Psychometric Properties and Measurement Invariance of the Awareness of Age-Related Change Short Form in Older Adult Samples From Taiwan and Germany.

BACKGROUND AND OBJECTIVES: This study examined the psychometric properties and measurement invariance of the 10-item Awareness of Age-Related Change Short Form (AARC-SF) questionnaire in a Chinese-speaking sample of older adults in Taiwan. RESEARCH DESIGN AND METHODS: Data from 292 participants (Mage = 77.64 years) in the Healthy Aging Longitudinal Study in Taiwan cohort were used for Study 1, whereas data from young-old adult samples in Germany were used for Study 2. RESULTS: Study 1 showed that the AARC-SF had satisfactory reliability and validity for assessing adults' AARC in Taiwan. Analyses confirmed the 2-factor structure of AARC-gains and AARC-losses. Study 2 demonstrated strong measurement invariance across men and women, whereas direct comparisons of the item scores between young-old adults and old-old adults need to be made with caution. Noninvariance of loadings indicated that certain items were more closely linked to AARC-gains and AARC-losses in Taiwan than in Germany. Noninvariance of intercepts suggested potential biases in comparing item scores between Taiwanese and German older adults. DISCUSSION AND IMPLICATIONS: The AARC-SF emerged as a reliable and valid instrument for capturing positive and negative subjective aging experiences among Taiwanese older adults. However, it is noteworthy that some items on the AARC-SF may solicit different responses from individuals of different ages and different countries of origin, requiring caution with age group and cross-cultural comparisons.

Successful Aging and Subjective Aging: Toward a Framework to Research a Neglected Connection.

Research related to subjective aging, which describes how individuals perceive, interpret and evaluate their own aging, has substantially grown in the past two decades. Evidence from longitudinal studies shows that subjective aging predicts health, quality of life, and functioning in later life. However, the existing literature on successful aging has mostly neglected the role of subjective aging. This paper proposes an extended framework of successful aging linking subjective aging conceptually and empirically to Rowe and Kahn's (1997) three original key criteria of successful aging (i.e., avoiding disease and disability, maintaining high cognitive and physical function, and engagement with life). A particular focus is placed on subjective aging as an antecedent of successful aging. A review of the empirical subjective aging literature shows that subjective aging concepts consistently predict all three of Rowe and Kahn's criteria of successful aging. Mechanisms underlying these relations are discussed at three levels, namely psychological, behavioral, and physiological pathways. The proposed addition also takes into consideration the interconnections between subjective aging and successful aging throughout the lifespan and across historical time. Finally, we discuss the importance of facilitating successful aging through systematic interventions that support more positive views of aging at the individual and societal level.

Differential Item Functioning Along the Old Age Continuum: Contrasting Chronological Age With Contextual Variables in the Assessment of Gains and Losses Across Advanced Old Age.

OBJECTIVES: The fourth age is considered a life stage with a high likelihood of age-related losses. However, very old age extends over decades, and little is known about how transitions that may happen during this age period (e.g., developing support needs or adopting caregiving roles) or lack thereof might change perceptions of age-related gains or losses. Many subjective age scales assume implicitly that they work across advanced old age, but data to support this assumption are scarce. This study reports findings on (1) diverging, age-specific understandings of age-related change and (2) whether very old adults' functional health, received social support, and caregiving roles, rather than chronological age, account for such differences. METHODS: Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021, comprising 10,578 individuals aged 80-106 years. RESULTS: At equivalent levels of perceived gains and losses, adults in the early fourth age reported more "freedom in daily life," less "dependency on others," and fewer "needs to reduce activities," whereas adults in the late fourth age reported more "appreciation of others." Chronological age, as such, was not the primary source of this response shift. Rather, functional health, social support, and caregiving responsibilities accounted for the differences in how older adults interpreted and reported specific age-related gains and losses. DISCUSSION: Findings underscore that across the multiple decades of the fourth age, interpretations of aging experiences vary and depend on a person's own late-life health and functioning and on that of significant others.

