Awareness of Aging Processes
Summary and Keywords
The term Awareness of Aging (AoA) incorporates all aspects of individuals’ perceptions, behavioral experiences, and subjective interpretations related to their process of growing older. In this regard, AoA goes beyond objective descriptions of the aging process, such as calendar age or biological age. Commonly used AoA constructs referring to the ongoing experience of the aging process encompass concepts such as subjective age, attitudes toward one’s own aging, self-perceptions of aging, and awareness of age-related change. AoA also incorporates elements that are more pre-conscious in nature, such as age stereotypes and culturally held notions about the aging process. Despite their theoretically broad common foundation, AoA constructs differ according to their specific frames of reference, such as whether and how they take into account the multidimensionality and multi-directionality of development. Examining the existing body of empirical work identifies several antecedents of AoA, such as sociodemographic “background” variables, physical health and physical functioning, cognition, psychological well-being and mental health, psychological variables (e.g., personality, anxiety), and life events. In general, more positive manifestations on these variables are accompanied by a more positive perception and evaluation of the aging process. Moreover, AoA is longitudinally linked to important developmental outcomes, such as health, cognition, subjective well-being, and mortality. Overall, the study of AoA has developed as a promising area of psychological aging research that has grown in its conceptual and empirical rigor during recent years.
Aging is inseparably linked with the passage of objective life time and, hence, calendar age. Given the limited informative value of chronological age due to the heterogeneous and multifaceted character of development (Baltes, 1987), Staudinger (2015) proposes that the assessment of the aging process needs to be enriched by “outside” and “inside” perspectives on aging. Outside perspectives comprise biological (e.g., telomere length), social (e.g., fulfillment of social age norms), and psychological (e.g., cognitive functioning, personality) ages. Inside perspectives include, broadly speaking, the subjective representation of the aging process. Thus, instead of mere calendar age, the subjective meanings, views, and expectations ascribed to growing older are a critical constituent of the aging process and the aging self. The rationale for considering subjective constructions of age and the process of aging has been acknowledged in developmental psychology, psychological aging research, and related areas, such as the social sciences of aging, for a long time (e.g., Kastenbaum, Derbin, Sabatini, & Artt, 1972; see also Montepare, 2009; Settersten, 1999). The emerging body of literature referring to the concept of Awareness of Aging (AoA) is built on here. The term AoA incorporates all aspects of the awareness, perception, behavioral experience, and interpretation of the aging process (see also Westerhof, Whitbourne, & Freeman, 2012). As the aging process is closely tied to the passage of time, AoA—at a general level—also includes the subjective perception of time (Gabrian, Dutt, & Wahl, 2017). However, AoA differs from other subjective time constructs, such as perceived extension and valence of future time (future time perspective) or distance-to-death, in that it goes beyond the mere perception of time but explicitly takes into consideration the experience- and behavior-based perceptions that people have as they grow older.
AoA can be viewed as a superordinate construct encompassing several related concepts, such as subjective age (or age identity), attitudes toward own aging, self-perceptions of aging, awareness of age-related change, and age stereotypes. The concepts that exist in the AoA field differ according to their specific frames of reference. Do they target aging perceptions held by societies or by the aging individual? Do they capture beliefs about the own aging process or beliefs about aging in general (e.g., age stereotypes)? Are they descriptive or evaluative, and, in the case of the latter, do they comprise cognitive or affective judgements? Do they aim at past-present comparisons or at anticipations of the aging process with regard to future developments (e.g., fear of aging)? Are they explicit, conscious, and rooted within concrete, behavioral experiences or implicit and pre-conscious? Do they ask for aging experiences at a global level or do they distinguish between aging experiences across different domains? Do they treat perceived gains and losses as two ends of the same continuum or as separate scales?
Notwithstanding such differences, all AoA constructs have much in common. At the theoretical level, they all strongly underscore the evaluation and interpretation of perceived aging experiences. At the empirical level, research suggests similar predictive “power” of concepts related to AoA, particularly when it comes to outcomes related to health and well-being. For example, a recent meta-analysis reviewing the available longitudinal research in the area of physical health and mortality (Westerhof et al., 2014) confirmed that feeling younger, reporting more positive perceptions of and attitudes toward one’s own aging, and holding more positive beliefs about aging in general are robust predictors of better functional health, preventive health behavior, disability, and mortality. This effect was independent of the particular AoA construct under study.
