The uniqueness of subjective ageing: convergent and discriminant validity

Although a large body of research has demonstrated the predictive power of subjective ageing for several decisive developmental outcomes, there remains some controversy about whether subjective ageing truly represents a unique construct. Thus, information about the convergent and discriminant validity of different approaches to measuring subjective ageing is still critically needed. Using data from the 2014 wave of the German Ageing Survey, we examined how three established subjective ageing measures (subjective age, global attitude toward own ageing, multidimensional ageing-related cognitions) were inter-related as well as distinct from general dispositions (optimism, self-efficacy) and well-being (negative affect, depressive symptoms, self-rated health). Using correlational and multivariate regression analysis, we found that the three subjective ageing measures were significantly inter-related (r = |.09| to |.30|), and that each measure was distinct from general dispositions and well-being. The overlap with dispositional and well-being measures was lowest for subjective age and highest for global attitudes towards own ageing. The correlation between global attitudes towards own ageing and optimism was particularly striking. Despite the high convergent validity of the different dimensions of ageing cognitions, we nevertheless observed stronger associations between specific dimensions of ageing cognitions with negative affect and self-rated health. We conclude that researchers should be aware of the multidimensional nature of subjective ageing. Furthermore, subjective age appears to be a highly aggregated construct and future work is needed to clarify its correlates and reference points.Electronic supplementary materialThe online version of this article (10.1007/s10433-019-00529-7) contains supplementary material, which is available to authorized users.     

Determining priorities for research in ageing: A community survey

Objectives: This paper reports the culmination of a local process of priority setting for ageing research. Methods: A cross‐sectional random community mailout was conducted across 1500 Hunter region, Australia, households during 2001, using the modified Dillman procedures. The survey included 38 research topics and priority items. Research priorities were grouped according to factors identified by factor analysis. Results: There were 694 respondents. Four research priority factors were identified: age‐related diseases, symptoms and problems of ageing, lifestyle factors, and mental and social issues of ageing. Top‐rating priorities were stroke, dementia, heart disease and cancer. Overall, more women and older people (65+ years) ranked items as very important. Lifestyle factors were mentioned most often as the most important health and social issues facing older people. Conclusions: Community views should be considered where evidence and researcher interest can support this.     

Successful ageing in the oldest old: objectively and subjectively measured evidence from a population-based survey in Germany

Despite rapid increase of people aged 80 and over, concepts of successful ageing (SA) are primarily examined for people below that age. Therefore, successful ageing was examined in a population-based representative sample of N = 1863 people aged 80 to 102 (NRW80+) with 11% living in institutionalized settings. In this survey on quality of life and well-being, multiple linear and logistic regression models were used to calculate the distribution of successful agers. According to Rowe and Kahn’s objective definition, 9% of the sample aged successfully, but one-third (33%) still met four to five SA criteria. This is in line with the theoretical a priori criterion of 10% in a normal distribution of a sample, while 80% age normally and 10% pathologically. However, averages of life satisfaction, affective well-being, positive ageing experience and valuation of life were high. The majority of the oldest old (65%) are successful agers in their own subjective perception, which is not in line with objective measurements. Moreover, 11% of objectively measured successful agers do not meet subjective criteria. These empirical findings reveal a remarkable discrepancy between objective and subjective criteria of SA. Future research on concepts that define successful ageing for the oldest old should consider more holistic markers of success, e.g., outcomes of productive social engagement.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-021-00609-7.     

Relations between views on ageing and perceived age discrimination: a domain-specific perspective

This study investigates the relation between age stereotypes and perceived age discrimination. Existing evidence for such a relation is notoriously ambiguous with regard to its direction—age stereotypes can predict (perceived) discrimination, but experiencing discrimination may also change views on ageing—which is why we used a dataset with two waves to disentangle the direction of the associations. Considering research on the multi-dimensionality of views on ageing and perceived age discrimination, we addressed this question from a domain- and age group-specific perspective. Drawing on data from two measurement points of the German Ageing Survey (DEAS; t ₁: 2008, t ₂: 2011; age range at t ₁: 40–93 years, n = 6092 participants at t ₁), we examined reciprocal relations between views on ageing and perceived age discrimination. Cross-lagged models revealed that domain-specific views on ageing predict subsequent changes in perceived discrimination in corresponding domains: Negative views on ageing regarding personal competence, physical decline, and social interactions were associated with increases in perceived discrimination in the domains of work, medical care, and social life, respectively. However, we did not find evidence for a reciprocal effect of perceived age discrimination on views on ageing. In sum, results indicate that negative views on ageing act as self-fulfilling prophecies by predisposing people to categorize other people’s behaviour as age discrimination or to act themselves in a way that might elicit ageist behaviour in others.     

