Keywords
Psychological Well-Being, Quality of Life, Stereotyping, Life Satisfaction, Multilevel Models
With the rapid aging of the population, increasing life satisfaction among older adults is essential. Negative perceptions of older adults are internalized, leading to poor mental health. This study hypothesized that participants with more negative perceptions of older adults would have lower life satisfaction.
A cross-sectional survey of older adults was conducted across five wards and four cities in Tokyo, Japan. Participants responded to questions regarding demographics, life satisfaction, and negative perceptions of older adults. Data from 285 participants (264 women, M = 71.97 years) were analyzed.
The intraclass correlation coefficient for life satisfaction concerning residential areas was. 03 (95% confidence interval [CI] = [-.03, .10]). Instead of multilevel models, a multiple regression model with life satisfaction as the dependent variable and negative perceptions of older adults and demographics as the independent variables yielded the best fit. Results indicated that participants with more negative perceptions of older adults reported lower life satisfaction (β = -.16, 95% CI = [-.28, -.04], p = .008), supporting our hypothesis.
This study was constrained by limited variance in residential areas and a predominantly female participant pool. Previous studies have shown that higher life satisfaction is associated with increased social participation and extended life expectancy, and interventions aimed at enhancing life satisfaction in older adults are significant. Further exploration is warranted to ascertain whether a causal relationship exists, wherein more negative perceptions of older adults diminish life satisfaction.
Psychological Well-Being, Quality of Life, Stereotyping, Life Satisfaction, Multilevel Models
The following modifications were made in this study in line with the reviewers' suggestions. For example, we have added the following statement to the first paragraph of Discussion: “However, the association between negative perceptions toward seniors and life satisfaction is not strong enough, so we should be careful about over-interpreting the results.” Moreover, we have added the following statement to the second paragraph of Introduction: “There are other psychological variables that affect the life satisfaction of older people, although these are not examined in detail in this study. For a review of variables that contribute to life satisfaction among older adults in Asia, please refer to the following literature. 15” In addition, we have also added the following statement to the last paragraph of Discussion: “In this study, we mainly analyzed data from older women, but we should also consider older men in the future.” Thus, the Introduction and Discussion were mainly revised.
See the authors' detailed response to the review by Chang Hyun Seo
See the authors' detailed response to the review by Michiko Iwasaki
See the authors' detailed response to the review by Joanne Hudson
See the authors' detailed response to the review by Susiana Nugraha
See the authors' detailed response to the review by Anna Zalewska
Globally, the population is aging rapidly. This is especially evident in Japan, where 29.0% of the population will be 65 years or older by 2022.1 While social problems associated with aging have become more apparent, older adults generally have a higher level of life satisfaction than other generations.2,3 However, life satisfaction among older adults in Japan has declined in recent years.4 As life satisfaction among older people is closely associated with a higher level of physical health,5 increased social participation,6 and longer life expectancy,7,8 efforts to increase life satisfaction in this demographic are of great importance.
One variable that could be related to life satisfaction among them is negative perceptions toward older adults, which is how older citizens perceive the social group of “older adults.” Some people view older adults in a positive light, while others view them in a negative light. Stereotype embodiment theory (SET) assumes that older adults internalize negative old-age perceptions.9 Moreover, the SET argues that older adults who hold more negative perceptions are more likely to experience various negative effects. Previous studies have shown that older adults with more negative perceptions have poorer mental health,10,11 lower cognitive function,12 and slower recovery from illness.13 Similar to the SET, the risks of ageism model14 suggest that three factors broadly inhibit active aging: “stereotype embodiment,” “stereotype threat,” and “being a target of ageism.” Based on the above findings, negative perceptions toward older adults among the older participants will be associated with lower life satisfaction. There are other psychological variables that affect the life satisfaction of older people, although these are not examined in detail in this study. For a review of variables that contribute to life satisfaction among older adults in Asia, please refer to the following literature.15
This study’s aim is examining the relationship between their negative perceptions toward older adults and life satisfaction. In this study, a cross-sectional survey of community-dwelling older adults in Tokyo, Japan, was conducted. The hypothesis is that participants with more negative perceptions toward older adults would have lower levels of life satisfaction. The study will also focus on the effect of the participant’s residential area. In a large survey of residents in a wide range of Japanese cities, it has been reported that people in more urban areas have fewer close neighbors who greet each other.16 Thus, results may vary depending on the participant’s residential area. Details regarding their residential area are provided in the next section.
