Study finds older adults with positive expectations about aging report better cognitive health and less perceived decline.

Study: As expected? Older adults’ expectations about aging are associated with subjective cognition. Image Credit: Grustock/Shutterstock.com

In a recent study published in Aging and mental healthResearchers examined the link between older adults’ expectations about aging and their subjective cognitive experiences.

Their results indicate that expectations about aging impact cognitive self-perceptions and that improving these expectations could contribute to better cognitive aging through increased awareness and realistic views.

Background

Older adults’ expectations about aging affect their physical, mental, and cognitive health. Positive expectations about aging are linked to healthier behaviors, such as physical activity, leading to better outcomes.

Negative perceptions of aging can lead to more rapid physical and cognitive decline and increase the risk of dementia.

Positive expectations can motivate actions that improve health and reinforce optimistic beliefs. Negative expectations can lead to less proactive behaviors and poorer health outcomes. Self-perceptions related to aging include attitude toward aging and subjective age.

Expectations for aging focus specifically on future prospects for physical, mental, and cognitive health. Previous studies have primarily focused on subjective age, while the specific links between aging expectations and subjective cognition require further research.

Subjective cognitive decline (SCD) is often an early indicator of Alzheimer’s disease (AD). SCD, especially when accompanied by worry, doubles the risk of developing AD or mild cognitive impairment (MCI).

Other problems related to subjective cognition, such as cognitive complaints, are linked to negative consequences of aging, such as depression and lower quality of life.

About the study

In this study, researchers sought to examine the associations between older adults’ expectations of aging in cognitive, mental, and physical domains and their subjective cognition and SCD. Identifying whether specific expectations have more impact on subjective cognition than others could inform cognitive health intervention strategies.

The study was conducted using online surveys of adults in the United States who were at least 65 years old, spoke English, lived independently, and did not report dementia. The sample was capped at 80% non-Hispanic White participants to ensure demographic diversity.

Information was collected on marital status, education, income, race and ethnicity, gender, and age, which could affect the results. Expectations related to aging were rated on a 12-point scale, with higher scores indicating more positive expectations.

Current subjective cognition was measured on a five-point scale, with higher scores associated with better perceived cognitive ability. SCD was measured on a 12-point scale to understand perceived decline in daily tasks over the past decade, with higher scores associated with greater SCD.

Results

The study sample included 581 adults aged 65 to 90 years, with an average age of 71.4 years. Approximately 51% of participants were female, 53% were married, and 74% were non-Hispanic White. Education levels ranged from those who had completed high school to approximately 14% of those with a graduate degree.

Researchers found that positive expectations related to physical health were associated with small cognitive improvements. However, optimism related to cognitive and mental health was linked to low to moderate cognitive improvement.

Overall, positive aging expectations were related to decreased SCD with a small to medium effect. In specific domains, physical and mental health expectations were linked to small reductions, while those related to cognitive function were linked to small to medium decreases.

Conclusions

Positive expectations regarding the physical, mental, and cognitive aspects of aging were linked to better current cognition and less perceived cognitive decline (SCD).

These associations were consistent across short-term (current) and long-term (10 years) perceptions of cognitive performance. Physical health expectations had slightly smaller effects on cognition and SCD than mental and cognitive function expectations, although the differences were minor.

These results have important implications. Expectations of aging may influence how older adults perceive and report cognitive changes, which could affect early identification of cognitive decline. Potential stigma or stereotypes related to aging could impact whether older adults disclose cognitive problems, which would impact dementia diagnoses.

The results are consistent with previous studies on perceptions of aging related to subjective age and attitudes toward aging.

However, the use of online surveys, while reducing social desirability bias and encouraging honest responses, could limit accuracy and representativeness, and excluding full cognitive assessments may not account for the MCI in some participants. Personality traits, confounding factors, were not assessed.

Longitudinal studies are needed to determine whether changes in aging expectations impact cognition or whether the reverse is true and examine the influence of these relationships on long-term well-being and health.

Future explorations could also examine how environmental factors, health status, and demographics affect aging-related cognition and expectations and focus on the underlying psychological mechanisms through qualitative research.

This understanding could prove invaluable in supporting the cognitive health of older adults and improving outcomes related to AD and other forms of cognitive decline.