Attitudes to aging mediate the relationship between older peoples’ subjective health and quality of life in 20 countries

Abstract

BackgroundWith ever-increasing life expectancy globally, it is imperative to build knowledge of how older peoples’ views of their own aging, considering their health-related circumstances, affect quality of life for practitioners and policy-makers alike. Based on our literature review, we wanted to determine whether older adults’ attitudes toward their own aging would partly mediate the effect of their health satisfaction ratings upon their quality of life. Furthermore, would these attitudes mediate the relationship between health satisfaction and quality of life in the same way when we account for older adults’ country of origin, and their age and gender?MethodsThis was a secondary analysis of cross-sectional survey data collected in 20 countries taking part in the 2003 WHOQOL-OLD Field study. The study sample consisted of 4593 adults whom were, on average, 72.10 years of age (range = 60 to 100 years of age); 42.8% were female. The WHOQOL-BREF measured quality of life and health satisfaction. The Attitudes to Aging Questionnaire measured participants’ attitudes toward physical change, psychosocial loss, and psychological growth. All items in both questionnaires were measured on a 5-point Likert scale. Questionnaire responses were analyzed using multilevel modeling and path analysis.ResultsAll three attitudes to aging partly mediated the relationship between health satisfaction and physical, psychological, social, environmental, and global quality of life. These partial mediations manifested in the same way across all 20 country samples, regardless of age or gender. Attitudes toward physical change were the strongest mediator of health satisfaction upon global and domain-specific quality of life, followed by psychosocial loss and psychosocial growth.ConclusionsOur study is the first cross-cultural study with a large sample to show that quality of life judgements, between 60 to 100 years of age, are a product of older men’s and women’s perceptions of health-related circumstances, and attitudes toward physical and psychosocial aspects of the aging self. A prospective study of the linkages between older peoples’ subjective views of health and attitudes toward the aging self over time using multiple subjective measures of health is warranted. Understanding these linkages may help practitioners and policy makers consider strategies to enhance quality of life.

The relationship between attitudes toward aging and health‐promoting behaviours in older adults

“…These scores were 0.807, 0.809, and 0.738, respectively. Low et al () reported the internal consistency reliability for the scale was 0.86 for the entire instrument (0.81 for physical change and 0.74 and 0.81 for psychological growth and psychological loss, respectively). Eser et al () assessed the validity and reliability of this instrument in Turkey.…”

“…Low, Molzahn, and Schopflocher () defined attitudes as stable, integrative judgments that summarize the thoughts, feelings, and memories of people regarding objects or situations. Attitudes are derived from direct experience or from observation.…”

The World report on ageing and health: a policy framework for healthy ageing

“…Moreover, older people's self-perceptions of health can be greatly affected by other factors, including their attitudes toward their own ageing. 31 Nor do these approaches take account of the differing environments or differential access to services between countries that might mitigate the effects on functioning of different disorders.…”

Self-compassion, attitudes to ageing and indicators of health and well-being among midlife women

“…Attitudes measured with the AAQ have been found to be associated with a range of health and well-being benefits among midlife and older adults (Bryant et al, 2012;Low, Molzahn, & Schopflocher, 2013). The relationships between attitudes and health outcomes, however, are likely to be bi-directional, and, to date, only one study has identified psychological factors that might explain why some people hold more positive attitudes to ageing than others, based on scores on the AAQ ).…”