Older Subjective Age Research Articles

Telomere Length and Depression Among Ex-Prisoners of War: The Role of Subjective Age.

Exposure to captivity increases the risk for multiple disturbances that may intensify during old age. In later phases of life, former-prisoners-of-war (ex-POWs) may suffer from depression as well as from accelerated aging, manifested in older subjective age and leukocyte telomere shortening. The current study assesses the link between these varied facets of increased vulnerability during old age and explores (a) the associations between subjective age and telomere length; (b) the mediating role of changes in subjective age over time within the associations between depression and telomere length. Eighty-eight ex-POWs were assessed prospectively 30 (T1), 35 (T2), and 45 (T3) years after the 1973 Israeli Yom-Kippur War. Depression was assessed at T1; subjective age was assessed at T2 and T3; and telomere length and control variables were assessed at T3. Older subjective age at T3 was associated with concurrent shorter telomeres, beyond the effect of chronological age. Change in subjective age between T2 and T3 mediated the relations between depression at T1 and shorter telomeres at T3 beyond the effects of control variables. Findings suggest that the detrimental ramifications of accelerated subjective age involve premature cellular senesces, and may explain the relation between depression and accelerated aging processes among trauma victims. Hence, clinical interventions may seek to address accelerated subjective age among trauma survivors who suffer from depression.

The moderating effect of subjective age on the association between depressive symptoms and cognitive functioning in Korean older adults

ABSTRACTObjectives: Depressive symptoms are greatly associated with cognitive impairment in older adults. Recent growing body of literature has reported that the subjective perception of one's own age (subjective age) predicts both cognitive performance and mental well-being in old age. This study aims to examine whether subjective age moderates the association between depressive symptoms and cognitive functioning in a representative sample of Korean older adults. To address this research question, we employed the Stereotype-Embodiment Theory as a theoretical guide. Method: Data are from the 2016 Dementia Literacy Survey collected by Kyung Hee University, and 526 community-dwelling Korean older adults (ages 60–79) completed the questionnaire about depressive symptoms, cognitive functioning, and subjective age. Results: According to the hierarchical regression analysis, both higher levels of depressive symptoms and older subjective age were associated with poorer cognitive functioning. Further analyses showed that subjective age attenuated the effect of depressive symptoms on cognitive functioning: when older adults have a higher level of depression, those with younger subjective age reported a higher level of cognitive functioning than those with older subjective age. Conclusion: Based on the findings from this study, both theoretical and practical implications were discussed.

Subjective Age and Cystatin C Among Older Adults.

Cystatin C (CysC) is a marker of kidney function that is relevant for the health and cognition of older adults. Little is known about the link between psychological factors and CysC. Therefore, the present study examined whether subjective age is related to CysC level and changes in CysC over time. Participants were 5,066 individuals drawn from the Health and Retirement Study aged from 50 to 107 years (60% women, mean age = 69.36 years, SD = 9.54). They provided data on subjective age, demographic covariates, and CysC at baseline. CysC was assessed again 4 years later. Analysis revealed that an older subjective age was related to higher level of CysC at baseline and to an increase in CysC over 4 years, controlling for demographic factors. An older subjective age was also related to higher risk of exceeding the clinical threshold of CysC at baseline and 4 years later. Additional analysis revealed that disease burden, depressive symptoms, physical inactivity, and BMI partly mediated these associations. The present study provides new evidence on the role of subjective age as a psychological factor associated with individuals' risk of kidney dysfunction, an association beyond chronological age.

The reciprocal relationship between depression and physical morbidity: The role of subjective age.

The study aims to examine whether the reciprocal effects of physical morbidity and depression are moderated by subjective age-that is, individuals' perception of themselves as young or old. Data from the first two waves of the Midlife in the United States study (1995-6, T1; 2004-6, T2; http://midus.wisc.edu/) were analyzed using a cross-lagged design. We assessed 3,591 individuals who participated in both waves and provided full data on all the relevant variables (mean age at T1 = 47.4). Depression and the number of chronic illnesses (the indicator of physical morbidity) were measured at both waves and were tested as predictors and outcomes in a cross-lagged model. The moderating role of subjective age was assessed by examining whether T1 variables interacted with subjective age in predicting T2 outcomes. Subjective age moderated the T1 depression-T2 morbidity relationship, so that the relationship was stronger for those with older subjective age. Subjective age did not moderate the T1 morbidity-T2 depression relationship. Older subjective age could be a risk factor for experiencing greater physical morbidity following depression. (PsycINFO Database Record

Context influences on the relationship between views of aging and subjective age: The moderating role of culture and domain of functioning.

