Attitudes to Ageing in Midlife Anna Thorpe, Peter Joyce, John Pearson, Philip Schluter 1 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. 1 • Used the Attitudes to Ageing Questionnaire (AAQ) on a midlife population in New Zealand. 1 2 Levy et al, 2002 Laidlaw et al, 2007 2 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 90 85 80 Non-Māori Women Non-Māori Men Māori Women Māori Men 75 70 65 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006 Statistics New Zealand 3 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. 4 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. 5 Canterbury Earthquakes Over 12,000 aftershocks…. Resulting in death, widespread damage, exodus, housing shortages and ongoing stress 6 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 7 Attitudinal measures used • • • • • Felt age 1 Ideal age Subjective life expectancy 2 Positivity to ageing 3 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 8 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 subscales: • Psychosocial loss • Physical change • Psychological growth 1 Laidlaw, Power, Schmidt and the WHOQOL Group, 2007. 9 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 10 AAQ with SF36 general health 120 120 12 110 110 100 100 Male n=87 AAQ 9090 Female n=113 8080 7070 30 40 50 60 SF36 General Health 70 11 Does health predict attitudes to ageing? Health condition Beta value Allergies -.053 Asthma -.110 Arthritis -.163 * Cancer .035 Chronic obstructive pulmonary disease .041 Depression – current -.226 ** Depression – lifetime -.006 Diabetes -.107 Heart disease -.052 High blood pressure measurement .079 Hypertension -.008 Stroke .062 SF36 General Health .528 *** 12 Do attitudes predict health behaviours? Health behaviour Beta value Alcohol audit -.158 * BMI -.173 * GP Visit -.205 ** Health screening -.071 Smoking -.114 13 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. 14