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.

The Holocaust Experience and Its Role in the Association Between Meaning in Life, Depressive Symptoms and Life Satisfaction.

Holocaust survivors often reveal long-term depressive symptoms, while demonstrating life satisfaction. The present study examined the role of meaning in life (MIL) of Holocaust survivors in this context. Survivors (n = 44) and comparisons (n = 51) provided background information and completed MIL, depressive symptoms, and life satisfaction scales. MIL was associated with lower depressive symptoms and higher life satisfaction. Moreover, the MIL-depressive symptoms/life satisfaction links were stronger among Holocaust survivors. Results provide insight for tailoring treatment interventions for older adults who have been exposed to prolonged traumatic experiences or genocide, that focus on MIL, to enhance mental health.

Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients.

INTRODUCTION: The current study aimed to find reciprocal effects between subjective age and functional independence during rehabilitation from osteoporotic fractures and stroke and whether these effects can be mediated by indicators of well-being. METHODS: Participants were 194 older adults (mean age = 78.32 years, SD = 7.37; 64.8% women) who were hospitalized following an osteoporotic fracture or stroke. Participants completed measures of subjective age and well-being (i.e., optimism, self-esteem, and life satisfaction) several times during rehabilitation. Functional Independence Measure (FIM) was completed by nursing personnel at admission and at discharge. RESULTS: Younger subjective age at admission predicted higher FIM scores at discharge. The reverse effect, that is, of FIM scores at admission on subjective age at discharge, was nonsignificant. Optimism during hospitalization mediated the effect of subjective age on subsequent FIM scores while self-esteem and life satisfaction did not. Sensitivity analyses further showed that the effect of subjective age on FIM was significant for both fracture and stroke patients. DISCUSSION: The findings highlight the effect of subjective age on rehabilitation outcomes among osteoporotic fractures and stroke patients and suggest several potential mechanisms behind this effect. Rehabilitation outcomes following osteoporotic fractures or strokes could improve if subjective age and an optimistic outlook are taken into consideration.

Let there be light: The moderating role of positive solitude in the relationship between loneliness and depressive symptoms.

Positive solitude (PS), the choice of being alone to engage in meaningful inner or physical, spiritual, mental, or cognitive activity/ experience, was recently suggested as a stand-alone phenomenon differentiated from loneliness and negative solitude. As loneliness was previously found to have adverse implications for mental health, the present study examined whether the ability to engage in PS can moderate the harmful effect of loneliness on depressive symptoms. The sample consisted of 520 community-dwelling older adults in Israel aged 68-87 (Mage = 72.66). Participants answered an online questionnaire through a survey company (Ipanel) assessing their background characteristics, depressive symptoms, loneliness, and PS. Loneliness was positively associated with depressive symptoms, whereas PS was negatively associated with depressive symptoms. Furthermore, PS moderated the relationship between loneliness and depressive symptoms, such that higher levels of PS weakened this association. The findings indicate that PS may serve as a buffering factor for mental health among older adults by augmenting coping with the adverse outcomes of loneliness. The results provide insight for tailoring future treatment interventions focusing on PS to enhance mental health among older adults.

Dental anxiety and ageing anxiety: Moderated mediation roles of Oral Health-Related Quality of Life and subjective accelerated ageing.

BACKGROUND: Oral health and its relation to ageing is an important topic often neglected among geriatric populations. Proper oral rehabilitation may aid in alleviating mental health burdens in such populations. OBJECTIVES: The present study aimed to explore the association between dental anxiety and ageing anxiety, with regard to the interplay of Oral Health-Related Quality of Life (OHRQoL) as mediator and subjective accelerated ageing as a moderator. METHODS: A total of 577 participants with mean age 72.78 years (SD = 3.832, range = 68-87) were recruited via a survey company in Israel. They completed a self-report battery of questionnaires about dental anxiety, OHRQoL, subjective accelerated ageing and ageing anxiety, along with their informed consent. RESULTS: The findings revealed that dental anxiety was positively associated with ageing anxiety (direct effect), and that OHRQoL mediated the link between dental anxiety and ageing anxiety (indirect effect). Additionally, subjective accelerated ageing moderated the positive link between dental anxiety and OHRQoL, as well as the positive link between OHRQoL and ageing anxiety. CONCLUSIONS: The results provide insight for the roles of OHRQoL and subjective accelerated ageing among older adults between dental anxiety and ageing anxiety. Tailoring oral rehabilitation interventions that focus on these factors are warranted to improve older adults' dental health.