Several AoA constructs referring to the individual experience of aging as well as constructs targeting views about the aging process in general will be discussed. Five concepts are focused on: subjective age (or age identity), attitudes toward own aging, self-perceptions of aging, awareness of age-related change, and age stereotypes (see also Table 1). This list is by no means exhaustive. Rather, the selection of these concepts was guided by the idea that they are based on a broad conceptual basis or have been extensively empirically examined (Diehl et al., 2014).
Review of Major Awareness of Aging-Related Constructs
The most frequently used concept in the subjective aging literature is subjective age, sometimes also termed age identity. This construct refers to the simple approach of asking individuals how old they perceive themselves to be. A multidimensional conceptualization of subjective age was first proposed by Kastenbaum, Derbin, Sabatini, and Artt (1972), distinguishing between the age a person feels, the age a person looks, and the age mirrored in the activities and interests of a person. Other than use in some recent experimental work (see Gabrian & Wahl, 2017; Kotter-Grühn & Hess, 2012), however, Kastenbaum et al.’s multidimensional conception of subjective age did not become firmly established in the literature. Although empirical studies point to substantial associations of different subjective age dimensions with well-being and health (e.g., Keyes & Westerhof, 2012; meta-analysis by Westerhof et al., 2014), subjective age has mostly focused on the unidimensional self-evaluation of how old a person feels.
Subjective age derives from comparison processes, with individuals comparing where they are in their lives to personal models denoting where they are expected to be (Barrett & Montepare, 2015). Whereas children and adolescents usually tend to feel older than they are, there seems to be a turning point at age 25, after which adults usually tend to feel younger than they are (Rubin & Berntsen, 2006). The discrepancy between felt age and chronological age seems to be rather stable across the second half of life (Uotinen, Rantanen, Suutama, & Ruoppila, 2006); for example, people aged 40 and older feel approximately 20% younger than they are (Rubin & Berntsen, 2006).
Feeling younger than one’s chronological age might have different origins. First, according to the motivational pathway, a youthful age identity can be considered a self-enhancement and self-protective strategy or defense mechanism: The dissociation of oneself as an old person helps to protect against the negative age stereotypes held by society (Peters, 1971; Teuscher, 2009; Weiss & Lang, 2012). Second, the information-processing approach proposes that older adults tend to look younger nowadays than in previous generations, which may lead to an underestimation of their own age because people compare themselves to an age-prototype that is no longer accurate (Teuscher, 2009). And third, feeling younger can be considered as an attempt to maintain self-continuity or self-consistency by integrating ongoing experiences into previously established self-schemata, a phenomenon known as identity assimilation (Westerhof, Whitbourne, & Freeman, 2012).
A clear strength of the subjective age construct lies in its intuitively easy-to-understand way of assessment. This certainly explains why subjective age is the most established subjective aging construct. Also, despite its parsimony, it is highly predictive with regard to important developmental outcomes.
However, although subjective age, in its origin, is a rather simple construct that can be understood as a manifest variable (e.g., “Indicate in years the age you feel most of the time”), there is no clear theoretical consensus how measures of felt age should be related to chronological age. For example, one could argue that feeling 10 years younger is qualitatively completely different when a 90-year-old person is considered compared to when a 30-year-old person is considered. Hence, whereas some studies examining subjective age worked with the felt age raw scores (Hughes & Lachman, 2017), others calculated a discrepancy score between felt age and chronological age (Spuling, Miche, Wurm, & Wahl, 2013) or divided this discrepancy by chronological age to obtain a proportional discrepancy measure (Gabrian & Wahl, 2017). Still others used a visual analogue scale (Hughes, Geraci, & De Forrest, 2013), or asked participants to classify themselves into categories of middle-aged and old (Bultena & Powers, 1978). Certainly, the optimal strategy depends on the specific research question as well as on the analytical procedure adopted. However, the comparability of findings is complicated due to this heterogeneity of operationalizations.
Another limitation of the felt-age measure is its reductionist perspective in light of the multidimensionality of development. Given the propositions of life-span psychology regarding the dynamic interplay between growth and decline accompanying the aging process (Baltes, 1987), the validity of the current subjective age operationalization is challenged (Gendron, Inker, & Welleford, 2017). Because we usually do not know what growing older means for the individual (for some it is decline, for some it is growth, and for others it is a combination of both), we are not able to say what feeling younger or older actually means. Thus, despite the multidirectionality of development, an older felt age is often equated with a negative state and possibly a less optimal aging process. This not only seems to be a too pragmatic resolution of the validity problem, but the stigmatization of older felt ages as an unpleasant feeling also raises ethical problems. Although empirical research indeed suggests that older felt ages are more likely to be associated with poorer outcomes (e.g., Westerhof et al., 2014), naively connoting older felt ages with negative states imposes a normative view of the aging process as, by definition, an only negative phenomenon (Gendron et al., 2017). This limitation is overcome with the introduction of more complex Awareness of Aging (AoA) constructs that are rooted in a person’s concrete aging experiences, thus providing less room for ambiguous meanings and interpretations. Given that the study design allows the use of assessment methods that are more comprehensive as compared to the single-item measure of felt age, researchers are encouraged to use those questionnaires in their research.
