1. Attitudes to Ageing in Midlife Anna Thorpe, Peter Joyce, John Pearson, Philip Schluter 1

2. 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. Used the Attitudes to Ageing Questionnaire (AAQ) on a midlife population in New Zealand. 2 1 Levy et al, 2002 Laidlaw et al, 2007 1 2

3. 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 Statistics New Zealand 3

4. 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

5. 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

6. Canterbury Earthquakes 6 Over 12,000 aftershocks…. Resulting in death, widespread damage, exodus, housing shortages and ongoing stress

7. 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

8. Attitudinal measures used Felt age Ideal age Subjective life expectancy Positivity to ageing 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 1 2 3

9. Attitudes to Ageing Questionnaire 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 sub- scales: Psychosocial loss Physical change Psychological growth Laidlaw, Power, Schmidt and the WHOQOL Group, 2007. 9 1 1

10. AAQ results: comparison 10 2: Matthews, Lindner & Collins, 2007 3 & 4: Kalfoss, Low & Molzahn, 2010 5: Laidlaw, Wang, Coelho & Power, 2010 6: Quinn, Laidlaw & Murray, 2009

11. AAQ with SF36 general health AAQ 11 SF36 General Health 70 Male n=87 Female n=113 80 90 100 110 120 12 70 80 90 100 110 120 40 30 50 60 70

12. Does health predict attitudes to ageing? Health conditionBeta 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

13. Do attitudes predict health behaviours? Health behaviourBeta value Alcohol audit-.158 * BMI-.173 * GP Visit-.205 ** Health screening-.071 Smoking-.114 13

14. 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