Julia K. Wolff

How do negative self-perceptions of aging become a self-fulfilling prophecy?

Recent studies have provided considerable evidence on long-term effects of self-perceptions of aging (SPA) on indicators of successful aging such as health or life satisfaction. To date, little is known about the mechanisms underlying these effects. This study therefore examined whether negative SPA impair the use of self-regulation strategies that include selection, optimization, and compensation (SOC) in case of a serious health event and thus turn into self-fulfilling prophecies for health and life satisfaction. Based on a longitudinal nationwide study with 2 measurement points over a 6-month period in 309 older people (65+ years of age) with multiple illnesses, 2 major findings emerged: First, the occurrence of a serious health event predicted increased use of SOC strategies, which in turn predicted higher self-rated health and life satisfaction. Second, this effect was moderated by negative SPA, that is, in case of a serious health event, the perception that aging is associated with physical losses led to lower use of SOC strategies promoting a healthy lifestyle (B = -0.43, SE = 0.15, p < .01). These findings contribute to a better understanding of the underlying mechanisms of SPA on health by showing that negative SPA as associated with physical losses might impair health-related strategies that are important for maintaining a healthy lifestyle. Future intervention studies could attempt to challenge negative SPA to support effective strategy use in older adults with serious illnesses.

What do targeting positive views on ageing add to a physical activity intervention in older adults? Results from a randomised controlled trial

Objective: Physical activity is a key factor for healthy ageing, yet many older people lead a sedentary lifestyle. Traditional physical activity interventions do not consider the specific needs and views of older adults. As views on ageing are known to be related to health behaviours, the current study evaluates the effectiveness of prompting positive views on ageing within a physical activity intervention. Design: Randomised controlled trial with three groups aged 65+: Intervention for physical activity with ‘views-on-ageing’-component (n = 101; IGVoA), and without ‘views-on-ageing’-component (n = 30; IG), and active control intervention for volunteering (n = 103; CG). Main outcome measures: Attitudes towards older adults and physical activity were assessed five weeks before intervention, two weeks, six weeks and 8.5 months after the intervention. Results: Compared to the IG and CG, positive attitudes towards older adults increased in the IGVoA after the intervention. For IGVoA, the indirect intervention effect on change in activity via change in attitudes towards older adults was reliable. Conclusion: A ‘views-on-ageing’-component within a physical activity intervention affects change in physical activity via change in views on ageing. Views on ageing are a promising intervention technique to be incorporated into future physical activity interventions for older adults.

Cohort Profile: The German Ageing Survey (DEAS)

Population ageing and longevity as observed in Germany is not simply a phenomenon of an increasing number of old people: it also involves a range of qualitative and structural changes affecting older people. For this reason the German Federal Government, aiming to improve the quality of its monitoring efforts on older people in Germany, launched the German Ageing Survey (DEAS) in the mid 1990s, under the auspices of the Federal Ministry for Family Affairs and Senior Citizens (BMFuS, now German Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth, BMFSFJ). In 1996, the first wave of the survey was conducted by two collaborating research groups: the Research Group on Ageing and the Life Course at the Freie Universit€at in Berlin; and the Research Group on Psycho-Gerontology at the University of Nijmegen in The Netherlands. From the year 2002 onwards, the German Centre of Gerontology in Berlin (DZA) has been responsible for the conduct and ongoing development of the study. The DEAS is funded by the BMFSFJ. Fieldwork for all waves (1996–2014) is carried out by the Bonn-based Institute for Applied Social Sciences (infas). The primary goal of the project is to provide a representative national database containing information describing the living conditions of the country’s middle-aged and older population and to study diversity within the older section of the population, the process of ageing as it affects individuals and processes of social change as they relate to old age and ageing. For this purpose, a cohort-sequential design has been set up combining large cross-sectional samples with longitudinal samples. The design of the DEAS permits three different perspectives for analyses: (i) analysis of social change; (ii) analysis of intra-individual change; and (iii) analysis of historical changes affecting individual ageing trajectories.

The role of physical activity in the relationship between self-perceptions of ageing and self-rated health in older adults

Objective: Positive self-perceptions of ageing are associated with better health; however, little is known about the potentially underlying mechanisms. The present longitudinal study examines whether the relationship between self-perceptions of ageing and self-rated health is mediated by physical activity in older adults with multiple chronic conditions. Design: A sample of 309 German community-dwelling older adults aged 65–85 years with two or more chronic conditions was assessed at three measurement occasions over 2.5 years. Participants provided information on self-perceptions of ageing, physical activity, self-rated health, number of chronic conditions and demographics (T1). Physical activity was reassessed six months later (T2) and self-rated health after 2.5 years (T3). Data were analysed using multiple regression and path analyses. Main outcome measures: Self-rated health and physical activity. Results: More positive self-perceptions of ageing were related to better self-rated health over a 2.5-year period controlling for confounding variables. Physical activity six months after T1 partially mediated this relationship. Conclusion: Having more positive self-perceptions of ageing is associated with higher levels of physical activity, which in turn predict better self-rated health over time. This supports the hypothesis of a behavioural pathway in the self-perceptions of ageing – health link.