Attitudes Toward Own Aging
Attitudes toward own aging (ATOA) comprise concrete questions about the cognitive-emotional experience of age-related change (Kleinspehn-Ammerlahn, Kotter-Grühn, & Smith, 2008). ATOA are commonly measured with an instrument established by Lawton (1975). He elaborated the ATOA subscale within the Philadelphia Geriatric Center Morale Scale. Originally, the ATOA subscale was considered as one of three factors—with the remaining two factors labeled Agitation and Lonely Dissatisfaction. Today, however, the ATOA subscale is often used by itself. The five ATOA items assess temporal comparisons about changes in energy level, perceived usefulness, happiness, and life quality (Kleinspehn-Ammerlahn et al., 2008). Examples of item formulations are “Things keep getting worse as I get older” or “I am as happy now as when I was younger.” The statements are answered with either a Yes or a No. All items load on a single factor (Liang & Bollen, 1983; McCulloch, 1991), such that the ATOA scale can be considered a unidimensional instrument.
ATOA show pronounced inter-individual variability in midlife (Miche, Elsässer, Schilling, & Wahl, 2014). With growing age, participants’ answers become increasingly negative (Kleinspehn-Ammerlahn et al., 2008) and distance-to-death data suggest that this downturn can be best modeled as a mortality-related phenomenon (Kotter-Grühn, Kleinspehn-Ammerlahn, Gerstorf, & Smith, 2009). Research with the ATOA scale has consistently shown that a negative attitude tends to be associated with poorer subjective health, lower life satisfaction, and other indicators of poorer functioning (see Levy, Slade, & Kasl, 2002; see, again, meta-analysis by Westerhof et al., 2014). However, the unidimensional character of the ATOA construct is still a limitation of this measurement approach, as it neglects the potential that aging experiences might differ across different life domains.
Self-Perceptions of Aging
Authors who refer to self-perceptions of aging—at times also called “self-views of aging”—acknowledge that subjective aging is a multidimensional and multidirectional construct. For example, Steverink, Westerhof, Bode, and Dittmann-Kohli (2001) examined a nationally representative sample of German adults between the ages of 40 and 85 to extract three dimensions of personal experiences of aging. Two dimensions captured individuals’ perceptions related to physical declines and social losses. The third dimension captured aspects of continuous growth, reflecting adults’ perceptions that their growing older was associated not only with losses but also with gains and positive developments. In summary, self-perceptions of aging focus on the varied and multidimensional perceptions and experiences that shape individuals’ subjective aging experiences. In a similar vein, Laidlaw, Power, and Schmidt (2007) differentiated between physical change, psychological growth, and psychosocial loss.
A key strength of this approach lies in its simultaneous consideration of different life domains, such as the physical or interpersonal domain, thereby acknowledging that aging experiences may differ across life domains. Moreover, the construct of self-perceptions of aging takes into account the multidirectional character of development, acknowledging the co-occurrence of gain- and loss-related experiences.
Awareness of Age-Related Change
A more recent contribution to the AoA literature is the concept of Awareness of Age-Related Change (AARC; Diehl & Wahl, 2010). Diehl and Wahl (2010) defined AARC as “all those experiences that make a person aware that his or her behavior, level of performance, or ways of experiencing his or her life have changed as a consequence of having grown older (i.e., increased chronological age)” (p. 340). Two aspects of this definition are noteworthy. First, Diehl and Wahl (2010) wanted to be explicit that a person’s AARC is based on his or her conscious perceptions of changed behavior, performance, or experiences. Second, in perceiving and reflecting about such changes it is essential that the individual attributes them to his or her increased chronological age and not to any other conditions (e.g., changes in health status or living conditions). Diehl and Wahl (2010) also proposed that AARC should be studied in five behavioral domains: (1) health and physical functioning, (2) cognitive functioning, (3) interpersonal relations, (4) social-cognitive and social-emotional functioning, and (5) lifestyle and engagement. An additional essential feature of this approach is, as is the case with self-perceptions of aging, that in each of these domains losses (AARC-Loss) as well as gains (AARC-Gain) are considered, thus reflecting the multidirectional character of subjective aging experiences. Emerging findings support the heuristic and empirical value of the AARC concept. For example, it has been found that AARC is able to account for unique portions of variance in the context of dependent variables such as health and well-being (Brothers, Miche, Wahl, & Diehl, 2017). In addition, both AARC-Loss and AARC-Gain play a significant and meaningful role in the prediction of psychological well-being within a more complex model of constructs including future time perspective (Brothers, Gabrian, Wahl, & Diehl, 2016).
