Abstract
Perceptions of age and perceptions of health have each been found to predict future health and well-being, yet surprisingly, studies typically focused on one or the other. Studies on perceived age suggested that its effects on longevity may be mediated by perceived health. Within each of these lines of research, the constructs have not been consistently operationalized, making it difficult to generalize across studies. We aimed to investigate the associations of different measures of perceptions of age and of health with one another and with longevity. Data collected at baseline from the 851 participants of the Rutgers Aging and Health longitudinal study (mean age 73) included perceptions of age and health, each assessed with four different single-item measures, sociodemographic, and health measures. Mortality was followed-up for 10 years. All four health perceptions and two of the age perceptions (Age-group identity and nearness-to-death) were associated with survival time. Age and health perceptions had similar independent effects in models that included measures of both types, controlling for demographics and chronic conditions, though not after controlling for age. In contrast with our hypothesis, health perceptions did not mediate the association between age perceptions and mortality. Findings regarding health perceptions were generally consistent across measures, whereas age perception measures differed in their associations with various outcomes, indicating that they assess different subjective age constructs. The findings correspond with proposed explanations for the predictive effect of age and health perceptions and support the significant though weaker independent effects of age perceptions compared with health perceptions.
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References
Baron-Epel O, Shemy G, Carmel S (2004) Prediction of survival: a comparison between two subjective health measures in an elderly population. Soc Sci Med 58:2035–2043. https://doi.org/10.1016/S0277-9536(03)00412-X
Barrett AE, Montepare JM (2015) “It’s about time”: applying life span and life course perspectives to the study of subjective age. Ann Rev Gerontol Geriatr 35:55–77. https://doi.org/10.1891/0198-8794.35.55
Benyamini Y (2011) Editorial: why does self-rated health predict mortality? An update on current knowledge and a research agenda for psychologists. Psychol Health 26:1407–1413. https://doi.org/10.1080/08870446.2011.621703
Benyamini Y, Leventhal EA, Leventhal H (1999) Self-assessments of health: what do people know that predicts their mortality? Res Aging 21:477–500. https://doi.org/10.1177/0164027599213007
Benyamini Y, Leventhal EA, Leventhal H (2003) Elderly people’s ratings of the importance of health-related factors to their self-assessments of health. Soc Sci Med 56:1661–1667. https://doi.org/10.1016/s0277-9536(02)00175-2
Benyamini Y, Blumstein T, Murad H, Lerner-Geva L (2011) Changes over time from baseline poor self-rated health: for whom does poor self-rated health not predict mortality? Psychol Health 26:1446–1462. https://doi.org/10.1080/08870446.2011.559231
Beyer A-K, Wolff JK, Freiberger E, Wurm S (2019) Are self-perceptions of ageing modifiable? Examination of an exercise programme with vs. without a self-perceptions of ageing-intervention for older adults. Psychol Health 34:661–676. https://doi.org/10.1080/08870446.2018.1556273
Bordone V, Arpino B (2016) Do grandchildren influence how old you feel? J Aging Health 28:1055–1072. https://doi.org/10.1177/0898264315618920
Brothers A, Diehl M (2017) Feasibility and efficacy of the AgingPlus program: changing views on aging to increase physical activity. J Aging Phys Act 25:402–411. https://doi.org/10.1123/japa.2016-0039
Chipperfield JG (1993) Incongruence between health perceptions and health problems: implications for survival among seniors. J Aging Health 5:475–496. https://doi.org/10.1177/089826439300500404