Differences in self-perceptions of aging across the adult lifespan: The sample case of awareness of age-related gains and losses.

Rooted in the premises of lifespan developmental theory, the concept of awareness of age-related change (AARC) posits that growing older comes with both experiences of gains and losses across different behavioral domains. However, little is known about how age-related change is perceived across the entire adult lifespan, provided that respective measures can be validly compared. Further, few studies have adopted an approach that examines gains and losses simultaneously to study a potential shift in the ratio of perceived age-related gains and losses from adolescence to advanced old age. Using cross-sectional data from the German Socio-Economic Panel, this study tested the measurement invariance of the 10-item AARC short form and examined age differences in the awareness of age-related changes across 1,612 participants aged 16-93 years. First, partial measurement invariance of the AARC-Gains and AARC-Losses scales was established, allowing for valid group comparisons across young adulthood, midlife, and old age. Second, results indicated that people experience more AARC-Gains than AARC-Losses throughout the adult lifespan. However, older adults exhibited an increasingly less favorable gains-to-losses ratio, primarily driven by more loss experiences. Gain experiences were mostly stable across age groups. Third, differences in levels of AARC were related to individuals' background characteristics relevant at the respective time of life, such as education (early adulthood), employment (midlife), and social resources (old age). These results highlight the utility of considering a broad age range when examining the nature and correlates of age differences in perceived age-related gains and losses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Levels of awareness of age-related gains and losses throughout adulthood and their developmental correlates.

Views of aging predict key developmental outcomes. Less is known, however, about the consequences of constellations of domain-specific perceived gains and losses across the full adult lifespan. First, we explored levels of awareness of age-related gains (AARC-gains) and losses (AARC-losses) in five behavioral domains across adulthood. Second, we identified the number and types of profiles of AARC-gains and AARC-losses in young adulthood, midlife, young-old age, and old-old age. Third, we investigated whether the identified profiles differed in their associations with developmental correlates. Data came from the 2018 German Socio-Economic Panel Innovation Sample (SOEP-IS), comprising 403 young, 721 middle-aged, 260 young-old and 228 old-old individuals. We assessed AARC, physical and mental functioning, information processing speed, social relations, lifestyle, and engagement. At the sample level, AARC-losses were higher in old age, whereas AARC-gains did not differ across adulthood. Latent profile analyses revealed two distinguishable constellations of AARC-gains and AARC-losses that characterize young adulthood and old-old age, whereas four and three gains-to-losses constellations are needed to characterize midlife and young-old age, respectively. In middle, young-old, and old-old age, profiles with more AARC-losses were associated with poorer scores on all developmental correlates. Overall, study results suggest that age-related experiences are most diversified in midlife and young-old age. Asking individuals about their negative age-related experiences may help identify those individuals who are doing less well in important developmental correlates. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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

Background and Objectives: Advanced old age is a life stage with a high likelihood of age-related loss experiences. However, little is known about remaining gain experiences and their relation with perceived losses and health correlates in community-dwelling very old adults. Moreover, virtually nothing is known in this regard about the experiences of individuals in long-term care settings. First, we strived to establish the normative course of age-related gains and losses in advanced old age. Second, we examined whether such gain/loss perceptions in advanced aging moderated health correlates. Research Design and Methods: Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021. The sample comprised 10 578 individuals aged 80-106 years, including 587 individuals in long-term care. We used the multidimensional Awareness of Age-Related Change (AARC) questionnaire and moderated regression to analyze associations with late-life health and functioning correlates. Results: Levels of AARC-Gains were higher than those of AARC-Losses across most of the age range. Long-term care residents showed more AARC-Losses and fewer AARC-Gains compared with community-dwelling adults and contributed significantly to an overall negative balance of more losses than gains in those aged 90 years or older. Regarding functional health and autonomy, negative age effects were amplified by AARC-Losses, but buffered by AARC-Gains. A more positive ratio of gains-to-losses predicted better health and functioning. Discussion and Implications: Findings suggest that the loss aspect of development in very late life might have been overstated in the existing literature. Perceived gains and losses are of critical importance for the understanding of health correlates in very old age.