Whereas subjective age, ATOA, self-perceptions of aging, and AARC capture the experience of one’s own aging process, age stereotypes encompass views of aging in general (Hummert, 2011). This concept includes affective, cognitive, and evaluative components of behavior toward older adults as an age group. Age stereotypes primarily convey the negative aspects of growing old (Hess, 2006; Kite, Stockdale, Whitley, & Johnson, 2005). However, it is important to note that age stereotypes do not necessarily have to be negative; they can also focus on positive aspects of the aging process, such as personal growth, increase in experience, or personal accomplishments (Hummert, 2011). Importantly, old adults are the only outgroup that inevitably becomes the ingroup for individuals who live long enough (Snyder & Miene, 1994). As such, age stereotypes are internalized over the life course and are likely to become the basis for negative self-stereotyping (Levy, 2003).
Synthesis of Awareness of Aging Constructs
The AoA constructs coexist side by side. Imagine a 50-year-old man. Although old age is still a matter of the distant future, he has a detailed picture of what old age means to him. When he thinks of aging and old age, he primarily thinks of wisdom, freedom, and maturity (age stereotypes). He is not only optimistic about aging in general, but he also has a positive outlook on his own aging process. Despite perceiving some physical limitations, he still experiences personal growth and development (self-perceptions of aging). Although he may, for example, see the aging process as entailing slight hearing losses (AARC-Loss), he may also observe gains in creativity and self-confidence (AARC-Gain). Overall, he may still feel like he is in his forties (subjective age), and he may be as happy now as when he was younger (ATOA).
Most studies operationalize only one AoA construct, but some studies are available that have focused on two or more AoA constructs, thus facilitating the creation of a more coherent and integrative body of knowledge. Findings suggest that whereas some AoA constructs can be seen as distal antecedents of developmental outcomes, others may play a moderating or mediating role within this association. Mock and Eibach (2011) found that older subjective age predicted lower life satisfaction and higher negative affect 10 years later when aging attitudes were less favorable but not when aging attitudes were more favorable. In a similar vein, a cross-sectional study by Teuscher (2009) showed that people who felt younger were in general more satisfied with different aspects of their life—this connection was especially strong for people with a negative view of old age. Brothers and colleagues (2017) found that AARC-Loss mediated the association between global AoA measures (i.e., subjective age and ATOA) and developmental outcomes. Specifically, older felt ages and more negative ATOA predicted more AARC-Loss, which, in turn, predicted poorer functional health and life satisfaction. Future studies should pay more attention to clarifying and extending the conceptual relations among AoA–related constructs. Such a clarification is needed to better understand and synthesize empirical findings on AoA constructs.
Table 1. Review of Major Awareness of Aging-Related Constructs
Development Over the Life Course
Subjective age (age identity)
How old individuals perceive themselves to be
Often 1-item: “How old do you feel inside, irrespective of your calendar age?”
