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Abstract

Objective: Subjective age is a biopsychosocial marker of aging associated with a range of outcomes in old age. In the domain of cognition, feeling older than one's chronological age is related to lower cognitive performance and steeper cognitive decline among older adults. The present study examines whether an older subjective age is associated with the risk of incident cognitive impairment and dementia. Method: Participants were 5,748 individuals aged 65 years and older drawn from the Health and Retirement Study. Measures of subjective age, cognition, and covariates were obtained at baseline, and follow-up cognition was assessed over a 2- to 4-year period. Only participants without cognitive impairment were included at baseline. At follow-up, participants were classified into one of the three categories: normal functioning, cognitive impairment without dementia (CIND), and dementia. Results: An older subjective age at baseline was associated with higher likelihood of CIND (odds ratio [OR] = 1.18; 1.09-1.28) and dementia (OR = 1.29; 1.02-1.63) at follow-up, controlling for chronological age, other demographic factors, and baseline cognition. Physical inactivity and depressive symptoms partly accounted for these associations. Conclusion: An older subjective age is a marker of individuals' risk of subsequent cognitive impairment and dementia.

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... There is increasing evidence that, besides chronological age, subjective age is an important predictor of beneficial health outcomes. In particular, younger subjective age is associated with psychological wellbeing (3), younger estimated brain age assessed by regional gray matter volume (4), better cognitive functioning (5,6), increased grip strength (7), faster walking speed (8), less frailty (9), a lower risk of cardiovascular diseases (10), hospitalization (11), and mortality (12). However, apart from these positive health effects, there is little knowledge about the factors contributing to younger subjective age, which may set the course for these beneficial outcomes. ...
... Subjective age is an important predictor of positive health outcomes (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In a representative sample of 4,665 older community-dwelling people in Germany, the majority reported feeling younger than their chronological age. ...
... It is plausible that participants who answered the questionnaire may have had better physical and mental capabilities. In addition, there is an association between cognitive deficits and older subjective age (6). Therefore, it is probable that our available data underestimate the proportion of people feeling older than their chronological age. ...
Article
Full-text available
Background There is increasing evidence that subjective age is an important predictor of beneficial health outcomes besides chronological age. However, little is known about the factors associated with younger subjective age. This study aimed to identify which factors are predictive of feeling younger in old age. In this context, feeling younger was defined as an individual's perception of being younger than their current chronological age. Methods Data from 4,665 community-dwelling older people were drawn from wave 7 (2020) of the German Aging Survey (DEAS), a nationally representative study in Germany. Network, mediation, and binomial logistic regression analyses were performed to reveal the associations between feeling younger and biopsychosocial factors. Results A total of 4,039 participants reported feeling younger, while 626 did not. Older chronological age, engaging in sports more frequently, a better standard of living, a better state of health, higher satisfaction with life, more positive attitudes toward one's aging, and fewer depressive symptoms are associated with feeling younger in older people. Conclusion The present study provides novel and consistent evidence regarding the association between feeling younger and biopsychosocial factors. Further research is needed to confirm these factors and identify how they can be adapted in potential intervention studies to generate the life and health circumstances that allow older people the benefit of feeling younger.
... Emerging literature suggests that subjective age, or the age one feels relative to one's chronological age (Rubin & Berntsen, 2006), is an understudied but important predictor of cognitive and other health outcomes in older adults (Kotter-Grühn, Kornadt, & Stephan, 2015;Stephan, Sutin, Caudroit, & Terracciano, 2016;Stephan, Sutin, & Terracciano, 2015;Westerhof et al., 2014). Indeed, longitudinal studies indicate that younger subjective age is associated with better subsequent episodic memory and executive function over time (Stephan et al., 2014) and lower incidence of cognitive impairment and dementia (Stephan et al., 2017), independent of chronological age. ...
... One potential mechanism by which subjective age may influence cognition is through the experience of depressive symptoms (Stephan et al., 2016(Stephan et al., , 2017. Prior research suggests that a more youthful subjective age is associated with fewer depressive symptoms (Keyes & Westerhof, 2012), which mediates the relationship between subjective age and cognitive outcomes such as episodic memory (Stephan et al., 2016) and incidence of dementia (Stephan et al., 2017). ...
... One potential mechanism by which subjective age may influence cognition is through the experience of depressive symptoms (Stephan et al., 2016(Stephan et al., , 2017. Prior research suggests that a more youthful subjective age is associated with fewer depressive symptoms (Keyes & Westerhof, 2012), which mediates the relationship between subjective age and cognitive outcomes such as episodic memory (Stephan et al., 2016) and incidence of dementia (Stephan et al., 2017). Importantly, a recent meta-analysis found a robust association between more youthful subjective age and fewer depressive symptoms (Alonso Debreczeni & Bailey, 2020). ...
Article
Objective: Younger subjective age predicts better episodic memory and executive functioning performance independent of chronological age. This study examined whether subjective age is associated with performance in five cognitive domains, quantified the extent to which these relationships are mediated by depressive symptoms, and tested whether these associations are moderated by chronological age. Method: Participants in this cross-sectional study included 993 adults aged 65 and older from the Health and Retirement Study’s 2016 Harmonized Cognitive Assessment Protocol. Moderated mediation models estimated direct and indirect effects of subjective age on factor scores representing episodic memory, executive functioning, language, visuoconstruction, and speed through depressive symptoms and tested whether associations differed according to chronological age. Results: Depressive symptoms explained 21–32% of the associations between subjective age and language, speed, episodic memory, and executive functioning. Chronological age moderated the indirect effect involving language, such that depressive symptoms were more strongly related to worse language performance at older chronological ages. After accounting for indirect effects, direct effects of younger subjective age remained for language and speed domains. Conclusions: This study extends research on the cognitive correlates of subjective age and demonstrates that depressive symptoms partly mediate these relationships. Subjective age may bemost strongly associated with language among individuals at older chronological ages not because they are more sensitive to the negative mental health impact of feeling older than they are but because they may be particularly vulnerable to the negative effects of depressive symptoms on language ability. Additional longitudinal research is needed to determine whether links between subjective age and cognition are causal versus predictive.
... They stimulate or dampen well-studied resources contributing to cognitive health in old age, such as engaging in leisure activities, leading a healthy lifestyle, and having less physiological stress (e.g., Baumgart et al., 2015). Yet, these long-term pathways remain mainly assumptions, since only a few studies so far have empirically tested the underlying mechanisms of views on aging; that is, most of them focused on physical health and only a few concentrated on memory function and cognitive impairment over time (Stephan et al., 2016;Stephan et al., 2017). ...
... A major reason for this assumption is that previous research has already shown that subjective aging processes (such as aging attitudes and negative age self-stereotyping) are related to late-life developmental outcomes, including normal cognitive functioning, health, hospitalization, and mortality (Levy et al., 2012;Westerhof et al., 2014). However, the potential role of subjective aging for pathological cognitive processes has so far received very limited attention (Levy et al., 2016;Stephan et al., 2017). Thus, this study examines whether attitude toward own aging (ATOA), a well-established and health-predictive construct in the subjective aging literature (Westerhof et al., 2014;Wurm et al., 2017), is associated with expert-diagnosed pathological cognitive decline across a rather long observational interval of 12 years. ...
... Extending previous research that linked subjective aging to biomarkers of AD and cognitive impairment over time (Levy et al., 2016;Stephan et al., 2017), this study aimed to examine the long-term (12 years) association of ATOA regarding expert-diagnosed MCI and AD in old age. ...
Thesis
In the face of population aging, the high relevance of identifying favorable conditions, individual resources, and malleable factors to promote cognitive health in old age is unwavering (Deary et al., 2009). Longitudinal research in the last decade suggests that individual beliefs towards age and aging possess remarkable developmental relevance to shaping the actual aging process. As such, evidence underlines the importance of views on aging for health and longevity in old age (Westerhof et al., 2014). Building on the emerging longitudinal work that also suggests associations with memory (Levy, Zonderman, Slade, & Ferrucci, 2012; Stephan, Sutin, Caudroit, & Terracciano, 2016) and pathological brain changes (Levy et al., 2016), the aim of the present dissertation is to explicitly combine the two research traditions of views on aging and cognitive aging. Main reasoning is that negative views on aging constitute a substantial risk factor for cognitive aging that has been rather neglected by the classical literature on age-related cognitive decline. In three individual papers, this dissertation addresses four major questions. First, do people with more negative views on aging show accelerated cognitive decline over time (Paper 1, 3) and have higher odds of developing dementia in old age (Paper 2)? Second, addressing issues of bidirectionality, do cognitive abilities and respective loss experiences—objective change as well as subjective complaints—also contribute to a more negative evaluation of the aging process (Paper 3)? Third, which long-term pathways mediate the relationship between views on aging and cognitive development (Paper 2)? And, fourth, do effects differ depending on individual factors like gender or age group (Paper 1, 3)? Data came from the population-based Interdisciplinary Longitudinal Study of Adult Development (ILSE; Sattler et al., 2017). ILSE is an ongoing German cohort study starting in 1993/94 with four completed measurement occasions. Two birth cohorts, a midlife group (1950-52; n = 502; Mage = 43.7 at baseline) and an old age group (1930-32; n = 500; Mage = 62.5 at baseline) were reassessed after 4 years (1997/98), 12 years (2005/06), and 20 years (2014/16) with longitudinal response rates of 78.7% and 56.9 % after 12 and 20 years, respectively. Measurements in the present thesis include the widely used Attitude Toward Own Aging scale (ATOA) to assess individual views on aging (Lawton, 1975), well-established cognitive indicators of fluid and crystallized abilities (e.g., WAIS-R; Tewes, 1991), an expert-based clinical diagnosis of participants’ cognitive status, and a range of control variables (e.g., sociodemographics, genetic and health variables, control beliefs, leisure activities). Drawing on the older birth cohorts (1930-32; n = 500) and 12 years of observation in Paper 1, overall and gender-specific latent change score models were applied to investigate the impact of ATOA on rate of decline in fluid and crystallized abilities and whether this impact differed for men and women. In a cognitively healthy subsample of the old age cohort (n = 260), Paper 2 examined whether more negative baseline ATOA increased the risk of developing mild cognitive impairment (MCI) or Alzheimer disease (AD) within 12 years by means of logistic regression. Moreover, leisure activities and control beliefs were examined as possible mediators of the association. Making use of both birth cohorts and 20 years of observation, Paper 3 targeted issues of bidirectionality between ATOA and cognitive development. A multigroup latent growth curve model examined longitudinal associations of ATOA, performance-based cognitive measures, and subjective cognitive complaints contrasting mid- and later life. First, as expected, negative ATOA was a risk factor for accelerated cognitive decline, predicting change in fluid abilities—but not in crystallized performance—over 12 years (Paper 1) and over 20 years (Paper 3). Moreover, negative baseline ATOA was associated with a 31% higher risk of developing dementia within a 12-year follow-up (Paper 2). These effects emerged after controlling for sociodemographic, various health, as well as genetically relevant indicators and thus seemed to be robust over up to two decades of observation. Second, there was no long-term association between (change in) cognitive abilities and subsequent change in ATOA. Paper 3 revealed instead that cognitive complaints rather than objective cognitive decline were an important correlate and precursor of changes in ATOA. Higher cognitive complaints were substantially related to worsening in ATOA, indicating that the subjective awareness of cognitive loss matters more for attitude formation than objectively measurable decline. Third, testing empirical pathways that were assumed to operate between ATOA and cognitive impairment, evidence for a mediating role of leisure-activity level and control beliefs was scarce (Paper 2). Finally, results illustrated the important consideration of the individual factors gender and age group. Gender-specific analyses showed a stronger association between ATOA and decline in fluid abilities for men, even after controlling for health and education (Paper 1). Moreover, findings indicated that the predictive effect from ATOA on cognitive decline gained developmental relevance with increasing age. That is, ATOA predicted cognitive change over 20 years in old age but not in midlife (Paper 3). Overall, the results of this dissertation suggest that negative views on aging accelerate cognitive decline and pose a threat for dementia in later life. Taken together with other recent studies, there is robust evidence to conclude that views on aging deserve to be considered as a meaningful risk factor of cognitive decline alongside other established risk factors. This underlines the need of exploiting the emerging potentials and improving views on aging in individuals, communities, and society via targeted interventions and public health practices as a rewarding avenue to promote cognitive health in old age. One important direction for future research therefore is to evaluate whether and how findings can be transferred into efficient intervention strategies. Such interventions on malleable psychological risk factors offer promising low-cost options. Dissertation findings further suggest that interventions may also explicitly treat subjective cognitive complaints. Focusing on individuals already in midlife may prevent them from developing even more complaints and even more negative age views as they age. Another major task for future research is to empirically identify underlying mechanisms, for example, by using measurement burst designs on daily activities and health behaviors to track back what people with more positive views on aging actually do and experience throughout their days. Understanding how negative views on aging accelerate cognitive decline is pivotal to validate and anchor the predictor effect as well as to inform prevention efforts.