Contextual and Individual Predictors of Physical Activity: Interactions Between Environmental Factors and Health Cognitions

OBJECTIVE Although health behavior theories assume a role of the context in health behavior self-regulation, this role is often weakly specified and rarely examined. The two studies in this article test whether properties of the environment (districts) affect if and how health-related cognitions are translated into physical activity. METHODS Multilevel modeling was used to examine the assumed cross-level interactions. Study 1 is a large-scale survey representative of the German adult population (N = 6,201). Gross domestic product (GDP) on the level of administrative districts was used to indicate environmental opportunities and barriers. Study 2 examined cross-level interactions of proximal predictors of physical activity (intentions, action planning, and coping planning) in older adults with multiple illnesses (N = 309), a high-risk group for health deteriorations. RESULTS Study 1 showed that on the individual level, health attitudes (B = .11) and education (B = .71) were significantly associated with physical activity. GDP moderated the attitudes-behavior relation (B = .01), with higher attitude-behavior relations in districts with higher GDP. Study 2 finds that intention (B = .16), action planning (B = .17), and coping planning (B = .13) significantly predict activity. In addition, district-level GDP significantly moderated the relations between action planning and coping planning, but not intention, on physical activity. CONCLUSIONS Results suggest that the effects of health attitudes and planning on physical activity are moderated by environmental factors. Districts with higher GDP provide better contextual opportunities for the enactment of concrete if-then plans for physical activity. This has implications for both theory and health promotion.

Physical and emotional well-being and the balance of needed and received emotional support: age differences in a daily diary study.

Whether received social support matches the actual needs of the recipient is a largely overlooked aspect in research on associations of support and well-being. In particular, studies that investigate the match of needed and received support from a within-person perspective are rare. Therefore, we investigated the daily within-person relationship of well-being and the balance of needed and received social support in a German Sample of 79 younger (23-34 years) and 88 older adults (68-83 years). Health complaints and negative affect were predicted with linear effects of received and needed emotional support and quadratic effects of the balance (i.e., difference) of these two aspects using multilevel modeling of self-reports over 20 days. The predicted beneficial association between a match of needed and received support (i.e., a support balance) and well-being was observed among younger adults. Needed support was associated with more health complaints and negative affect on the same day. The match of needed and received support is important for well-being, particularly in younger adults. Future research should account for support needed in research on received support and shed more light into the processes underlying these short-term within-person relationships of social support and well-being.

A randomized controlled trial to promote volunteering in older adults.

Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention.

Multiple illness perceptions in older adults: Effects on physical functioning and medication adherence

Objective: Previous research on illness perceptions has focused on single illnesses, but most adults over 65 suffer from multiple illnesses (multimorbidity). This study tests three competing operationalisations of multiple illness perceptions in predicting physical functioning and adherence: (1) main effects and interactions model; (2) peak model with effects of the most prominent illness perception; and (3) combined model with averaged illness perceptions over multiple illnesses. Design: Longitudinal study in N = 215 individuals (65–86 years) with multimorbidity at two measurement points over six months. Participants filled in two Brief Illness Perception Questionnaires (B-IPQ) on their two most severe illnesses. Main outcome measures: Physical functioning, medication adherence. Results: Factor analyses suggest that the B-IPQ contains three dimensions; consequences, control and timeline. Multiple regression models fit the data best for (1) and (3). Timeline (β = −.18) and control (β = .21) predict adherence in (1); consequences (β = .16) and control (β = .20) in (3). Physical functioning was significantly predicted by interacting control beliefs in (1; β = .13), by peak consequences in (2; β = −.14) and by consequences (β = −.15) in (3). Conclusions: Individuals with multimorbidity hold both distinct and combined perceptions about their illnesses. To understand individual responses to multimorbidity, perceptions about all illnesses and multimorbidity as entity should be examined.

Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial

Objective. A randomised controlled trial (RCT) was conducted to evaluate a three-hour face-to-face physical activity (PA) intervention in community-dwelling older German adults with four groups: The intervention group (IG) received behaviour change techniques (BCTs) based on the health action process approach plus a views-on-ageing component to increase PA. The second intervention group ‘planning’ (IGpl) contained the same BCTs, only substituted the views-on-ageing component against an additional planning task. An active control group received the same BCTs, however, targeting volunteering instead of PA. A passive control group (PCG) received no intervention. Design. The RCT comprised 5 time-points over 14 months in N = 310 participants aged 64+. Main outcome measures. Self-reported as well as accelerometer-assessed PA. Results. Neither PA measure increased in the IG as compared to the other groups at any point in time. Bayes analyses supported these null-effects. Conclusion. A possible explanation for this null-finding in line with a recent meta-analysis is that some self-regulatory BCTs may be ineffective or even negatively associated with PA in interventions for older adults as they are assumed to be less acceptable for older adults. This interpretation was supported by observed reluctance to participate in self-regulatory BCTs in the current study.

Health Is Health Is Health? Age Differences in Intraindividual Variability and in Within-Person Versus Between-Person Factor Structures of Self-Reported Health Complaints

The variability of health complaints within individuals across time has rarely been studied, and the question whether between- and within-person factor structures of health-related variables are equivalent has not been tested so far. We examined self-reported health complaints in 101 younger (20-31 years) and 103 older adults (65-80 years) over a period of 100 daily assessments. Data were analyzed with confirmatory two-level factor analysis. One-factor structures of health complaints provided an acceptable fit at the between- and average within-person levels in both age groups, supporting the assumption of equivalent average within- and between-person factor structures for health complaints. Age differences in loading patterns indicated that subjective health may be experienced differently by younger and older adults. Small age differences in mean levels of health symptoms were observed. Intraindividual variability in health complaints was reliable. Older adults fluctuated less from day to day than younger adults, presumably reflecting less fluctuation in objective health, differences in response styles, situational influences, or habituation processes. We conclude that future research should consider intraindividual variability as being descriptive of a persons health status, and take possible differences between within- and between-person factor structures of subjective health into account.