People over 40 consistently feel approximately 20% younger than they are (Rubin & Berntsen, 2006)
Multidimensional in its origin (e.g., feel age, look age, do age, interest age; Kastenbaum, Derbin, Sabatini, & Artt, 1972); but most often focus on feel age
Own aging process
Attitudes toward own aging
Cognitive-emotional experience of age-related change
Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale (Lawton, 1975); 5 dichotomous items, e.g., “I am as happy now as when I was younger”
Own aging process
Self-perceptions of aging
Meaning of age and aging across several concrete life domains
Scales by Steverink and colleagues (2001): physical decline, social loss, continuous growth; e.g., “Aging means to me being less energetic and fit”; scales by Laidlaw and colleagues (2007): psychosocial loss, physical change, psychological growth; e.g., “As I get older I find it more difficult to make new friends”
Systematic research on life-span trajectories still needed
Own aging process
Awareness of age-related change
All those experiences that make a person aware that his or her behavior, level of performance, or ways of experiencing his or her life have changed as a consequence of having grown older (i.e., increased chronological age)
Scales by Diehl and Wahl (2010): assessment of perceived age-related gains and losses across five behavioral domains: health and physical functioning, cognitive functioning, interpersonal relations, social-cognitive and social-emotional functioning, lifestyle and engagement; e.g., “With my increasing age, I realize that it is more difficult for me to learn new things”
Systematic research on life-span trajectories still needed
Own aging process
Views of aging in general
Implicit association test; scales by Kornadt & Rothermund (2011): bipolar scales assessing positive vs. negative stereotypic beliefs about old age across eight life domains; e.g., “old persons . . . have few friends and acquaintances vs. . . . have many friends and acquaintances”
Older people have in general more positive attitudes toward aging as compared to younger people (Kite, Stockdale, Whitley, & Johnson, 2005)
Views about aging in general, with the possibility to become internalized into self-stereotypes over the life course (Levy, 2009)
Conceptual Integration: Awareness of Aging as a Form of Multifaceted Self-Knowledge
AoA can be considered as a specific form of self-knowledge, that is, mental representations of the self that become part of a person’s self-concept and identity over time (Diehl et al., 2014). Like other self-representations, this aging-related self-knowledge manifests itself in a multifaceted way.
As a fundamental principle of life-span developmental theory (e.g., Baltes, Lindenberger, & Staudinger, 2006; Heckhausen, Dixon, & Baltes, 1989), the experience of gains versus losses related to individuals’ own development and aging can be considered as the foundation of perceptions and evaluations of awareness of aging. This multidirectional view is consistent with (a) findings related to self-perceived age-related growth and decline in adulthood and old age (Keller, Leventhal, & Larson, 1989; Miche, Wahl, et al., 2014; Steverink, Westerhof, Bode, & Dittmann-Kohli, 2001); (b) empirical findings in the age stereotype literature, showing that stereotypes can be negative as well as positive (Hummert, 2011); and (c) the theoretical propositions related to adults’ awareness of age-related changes (Diehl & Wahl, 2010). Specifically, Diehl and Wahl (2010) argued that the perception and awareness of age-related losses may impose developmental constraints on a person’s behavior and experiences, whereas perceptions of age-related gains may foster an awareness of developmental opportunities and may motivate positive behaviors.
It seems important to investigate adults’ age-related perceptions and experiences in specific behavioral domains, such as the physical, cognitive, or interpersonal domain. This multidimensional approach was suggested by the empirical work of Steverink and colleagues (2001) and further advocated by Diehl and Wahl (2010). As already indicated, Diehl and Wahl (2010) proposed that adults’ awareness of age-related changes could be fruitfully studied in five behavioral domains (i.e., health and physical functioning, cognitive functioning, interpersonal relations, social-cognitive and social-emotional functioning, and lifestyle and engagement). With their proposition, Diehl and Wahl (2010) emphasized the notion that personal experiences of aging may vary according to behavioral domains. Such differences may affect the aging person in quite profound ways. For example, experiencing decline exclusively in one behavioral domain as compared to experiencing it simultaneously in multiple domains may differentially impact a person’s self-image and may also affect that person’s motivation to engage in any adaptive behaviors to a different degree.
Assuming that self-knowledge is always anchored in social representations, it seems critical to take into account the social, societal, and cultural contexts in which individuals’ aging occurs, hence the focus on age stereotypes. The most advanced approach in this area is the work of Kornadt and Rothermund (2011). These authors developed a measure to assess domain-specific age stereotypes, covering domains such as physical and mental fitness, work and employment, or family and partnership. Kornadt and Rothermund (2011) showed that older adults are evaluated differently in these life domains, and in subsequent work these authors also found that the association between age stereotypes and current self-conceptions was mediated by adults’ future self-views (i.e., anticipations regarding how they will be, feel, and behave as an old person) (Kornadt & Rothermund, 2012). Thus, this work not only showed that age stereotypes become increasingly self-relevant as individuals grow older, but also suggested a psychological pathway by which age-stereotypes become part of individuals’ own self-concepts (i.e., through future self-views). Although the finding needs to be interpreted with caution due to the cross-sectional character of the study, it is in line with the assumptions of stereotype embodiment theory as proposed by Levy (2009). Specifically, Levy suggests that age stereotypes, originally directed toward old adults as an outgroup, become internalized over the life course and ultimately manifest themselves as self-stereotypes. Findings based on experimental data supporting this hypothesis are mixed. As such, the question of whether the activation of negative age stereotypes results in older (assimilation effect) or younger (contrast effect) subjective ages cannot be answered unambiguously with the existing experimental findings (Kotter-Grühn & Hess, 2012; Weiss & Freund, 2012; Weiss & Lang, 2012). The opposite direction of effects, with self-views shaping age stereotypes, is also conceivable. This line of research has shown that the projection of current self-views onto age stereotypes is particularly pronounced for older adults (Kornadt, Voss, & Rothermund, 2017; Rothermund & Brandtstädter, 2003).
