Views on Aging and Health: A Multidimensional and Multitemporal Perspective

This is the authors' abstract. We don't add key points for this paper.

As we get older, we repeatedly construct the way we refer to our age and our aging. This process seems to occur mainly on two levels, the social and cultural levels, where the way our society refers to older adults affects the inner dialogue with ourselves regarding our identity as an aging individual in society. The second process occurs at the inner psychological level, where small biological and physical changes increase our awareness of the aging process and force us to confront these changes and the fact that we are mortal and getting older. These social and psychological processes interact with each other, construct our view toward our aging, and serve as the basis for vast theoretical and practical research. In recent decades there has been a dramatic increase in interest in views on aging (VoA), as evidence accumulated to show they serve as potent predictors of health and longevity (see Diehl & Wahl, 2015; Wurm et al., 2017, for a review). However, most work has typically used a unidimensional perspective focusing on one VoA construct within a specific time frame. As research on VoA is taking its place at the forefront of the study of aging, this special issue aimed to push beyond what has been done before. Thus, using data collected across several countries and across several timescales, the body of works assembled here delves deeper into the VoA–health nexus, presenting novel insights about the importance of multidimensionality of VoA and health assessed across different time frames. The papers in this special issue push the field to further integrate multiple VoA across dimensions in order to understand their unique and combined contributions. From a methodological standpoint, Boeder and Tse (2021) investigate the valence, specificity, and overlap of multiple measures, highlighting the importance of taking a multidimensional perspective of VoA. Bodner et al. (2021) demonstrate how multiple measures interact with each other to increase explanatory power, and Brothers et al. (2021) and Zhang and Neupert (2021) each examine possible directional pathways by testing mediation models across multiple domains of VoA and health. These papers highlight the multidirectional nature of VoA (Kornadt et al., 2020) and may help explain the relatively consistent finding that negative VoA are powerful predictors across many health domains (i.e., physical and psychological), whereas positive VoA predict more specific domains, mainly psychological health (Boeder et al., 2021; Brothers et al., 2021; Zhang & Neupert, 2021). In addition to methodological advances, papers in this special issue also highlight important conceptual innovations. Consistent with the multidimensional nature of VoA (e.g., Diehl et al., 2014; Kornadt et al., 2020), Avidor et al. (2021) show that subjective age and subjective life expectancy represent distinct features with differential associations with health. The multidimensional nature of aging expectations and aging stereotypes (Diehl et al., 2014) are addressed in the special issue as well. Rothermund et al. (2021) found that age-related attributions are a major factor that worsen subjective aging experiences, and assert the need to distinguish attributions about changes to those that are due to age versus those that could be attributed to other factors. Bodner et al. (2021) show that ageist attitudes fluctuate from day to day and that increases in ageist attitudes on one day predict increases in depressive symptoms the subsequent day. In sum, each study emphasizes the need to move beyond a single measure of VoA, to acknowledge the multidirectionality and multidimensionality of VoA, and to further explore how various components may work together. These are challenges that may require complex modeling techniques in data sets with tremendous amounts of power, and many papers in this special issue speak to how VoA can operate at various levels. The current special issue taps into several cardinal issues regarding VoA operating on various levels across time. The first type of sequential relations refers to the association between VoA and health. In that vein, some of the studies examined how health predicts VoA. For example, Smith and Larkina (2021) show that reported health in childhood predicts later life subjective perceptions of aging and subjective age. Their finding suggests that childhood health sets a lifelong foundation for later VoA. Other studies refer to VoA as a moderator between mental and physical health. For example, Avidor et al. (2021) show in two studies that worse physical health at Time 1 predicts worse mental health at Time 2 and that this association is stronger among participants with older subjective age. In another longitudinal study, VoA at Time 1 predicts mental and physical health 4 and 6 years later (Cohn-Schwartz et al., 2021). Stephan et al. (2021) show that older subjective age and negative self-perceptions of aging are related to almost twofold higher risk of incident stroke 9 years later. The second type of sequential relations refers to microlongitudinal daily