Awareness of Age-Related Gains and Losses and Their Associations with Hearing-Related Health Behaviors in Midlife and Older Adulthood

Introduction: How people perceive their own aging may delay (or motivate) engagement in health behaviors in response to age-related decline. Hearing loss is a common, age-related condition but many adults delay help-seeking and underutilize hearing aids. We examined whether gain- and loss-focused Awareness of Age-Related Change (AARC) predict interindividual differences in hearing-related health behaviors. Methods: Data were drawn from 503 adults (mean age=64.06 years, 69.4% female) from Resilient Minds, an app-based research study. All participants reported at least some hearing difficulties (80.5% mild, 13.5% moderate, 6% severe). AARC-gains and AARC-losses were assessed using the 10-item Awareness of Age-Related Change questionnaire. Informal help-seeking, formal help-seeking, and hearing aid use were assessed using dichotomous items (yes/no). We conducted logistic regressions, adjusting for objective hearing (pure tone average), age, sex, socioeconomic status, social engagement, and comorbidities. Interaction terms assessed whether age moderated these associations. Results: Higher AARC-losses were associated with greater likelihood of formal help-seeking (OR = 1.06, p = .04) and using hearing aids (OR = 1.13, p = .01). While AARC-gains did not directly predict these behaviors, an age interaction showed that higher AARC-gains were linked to informal help-seeking only among older adults. Conclusion: Awareness of age-related losses may be adaptive when it reflects realistic recognition of age-related challenges, like hearing difficulties. Promoting positive, gain-focused views of aging could support earlier informal help-seeking among older adults by encouraging open conversations about hearing concerns within their close social networks.