tests and compares those declines with reference data of older adults is scarce. METHODS: In a standardized lab setting, we compared performance of N = 61 participants (46 middle-aged, 15 young adults) with and without age simulation suit, for example in the Timed Up and Go Test (+dual task), Short Physical Performance Battery, grip strength, and 30-Second-Chair- Standing Test. Additionally, we compared the results with suit to established reference values of older adults in different age groups. RESULTS: Reduced performance was observed in both groups when wearing the suit, yet to different degrees dependent on the assessment and user age. For one, larger declines were observed in more challenging and complex tasks across age groups. In addition, comparisons with reference values revealed age-differential "instant aging" effects. DISCUSSION: A simulated "fourth age," where frailty and impairments are accumulating, was not reached in the majority of assessments, especially not among younger participants. In conclusion, existing age simulation suits may have some educational and empathy potential, but so far, they fail in simulating the age period with most serious functional loss.

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

BACKGROUND: Impaired hearing is associated with disadvantages in developmental outcomes, such as compromised everyday social communication or reduced well-being. Hearing impairment might also have an impact on how individuals evaluate their own aging as deterioration in hearing can be interpreted as being age-related and as a phenomenon individuals attribute to getting older. OBJECTIVE: This study investigated how self-reported hearing is related to awareness of age-related change (AARC). MATERIAL AND METHODS: AARC is a multidimensional construct comprising perceived age-related gains and losses in general as well as across five functional domains (health and physical functioning, cognitive functioning, interpersonal relations, social cognitive and social emotional functioning, lifestyle and engagement). A sample of 423 individuals (age range 40-98 years; mean age, M = 62.9 years; standard deviation (SD) = 11.8 years) was assessed up to 3 times over approximately 5 years. RESULTS: Based on longitudinal multilevel regression models, controlling for age, gender, subjective health and education, it was found that poorer self-reported hearing was associated with more perceived general AARC losses as well as with more AARC losses in health and physical functioning and in cognitive functioning at baseline. With an older age at baseline, poorer self-reported hearing was associated with a steeper decline in AARC gains regarding interpersonal relations over time, whereas in those who were younger at baseline poorer hearing was related to fewer gains in social cognitive and social emotional functioning at baseline. DISCUSSION: Self-reported hearing reveals differential associations with AARC domains; however, changes in most AARC domains of gains and losses seem to be only weakly related to subjective hearing.

The relevance of perceived work environment and work activities for personality trajectories in midlife.

OBJECTIVES: Work is an important developmental context in adulthood, yet little is known about how it contributes to personality trajectories in midlife. The present study examines how subjectively perceived work environment (autonomy, innovation, social integration, stress) and objectively measured work activities (activities related to information and people, physical/manual activities) are related to levels of Big Five personality traits at age 44 and to change over 20 years. METHODS: We analyzed four-wave longitudinal data from N = 374 participants (born 1950-1952; Mage T1 = 44 years, SD = 1; 44% women) from the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE) within the structural equation modeling framework. RESULTS: At baseline, subjective perceptions of work environments showed a higher number of significant associations with personality than objective work activities. Over time, small declines in neuroticism and extraversion and small increases in agreeableness and conscientiousness were observed, which were largely independent of work characteristics. CONCLUSIONS: Our findings show slight changes in most Big Five traits from age 44 to 64, which were mostly unrelated to work characteristics. More research is needed to uncover the sources and dynamics of personality trait change in midlife and the role of work for personality trajectories.

Using wearables to promote physical activity in old age : Feasibility, benefits, and user friendliness.