Subjective age has been shown to reliably predict a variety of psychological and physical health outcomes, yet our understanding of its determinants is still quite limited. Using data from the Aging as Future project, the authors examined the degree to which views of aging influence subjective age and how this influence varies across cultures and domains of everyday functioning. Using data from 1,877 adults aged from 30 to 95 years of age collected in China, Germany, and the United States, they assessed how general attitudes about aging and perceptions of oneself as an older adult influenced subjective age estimates in 8 different domains of functioning. More positive attitudes about aging were associated with older subjective ages, whereas more positive views of self in old age were associated with younger subjective age. It is hypothesized that these effects are reflective of social-comparison processes and self-protective mechanisms. These influences varied considerably over contexts, with views of aging having a greater impact in domains associated with stronger negative stereotypes of aging (e.g., health) compared to those with more positive ones (e.g., family). Culture also moderated the impact of aging views in terms of the strength of prediction, direction of effect, and age of greatest influence, presumably due to cultural differences in the salience and strength of aging-related belief systems across contexts. The results illustrate the contextual sensitivity of subjective age and highlight the role played by an individual's views of old age-both in general and regarding oneself-in determining their own experience of aging. (PsycINFO Database Record

Subjective age and sleep in middle-aged and older adults

Objective : Chronological age is commonly used to explain change in sleep. The present study examines whether subjective age is associated with change in sleep difficulties across middle adulthood and old age. Design : Participants were drawn from the second (2004–2005) and third (2013–2014) waves of the Midlife in the United States Survey (MIDUS, N = 2350; Mean Age: 55.54 years), the 2008 and 2014 waves of the Health and Retirement Study (HRS, N = 4066; Mean Age: 67.59 years) and the first (2011) and fourth (2014) waves of the National Health and Aging Trends Survey (NHATS, N = 3541; Mean Age: 76.46). In each sample, subjective age, sleep difficulties, depressive symptoms, anxiety and chronic conditions were assessed at baseline. Sleep difficulties was assessed again at follow-up. Main outcome measures: Sleep difficulties. Results: An older subjective age at baseline was related to an increase in sleep difficulties over time in the three samples, and was mediated, in part, through more depressive symptoms, anxiety and chronic conditions. Feeling older was associated with an increased likelihood of major sleeping difficulties at follow-up in the three samples. Conclusion: Subjective age is a salient marker of individuals’ at risk for poor sleep quality, beyond chronological age.

Posttraumatic stress disorder symptoms as a function of the interactive effect of subjective age and subjective nearness to death

An older age identity is related to higher posttraumatic stress disorder (PTSD) symptoms. However, in relating to PTSD symptoms, an older subjective age can interact with other major perceptions of aging, such as the subjective nearness to death, reflecting how close or far people experience themselves to be from their death. We examined this possible interaction effect on PTSD symptoms in two samples. Sample 1 included 1268 respondents exposed to missile attacks during the 2014 Israel-Gaza conflict. Sample 2 included 628 respondents exposed to terrorist attacks during the 2015 escalation in the Israeli-Palestinian conflict. Findings from both samples showed that after controlling for level of exposure and background characteristics, an older subjective age and perceiving death as near had an interactive effect on PTSD symptoms. While the combination of feeling older and nearer to death was related to the highest ratings of PTSD symptoms, effects of subjective age on PTSD symptoms were mitigated by perceiving death as far. These findings emphasize the importance of an integrative view of two time perspectives – one that focuses on time since birth and another that concerns time left until death – which can be conceptualized as reflecting psychological resources vis-à-vis adversity.

Feeling Older and the Development of Cognitive Impairment and Dementia.

