The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults.

INTRODUCTION: Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly. METHODS: This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge. RESULTS: The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes. CONCLUSION: Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.

How Do Social Relationships Affect Later Life Planning?

Relatively little is known about how social relationships affect later life planning. Our study focuses on an underexamined aspect of social relationships, frequency of contact - not only with family members but also with friends. Using data from a survey of Floridians aged 50 and older conducted between December 2020 and April 2021 (n = 3,832), we examine the association between frequency of contact and five planning types: finances, health care, living arrangements, driving retirement, and end-of-life. We found that more frequent contact was associated with greater likelihood of planning, and this result was largely consistent across types of relationships and types of planning. Our findings suggest that contact with family members and friends may encourage more planning, which could reduce the stress that can accompany later life transitions. Our study offers further evidence of social relationships' centrality to later life well-being and points to the many benefits of enhancing them.

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

OBJECTIVES: Older people describe positive and negative age-related changes, but we do not know much about what contributes to make them aware of these changes. We used content analysis to categorize participants' written comments and explored the extent to which the identified categories mapped onto theoretical conceptualizations of influences on awareness of age-related change (AARC). DESIGN: Cross-sectional observational study. PARTICIPANTS: The study sample comprised 609 UK individuals aged 50 years or over (mean (SD) age = 67.9 (7.6) years), enrolled in the PROTECT study. MEASUREMENTS: Between January and March 2019, participants provided demographic information, completed a questionnaire assessing awareness of age-related change (AARC-10 SF), and responded to an open-ended question asking them to comment on their responses. RESULTS: While some of the emerging categories were in line with the existing conceptual framework of AARC (e.g. experiencing negative changes and attitudes toward aging), others were novel (e.g. engagement in purposeful activities or in activities that distract from age-related thoughts). Analysis revealed some of the thought processes involved in selecting responses to the questionnaire items, demonstrating different ways in which people make sense of specific items. CONCLUSIONS: Results support the ability of the AARC questionnaire to capture perceived age-related changes in cognitive functioning, physical and mental health, and engagement in social activities and in healthy and adaptive behaviors. However, findings also suggest ways of enriching the theoretical conceptualization of how AARC develops and offer insights into interpretation of responses to measures of AARC.

Attitudes toward own aging and cognition among individuals living with and without dementia: findings from the IDEAL programme and the PROTECT study.

BACKGROUND: It is unclear whether people with dementia (PwD) have more negative attitudes toward own aging (ATOA) than people without dementia and what factors influence ATOA among PwD. We investigated whether PwD have more negative ATOA than individuals without dementia and whether cognition and dementia subtype are associated with ATOA in PwD. METHODS: Data from the IDEAL and PROTECT studies were used to compare ATOA between 1502 PwD (mean (SD) age = 76.3 (8.5)) and 6377 individuals without dementia (mean (SD) age = 66.1 (7.1)). Linear regressions and ANOVA were used. RESULTS: PwD reported slightly more negative ATOA than people without dementia; this relationship disappeared after controlling for depression and self-rated health. In PwD more positive ATOA showed negligible associations with better general cognition, memory performance, verbal fluency, and visuospatial ability. However, after adjusting for covariates only better visuospatial ability predicted more positive ATOA. Additional analyses showed that before and after controlling for covariates, individuals with poorer self-reported visual acuity have more negative ATOA. Amongst dementia subtypes, people with Parkinson's disease dementia and dementia with Lewy bodies reported most negative ATOA. CONCLUSIONS: ATOA between PwD and people without dementia do not differ. ATOA in PwD appear to be affected not by cognitive impairment but by other characteristics that vary across dementia subtypes. Among PwD, those with Parkinson's disease dementia and dementia with Lewy bodies may have higher risk of experiencing negative ATOA due to the motor and visual impairments that they experience.