BACKGROUND: Wearables provide new opportunities to promote physical activity also among older adults but data on effectiveness and user friendliness are rare. OBJECTIVE: The effects of a comprehensive self-regulative intervention on moderate to vigorous physical activity (MVPA) and number of steps were examined using commercially available activity trackers. Acceptance regarding the devices was analysed in various domains. METHODS: In this study 80 older adults (mean = 67.03 years, standard deviation = 3.97 years; 59% women) wore a Fitbit Charge HR for 21 days including a baseline, a postintervention and a follow-up week. The intervention comprised feedback, goal setting and planning and 50% of the participants were additionally randomized to a role model component. Social cognitive predictors based on the health action process approach (HAPA) and user experience were assessed via questionnaires. RESULTS: The MVPA increased by an average of 19 min per week and steps by 1317 per day. An additional benefit of the role model component could be observed for MVPA. In the follow-up, the intervention effect was still significant for the number of steps, while MVPA dropped back to baseline. Multilevel models including HAPA variables explained small but significant amounts of variance in MVPA (8% within-person, 26% between-person) and steps (11% within-person, 12% between-person). User experience was rated as very high. CONCLUSION: Providing an intervention based on established behavior change techniques and self-monitoring via wearables seems to be effective for increasing physical activity among older adults. The HAPA variables seem to play a limited role to explain activity levels. Acceptance of wearables can be expected to be high.

Benefits and challenges of conversational agents in older adults : A scoping review.

BACKGROUND: Commercial conversational agents (CAs) bear the promise of low threshold accessibility for individuals with limited digital competencies. This applies not only for healthy aging older adults but also for specific subgroups such as those with life-long intellectual disabilities (ID). OBJECTIVE: This scoping review aims to synthesize the current evidence on benefits and challenges of CAs for older adults with and without ID. In doing so, we hope to inform future research as well as practical decision-making in the context of CAs as potential quality of life enhancers for older adults with various competence levels. MATERIAL AND METHODS: A literature search was conducted in form of a scoping review. A total of 841 publications were screened for benefits and challenges of CAs, resulting in an extraction of 18 articles targeting healthy aging older adults (60 years+) and 5 articles targeting older adults with ID (50 years+) for synthesis. RESULTS: The existing evidence suggests that CAs come with more benefits than challenges, e.g., general ease of use, easier information access, and feelings of companionship. Higher perceived agency due to using a CA seems to be a specific issue for older adults with ID. Challenges concern mostly learning how to use a CA and privacy concerns. CONCLUSION: The results indicate that CAs can serve as quality of life enhancers both in healthy aging adults and in older adults with ID; nevertheless, thoughtful preparation is necessary, especially in relation to learning needs, capabilities present and privacy concerns.

The Impact of the COVID-19 Pandemic on Trajectories of Well-Being of Middle-Aged and older Adults: A Multidimensional and Multidirectional Perspective.

The COVID-19 pandemic has resulted in profound changes of individuals' everyday lives. Restrictions in social contacts and in leisure activities and the threatening situation of a spreading virus might have resulted in compromised well-being. At the same time, the pandemic could have promoted specific aspects of psychosocial well-being, e.g., due to intensified relationships with close persons during lockdown periods. We investigated this potentially multidimensional and multi-directional pattern of pandemic-specific change in well-being by analyzing changes over up to 8 years (2012-2020) in two broad well-being domains, hedonic well-being (life satisfaction) and eudaimonic well-being (one overarching eudaimonic well-being indicator as well as environmental mastery, personal growth, positive relations with others, and self-acceptance), among 423 adults who were aged 40-98 years in 2012. By modelling longitudinal multilevel regression models and allowing for a measurement-specific intra-individual deviation component from the general slope in 2020, i.e. after the pandemic outbreak, we analyzed potential normative history-graded changes due to the pandemic. All mean-level history-graded changes were nonsignificant, but most revealed substantial interindividual variability, indicating that individuals' pandemic-related well-being changes were remarkably heterogeneous. Only for personal growth and self-acceptance, adding a pandemic-related change component (and interindividual variability thereof) did not result in a better model fit. Individuals with poorer self-rated health at baseline in 2012 revealed a pandemic-related change toward lower life satisfaction. Our findings suggest that not all well-being domains - and not all individuals - are equally prone to "COVID-19 effects", and even pandemic-associated gains were observed for some individuals in certain well-being domains.

Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition.

OBJECTIVES: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. DESIGN: Cross-sectional observational study. PARTICIPANTS: The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age. MEASUREMENTS: We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). RESULTS: Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. CONCLUSIONS: Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables - alongside psychological variables - related to perceived cognitive losses.

[Gerontology, geriatric medicine and robot research : Look back to the future]. / Gerontologie, Geriatrie und Robotikforschung : Blick zurück nach vorn.

Assistive robotics as a gerontological geriatric field of research so far seem to be perceived more as "recalcitrant". Predominant is a reserved attitude as to whether this should be considered a research topic to be taken seriously. The reliability of research results and the scientific half-life period are questioned as digital technique generations change exceedingly rapidly and also only a few sustainable standards and guidelines are established. In this context there is a danger that essential developments will be missed in gerontology and geriatrics, then the momentum is active right now and can now be shaped. In the scientific gerontology and geriatrics these developments should not be missed out on but must be grasped with pioneering spirit and proactively co-created. This can be achieved by further research endeavors, public activities and the utilization of knowledge from clinical and nursing practice with each having feedback into development and research.

Six Propositions against Ageism in the COVID-19 Pandemic.

The risk of developing severe illness from COVID-19 and of dying from it increases with age. This statistical association has led to numerous highly problematic policy suggestions and comments revealing underlying ageist attitudes and promoting age discrimination. Such attitudes are based on negative stereotypes on the health and functioning of older adults. As a result, the lives of older people are disvalued, including in possible triage situations and in the potential limitation of some measures against the spread of the pandemic to older adults. These outcomes are unjustified and unethical. We develop six propositions against the ageism underlying these suggestions to spur a more adequate response to the current pandemic in which the needs and dignity of older people are respected.

Assimilative and accommodative coping in older adults with and without sensory impairment: four-year change and prospective relations with affective well-being.

Objectives: Sensory impaired older adults may be particularly dependent on coping strategies such as assimilation (or tenacious goal pursuit [TGP]) and accommodation (or flexible goal adjustment [FGA]) to secure high levels of well-being. We investigated if late-life changes in these coping strategies and prospective associations of TGP and FGA with affective well-being vary according to sensory impairment status. Method: Our study sample consisted of 387 adults aged 72-95 years (M = 82.50 years, SD =4.71 years) who were either visually impaired (VI; n = 121), hearing impaired (HI; n = 116), or sensory unimpaired (UI; n = 150). One hundred sixty-eight individuals were reassessed after approximately 4 years. Results: Both VI and HI revealed a decrease in TGP, whereas TGP remained stable in UI. For FGA, a significant increase in HI was observed, whereas a significant decline emerged in UI. Controlling for age, gender, and cognitive abilities, higher TGP at baseline was significantly associated with higher negative affect 4 years later in VI. Moreover, the positive association between baseline FGA and subsequent positive affect was stronger in HI than in UI older adults. Conclusion: Our findings suggest that older adults with sensory impairments reveal trajectories of assimilative and accommodative coping and associations of TGP and FGA with affective well-being that are different from sensory unimpaired individuals.

Communication behavior of cognitively impaired older inpatients : A new setting for validating the CODEM instrument.

BACKGROUND AND OBJECTIVE: Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients' well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. MATERIAL AND METHODS: Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. RESULTS: Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. CONCLUSION: CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

Visual Acuity and Cognition in Older Adults With and Without Hearing Loss: Evidence For Late-Life Sensory Compensation?