Subjective age is a biopsychosocial marker of aging associated with a range of outcomes in old age. In the domain of cognition, feeling older than one's chronological age is related to lower cognitive performance and steeper cognitive decline among older adults. The present study examines whether an older subjective age is associated with the risk of incident cognitive impairment and dementia. Participants were 5,748 individuals aged 65 years and older drawn from the Health and Retirement Study. Measures of subjective age, cognition, and covariates were obtained at baseline, and follow-up cognition was assessed over a 2- to 4-year period. Only participants without cognitive impairment were included at baseline. At follow-up, participants were classified into one of the three categories: normal functioning, cognitive impairment without dementia (CIND), and dementia. An older subjective age at baseline was associated with higher likelihood of CIND (odds ratio [OR] = 1.18; 1.09-1.28) and dementia (OR = 1.29; 1.02-1.63) at follow-up, controlling for chronological age, other demographic factors, and baseline cognition. Physical inactivity and depressive symptoms partly accounted for these associations. An older subjective age is a marker of individuals' risk of subsequent cognitive impairment and dementia.

Abstract 212: Andexanet Alfa, a Universal Antidote for Reversal of Anticoagulation of Factor Xa Inhibitors in Healthy Human Volunteers

Introduction: Andexanet alfa (AnXa) is a recombinant modified fXa molecule that acts as a specific antidote for fXa inhibitors. We report clinical results in healthy subjects anticoagulated with apixaban (apix), rivaroxaban (riva), edoxaban (edox), or enoxaparin (enox), demonstrating rapid and sustained reversal of anticoagulation following administration of AnXa. Methods: These were Phase 2/3 randomized, double-blind, placebo-controlled studies in healthy subjects. In Phase 2, about153 subjects age18 - 45 were given one of the fXa inhibitors (apix 5 mg BID, riva 20 mg QD, edox 60 mg QD or enox 40 mg QD) for 6 days. AnXa or placebo (3:1 randomization) was given IV on Day 6, 3hrs after the last inhibitor dose (∼inhibitor Cmax). Safety was followed through Day 48. A range of AnXa doses (bolus or bolus+infusion) was evaluated by correction of biomarkers (anti-fXa activity, free inhibitor concentrations and thrombin generation (TG)). In Phase 3 (ANNEXA™), older subjects age 50 to 75 were dosed with apix (5 mg BID) or riva (20 mg QD) for 4 days. ANNEXA™-A had 63 subjects treated with apix. AnXa (400 mg bolus; 400 mg bolus plus 4 mg/min x 2hr infusion) or placebo (3:1 randomization) was given on Day 4, 3 hrs after the last apix dose. ANNEXA™-R had 82 subjects treated with riva. AnXa (800 mg bolus; 800 mg bolus plus 8 mg/min x 2hr infusion) or placebo (2:1) was given on Day 4, 4 hrs after the last riva dose. Safety was followed through Day 43. Results: About 298 healthy subjects were enrolled in the studies. AnXa demonstrated rapid and sustained reversal of both direct and indirect fXa inhibitors as measured by correction of biomarkers. The ANNEXA™ studies confirmed findings from Phase 2, and met all primary (reversal of anti-fXa) and secondary endpoints (reduction of free inhibitor concentration and restoration of TG) with high statistical significance. AnXa was well-tolerated with no serious adverse events, thrombotic events, or antibodies to fX or fXa reported. Conclusion: AnXa treatment results in rapid and sustained reversal of anticoagulation of fXa inhibitors. A Phase 3b/4 confirmatory study (ANNEXA-4) in patients with acute major bleeds is ongoing.

Risk Factor Analysis for Capsular Contracture, Malposition, and Late Seroma in Subjects Receiving Natrelle Style 410 Form-Stable Silicone Breast Implants