A paper-based questionnaire survey was used in this study. Participants read the questionnaire themselves and responded using a writing instrument. A power analysis assuming a small to moderate effect size (ρ = .20, α = .05, 1–β = .80) yielded a required sample size of 193. Three hundred and two older Japanese individuals from Tokyo participated in this study. However, 17 participants were excluded from the analysis because they were < 65 years old. Thus, the data of 285 participants (aged 65–92, M = 71.97 years, SD = 5.16) were analyzed. The participants comprised 21 men and 264 women. They were older adults who voluntarily applied for a health course to train volunteers to read picture books to children, which was held in five wards and four cities in Tokyo from 2021–2022. In addition to population and economic size, each area had different main goals for the health course presented when recruiting participants (e.g., volunteer training, dementia prevention, long-term care prevention, and/or social participation). Participants were informed in advance of the objective(s) of the course. Thus, an exploratory multilevel analysis was conducted to examine the hypothesis, considering the effect of participants’ residential areas. Note that, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results. Moreover, it was unclear how strongly participants understood the course objectives. Therefore, this study analyzed the effect of merely residential areas and did not focus on the differences in the objectives of the course. A summary of the participants by residential area is available in the Open Science Framework (OSF) repository (https://doi.org/10.17605/OSF.IO/X6JSN).17
Participants were required to attend the health course venue independently. There were no other exclusion criteria specifically, as long as the participants met the criteria of being 65 years of age or older. Note that the data for this study were collected before the implementation of the health course; therefore, results in this study do not include course effects. This study was approved by the first author’s institution for ethical review.
All procedures were in accordance with the ethical standards of Tokyo Metropolitan Institute for Geriatrics and Gerontology (approval number: 748; June 10, 2020) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants in written format.
Negative perceptions toward older adults were measured using the eight adjectives (five-point Likert scale).18 Participants were asked the following question: “To what extent do you think older adults fit each of the following adjectives?” Adjectives presented to participants included “depressed” and “passive.” The mean was taken as the score (α = .89), with higher scores indicating more negative perceptions toward older adults.
Life satisfaction was measured using the five-items of the Satisfaction with Life Scale19 measured on a seven-point Likert scale. Examples of items include: “In most ways, my life is close to my ideal.” The mean was taken as the score (α = .86), with higher scores indicating a higher level of life satisfaction. Demographic variables included years of education, age, and sex. Although there may be other confounding individual difference variables, other variables were not measured in this study in consideration of participants’ burden.
Participants received an explanation regarding the use of survey data for research purposes and agreed to participate in the study. Subsequently, they responded to demographic variables, life satisfaction, and negative perceptions toward older adults. The statistical software R (ver.4.1.0) was used for all analyses. The list of questions, data used in the analysis, scripts for R, histograms for each variable, and summary statistics can be accessed through the OSF.
The intraclass correlation coefficient (ICC) for life satisfaction concerning residential areas was.03 (95% CI = [-.03, .10]). Therefore, applying a multilevel analysis was not necessary. However, in this study, a simple multiple regression analysis (Model 1), a random effect with an analysis of covariance (RANCOVA) model, including the effect of residential area (Model 2), a random intercept and slope model with a group-level effect of negative perceptions toward older adults (Model 3), and a random intercept and slope model with a cross-level interaction (Model 4) were conducted. These models were compared in Table 1.