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

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

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

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

Awareness of Age-Related Change as a Behavioral Determinant of Survival Time in Very Old Age.

Although research on the association between subjective views of aging (VOA) and survival is scarce, more negative VOA have been found to be associated with increased all-cause mortality, even after controlling for possible confounders. Longitudinal studies on the predictive association of VOA with survival in individuals aged 80 years or older are, however, very limited. Thus, the aim of this study was to link adults' awareness of age-related change (AARC), a multidimensional measure of adults' subjective VOA, to survival time across a 3.5-year observation interval in advanced old age. To put the AARC construct in context, the study also considered related psychosocial concepts (i.e., perceived control and appraisal of life) essential for coping with late-life challenges as potential behavioral predictors of longevity. Data came from a representative panel study that included persons living in community and institutional settings. A total of 1,863 interviews were conducted at wave 1. This study used meta-data from wave 2 fieldwork 2 years after the initial assessment and death records obtained during panel maintenance after 3.5 years to estimate determinants of survival. Results showed that loss-related VOA indicated increased risk to survival, whereas gain-related VOA were predictive of longer survival. Both perceived age-related losses and perceived age-related gains exerted a significant independent effect on late-life mortality over and above socio-demographic background characteristics, perceived control, engagement with life, as well as health status. These findings suggest that the multidimensional examination of very old adults' VOA may help to better understand successful longevity in the Fourth Age.

The NRW80+ study: conceptual background and study groups.

BACKGROUND: The study "Quality of life and well-being of the very old in North Rhine-Westphalia NRW80+" aims at giving a representative picture of the quality of life (QoL) in this population. Conceptually, QoL research has rarely considered the values of older individuals themselves and societal values, and their relevance for successful life conduct. Empirically, comparisons of different age groups over the age of 80 years are rare and hampered by quickly decreasing numbers of individuals in oldest age groups in the population of very old individuals. STUDY DESIGN AND THEORETICAL FRAMEWORK: This paper describes the population of the NRW80+ study and different age groups of very old individuals with respect to biographical background. Furthermore, using the challenges and potentials model of QoL in very old age (CHAPO), key aspects of QoL in late life are discussed and the importance of normative stipulations of what constitutes a successful life conduct are highlighted. In the NRW80+ study older age groups (i.e., 85-89 years, 90+ years) were deliberately overrepresented in the survey sample to enable robust cross-group comparison. Individuals willing to participate in the study but unable to participate in the interview themselves for health reasons were included by means of proxy interviews. The total sample included 1863 individuals and 176 individuals were represented by proxy interviews. Pronounced differences were observed between age groups 80-84 years (born 1933-1937, N = 1012), 85-89 years (born 1928-1932, N = 573), and 90 years or older (*born before 1927, N = 278) with respect to education, employment and the timing of major life events (e.g., childbirth). CONCLUSION: Different life courses and resulting living conditions should be considered when discussing QoL disparities in very old age.

Psychometric study of the Awareness of Age-Related Change (AARC) Short Scale translated to Portuguese, applied to Brazilian older adults.

