Exploration of the relationship between attitudes and expectations regarding ageing and health behaviours in older adults: a thesis portfolio
McColl, Ashley L.
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Background: With life expectancies continuing to rise and more people living beyond the age of 65, health services are under increasing pressure to provide effective care for an ageing population. Increased life expectancy increases the risk of long-term conditions like Type 2 Diabetes and cardiovascular disease that require self-management – something that poses a challenge for many people, and for older adults there may be additional barriers. Identifying modifiable factors that impede self-management is an ongoing focus in the literature; and in recent years increasing attention has been paid to the impact of individuals’ attitudes to their own ageing. Aims: The first part of this thesis portfolio is a systematic review of the literature that aims to answer the question “Are lower expectations regarding ageing associated with lower levels of physical activity in older adults?” The second is an empirical study that aims to explore the relationships between attitudes to ageing, executive function, glycaemic control and selfmanagement adherence in older adults with Type 2 Diabetes. Method: A systematic literature search was undertaken to identify studies reporting quantitative analyses of the relationship between expectations regarding ageing and physical activity. Methodological quality of the studies was appraised and synthesized, and clinical and research implications discussed. In the empirical study; 77 older adults completed self-report measures of attitudes to ageing and self-management adherence, and two brief measures of executive function. HbA1c; a biological measure of glycaemic control was also recorded for each participant. Correlations and multiple linear regressions tested the relationships between attitudes to ageing, EF, self-management and glycaemic control. Results: 8 studies (derived from 9 papers) were eligible for the systematic review, and were in consensus in their support of lower expectations regarding ageing being associated with lower levels of physical activity. The findings of the empirical study indicated that more negative attitudes to ageing in relation to physical changes predicted poorer self-management; and more negative attitudes to ageing in relation to psychosocial loss predicted poorer glycaemic control. Conclusion: The current findings are in line with an emerging evidence base supporting a relationship between attitudes to ageing, and physical health outcomes and behaviours; with more negative attitudes and perceptions of old age acting as a barrier to health promoting behaviours. Therefore, interventions targeting those cognitions could help to promote better health outcomes for older populations, as well as promoting healthy ageing and valuing older people – a current focus in policy and strategy.