Victoria I. Michalowski, Denis Gerstorf, and Christiane A. Hoppmann
Aging does not occur in isolation, but often involves significant others such as spouses. Whether such dyadic associations involve gains or losses depends on a myriad of factors, including the time frame under consideration. What is beneficial in the short term may not be so in the long term, and vice versa. Similarly, what is beneficial for one partner may be costly for the other, or the couple unit over time. Daily dynamics between partners involving emotion processes, health behaviors, and collaborative cognition may accumulate over years to affect the longer-term physical and mental health outcomes of either partner or both partners across adulthood and into old age. Future research should move beyond an individual-focused approach to aging and consider the importance of and interactions among multiple time scales to better understand how, when, and why older spouses shape each other’s aging trajectories, both for better and for worse.
Anne Josephine Dutt, Hans-Werner Wahl, and Manfred Diehl
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.
Thomas M. Hess, Erica L. O'Brien, and Claire M. Growney
Blood pressure is a frequently used measure in studies of adult development and aging, serving as a biomarker for health, physiological reactivity, and task engagement. Importantly, it has helped elucidate the influence of cardiovascular health on behavioral aspects of the aging process, with research demonstrating the negative effect of chronic high blood pressure on various aspects of cognitive functioning in later life. An important implication of such research is that much of what is considered part and parcel of getting older may actually be reflective of changes in health as opposed to normative aging processes. Research has also demonstrated that situational spikes in blood pressure to emotional stressors (i.e., reactivity) also have implications for health in later life. Although research is still somewhat limited, individual differences in personal traits and living circumstances have been found to moderate the strength of reactive responses, providing promise for the identification of factors that might ameliorate the effects of age-related changes in physiology that lead to normative increases in reactivity. Finally, blood pressure has also been successfully used to assess engagement levels. In this context, recent work on aging has focused on the utility of blood pressure as a reliable indicator of both (a) the costs associated with cognitive engagement and (b) the extent to which variation in these costs might predict both between-individual and age-related normative variation in participation in cognitively demanding—but potentially beneficial—activities. This chapter elaborates on these three approaches and summarizes major research findings along with methodological and interpretational issues.
Alison Chasteen, Maria Iankilevitch, Jordana Schiralli, and Veronica Bergstrom
In 2016, Statistics Canada released the results of the most recent census. For the first time ever, the proportion of Canadians aged 65-plus years surpassed the proportion aged 15 and under. The increase in the proportion of older adults was viewed as further evidence of the faster rate of aging of Canada’s population. Such demographic shifts are not unique to Canada; many industrialized nations around the world are experiencing similar changes in their populations. Increases in the older adult population in many countries might produce beneficial outcomes by increasing the potential for intergenerational contact and exposure to exemplars of successful aging. Such positive intergenerational contact could counter prevailing age stereotypes and improve intergenerational relations. On the other hand, such increases in the number of older adults could be viewed as a strain and potential threat to resources shared with younger age groups. The possibility of increased intergenerational conflict makes it more important than ever before to understand how older adults are stereotyped, how those stereotypes can produce different kinds of biased behavior toward them, and what the impact of those stereotypes are on older adults themselves.
Social-cognitive age representations are complex and multifaceted. A common stereotype applied to older people is one of warmth but incompetence, often resulting in paternalistic prejudice toward them. However, such benevolent prejudice, characterized by warm overtones, can change to hostile bias if older adults are perceived to violate prescriptive norms about age-appropriate behavior. In addition to coping with age prejudice, older adults also have to deal with the deleterious effects of negative age stereotypes on their day-to-day function. Exposure to negative aging stereotypes can worsen older adults’ cognitive performance in a number of contexts. As well, age stereotypes can be incorporated into older adults’ own views of aging, also leading to poorer outcomes for them in a variety of domains. A number of interventions to counteract the effects of negative aging stereotypes appear promising, but more work remains to be done to reduce the impact of negative aging stereotypes on daily function in later life.
Shevaun D. Neupert and Jennifer A. Bellingtier
Daily diary designs allow researchers to examine processes that change together on a daily basis, often in a naturalistic setting. By studying within-person covariation between daily processes, one can more precisely establish the short-term effects and temporal ordering of concrete daily experiences. Additionally, the daily diary design reduces retrospective recall bias because participants are asked to recall events that occurred over the previous 24-hour period as opposed to a week or even a year. Therefore, a more accurate picture of individuals’ daily lives can be captured with this design. When conclusions are drawn between people about the relationship between the predictors and outcomes, the covariation that occurs within people through time is lost. In a within-person design, conclusions can be made about the simultaneous effects of within-person covariation as well as between-person differences. This is especially important when many interindividual differences (e.g., traits) may exist in within-person relationships (e.g., states).