Self and Perceived Others' Views of Aging and Their Association with Mental Health in the Second Half of Life.

This study focuses on the concepts of subjective age and subjective nearness-to-death (views-of-aging) and examines the association between individuals' chronological age, self, and others' perceptions of these variables and mental health. A total of 267 participants aged 40-95 M = 64.33 provided sociodemographic information and filled out scales assessing self and others' views-of-aging, depressive symptoms, and their well-being. After controlling for covariates, age was not related to the dependent variables, whereas young/far from death self, and perceived others' views-of-aging was related to better mental health. The interaction between young age and young/far from death perceived others', but not self, views-of-aging was associated with lower depressive symptoms and higher well-being. Finally, the interaction between young/far from death self and perceived others' views-of-aging was associated with lower depressive symptoms but not with well-being. These findings provide an initial glance at the complex relations between two types of personal views-of-aging and emphasize the importance of how individuals appraise others' perceptions of their own aging process and life expectancy.

Close social relationships and loneliness: the role of subjective age.

Loneliness is considered a major issue, often negatively influencing the quality of life of individuals of all ages, and of older adults, in particular. The aims of this study are: (1) to assess the association between close social relationships and loneliness; and (2) to examine the moderating role of subjective age in this association. Married or cohabiting community-dwelling Israelis in the second half of life (N = 360) were interviewed and reported on their close social relationships, their level of loneliness, and their subjective age. The number of close social relationships was found to have a negative relationship with loneliness. Moreover, subjective age was found to moderate the relationship between close social relationships and loneliness, such that the association was weaker for those with older subjective age. Those with older subjective age are often not able to benefit from close social relationships to alleviate loneliness as much as their younger-subjective-age counterparts. Efforts to address older adults' loneliness should consider focusing on older adults' perceptions of aging.

The moderating role of subjective nearness-to-death in the association between health worries and death anxieties from COVID-19.

The purpose of this study was to examine whether subjective nearness-to-death moderated the association between health worries and death anxiety due to the COVID-19 outbreak among older adults in Israel. Using an online survey, 277 participants were recruited and completed self-reported questionnaires, which included background characteristics, exposure to COVID-19 risk experiences, self-rated health, subjective nearness-to-death, health worries regarding COVID-19, and death anxiety. Findings revealed that subjective nearness-to-death moderated the association between health worries and death anxiety. The importance and significance of subjective perceptions concerning the distance from death as far, which may serve as a resilient resource, is discussed.

Nursing aides' mentalization, expressed emotion, and observed interaction with residents with dementia: A quasi-experimental study.

This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.

Synchrony in Old Age: Playing the Mirror Game Improves Cognitive Performance.

OBJECTIVES: Studies have shown that synchronized motion between people positively affects a range of emotional and social functions. The mirror-game is a synchrony-based paradigm, common to theater, performance arts, and therapy, which includes dyadic synchronized motion, playfulness, and spontaneity. The goal of the current study is to examine the effects of the mirror-game on subjective and cognitive indices in late life. METHODS: Thirty-four older adults (aged 71-98) participated in a within-group study design. Participants conducted two sessions of 9-minute movement activities: the mirror-game and the control condition - a physical exercise class. Several measures were taken before and after experimental sessions to assess socio-emotional and attentional functions. RESULTS: The mirror-game enhanced performance on the attention sub-scale and led to faster detections of spoken words in noise. Further, it enhanced perceived partner responsiveness and led to an increase in positive reported experience. CONCLUSIONS: Our preliminary findings suggest that the mirror-game, rather than the exercise class, may have an immediate impact on mood and some attentional functions. CLINICAL IMPLICATIONS: The mirror-game is a novel intervention, with potential benefits of social-emotional and cognitive functioning, which can be easily implemented into the daily routine care of older adults. Future studies should explore the effect of the mirror-game on additional cognitive and socio-emotional aspects.

