Think young, stay sharp? Positive aging outlook tied to improved cognitive self-perception

By Priyanjana Pramanik, MSc.Reviewed by Lily Ramsey, LLMNov 1 2024

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

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

In a recent study published in Aging & Mental Health, researchers examined how older adults' expectations about aging relate to their subjective cognitive experiences.

Their findings indicate that expectations about aging impact cognitive self-perceptions and that improving these expectations could help support better cognitive aging through increased awareness and realistic views.

Background

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

Negative perceptions of aging can result in faster physical and cognitive decline and increase the risk of dementia.

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

Aging expectations specifically focus on future outlooks for physical, mental, and cognitive health. Previous studies have mostly looked at subjective age, while specific links between aging expectations and subjective cognition need 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 issues related to subjective cognition, like cognitive complaints, relate to negative aging outcomes, such as depression and lower quality of life.

About the study

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

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 had not reported dementia. The sample was capped at 80% non-Hispanic White participants to ensure diverse demographics.

Information was collected on marital status, education, income, race and ethnicity, gender, and age, which could affect the results. Expectations related to aging were assessed 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 the perceived decline in everyday tasks over the past decade, with higher scores associated with greater SCD.

Findings

The study sample comprised 581 adults between the ages of 65 and 90 who were 71.4 years old on average. Approximately 51% of the participants were female, 53% were married, and 74% were non-Hispanic White. Education levels varied from those who had completed high school to approximately 14% with graduate degrees.

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

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

Conclusions

Positive expectations regarding 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, though differences were minor.

These findings have important implications. Aging expectations 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 issues, impacting dementia diagnoses.

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

However, the use of online surveys, while reducing social desirability biases and encouraging honest responses, could limit accuracy and representativeness, and the exclusion of full cognitive assessments may not consider MCI in some participants. Personality traits, which are confounding factors, were not assessed.

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

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

This understanding could be invaluable to support older adults’ cognitive health and improve outcomes related to AD and other forms of cognitive decline.