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
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 of older adults, which is how older citizens perceive the social group of “older adults.” 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 of older adults among the older participants will be associated with lower life satisfaction.
We conducted a cross-sectional survey of community-dwelling older adults in Japan and examined the relationship between their negative perceptions and life satisfaction. Participants were enrolled in a health course conducted by local governments in Tokyo, Japan to train volunteers to read picture books to their children. 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 and/or dementia prevention). Thus, an exploratory multilevel analysis was conducted to examine the relationship between the two variables, considering the effect of participants’ residential areas. We hypothesized that participants with more negative perceptions of older adults would have lower levels of life satisfaction.
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. 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).15 Participants were required to attend the health course venue independently. Note that the data for this study were collected before the implementation of the health course; therefore, our results 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 of older adults were measured using the eight adjectives (five-point Likert scale).16 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 of older adults.
Life satisfaction was measured using the five-items of the Satisfaction with Life Scale17 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.
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 of 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, we conducted 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 of older adults (Model 3), and a random intercept and slope model with a cross-level interaction (Model 4). 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 of older adults had lower life satisfaction (β = -.16, 95% CI = [-.28, -.04], p = .008). In Model 2, we conducted a RANCOVA model with an individual-level effect (group-mean centering) of negative perceptions of older adults and found a similar effect to Model 1 (β = -.18, 95% CI = [-.30, -.05], p = .005). In Model 3, we employed a random intercept and slope model, including a group-level effect (deviating from regional means) of the negative perceptions of older adults. 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, we employed a random intercept and slope model, including cross-level interaction. 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, our hypothesis that participants with more negative perceptions of older adults have lower levels of life satisfaction was supported.
In this study, we conducted a cross-sectional survey of community-dwelling older adults in nine areas in Tokyo to examine the relationship between negative perceptions of 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 of older adults had lower life satisfaction, thus supporting our hypothesis. Note that a reverse relationship could also be assumed: individuals with lower life satisfaction have more negative perceptions of 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 our 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, we should examine whether a causal relationship exists between more negative perceptions of older adults and decreased life satisfaction. Meanwhile, given that older adults with negative perceptions of themselves have poorer mental health,10,11 positively changing their perceptions of 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.18,19 Although these findings targeted younger people, a similar experimental manipulation for older adults may affirm their perceptions of older adults. Future empirical studies are required to positively change the perceptions of old age among older adults.
This study had two 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. Therefore, our findings should be re-examined with a sufficient number of male participants.
In this study, we found an association between negative perceptions of older adults and life satisfaction 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 of older adults. In addition, we conducted an exploratory multilevel analysis. Future studies on life satisfaction and negative perceptions of older adults in a broader geographic area should consider the effects of residential areas.
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 of older adults and life satisfaction among community-dwelling older citizens in Japan, https://doi.org/10.17605/OSF.IO/X6JSN. 15
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.
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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
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