In summary, individuals’ perceptions about their own age and aging represent a specific kind of self-knowledge that exhibits a high degree of multifacetedness (i.e., multidirectionality and multidimensionality) and interacts with perceptions about the aging process in general (i.e., age stereotypes) (Diehl, 2006; Diehl et al., 2014; Diehl, Wahl, Brothers, & Miche, 2015).
Empirical Findings on Awareness of Aging
Research examining major antecedents of AoA as well as constructs that have been investigated as outcomes of AoA is reviewed. The focus here is on outcomes indicative of subjective well-being (i.e., depressive symptoms, positive and negative affect, life satisfaction) (see also Figure 1). This selection was motivated by two considerations. First, there are already a number of reviews and review-like papers available summarizing health-related findings (Westerhof et al., 2014; Westerhof & Wurm, 2015). However, to the authors’ knowledge, no such compilation of research findings exists in the domain of subjective well-being. Second, subjective well-being can be considered a key concept in developmental psychology, as it is closely linked with the concept of successful development and aging (Wahl, Siebert, & Taubert, 2017). Also, well-being–related phenomena, such as late-life depressive symptoms, are themselves associated with adverse effects on health (Ho et al., 2014), cognitive performance (Bunce, Batterham, Christensen, & Mackinnon, 2014), social functioning (Szanto et al., 2012), and mortality (Gallo et al., 2005). There is a focus on longitudinal studies, and a broad range of AoA constructs (Diehl et al., 2014), including age stereotypes and domain-specific AoA constructs, are considered. The plasticity of AoA is discussed by summarizing findings of experimental and intervention studies.
Antecedents of Awareness of Aging
The antecedents of AoA were classified along six dimensions: sociodemographic “background” variables (e.g., age, sex, socioeconomic status, occupational status), physical health and physical functioning (operationalized via objective and subjective measures), cognition (e.g., processing speed), psychological well-being and mental health (e.g., life satisfaction, depressive symptoms, affect), psychological variables (e.g., personality, anxiety, control beliefs/mastery), and life events (e.g., daily stressors, negative life events). Whereas some domains, such as health and psychological variables, have been extensively investigated, others, such as cognition, still lack a large evidence base.
In general, the available empirical findings suggest that more positive manifestations on the antecedent variables (e.g., better health, higher processing speed, lower depressive symptoms, higher control beliefs, or fewer stressful life events) are associated with a more positive AoA. Most effects are robust even when controlling for the influence of sociodemographic and health variables. Furthermore, some studies point to a moderating role of individual dispositions (e.g., coping strategies, personality traits, control beliefs) for the association between antecedent factors and AoA. For example, Jopp and Smith (2006) found that optimization and compensation strategies buffered the detrimental impact of low resources on changes in attitudes toward aging.
However, with regard to some sociodemographic variables (e.g., sex, marital status, education), where theoretical reasoning for associations with AoA tends to be weak, findings are mixed, prohibiting any definitive conclusions (e.g., Bergland, Nicolaisen, & Thorsen, 2014; Markides & Pappas, 1982; Sargent-Cox, Anstey, & Luszcz, 2012a).
Well-Being–Related Outcomes of Awareness of Aging
Regarding well-being–related outcomes of AoA, cross-lagged panel studies suggest that the effect of AoA on depressive symptoms is larger than vice versa (Dutt, Gabrian, & Wahl, 2016; Spuling, Miche, Wurm, & Wahl, 2013)—this result has also been found in the domain of health and physical functioning (Levy, Slade, & Kasl, 2002; Sargent-Cox, Anstey, & Luszcz, 2012b; Wurm, Tesch-Römer, & Tomasik, 2007). Also, findings regarding a longitudinal effect of AoA on depressive symptoms extend to other operationalizations of well-being, such as life satisfaction (Wurm, Tomasik, & Tesch-Römer, 2008) or an eudaimonic conceptualization of well-being (Brothers, Gabrian, Wahl, & Diehl, 2016).1 In general, more positive AoA experiences have been shown to be associated with higher levels of subjective well-being.