... A second construct related to aging that has emerged in the psychosocial literature is subjective age, which evaluates an individual's self-evaluation of how old one perceives oneself to be (4). Though subjective age is a multidimensional construct that includes how old one feels (felt age), how old one would like to be (desired age), and at what age old age begins (perceived age), subjective age is commonly studied as a unidimensional construct with the first construct (felt age) being most extensively studied with regards to health outcomes (5)(6)(7)(8)(9). There are two theoretical frameworks to explain why subjective age is associated with a variety of adverse health outcomes including mortality; a social and psychological perspective that views subjective age as being associated with social and environmental cues such as social roles and loneliness (10) and a biomedical perspective that views subjective age as a proxy for individual's physical health and functioning (11). ...
... In support of the biomedical perspective, prior research has demonstrated that feeling older than one's chronological age ("older subjective age") has been found to be associated with several negative health outcomes including increased hospitalization (8), cognitive impairment (5,6), dementia (6,7), and higher mortality (9). Furthermore, older subjective age has been associated with increased levels of specific biomarkers such as cystatin C and C-reactive protein (CRP) (12,13). ...
... In support of the biomedical perspective, prior research has demonstrated that feeling older than one's chronological age ("older subjective age") has been found to be associated with several negative health outcomes including increased hospitalization (8), cognitive impairment (5,6), dementia (6,7), and higher mortality (9). Furthermore, older subjective age has been associated with increased levels of specific biomarkers such as cystatin C and C-reactive protein (CRP) (12,13). ...
Article
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Background and Objectives Though subjective age is a well-recognized risk factor for several chronic diseases, the biological basis for these associations remains poorly understood. Research Design and Methods We used new comprehensive biomarker data from the 2016 wave of the nationally representative Health and Retirement Study (HRS) to evaluate the association between biomarker levels and self-reported subjective age in a subset of 3,740 HRS participants who provided a blood sample. We measured biomarkers in seven biological domains associated with aging: inflammation, glycemia, lipids, liver function, endocrine function, renal function, and cardiac function. The primary outcome was the age discrepancy score (subjective age − chronological age) categorized as those who felt younger, older, or the same as their chronological age (reference group). Analyses adjusted for comprehensive psychosocial factors (chronic stress index, depression score), demographic factors (race, sex, body mass index, marital status, physical activity), and prevalence of chronic health conditions (comorbidity index). Results The prevalence of clinically relevant reduced levels of albumin concentrations was lower in those who felt younger (8.8% vs. 16.0%; p = .006) and higher in those who felt older (20.4% vs. 16.0%; p = .03) when compared with the reference category. The prevalence of clinically significant elevation in liver enzymes such as alanine aminotransferase was also significantly lower among those who felt younger (7.1% vs. 8.6%; p = .04) when compared with the reference category. Prevalence of clinically elevated levels in cystatin C was also lower among those who felt younger when compared with the reference category (50.0% vs. 59.1%; p = .04). There was no association between lipids, glucose, or C-reactive protein (inflammatory marker) and subjective age categories. Discussion and Implications These results suggest that people who feel younger may have favorable biomarker profiles and as a result may have lower prevalence of age-related diseases when compared with those who feel older or those who feel the same as their chronological age.
... 18 Further, Stephan and colleagues reported that feeling older was a marker of older adults' subsequent cognitive impairment. 19 Robertson and colleagues emphasised that negative views of ageing predicted cognitive decline. Specifically, verbal fluency and memory declined in the older population after adjusting for other related factors over a 2-year longitudinal study. ...
... Debates about the effects of different dimensions of the SPA on the impacts of cognitive function are ongoing. [19][20][21] Given individuals who had the lowest scores on Consequence and Control Positive in the LPCC subgroup also had low cognitive functioning, our results supported that positive rather than negative control of SPA might be more important for maintaining cognitive functions, indicating targeted interventions toward ageing attitudes in the LPCC subgroup. ...
Article
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Background: Self-perceptions of ageing (SPA) is an important predictor for physical and mental health of older adults in successful ageing. SPA is mainly studied from negative or positive perspectives using variable-centred methodologies. The aim of the current study was to explore distinct profiles of SPA among Chinese community-dwelling older adults using a person-centred method and validate the SPA profiles by examining associations with psychological outcomes. Methods: Participants aged 65 and over were randomly divided into test and validation samples (n = 451, respectively). SPA was measured by the Brief Ageing Perceptions Questionnaire using latent profile analysis. Results: Three SPA profiles were identified. One adaptive subgroup was designated as 'Low ageing awareness and high positive control' (LAPC, 84.7% and 75% in both samples, respectively). Two maladaptive SPA subgroups were designated as 'Low positive consequences and control' (LPCC, 3.9% and 8.2% in both samples, respectively), and 'High ageing awareness and negative control' (HANC, 11.4% and 16.8% in both samples, respectively). Similar to negative/positive SPA, the HANC and LAPC subgroups showed the highest and lowest levels of depressive symptoms and cognitive decline. Low cognitive function was found in the LPCC subgroup. Conclusions: These findings highlight the heterogeneity of older adults' SPA. SPA profiles may aid community healthcare providers in China to identify individuals with high risk of maladaptive SPA and to tailor targeted interventions for psychological health in later life. Distinct SPA profiles require different interventions targeting negative or positive control or both aspects. More positive control strategies might be beneficial for cognitive functioning in older adults from the LPCC subgroup.
... Indeed, feeling older than one's age has been related to a higher risk of cardiovascular disease (Stephan, Sutin, Wurm et al., 2020) and a higher mortality risk (Rippon & Steptoe, 2015;Stephan et al., 2018). Furthermore, an older subjective age predicts a higher risk of cognitive impairment and dementia (Stephan et al., 2017). However, little is known about the association between subjective age and predementia syndromes, such as motoric cognitive risk (MCR) syndrome. ...
... In addition, this study complements the growing research on subjective age and cognitive outcomes. Indeed, an older subjective age is consistently related to a higher risk of dementia (Stephan et al., 2017). As a predementia syndrome, MCR is related to a higher risk of dementia (Verghese et al., 2013(Verghese et al., , 2014. ...
Article
Objectives The motoric cognitive risk (MCR) syndrome, characterized by cognitive complaints and slower gait speed, is a pre-dementia syndrome associated with dementia and mortality risk. The present study examined whether subjective age, that is how old or young individuals feel relative to their chronological age, is related to concurrent and incident MCR syndrome. A relation between subjective age and MCR will inform knowledge on psychological factors related to dementia risk, identify who is at greater risk, and suggest a potential target of intervention. Method The study sample was composed of 6,341 individuals aged 65 to 107 years without dementia from the Health and Retirement Study (HRS), a longitudinal study of adults aged 50 years and older. Participants completed measures of subjective age, cognitive complaints, and gait speed and provided information on demographic factors, cognition, physical activity, depressive symptoms, and body mass index (BMI) at baseline in 2008/2010. Incident MCR was assessed four and eight years later. Results Controlling for demographic factors, an older subjective age was related to more than 60% higher likelihood of MCR at baseline and to around 50% higher risk of incident MCR over time. These associations remained significant when cognition, physical inactivity, depressive symptoms, and BMI were included in the analytic models. Conclusion This study provides evidence that how old individuals feel is related to concurrent and incident MCR beyond the effect of chronological age, other demographic factors, physical inactivity, depressive symptoms, BMI, and cognitive functioning.
... According to a previous study , self-perceived age can be assessed by asking participants to specify, in years, how old they feel. In another study (Stephan, Sutin, Luchetti, & Terracciano, 2016), subtracting the chronological age from the selfperceived age and dividing the result by the chronological age was defined as the discrepancy score. A lower value of the discrepancy score indicates a younger self-perceived age, while a higher value indicates an older self-perceived age. ...
... As for the discrepancy between the selfperceived age and the chronological age, the self-perceived age was significantly younger than the chronological age, and mean discrepancy score was -0.10 ± 0.08. Our results are consistent with those reported previously (Stephan et al., 2015a(Stephan et al., , 2015cStephan et al., 2016). ...
Article
Background and objective: For the elderly, maintaining a young self-perceived age has a positive impact on physical and mental health. The purpose of this study was to investigate the impact of the discrepancy between self-perceived age and chronological age in regards to physical activity, instrumental activities of daily living, functional capacity, personality, general self-efficacy, depressive symptoms, and disease burden. Methods: Participants were 3094 older adults from 2015 baseline data of the Keeping Active across Generations Uniting the Youth and the Aged study. The questionnaire was mailed to 8004 elderly people aged 65 years or older. Of the 3871 people who returned the questionnaire (collection rate, 48.3%), 3094 subjects were analyzed in this study (female, 52%). The questionnaire included aspects of physical activity, instrumental activity of daily living, functional capacity, personality traits, general self-efficacy, depressive symptoms, history of falls, fear of falling, communication with young people, medical history, and self-perceived age, as well as basic characteristics such as age, sex, living alone or not, and educational history. Results: Regression analysis showed that the presence of high self-rated health, personality traits of extraversion and openness to experience, higher general self-efficacy, and the presence of fear of falling were positively associated with a younger self-perceived age. Conclusions: The results identified personality and psychological factors related to of self-perceived age in community-dwelling elderly people. Therefore, changes in personality traits and subjective health accompanying aging affect the self-perceived age, which may also affect the extension of healthy life expectancy.
... In a previous study [3], felt age was assessed by asking participants to specify how old they felt (in years). In another study [17], self-perceived age was defined as the discrepancy between the chronological age and the felt age (calculated as felt age minus Health chronological age). The difference was then divided by the chronological age. ...
... We calculated the discrepancy score between felt age and chronological age (i.e., self-perceived age), and the average score was −0.10. This value was similar to that reported by [17], who employed the same methodology to calculate self-perceived age. Therefore, the participants in both studies had similar characteristics. ...
... It was well established that cognitive function was associated with age (Li & Hsu, 2015;McArdle, Fisher, & Kadlec, 2007), gender (Ofstedal et al., 1999;Suthers et al., 2003), levels of education (Cagney & Lauderdale, 2002;Lièvre, Alley, & Crimmins, 2008), and nursing home (Clark et al., 2013). Available studies have unanimously demonstrated that age is the strongest risk factor for cognitive decline (Boot et al., 2013;Li & Hsu, 2015;McArdle et al., 2007;Stephan, Sutin, Luchetti, & Terracciano, 2016). The prevalence of cognitive impairment in the population differs by gender, indicating that females tend to bear greater cognitive impairment than males (Ofstedal et al., 1999;Suthers et al., 2003). ...
... As one grows older, cognitive impairment is one of the major causes of disability, which can result in an inability to care for oneself (Suthers et al., 2003). Consistent with previous studies, age was associated with older adults' cognitive function, which might be at higher risk of subsequent cognitive decline (Crimmins et al., 2011, Boot et al., 2013McArdle et al., 2007;Stephan et al., 2016;Suthers et al., 2003). Further, we found that women were at higher risk of lower cognitive function than men. ...
Article
Cognitive decline in late life is a crucial health problem. It is important to understand the consistency and change of older adults' cognitive function in late life. Data for older adults (78 years and above) from the Health and Retirement Study (N = 1680) were used to explore meaningful subtypes of cognitive function and transitions patterns between those profiles across times. Age, gender, levels of education and nursing home were incorporated as covariates to explore the association between these variables and cognitive function transition pattern. Three cognitive function subgroups (Normal Cognitive Function, Fluid Intelligence Impairment and Cognitive Impairment) were identified. Individuals in Normal Cognitive Function status had a high probability to convert to the Fluid Intelligence Impairment status whereas the Cognitive Impairment status appeared a predominant tendency for stability. Increasing age played a significant role in fluid intelligence impairment and cognitive impairment process. Female and individuals with nursing home might be at higher risk of subsequent fluid intelligence impairment, while higher education did not protect against fluid intelligence impairment. These findings highlighted the usefulness to adopt a person-centered approach rather than a variable-centered approach, suggesting directions for future research and tailored interventions approaches to older adults with particular characteristics.
... Research indicates a connection between feeling younger and enhanced cognitive abilities. In studies by Stephan et al. (2016), those with a younger subjective age displayed better long-term memory and executive function over a decade. Intriguingly, these cognitive benefits remained when considering age, demographics, and health factors. ...
Article
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Aim: Older age is not a homogenous or stereotypical experience. Age-stereotypical representations can often be disconnected from older people’s own experiences. Challenging the status quo is relevant for aging well. The aim of this study is to analyze older adults’ perspectives on stereotypical versus their own age representations. Method: This qualitative study included a sample of 433 older adults who were 65 to 74, 75 to 84, and 85+ years of age. Content analysis was carried out. Results: Findings from this study indicated that the great majority of the participants (88%) did not identify with stereotypical age representations. This was so among participants in the 65–74 age group in relation to Showing a sense of agency (81.1%); Feeling spiritual (73.4%); Having meaningful goals (72.2%); Holding a significant social network (70.9%); Staying tuned to the world (67.1%); and feeling physically attractive (59.8%). Participants who were 75–84 years of age clarified what physical health (81.0%) and surviving chronic illnesses (78.9%), autonomy (75.5%), being socially active (74.9%), and staying mentally active (70.1%) represent at that age. The +85 years age group drew attention to No pain or physical limitations (95.6%), Physical health (93.1%), Cognitive autonomy (87.1%), Staying tuned to society and the world (76.3%); and Mobility (72.2%). Conclusions: Participants’ favoring their own over stereotypical thinking about people their age represents inner resourcefulness and a penchant for aging well. Collaborative partnerships for sharing such wisdom around could enrich policy programs and interventions that favor inclusivity and fight ageism, fostering a more accurate perspective of what it means to be a certain ‘age’ versus simply being ‘old’.