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

OBJECTIVES: How people adjust their goals is central to adaptation across the lifespan. However, little is known about individual difference characteristics that predict how and why people use different self-regulatory strategies. The present study investigated associations of perceived age-related gains and losses, and their interaction, as predictors of goal adjustment in older adulthood. Furthermore, we examined whether future time perspective (FTP) mediated relationships between awareness of age-related change (AARC) and goal adjustment. METHOD: A community-based sample of 408 adults (aged 60-88 years) was recruited via an internet-based research platform. Participants completed questionnaire measures of AARC, FTP, goal disengagement, and goal re-engagement. A flexibility index reflecting tendencies toward use of both goal disengagement and goal re-engagement strategies was also analyzed. RESULTS: Although AARC-losses was associated with lower goal re-engagement and goal flexibility, this association was weaker among those with higher AARC-gains, indicating AARC-gains may be protective in the relationship between AARC-losses and goal adjustment. The association between AARC and goal adjustment was also shown to be mediated by FTP. Higher AARC-gains was associated with more expansive FTP, which was associated with lower goal disengagement and higher goal re-engagement. On the other hand, higher AARC-losses was associated with more restricted FTP, which was associated with higher goal disengagement and lower goal re-engagement. DISCUSSION: Results have implications for how we conceptualize the combined effects of age-related gains and losses on developmental outcomes relevant to adaptive aging. Furthermore, perceptions of future time with advancing age may be implicated in processes linking AARC with goal adjustment.

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.

International relevance of two measures of awareness of age-related change (AARC).

BACKGROUND: A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany. We validated the short form of the measure (AARC-10 SF) and the cognitive functioning subscale from the 50-item version of the AARC (AARC-50) questionnaire in the UK population aged 50 and over. METHODS: Data from 9410 participants (Mean (SD) age = 65.9 (7.1)) in the PROTECT cohort were used to explore and confirm the psychometric properties of the AARC measures including: validity of the factor structure; reliability; measurement invariance across men and women, individuals with and without a university degree, and in middle age, early old age, and advanced old age; and convergent validity with measures of self-perception of aging and mental, physical, and cognitive health. We explored the relationship between demographic variables (age, sex, marital status, employment, and university education) and AARC. RESULTS: We confirmed the two-factor structure (gains and losses) of the AARC-10 SF and the AARC-50 cognitive functioning subscale. Both scales showed good reliability and good convergent validity for AARC losses, but weak convergent validity for AARC gains. For both scales metric invariance was held for the two subgroups defined by education level and age. For the AARC-50 subscale, but not for the AARC-10 SF, strong invariance was also held for the two subgroups defined by sex. Age, sex, marital status, employment, and university education predicted AARC gains and losses. CONCLUSIONS: The AARC-10 SF and AARC-50 cognitive functioning subscale identify UK individuals who perceive age-related changes in their mental, physical, and cognitive health.

Rising above It: Status Ambivalence in Older Adults.

BACKGROUND: Social status is the standing of a person or group in the social hierarchy, and is perceived to change across the life span from low social status in early life, to peak in midlife, and to a decline thereafter. As threats to subjective social status are known to be detrimental to individuals' health, it is important to better understand how older adults perceive themselves and others in terms of age-related social status. OBJECTIVE: We examined status ambivalence - the potential discrepancy between how older adults' perceive social status for themselves compared to older adults in general. METHOD: Study 1 used qualitative data from 37 semi-structured interviews with older adults to assess perceptions of social status. Study 2 used quantitative survey data from 114 older adults who completed explicit and implicit measures of social status. RESULTS: Study 1 (n = 37, meanage = 71.72, SDage = 5.69; 81.1% women) provided preliminary evidence for status ambivalence such that older adults reported unequivocal low social status for other older adults but a more ambivalent perception of their own social status. Study 2 (n = 114, meanage = 64.32, SDage = 8.98, 57.9% women) compared implicit and explicit measures of social status revealing that older adults consistently perceive older adults to have low social status but again show a more ambivalent perception of their own social status. CONCLUSION: We discuss status ambivalence as a potential protective mechanism in the context of negative societal perceptions of age-related social status that may be important for well-being in later life.

Variation in Subjective Aging by Sexual Minority Status.