This association might be mediated by a person’s coping strategies (Wurm, Warner, Ziegelmann, Wolff, & Schüz, 2013) or future time perspective (Brothers et al., 2016). Theoretical considerations and current empirical evidence suggest that the association between AoA and well-being might also be mediated by health and health behaviors (Westerhof et al., 2014), although this association has not yet been studied sufficiently.
Despite many expectation-consistent findings, the effect of AoA on well-being should not be over-interpreted (Boehmer, 2006; Choi & DiNitto, 2014; Wurm et al., 2013). Recent studies suggest that the detrimental effect of a negative AoA on well-being is buffered for individuals reporting high levels of optimism (Wurm & Benyamini, 2014), accommodative coping (Dutt et al., 2016), or positive aging attitudes (Mock & Eibach, 2011).
Plasticity of Awareness of Aging
Experimental studies show that the concepts subsumed under the construct of AoA are flexible and dynamic and can be transformed over fairly short time intervals, for example, as a response to a mood induction (Dutt & Wahl, 2017), social comparison feedback (Gabrian & Wahl, 2017; Stephan, Chalabaev, Kotter-Grühn, & Jaconelli, 2013), or manipulation of aging experiences (Eibach, Mock, & Courtney, 2010). However, robust evidence on whether and to what extent AoA can be altered for the long term and outside the laboratory is still lacking. Some studies point to positive effects of interventions (i.e., physical activity, attribution retraining) on AoA (Brothers & Diehl, 2017; Klusmann, Evers, Schwarzer, & Heuser, 2012; Levy, Pilver, Chung, & Slade, 2014; Sarkisian, Prohaska, Davis, & Weiner, 2007), whereas other studies found only weak support for a beneficial effect of interventions targeting self-perceptions of aging on AoA (Craciun et al., 2014; Wolff, Warner, Ziegelmann, & Wurm, 2014).
An important point needs to be made with regard to interventions. A negative AoA can be interpreted in two ways. On the one hand, the person underestimates his or her experienced age-related gains and overestimates his or her experienced age-related losses, resulting in a too pessimistic view of the aging process. One the other hand, the person has an objectively poor resource status and accurately judges this resource status, thus having a realistic view of the aging process. From an AoA perspective, the first scenario might be the more deleterious one. Over-attributing symptoms to “old age,” accompanied by the ongoing idea that these changes are inevitable, uncontrollable, and irreversible, is associated with poorer health, health behaviors, and mortality (e.g., Sarkisian, Lee-Henderson, & Mangione, 2003; Stewart, Chipperfield, Perry, & Weiner, 2012). In this case, AoA should be targeted directly, for example, through an attribution retraining where the aging person learns that negative time-related changes do not necessarily have to be tied to the aging process, making them uncontrollable and irreversible (Sarkisian et al., 2007). The aim of such a training should be to refine a person’s sense to realistically and objectively classify time-related changes. The second scenario (i.e., a negative, although realistic, perception of the aging process) raises a number of ethical issues. What is wrong about realistically acknowledging the signs of growing older? If we targeted these realistic, although negative, views, it would signal that we condemned signs of growing older, which could in turn be counterproductive, as it reinforces the stigma of old age (Kotter-Grühn, 2015). Instead, it seems to be more appropriate in this case to target AoA experiences indirectly through their moderators and mediators linking them to developmental outcomes. That is, interventions should pursue the aim of supporting the aging person to better handle his or her realistic outlook on the aging process and to strengthen his or her resilience capacities.
Methodological Issues Related to Studies of Awareness of Aging
In terms of methodological limitations, the terminology used to classify AoA constructs is not clearly defined. Often, terms like aging satisfaction, self-perceptions of aging, and attitudes toward aging are used interchangeably.
The reviewed empirical evidence supports the assumption of expectation-consistent associations between AoA constructs and various antecedents and well-being–related consequences. Some studies, however, did not find any associations between AoA and other constructs (e.g., Levy, Slade, & Kasl, 2002; Spuling, Miche, Wurm, & Wahl, 2013). Moreover, some studies report counterintuitive findings. For example, Knoll, Rieckmann, Scholz, and Schwarzer (2004) found that, among patients who had undergone cataract surgery, less conscientious individuals felt older after improvements in visual acuity. Miche, Elsässer, Schilling, and Wahl (2014) found that participants experiencing more depressive symptoms at baseline became more positive in their attitudes toward aging over the course of the 12-year observational interval. Conversely, Schafer and Shippee (2010) found that among men, those in better health felt more negative about their cognitive aging 10 years later. Moreover, some studies found that higher levels of education were associated with more negative AoA experiences (Bergland, Nicolaisen, & Thorsen, 2014; Sargent-Cox, Anstey, & Luszcz, 2012a). Although these findings are all somewhat counterintuitive, in each case, the authors offer possible explanations for their findings. Based on the published empirical evidence, however, counterintuitive and null findings clearly constitute a minority of findings.