... Diehl et al., 2021;Kornadt et al., 2018;Pinquart & Wahl, 2021;Stephan et al., 2018;Wahl et al., 2022;Weiss & Lang, 2012;Weiss & Weiss, 2019;Westerhof et al., 2023;Wettstein et al., 2023;Wurm et al., 2017). Feeling younger than one's chronological age may also be a positive marker of aging, including in biological, psychological, physical, cognitive, and social domains (Alonso Debreczeni & Bailey, 2021;Stephan et al., 2017Stephan et al., , 2018Weiss & Weiss, 2019;Westerhof et al., 2014). And yet desiring to be closer to one's chronological age (i.e., a less negative discrepancy between one's desired vs. chronological age) is linked with more positive functioning, including mental and physical health (Bellingtier et al., 2017;Hubley & Hultsch, 1994;Keyes & Westerhof, 2012;Keyes & Westerhof, 2012;Sargent-Cox et al., 2014;Veenstra et al., 2021;Ward, 2010Ward, , 2013. ...
Article
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The present study examined beliefs about how one’s life satisfaction is unfolding over time in relation to conceptions of aging in an online American adult lifespan sample (N = 882; Mage = 47.89, SD = 15.30, range = 19–84 years; 56% female). Single-item and multi-item ratings of recollected past, current, and anticipated future life satisfaction were employed, along with subjective perceptions of change in life satisfaction over time. Person-centered (latent profile) analysis identified distinct linear and nonlinear patterns of beliefs concerning past–current and current–future changes in life satisfaction: improve–improve, stable–stable, worsen–worsen, and worsen–improve. Multiple facets of conceptions of aging were assessed, including subjective perceptions of age (chronological vs. felt and desired age); attitudes toward, experiences of, and expectations concerning aging; future time perspective; and goal orientations (growth, maintenance, prevention of losses). Multinomial logistic regression models identified unique facets of conceptions of aging characterizing the four profiles. In general, individuals reporting a distinct profile conveying the belief that one’s life was improving (vs. worsening) over time were characterized by more positive conceptions of aging. Further, conceptions of aging partially explained the link between chronological age and the belief that one’s life is getting worse and worse (vs. better and better). Thus, the present work provides new insights into how age and conceptions of aging may shape the directions and patterns with which individuals view their lives to be unfolding over time.
... Subjective age describes how old a given person feels (Barrett & Montepare, 2015;Kotter-Grühn, Kornadt, & Stephan, 2015;, which can be quite discrepant to how old they are chronologically. Indeed, most middle-aged and older adults feel younger than they are (Benyamini & Burns, 2020;Pinquart & Wahl, 2021;Rubin & Berntsen, 2006), which seems to be adaptive because a younger subjective age has been found to predict various beneficial developmental outcomes (Alonso Debreczeni & Bailey, 2021;Kotter-Grühn, Kornadt, & Stephan, 2015;, including lower risk of cognitive decline and cognitive impairment (Stephan et al., 2014;Stephan et al., 2016;Stephan et al., 2017;Stephan, Sutin, Luchetti, & Terracciano, 2018), better mental and physical health (Blöchl et al., 2021;Choi & DiNitto, 2014;Spuling et al., 2013;Westerhof et al., 2023), and lower mortality hazards Westerhof et al., 2023). These associations may be due to different mechanisms. ...
Article
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Experiencing pain in middle adulthood and old age might be interpreted as a sign of aging and make people feel older, whereas feeling older has behavioral, motivational, and physiological consequences that might increase the risk of pain. We investigated between-person and within-person associations between pain, subjective age, and chronological age in middle-aged and older adults. Data from the German Ageing Survey were used (n = 13,874 who provided more than 32,000 observations, baseline mean age = 62.3 years). The observation period comprised up to 13 years (M = 4 years) and five (M = 2.4) measurement occasions. Based on the longitudinal multilevel regression models, we found significant between-person and within-person effects in both directions, which were small but robust when controlling for sociodemographic variables, depressive symptoms, and number of chronic diseases. At the between-person level, participants reporting overall more severe pain also felt older than others. Likewise, those who felt overall older than others reported more pain. At the within-person level, when participants experienced more pain than they usually do, they also reported feeling older than usual. Likewise, on measurement occasions when participants reported feeling older than usual, they reported more pain than usual. Additionally, those with overall stronger pain exhibited steeper age-related increases in their subjective age than those with less severe pain. Our findings suggest that an older subjective age may operate as both antecedent and consequence of pain, and pain might prompt a steeper increase in subjective age over time.
... Previous studies have established connections between subjective age and various health-related factors, such as personal health (Demakakos et al., 2007), symptoms of depression (Choi & Dinitto, 2014), physical well-being (Wienert et al., 2016), sleep quality disorder, forgetfulness, cognitive disorders, generalized weakness, physiological regulation (Stephan et al., 2017(Stephan et al., , 2019. Subjective age thus emerges as a potential indicator of age-related biological changes. ...
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This study investigates how age and mental experience affect psychological factors, and how this, in turn, impacts the community. Our aim is to examine how life expectancy, resilience, and locus of control vary across different age groups. We recruited 382 male and female students from Tehran as participants, using a causal-comparative design. The research involved the administration of three separate questionnaires. Our data analysis, conducted at both descriptive and inferential levels, revealed some interesting findings. The results indicate a significant correlation between subjective age categories (younger, equal, and older than the birth certificate age) and variations in life expectancy, resilience, and locus of control.
... Feeling younger was reported to be associated with lower risk of major depressive episode or cognitive impairment 4 . Studies have revealed associations between subjective age and positive health outcomes, such as reduced cardiovascular events, lower risks of motor decline, and fewer instances of dementia [5][6][7] . Nevertheless, discrepancies in subjective age exist among high-and low-income countries, as per a study where older adults in low-income felt less younger than similar age groups in high income settings and had a poor quality of life 8 . ...
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Objectives The objective of the study was to investigate factors associated with subjective aging among older patients visiting a geriatric medicine outpatient department in Northern-India. Methods The study is a cross-sectional study. Patients were categorized into three groups: whether they felt younger, equal, or older than their peers of same age. Factors such as fall, incontinence, anorexia, hand grip strength, cognition, depression, vision, hearing, cardiopulmonary function and immunization were assessed. Multinominal logistic regression was used to investigate the associated factors of subjective aging. Results We assessed 184 older patients with a median age of 66.5 years (IQR 63.0 -78.8). Chronological age and hand grip strength were the significant factors associated with subjective aging. With one year increase in age, odds of feeling older than peers of same age decreased by 8.9% (OR, 0.911; 95% CI, 0.831–0.999, p = 0.047). With one kilogram increase in hand grip strength, odds of feeling younger than peers of same age increased by 7.3% (OR, 1.073; 95% CI, 1.01–1.14, p = 0.032). Conclusion Chronological age and hand grip strength are the factors associated with subjective aging in Northern-Indian older adults. Further longitudinal multi-center studies are needed to confirm our findings.
... Findings showed that individuals with more negative SPA at the baseline had a significantly increased risk of being diagnosed with MCI or Alzheimer's disease 12 years later. This effect persisted after controlling for relevant rivaling risk factors (see also [32,34]). ...
Article
This article defines self-perceptions of aging (SPA) as individuals’ perceptions, expectations, and experiences regarding their own process of growing old(er). As such, SPA are considered a critically important element of the aging self. Furthermore, the authors present a heuristic model that positions adults’ SPA within a lifespan developmental and culturalsocietal context and elaborates distal and proximal antecedents, process modes, and developmental outcomes. The remainder of the article summarizes recent empirical findings and discusses future challenges and directions.
... Because of the strong connections between positive VoA and healthy behavioral regulation, more positive VoA are related to better longer-term physical and mental health (8)(9)(10). Conversely, people with more negative VoA are less engaged in healthenhancing and adaptive behaviors and are at greater risk of poorer current and future health, including increased risk of mortality (5,(11)(12)(13)(14). The promotion of positive VoA, and the decrease of negative VoA, are therefore increasingly recognized as a useful strategy for physical and mental health promotion (15). ...
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Background The concept of Awareness of Age-Related Changes captures people’s perceptions of the positive (AARC-gains) and negative (AARC-losses) age-related changes they experience in several life domains, including their health. We investigated the cross-sectional associations of number and type of physical and mental health conditions with AARC-gains and AARC-losses. Methods The sample comprised 3,786 middle-aged and older adults (mean age = 67.04 years; SD = 6.88) participating to the UK PROTECT study. We used hierarchical regression models to analyze whether after having included sociodemographic variables (model 1), number of physical (model 2) and of mental (model 3) health conditions explained a significant additional amount of variance in AARC-gains and AARC-losses, and whether the association between number of conditions and AARC depended on participants’ age. We used multiple regression models to analyze the associations of types of physical and mental health conditions with AARC-gains and AARC-losses. Results A higher number of physical health conditions was associated with higher AARC-gains and higher AARC-losses, but the association did not depend on participant age. After controlling for the number of physical health conditions, a higher number of mental health conditions was associated with higher AARC-losses but not with AARC-gains, and the association was stronger among older participants. Small effects were found between greater AARC-gains and current cancer and between greater AARC-losses and diagnoses of mild cognitive impairment, Parkinson’s disease, arthritic condition, cancer in full remission, osteoporosis, depression, anxiety disorders, and personality disorder. The remaining health conditions were either negligibly or non-statistically related to AARC-losses. Conclusion Middle-aged and older adults having more physical health conditions and more mental health conditions may be at higher risk of negative views on their own aging. However, specific physical health conditions, such as arthritis, and certain mental health conditions, such as depression, may make adults particularly vulnerable to negative age-related perceptions.
... A populationbased study in Italy also showed a positive correlation between age and dementia, with this correlation persisting into very old age (Lucca et al., 2020). Furthermore, subjective age has been associated with cognitive decline and dementia in middleaged and elderly adults (Stephan et al., 2017;Qiao et al., 2021). As the global population ages, cognitive deterioration and its most severe expression, dementia, inevitably increase (Prince et al., 2015;Beard et al., 2016). ...
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Objective: We aimed to evaluate the relationship between digital exclusion, such as neither mobile payments nor WeChat use, and cognitive impairment in Chinese individuals aged 45 and older. Methods: A population-based cross-sectional study utilizing data from the fourth national survey of the China Health and Retirement Longitudinal Study (CHARLS). In the fourth wave of CHARLS, 10,325 participants aged 45 and older with complete information were included in this analysis. Self-reported mobile payments and WeChat usage constituted our exposure. Cognitive impairment was the primary outcome. Univariate and multivariate logistic regression were used to assess the relationships between cognitive impairment risk and digital exclusion. Results: Data were analyzed from 10,325 participants [mean (SD) age, 60.3 (9.1) years; 44.8% women], including 1,232 individuals with cognitive impairment and 9,093 cognitively normal individuals. The overall proportion of users who did not use either mobile payment or WeChat and those who only used WeChat were 81.3 and 6.7%, for cognitively impaired individuals 95.0 and 3.1%, and for cognitively normal individuals 79.5 and 7.2% [neither WeChat nor mobile payments vs. control unadjusted odds ratio (OR), 8.16; P < 0.001; only WeChat use vs. control unadjusted OR, 2.91; P < 0.001]. Participants who did not use either WeChat or mobile payments had an elevated risk for cognitive impairment after adjusting for a number of covariates (neither WeChat nor mobile payments vs. control adjusted OR, 3.48; P < 0.001; only WeChat use vs. control adjusted OR, 1.86; P = 0.021). Conclusion: Our study reveals a positive correlation between digital exclusion and cognitive impairment in Chinese adults, providing insights for promoting active digital integration among older adults. Further longitudinal research is needed to further validate this hypothesis.
... Again, controlling for the same set of covariates as in the first study, participants with more negative views of aging earlier in life had a significantly greater accumulation of amyloid plaques and neurofibrillary tangles. Similarly, Stephan, Sutin, Luchetti, and Terracciano (2017) found in 5748 individuals age 65 and older from the Health and Retirement Study (HRS) that subjective age was related to cognitive status over a 4-year time span. Feeling older increased the risk of both dementia and cognitive impairment without dementia. ...
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This chapter reviews the literature published in the past decade on the topic of self-perceptions of aging, broadly defined. After a brief review of past approaches and their limitations, the chapter focuses specifically on the advances that took place during the past decade, including the introduction of new theoretical models, the development of multidimensional measures, and the increased availability of multicohort longitudinal data. In combination with the confluence of several other streams of research (e.g., work on age stereotypes and ageism), these developments moved the field of subjective aging research qualitatively forward and established its relevance in a robust fashion. Indeed, the use of prospective longitudinal data has helped to address the directionality of effects more conclusively, and a growing number of studies have provided evidence that self-perceptions of aging are the precursors and predictors of a whole host of relevant outcomes in adult development and aging, including cognitive functioning, brain health, and longevity.