PURPOSE: This study analyzed potential risk factors for capsular contracture, malposition, and late seroma in subjects receiving Natrelle 410 textured silicone breast implants. MATERIALS AND METHODS: Pooled data from 2 similarly designed, ongoing, prospective, multicenter clinical trials of subjects receiving Natrelle 410 breast implants were analyzed. Univariate and multivariate Cox proportional hazards regression analysis was performed to evaluate the association of subject, implant, surgical, and facility factors with the development of capsular contracture, malposition, and late seroma in subjects who underwent primary breast augmentation, revision-augmentation, primary breast reconstruction, and revision-reconstruction. RESULTS: In total, 17,656 subjects received Natrelle 410 breast implants for augmentation (n=5059), reconstruction (n=7502), revision-augmentation (n=2632), and revision-reconstruction (n=2463); median follow-up was 4.1 years, 2.1 years, 2.6 years, and 2.3 years, respectively. Significant risk factors for capsular contracture in the primary augmentation cohort included subglandular device placement (strongest multivariate risk factor; adjusted risk ratio [aRR]: 2.89; P<.0001), older device age, and periareolar incision site (both P<.0001). In the primary reconstruction cohort, significant risk factors were higher body mass index (BMI) (aRR: 1.03; P=.0026) and absence of betadine pocket irrigation (aRR: 2.00; P=.0006). The only significant risk factor in the revision-augmentation cohort was older subject age (aRR: 1.47; P<.0001). No significant risk factors were identified in the revision-reconstruction cohort. Significant risk factors for malposition included longer incision size in the primary augmentation cohort (aRR: 1.44; P=.0003) and capsulectomy performed at time of implantation in the primary reconstruction cohort (aRR: 1.55; P=.0028). In both revision cohorts, the risk was 2 to 3 times greater for implant surgeries performed in physicians’ offices versus hospitals or stand-alone surgical facilities (both P<.0001). Risk of malposition was not associated with any subject- or device-related factors. The incidence of late seroma (31 cases out of 31,992 implants) was insufficient to perform a risk factor analysis. Twenty-nine cases occurred with submuscular placement, one with subglandular placement, and one was unknown; no trends were observed for subject age, BMI, incision site, or device size, style, or age. CONCLUSION: These analyses reaffirm the low rates of complications in subjects receiving Natrelle 410 breast implants in primary and secondary surgical settings. Knowledge of the risk factors associated with capsular contracture and implant malposition offers additional guidance to surgeons for reducing complication rates and optimizing outcomes.

How old do you feel? The role of age discrimination and biological aging in subjective age.

Subjective age, or how young or old individuals experience themselves to be relative to their chronological age, is a crucial construct in gerontology. Subjective age is a significant predictor of important health outcomes, but little is known about the criteria by which individuals' subjectively evaluate their age. To identify psychosocial and biomedical factors linked to the subjective evaluation of age, this study examined whether perceived age discrimination and markers of biological aging are associated with subjective age. Participants were 4776 adults (M age = 68) from the 2008 and 2010 waves of the Health and Retirement Study (HRS) who completed measures of subjective age, age discrimination, demographic variables, self-rated health and depression, and had physical health measures, including peak expiratory flow, grip strength, waist circumference, systolic and diastolic blood pressure. Telomere length was available for a subset of participants in the 2008 wave (n = 2214). Regression analysis indicated that perceived age discrimination, lower peak expiratory flow, lower grip strength, and higher waist circumference were associated with an older subjective age, controlling for sociodemographic factors, self-rated health, and depression. In contrast, blood pressure and telomere length were not related to subjective age. These findings are consistent with the hypothesis that how old a person feels depends in part on psychosocial and biomedical factors, including the experiences of ageism and perceptible indices of fitness and biological age.

Bottom dogs on campus: how subjective age and extrinsic self-esteem relate to affect and stress in first semester of university

The first semester of university can be a difficult transitional period that affects students' psychological well-being, and ultimately, their academic success. Personal resources and vulnerabilities that they bring to the transition may shape their day-to-day experiences. Subjective age (how old one feels) and extrinsic self-esteem (ESE; the extent to which self-worth is based on external sources) were examined as predictors of mean levels of and intraindividual variability in daily affect (positive and negative) and stress in 170 Canadian students tracked for 14 days during their first semester. Consistent with a self-enhancing effect of an older subjective age, regression models found that feeling older predicted higher mean levels of positive affect, and students with higher ESE reported more negative affect unless they felt considerably older than their chronological ages. In addition, an older subjective age and higher ESE predicted higher levels of and more intraindividual variability in daily stress experience. An ESE appears to contribute to negative affect and stress, but an older subjective age might counteract some negative emotion and play a part in positive emotion. As much as an older subjective age is a possible personal resource, its association with stress suggests that it might have some disadvantages for first-year university students, the bottom dogs on campus.