measurements. Several studies in this issue examine between-person as well as within-person differences of the relations between VoA and health in daily diary studies. In one study, ageist attitudes reported on previous days predicted feeling older and more mental health symptoms (depressive symptoms) on following days, but not vice versa (Bodner et al., 2021). In another study positive attitudes toward own aging served as a protective factor against the effects of daily stressors on daily cognitive interference, and increases in awareness of age-related change losses were associated with increases in cognitive interference (O’Brien et al., 2021). Finally, Zhang and Neupert (2021) show that control beliefs mediated the relations between daily health and awareness of age-related change. Although most of the available literature suggests that VoA affect physical and mental health (Westerhof et al., 2014), the sequential findings in the current special issue offer other options for sequential time courses and highlight the importance of considering longitudinal and microlongitudinal data. The third type of sequential relation refers to the possible temporal sequence between different types of VoA. In this vein, age stereotypes at Time 1 predicted self-perceptions of aging at Time 2. More specifically, gain and loss self-perceptions of aging at Time 2 mediated the association between age stereotypes and physical or mental health (Brothers et al., 2021). Bodner et al. (2021) also found that ageist attitudes on one day can precede subjective age the next day. Thus, it seems that this sequential time course type is ripe for future inquiry with further microlongitudinal studies. Although the field of VoA shows exponential growth, several issues remain relatively less explored. We would like to conclude this editorial by referring to underexplored topics. We do not intend to present a comprehensive list of research gaps, but rather to highlight several issues we hold especially important in order for the field to move forward. First, our knowledge of VoA and their health concomitants is mainly based on findings coming from community-dwelling samples of relatively healthy and functioning older adults. We know much less of how VoA and health act among those coping with acute medical conditions or extreme frailty, those living in continuing care retirement communities, or those facing the challenges of old-old age (see Ayalon & Cohn-Schwartz, 2021; Infurna et al., 2010, for exceptions). Demographically, the population of octogenarians and older individuals is the fastest-growing age group in the world. Consequently, an increasing number of individuals is pushed into the limits of their functional and cognitive capabilities. It remains unclear whether positive VoA can be maintained in latest life, and to what extent VoA are still relevant to health when multimorbidity is present. Accordingly, there is a need for studies focusing primarily on VoA and health in highly vulnerable groups. Second, significant research endeavors were invested to delineate the relationship between VoA and health on the individual level (i.e., how one’s VoA may relate to one’s health). Nevertheless, humans are by nature social creatures, and their views and behaviors are affected and molded by their interpersonal surroundings. More recently, one can notice some initial attempts to capture the relationships between individuals’ reports and significant others’ reports of VoA and health (e.g., Kim et al., 2021; Shrira, 2020). One such attempt is also included in this special issue (Cohn-Schwartz et al., 2021). Future efforts to understand VoA and health within proximal (e.g., family) and distal (e.g., health care system) interpersonal contexts will certainly enrich the field with additional important ecological insights. Lastly, most of the works published in this special issue (Rothermund et al., 2021 for an exception), as well as the bulk of research (see Barak, 2009; Löckenhoff et al., 2009, for exceptions), focused on Western cultures, so findings and conclusions are mostly based on individualistic societies (e.g., American and European samples). There is an urgent need to expand the cross-cultural perspective on VoA in order to better understand global commonalities and cultural differences. In addition to including thus-far-neglected cultural groups, cross-cultural comparisons should also consider more sophisticated research questions about cultural variance in temporal sequencing of various VoA (e.g., assimilation of stereotypes into own perceptions of aging), and in the strength and direction of VoA–health effects. In summary, while the vast theoretical background for understanding the field of VoA and its relationship to health was previously set (Diehl & Wahl, 2015; Levy, 2009; Montepare, 2009; Wurm et al., 2017), the multidimensional and multitemporal perspectives adopted in this special issue open the field for many future research directions. We are encouraged by the innovative studies in this special issue and believe they can be used as a roadmap for further work with global implications. This work was supported by the Israel Science Foundation (ISF; grant number 1431/18). None reported.