... Subjective age has been considered as a biopsychosocial marker of aging that can predict an individual's health condition [12,13]. A large body of literature has shown that older subjective age is associated with a series of negative health outcomes, including poorer mental health [14], worse physical, functional and cognitive health [15][16][17][18], increased risk of hospitalizations [19] and reduced longevity [20,21]. Despite the significance of subjective age in people's health, to our knowledge, little research has examined the relationship between subjective age and frailty among older adults. ...
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Background Subjective age refers to how young or old individuals experience themselves to be and is associated with health status, behavioral, cognitive, and biological processes that influence frailty. However, little research has examined the relationship between subjective age and frailty among older adults. This study examined the bidirectional association between subjective age and frailty among community-dwelling older adults. Methods We used data from the 2011 to 2015 waves of the National Health and Aging Trends Study. Our sample consists of 2,592 community-dwelling older adults with complete data on main outcome variables. Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust = 0, pre-frailty = 1 or 2; frailty = 3 or more criteria met. Generalized estimating equation models were used to examine the concurrent and lagged association between subjective age and frailty. Results Participants were, on average, 75.2 ± 6.8 years old, non-Hispanic whites (76 %), female (58 %). 77 % of the participants felt younger, 18 % felt the same, and 5 % felt older than their chronological age. About 45 %, 46 %, and 9 % of the participants were robust, pre-frailty and frailty in the first wave, respectively. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95 % CI = 1.93, 1.45–2.56). Conclusions These findings suggest that people with older subjective age are more likely to be pre-frail/frail. Subjective age could be used as a quick and economical screening for those who are potentially frailty or at risk for frailty.
... The number of chronic conditions (i.e., high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, and arthritis; range = 0-7), functional limitations (i.e., bathing, eating, dressing, walking across a room, and getting in or out of bed; range = 0-5), and depressive symptoms (8-item Center for Epidemiologic Studies Depression (CES-D) scale; range = 0-8) were taken from the RAND constructed measures (Radloff & Teri, 1986). Consistent with past research using the HRS, the level of cognition was assessed using the modified Telephone Interview for Cognitive Status (TICSm; Crimmins et al., 2011;Stephan et al., 2017). A 27-point TICSm included a test of immediate and delayed recall, a serial-7 subtraction test, and a backward counting test, with the higher scores indicating better cognitive functioning. ...
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To what extent self-perceptions of aging and their correlates in later life may be gendered remains relatively unexplored. In particular, little is known about how changes in the health and spousal relationship quality over time contribute to self-perceptions of aging among married men and women. To clarify these links, we analyzed panel data from the Health and Retirement Study (2008–2016) on married individuals aged 65 years and older (N = 2,623) using within-between random effects models. Findings showed no gender difference in self-perceptions of aging at baseline and in the rate of change, and poorer health and spousal relationship quality were generally associated with less positive self-perceptions of aging. However, men and women differed in how within-person changes in health and spousal relationship quality were associated with their self-perceptions of aging. Increases in spousal strain and chronic conditions were associated with less positive self-perceptions of aging on that wave for men, whereas increases in functional limitations were associated with less positive self-perceptions of aging on that wave for women. Finally, a person-mean of spousal strain had a moderating effect for men, such that men with more overall spousal strain reported less positive self-perceptions of aging across a range of chronic conditions, compared to the men with less overall spousal strain. Findings highlight the intersection of social resources, health, and self-perceptions of aging, suggesting that gender differences in older adults’ self-perceptions of aging are contextualized by different behaviors and social experiences among married men and women.
... In addition to cardiovascular diseases, studies of the influence of the occupational type on another biomarker of aging -the work of the system of balance organs and the musculoskeletal system -are also known. A study of Finnish municipal workers [14] revealed that in men, retirement leads to an increase in morbidity associated with disorders of the musculoskeletal system (39-58% versus 25-37% among those who continue to work). The authors especially noted that the likelihood of developing diseases in mental workers is higher than in physical workers, and in men it is higher than in women. ...
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The aim of the research is to study how a person's belonging to a certain type of personality (phenotypic, professional, emotional, communicative) influences the rate of his individual aging. Method: we used the Russian frailty index according to Dr. Voitenko, which includes subjective and objective biomarkers of aging: duration of static balancing, blood pressure indicators, body weight, subjective assessment of diseases. Data processing method - one-way analysis of variance (ANOVA). Empirical base: 987 people (including 575 women) aged 35-70 years, collected from different regions of Russia on a territorial basis. Results : in the professional sphere, the lowest frailty index was found in representatives of the Artistic type and Investigative type of professions, and in terms of the duration of static balancing, the best result was in the Enterprising type. In terms of phenotypic characteristics, representatives of the asthenic and athletic body types had a lower frailty index, and in terms of functional asymmetry - in ambidexters and retrained left-handers. Among the emotional types, the lower frailty index was observed in persons with a predominance of communicative emotionality and those who preferred the style of cooperation when interacting with other people. Conclusions: lifestyle, attitude to the world and other people, as well as phenotypic characteristics of a person affect his biological age and the intensity of his biomarkers of aging.
... Subjective age can be conceptualized as a biopsychosocial marker of aging (Stephan, Sutin, & Terracciano, 2018), which is associated with health-related outcomes in aging (Wurm, Diehl, Kornadt, Westerhof, & Wahl, 2017). Indeed, a growing body of research support the relationship between the tendency to feel older that his chronological age and higher risk of cognitive impairment and dementia (Stephan, Sutin, Luchetti, & Terracciano, 2017), poorer physical performance (Stephan, Chalabaev, Kotter-Gr€ uhn, & Jaconelli, 2013), higher risk of health conditions (Demakakos, Gjonca, & Nazroo, 2007) and mortality (Rippon & Steptoe, 2015;Stephan et al., 2018). Although no study to date has tested the extent to which subjective age may be related to the incidence of FoF in advanced age, the relation between subjective age and a range of psychological, behavioral, and functional factors that have been found to contribute to FoF suggests that feeling older than his chronological age may increase the risk of developing FoF in old age. ...
Article
Objective Subjective age has been implicated in a range of health outcomes but its associations with Fear of Falling (FoF) are unknown. The present study examined the relation between subjective age and FoF in large national sample. Methods Participants were drawn from the National Health and Aging Trends Study (NHATS, 2011–2017). 1,679 participants provided data on FoF, subjective age, demographic factors, depressive symptoms, prior falls, self-rated health and measures of the Short Physical Performance Battery. FoF was assessed again 7 years later. Results Regression analyses revealed that an older subjective age was related to a 24% higher likelihood to develop FoF 7 years later. This association was independent of age, sex, educational attainment, race and prior falls. In addition, depressive symptoms, self-rated health, and physical inactivity mediated the associations between subjective age and FoF. Conclusions The present study showed that an older subjective age is related to the development of FoF over time, and further identified psychological and functional pathways that may explain this association. These results confirm the role of subjective age on one of the markers of frailty in the aging population.
... An older subjective age has been related to a range of health outcomes, such as worse physical and mental health and higher functional difficulties over time (Palgi, Ayalon, Avidor, Segel-Karpas, & Bodner, 2018;Rippon & Steptoe, 2018) and ultimately higher mortality risk (Rippon & Steptoe, 2015;Westerhof et al., 2014). Furthermore, subjective age is related consistently to cognitive function among older adults (Hughes & Lachman, 2018;Stephan, Sutin, Caudroit, & Terracciano, 2016;Stephan, Sutin, Luchetti, & Terracciano, 2017 and incidence of dementia (Stephan, Sutin, Bayard, & Terracciano, 2017. Individuals with an older subjective age, for example, perform worse on memory tasks when measured concurrently (Hughes et al., 2018) and on memory and executive functioning tasks assessed 10 years later (Stephan, Caudroit, Jaconelli, & Terracciano, 2014). ...
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The present study examined whether subjective age is related to informant-rated cognition. Participants were adults (N = 2,337, mean age = 69.84 years, SD = 7.45) from the Health and Retirement Study who provided subjective age and demographic factors in 2008/2010 and informant-rated cognition in 2016 as part of the Harmonized Cognitive Assessment Protocol. An older subjective age was associated with informant reports of steeper cognitive decline, worse cognitive function, lower ability, and loss of ability to do everyday activities. The present study indicates that subjective age predicts cognitive function in everyday life as observed by knowledgeable informants.
... Previous studies mainly showed a link between feeling younger and healthy aging, including cognitive health and protection against inflammatory markers (Stephan, Sutin, & Terracciano, 2015;Stephan, Sutin, Luchetti, & Terracciano, 2017;Zee & Weiss, 2019). The link between age comparisons and SWB has mostly been investigated in cross-sectional studies (Ambrosi-Randić et al., 2018;Barak & Stern, 1986;Brothers et al., 2017;Logan et al., 1992),with mixed evidence. ...
Article
Objectives A lack of longitudinal studies exists where the difference between chronological age and perceived age (feeling older/feeling younger) and its association with subjective well-being (SWB) is examined. Therefore, the purpose of this study was to investigate whether these differences are associated with SWB. Method Longitudinal data (year 2002 to 2017; n = 18,373 observations in the analytical sample) were taken from the nationally representative German Ageing Survey. To capture SWB comprehensively, positive and negative affect as well as life satisfaction was considered. The Positive and Negative Affect Schedule was used to assess positive and negative affect. Life satisfaction was quantified using the Satisfaction with Life Scale. The difference between chronological age and perceived age was used to quantify our main independent variable. More specifically, asymmetric effects were used, i.e. we tested whether changes in negative (chronological age was lower than perceived age, “feeling older”) and positive age comparisons (otherwise, “feeling younger”) are associated with changes in SWB differently. Results Fixed effects regressions showed that feeling younger was associated with a slight increase in life satisfaction (β = .15, p < .001) and positive affect (β = .15, p < .001). Moreover, feeling younger was associated with a slight decrease in negative affect (β=-.07, p < .05). Feeling older was associated with a considerable decrease in life satisfaction (β=-.65, p < .01) and positive affect (β=-.45, p < .01), was well as a considerable increase in negative affect (β = .49, p < .01). Conclusions Findings highlight the importance of negative age comparisons (feeling older) for SWB. Strategies to shift age perceptions may be beneficial for SWB in older individuals.
... Alternatively, the similar associations between subjective age and the various outcomes may be explained at least in part by the biopsychosocial perspective of subjective aging. Older adults who are more physically healthy are likely to Downloaded from https://academic.oup.com/psychsocgerontology/advance-article-abstract/doi/10.1093/geronb/gbaa069/5846119 by guest on 27 May 2020 A c c e p t e d M a n u s c r i p t 17 both feel younger and have improved cognition and wellbeing Stephan, Sutin, Luchetti et al., 2017). Similarly, feeling younger may improve wellbeing and cognition, which then improves health and longevity (Stephan et al., 2014;Westerhof et al., 2014). ...
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Objectives: A systematic review and meta-analysis was conducted to quantify the degree to which subjective age is associated with cognition, subjective wellbeing, and depression. Methods: A systematic search was performed in three electronic social scientific databases, PsycINFO, Scopus, and Web of Science in May 2018. A manual forward and backward citation search of articles meeting the criteria for inclusion, including a mean participant age of 40+ years, was conducted November, 2019. Twenty-four independent data sets were included in the meta-analysis. Results: Overall, a younger subjective age was related to enhanced subjective wellbeing and cognitive performance, and reduced depressive symptoms (r = 0.18). This association was stronger among collectivist (r = .24) than individualist (r = .16) cultures. Mean chronological age across samples (ranging from 55 to 83 years), type of subjective age scoring, and gender did not influence the strength of the overall association. Further analysis revealed that subjective age was individually associated with depressive symptoms (r = .20), subjective wellbeing (r = .17), and cognition (r = .14), and none had a stronger association with subjective age than the other. Discussion: The results indicate a small yet significant association between subjective age and important developmental outcomes.
... This study further reveals that subjective age is a marker of the adoption and benefits of health-related behaviors such as physical activity. The present research thus provides an additional explanation for the consistent association between subjective age and a range of outcomes, including dementia (Stephan et al. 2017) and mortality (Stephan et al. 2018). A younger subjective age may be related to a lower risk of incident dementia and mortality because it reflects the adoption of a physically active lifestyle beneficial for cognition and survival. ...
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The present study examined the prospective association between physical activity and subjective age across adulthood and factors that mediate this association. Participants were adults aged from 20 to 90 years (N > 10,000) drawn from the Wisconsin Longitudinal Study graduates and siblings samples, the Health and Retirement Study and the Midlife in the United States Survey. In the four samples, physical activity was assessed at baseline and subjective age was measured 8 to 20 years later. Personality, self-rated health, disease burden, depressive symptoms, and cognition were assessed as potential mediators. In the four samples, higher physical activity at baseline was associated with a younger subjective age at follow-up. Logistic regression revealed that physical activity was related to a 30–50% higher likelihood of feeling younger 8 to 20 years later. Significant indirect effects were found through openness to experience and self-rated health in the four samples. This study provides new evidence on the link between a health-related behavior and subjective age. Physically active individuals may sustain health and an open psychological disposition that is associated with feeling younger.