The interactive effect of subjective age and subjective distance-to-death on psychological distress of older adults

Objectives: Subjective age refers to how young or old people experience themselves to be, while subjective distance-to-death reflects how far or close they experience themselves to be from their death. The present study examined whether subjective age and subjective distance-to-death interact in predicting psychological distress.Method: A sample of 1073 community-dwelling older adults at the age range of 50–86 (M = 58.1, SD = 5.3) evaluated their subjective age, subjective distance-to-death, psychological distress, and rated several measures of physical health.Results: After controlling for background characteristics and physical health indices, perceiving death as far and reporting younger subjective age predicted lower psychological distress. The combination of feeling close to death and older subjective age was related to the highest ratings of psychological distress. Moreover, the effect of subjective distance-to-death on psychological distress was mitigated by younger subjective age.Conclusion: The findings underscore the importance of an integrative view of two time perspectives – one that focuses on time since birth and another that concerns time left till death – to psychological distress of older adults.

The implications of adult identity for educational and work attainment in young adulthood.

This study investigates the relation of young adult identities (ages 18-22 years), reflecting subjective age and psychosocial maturity, to educational and career attainment in young adulthood (ages 25-29 years). Add Health data show that having an older subjective age alone does not curtail attainment; the critical issue is the level of psychosocial maturity that accompanies subjective age. Those with older subjective ages and low psychosocial maturation have the lowest attainment at ages 25-29 years, while those with older subjective ages and high psychosocial maturation show considerable progress toward work-related attainment. For those with younger subjective ages, a lower level of psychosocial maturity is not as detrimental to attainment.

Predictors of Colorectal Cancer After Negative Colonoscopy: A Population-Based Study

A higher proportion of colorectal neoplasia among women occurs in the proximal colon, which might be more frequently missed by colonoscopy. There are no data on predictors of developing colorectal cancer (CRC) after a negative colonoscopy in usual clinical practice. We evaluated gender differences and predictors of CRC occurring after a negative colonoscopy. All individuals 40 years or older with negative colonoscopy were identified from Manitoba's provincial physicians' billing claims database. Individuals with less than 5 years of coverage by the provincial health plan, earlier CRC, inflammatory bowel disease, resective colorectal surgery, or lower gastrointestinal endoscopy were excluded. CRC risk after negative colonoscopy was compared to that in the general population by standardized incidence ratios. Cox regression analysis was performed to determine the independent predictors of CRC occurring after negative colonoscopy. A total of 45,985 individuals (18,606 men; 27,379 women) were followed up for 229,090 person-years. After a negative colonoscopy, men had a 40-50% lower risk of CRC diagnosis through most of the follow-up time. Risk among women was similar to that of women in the general population in the first 3 years and then was 40-50% lower. Older subject age and performance of index colonoscopy by non-gastroenterologists were independent predictors for early/missed CRC (cancers occurring within 3 years of negative colonoscopy). Women may have a higher rate of missed/early CRCs after negative colonoscopy. Predictors of missed/early CRCs after negative colonoscopy include older age and performance of index colonoscopy by a non-gastroenterologist.

Parental Death and Subjective Age: Indelible Imprints from Early in the Life Course?*

Past research suggests that sustaining a young identity helps adults maintain a greater sense of well‐being. The experience of subjective aging, however, is not a spontaneous phenomenon, but stems from lifelong developmental experiences. Drawing from writings on the life course and self‐concept, I consider how parental death in childhood shapes subjective age in adulthood. To examine the effects of maternal and paternal death on subjective age, I employ the Midlife Development in the United States Study (MIDUS). A series of linear regression analyses indicates that maternal death during childhood is associated with an older subjective age in adulthood, death of a father does not have a similar influence on subjective age, and that the effect on subjective age is stronger if maternal death occurred during childhood than during other periods of the life course. The findings highlight interconnections between timing of transitions in the life course, linked lives, and the development of self‐concept. Subjective age in adulthood seems to hinge on important biographical experiences from childhood, such as parental death, though the processes differ by the gender of the deceased parent.