The concept Awareness of Age-Related Change (AARC) is defined as a person's awareness that their behavior, level of physical, cognitive and social performance, and ways of experiencing life have changed as a consequence of having grown older, and not because of disease. OBJECTIVE: A psychometric study investigating evidence of construct validity and internal consistency of the Portuguese version of the AARC Short Scale was carried out. METHOD: A convenience sample of 387 individuals aged≥60 years with no deficit suggestive of dementia were recruited at venues frequented by older persons and at households. Participants answered the Portuguese version of the scale, along with questionnaires collecting sociodemographic and frailty variables and self-rated health based on personal criteria and relative to peers. RESULTS: Exploratory and confirmatory factorial analyses derived a structure with two orthogonal factors representing the latent variables gains and losses, invariant for age group, thus replicating the original scale. The factors explained a large proportion of item variability (58.6 to 51.8%) and exhibited high loadings (0.886 to 0.432) and good communality [0.787 for item 4 (better sense of what is important) and 0.369 for item 6 (less energy)]. The hypotheses of covariance between the new instrument and the parallel measures of frailty and self-rated health were confirmed. The levels of internal consistency were high (α>0.700). CONCLUSION: Evidence confirmed the factor and convergent (construct) validity and internal consistency of the new scale in Portuguese.

O reconhecimento de ganhos e perdas associados ao envelhecimento desempenha papel regulador em relação ao self e às atitudes sociais quanto à velhice. OBJETIVO: Investigar indicadores de validade de construto, consistência interna e validade convergente da Awareness of Age-Related Change Short Scale (AARC) traduzida para o português. MÉTODO: Um total de 387 indivíduos de 60 anos ou mais compuseram amostra de conveniência que respondeu à versão do estudo AARC Short Scale em português, e a medidas de fragilidade, autoavaliação de saúde e caracterização sociodemográfica. As explorações de validade de construto foram mediadas por análises fatoriais exploratórias (com rotação Varimax e oblíqua/Promax), e confirmatórias (método de equações estruturais para variáveis latentes); as de consistência interna, pelo teste de Cronbach e as de validade convergente, pelas correlações entre os itens da escala, fragilidade e saúde autorreferida. RESULTADOS: A estrutura de dois fatores, ganhos e perdas, as cargas e a comunalidade dos itens da escala em português foram altas e similares nas análises fatoriais exploratórias e confirmatórias, e similares à versão original. Foi rejeitada a hipótese de correlação entre os fatores e confirmada a de invariância do construto às idades; consistência interna da escala e dos fatores indicada por índices α>0,700; fragilidade e saúde autorreferida correlacionaram-se negativamente com a pontuação na escala e em ganhos, e positivamente em perdas. CONCLUSÕES: Foram observadas evidências de validade de construto, consistência interna e validade convergente da versão do AARC Short Scale em português, para aplicação em amostras com características similares às desse estudo.

WWII traumatic events, subjective well-being and valuation of life in the very old.

BACKGROUND: Experiencing war is a major trigger for physical and mental health problems. People in the German population who are currently over 80 years of age experienced the Second World War (WWII) as children or adolescents, at a time when psychological vulnerability is high. Empirical results show that positive subjective well-being (SWB) and valuation of life (VoL) in older cohorts are widespread; however, when confronted with existential age-associated changes, many older adults experience increased burden, sometimes bringing biographical vulnerabilities to the forefront. This study investigated SWB and VoL in the very old and examined the influence of negative WWII experiences on these outcomes. METHOD: Cross-sectional data from the "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)" are presented. Multiple regression models, adjusted for gender, age, physical health, and full inpatient care, were computed to assess the impact of suffering from the effects of WWII traumatic experiences on SWB and VoL. RESULTS: Over 13% spontaneously reported suffering from the effects of WWII events and an additional 29% reported negative experiences when explicitly asked about them. Multiple regression models showed elevated depression scores for participants suffering from the effects of WWII traumatic events. No association with positive affect was found. Suffering from the effects of WWII traumatic events did not influence VoL engagement with life or VoL optimism. DISCUSSION: Many very old adults still seem to struggle with the repercussions of WWII traumatic experiences. Future studies could further examine if the missing association with positive affect and VoL is a sign of resilience.

