Exploring the bidirectional influence between awareness of age-related change and health outcomes in the second half of life

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Our society tends to view older people (i.e., those aged > 65 years) as being frail, sad, and forgetful. However, this is not the reality for many. Older aged people can experience both positive and negative changes. Examples of positive changes are increased free time to spend with friends or increased knowledge. Examples of negative changes are reduced energy and poorer memory. To capture the positive (gains) and negative (losses) changes an individual may experience as they age, a questionnaire assessing Awareness of Age Related Changes (AARC) was created. It asks about the gains and losses people perceive from mid-life to older age in five domains including cognition, mood, physical health, social relations, and lifestyle. My PhD documented for the first time levels of AARC gains and AARC losses among UK residents aged 50 + years. On average, people reported higher AARC gains than AARC losses and the losses they experienced mostly related to reduced energy and having to abandon physically demanding activities such as running. However, one's experience of age-related changes is unique, and each person can report different degrees of AARC gains and AARC losses. For example, healthier people reported higher AARC gains and lower AARC losses, compared to those in poorer health. Hence, my PhD contributed to ageing research by showing that asking people about the age-related changes they experience may help to identify those struggling the most while ageing.However, we do not know what is the causal relationship between AARC and one's health. For example, those people that find it increasingly harder to remember things, experience new illnesses, or have low mood as they age, may notice these negative changes in their daily life and, consequently, report lower AARC gains and higher AARC losses. Alternatively, those who think that losses are an inevitable part of ageing, also tend to believe they have little control over their health and, consequently, are less likely to make the effort to follow a healthy lifestyle. Due to lack of engagement in healthy behaviours, such as physical activity, those who believe that losses are intrinsic in older age may experience poorer health over time and report higher AARC losses and lower AARC gains. Finally, it may be that the occurrence of losses in one health domain shapes individuals' perception of their ageing which in turn influences other aspects of their health. For instance, memory difficulties may lead to perceived AARC losses which may then trigger poor mood. This fellowship aims to start addressing the link between AARC and health. This is important for informing the development of new strategies for promoting health in mid to old age. For example, if we were to find that those people whose cognitive abilities have been decreasing report higher AARC losses, asking people to complete the AARC questionnaire would help to detect those at higher risk of further cognitive decline. Such individuals could be enrolled in cognitive training and other programs aimed at delaying further cognitive impairment. Another example, if we were to find that those who report higher AARC losses experience poorer future health and, that this is somewhat due to them not engaging in healthy behaviours, assessing AARC would help to identify those who would benefit most from programs promoting positive views of older age, positive self-perceptions of ageing, greater self-efficacy, and a healthy lifestyle. I aspire to lead an independent, world renowned program of work in the fields of health and ageing. This fellowship would be the first step toward achieving this goal. It would enable me to extend my PhD research and strengthen the empirical basis for future fellowship applications focused on developing new interventions for promoting more positive self-perceptions of ageing and health in the older population. It would also maximise the dissemination of my work and help widen my network of collaborators.