Examining the Malleability of Negative Views of Aging, Self-Efficacy Beliefs, and Behavioral Intentions in Middle-Aged and Older Adults.

OBJECTIVES: This study examined the malleability of a tripartite cluster of purported mechanistic variables targeted in a 4-week intervention program designed to improve adults' engagement in physical activity. The targeted cluster of purported mechanisms consisted of negative views of aging (NVOA), self-efficacy beliefs, and behavioral intentions. METHODS: A randomized single-blind control group design was used to implement the AgingPLUS program in a sample of middle-aged and older adults (N = 335; Mage = 60.1 years; SDage = 8.3 years; age range 45-75 years). RESULTS: Using an intention-to-treat approach and analyses of covariance adjusting for participants' baseline scores, findings showed significant improvements in the purported mechanistic variables both at the immediate (Week 4) and delayed posttest (Week 8) in the treatment group but not in the control group. These improvements were for the most part maintained until 8-month postrandomization, although to a smaller extent. Specifically, participants in the AgingPLUS group showed significant improvements in NVOA, self-efficacy beliefs, and behavioral intentions compared to the Health Education control group. Standardized effect sizes for statistically significant effects were variable and ranged from small (d = -0.23) to large (d = 0.80). Effect sizes showed some decay of the intervention at the 8-month posttest. DISCUSSION: Taken together, the findings supported the efficacy of the AgingPLUS program and showed that variables representing the purported mechanisms of the intervention were significantly moved in a positive direction. In doing so, the AgingPLUS program met a major requirement of the experimental medicine approach to behavior change interventions. CLINICAL TRIALS REGISTRATION NUMBER: NCT0329948.

Longitudinal effects of subjective aging on health and longevity: An updated meta-analysis.

This article updates and extends an earlier meta-analysis (Westerhof et al., 2014) on the longitudinal effects of subjective aging (SA) on health outcomes. A systematic search in different databases (APA PsycInfo, PubMed, Web of Science, and Scopus) resulted in 99 articles, reporting on 107 studies. Participants: Studies had a median sample size of 1,863 adults with a median age of 66 years. A randomized effect meta-analysis showed a significant, small effect (likelihood ratio = 1.347; 95% confidence interval [1.300, 1.396]; p < .001), similar in magnitude to the previous meta-analysis of 19 studies. Although the results showed high heterogeneity in the longitudinal link between SA and health outcomes, there were no differences in effects according to chronological age of participants, welfare state status (more or less developed social security system), length of follow-up, type of health-related outcome, or quality of the study. Effects were stronger for multiitem measures of self-perceptions of aging than for the frequently used single-item measures assessing subjective age, especially for indicators of physical health. Based on this meta-analysis, building on five times more studies than the 2014 review, we consider the associations of measures of SA with health and longevity across time as robust, albeit small in size. Future research should concentrate on the clarification of pathways mediating the relation between SA and health outcomes, as well as potential bidirectional effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Change in Views of Aging, Physical Activity, and Physical Health Over 8 Weeks: Results From a Randomized Study.

The AgingPLUS program targets motivational barriers, including negative views of aging, as mechanisms to increase adult physical activity. A pilot study was conducted to test the efficacy of this new program against a generic successful aging program. Fifty-six participants were randomly assigned to the AgingPLUS group, and 60 participants were assigned to the active control group. Repeated-measures multivariate analyses of variance assessed changes in views of aging, physical activity, blood pressure, and hand-grip strength from pretest (Week 0) to delayed posttest (Week 8). The Condition × Occasion interactions were nonsignificant; however, significant main effects for condition and occasion were found. Follow-up tests showed that views of aging were more positive, and physical activity had significantly increased at Week 8 for all participants. In addition, in the treatment group, elevated blood pressure had significantly decreased and hand-grip strength had significantly increased at Week 8. Despite the nonsignificant multivariate findings, the main effect findings provided partial support for the efficacy of the AgingPLUS program.

The Effects of Age Stereotypes on Physical and Mental Health Are Mediated by Self-perceptions of Aging.

OBJECTIVES: Although the evidence linking views on aging (VoA) with aging outcomes is robust, little is known about how different types of VoA may interact to influence such outcomes. Therefore, this study examined two types of VoA, age stereotypes (AS), representing general VoA, and self-perceptions of aging (SPA), representing personal VoA. We operationalized SPA in terms of awareness of age-related change (AARC), distinguishing between gain- and loss-related SPA (e.g., awareness of positive and negative age-related changes, respectively). Based on theoretical reasoning, we hypothesized that AS would be an antecedent of SPA, and that the effect of AS on physical and mental health would be mediated by SPA. METHOD: A total of 819 German and U.S. adults aged 40-98 completed a survey on VoA, physical health, and mental health at baseline and 2.5 years later. Structural equation modeling with latent variables was used to examine the effects of Time 1 AS (predictor) and Time 2 gain- and loss-related SPA (mediators) on physical and mental health outcomes. RESULTS: As hypothesized, AS predicted later SPA. Loss-related SPA mediated the effect of AS on physical health; both gain- and loss-related SPA mediated the effect of AS on mental health. DISCUSSION: Congruent with theoretical assumptions, our findings provide empirical support for a directional pathway by which AS shape later SPA. We conclude that AS and SPA may affect physical health outcomes more strongly than mental health outcomes. Studies that assess both types of VoA are needed to illuminate the pathways by which VoA influence aging outcomes.

The AgingPLUS trial: Design of a randomized controlled trial to increase physical activity in middle-aged and older adults.

BACKGROUND: Negative views of aging (NVOA), low self-efficacy beliefs, and poor goal planning skills represent risk factors that undermine adults' motivation to engage in physical activity (PA). Targeting these three risk factors may motivate adults to become physically active. OBJECTIVE: To assess the efficacy of AgingPLUS, a 4-week educational program that explicitly targets NVOA, low self-efficacy beliefs, and poor goal planning skills compared to a 4-week health education program. The study also examines the role of NVOA, self-efficacy beliefs, and goal planning as the mechanisms underlying change in PA. DESIGN: This randomized controlled trial (RCT) utilizes the experimental medicine approach to assess change in PA as a function of modifying three risk factors. The RCT recruitment target includes 288 mostly sedentary adults ranging in age from 45 to 75 years. METHODS: Eligible middle-aged and older adults are recruited through community sources. Participants are randomized to either the AgingPLUS or the control group. Participants in both groups are enrolled in the trial for 8 months total, with four assessment points: Baseline (pre-test), Week 4 (immediate post-test), Week 8 (delayed post-test), and Month 6 (long-term follow-up). The intervention takes place over 4 consecutive weeks with 2-h sessions each week. PA engagement is the primary outcome variable. Positive changes in NVOA, self-efficacy beliefs, and goal planning are the intervention targets and hypothesized mediators of increases in PA. SUMMARY: By utilizing a multi-component approach and targeting a cluster of psychological mechanisms, the AgingPLUS program implements the experimental medicine approach to health behavior change.