Psychometric study of the Awareness of Age-Related Change (AARC) Short Scale translated to Portuguese, applied to Brazilian older adults / Estudo psicométrico AARC Short Scale traduzido para o português, respondido por idosos brasileiros

ABSTRACT. The concept Awareness of Age-Related Change (AARC) is defined as a person's awareness that their behavior, level of physical, cognitive and social performance, and ways of experiencing life have changed as a consequence of having grown older, and not because of disease. Objective: A psychometric study investigating evidence of construct validity and internal consistency of the Portuguese version of the AARC Short Scale was carried out. Method: A convenience sample of 387 individuals aged≥60 years with no deficit suggestive of dementia were recruited at venues frequented by older persons and at households. Participants answered the Portuguese version of the scale, along with questionnaires collecting sociodemographic and frailty variables and self-rated health based on personal criteria and relative to peers. Results: Exploratory and confirmatory factorial analyses derived a structure with two orthogonal factors representing the latent variables gains and losses, invariant for age group, thus replicating the original scale. The factors explained a large proportion of item variability (58.6 to 51.8%) and exhibited high loadings (0.886 to 0.432) and good communality [0.787 for item 4 (better sense of what is important) and 0.369 for item 6 (less energy)]. The hypotheses of covariance between the new instrument and the parallel measures of frailty and self-rated health were confirmed. The levels of internal consistency were high (α>0.700). Conclusion: Evidence confirmed the factor and convergent (construct) validity and internal consistency of the new scale in Portuguese.

RESUMO. O reconhecimento de ganhos e perdas associados ao envelhecimento desempenha papel regulador em relação ao self e às atitudes sociais quanto à velhice. Objetivo: Investigar indicadores de validade de construto, consistência interna e validade convergente da Awareness of Age-Related Change Short Scale (AARC) traduzida para o português. Método: Um total de 387 indivíduos de 60 anos ou mais compuseram amostra de conveniência que respondeu à versão do estudo AARC Short Scale em português, e a medidas de fragilidade, autoavaliação de saúde e caracterização sociodemográfica. As explorações de validade de construto foram mediadas por análises fatoriais exploratórias (com rotação Varimax e oblíqua/Promax), e confirmatórias (método de equações estruturais para variáveis latentes); as de consistência interna, pelo teste de Cronbach e as de validade convergente, pelas correlações entre os itens da escala, fragilidade e saúde autorreferida. Resultados: A estrutura de dois fatores, ganhos e perdas, as cargas e a comunalidade dos itens da escala em português foram altas e similares nas análises fatoriais exploratórias e confirmatórias, e similares à versão original. Foi rejeitada a hipótese de correlação entre os fatores e confirmada a de invariância do construto às idades; consistência interna da escala e dos fatores indicada por índices α>0,700; fragilidade e saúde autorreferida correlacionaram-se negativamente com a pontuação na escala e em ganhos, e positivamente em perdas. Conclusões: Foram observadas evidências de validade de construto, consistência interna e validade convergente da versão do AARC Short Scale em português, para aplicação em amostras com características similares às desse estudo.

Advancing health literacy measurement in old age.

Health literacy is described as a domain of competence across the life-span, gaining particular prominence in light of age-associated health restrictions. However, no specific measurement approach has been proposed for old age. The aim of this study is to augment the existing HLS-EU-Q16 scale (16 items) by items sensitive to age-specific aspects of health literacy to ensure validity and reliability for use in old age. In a first step, the HLS-EU-Q16 was administered in a sample of 463 individuals aged 72 - 92 years. Psychometric properties were evaluated using confirmatory factor analysis and item-response-theory item fit statistics. Scale reliability was found to be poor in this population segment. In a second step, age-specific items were developed based on qualitative in-depth interviews with older persons. In a third step, we tested if the additional set of age-specific items was able to enhance a valid and reliable measurement of health literacy in a second sample of older adults (N = 107, 49 - 91 years). With the inclusion of an eight-item add-on, it was possible to measure health literacy in old and very old age with both high validity and satisfying precision (reliability = 0.80). The study contributes to a population-specific measurement of health literacy.