Model 1 | Model 2 | Model 3 | Model 4 | |||||
---|---|---|---|---|---|---|---|---|
β | 95%CI | β | 95%CI | β | 95%CI | β | 95%CI | |
NP | -.16** | [-.28, -.04] | — | — | — | |||
NP (individual) | — | -.18** | [-.30, -.05] | -.16 | [-.33, .02] | -.15 | [-.33, .04] | |
NP (area) | — | — | -.07 | [-.58, .42] | -.08 | [-.66, .44] | ||
NP (ind.×area) | — | — | — | .02 | [-.14, .18] | |||
Education years | .06 | [-.06, .18] | .06 | [-.06, .18] | .06 | [-.05, .19] | .06 | [-.05, .19] |
Age | -.07 | [-.19, .06] | -.05 | [-.17, .08] | -.03 | [-.16, .09] | -.03 | [-.16, .09] |
Sex | -.09 | [-.20, .03] | -.09 | [-.20, .03] | -.09 | [-.20, .03] | -.09 | [-.20, .03] |
AIC | 808.53 | 826.30 | 831.20 | 836.38 | ||||
BIC | 830.44 | 851.87 | 867.72 | 876.56 |
Life satisfaction was used as the dependent variable in each analysis. In Model 1, a multiple regression analysis including the demographics (years of education, age, and sex) showed that participants with more negative perceptions toward older adults had lower life satisfaction (β = -.16, 95% CI = [-.28, -.04], p = .008). In Model 2, a RANCOVA model with an individual-level effect (group-mean centering) of negative perceptions toward older adults was conducted and a similar effect to Model 1 (β = -.18, 95% CI = [-.30, -.05], p = .005) was found. In Model 3, a random intercept and slope model, including a group-level effect (deviating from regional means) of the negative perceptions toward older adults, was employed. The results showed that the individual-level effect (β = -.16, 95% CI = [-.33, .02], p = .11) and the group-level effect (β = -.07, 95% CI = [-.58, .42], p = .80) were not significant. In Model 4, a random intercept and slope model, including cross-level interaction, was employed. The results showed that the individual-level effect (β = -.15, 95% CI = [-.33, .04], p = .18), the group-level effect (β = -.08, 95% CI = [-.66, .44], p = .77), and the cross-level interaction (β = .02, 95% CI = [-.14, .18], p = .85) were not significant.
Model comparisons were conducted using the Akaike’s information criterion and the Bayesian information criterion, and Model 1 was determined to fit the data best. Note that when participants aged under 70 (n = 103) and 70 or over (n = 182) were analyzed separately; the results for both groups were similar to those in the main manuscript (see OSF). Similar results were obtained in a multiple regression analysis using a dummy variable for the residential area, with zero for the ward and one for the city (see OSF). Thus, the hypothesis in this study that participants with more negative perceptions toward older adults have lower levels of life satisfaction was supported.
In this study, a cross-sectional survey of community-dwelling older adults in nine areas in Tokyo was conducted to examine the relationship between negative perceptions toward older adults and life satisfaction. Each multilevel model fits the data worse than the simple multiple regression analysis. The results showed that participants with more negative perceptions toward older adults had lower life satisfaction, thus supporting the hypothesis. However, the association between negative perceptions toward seniors and life satisfaction is not strong enough, so we should be careful about over-interpreting the results. Note that a reverse relationship could also be assumed: individuals with lower life satisfaction have more negative perceptions toward older adults. The same association was found when this possibility was examined, as in the main manuscript (see OSF).
In this study, the ICC for life satisfaction in residential areas was small, and the fit of each multilevel model was relatively low. One reason for this may be that the participants were limited to those in a health course, training volunteers to read picture books. While detailed motivations for participating in the course varied from individual to individual, the attitude of “I am interested in picture books” and “I want to work as a volunteer” was probably shared by almost all participants. Thus, possibly, the group-level effect was relatively small due to the presence of factors common to participants across residential areas.
As this study is a cross-sectional survey, it should be examined whether a causal relationship exists between more negative perceptions toward older adults and decreased life satisfaction. Meanwhile, given that older adults with negative perceptions toward themselves have poorer mental health,10,11 positively changing their perceptions toward older adults is important. One way to achieve this is to present people with information that contradicts negative old-age stereotypes. For example, negative stereotypes exist that “older adults are prone to illness,” but it was shown that presenting people with the content that “many older adults are healthy enough and able to live on their own” decreased ageism toward older adults.20,21 Although these findings targeted younger people, a similar experimental manipulation for older adults may affirm their perceptions toward older adults. Future empirical studies are required to positively change the perceptions toward old age among older adults.