Exploring gaps in positive solitude perceptions: older adults vs. gerontology professionals.

OBJECTIVES: The aim of this study was to explore old persons' experiences of positive solitude (PS) and the gaps between their experience and professional caregivers' perceptions of older adults' experiences of PS. Moreover, we attempt to understand the basic mechanism that may explain these gaps. DESIGN: A qualitative method was used. PARTICIPANTS: Fourty-one older adults (aged 65-103 years) and 2 groups of professionals: 16 occupational therapists with a specialization in gerontology and 41 gerontology graduate students from other occupations. MEASUREMENT: Four open-ended questions about PS were asked. The older adults described their views on PS and experiences during solitude. The two caregiver groups, who are familiar with older adults, answered the questions twice, referring once to themselves and once to older adults in general. RESULTS: A. Gaps exist between old peoples' and caregivers' perceptions and experience of PS. B. The caregivers believe that older adults cannot easily enjoy PS. C. Caregivers believe that there are certain preconditions for older adults' experience of PS. D. Differences in attitude toward older adults between the caregiver groups were found. CONCLUSIONS: Although old people occasionally prefer PS, culture and age bias may prevent caregivers from accepting older adults' need for PS. Practical implications include the need to raise awareness of age bias among caregiving staff, in particular regarding their acceptance of older adults' PS experiences. This may improve the staff's willingness to enable older adults to experience PS without interruption.

The Moderating Effect of Older Adults' Receptive Arts Engagement on the Association Between Resilience and Anxiety Symptoms During Coronavirus Breakout.

ABSTRACT: In this study, we evaluated whether levels of receptive arts engagement (visiting museums/concerts/the theater/the cinema) during the year preceding the COVID-19 outbreak may have served as a psychological resource for older adults that mitigated the association between resilience levels and COVID-19 anxiety when the pandemic broke out. Data were collected after the enactment of the first emergency regulations (between March 15 and April 1, 2020) via the Qualtrics Survey Software link that was sent out through social media platforms. In total, 205 participants aged 65 to 92 (mean age, 72.32; SD, 5.63) reported general anxiety symptom levels (GAD-7) (Spitzer et al., 2006), resilience (Connor-Davidson Resilience Scale), frequency of receptive arts engagement in the previous year, health status, exposure to risk situations, and behavioral changes due to the pandemic. Our hypothesis that receptive arts would moderate the resilience-COVID-19 anxiety link was examined by a multiple hierarchical regression analysis and with the PROCESS computational tool. Findings show that resilience was associated with COVID-19 anxiety and that this association was moderated by levels of receptive arts engagement. The findings show that high levels of prior art engagement constituted a potent buffer against subsequent COVID-19 anxiety. Policy makers may benefit older adults by encouraging their engagement in arts activities, even during social distancing.

COVID-19 related loneliness and sleep problems in older adults: Worries and resilience as potential moderators.