... There is solid evidence that in the second half of life, feeling younger than one's chronological age (a younger subjective age bias) is linked to benefits to health, performance, and well-being (Kotter-Gruhn, Kornadt, & Stephan, 2015;Montepare, 2009;Westerhof et al., 2014). For example, adults with a younger subjective age experience better cognitive health (Stephan, Sutin, Luchetti, & Terracciano, 2017), including better episodic memory, despite normative age-related declines (Stephan, Sutin, Caudroit, & Terracciano, 2016). In addition, a younger subjective age bias can protect against inflammatory markers associated with heart disease (Stephan, Sutin, & Terracciano, 2015), suggesting that feeling younger may benefit heart health and play a role in protecting individuals from cardiovascular disease risk. ...
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Feeling younger than one's chronological age-a younger subjective age bias-has been consistently linked to healthy aging. However, little is known about conditions under which such benefits are strengthened. In high-quality relationships, partners affirm individuals' self-views and offer support that can encourage individuals to engage in behaviors compatible with their subjective age. Thus, we hypothesized the benefits of a younger subjective age bias would be stronger among adults in high-quality relationships. Hypotheses were supported in a 10-year longitudinal study of married adults (ages 34-84; N > 600): Relationship quality moderated the effect of subjective age bias on memory performance and heart rate variability, such that individuals in higher-quality relationships showed stronger beneficial effects of a younger subjective age bias. Results suggest psychological and relational resources may work together to jointly influence healthy aging. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Generational categories classify individuals born in specific time frames, known for unique traits and tech adaptability. Some research indicates that the digital-native generation is more prone to distractions than other groups. However, the underlying mechanism is unclear and influenced by many factors, such as stress. In the current study (n=299), the authors leveraged the mobile monitoring of cognitive change (M2C2) symbol search task to measure processing speed. This study examines the relationships between generational categories (Gen X, Millennials, and Gen Z), perceived stress, subjective age (considered to predict important aspects of well-being beyond chronological age), and distraction cost. These results emphasize the significant influence of age-related variables and stress in shaping susceptibility to distractions. Future research can expand participant numbers, conduct longitudinal studies to track cognitive changes in digital-era generational cohorts, and explore neurocognitive mechanisms and technological fluency's role in distraction susceptibility.
Article
Significant research efforts have been devoted to explaining why and how aging impacts employees’ attitudes and behaviors. However, age itself has been subject to a range of conceptualizations and measurements, which has resulted in a fragmented literature. Chronological age (CA) captures biological differences, and subjective age (SA) captures people’s perceptions of their own chronological aging. Not surprisingly, these constructs have different effects on aging-related outcomes. More recently, a relatively newer construct, attitudes toward own aging (ATOA), has gained research traction. In this study, we synthesize the empirical evidence concerning ATOA, and we establish criterion-related and incremental validity of ATOA using meta-analytical techniques. We found that ATOA not only predicted health, cognitive function, well-being, and self-efficacy, but also provided additional explanatory power regarding these aging-related outcomes above and beyond CA and SA. The theoretical and practical implications of these studies are discussed.
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There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures. Keywords: subjective aging; self-perceptions of aging; attitudes towards own aging; cognition; elderly adults; systematic review
Article
The ageing process begins at birth. It is a life-long process, and its exact origins are still unknown. Several hypotheses attempt to describe the normal ageing process, including hormonal imbalance, formation of reactive oxygen species, DNA methylation & DNA damage accumulation, loss of proteostasis, epigenetic alterations, mitochondrial dysfunction, senescence, inflammation, and stem cell depletion. With increased lifespan in elderly individuals, the prevalence of age-related diseases including, cancer, diabetes, obesity, hypertension, Alzheimer's, Alzheimer's disease and related dementias, Parkinson's, and other mental illnesses are increased. These increased age-related illnesses, put tremendous pressure & burden on caregivers, family members, and friends who are living with patients with age-related diseases. As medical needs evolve, the caregiver is expected to experience an increase in duties and challenges, which may result in stress on themselves, and impact their own family life. In the current article, we assess the biological mechanisms of ageing and its effect on body systems, exploring lifestyle and ageing, with a specific focus on age-related disorders. We also discussed the history of caregiving and specific challenges faced by caregivers in the presence of multiple comorbidities. We also assessed innovative approaches to funding caregiving, and efforts to improve the medical system to better organize chronic care efforts, while improving the skill and efficiency of both informal and formal caregivers. We also discussed the role of caregiving in end-of-life care. Our critical analysis strongly suggests that there is an urgent need for caregiving in aged populations and support from local, state, and federal agencies.
Article
Objectives: Clinical observations and studies of retrospective observer ratings point to changes in personality in persons with cognitive impairment or dementia. The timing and magnitude of such changes, however, are unclear. This study used prospective self-reported data to examine the trajectories of personality traits before and during cognitive impairment. Design: Longitudinal observational cohort study. Setting and participants: Older adults from the United States in the Health and Retirement Study were assessed for cognitive impairment and completed a measure of the 5 major personality traits every 4 years from 2006 to 2020 (N = 22,611; n = 5507 with cognitive impairment; 50,786 personality and cognitive assessments). Methods: Multilevel modeling examined changes before and during cognitive impairment, accounting for demographic differences and normative age-related trajectories. Results: Before cognitive impairment was detected, extraversion (b = -0.10, SE = 0.02), agreeableness (b = -0.11, SE = 0.02), and conscientiousness (b = -0.12, SE = 0.02) decreased slightly; there was no significant change in neuroticism (b = 0.04, SE = 0.02) or openness (b = -0.06, SE = 0.02). During cognitive impairment, faster rates of change were found for all 5 personality traits: neuroticism (b = 0.10, SE = 0.03) increased, and extraversion (b = -0.14, SE = 0.03), openness (b = -0.15, SE = 0.03), agreeableness (b = -0.35, SE = 0.03), and conscientiousness (b = -0.34, SE = 0.03) declined. Conclusions and implications: Cognitive impairment is associated with a pattern of detrimental personality changes across the preclinical and clinical stages. Compared with the steeper rate of change during cognitive impairment, the changes were small and inconsistent before impairment, making them unlikely to be useful predictors of incident dementia. The study findings further indicate that individuals can update their personality ratings during the early stages of cognitive impairment, providing valuable information in clinical settings. The results also suggest an acceleration of personality change with the progression to dementia, which may lead to behavioral, emotional, and other psychological symptoms commonly observed in people with cognitive impairment and dementia.
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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).
Article
Objective: A sense of purpose in life is associated with healthier cognitive outcomes, including lower risk of Alzheimer's Disease (ad). The present research examines whether purpose is also associated with beliefs and knowledge of ad. Method: A random subsample (N = 1,187) of community-dwelling participants from the Health and Retirement Study completed a module on self-reported beliefs and knowledge of ad. Results: Purpose in life was associated with lower perceived threat of ad and greater belief that modifiable factors (e.g., physical activity) decrease risk. Associations were not moderated by experience with ad or depressive symptoms. Purpose was unrelated to beliefs that genetics or stress increase risk or knowledge of ad. Conclusions: Individuals with a sense of purpose are less concerned about risk of developing ad and believe modifiable factors reduce risk. These beliefs may support engagement in behaviors that reduce risk and be one psychological pathway through which purpose protects against ad.
Chapter
Decades of research have shown that adults’ negative views of aging (VoA) are associated with a wide spectrum of negative outcomes, including lower life satisfaction, poorer health, and reduced longevity. Conversely, it has been shown that positive VoA are associated with important positive outcomes, including better brain health and longer survival. These findings have led researchers to increasingly ask the following questions: (1) Can adults’ subjective VoA be made more positive through structured implicit or explicit interventions? (2) Do more positive subjective VoA serve as a possible mechanism to promote lifestyle changes that may facilitate healthy aging? This chapter reviews the existing research that has addressed these questions. Specifically, the review shows that both implicit and explicit approaches to making middle-aged and older adults’ negative VoA more positive have been successful. Moreover, findings from several studies have documented that more positive VoA after the interventions were subsequently associated with positive behavior changes, such as greater engagement in physical activity. Based on the findings from this emerging literature, it seems justified to conclude that interventions targeting middle-aged and older adults’ negative VoA may represent a promising and cost-effective way to promote behaviors that are known to support successful aging. The chapter closes with a discussion of challenges and future directions in this area of research.
Chapter
This closing chapter discusses the major advances in theory, research, and practice to show that the field of subjective views of aging (VoA) has indeed reached a qualitatively new developmental stage. At the theoretical level there is an increasing consensus that a lifespan developmental perspective may be most appropriate to study VoA across the adult years and into late life. This perspective can serve as a unifying framework with important implications for the integration of diverse literatures and increased methodological diversity and sophistication. Specifically, the impact of greater methodological diversity and sophistication is seen at the level of empirical research, including the greater diversity in study designs, the emerging focus on multilevel investigations (e.g., the concomitant study of biological, psychological, and social processes), and the translation into areas of intervention and prevention. All these advances bode well for the future of the field of VoA research and lay the foundation for promising future directions.
Article
We provide an empirical foundation for research on the demography of loneliness at older ages. First, we use published life tables and data from the U.S.-based Health and Retirement Study for the period 2008–2016 to calculate lonely life expectancy for Americans aged 55 or older. Using Sullivan's method, we demonstrate pronounced differences in lonely life expectancy by sex, race/ethnicity, and educational attainment that correspond to well-established patterns of stratification in other dimensions of well-being. Next, we estimate models that decompose observed sex, racial/ethnic, and educational differences in three key health outcomes into the part explained (in a statistical accounting sense) by loneliness and the part accounted for by other factors. We find little evidence of an important role for loneliness in understanding disparities in mortality and the onset of physical disability and cognitive impairment among Americans aged 55 or older, net of several established correlates of health disparities. These descriptive findings provide an empirical foundation for continued development of a demography of loneliness at older ages in response to the anticipated growth in scientific and policy emphasis on loneliness and the fundamental life changes that have accompanied the COVID-19 pandemic.
Article
Objectives The present study examined the longitudinal relationships between subjective age (SA) and future functional status in later life, via depressive symptoms. Additionally, we assessed the role of subjective nearness to death (SNtD) as a potential moderator within these pathways. Methods Older adults (average age 81.14 at T1) were interviewed once a year for three consecutive years (N=224 at T1, N=178 at T2, and N=164 at T3), Participants reported their SA, SNtD, depressive symptoms, and functional status. Additionally, grip strength was employed as an objective measure of functional status. Results Data analysis revealed distinct pathways leading from T1 SA to T3 functional status through T2 depressive symptoms. Moreover, T1 SNtD was found to significantly moderate most of these indirect pathways, so that the mediation model of T1 SA-T2 depressive symptoms-T3 functional status was mostly significant among those who felt closer to death. Discussion The findings contribute to our understanding of the underlying mechanism through which SA predicts long-term functioning sequelae by underscoring the indirect effect of depressive symptoms. They further indicate the importance of gauging the effects of SNtD on these longitudinal relationships. Present results may further contribute to establishing an integrative model for predicting long-term functional outcomes based on older adults' earlier subjective views of aging.
Article
Objectives This study aimed to examine the relation between subjective age and verbal fluency in five large samples of older adults to advance knowledge on the role of subjective age in a complex cognitive function that is an intermediate marker of cognitive impairment and dementia risk. Methods Participants (N > 27,000), aged 32 to 99 years old, predominantly white, were from the Wisconsin Longitudinal Study Graduate (WLSG) and Siblings (WLSS) samples, the Health and Retirement Study (HRS), the Midlife in the United States Study (MIDUS), and the English Longitudinal Study of Ageing (ELSA). They provided complete data on subjective age, demographic factors and verbal fluency. Estimates from each sample were combined in a meta-analysis. Results Across each of the five samples and in the meta-analysis, an older subjective age was related to lower performance on the verbal fluency task. This association was independent of chronological age and was not moderated by age, sex, nor education. The difference in fluency between individuals with an older and younger subjective age ranged from d= .09 to d= .37 across the five samples. Conclusions This study found replicable evidence for an association between an older subjective age and lower verbal fluency, extending knowledge about an intermediate marker of cognitive function.
Article
Objective Subjective age is consistently related to memory performance and global cognitive function among older adults. The present study examines whether subjective age is prospectively related to specific domains of cognitive function. Method Participants were drawn from the Health and Retirement Study (HRS, N = 2549, Mean Age = 69.66, SD = 7.36) and the Midlife in the United States Survey (MIDUS, N = 2499, Mean Age = 46.24, SD = 11.25). In both samples, subjective age, depressive symptoms, chronic conditions, and demographic factors were assessed at baseline. Four domains of cognition were assessed 8 years later in the HRS and almost 20 years later in the MIDUS: episodic memory, speed-attention-executive, verbal fluency, and numeric reasoning. HRS also assessed visuospatial ability. Results Regression analysis revealed that an older subjective age was related to worse performance in the domains of episodic memory and speed-attention-executive in both samples. The effect size for the difference between a younger and an older subjective age was d = 0.14 (MIDUS) and d = 0.24 (HRS) for episodic memory and d = 0.25 (MIDUS) and d = 0.33 (HRS) for speed-attention-executive. Feeling older was related to lower verbal fluency in HRS (d = 0.30) but not in MIDUS, whereas no association was found with numeric reasoning in either sample. An older subjective age was related to lower visuospatial ability in HRS (d = 0.25). Conclusion Subjective age is prospectively related to performance in different cognitive domains. The associations between subjective age and both episodic memory and speed-attention-executive functions were replicable and robust over up to 20 years of follow-up.
