Some people may frequently forget about their age and be horrified at those moments when they realise their age

What does feeling younger or older than one’s chronological age mean to men and women? Qualitative and quantitative findings from the PROTECT study. Serena Sabatini et al. Psychology & Health, Aug 5 2021. https://doi.org/10.1080/08870446.2021.1960989

Abstract

Objective: We explored which factors are associated with subjective age (SA), i.e. feeling younger, the same as, or older than one’s chronological age, and whether these factors differ between men and women and between two age sub-groups.

Design: Cross-sectional study using qualitative and quantitative data for 1457 individuals (mean age= 67.2 years).

Main outcome measures: Participants reported how old they feel they are and provided comments in relation to their SA judgments.

Results: By using content analysis participants’ comments were assigned to 13 categories, grouped into three higher-order categories (antecedents of age-related thoughts, mental processes, and issues when measuring subjective age). SA may result from the interaction between factors that increase or decrease age-related thoughts and mental processes that individuals use to interpret age-related changes. Chi-squared tests show that individuals reporting an older SA are more likely to experience significant negative changes and to engage in negative age-related thoughts than individuals reporting an age-congruent SA or a younger SA. Women experience a more negative SA and more age-salient events than men.

Conclusion: Individuals reporting an older SA may benefit from interventions promoting adaptation to negative age-related changes. There is the need to eradicate negative societal views of older women.

Keywords: Ageingsubjective agefelt ageawareness of age-related changehealth promotion

Discussion

This study identified thirteen factors related to SA judgments and tested whether the frequency with which individuals comment on these factors differs among individuals reporting a younger SA, an age-congruent SA, or an older SA; between age sub-groups; and between men and women. In line with our first hypothesis, when evaluating their SA participants considered, not only their health status, but also a variety of life events and psychosocial factors. Participants’ comments suggest that SA judgments emerge from the interaction between factors that facilitate or decrease age-related thoughts and several mental processes that people use to make sense of age-related changes or to decrease the emotional impact of negative changes. Use of these mental processes frequently results in positive evaluations of SA. In line with our second and third hypotheses, the factors that participants considered when reporting their SA differed among sub-samples. Participants reporting an older SA were more likely to be aware of changes and less likely to engage in activities, compared to participants reporting a younger SA or an age-congruent SA. In line with existing literature on SA, participants in the older age sub-group reported a younger SA compared to those in the younger age sub-group (Bordone et al., 2020). Women experienced more age-symbolic events, especially in the younger age sub-group, and reported a more negative SA than men.

Among the categories that we identified, awareness of changes (Bowling et al., 2005; Sabatini, Silarova, et al., 2020), poor physical health (Desrosiers et al., 2006), the experience of age-symbolic events, and some life circumstances were associated with participants reporting an older SA (Bordone & Arpino, 2016). Events such as retirement, menopause, birthdays, and bereavement, and life circumstances such as being a caregiver may have reminded participants of their position in their lifespan (Barrett, 2003; Bordone & Arpino, 2016; Brothers et al., 2016; Bytheway, 2009; Montepare, 1996a, 2009). The combination of levels of gains and losses experienced by older individuals may play a role in whether these changes are attributed to age. Indeed a recent study showed that individuals are more likely to attribute negative changes to ageing compared to positive changes (Rothermund et al., 2021). The interpretation of negative changes as being a consequence of older age may in turn result in an older SA. Indeed, evidence shows that those individuals that report higher levels of awareness of age-related losses (AARC losses) tend to report an older SA compared to those who experience fewer AARC losses (Brothers et al., 2019; Kaspar et al., 2019; Sabatini, Ukoumunne, Ballard, Brothers, et al., 2020).

As participants reporting an older SA were more likely to be aware of age-related changes, less likely to engage in adaptive behaviours or activities, and rated their health as being poor, an older SA may represent a legitimate reaction to significant and permanent losses (e.g. decrease functional and cognitive ability) (Sabatini, Ukoumunne, Ballard, et al., 2021). As the experience of AARC losses and of an older SA are related to poorer emotional and physical well-being (Mock & Eibach, 2011; Sabatini, Silarova, et al., 2020; Westerhof et al., 2014) and lower engagement in health-related and adaptive behaviours (Brothers & Diehl, 2017; Dutt et al., 2018; Montepare, 2020; Wilton-Harding & Windsor, 2021), the emotional well-being of individuals reporting an older SA could be enhanced through disengagement from unachievable goals (Wrosch et al., 2003) and acceptance of negative changes (Collins & Kishita, 2019). However, when individuals with an older SA experience potentially modifiable changes, more active coping strategies should be promoted in order to enable these individuals to continue engaging in enjoyable activities (Brandtstädter & Rothermund, 2002).