In this study, a cross-sectional survey of community-dwelling older adults who voluntarily applied for a health course to train volunteers to read picture books to children in Tokyo was conducted. Although course improvement is not the main objective of this study, the findings of this study can be partially utilized to improve programs aimed at promoting the health of older adults. For example, reducing negative perceptions toward older adults prior to enrolling in a program may make it easier for them to achieve greater life satisfaction. As noted above, this study is limited to the examination of correlations, and longitudinal experiments should be conducted in the future.
This study had three major limitations. First, the areas covered in this study were all located in Tokyo, Japan, and the regional differences were small. Compared with Japan’s underpopulated regions, all nine regions in this study share a high population density and a very small number of people engaged in agriculture, forestry, and fisheries. Therefore, follow-up studies are required to select regions with significantly different geopolitical characteristics from a wide range of prefectures. Second, the participation was skewed toward women. Since this study was conducted before a health course to train volunteers to read picture books to children, women comprised the majority of the participants. Note that results similar to those in the main manuscript were obtained when the analysis was limited to women’s data (see OSF); however, this study could not make adequate comparisons between men and women. It may be important to promote post-retirement social participation, especially with regard to men. Therefore, the findings in this study should be re-examined with a sufficient number of male participants. Third, 95% Cis for the group-level and cross-level interaction effects in Models 3 and 4 were wide. This indicates that the estimates contained large uncertainties. This may be due to insufficient sample size for each area. While it is significant that the survey was conducted in a wide range of areas, the number of participants in each area was insufficient. Therefore, elaborate estimates of group-level effects and interactions should be made in the future.
In this study, a significant association between negative perceptions toward older adults and life satisfaction was found among community-dwelling older adults. Interventions that increase life satisfaction in older adults are meaningful because higher life satisfaction leads to increased social participation and longer life expectancies. Thus, it would be useful to focus on the negative perceptions toward older adults. The strength of this study is that the analysis of the relationship between negative perceptions toward older adults and life satisfaction takes into account the effects of residential areas. Future studies on life satisfaction and negative perceptions toward older adults in a broader geographic area should consider regional effects. In this study, we mainly analyzed data from older women, but we should also consider older men in the future.
All procedures were in accordance with the ethical standards of the research committee of Tokyo Metropolitan Institute for Geriatrics and Gerontology, (approval number: 748; June 10, 2020 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written Informed consent was obtained from all individual participants included in the study.
The data used in the analysis is available in the Open Science Framework (OSF) repository:
Negative perceptions toward older adults and life satisfaction among community-dwelling older citizens in Japan, https://doi.org/10.17605/OSF.IO/X6JSN.17
The project contains the following data:
• old image place4.csv (dataset),
• old image place code_3.R (the R codes for analysis),
• OSF_supplemental_1.pdf (supplementary file of the manuscript).
This data was collected and formed by the authors of this paper. The license of this data is CC-BY 4.0 International.
The authors acknowledge the continued efforts in the management of survey by Senior Citizen Activities Promotion Section in Welfare Division of Hachioji City in Tokyo, Japan. The authors also thank members of the Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology.
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Gerontology, Public Health, Mental Health, Health Promotion
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Social Policy analysis
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Exercise Psychology; Older adults
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Exercise Psychology; Older adults
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Partly
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Assessment of ageism; caregiving, and minority mental health
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Partly
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Partly
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Social Policy analysis
Is the work clearly and accurately presented and does it cite the current literature?
Yes
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
I cannot comment. A qualified statistician is required.
Are all the source data underlying the results available to ensure full reproducibility?
No source data required
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Exercise Psychology; Older adults
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: health sciences
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Partly
If applicable, is the statistical analysis and its interpretation appropriate?
Partly
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
No
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Gerontology and Public Health
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Partly
Are sufficient details of methods and analysis provided to allow replication by others?
Partly
If applicable, is the statistical analysis and its interpretation appropriate?
Yes
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: health sciences
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | |||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | |
Version 4 (revision) 11 Mar 25 |
read | read | read | ||
Version 3 (revision) 24 Feb 25 |
read | ||||
Version 2 (revision) 23 Aug 24 |
read | read | read | read | |
Version 1 09 May 24 |
read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)