Most results published within the AoA field come from Western and industrialized cultures, and most studies were based on a sample of healthy participants, with only a few exceptions (Boehmer, 2006, 2007; Harrison, Blozis, & Stuifbergen, 2008; Knoll et al., 2004). Hence, most results can be generalized only to community-dwelling, normal-aging adults residing in industrialized nations. A small number of studies examining cross-cultural differences and similarities regarding AoA have been published, however. A study with college students from 26 countries on six continents suggests that there seems to be widespread cross-cultural consensus regarding the expected direction of aging trajectories in different characteristics (Loeckenhoff et al., 2009). A review by Barak (2009) suggests that feeling younger than one’s calendar age seems to be a universal phenomenon, with respondents from 18 culturally disparate countries (e.g., Germany, United States, Japan, Ukraine, Brazil) typically showing youthful age identities. However, the concrete meaning of feeling younger may change across cultural systems. As such, Westerhof and colleagues (Westerhof & Barrett, 2005; Westerhof, Barrett, & Steverink, 2003; Westerhof, Whitbourne, & Freeman, 2012) assume that youth-centeredness (i.e., younger felt ages) seems to be more closely linked to individualistic as compared to collectivist cultures. Youthfulness should be valued more in cultures that place a high responsibility on the individual (e.g., United States) and provide less societal or community-based support in old age. In line with this reasoning, Americans have been shown to express even younger felt ages than Germans (Westerhof et al., 2003). Moreover, a younger felt age and more positive self-perceptions of aging have been shown to be linked to lower levels of negative affect and higher levels of self-esteem in the United States but not in Germany or the Netherlands (Westerhof & Barrett, 2005; Westerhof et al., 2012). In addition, attributing health problems to old age was associated with worse functional health in Americans but not in Japanese (Levy, Ashman, & Slade, 2009). Hence, acknowledging the signs of growing older seems to be particularly detrimental in individualistic and youth-oriented cultures.
Conclusion and Outlook
Although the usefulness of AoA-related constructs has often been questioned, a recent resurgence of interest in these constructs and more refined theoretical frameworks have clearly shown that these constructs make valuable contributions to the overall psychology of aging. AoA represents an essential facet of older adults’ identity in that the representations associated with becoming older can be considered an important form of self-knowledge that may drive or hinder late-life development. A challenge in the area is the existence of a rather large number of constructs that all try to capture this self-knowledge. Although these constructs show considerable overlap, there are also differences in terms of the degree of multidimensionality taken into consideration. More work toward a consensus on a common nomenclature and operationalization of AoA constructs is required, to promote an integration of different lines of research.
Empirical research suggests that AoA experiences are shaped by various antecedent factors. More positive AoA, in turn, exerts a longitudinal effect in terms of improved outcomes of well-being, whereas negatively toned AoA may undermine adaptive development and impede the use of existing potentials and resources late in life. Future research should focus on the mediators and moderators that have been suggested for the associations between AoA and its antecedents and outcomes, in order to better understand the mechanistic pathways linking AoA to other constructs and to developmental outcomes.
Finally, consistent with the modifiability principle of life-span developmental psychology it seems also important to learn more about the plasticity of AoA. It is critical to know in which way negatively toned AoA can be changed toward more positive views on aging. Although AoA can be manipulated experimentally, more research is needed to explore its long-term modifiability (e.g., via intervention programs) and maintenance of the modified AoA. A number of ethical issues related to AoA interventions are still open to debate. For example, is it always helpful to feel younger? In a situation of severe chronic health conditions feeling younger may indeed be dysfunctional as it might reinforce the stigma of old age and hamper the use of adaptive coping efforts (e.g., treatment seeking). Instead, recognizing and accepting one’s age and aging process as it is may be better, as it may open a person’s view on those aspects that still may be modifiable and, hence, may be able to improve the person’s quality of life. Such ethical discourse should be on the agenda of future research and discussion.
Anne Josephine Dutt was supported by a scholarship from the Konrad-Adenauer-Stiftung. Manfred Diehl’s work was supported by grant R01 AG051723 from the National Institute on Aging, National Institutes of Health.
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