OBJECTIVES: Older adults may experience loneliness due to social distancing and isolation during the Coronavirus disease 2019 (COVID-19) pandemic. Loneliness may further catalyze numerous poor health outcomes including impaired sleep. This study aimed to assess COVID-19 related worries and resilience as potential moderators of the loneliness-sleep problems link. METHOD: In the midst of the lock-down period of COVID-19, we collected data using a web-based public platform from 243 Israeli older adults (mean age = 69.76, SD = 6.69, age range = 60-92). Participants completed measures of COVID-19 related loneliness, sleep problems, COVID-related worries, and resilience. RESULTS: COVID-19 related loneliness was related to more sleep problems. The loneliness-sleep association was especially strong among those with more COVID-19 related worries or among those with lower resilience. CONCLUSION: The relationship between COVID-19 related loneliness and sleep problems is not uniform across older adults. The subjective sleep quality of those with more COVID-19 related worries or less resilience (i.e., feeling less being able to adapt to the challenging circumstances) is more susceptible to feeling lonely. Considering these variables may facilitate detection of and intervention for older adults vulnerable to aversive results in the context of COVID-19.

The Definition and Categories of Positive Solitude: Older and Younger Adults' Perspectives on Spending Time by Themselves.

This paper attempts to develop a better understanding of the positive solitude (PS) phenomenon and its meaning among age groups, as well as formulate a unanimous definition for PS. A qualitative study (N = 124) was conducted. Participants were gerontology professionals and laypeople. Interviews were conducted and content was analyzed in order to understand the essence of PS, themes, and subthemes. Two major categories were found: the essence and the components of the PS experience. Seven PS content categories and three meta-themes were raised: (1) PS is a matter of choice; (2) PS is satisfying and enjoyable; and (3) PS is meaningful. Differences in PS categories between younger and older adults were found. The meta-themes served as the foundation of a new definition. PS has different attributes in old age. A unified definition of PS may help distinguishing between PS and other forms of being alone. Recognizing and facilitating the PS experience among older adults might be beneficial and contribute to their quality of life.

COVID-19-Related Loneliness and Psychiatric Symptoms Among Older Adults: The Buffering Role of Subjective Age.

OBJECTIVE: The study examined whether subjective age moderated the relationship between loneliness due to the COVID-19 pandemic and psychiatric symptoms. METHODS: A convenience sample of older adult Israelis (N = 277, mean age = 69.58 ± 6.72) completed web-based questionnaires comprising loneliness, anxiety, depressive, and peritraumatic distress symptoms. They also reported how old they felt. RESULTS: The positive relationship between loneliness due to the COVID-19 pandemic and psychiatric symptoms was weak among those who felt younger than their age while this very same relationship was robust among those feeling older. CONCLUSIONS: Young subjective age may weaken the loneliness-symptom association among older adults during the COVID-19 pandemic. Older adults holding an older age identity are more susceptible to the adverse effects of loneliness. Although preliminary, the findings may inform screening and interventions. Subjective age may help identify those at high risk in suffering from loneliness, and suggest interventions aimed at ameliorating both loneliness and older subjective ages.

Positive mental health moderates the association between PTSD symptoms and subjective accelerated aging among older adults.

Posttraumatic stress disorder (PTSD) symptoms are known for predicting accelerated aging. However, it has not been examined whether individuals are subjectively aware of this process. The present study examined whether PTSD symptoms predict subjective accelerated aging and whether positive mental health status moderates this relationship. One hundred and thirty-two community-dwelling older adults (M = 66.85, SD = 9.13) who were sampled through random dialing of Jewish residents in the south of Israel completed the questionnaire twice: At Wave 1 after the flare-up of an Israeli-Palestinian conflict, and at Wave 2, a year later. Participants reported their PTSD symptoms, positive mental health, and on their subjective accelerated aging a year later. Higher levels of PTSD symptoms and lower levels of positive mental health were separately related to increased subjective accelerated aging. Participants with a lower level of positive mental health demonstrated a stronger association between PTSD symptoms and subjective accelerated aging. These findings emphasize that individuals who suffer from higher levels of PTSD symptoms and specifically those with lower levels of positive mental health status tend to feel they are aging faster. This finding adds to previous research suggesting that alongside the physiological process of accelerated aging there is also a subjective similar process.

Ageism: can a museum exhibit make a difference?

