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

我们的社会倾向于认为老年人(即那些65岁的人)是虚弱、悲伤和健忘的。然而，对许多人来说，这并不是现实。老年人既可以经历积极的变化，也可以经历消极的变化。积极变化的例子包括与朋友共度的空闲时间的增加或知识的增长。消极变化的例子是能量减少和记忆力下降。为了捕捉个体随着年龄的增长可能经历的积极(收益)和负面(损失)变化，创建了一份评估年龄相关变化意识的问卷(AARC)。它询问人们从中年到老年在认知、情绪、身体健康、社会关系和生活方式等五个领域的得失。我的博士学位首次记录了50岁以上英国居民的AARC收益和AARC损失水平。平均而言，人们报告的AARC收益高于AARC损失，他们经历的损失主要与能量减少和不得不放弃跑步等体力消耗活动有关。然而，一个人对年龄相关变化的体验是独一无二的，每个人都可以报告不同程度的AARC收益和AARC损失。例如，与健康状况较差的人相比，健康的人报告的AARC收益更高，AARC损失更低。因此，我的博士学位对衰老研究做出了贡献，因为它表明，询问人们与年龄相关的变化可能有助于识别那些在衰老时最挣扎的人。然而，我们不知道AARC和一个人的健康之间有什么因果关系。例如，那些发现随着年龄的增长越来越难以记忆事物、经历新疾病或情绪低落的人，可能会注意到日常生活中的这些负面变化，因此，报告ARC收益较低，AARC损失较高。或者，那些认为减重是衰老不可避免的一部分的人，也倾向于认为他们几乎无法控制自己的健康，因此不太可能努力遵循健康的生活方式。由于缺乏对健康行为的参与，如体力活动，那些认为减重是老年人固有的，随着时间的推移，他们可能会经历更差的健康状况，报告更多的AARC损失和更低的AARC收益。最后，一个健康领域的损失的发生可能塑造了个人对自己衰老的看法，而这反过来又影响了他们健康的其他方面。例如，记忆障碍可能会导致感知到的AARC缺失，这可能会引发糟糕的情绪。这一奖学金旨在开始解决AARC与卫生之间的联系。这对于制定促进中老年健康的新战略很重要。例如，如果我们发现那些认知能力一直在下降的人报告了更高的AARC损失，要求人们完成AARC问卷将有助于发现那些认知能力进一步下降的风险更高的人。这些人可以参加认知培训和其他旨在延缓进一步认知障碍的计划。另一个例子是，如果我们发现那些报告AARC损失较高的人未来的健康状况较差，这在某种程度上是由于他们没有从事健康的行为，评估AARC将有助于确定那些将从促进积极的老年观点、积极的老龄化自我认知、更高的自我效能感和健康的生活方式的计划中受益最大的人。我渴望在健康和老龄化领域领导一个独立的、世界知名的工作计划。这一奖学金将是实现这一目标的第一步。这将使我能够扩展我的博士研究，并加强未来奖学金申请的经验基础，重点是开发新的干预措施，促进老年人对老龄化和健康的更积极的自我认知。它还将最大限度地传播我的作品，并帮助扩大我的合作者网络。

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.