Diehl M, Wahl H-W, Brothers A, Miche M (2015) Subjective aging and awareness of aging: toward a new understanding of the aging self. Ann Rev Gerontol Geriatr 35:1–28. https://doi.org/10.1891/0198-8794.35.1
Friedsam HJ, Martin HW (1963) A comparison of self and physician’s health ratings in an older population. J Health Hum Behav 4:179–183. https://doi.org/10.2307/2948660
Harris SE et al (2016) Molecular genetic contributions to self-rated health. Int J Epidemiol 46:994–1009. https://doi.org/10.1093/ije/dyw219
Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37. https://doi.org/10.2307/2955359
Idler EL, Kasl SV (1995) Self-ratings of health: do they also predict change in functional ability? J Gerontol B 50:S344–S353
Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69:307–316. https://doi.org/10.1016/j.socscimed.2009.05.013
Kastenbaum R, Derbin V, Sabatini P, Artt S (1972) “The Ages of Me”: toward personal and interpersonal definitions of functional aging. Aging Human Dev 3:197–211. https://doi.org/10.2190/tujr-wtxk-866q-8qu7
Klusmann V, Notthof N, Beyer A-K, Blawert A, Gabrian M (2019) The psychological assessment of views on ageing: a review of methods and innovative extensions. Eur J Ageing (this issue)
Kornadt AE, Kessler E-M, Wurm S, Bowen CE, Gabrian M, Klusmann V (2019) Views on aging: a life span perspective. Eur J Ageing (this issue). https://doi.org/10.1007/s10433-019-00535-9
Kotter-Grühn D, Neupert SD, Stephan Y (2015) Feeling old today? Daily health, stressors, and affect explain day-to-day variability in subjective age. Psychol Health 30:1470–1485. https://doi.org/10.1080/08870446.2015.1061130
Kotter-Grühn D, Kornadt AE, Stephan Y (2016) Looking beyond chronological age: current knowledge and future directions in the study of subjective age. Gerontology 62:86–93. https://doi.org/10.1159/000438671
Leshem-Rubinow E et al (2015) Self-rated health is associated with elevated C-Reactive Protein even among apparently healthy individuals. Isr Med Assoc J 17:213–218
Levy BR (2003) Mind matters: cognitive and physical effects of aging self-stereotypes. J Gerontol B 58:P203–P211. https://doi.org/10.1093/geronb/58.4.P203
Levy BR (2009) Stereotype embodiment: a psychosocial approach to aging. Curr Dir Psychol Sci 18:332–336. https://doi.org/10.1111/j.1467-8721.2009.01662.x
Levy BR, Bavishi A (2018) Survival advantage mechanism: inflammation as a mediator of positive self-perceptions of aging on longevity. J Gerontol B 73:409–412. https://doi.org/10.1093/geronb/gbw035
Levy BR, Slade MD, Kunkel SR, Kasl SV (2002) Longevity increased by positive self-perceptions of aging. J Pers Soc Psychol 83:261–270. https://doi.org/10.1037/0022-3514.83.2.261
Montepare JM (2009) Subjective age: toward a guiding lifespan framework. Int J Behav Dev 33:42–46. https://doi.org/10.1177/0165025408095551
Palgi Y (2016) Subjective age and perceived distance-to-death moderate the association between posttraumatic stress symptoms and posttraumatic growth among older adults. Aging Ment Health 20:948–954. https://doi.org/10.1080/13607863.2015.1047320
Palgi Y, Shrira A, Ben-Ezra M, Spalter T, Kavé G, Shmotkin D (2014) Age-related and death-related differences in emotional complexity. Psychol Aging 29:284–296. https://doi.org/10.1037/a0036302
Palgi Y, Shrira A, Rubinstein T, Kavé G, Shmotkin D (2018) Which factors do older adults consider when estimating the time left for them to live? J Gerontol B 74:69–73. https://doi.org/10.1093/geronb/gby048
Rippon I, Steptoe A (2018) Is the relationship between subjective age, depressive symptoms and activities of daily living bidirectional? Soc Sci Med 214:41–48. https://doi.org/10.1016/j.socscimed.2018.08.013
Rubin DC, Berntsen D (2006) People over forty feel 20% younger than their age: subjective age across the lifespan. Psychon Bull Rev 13:776–780. https://doi.org/10.3758/bf03193996