Ageism is a key challenge to today's aging societies. "Dialogue with Time" is an original Israeli interactive museum exhibit that aims to change negative ageist attitudes by creating a meaningful and stereotype-breaking encounter between visitors and old age. The objective of this study was to examine whether the exhibition reduces ageist attitudes among its visitors. The study employed a comparative pre-post structure with a comparison group. A closed-answer questionnaire was supplied to 100 participants in the experimental group, visitors to the "Dialogue with Time" exhibit, and to 100 participants in the control group. Participants were asked to complete the questionnaire before entering the exhibits and again after experiencing them. Changes in the level of ageism were measured using the Farboni Scale of Ageism. A significant reduction in ageism attitudes was shown in the experimental group when comparing before and after the visit, t(91) = 11.75, p = 0.001, with a good effect size of Cohen's d = 0.50, whereas in the control group there was no significant change, t(76) = 0.05, p = 0.95, and a weak effect size of Cohen's d = 0.00. The findings indicate that combating ageism can also be sustained by means of museum exhibits. We recommend that museums and other similar public institutions (e.g. art galleries, exhibition halls) use public spaces to advance multigenerational exposure to positive images of aging.

COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism.

A prominent feature of anxiety in late life is concerns regarding physical health. Anxiety symptoms among older adults have been connected with various psychological outcomes, including social isolation and loneliness. During the coronavirus disease 2019 (COVID-19) pandemic, many societies have demonstrated increased ageist attitudes, encouraging older adults to distance themselves from society. Accordingly, the current study examined the moderating role of COVID-19-related ageism in the connection between COVID-19 health worries and anxiety symptoms among older adults. Data were collected from 243 older adults (age range 60-92; M = 69.75, SD = 6.69), who completed scales assessing COVID-19-related health worries and ageism, as well as anxiety symptoms. The results demonstrated that both health worries and ageism were positively associated with anxiety symptoms. Moreover, the connection between health worries and anxiety symptoms was more pronounced among older adults with high ageism levels. The study highlights the vulnerability of older adults in general, and ageist older adults in particular, to the negative consequences of COVID-19-related health worries, and emphasizes the role of the increased ageist stance of society during the pandemic in this regard.

'It is nothing more than a senior moment': the moderating role of subjective age in the effect of change in memory on self-rated memory.

OBJECTIVE: The association between memory performance and self-rated memory is yet to be understood. More specifically, little is known about the factors that lie at the base of self-evaluations of memory in relation to actual changes in memory. In this study, we suggest that subjective age modifies the effect of objective change in memory on self-rated memory. METHOD: We used two waves of the Health and Retirement Study (N = 4624) to examine whether subjective age moderates the effect of experienced changes in memory between T1 and T2 on self-rated memory at T2. RESULTS: Our results suggest that subjective age is a significant moderator of the effect of change in memory on self-rated memory. The effect is weaker among those with younger subjective age, and stronger for those with older subjective age. CONCLUSION: While preserving a young subjective age is usually considered an adaptive strategy, it also has potential negative effects, masking changes in memory performance.

A light in a sea of darkness: the moderating role of emotional complexity in the PTSD symptoms-successful aging association.

OBJECTIVES: This study aimed to assess the underexplored effects of posttraumatic stress disorder (PTSD) symptoms on objective and subjective successful aging and to inquire whether emotional complexity moderates these effects. METHODS: Community-dwelling older adults (N = 127, mean age = 67.86, SD = 11.07) rated their PTSD symptoms and completed measures of objective and subjective successful aging. They further reported their emotions on a daily basis over 14 days. RESULTS: After controlling for background characteristics, self-rated health and cumulative lifetime adversity, results showed that higher PTSD symptoms were related to less successful aging, both objective and subjective. However, this relationship existed only amongst older adults with low emotional complexity, but not amongst those with high emotional complexity. CONCLUSION: The findings suggest that high emotional complexity buffers against the negative effects of PTSD symptoms on successful aging. Interventions that empower emotional complexity amongst traumatized older adults may attenuate these negative effects.