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.

Non-response in surveys of very old people.

Very old people are known to participate less often in social surveys than younger age-groups. However, survey participation among very old people in institutional settings is understudied. Additionally, the focus of the literature is on response rates, which neglects the complexity of the process of survey participation. The present study uses standard definitions of the American Association for Public Opinion Research to give a detailed description of survey participation among very old people, including those in institutional settings. Data come from a German survey on quality of life and subjective well-being of persons aged 80-84, 85-89, and 90+ (N = 1800). The present study (a) estimates contact, cooperation, response, and refusal rates and (b) identifies associations of age, sex, and type of residence with each of these rates. Weighted outcome rates for the survey were: contact = 66.0%, cooperation = 39.6%, response = 26.1%, and refusal = 26.9%. Age, sex, and type of residence were not associated with the contact, cooperation, and response rate. Lower refusal rates were found for people aged 90+, men, and institutionalized people. Additional analyses showed higher rates of non-interviews due to health-related reasons for institutionalized people and those aged 90+. Overall, results indicate that institutionalized and non-institutionalized people showed similar levels of survey participation. Willingness to participate is a key factor for women and people in private households, while the ability to participate is more important for institutionalized people.

Correction to: Non-response in surveys of very old people.

[This corrects the article DOI: 10.1007/s10433-018-0488-x.].

Measuring Awareness of Age-Related Change: Development of a 10-Item Short Form for Use in Large-Scale Surveys.

BACKGROUND AND OBJECTIVES: Existing measures of subjective aging have been useful in predicting developmental outcomes. Unlike other constructs of subjective aging, Awareness of Age-Related Change (AARC) focuses on how adults' self-perceptions of aging result in an awareness of age-related gains and losses. We developed a 10-item short form (SF) of the existing 50-item AARC questionnaire as a reliable, valid, and parsimonious solution for use primarily in large-scale surveys but also in applied contexts. RESEARCH DESIGN AND METHODS: AARC was assessed in a German and North American sample of 819 individuals. Item selection for the suggested AARC-10 SF was based on multidimensional item response theory (MIRT). Multi-group confirmatory factor analysis (CFA) was used to test for measurement invariance (MI) across groups of participants in middle age (40-69 years), early old age (70-79 years), and advanced age (80+ years). Concurrent and discriminant validity in old age was assessed with regard to established measures of subjective aging, well-being, and health. RESULTS: The AARC-10 SF showed adequate fit to the data and reliability for the perceived gains and losses composites. Valid comparison of latent means was confirmed for early old and advanced age respondents and with some reservation also for middle-aged individuals due to partial MI. Concurrent and discriminant validity were confirmed. DISCUSSION AND IMPLICATIONS: The proposed AARC-10 SF offers an economic device to measure AARC and use the construct as an antecedent or outcome in the context of substantive model testing in large-scale survey data.

Improving Quality of Work life for Care Providers by Fostering the Emotional well-being of Persons with Dementia: A Cluster-randomized Trial of a Nursing Intervention in German long-term Care Settings.

We tested the feasibility of a nursing intervention (DEMIAN) in routine care and its effects on care providers' job satisfaction, motivation, and work strain. This cluster-randomized trial was conducted in 20 German long-term care facilities. We randomly assigned 20 facilities to an intervention group (84 care providers, 42 residents with dementia) or a control group (96 care providers, 42 residents with dementia). Intervention group providers received two training days on the intervention; 68 providers attended both training days. Sixty two providers completed both baseline and follow-up questionnaires. Trained providers created individualized mini-intervention plans for participating residents. Control group residents received 'usual care'. Intervention group providers stated that the intervention was feasible and helped them improve emotional well-being of residents with dementia. We found significantly decreased time pressure and decreased job dissatisfaction for intervention group providers. DEMIAN is an effective and pragmatic contribution to implementing person-centred care in long-term care, with positive effects on providers' working conditions.