Article
As a biopsychosocial marker of aging, subjective age (i.e., the age individuals feel regardless of their actual age) was related to many health issues in the elderly. The purpose of this study is to investigate whether subjective age is associated with subsequent cognition and dementia risk in middle-aged and older adults. Samples were drawn from the English Longitudinal Study of Ageing (ELSA). Participants reported their subjective ages at the baseline (2004/2005), and their cognitive functions were measured after 10 years (2014/2015). Newly diagnosed dementias were recorded between 2006/2007 to 2014/2015. Overall, 6,475 adults aged 50 years or older were included in the current analyses. The relationship between subjective age reported at baseline and cognition assessed ten years later was modeled using multiple linear regression models. Compared to participants who reported a younger subjective age, those who reported an older subjective age were more likely to have poorer cognition after ten years (β = -0.705, P = .002 for memory, β = -1.567, P = .001 for executive function). A Cox proportional hazard regression model suggested that older subjective age was an independent risk factor for incident dementia (HR = 1.737, 95% CI =1.060-2.848). Other than chronological age, subjective age could also be considered as an important predictor for the development of cognitive dysfunction.
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Converging longitudinal research suggests that more negative views on aging predict accelerated cognitive decline. Although conceptually suggested, reciprocal relationships between cognitive functioning and attitudes toward aging have remained less clear empirically. We used the 20-year data from the Interdisciplinary Longitudinal Study of Adult Development (ILSE) to better understand such potential bidirectionality. Drawing on 1,002 baseline participants from 2 age groups, a midlife (Mage = 43.7 at baseline) and an old age group (Mage = 62.5 at baseline), we examined longitudinal trajectories between attitude toward own aging, performance-based cognitive measures, and subjective cognitive complaints. Findings from multigroup latent growth curve modeling replicated previous findings that attitude toward own aging predicts cognitive change over 20 years in old age with 2 important specifications: We show that this effect (a) does not apply to midlife and (b) disappears in old age after controlling for depression over time. Further, as expected, cognitive complaints but not cognitive performance were related to change in attitude toward own aging in midlife and old age. Results suggest that differentiating between objective cognitive functioning and subjective cognitive complaints is important when investigating relations between cognitive functioning and attitude toward own aging in different age groups. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Article
Objectives: Little research has investigated the prospective association between subjective-aging-perception and depressive symptoms in Chinese older adults. The aim of this study is to evaluate the differential associations of feeling old with depressive symptoms among urban and rural community-dwelling Chinese older adults using panel data drawn from two waves of nationally representative surveys. Method: We conducted secondary data analysis and utilized the data of 5,685 urban and 5,612 rural community-dwelling older adults aged 60 years and above who participated in both the 2006 and the 2010 Sample Survey on the Aged Population in Urban/Rural China (SSAPUR). A single-item measure of subjective age was used to distinguish between feeling old and feeling not old. Results: Ordinary least regression analyses indicated that the longitudinal effect of subjective age on depressive symptoms existed only in the urban sample (p<.001) but not in the rural sample and that feeling not old was related to less depressive symptoms in the urban sample, after controlling for baseline measures of depressive symptoms and sociodemographic and health factors. Conclusion: This study provides new longitudinal evidence of the impact of subjective age on depression among Chinese older individuals. The findings provide useful information for depression interventions among urban older Chinese individuals.
Article
Building on recent findings in psychology, we study the impact of subjective age identity (feeling younger or older than one's chronological age) on economic behaviors. Using data from the Health and Retirement Study we find: Individuals with a younger age identity have higher work engagement, and their savings profile, as a function of the subjective age gap, is hump-shaped. The effects are economically significant, for example, increasing the subjective age gap by one standard deviation increases an individual's likelihood to be employed in a subsequent HRS wave by 1.1% (about 21% of the conditional mean). The relationships found are consistent with an interplay of two subjective age channels: Ability (self-perceived abilities to perform certain economic behaviors) and Preference (choosing (avoiding) “young” (“old”) behaviors). Our results have implications for policy and financial advice that traditionally target individuals based on chronological age. That is, for example, allowing more flexibility with respect to retirement decisions as well as aligning financial products and services with subjective age identities.
Article
Background: Aging that indicates changes in body functioning with progressive reduction in viability of organism, can be determined using chronological age as well as biological age. Objectives: Present study aims to assess the extent to which the two types of age differ significantly for their influence on adiposity and obesity indicators and relate to them. Study design: For this cross-sectional study 444 female participants with their age ranging between 18-22 years affiliated with University of Delhi were approached. Methods: Participants were asked for their chronological age. Different anthropometric measurements were recorded and derived ratios were further calculated. Biological age along with body composition assessment was carried out using Omron Karada Scan (Model HBF-362). Difference of chronological and biological age was computed. Statistical Package for Social Sciences version 20.0 was used for data analysis comparing means applying t-test, analysis of variance and predicting risk factor for different conditions by means of odds ratio. Level of significance was taken at p < 0.05. Results: Both chronological and biological age associate positively with body physique and composition parameters. Body adiposity and obesity increase significantly with increasing biological age difference with respect to chronological age (total body fat percentage, OR=11.10; BMI, OR=7.74; waist circumference, OR=2.21; WHtR, OR=1.43). Conclusion: Biological age is an active indicator for tracking adiposity/ obesity.
Article
Objective: Individuals who perceive unfair treatment because of their body weight have been found to be at increased risk of poor health outcomes, including risk of dementia. The present research examines the relation between weight discrimination and performance in five cognitive domains (episodic memory, speed-attention, visuospatial ability, language, numeric reasoning) and whether the associations extend to other common attributions for discrimination (age, gender, race). Method: Participants (n = 2593) were from the Harmonized Cognitive Assessment Protocol (HCAP) sub-study of the Health and Retirement Study (HRS). HCAP participants completed a battery of cognitive tasks that measured the five focal cognitive domains. Participants reported on their perceived experiences with discrimination at the previous regular HRS assessment. Results: In models that accounted for demographic covariates and BMI, weight discrimination (reported by 6% of participants) was associated with a two-fold increased risk of poor performance on tasks of episodic memory, speed-attention, visuospatial ability, and numeric reasoning. Body mass index was largely unrelated to performance in the five cognitive domains. The other attributions for discrimination were generally unrelated to cognition, but there were sex- and race-specific associations for gender and race discrimination, respectively. Conclusions: The present study identified attribution- and domain-specific associations between discrimination and cognitive performance in older adulthood.
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Although negative age stereotypes have been found to predict adverse outcomes among older individuals, it was unknown whether the influence of stereotypes extends to brain changes associated with Alzheimer's disease. To consider this possibility, we drew on dementia-free participants, in the Baltimore Longitudinal Study of Aging, whose age stereotypes were assessed decades before yearly magnetic resonance images and brain autopsies were performed. Those holding more-negative age stereotypes earlier in life had significantly steeper hippocampal-volume loss and significantly greater accumulation of neurofibrillary tangles and amyloid plaques, adjusting for relevant covariates. These findings suggest a new pathway to identifying mechanisms and potential interventions related to the pathology of Alzheimer's disease. (PsycINFO Database Record
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Objectives: This study examined (a) the empirical associations among three subjective aging (SA) constructs: felt age, attitudes toward own aging (ATOA), and awareness of age-related change (AARC); (b) the moderating role of chronological age in these associations; and (c) the predictive relevance of the SA constructs with regard to two developmental correlates: functional health and satisfaction with life. Method: Participants were 819 adults aged 40-98 years from the United States and Germany. Parallel multiple mediation, moderated mediation, and hierarchical regression analyses were used. Results: As hypothesized, AARC mediated the association between the global measures of SA (felt age and ATOA) and the developmental correlates. Specifically, more negative global subjective aging predicted more AARC losses, which predicted poorer health and well-being. Furthermore, this mediation pathway was moderated by chronological age, such that, with increasing age, greater AARC was more strongly related to poorer functional health (but not well-being). The multidimensional measure, AARC, accounted for a significant amount of the variance in the developmental correlates over and above the unidimensional SA constructs. A consistent pattern emerged supporting the role of domain specificity and valence. Discussion: These findings support the need for conceptualizing SA across different behavioral domains and for distinguishing between positive and negative SA.
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Subjective age is an important correlate of health, well-being, and longevity. So far, little is known about short-term variability in subjective age and the circumstances under which individuals feel younger/older in daily life. This study examined whether (a) older adults' felt age fluctuates on a day-to-day basis, (b) daily changes in health, stressors, and affect explain fluctuations in felt age, and (c) the daily associations between felt age and health, stressors, or affect are time-ordered. Using an 8-day daily diary approach, N=43 adults (60-96 years, M=74.65, SD=8.19) filled out daily questionnaires assessing subjective age, health, daily stressors, and affect. Data were analysed using multilevel modelling. Subjective age, health, daily stressors, affect. Intraindividual variability in felt age was not explained by time but by short-term variability in other variables. Specifically, on days when participants experienced more than average health problems, stress, or negative affect they felt older than on days with average health, stress, or negative affect. No time-ordered effects were found. Bad health, many stressors, and negative affective experiences constitute circumstances under which older adults feel older than they typically do. Thus, daily measures of subjective age could be markers of health and well-being.
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Aging researchers have long been interested in understanding individuals' subjective perceptions of their own memory functioning. Previous research has shown that subjective memory ratings are partly based on memory performance but also reflect the influence of other factors, such as depressive symptoms. The aim of the present study was to examine (1) longitudinal associations between trajectories of subjective memory and memory performance, (2) variables that predict levels of and changes in subjective memory and memory performance, and (3) variables that moderate associations between these constructs. We applied a latent growth curve model to four occasions of data from 15,824 participants of the Health and Retirement Study (HRS; mean age at baseline = 64.27 years, SD = 9.90; 58% women). Results revealed that latent changes in subjective memory were correlated with latent changes in memory performance (φ = 0.49), indicating that participants who reported steeper declines of subjective memory indeed showed steeper declines of memory performance over time. Three major patterns of associations emerged with respect to predictors of subjective memory and subjective memory change. First, the level of memory performance showed stronger associations with age, gender, and education, whereas subjective memory was more strongly associated with subjective age and personality traits. For example, women performed better than men on the episodic memory test, but there were no gender differences in subjective memory. Also, older age was associated with steeper declines of memory performance but with less decline of subjective memory. Second, personality traits that predicted subjective memory intercepts did not predict subjective memory slopes. Third, the strength of associations between levels and slopes of subjective memory and memory performance varied as a function of gender, education, depressive symptoms, and personality traits. Conscientiousness moderated the relationship of the level of subjective memory to the level of memory performance, consistent with the hypothesis that persons high in conscientiousness more accurately monitor memory successes and failures. The results reinforce the importance of depressive symptoms as a predictor of subjective memory but also indicate that a broader perspective on the reasons why memory complaints have modest correlations with memory itself is needed. © 2015 S. Karger AG, Basel.
Article
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Subjective age, or how young or old individuals experience themselves to be relative to their chronological age, is a crucial construct in gerontology. Subjective age is a significant predictor of important health outcomes, but little is known about the criteria by which individuals' subjectively evaluate their age. To identify psychosocial and biomedical factors linked to the subjective evaluation of age, this study examined whether perceived age discrimination and markers of biological aging are associated with subjective age. Participants were 4776 adults (Mage= 68) from the 2008 and 2010 waves of the Health and Retirement Study (HRS) who completed measures of subjective age, age discrimination, demographic variables, self-rated health and depression, and had physical health measures, including peak expiratory flow, grip strength, waist circumference, systolic and diastolic blood pressure. Telomere length was available for a subset of participants in the 2008 wave (n = 2214). Regression analysis indicated that perceived age discrimination, lower peak expiratory flow, lower grip strength, and higher waist circumference were associated with an older subjective age, controlling for sociodemographic factors, self-rated health, and depression. In contrast, blood pressure and telomere length were not related to subjective age. These findings are consistent with the hypothesis that how old a person feels depends in part on psychosocial and biomedical factors, including the experiences of ageism and perceptible indices of fitness and biological age.
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Objective: We assessed salience of subjective memory complaints (SMCs) by older individuals as a predictor of subsequent cognitive impairment while accounting for risk factors and eventual neuropathologies. Methods: Subjects (n = 531) enrolled while cognitively intact at the University of Kentucky were asked annually if they perceived changes in memory since their last visit. A multistate model estimated when transition to impairment occurred while adjusting for intervening death. Risk factors affecting the timing and probability of an impairment were identified. The association between SMCs and Alzheimer-type neuropathology was assessed from autopsies (n = 243). Results: SMCs were reported by more than half (55.7%) of the cohort, and were associated with increased risk of impairment (unadjusted odds ratio = 2.8, p < 0.0001). Mild cognitive impairment (dementia) occurred 9.2 (12.1) years after SMC. Multistate modeling showed that SMC reporters with an APOE ε4 allele had double the odds of impairment (adjusted odds ratio = 2.2, p = 0.036). SMC smokers took less time to transition to mild cognitive impairment, while SMC hormone-replaced women took longer to transition directly to dementia. Among participants (n = 176) who died without a diagnosed clinical impairment, SMCs were associated with elevated neuritic amyloid plaques in the neocortex and medial temporal lobe. Conclusion: SMC reporters are at a higher risk of future cognitive impairment and have higher levels of Alzheimer-type brain pathology even when impairment does not occur. As potential harbingers of future cognitive decline, physicians should query and monitor SMCs from their older patients.