Dating, sex, and substance use predict increases in adolescents' subjective age across two years

This study examined the nature of the relationship between adolescents' subjective age (how old they feel) and chronological age, and explored whether dating, sex, and substance use predicted increases in adolescents' subjective age across a two-year period. The participants were 570 adolescents who were interviewed when they were first ages 12—19 and again two years later (ages 14—21). Results were that a quadratic function characterized the relationship between chronological and subjective age: subjective age increased from age 14 to 18.25 years, and then declined. Adolescents who dated, reported having sex, used alcohol, and used drugs at time 1 experienced an increased subjective age, that is, they felt older than less experienced adolescents by time 2. An older subjective age at time 1 did not predict increases in dating, sex, and substance use behaviors, with one exception: smoking. The results are consistent with theories assuming that self-perceptions of maturity may arise from engaging in “adult-like” behaviors.

People over forty feel 20% younger than their age: Subjective age across the lifespan

Subjective age--the age people think of themselves asbeing--is measured in a representative Danish sample of 1,470 adults between 20 and 97 years of age through personal, in-home interviews. On the average, adults younger than 25 have older subjective ages, and those older than 25 have younger subjective ages, favoring a lifespan-developmental view over an age-denial view of subjective age. When the discrepancy between subjective and chronological age is calculated as a proportion of chronological age, no increase is seen after age 40; older respondents feel 20% younger than their actual age. Demographic variables (gender, income, and education) account for very little variance in subjective age.

An exploration of the skills needed for inhalation therapy in schoolchildren with asthma in Taiwan

Clinical observation has shown that many asthma-affected children and their parents are not familiar with appropriate techniques for inhaler use. This may result in misuse, overdose, or diminished response of the administered therapeutic drugs, or may even result in unnecessary, repeated hospitalization. Inappropriate inhalation technique is hazardous to the safety of children with asthma and unnecessarily increases costs resulting from unnecessary rehospitalization. We designed a study to evaluate the skills needed for inhaler use among children with asthma in Taiwan. Schoolchildren with asthma, aged 8 to 13 years, were asked to demonstrate their inhalation technique. The inhalers used in this study were either metered-dose inhalers or dry-power inhalers. Assessment of the inhalation technique was made using a standardized inhaler checklist. A higher score indicates greater skill using the inhaler. This study surveyed 132 schoolchildren with asthma. Of those, only 23 (17.4%) asthmatic children who received inhalation therapy revealed good compliance with their medication regimens. No child was observed to have completed all inhaler techniques correctly. Those family members who participated in educational programs and who received instruction from health teams had higher scores for the inhaler checklist (P < 0.05). It was found that children who inhaled medication unaided had a better knowledge of asthma, and their drug inhalation technique was also more skillful (P < 0.03). By multiple regression analysis, we found that determinants of a child's skill at performing the inhalation maneuver included: number of asthma attacks within the preceding year, unaided application of inhaler therapy, older subject age, potential for subjects to receive instructions from parents regarding inhaler use, subjects reading related publications, and the family's degree of satisfaction with the physician's educational program. These variables contributed a total of 23% to variance in the subjects' inhalation technique. This study revealed that most asthmatic children being treated with inhaler medication do not use such devices appropriately. More aggressive asthma education is necessary in Taiwan.

Adolescents' Subjective Age: An Indicator of Perceived Maturity

Two studies investigated the relation between adolescents' subjective age and their self-reported problem behavior, autonomy, and peer relationships. In Study 1, an older subjective age among 15-year-old girls and boys was correlated significantly and positively with several problem behaviors (e.g., substance use), behavioral autonomy, and aspects of peer relationships such as association with deviant peers and involvement with other-sex peers. In Study 2, data from 9- to 17-year-old adolescents revealed that after controlling for chronological age and pubertal status, subjective age was related significantly to several measures of self-reported problem behavior, behavioral autonomy, and peer relationships. The relations between subjective age and boys' problem behaviors and deviant peer association were curvilinear. The highest levels of these behaviors were reported by boys who felt markedly older than their chronological ages, compared to boys with younger subjective ages. These studies support the not...