Daily diary research can take many forms. Diary research can be conducted with printed paper questionnaires, divided into daily booklets where participants mail back each daily booklet at the end of the day or entire study period. Previous studies have called participants on the telephone to respond to interview questions each day for a series of consecutive days, allowing for quantitative as well as qualitative data collection. Online surveys that can be completed on a computer or mobile device allow the researcher to know the specific day and time that the survey was completed while minimizing direct involvement with the collection of each daily survey. There are many opportunities for lifespan developmental researchers to adopt daily diary designs across a variety of implementation platforms to address questions of important daily processes. The benefits and drawbacks of each method along with suggestions for future work are discussed, noting issues of particular importance for aging and lifespan development.
Carolyn M. Aldwin and Ritwik Nath
Erythocyte sedimentation rate (ESR) is one of the oldest measures of inflammation. It is used extensively in clinical medicine and has shown some utility in biomedical research. It is a nonspecific inflammation assay, and although it is less sensitive than more modern measures such as C-reactive protein, it is a useful measure in chronic illnesses.
In general, ESR increases with age and appears to be a biomarker of aging in general. It predicts both cardiovascular disease (CVD) and cancer and is elevated in autoimmune disorders such as rheumatoid arthritis. Further, it predicts mortality both in the general population and in those with chronic illnesses such as CVD and cancer, independent of other indicators of illness severity.
Interestingly, ESR is not associated with anxiety or general measures of distress but is consistently associated with measures of depression and suicidal ideation. Further, the effect of depressive symptoms on mortality appears to be mediated through increases in ESR.
Studies of the relationship between stress and ESR have been less consistent, primarily because early studies were largely cross-sectional and in small samples. Studies using more modern, longitudinal analyses in larger samples may show more consistent results, especially if multilevel modeling was used that examined within-person changes in ESR in response to stress. Given that other large, longitudinal studies, such as the Baltimore Longitudinal Study on Aging, the Rotterdam Study, The Reykjavik Cohort Study, and Women’s Healthy Ageing Study have included ESR in their biomedical assays, it should be possible to analyze existing data to examine how psychosocial factors influence inflamm-aging in humans.
Philip Sayegh, David J. Moore, and Pariya Fazeli Wheeler
Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States.
Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes.
Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.
Stephanie J. Wilson, Alex Woody, and Janice K. Kiecolt-Glaser
Inflammatory markers provide invaluable tools for studying health and disease across the lifespan. Inflammation is central to the immune system’s response to infection and wounding; it also can increase in response to psychosocial stress. In addition, depression and physical symptoms such as pain and poor sleep can promote inflammation and, because these factors fuel each other, all contribute synergistically to rising inflammation. With increasing age, persistent exposure to pathogens and stress can induce a chronic proinflammatory state, a process known as inflamm-aging.
Inflammation’s relevance spans the life course, from childhood to adulthood to death. Infection-related inflammation and stress in childhood, and even maternal stress during pregnancy, may presage heightened inflammation and poor health in adulthood. In turn, chronically heightened inflammation in adulthood can foreshadow frailty, functional decline, and the onset of inflammatory diseases in older age.
The most commonly measured inflammatory markers include C-reactive protein (CRP) and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These biomarkers are typically measured in serum or plasma through blood draw, which capture current circulating levels of inflammation. Dried blood spots offer a newer, sometimes less expensive collection method but can capture only a limited subset of markers. Due to its notable confounds, salivary sampling cannot be recommended.
Inflammatory markers can be added to a wide range of lifespan developmental designs. Incorporating even a single inflammatory assessment to an existing longitudinal study can allow researchers to examine how developmental profiles and inflammatory status are linked, but repeated assessments must be used to draw conclusions about the associations’ temporal order and developmental changes. Although the various inflammatory indices can fluctuate from day to day, ecological momentary assessment and longitudinal burst studies have not yet incorporated daily inflammation measurement; this represents a promising avenue for future research.
In conclusion, mounting evidence suggests that inflammation affects health and disease across the lifespan and can help to capture how stress “gets under the skin.” Incorporating inflammatory biomarkers into developmental studies stands to enhance our understanding of both inflammation and lifespan development.
Markus Wettstein, Hans-Werner Wahl, and Michael Schwenk
When referring to life space, researchers usually mean the area in which individuals move in their everyday lives. Life space can be measured based on different approaches, by means of self-reports (i.e., questionnaires or diaries) or by more recent approaches of technology-based objective assessment (e.g., via Global Positioning System [GPS] devices or smartphones). Life space is an important indicator of older adults’ out-of-home mobility and is meaningfully associated with autonomy, well-being, and quality of life. Substantial relationships between life space and socio-demographic indicators, health, and cognitive abilities have been reported in previous research. Future research on life space in old age will benefit from a more comprehensive and stronger interdisciplinary perspective, from taking into account different time scales (i.e., short- and long-term variability), and from considering life space as a multidimensional measure that can be best assessed based on multi-method approaches with multiple indicators.