The importance of cognitive ageing for understanding dementia

A third of those over 80 years of age are likely to have dementia, the lack of a cure requires efforts directed at prevention and delaying the age of onset. We argue here for the importance of understanding the cognitive ageing process, seen as the decline in various cognitive functions from adulthood to old age. The impact of age on cognitive function is heterogeneous and the identification of risk factors associated with adverse cognitive ageing profiles would allow well-targeted interventions, behavioural or pharmacological, to delay and reduce the population burden of dementia. A shift away from binary outcomes such as dementia assessed at one point in time in elderly populations to research on cognitive ageing using repeated measures of cognitive function and starting earlier in the life course would allow the sources of variability in ageing to be better understood.     

Reactions to ageing among Australian psychologists

Objective: To assess attitudes towards personal ageing among Australian psychologists. Methods: Six hundred and four practising psychologists were surveyed using the Reactions to Ageing Questionnaire (RAQ). Potential predictors of attitudes to ageing, such as age, gender and number of years in clinical practice were examined, together with the amount and quality of contact with older family members and older friends. Measures related to the training of psychologists were also of interest. Results: The strongest significant predictors of attitudes to ageing were respondents’ age and positive attitudes towards conducting therapy with older clients. Contact and training variables were not associated with scores on the RAQ. Conclusion: These results highlight age as a contributing factor in attitude formation.     

A cross-sectional assessment of frailty,falls and perceptions of ageing in people living with HIV using an mHealth platform

Objective

To evaluate frailty, falls and perceptions of ageing among clinically stable individuals with HIV, engaged with remote healthcare delivered via a novel smartphone application.

Methods

This was a multi-centre European cross-sectional, questionnaire-based sub-study of EmERGE participants. Frailty was assessed using the five-item FRAIL scale. Present criteria were summed and categorized as follows: 0, robust; 1–2, pre-frail; 3–5, frail. Falls history and EQ-5D-5L quality of life measure were completed. Participants were asked their felt age and personal satisfaction with ageing.

Results

A total of 1373 participated, with a mean age of 45 (± 9.8) years. Frailty was uncommon at 2%; 12.4% fell in the previous year, 58.8% of these recurrently. Mood symptoms and pain were prevalent, at 43.3% and 31.8%, respectively. Ageing satisfaction was high at 76.4%, with 74.6% feeling younger than their chronological age; the mean felt age was 39.3 years. In multivariable analysis, mood symptoms and pain were positively associated with frailty, falls and ageing dissatisfaction. An increase in pain severity and mood symptoms were respectively associated with 34% and 63% increased odds of pre-frailty/frailty. An increment in pain symptoms was associated with a 71% increase in odds of falling. Pain was associated with ageing poorly, as were mood symptoms, with odds of dissatisfaction increasing by 34% per increment in severity.

Conclusions

Although uncommon, frailty, falls and ageing dissatisfaction were seen in a younger cohort with medically stable HIV infection using a remote care model, promoting screening as advocated by European guidelines. These were more common in those with pain or mood symptoms, which should be proactively managed in clinical care and explored further in future research.     

Questionnaire measures of self-directed ageing stereotype in older adults: a systematic review of measurement properties

The population is ageing, but while average life expectancy continues to increase, healthy life expectancy has not necessarily matched this and negative ageing stereotypes remain prevalent. Self-directed ageing stereotypes are hypothesised to play an important role in older adults’ health and well-being; however, a wide variety of terms and measures are used to explore this construct meaning there is a lack of clarity within the literature. A review was conducted to identify tools used to measure self-directed ageing stereotype in older adults and evaluate their quality. Searches identified 109 papers incorporating 40 different measures. Most common were the Philadelphia Geriatric Centre Morale Scale Attitude Towards Own Ageing (ATOA) subscale, Ageing Perceptions Questionnaire (APQ) and Attitudes to Ageing Questionnaire. Despite being most frequently used, the ATOA was developed to measure morale in older adults rather than self-directed ageing stereotypes. Over 25 terms were used to describe the concept, and it is suggested that for consistency the term “self-directed ageing stereotype” be adopted universally. Across measures, poor reporting of psychometric properties made it difficult to assess scale quality and more research is needed to fully assess measures before conclusions can be drawn as to the best tool; however, the Brief-APQ appears to hold most promise. Future research must address this issue before interventions to reduce negative self-directed ageing stereotypes can be developed and fully evaluated.Electronic supplementary materialThe online version of this article (10.1007/s10433-020-00574-7) contains supplementary material, which is available to authorized users.     