The past few decades have seen increased scholarly attention to gay and lesbian individuals' aging experiences; however, few studies examine differences in subjective aging by sexual minority status. We identify four perspectives on the association between sexual minority status and subjective aging-double jeopardy, crisis competence, gender interactive, and limited salience perspectives. We examine each perspective's predictions using data from the first wave of Midlife in the United States (1995-1996; MIDUS). Ordinary least square regression models reveal strongest support for the limited salience perspective, suggesting that sexual minority status has weaker effects on subjective aging than do other social factors, such as age, health, and gender. However, some results provide support for the gender interactive perspective, positing that the effect of sexual minority status on subjective aging varies by gender. Our study provides an organizational framework of theoretical perspectives that can guide further examinations of variation in aging experiences by sexual minority status.

An empirical examination of subjective age in older adults.

It has been observed that subjective age (SA) often trails chronological age, especially in older adults. In a previously published article, we argued that differences in individual's SA is a function of their level of activity on biological, mental, and social dimensions. This article empirically tests this proposition using a newly created Subjective Aging Index (SAI). The SAI is related to SA above the effect of age with differences existing across age groups and sex. The findings contribute to the literature on successful aging strategies with important implications for health care practitioners, marketers, and individuals heading towards older adult years.

Satisfaction with aging results in reduced risk for falling.

BACKGROUND: Falls are highly frequent in older adults and are associated with increased morbidity and mortality. The present study was designed to assess the role of satisfaction with one's aging process as a predictor of the risk for falling over a four-year period and to identify potential mediators of this relationship. METHODS: The Health and Retirement Study (HRS) is a US nationally representative sample of individuals over the age of 50 years and their spouse of any age. The present study was based on the 2008-2012 waves of the HRS. Analyses were restricted to 4,121 respondents over the age of 50 years, who had fall data in 2008 and 2012 and were eligible to complete the satisfaction with aging measure as part of the 2008 psychosocial questionnaire. RESULTS: Overall, 38.1% of the sample reported having fallen at least once between 2006 and 2008 and 40.7% reported having fallen at least once between 2010 and 2012. Higher levels of satisfaction with aging in 2008 were found to be protective against falls assessed in 2012 (OR[95%CI] = 0.88[0.79-0.98]) even after adjustment for age, gender, education, ethnicity, medical status, functional status, cognitive functioning, walking speed, balance, vision, depressive symptoms, physical activities, and past falls. Bootstrap procedures have shown that the effect of satisfaction with aging on falls is partially accounted for through its effect on functional decline. CONCLUSIONS: The findings point to the important role of satisfaction with aging as a potential protective mechanism against falls. The results call for the development of psychosocial interventions to reduce falls in older adults.

Time benders: a model of subjective aging in aging adults.

This article develops a new model for understanding the aging experience. Drawing upon aging literature from the chronological, biological, mental, and social aging perspectives, the model offered is an integrated perspective that provides better understanding of the relationship between chronological age and an individual's perceived age. The article provides evidence of ways that consumers are trying to "time bend" and change today's perceived reality of aging. The article concludes with a discussion of implications for the health care industry and provides examples of how some businesses seem to already be looking at aging and health related issues through this lens.

Unveiling the multifaceted nexus of subjective aging, biological aging, and chronological age: Findings from a nationally representative cohort study.

OBJECTIVES: This study aims to investigate how subjective aging influences the psychological and behavioral responses of older individuals, specifically focusing on the associations between subjective aging and longitudinal changes in biological age. METHODS: This is a retrospective cohort study retrieving data from the Taiwan Longitudinal Study on Aging (TLSA), over a 4-year follow-up period. Subjective aging is assessed by asking participants if they perceive themselves as old, while frailty is measured using a frailty index comprising 34 deficits from various domains. Participants are categorized into three groups based on their chronological age. The association between subjective aging and transition of biological age (as indicated by an increased frailty index) from 2011 to 2015 is examined using logistic regression models. RESULTS: The study consisted of 2412 participants, who were categorized into middle-age (n = 1,082), young-old (n = 779), and old-old (n = 551) groups. Among them, individuals exhibiting subjective aging at baseline were more likely to be older in chronological age, female, illiterate, and unemployed, compared to those without subjective aging. The adjusted odds ratios (aORs) for the association between subjective aging and an increased biological age were 1.72 [95% CI: 0.88-3.34], 1.61 [0.77-3.37], and 1.08 [0.65-1.80], in the middle-age, young-old, and old-old groups, respectively. DISCUSSIONS: No significant associations were found between changes in biological age and subjective aging across various chronological age groups. Notably, within the younger age group, a discernible trend towards an association was observed, indicating the potential age-related nuances in the complex interrelation between subjective age, biological aging, and chronological aging.

