Attitudes to Ageing in Midlife

1. Attitudes to Ageing in Midlife Anna Thorpe, Peter Joyce, John Pearson, Philip Schluter

2. Focus: Attitudes and Health • This study set out to understand more about the relationship between personal attitudes, health and health promoting behaviours. • How people feel about their own ageing may influence self-rated health, health related behaviours and even mortality. • Used the Attitudes to Ageing Questionnaire (AAQ) on a midlife population in New Zealand. 1 1 Levy et al, 2002 Laidlaw et al, 2007 2

3. Context: Ageing in New Zealand • NZ population over 65 projected to double by 2051. • Some regions, like Canterbury, doubling will happen 20 years earlier; ¼ of the population will reach 65 by 2031. • Our ageing population means it is more urgent to understand how to enhance health and wellbeing. Life expectancy at 50 Statistics New Zealand

4. Canterbury Health and Lifecourse study • CHALICE is a new longitudinal study of midlife health & wellbeing in Canterbury, New Zealand. • Face-to-face interviews involve blood tests, fundus photos, Echo & ECG, family health history, cognitive testing, mental health screening, food & physical activity diaries, plus attitudes to health & wellbeing.

5. CHALICE design • Random sample of 49-52 year olds from Canterbury, New Zealand. • Māori are oversampled, with about 15% Chalice participants being Māori. • Participants & their GP’s receive results. • Response rates have been about 65%, despite the Canterbury earthquakes.

6. Canterbury Earthquakes Over 12,000 aftershocks…. Resulting in death, widespread damage, exodus, housing shortages and ongoing stress

7. Health measures & health behaviours • The common “giants” of NZ ageing: heart disease, stroke, dementia, diabetes, cancer, arthritis, asthma & depression • The Short Form 36 (SF36) • Smoking • Alcohol use • BMI • GP visits • Health screening

8. Attitudinal measures used 1 • Felt age • Ideal age • Subjective life expectancy • Positivity to ageing • Attitudes to ageing questionnaire (AAQ) 1 English Longitudinal Study of Ageing (ELSA); Evergreen Project; Health & Retirement Study (HRS); Midlife in the US (MIDUS) 2 Australian Longitudinal Study of Ageing (ALSA); Berlin Ageing Study; HRS; Aging, Status and the Sense of Control (ASOC) 3 ELSA 2 3

9. Attitudes to Ageing Questionnaire 1 • The AAQ is a new self-report scale developed for older people to express their attitudes to the process of ageing. • Tested in 20 countries with 5,566 participants after extensive pilot-testing with a larger scale. • 24 item cross-cultural questionnaire with 3 sub-scales: • Psychosocial loss • Physical change • Psychological growth Laidlaw, Power, Schmidt and the WHOQOL Group, 2007. 1

10. AAQ results: comparison 2: Matthews, Lindner & Collins, 2007 3 & 4: Kalfoss, Low & Molzahn, 2010 5: Laidlaw, Wang, Coelho & Power, 2010 6: Quinn, Laidlaw & Murray, 2009

11. AAQ with SF36 general health 12012 120 AAQ 110 110 100 100 Male n=87 90 90 Female n=113 80 80 70 70 30 50 70 40 60 SF36 General Health

12. Does health predict attitudes to ageing?

13. Do attitudes predict health behaviours?

14. AAQ: in conclusion • CHALICE sample had more positive physical change & psychological growth, but lower psycho-social loss. • General health in the SF36 is highly correlated with the AAQ. • Current depression & arthritis were the 2 health conditions predicting attitudes to ageing. • Alcohol consumption & BMI mildly influenced by attitudes to ageing; people with higher AAQ scores had fewer GP visits.