Effects of age simulation suits on psychological and physical outcomes: a systematic review

Age simulation suits (ASS) are widely used to simulate sensory and physical restrictions that typically occur as people age. This review has two objectives: first, we synthesize the current research on ASS in terms of the observed psychological and physical effects associated with ASS. Second, we analyze indicators able to estimate the validity of ASS in simulating “true” ageing processes. Following the PRISMA guidelines, eight electronic databases were searched (BASE, Cinhal, Cochrane, Google Scholar, ProQuest, PsychINFO, Pubmed, and Web of Science). Qualitative and quantitative studies addressing effects of ASS interventions regarding psychological outcomes (i.e., empathy, attitudes) or physical parameters (i.e., gait, balance) were included. The Mixed Methods Appraisal Tool was applied for quality assessment. Of 1890 identified citations, we included 94 for full-text screening and finally 26 studies were examined. Publication years ranged from 2001 to 2021. Study populations were predominantly based on students in health-related disciplines. Results suggest that ASS can initiate positive effects on attitudes toward (d_weighted = 0.33) and empathy for older adults (d_weighted = 0.54). Physical performance was significantly reduced; however, there is only little evidence of a realistic simulation of typical ageing processes. Although positive effects of ASS are supported to some extent, more diverse study populations and high-quality controlled designs are needed. Further, validation studies examining whether the simulation indeed reflects “real” ageing are needed and should build on reference data generated by standardized geriatric assessments or adequate comparison groups of older adults.Prospero registration: 232686.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-022-00722-1.     

The anorexia of ageing

Ageing is associated with a reduction in appetite and food intake, which has been termed the `anorexia of ageing'. After age 70–75 years average body weight decreases, even in healthy people, disproportionately due to loss of lean tissue. The `physiological' anorexia and weight loss of ageing predispose to pathological weight loss and malnutrition. Marked weight loss is common in the elderly and a major cause of morbidity and increased mortality. The cause(s) of the anorexia of ageing are largely unknown. We have identified several possibilities. Animal and preliminary human studies indicate that ageing is associated with increased satiety factors and a reduced feeding drive. Endogenous opioids stimulate eating. We administered iv infusions of the opioid antagonist naloxone to young and older adults. Overall, the suppression of food intake was not different in the two age groups, but was increased in older women, suggesting reduced stimulation of feeding by endogenous opioids in this group. Plasma concentrations of the satiety hormonecholecystokinin (CCK) increase with ageing. Intravenous CCK-8 infusion produced greater suppression of food intake in older than young subjects (33.5 vs 15.5% P = 0.026),indicating that sensitivity to the satiating effects of CCK is at least maintained and may increase withage. This raises the possibility of using CCK antagonists as stimulants of appetite and food intake in malnourished older people. This revised version was published online in July 2006 with corrections to the Cover Date.     

The assessment of views on ageing: a review of self-report measures and innovative extensions

This is a review of existing self-report measures for assessing views on ageing. It provides an overview of instruments, for which basic psychometric properties are available and describes them according to the purposes for which they are suitable. Literature search resulted in the inclusion of 89 instruments which were categorised along eight dimensions. The majority of measures focus on explicit cognitions about people’s own age and ageing or other (older) people. A substantial amount of tools account for the multidimensionality and multidirectionality of views on ageing, i.e. the idea that ageing is accompanied by both gains and losses in several different domains. To some extent, measures reflect that ageing is a long-term process and that views on ageing are malleable, rather than just stable traits. Cluster analysis revealed heterogeneity in instruments regarding the dimensions of Ecosystem, Balance, Stability, Dynamics, and Complexity. It becomes apparent, however, that approaches to measure views on ageing should be extended to more specifically target the implicit level as well as affective, physiological, and behavioural manifestations. Additionally, means for capturing views on ageing on the societal level and tools with a distinct time reference are needed. This is particularly important when one wants to account for the lifelong dynamics of views on ageing.     