Mary Fry and Candace M. Hogue
There is a large literature base within the field of sport psychology that provides tremendous direction to coaches and parents on how to structure youth sport so that young athletes develop sport skills and concurrently reap psychological benefits from their sport participation. Much of this research has employed Nicholls’ Achievement Goal Perspective Theory and a Caring Framework to (a) identity the processes children undergo as their cognitive development matures across the elementary years, allowing them to accurately judge their ability by adolescence, (b) formulate their personal definitions of success in sport (develop their goal orientations), and (c) note features of the team and overall sport climate created by coaches and parents. Of particular importance is athletes’ perceptions of the motivational climate prevailing on their teams. Athletes can perceive a caring and task-involving climate where coaches reward effort, improvement, and cooperation among teammates, make everyone feel they play an important role on the team, and treat mistakes as part of the learning process. In contrast, athletes can also perceive an ego-involving climate where the coach rewards ability and performance outcome, fosters rivalry among teammates, punishes mistakes, and gives most of the recognition to a few “stars.”
When athletes perceive a caring and task-involving climate on their teams, they are more likely to have fun, exert high effort, experience intrinsic motivation, have better interpersonal relationships with coaches and athletes, display better sportsperson-like values and behaviors, have better psychological well-being, and even perform better. In contrast, when athletes perceive an ego-involving climate on their teams they experience fewer adaptive and positive motivational outcomes and greater problematic outcomes (e.g., increased cortisol; greater endorsement of unsportsperson-like behaviors). Research has clearly identified the benefits of coaches and parents creating a caring and task-involving climate for young athletes, yet there are still many ego-involving climates in the youth sport world. A number of organizations are committed to helping coaches and parents transform youth sport culture into a positive arena where young people can develop their athletic skills and have a rewarding sport experience.
Idan Shalev and Waylon J. Hastings
Stress is a multistage process during which an organism perceives, interprets, and responds to threatening environmental stimuli. Physiological activity in the nervous, endocrine, and immune systems mediates the biological stress response. Although the stress response is adaptive in the short term, exposure to severe or chronic stressors dysregulates these biological systems, promoting maladaptive physiology and an accelerated aging phenotype, including aging on the cellular level. Two structures implicated in this process of stress and cellular aging are telomeres, whose length progressively decreases with age, and mitochondria, whose respiratory activity becomes increasingly inefficient with advanced age. Stress in its various forms is suggested to influence the maintenance and stability of these structures throughout life. Elucidating the interrelated connection between telomeres and mitochondria and how different types of stressors are influencing these structures to drive the aging process is of great interest. A better understanding of this subject can inform clinical treatments and intervention efforts to reduce (or even reverse) the damaging effects of stress on the aging process.
Agus Surachman and David M. Almeida
Stress is a broad and complex phenomenon characterized by environmental demands, internal psychological processes, and physical outcomes. The study of stress is multifaceted and commonly divided into three theoretical perspectives: social, psychological, and biological. The social stress perspective emphasizes how stressful life experiences are embedded into social structures and hierarchies. The psychological stress perspective highlights internal processes that occur during stressful situations, such as individual appraisals of the threat and harm of the stressors and of the ways of coping with such stressors. Finally, the biological stress perspective focuses on the acute and long-term physiological changes that result from stressors and their associated psychological appraisals. Stress and coping are inherently intertwined with adult development.
Gerben J. Westerhof and Susanne Wurm
Aging is often associated with inevitable biological decline. Yet research suggests that subjective aging—the views that people have about their own age and aging—contributes to how long and healthy lives they will have. Subjective age and self-perceptions of aging are the two most studied aspects of subjective aging. Both have somewhat different theoretical origins, but they can be measured reliably. A total of 41 studies have been conducted that examined the longitudinal health effects of subjective age and self-perceptions of aging. Across a wide range of health indicators, these studies provide evidence for the longitudinal relation of subjective aging with health and longevity. Three pathways might explain this relation: physiological, behavioral, and psychological pathways. The evidence for behavioral pathways, particularly for health behaviors, is strongest, whereas only a few studies have examined physiological pathways. Studies focusing on psychological pathways have included a variety of mechanisms, ranging from control and developmental regulation to mental health. Given the increase in the number of older people worldwide, even a small positive change in subjective aging might come with a considerable societal impact in terms of health gains.
Stephen J. Bright
In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue.
Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings.
The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.