Sargent-Cox KA, Anstey KJ, Luszcz MA (2013) Longitudinal change of self-perceptions of aging and mortality. J Gerontol B 69:168–173. https://doi.org/10.1093/geronb/gbt005
Spini D, Clémence A, Ghisletta P (2007) How are temporal and social comparisons related to appraisals of self-rated health during very old age? Swiss J Psychol 66:79–89. https://doi.org/10.1024/1421-0185.66.2.79
Spuling SM, Miche M, Wurm S, Wahl H-W (2013) Exploring the causal interplay of subjective age and health dimensions in the second half of life. Z Gesundheitspsychol 21:5–15. https://doi.org/10.1026/0943-8149/a000084
Stephan Y, Chalabaev A, Kotter-Grühn D, Jaconelli A (2013) “Feeling Younger, Being Stronger”: an experimental study of subjective age and physical functioning among older adults. J Gerontol B 68:1–7. https://doi.org/10.1093/geronb/gbs037
Stephan Y, Sutin AR, Terracciano A (2015) Younger subjective age is associated with lower C-reactive protein among older adults. Brain Behav Immun 43:33–36. https://doi.org/10.1016/j.bbi.2014.07.019
Stephan Y, Sutin AR, Terracciano A (2018) Subjective age and mortality in three longitudinal samples. Psychosom Med 80:659–664. https://doi.org/10.1097/psy.0000000000000613
Stephan Y, Sutin AR, Kornadt A, Terracciano A (2019a) Polygenic scores for education, health, and personality as predictors of subjective age among older individuals of European ancestry: evidence from the Health and Retirement Study. Psychol Aging 34:139–144. https://doi.org/10.1037/pag0000283
Stephan Y, Sutin AR, Terracciano A (2019b) Subjective age and Cystatin C among older adults. J Gerontol B 74:382–388. https://doi.org/10.1093/geronb/gbx124
Stewart TL, Chipperfield JG, Perry RP, Weiner B (2012) Attributing illness to ‘old age:’ consequences of a self-directed stereotype for health and mortality. Psychol Health 27:881–897. https://doi.org/10.1080/08870446.2011.630735
Warmoth K, Tarrant M, Abraham C, Lang IA (2016) Older adults’ perceptions of ageing and their health and functioning: a systematic review of observational studies. Psychol Health Med 21:531–550. https://doi.org/10.1080/13548506.2015.1096946
Westerhof GJ, Wurm S (2015) Longitudinal research on subjective aging, health, and longevity: current evidence and new directions for research. Ann Rev Gerontol Geriat 35:145–165. https://doi.org/10.1891/0198-8794.35.145
Westerhof GJ et al (2014) The influence of subjective aging on health and longevity: a meta-analysis of longitudinal data. Psychol Aging 29:793–802. https://doi.org/10.1037/a0038016
Wolff JK, Warner LM, Ziegelmann JP, Wurm S (2014) What do targeting positive views on ageing add to a physical activity intervention in older adults? Results from a randomised controlled trial. Psychol Health 29:915–932. https://doi.org/10.1080/08870446.2014.896464
Wurm S, Tesch-Römer C, Tomasik MJ (2007) Longitudinal findings on aging-related cognitions, control beliefs, and health in later life. J Gerontol B 62:P156–P164. https://doi.org/10.1093/geronb/62.3.P156
Wurm S, Warner LM, Ziegelmann JP, Wolff JK, Schüz B (2013) How do negative self-perceptions of aging become a self-fulfilling prophecy? Psychol Aging 28:1088–1097. https://doi.org/10.1037/a0032845
Wurm S, Diehl M, Kornadt AE, Westerhof GJ, Wahl H-W (2017) How do views on aging affect health outcomes in adulthood and late life? Explanations for an established connection. Dev Rev 46:27–43. https://doi.org/10.1016/j.dr.2017.08.002
Acknowledgements
This research was supported by Grant AG03501 from the National Institute on Aging to Howard Leventhal and Elaine Leventhal. We thank Howard Leventhal for his thoughtful comments.
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Benyamini, Y., Burns, E. Views on aging: older adults’ self-perceptions of age and of health. Eur J Ageing 17, 477–487 (2020). https://doi.org/10.1007/s10433-019-00528-8
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DOI: https://doi.org/10.1007/s10433-019-00528-8