A roadmap to build a phenotypic metric of ageing: insights from the Baltimore Longitudinal Study of Aging

Over the past three decades, considerable effort has been dedicated to quantifying the pace of ageing yet identifying the most essential metrics of ageing remains challenging due to lack of comprehensive measurements and heterogeneity of the ageing processes. Most of the previously proposed metrics of ageing have been emerged from cross‐sectional associations with chronological age and predictive accuracy of mortality, thus lacking a conceptual model of functional or phenotypic domains. Further, such models may be biased by selective attrition and are unable to address underlying biological constructs contributing to functional markers of age‐related decline. Using longitudinal data from the Baltimore Longitudinal Study of Aging (BLSA), we propose a conceptual framework to identify metrics of ageing that may capture the hierarchical and temporal relationships between functional ageing, phenotypic ageing and biological ageing based on four hypothesized domains: body composition, energy regulation, homeostatic mechanisms and neurodegeneration/neuroplasticity. We explored the longitudinal trajectories of key variables within these phenotypes using linear mixed‐effects models and more than 10 years of data. Understanding the longitudinal trajectories across these domains in the BLSA provides a reference for researchers, informs future refinement of the phenotypic ageing framework and establishes a solid foundation for future models of biological ageing.     

Exposure to the troubles in Northern Ireland,memory functioning,and social activity engagement: results from NICOLA

We investigated the potential impact of a cohort traumatic exposure, the Troubles in Northern Ireland, on memory functioning in later life, and the potential moderating effect of social activity engagement. Using data from 6571 participants aged 60 + in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) cohort, we used a structural equation modelling framework to explore associations between traumatic exposure during the Troubles and memory functioning. As expected, social activity engagement was positively associated with memory functioning, β = .102. Traumatic exposure was also positively associated with memory functioning, β = .053. This association was stronger at low levels of social activity engagement; among those with higher levels, there was little association, interaction β = − 0.054. The positive association between traumatic exposure during the Troubles and memory functioning was not moderated by the age at which the exposures occurred (based on analysis of a subsample with available data), interaction β = − 0.015. We conclude that superior memory functioning was associated with higher levels of traumatic exposure during the Troubles, particularly among those with lower levels of social activity engagement, and regardless of the age at which the exposures occurred. Future longitudinal analyses are required to build on these results, which potentially have implications for life-course epidemiology, in relation to critical periods for traumatising experiences. Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-022-00683-5.     

Differences in awareness of positive and negative age-related changes accounting for variability in health outcomes

Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N = 6192; mean (SD) age = 66.1 (7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-squared tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one’s ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-021-00673-z.     

Successful ageing by whose definition? Views of older,spiritually affiliated women

Objectives: Researchers have pointed to significant omissions in Rowe and Kahn's model of successful ageing and their lack of consultation with older people. This study examined late mid‐life and older women's views of successful ageing. Methods: In‐depth interviews were conducted with 14 women aged 60–89 years. Participants who identified themselves as spiritual and religious, or spiritual only and not religious, were recruited using the ‘snowball technique’. Thematic analyses were conducted within an Interpretive Phenomenological Analysis framework. Results: Participants described multiple dimensions of successful ageing with 15 subthemes grouped into three overarching categories of personal agency, social value and quality of life/quality of death. Conclusions: Participants’ multidimensional views of successful ageing were broader than Rowe and Kahn's model and included the need to have a degree of autonomy over the place and manner of the last phase of life and final days (successful dying).      

Obesity and ageing: Two sides of the same coin

Conditions and comorbidities of obesity mirror those of ageing and age‐related diseases. Obesity and ageing share a similar spectrum of phenotypes such as compromised genomic integrity, impaired mitochondrial function, accumulation of intracellular macromolecules, weakened immunity, shifts in tissue and body composition, and enhanced systemic inflammation. Moreover, it has been shown that obesity reduces life expectancy by 5.8 years in men and 7.1 years in women after the age of 40. Shorter life expectancy could be because obesity holistically accelerates ageing at multiple levels. Besides jeopardizing nuclear DNA and mitochondrial DNA integrity, obesity modifies the DNA methylation pattern, which is associated with epigenetic ageing in different tissues. Additionally, other signs of ageing are seen in individuals with obesity including telomere shortening, systemic inflammation, and functional declines. This review aims to show how obesity and ageing are “two sides of the same coin” through discussing how obesity predisposes an individual to age‐related conditions, illness, and disease. We will further demonstrate how the mechanisms that perpetuate the early‐onset of chronic diseases in obesity parallel those of ageing.     