Daily Dynamics of Awareness of Aging and Basic Psychological Need Satisfaction and Frustration in Middle and Older Adulthood.

OBJECTIVES: This daily diary study examined associations between awareness of age-related change (AARC) and satisfaction/frustration of basic psychological needs of autonomy, competence, and relatedness in a sample of midlife and older adults. We expected that greater satisfaction and lower frustration of needs would be associated with higher AARC-gains and lower AARC-losses. We also examined whether within-person associations of need satisfaction/frustration with AARC were moderated by age. METHODS: Participants (N = 152; aged 53+) completed measures of AARC and basic psychological need satisfaction and frustration on their smartphones for 10 consecutive days. Data were analyzed using multilevel models, with time-varying basic need satisfaction/frustration variables disaggregated into between-person and within-person components. RESULTS: On days participants reported higher than usual overall satisfaction of needs, and lower than usual frustration of needs, AARC-gains was higher, and AARC-losses was lower. Analysis of individual needs showed that autonomy and competence were more consistently related to higher AARC-gains and lower AARC-losses than relatedness. Within-person autonomy satisfaction was more strongly (negatively) associated with AARC-losses at older ages. DISCUSSION: Findings suggest that daily experiences related to satisfaction and frustration of goals related to autonomy and competence in particular may be proximal antecedents of short-term variation in AARC.

Traumatic losses permeate daily emotional experiences: roles of daily uplifts and subjective age.

Daily emotional experiences may vary depending on a stressor's intensity or source. The present study aimed to examine the interaction between traumatic loss, daily uplifts, and daily subjective age predicting daily negative affect. Results from a 14-day daily diary study of 440 US adults aged 50-85 showed that daily increases in uplifts were associated with decreases in negative affect, especially for those who reported a traumatic loss when they also experienced increases in subjective age. Based on our study, daily events and perceptions can have a considerable impact on daily functioning and may serve as important mechanisms after a traumatic loss. Although traumatic losses may impact individuals differently, incorporating daily uplifts, based on available resources and capacities, may foster daily emotional well-being.

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

OBJECTIVES: How people reflect on their own age may influence their well-being in the face of disruptions associated with the coronavirus (COVID-19). Subjective aging was operationalized in terms of one's awareness of age-related change (AARC), specifically, the gains and losses associated with aging. We developed a measure assessing disruptions to daily life associated with the COVID-19 pandemic across 3 dimensions (i.e., Social and Lifestyle Disruption, Work and Health Disruption, and Others Contracting COVID-19). We hypothesized that COVID-19 disruption would be positively associated with both AARC-losses and AARC-gains. Greater COVID-19 disruption would also be associated with poorer psychosocial outcomes (higher perceived stress and negative affect [NA] and lower positive affect [PA]) and these associations would be stronger for those reporting greater AARC-losses and weaker for those reporting greater AARC-gains. METHODS: Cross-sectional questionnaire data were collected from 263 participants from the United States (aged 40-83; mean age: 62.88 years, standard deviation = 9.00; 56.3% females). RESULTS: After controlling for age, gender, education, employment, socioeconomic status, and physical functioning, greater Work and Health Disruption was associated with greater AARC-losses. Greater Social and Lifestyle Disruption was associated with both greater AARC-gains and AARC-losses. Moderation effects showed an exacerbating effect of AARC-losses on NA in the face of Work and Health Disruption and a protective effect of AARC-gains on PA in the context of Social and Lifestyle Disruption. DISCUSSION: We extend research detailing antecedents of AARC and highlight the need for longitudinal research that considers the ever-changing nature of the pandemic.

Sexual Activity and Satisfaction in Older Adult Dyads: The Role of Perceptions of Aging.