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Cross-sectional and longitudinal relationships between memory complaint and memory performance were examined in a sample of old-old participants from the Berlin Aging Study (BASE; N = 504, ages 70 to 100, age M = 84.7 at study onset). Participants were measured 4 times over the course of 6 years. Similar to many previous studies, initial cross-sectional memory complaints were predicted by depression and neuroticism, but not memory performance. Subjective age also predicted memory complaint independent of other variables. Latent growth curve models based on age and time in the study revealed that memory complaints did not change in level with age or time, and manifested no reliable random effects (individual differences in change). These models also detected no significant relationship between changes in memory and either initial memory complaint or changes in memory complaint over age or over time. None of the covariates that predicted initial memory complaints were related to changes in memory complaints over time. An autoregressive latent variable model for memory complaints, consistent with a conceptualization of complaints as judgments constructed from beliefs and other influences in the moment, did detect a concurrent effect of memory on memory complaints at the third occasion, controlling on initial complaints. These results suggest that for the oldest-old, changes in memory complaints may not primarily reflect monitoring of actual age-related memory changes, but rather are affected by other variables, including age-based memory stereotypes, neuroticism, depression, and concerns about aging. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Background By 2050, it has been estimated that approximately one-fifth of the population will be made up of older adults (aged ≥60 years). Old age often comes with cognitive decline and dementia. Physical activity may prevent cognitive decline and dementia. Methods We reviewed and synthesised prospective studies into physical activity and cognitive decline, and physical activity and dementia, published until January 2014. Forty-seven cohorts, derived from two previous systematic reviews and an updated database search, were used in the meta-analyses. Included participants were aged ≥40 years, in good health and/or randomly selected from the community. Studies were assessed for methodological quality. Results Twenty-one cohorts on physical activity and cognitive decline and twenty-six cohorts on physical activity and dementia were included. Meta-analysis, using the quality-effects model, suggests that participants with higher levels of physical activity, when compared to those with lower levels, are at reduced risk of cognitive decline, RR 0.65, 95% CI 0.55-0.76, and dementia, RR 0.86, 95% CI 0.76-0.97. Sensitivity analyses revealed a more conservative estimate of the impact of physical activity on cognitive decline and dementia for high quality studies, studies reporting effect sizes as ORs, greater number of adjustments (≥10), and longer follow-up time (≥10 years). When one heavily weighted study was excluded, physical activity was associated with an 18% reduction in the risk of dementia (RR 0.82; 0.73-0.91). Conclusions Longitudinal observational studies show an association between higher levels of physical activity and a reduced risk of cognitive decline and dementia. A case can be made for a causal interpretation. Future research should use objective measures of physical activity, adjust for the full range of confounders and have adequate follow-up length. Ideally, randomised controlled trials will be conducted. Regardless of any effect on cognition, physical activity should be encouraged, as it has been shown to be beneficial on numerous levels.
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Dementia affects a large and growing number of older adults in the United States. The monetary costs attributable to dementia are likely to be similarly large and to continue to increase. In a subsample (856 persons) of the population in the Health and Retirement Study (HRS), a nationally representative longitudinal study of older adults, the diagnosis of dementia was determined with the use of a detailed in-home cognitive assessment that was 3 to 4 hours in duration and a review by an expert panel. We then imputed cognitive status to the full HRS sample (10,903 persons, 31,936 person-years) on the basis of measures of cognitive and functional status available for all HRS respondents, thereby identifying persons in the larger sample with a high probability of dementia. The market costs associated with care for persons with dementia were determined on the basis of self-reported out-of-pocket spending and the utilization of nursing home care; Medicare claims data were used to identify costs paid by Medicare. Hours of informal (unpaid) care were valued either as the cost of equivalent formal (paid) care or as the estimated wages forgone by informal caregivers. The estimated prevalence of dementia among persons older than 70 years of age in the United States in 2010 was 14.7%. The yearly monetary cost per person that was attributable to dementia was either 56,290(9556,290 (95% confidence interval [CI], 42,746 to 69,834)or69,834) or 41,689 (95% CI, 31,017to31,017 to 52,362), depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between 157billionand157 billion and 215 billion. Medicare paid approximately $11 billion of this cost. Dementia represents a substantial financial burden on society, one that is similar to the financial burden of heart disease and cancer. (Funded by the National Institute on Aging.).
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To determine the association between change in pulmonary function (PF) and mid- and late-life cognitive function. Prospective population-based cohort study that included measures of pulmonary function in midlife and brain magnetic resonance imaging data acquired in late life. The Age, Gene/Environment Susceptibility-Reykjavik Study. Three thousand six hundred sixty-five subjects who had at least one measure of forced expiratory volume in 1 second (FEV(1) ) and were cognitively tested on average 23 years later. A subset of 1,281 subjects had two or three measures of FEV(1) acquired over a 7.8-year period. Pulmonary function was estimated as FEV(1) /height(2) . Rate of PF decline was estimated as the slope of decline over time. Cognitive status was measured with continuous scores of memory, speed of processing, and executive function and as the outcome of mild cognitive impairment (MCI) and dementia. Lower PF measured in midlife predicted poorer memory, slower speed of processing, poorer executive function, and greater likelihood of MCI and dementia 23 years later. Decrease in PF over a 7.8-year period in midlife was not associated with MCI or dementia. Low PF measured in midlife may be an early marker of later cognitive problems. Additional studies characterizing early and late PF changes are needed.
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Objectives: Individuals' perceptions of their own age(ing) are important correlates of well-being and health. The goals of the present study were to (a) examine indicators of self-perceptions of aging across adulthood and (b) experimentally test whether age stereotypes influence self-perceptions of aging. Method: Adults 18-92 years of age were presented with positive, negative, or no age stereotypes. Before and after the stereotype activation, aging satisfaction and subjective age were measured. Results: The activation of positive age stereotypes did not positively influence self-perceptions of aging. Quite the contrary, priming middle-aged and older adults in good health with positive age stereotypes made them feel older. After the activation of negative age stereotypes, older adults in good health felt older and those in bad health wanted to be younger than before the priming. Even younger and middle-aged adults reported younger desired ages after the negative age stereotype priming. Persons in bad health also thought they looked older after being primed with negative age stereotypes. Discussion: Taken together, although we find some support for contrast effects, most of our results can be interpreted in terms of assimilation effects, suggesting that individuals integrate stereotypical information into their self-evaluations of age(ing) when confronted with stereotypes.
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This study examines the similarity of cognitive assessments using 1 interview in a large population study, the Health and Retirement Study (HRS), and a subsample in which a detailed neuropsychiatric assessment has been performed (Aging, Demographics, and Memory Study [ADAMS]). Respondents are diagnosed in ADAMS as demented, cognitively impaired without dementia (CIND), or as having normal cognitive function. Multinomial logistic analysis is used to predict diagnosis using a variety of cognitive and noncognitive measures from the HRS and additional measures and information from ADAMS. The cognitive tests in HRS predict the ADAMS diagnosis in 74% of the sample able to complete the HRS survey on their own. Proxy respondents answer for a large proportion of HRS respondents who are diagnosed as demented in ADAMS. Classification of proxy respondents with some cognitive impairment can be predicted in 86% of the sample. Adding a small number of additional tests from ADAMS can increase each of these percentages to 84% and 93%, respectively. Cognitive assessment appropriate for diagnosis of dementia and CIND in large population surveys could be improved with more targeted information from informants and additional cognitive tests targeting other areas of brain function.
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We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and "cognitive impairment, not demented" (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals age 70 or older who were participants in the ongoing HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g. Alzheimer's disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.
Article
Objectives: To investigate the association between subjective memory complaints (SMCs) and long-term risk of cognitive impairment in aging because most previous studies have followed individuals for only a few years. Methods: Participants were 1,107 cognitively normal, community-dwelling older women (aged 65 years and older at baseline) in a prospective study of aging. SMCs were assessed shortly after baseline and repeatedly over time with the yes/no question, "Do you feel you have more problems with memory than most?" Cognitive status 18 years later (normal or impaired with mild cognitive impairment or dementia) was determined by an expert panel. Using logistic regression, we investigated the association between SMCs over time and risk of cognitive impairment, adjusting for demographics, baseline cognition, and characteristics that differed between those with and without SMCs. Results: At baseline, 8.0% of participants (n = 89) endorsed SMCs. Baseline SMCs were associated with increased risk of cognitive impairment 18 years later (adjusted odds ratio [OR] = 1.7, 95% confidence interval 1.1-2.8). Results were unchanged after excluding participants with depression. The association between SMCs and cognitive impairment was greatest at the last SMC assessment time point (18 years before diagnosis: adjusted OR = 1.7 [1.1-2.9]; 14 years before diagnosis: adjusted OR = 1.6 [0.9-2.7]; 10 years before diagnosis: adjusted OR = 1.9 [1.1-3.1]; 4 years before diagnosis: adjusted OR = 3.0 [1.8-5.0]). Conclusions: SMCs are associated with cognitive impairment nearly 2 decades later among older women. SMCs may be a very early symptom of an insidious neurodegenerative disease process, such as Alzheimer disease.
Article
National Institutes of Health (NIH) consensus and stateof-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of 1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality, 2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, 3) questions and statements from conference attendees during open discussion periods that are part of the public session, and 4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of NIH or the U.S. government. The following statement is an abridged version of the panel’s report, which is available in full at http://consensus.nih.gov/2010 /alzstatement.htm. Alzheimer disease is the most common cause of dementia. It was first described in 1906 by German psychiatrist and neuropathologist Alois Alzheimer, who observed the pathologic hallmarks of the disease—abnormal clumps of protein (-amyloid plaques) and tangled bundles of protein fibers (neurofibrillary tangles)—in the brain of a woman who had experienced memory loss, language problems, and unpredictable behavior. An important breakthrough was the invention of the photomicrograph in the early 1900s by the psychiatrist Solomon Carter Fuller; this key innovation provided a method for taking photographs through the lens of a microscope, allowing visualization of amyloid plaques and neurofibrillary tangles. Since its first description, Alzheimer disease has gone
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Depression is associated with cognitive impairment and dementia, but whether treatment for depression with antidepressants reduces the risk for cognitive decline is unclear. We assessed the association between antidepressant use and cognitive decline over 6 years. Participants were 3,714 adults aged 50 or older enrolled in the nationally-representative Health and Retirement Study (HRS) and with self-reported antidepressant use. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed at four time-points (2004, 2006, 2008, 2010) through using a validated 27-point scale. Change in cognitive function over the 6-year follow-up period was examined using linear growth models, adjusted for demographics, depressive symptoms, comorbidities, functional limitations and antidepressant anticholinergic activity load. At baseline, cognitive function did not differ significantly between the 445 (12.1%) participants taking antidepressants and those not taking antidepressants (mean 14.9%, 95% CI: 14.3-15.4 vs. mean 15.1%, 95% CI: 14.9-15.3). During the 6-year follow up period, cognition declined in both users and nonusers of antidepressants, ranging from -1.4 change in mean score in those with high depressive symptoms and taking antidepressants to -.5 change in mean score in those with high depressive symptoms and not taking antidepressants. In adjusted models, people taking antidepressants declined at the same rate as those not taking antidepressants. Results remained consistent across different levels of baseline cognitive function, age, and duration of antidepressant use (prolonged versus short-term). Antidepressant use did not modify the course of 6-year cognitive change in this nationally- representative sample. Copyright © 2015 Elsevier Inc. All rights reserved.
Article
To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. This retrospective-cohort study examined a population-based sample of 7031 Americans older than 50 years participating in the Health and Retirement Study (1998-2008) who consented to have their interviews linked to their Medicare claims. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses. After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.11-1.69) and co-occurring depression and CIND (OR = 1.65, 95% CI = 1.24-2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR = 1.11, 95% CI = 0.88-1.40) in unadjusted analyses. Neither dementia alone (OR = 1.09, 95% CI = 0.82-1.45) nor co-occurring depression and dementia (OR = 1.25, 95% CI = 0.89-1.76) were associated with odds of ischemic stroke after adjusting for demographics. CIND and co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.