Some participants reported an age-congruent SA or even a younger SA despite experiencing negative age-related changes and negative life circumstances. This finding may be due to several reasons. First, these individuals may have experienced positive changes alongside negative ones (Sabatini, Ukoumunne, Ballard, Diehl, et al., 2020; Wilton-Harding & Windsor, 2021). Second, as those participants who reported a younger SA or an age-congruent SA perceived their health as good and were able to continue performing a variety of meaningful activities, the health changes they experienced may have been mild (Spuling et al., 2013) and not severe enough to prevent them from leading an active and independent life (Franke et al., 2017). Third, some participants may report a positive SA despite the experience of age-related losses due to the use of a variety of mental processes that enable them to perceive their situation in a more optimistic light (Heckhausen & Krueger, 1993). However, subjective evaluations of health can differ greatly from scores obtained with objective measures of health (Carstensen, 1992, 1993, 2006; Chan et al., 2007; Idler & Benyamini, 1997; Jylha et al., 2001). Due to the subjective nature of the concepts, SA may be more strongly associated with self-rated health compared to objective measures of health and future studies should test this. We were unable to test this in the current study as in 2019 the PROTECT study annual assessment did not include an objective measure of health. However, the assessment of comorbidity was included as part of the 2020 annual assessment of the PROTECT study; this will enable the authors to explore in future studies the associations of SA with self-rated health and comorbidity.

Among the mental processes identified in the current study, consistent with social comparison theory (Rickabaugh & Tomlinson-Keasey, 1997) and with temporal comparison theory (Ferring & Hoffmann, 2007), participants reported a younger SA when they compared themselves to people in worse health than themselves (Beaumont & Kenealy, 2004) or when they concluded that despite their increasing age they had not changed significantly. In line with resilience theory some participants reported a younger SA when they concluded that they did not match negative stereotypes of older individuals (Kotter-Grühn & Hess, 2012). Finally, some participants reported a younger SA when others attributed a younger age to them or when they spent time with younger people (Bordone & Arpino, 2016). In contrast, participants reported an older SA when they compared themselves with more healthy others, they felt they matched negative stereotypes of older individuals and/or they thought they had changed significantly compared to previous versions of themselves. This pattern of results emphasises the positive impact that eradicating negative age-related stereotypes at societal level and promoting more realistic age-related expectations and intergenerational contact, may have on individuals’ experiences of ageing (Levy, 2017). Intervention programs promoting positive and realistic age-related beliefs, in addition to healthy behaviours, are effective in promoting more positive experiences of ageing, healthier lifestyle (e.g. more engagement in physical activity), and better mental (e.g. reduction in depressive symptoms) and physical (e.g. better physical performance in terms of balance, gait speed, and chair rise) health (Beyer et al., 2019; Brothers & Diehl, 2017; Menkin et al., 2020).

When estimating their SA, both men and women reflected most frequently on the changes they had experienced in multiple domains (e.g. physical, cognitive, social) of their lives and on how such changes led to modifications in their lifestyle. However, as expected, we found some differences in the way in which men and women evaluate their own ageing (Antonucci et al., 2010; Barrett, 2005). Compared to men, women, especially in the older sub-group, were more likely to experience variability in their SA evaluations. As women also commented more frequently than men on the co-occurrence of positive and negative changes in multiple domains of their lives, the more frequent variability in SA reported by women may be due to them being more likely to experience a mix of positive (e.g. enjoyable social relationships) and negative (e.g. decreased health) age-related changes (Miche et al., 2014). Whereas women were more likely to reflect on age-symbolic events, men commented more frequently on whether their preserved strength enabled them to continue those activities they had initiated earlier in life. This pattern of results suggests that when evaluating their SA men are more likely to reflect on their daily performance whereas women are more influenced by age-salient events and social expectations rather than by their actual daily abilities.