BACKGROUND AND OBJECTIVES: This study assessed the associations between perceptions of aging (POA) and sexual frequency and satisfaction in older adult dyads. RESEARCH DESIGN AND METHODS: Using dyadic data from up to 1,122 different-sex married and cohabiting couples ages 50-89 (Mmen = 66.63 [7.40]; Mwomen = 64.43 [7.27]), we estimated 2 actor-partner interdependence models. We first examined the association between men's and women's POA and each partner's reports of frequency of partnered sexual activity (e.g., intercourse, oral sex, kissing, petting, and fondling). Then, we tested the link between POA and each partner's sexual satisfaction. RESULTS: Actor effects were detected in both models. Both men's and women's positive POA were associated with their own reports of more frequent sexual activity and greater satisfaction with their sex lives. DISCUSSION AND IMPLICATIONS: These findings provide insight into how positive views on aging relate to older couples' sexuality. Future research should consider how attitudes shape later-life sexuality over time.

Testing Bidirectionality in Associations of Awareness of Age-Related Gains and Losses With Physical, Mental, and Cognitive Functioning Across 1 Year: The Role of Age.

OBJECTIVES: The bidirectionality between self-perceptions of aging and health-related outcomes may depend on age group. Therefore, we tested such bidirectionality among individuals in late midlife (50-64 years), young-old age (65-74 years), and old-old age (75+ years), taking advantage of the construct of Awareness of Age-Related Change (AARC) and its 2-dimensionality in terms of AARC-gains and AARC-losses. Various conceptualizations of physical, mental, and cognitive functioning were used as outcomes. METHODS: Data from 2 measurement occasions (2019 and 2020) from the UK PROTECT study for individuals in late midlife (N = 2,385), young-old age (N = 2,430), and old-old age (N = 539) were used. Data on self-reported functional difficulties, depression, anxiety, and performance on four computerized cognitive tasks (i.e., verbal reasoning, paired associate learning, self-ordered search, and digit span) providing a score for verbal reasoning and a score for working memory were analyzed using cross-lagged panel models. RESULTS: Across all 3 age groups, the bidirectional associations of AARC-gains with indicators of functioning were not significant, whereas higher AARC-losses significantly predicted slightly greater functional difficulties and higher depression and anxiety levels. Higher AARC-losses predicted slightly poorer Verbal Reasoning only in old-old age and poorer Working Memory predicted slightly higher AARC-losses only in young-old age. The remaining associations of AARC-losses with cognitive tasks were not statistically significant. DISCUSSION: In accordance with previous research targeting other indicators of self-perceptions of aging, this study supported a stronger impact of AARC-losses on indicators of physical functioning and mental health than vice versa from midlife to old-old age.

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

Background: The concept of Awareness of Age-Related Changes captures people's perceptions of the positive (AARC-gains) and negative (AARC-losses) age-related changes they experience in several life domains, including their health. We investigated the cross-sectional associations of number and type of physical and mental health conditions with AARC-gains and AARC-losses. Methods: The sample comprised 3,786 middle-aged and older adults (mean age = 67.04 years; SD = 6.88) participating to the UK PROTECT study. We used hierarchical regression models to analyze whether after having included sociodemographic variables (model 1), number of physical (model 2) and of mental (model 3) health conditions explained a significant additional amount of variance in AARC-gains and AARC-losses, and whether the association between number of conditions and AARC depended on participants' age. We used multiple regression models to analyze the associations of types of physical and mental health conditions with AARC-gains and AARC-losses. Results: A higher number of physical health conditions was associated with higher AARC-gains and higher AARC-losses, but the association did not depend on participant age. After controlling for the number of physical health conditions, a higher number of mental health conditions was associated with higher AARC-losses but not with AARC-gains, and the association was stronger among older participants. Small effects were found between greater AARC-gains and current cancer and between greater AARC-losses and diagnoses of mild cognitive impairment, Parkinson's disease, arthritic condition, cancer in full remission, osteoporosis, depression, anxiety disorders, and personality disorder. The remaining health conditions were either negligibly or non-statistically related to AARC-losses. Conclusion: Middle-aged and older adults having more physical health conditions and more mental health conditions may be at higher risk of negative views on their own aging. However, specific physical health conditions, such as arthritis, and certain mental health conditions, such as depression, may make adults particularly vulnerable to negative age-related perceptions.