OBJECTIVES: Relationships between cognitive and sensory functioning become stronger with advancing age, and the debate on underlying mechanisms continues. Interestingly, the potential mechanism of compensation by the unaffected sensory modality has so far been investigated in younger age groups with congenital sensory impairment but not in older adults with late-life sensory loss. We compared associations between visual acuity and cognitive functioning in hearing-impaired older adults (HI), and sensory-unimpaired controls (UI). We expected stronger associations in the HI group as compared with the UI group. DESIGN: Our study sample was drawn from the pools of outpatients from regional university clinics and city registries and consisted of n = 266 older adults (mean age = 82.45 years, SD = 4.76 years; HI: n = 116; UI: n = 150). For the assessment of cognitive performance, multiple established tests (e.g., subtests of the revised Wechsler Adult Intelligence Scale) were used. Moreover, objective visual acuity (distance vision) was assessed. RESULTS: As expected, bivariate correlations between vision and cognitive abilities were stronger in the HI group compared with the UI group. In regression models controlling for age, sex, education, subjective health and number of chronic diseases, distance visual acuity was a significant predictor of general cognitive ability in the HI group only. CONCLUSIONS: Our findings suggest that visual acuity may play an important compensatory role for maintaining cognitive ability when hearing impairment sets in, which may reflect an adaptive process of late-life sensory compensation.

Four-year reciprocal relationships between personality and functional ability in older adults with and without sensory impairment: focus on neuroticism and agreeableness.

OBJECTIVES: Personality traits have been found to influence health and functional ability (FA) via multiple pathways. However, personality traits may also change in reaction to constraints in FA, particularly in more vulnerable individuals with high risk of decline in independent functioning in daily life (e.g. older adults with sensory impairment). Therefore, conceptually anchored in the World Health Organization's International Classification of Functioning, Disability and Health (ICF model), this study investigated reciprocal relationships between personality, focusing on neuroticism and agreeableness, and indicators of FA (i.e. activities of daily living and subjective autonomy) as well as the potentially moderating role of sensory impairment status. METHOD: The study sample consisted of 387 older adults (mean age at T1: M = 82.50 years, SD = 4.71 years) who were either sensory impaired (SI; i.e. visually or hearing impaired) or sensory unimpaired (UI). A total of 168 individuals were reassessed four years later. RESULTS: Depending on sensory status, personality acted both as predictor and as outcome of FA. Neuroticism was more strongly related with later FA outcomes in SI than in UI individuals. FA variables, in turn, were significant predictors of later neuroticism in UI older adults only and of later agreeableness in SI individuals only. CONCLUSION: These findings suggest that the late-life personality-FA interplay needs to be considered bidirectional, and the direction of associations varies systematically as a function of sensory impairment status.

Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach.

OBJECTIVES: Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. Addressing potential shortcomings of previous research, we examined the effect of a whole-ecology PA intervention program on NH residents' depressive symptoms using generalized linear mixed-models (GLMMs). METHOD: We used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning (n = 163, Mage = 83.1, 53-100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale-Residential) by using gamma distribution. RESULTS: Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilization in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. CONCLUSION: Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents' depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered.

Subjective Time Perceptions and Aging Well: A Review of Concepts and Empirical Research - A Mini-Review.

Human beings impose subjective, time-related interpretations on their existence, and the experience of time is a major aspect of lifespan development. In this mini-review, we understand subjective time as the way individuals subjectively perceive and evaluate the passing of their personal "objective" lifetime. A broad range of constructs and operationalizations has been developed in (gero-) psychology to capture subjective time, including future time perspective, personal goals, or autobiographical memories. In order to theoretically integrate this yet loosely connected body of literature, we propose a conceptual model of subjective time concepts according to 2 dimensions: temporal direction (past, present, future) and thematic field (duration/expansion, time-ordered life content, and time-related evaluations, attitudes, and mindsets). This conceptual model of subjective time perceptions builds the foundation for a review of the empirical literature regarding associations of subjective time with developmental outcomes (i.e., subjective well-being and physical health) in middle and late adulthood. Empirical findings establish subjective time concepts as a consistent predictor of well-being and health. Positive subjective time perceptions (i.e., an expanded view of the future, a focus on positive past and future life content, and favorable time-related evaluations) were associated with higher well-being and better physical health, while negative subjective time perceptions in general were linked to lower levels of health and well-being. Contrasting past- and future-oriented subjective time perceptions, it appears that past-oriented subjective time perceptions have been studied primarily in relation to subjective well-being, while future-oriented time perceptions play a key role both with regard to physical health and well-being. In conclusion, we argue that a stronger integration of subjective time constructs into developmental regulation models may deepen our understanding of human development across the lifespan. To this end, we call for theoretical and empirical interlinkages between yet loosely connected conceptual developments related to subjective time. These endeavors should be paralleled by an extension of methodological procedures (e.g., implementation of longitudinal research designs as well as a focus on the oldest-old) in order to inform a "lifespan theory of subjective time."