Personal and societal intervention strategies for successful ageing

The article explores contemporary and future options for better personal and societal ageing. The phenomena of significantly more present and projected elders, especially the upcoming diverse American baby boomers, have generated peaked interest in ageing-related issues from academic, practicing professional, business, governmental, and adult constituencies. Although much of ageing-related theory, research, and practice remains discipline-specific, an integration of physical, psychological, and social ageing domains is suggested as a paradigm for personal and societal intervention. The integrative physical, psychological, and social successful ageing paradigm is used to illustrate advantages for the conceptual perspectives of multidimensional, multidirectional adult lifestyles, applied and interdisciplinary research agendas, and intervention strategies for productive ageing. Findings from a number of research programs emphasizing the integrative successful ageing approach are shared. Personal and societal priorities for productive ageing are reviewed. Successful ageing intervention strategies are presented in the context of personal decisions and lifestyles related to societal opportunities and restrictions. Preventive, rather than remedial intervention, is emphasized. Douglas Friedrich’s academic training is in developmental methodology, behavior genetics, and gerontology. His present research deals with successful ageing, including third wave longitudinal study of young-, middle-, and old-old adults with colleague Neil Davis. Primary study concerns are knowledge of ageing, psychological well-being, and activities associated with successful ageing.     

Life experience of the adult and ageing patient with haemophilia. Practical aspects for psychological support

This article discusses, from a psychological perspective, the life experience of the adult and ageing person with haemophilia, including psychological issues, aspects of his personal and social integration, decision‐making, communication and other factors that may affect treatment adherence and quality of life. The aim was to provide haematologists and healthcare staff with knowledge and resources to improve communication and support for adult persons with haemophilia, and raise awareness on psychosocial issues related to quality of life, sexuality and aspects associated with ageing with haemophilia. Adulthood is a period of many personal and social changes, and ageing with haemophilia is a relatively new phenomenon due to increased life expectancy in this population. Patients have to adapt to the disease continuously when facing new expectations, life projects and issues arising with increasing age, so the healthcare team should be ready to provide support. A good therapeutic alliance with the patient must be accompanied by assessment and counselling in aspects including satisfaction, perceived difficulties and barriers, and emotional needs. Raising awareness of all this will result in the patient benefiting from the recent improvements in treatments.     

The determinants of collateral circulation status in patients with chronic cerebral arterial circle occlusion: A STROBE Study

The condition of collateral pathways is an important predictor of stroke prognoses; however the major determinants of collaterals are still unknown. The purpose of this study is to identify potentially determinants for collateral circulation status in patients with chronic occlusion of cerebral arterial circle.All patients with chronic occlusion of either unilateral internal carotid artery or middle cerebral artery M1 or M2 segment, diagnosed by digital subtraction angiography at the neurology department of the First Medical Centre of Chinese PLA General Hospital from January 2015 to December 2017, were retrospectively collected in our sample. After screening according to inclusion and exclusion criteria, the patients’ relevant clinical data were collected and analyzed. Collateral circulations were assessed by 2 independent raters using the American society of interventional and therapeutic neuroradiology/society of interventional radiology flow-grading system.Baseline characteristics (n = 163): our sample consists of 116 (71.2%) male and 47 (28.8%) female patients with an average age of 57.5 ± 11.9 years. Cerebral collateral flow was poor in 59 (36.2%) patients. Our univariate analyses showed that poor collateral circulation was associated with lower high-density lipoproteins cholesterol (HDL), elevated homocysteine levels, aging and hyperlipidemia. A multivariate analysis identified HDL, homocysteine levels and ageing as major predictors for collateral circulation status. In the subgroup analysis, the HDL contributed to collateral angiogenesis internal carotid artery occlusion group. In the middle cerebral artery occlusion group, the homocysteine and ageing were related to the poor collateral status.Low HDL, high levels of homocysteine and ageing are identified as possible risk factors for a poor collateral vessel blood flow in patients with chronic anterior circulation occlusion.