Article
The subjective experience of aging, indexed by how old or young an individual feels, has been related to well-being and health-related outcomes among older adults. The present study examined whether subjective age is associated with memory level and changes, as indexed by measures of immediate and delayed recall. A complementary purpose was to test the mediating role of depressive symptoms and physical activity in the relation between subjective age and memory changes. Participants were drawn from three waves of the Health and Retirement Study. Subjective age, baseline memory measures, and covariates were assessed during the 2008 wave (N = 5809), depressive symptoms and physical activity were assessed again in the 2010 wave, and the follow-up memory measures were assessed in the 2012 wave. Regression analyses that included demographic, metabolic, and vascular covariates revealed that a younger subjective age at baseline was associated with better concurrent performance and with slower decline in immediate and delayed recall. Bootstrap procedures indicated that fewer depressive symptoms mediated these associations. Additional analyses revealed that memory level and change were unrelated to changes in subjective age. Beyond chronological age, the subjective experience of age is associated with cognitive aging. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Subjective age, or how young or old individuals experience themselves to be, is related to a range of health-related outcomes in old age, including mortality risk. Little is known, however, about its association with markers of systemic inflammation. Using data from the Health and Retirement Study (HRS), the present study examined the relation between subjective age and C-reactive protein (CRP). Participants were 4120 older adults from the 2008 wave of the HRS who provided measures of subjective age, CRP, demographic variables, Body Mass Index (BMI), depression, smoking, physical activity and disease burden. Regression analyses revealed that a younger subjective age was related to lower CRP, controlling for demographic factors. This association was reduced by half but remained significant when health and behavioral covariates were adjusted for, suggesting that BMI, physical activity and disease burden may partially account for lower inflammation in individuals with a younger subjective age. Furthermore, a logistic regression revealed that feeling younger than one’s age was associated with reduced risk of exceeding the clinical threshold of CRP, controlling for covariates. The present study provides the first evidence of an association between subjective age and systemic inflammation among older adults. It suggests that individuals who feel younger than their age may be less vulnerable to age-related immune dysregulation.
Article
Objectives: This study examined both cross-sectional and longitudinal relationships between felt age and cognitive-affective symptom dimensions of depression in late life. Method: Data for this study came from two interview waves (T1 and T2) of the National Health and Aging Trend Study. Sample persons (n = 6680) who resided in their own or another's home at T1 were included. At T2 (one year later), 5414 of the original 6680 were interviewed and depressive symptom data were available for 5371 sample persons. The associations between felt age and depressive symptoms were analyzed using stepwise linear regression analyses. Results: At T1, (1) more than 70% of the sample felt younger and 7% felt older than their chronological age; and (2) younger felt age was associated with lower depressive symptoms, and older felt age was associated with higher depressive symptoms. Controlling for T1 depressive symptoms and health conditions, older felt age at T1 also predicted higher depressive symptoms at T2; however, chronological age and felt age explained only a small amount of variance in depressive symptom scores. Conclusion: The self-enhancement or self-protection function of younger felt age at T1 does not appear to extend longitudinally to T2, while the negative depressive effect of older felt age at T1 extends to T2.
Article
The present study examines whether subjective age (i.e., how old or young individuals feel) is associated with cognitive functioning and tests potential mediators of this association. Data from the two waves of measurement of the Midlife in the United States survey were used, with assessments conducted at the first wave in 1994-1995 and at the second wave in 2004-2006. A total of 1,352 men and women aged from 50 to 75 years at baseline (M: 59.32; SD: 6.72). Subjective age, body mass index (BMI), physical activity, and the covariates sex, age, education, marital status, and disease burden were assessed at baseline to predict episodic memory and executive function measured 10 years later. Multiple regression analysis revealed that a younger subjective age at baseline was prospectively associated with better episodic memory and executive function. Bootstrap analysis indicated that the association of subjective age with episodic memory and executive function was partially mediated by BMI and frequency of physical activity respectively. Even after accounting for chronological age and other risk factors for cognitive decline, such as disease burden and sedentary lifestyle, the subjective experience of aging predicts cognitive functioning in old age.
Article
Background: We examine whether broad factors and specific facets of personality are associated with increased risk of incident Alzheimer's disease (AD) in a long-run longitudinal study and a meta-analysis of published studies. Methods: Participants (n = 1671) were monitored for up to 22 years from a baseline personality assessment. The meta-analysis pooled results from up to five prospective studies (n = 5054). Results: Individuals with scores in the top quartile of neuroticism (hazard ratio = 3.1; 95% confidence interval = 1.6-6.0) or the lowest quartile of conscientiousness (hazard ratio = 3.3; 95% confidence interval = 1.4-7.4) had a threefold increased risk of incident AD. Among the components of these traits, self-discipline and depression had the strongest associations with incident AD. The meta-analysis confirmed the associations of neuroticism (P = 2 × 10(-9)) and conscientiousness (P = 2 × 10(-6)), along with weaker effects for openness and agreeableness (P < .05). Conclusions: The current study and meta-analysis indicate that personality traits are associated with increased risk of AD, with effect sizes similar to those of well-established clinical and lifestyle risk factors.
Article
Objectives: To provide updated estimates of Alzheimer disease (AD) dementia prevalence in the United States from 2010 through 2050. Methods: Probabilities of AD dementia incidence were calculated from a longitudinal, population-based study including substantial numbers of both black and white participants. Incidence probabilities for single year of age, race, and level of education were calculated using weighted logistic regression and AD dementia diagnosis from 2,577 detailed clinical evaluations of 1,913 people obtained from stratified random samples of previously disease-free individuals in a population of 10,800. These were combined with US mortality, education, and new US Census Bureau estimates of current and future population to estimate current and future numbers of people with AD dementia in the United States. Results: We estimated that in 2010, there were 4.7 million individuals aged 65 years or older with AD dementia (95% confidence interval [CI] = 4.0-5.5). Of these, 0.7 million (95% CI = 0.4-0.9) were between 65 and 74 years, 2.3 million were between 75 and 84 years (95% CI = 1.7-2.9), and 1.8 million were 85 years or older (95% CI = 1.4-2.2). The total number of people with AD dementia in 2050 is projected to be 13.8 million, with 7.0 million aged 85 years or older. Conclusion: The number of people in the United States with AD dementia will increase dramatically in the next 40 years unless preventive measures are developed.
Article
Objective: To investigate the association of cardiac disease with amnestic and nonamnestic mild cognitive impairment (aMCI and naMCI, respectively). Nonamnestic mild cognitive impairment, a putative precursor of vascular and other non-Alzheimer dementias, is hypothesized to have a vascular etiology. Design: A prospective, population-based, cohort study with a median 4.0 years of follow-up. Setting: Olmsted County, Minnesota. Participants: A total of 2719 participants were evaluated at baseline and every 15 months using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing. A diagnosis of normal cognition, MCI, or dementia was made by consensus. Cardiac disease at baseline was assessed from the participant's medical records. Main outcome measures: Incident MCI, aMCI, or naMCI. Results: Of 1450 participants without MCI or dementia at baseline, 366 developed MCI. Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 1.77 [95% CI, 1.16-2.72]). However, the association varied by sex (P = .02 for interaction). Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 3.07 [95% CI, 1.58-5.99]) for women but not for men (hazard ratio, 1.16 [95% CI, 0.68-1.99]). Cardiac disease was not associated with any type of MCI or with aMCI. Conclusions: Cardiac disease is an independent risk factor for naMCI; within-sex comparisons showed a stronger association for women. Prevention and management of cardiac disease and vascular risk factors may reduce the risk of naMCI.
Article
Little is known about health care use in the cognitive impairment, not dementia (CIND) subpopulation. Using a cohort of 7130 persons aged 71 years or over from the Health and Retirement Survey, we compared mean and total health care use from 2002 to 2008 for those with no cognitive impairment, CIND, or dementia in 2002. Cognitive status was determined using a validated method based on self or proxy interview measures. Health care use was also based on self or proxy reports. On the basis of the Health and Retirement Survey, the CIND subpopulation in 2002 was 5.3 million or 23% of the total population 71 years of age or over. Mean hospital nights was similar and mean nursing home nights was less in persons with CIND compared with persons with dementia. The CIND subpopulation, however, had more total hospital and nursing home nights-71,000 total hospital nights and 223,000 total nursing home nights versus 32,000 hospital nights and 138,000 nursing home nights in the dementia subpopulation. A relatively large population and high health care use result in a large health care impact of the CIND subpopulation.
Article
Depression and dementia are common in older adults and often co-occur, but it is unclear whether depression is an etiologic risk factor for dementia. To clarify the timing and nature of the association between depression and dementia. We examined depressive symptoms assessed in midlife (1964-1973) and late life (1994-2000) and the risks of dementia, Alzheimer disease (AD), and vascular dementia (VaD) (2003-2009) in a retrospective cohort study. Depressive symptoms were categorized as none, midlife only, late life only, or both. Cox proportional hazards models (age as timescale) adjusted for demographics and medical comorbidities were used to examine depressive symptom category and risk of dementia, AD, or VaD. Kaiser Permanente Medical Care Program of Northern California. Thirteen thousand five hundred thirty-five long-term Kaiser Permanente members. Any medical record diagnosis of dementia or neurology clinic diagnosis of AD or VaD. Subjects had a mean (SD) age of 81.1 (4.5) years in 2003, 57.9% were women, and 24.2% were nonwhite. Depressive symptoms were present in 14.1% of subjects in midlife only, 9.2% in late life only, and 4.2% in both. During 6 years of follow-up, 22.5% were diagnosed with dementia (5.5% with AD and 2.3% with VaD). The adjusted hazard of dementia was increased by approximately 20% for midlife depressive symptoms only (hazard ratio, 1.19 [95% CI, 1.07-1.32]), 70% for late-life symptoms only (1.72 [1.54-1.92]), and 80% for both (1.77 [1.52-2.06]). When we examined AD and VaD separately, subjects with late-life depressive symptoms only had a 2-fold increase in AD risk (hazard ratio, 2.06 [95% CI, 1.67-2.55]), whereas subjects with midlife and late-life symptoms had more than a 3-fold increase in VaD risk (3.51 [2.44-5.05]). Depressive symptoms in midlife or in late life are associated with an increased risk of developing dementia. Depression that begins in late life may be part of the AD prodrome, while recurrent depression may be etiologically associated with increased risk of VaD.
Article
To compare the characteristics and outcomes of caregivers of adults with dementia with those of caregivers of adults with cognitive impairment, not dementia (CIND). Cross-sectional. In-home assessment for cognitive impairment and self-administered caregiving questionnaire. One hundred sixty-nine primary family caregivers of participants in the Aging, Demographics, and Memory Study (ADAMS). ADAMS participants were aged 71 and older drawn from the nationally representative Health and Retirement Study. Neuropsychological testing, neurological examination, clinical assessment, and medical history were used to assign a diagnosis of normal cognition, CIND, or dementia. Caregiving measures included caregiving time, functional limitations, depressive symptoms, physical and emotional strain, caregiving rewards, caregiver health, and demographic characteristics. Dementia caregivers spent approximately 9 hours per day providing care, compared with 4 hours per day for CIND caregivers (P=.001). Forty-four percent of dementia caregivers exhibited depressive symptoms, compared with 26.5% of CIND caregivers (P=.03). Physical and emotional strains were similar in both groups of caregivers. Regardless of the strains, nearly all caregivers reported some benefits from providing care. Behavioral problems (P=.01) and difficulty with instrumental activities of daily living (P=.01) in persons with CIND partially explained emotional strain experienced by CIND caregivers. For those with dementia, behavioral problems predicted caregiver emotional strain (P<.001) and depressive symptoms (P=.01). Although support services are available to dementia caregivers, CIND caregivers also expend considerable time and experience strains. The real caregiver burden of cognitive impairment in the U.S. population may therefore be greatly underestimated if people who have reached the diagnostic threshold for dementia are focused on exclusively.
Article
To estimate the prevalence of neuropsychiatric symptoms and examine their association with functional limitations. Cross-sectional analysis. The Aging, Demographics, and Memory Study (ADAMS). A sample of adults aged 71 and older (N=856) drawn from Health and Retirement Study (HRS), a nationally representative cohort of U.S. adults aged 51 and older. The presence of neuropsychiatric symptoms (delusions, hallucinations, agitation, depression, apathy, elation, anxiety, disinhibition, irritation, and aberrant motor behaviors) was identified using the Neuropsychiatric Inventory. A consensus panel in the ADAMS assigned a cognitive category (normal cognition; cognitive impairment, no dementia (CIND); mild, moderate, or severe dementia). Functional limitations, chronic medical conditions, and sociodemographic information were obtained from the HRS and ADAMS. Forty-three percent of individuals with CIND and 58% of those with dementia exhibited at least one neuropsychiatric symptom. Depression was the most common individual symptom in those with normal cognition (12%), CIND (30%), and mild dementia (25%), whereas apathy (42%) and agitation (41%) were most common in those with severe dementia. Individuals with three or more symptoms and one or more clinically significant symptoms had significantly higher odds of having functional limitations. Those with clinically significant depression had higher odds of activity of daily living limitations, and those with clinically significant depression, anxiety, or aberrant motor behaviors had significantly higher odds of instrumental activity of daily living limitations. Neuropsychiatric symptoms are highly prevalent in older adults with CIND and dementia. Of those with cognitive impairment, a greater number of total neuropsychiatric symptoms and some specific individual symptoms are strongly associated with functional limitations.
Article
To test the hypothesis that physical frailty is associated with risk of mild cognitive impairment (MCI). Prospective, observational cohort study. Approximately 40 retirement communities across the Chicago metropolitan area. More tha