Discrepancies in the way in which men and women experience ageing may be due to our society having different expectations for older men and women. In support of this Kornadt et al. (2013) showed that individuals aged 20 to 92 years attach different stereotypes to older men and women; older women are believed to be more religious, friendly, and engaged in leisure activities whereas men are believed to be more capable in financial and work-related tasks. The different expectations that our society has for older men and women may result in older men and women being treated differently, and this may explain why in our study women reported a more negative SA than men. Indeed, older women often become invisible in the public domain. For instance, among TV presenters, older men are distinguished whereas older women are frequently dismissed (Jermyn, 2013). In sum, our results highlight one more time how much our society -and men, in particular - need to learn to think differently about ageing women and how strategies aiming to eradicate negative age-related stereotypes (Levy, 2017) should give particular attention to negative stereotypes of older women.

Finally, although it was not a primary aim of the current study, participants’ comments outlined several sources of lack of validity and reliability when measuring SA with an unidimensional measure asking participants to specify how old they feel in general (Barrett, 2003). First, as different participants interpreted the SA question in distinct ways, answers to unidimensional measure of SA may not be comparable. Indeed, for instance, some participants reported their SA after reflecting on physical changes, whereas others on their mental abilities.

Second, as some participants reported that their SA fluctuates, assessing SA at one time point may oversimplify individuals’ experiences of ageing. Future studies could therefore adopt methodological designs that take into account the fluctuating nature of self-perceptions in older age (Armenta et al., 2018), for instance, by controlling for situational factors, such as levels of pain, that impact on SA (Sabatini, Ukoumunne, Ballard, Collins, et al., 2020), or by averaging individuals’ SA across several time points (Neupert & Bellingtier, 2017). Third, some participants experienced difficulty in reporting SA which arose from not being able to assign a specific number to SA. Asking individuals to report their SA on a scale ranging from ‘a lot younger than my age’ to ‘a lot older than my age’ may reduce difficulty in answering (Montepare, 1996b). Moreover, difficulty in reporting SA may underlie the difficulty of capturing the complexity of perceptions of ageing when using unidimensional measures. By collecting information about the coexistence of positive and negative experiences in individuals’ lives, multidimensional measures of SA may facilitate SA judgments (Kastenbaum et al., 1972; Turner et al., 2021).

The nature of our dataset places some limitations on our findings. First, all data were collected through self-report measures and descriptive analysis have not been conducted on objective indicators of health. Second, the sample included a majority of women and was predominantly white, with above average education and self-rated health. Among the 14757 participants that took part in the PROTECT study in 2019, only a small sub-group of participants answered the open-ended item (N = 1457); hence the opinions of the remaining participants are unknown. Third, some of the characteristics of study participants are slightly different from the remaining PROTECT participants. For instance, compared to participants included in the current study sample, those excluded from the study sample reported on average a younger SA. Fourth, SA was assessed with a single-item question rather than in a domain-specific format (Kastenbaum et al., 1972; Turner et al., 2021). This is a limitation of the current study as individuals can experience ageing differently in relation to different domains of their lives (e.g. physical and cognitive) which may lead to individuals reporting different subjective ages in relation to different domains of one’s life (Kaspar et al., 2019). Finally, views on ageing and age stereotypes were not taken into account when explaining SA and SA-related thoughts. However, views on ageing and age stereotypes may influence SA (Brothers et al., 2017; 2020; Mock & Eibach, 2011; Sabatini, Ukoumunne, Ballard, et al., 2021).

It should be noted that ours was a large sample for content analysis. The large sample also made it possible to include quantitative data for all the identified categories and to compare frequencies among individuals reporting a younger SA, an age-congruent SA, or older SA; between age sub-groups; and between men and women. The examination of sex difference in SA enriched the scarce literature on factors underpinning sex differences in SA. To analyze data, we generated categories directly from the data; this is a strength of our study as it made it possible to explore the additional role that mental processes play in shaping individuals’ SA, going beyond what has been reported by previous studies (e.g. Giles et al., 2010) and providing targets for future health promoting interventions. For instance, as we found that individuals’ mental processes impact on the age their feel, targeting negative mental processes such as self-attribution of negative age stereotypes may help to enhance mental health in older age. It also made it possible to identify limitations related to the SA questionnaire that had not been considered before and that may find application in the development of a multidomain tool assessing SA.