A new look at nursing home residents' depressive symptoms: the role of basic versus expanded everyday competence.

BACKGROUND: Depressive symptoms are highly prevalent in nursing home (NH) residents. The relationship between depressive symptoms and everyday competence in terms of basic (BaCo) and expanded everyday competence (ExCo; see Baltes et al., 2001) in the NH setting is, however, not clear. Applying Lewinsohn's depression model, we examined how residents' BaCo and ExCo relate to their depressive symptoms. Furthermore, we investigated the mediating role of perceived control. METHODS: Cross-sectional data from 196 residents (M age = 83.7 years, SD = 9.4 years) of two German NHs were analyzed. Study variables were assessed by the Geriatric Depression Scale-Residential (GDS-12R), maximal gait speed (BaCo), proxy ratings of residents' in-home activity participation, and self-initiated social contact done by staff (ExCo). Structural equation modeling (SEM) was used and a simulation study was included to determine power and potential estimation bias. RESULTS: At the descriptive level, one quarter of the residents showed symptoms of depression according to the GDS-12R cut-off criterion. Residents' BaCo and ExCo were independently and equally strongly associated with their depressive symptoms in the SEM analysis. These findings were affected neither by cognitive impairment, sex, nor age. Perceived control mediated between BaCo but not ExCo and depressive symptoms. CONCLUSION: Future research needs to follow the connection between residents' everyday competence and their depressive symptoms longitudinally to better understand the underlying mechanisms.

Life-space and movement behavior in nursing home residents: results of a new sensor-based assessment and associated factors.

BACKGROUND: Studies on life-space (LS) and its determinants have previously been limited to community-dwelling subjects but are lacking in institutionalized older persons. The purpose of this study was to provide an advanced descriptive analysis of LS in nursing home residents and to identify associated factors based on an established theoretical framework, using an objective, sensor-based assessment with a high spatiotemporal resolution. METHODS: Cross-sectional study in two nursing homes in Heidelberg, Germany (n = 65; mean age: 82.9 years; 2/3 female). Changes of location in the nursing home (Transits) as well as time spent away from the private room (TAFR) were assessed using a wireless sensor network. Measures of physical, psychosocial, cognitive, socio-demographic, and environmental factors were assessed via established motor performance tests, interviews, and proxy-reports. RESULTS: LS of residents was largely restricted to the private room and the surrounding living unit (90%); 10% of daytime was spent outside the living unit and/or the facility. On average, TAFR was 5.1 h per day (±2.3; Range: 0-8); seven Transits (6.9 ± 3.2; Range: 0-18) were performed per day. Linear regression analyses revealed being male, lower gait speed, higher cognitive status, and lower apathy to be associated with more Transits; higher gait speed, lower cognitive status, and less depressive symptoms were associated with more TAFR. LS was significantly increased during institutional routines (mealtimes) as compared to the rest of the day. CONCLUSIONS: The sensor-based LS assessment provided new, objective insights into LS of institutionalized persons living in nursing homes. It revealed that residents' LS was severely limited to private rooms and adjacent living units, and that in institutional settings, daily routines such as meal times seem to be the major determinant of LS utilization. Gait speed, apathy, and depressive symptoms as well as institutional meal routines were the only modifiable predictors of Transits and/or TAFR, and thus have greatest potential to lead to an enhancement of LS when targeted with interventions. TRIAL REGISTRATION: Current Controlled Trials ISRCTN96090441 (retrospectively registered).