Anxiety About Aging
Definition and Overview
Aging anxiety describes negative feelings and fears associated with growing older, including physical, psychological, social, and transpersonal losses (Lasher and Faulkender 1993). Fears related to physical losses include changes in health and functional abilities, such as being diagnosed with a disease or changes in one’s ability to attend to personal care like bathing; however, anxiety about physical changes also comprises those shifts in sexuality and outward appearance, such as loss of hair or wrinkles. Anxiety about psychological losses involves fears of dependency, loss of personal control, cognitive decline, and poor life satisfaction. Concerns about social losses center on relationships, including the number and quality of interactions with others and fear of loss also incorporates economic issues or lack of employment. Finally, fears associated with transpersonal losses are related to how one will face death as well as evaluate one’s life for meaning. That is, one’s existential identity, which may be related to religious or spiritual beliefs, must be reconciled. All of these fears associated with change and loss drive both aging anxiety and anxiety about being “old” (Lasher and Faulkender 1993).
Fear about aging stems, at least in part, from ageist biases and internalized stereotypes (see “Age Stereotypes”). Graying hair and wrinkles signify aging and thus are associated with decline and death, and the media perpetuate the notion that these natural changes should be “fought.” (see “Anti-Aging Movement in Mass Media”) Social messages that promote the beauty ideal, which is associated with youth and impacts women to a greater extent, was aptly named by Susan Sontag (1972) as the “double standard of aging.” (see “Appearance and Gender in Later Life”) That is, women feel greater pressure to maintain their “faces” as this is seen as one of their key assets (Sontag 1997), and this creates aging anxiety that rests on the fear that signs of aging equate to loss of attractiveness. Thus, participation in the antiaging industry or the so-called cosmeceuticals – a combination of cosmetic and pharmaceutical that is used to describe the medicalization of physical appearance (Bayer 2005) – is encouraged. As a result, the antiaging movement is socially accepted and feeds a major market in products and nonsurgical cosmetic procedures, such as Botox (Chonody and Teater 2018). The vilification of these changes in turn shapes the meaning that is attached to age and aging at the personal level and feeds aging anxiety.
Key Research Findings
Research findings support the association between ageist beliefs and anxiety about aging (Chonody and Wang 2014). In a study of college students, negative beliefs about personal aging helped predict participants’ dread of looking old (Chonody and Teater 2016). Perpetuation of the youth ideal and its association with beauty and vitality leads to the depiction of older people as the embodiment of physical (see “Abelism and Aging”) or mental inadequacy, which helps cement aging stereotypes, particularly when intergenerational contact is low. In fact, aging anxiety has been linked with poor knowledge about the aging process (Allan and Johnson 2008) and lack of contact with older people (Chonody et al. 2014) across numerous studies (see “Intergenerational Exchanges”). Research also indicates that negative beliefs about age and aging are amenable to change through thoughtful intervention (see “Intergenerational Programs”), such as the use of positive education about aging and contact experiences with older people (Levy 2018), which further supports the link between negative beliefs and fears about the aging process.
In addition to cultural norms and media messaging, death anxiety also likely plays a role in aging anxiety and biases toward older people. Terror management theory (TMT) provides a perspective on how fear of death shapes thinking and behavior. At the heart of TMT is the idea that being “old” is associated with “death,” which stimulates anxiety. To thwart this feeling, situations that are reminders of the fact that one will die are avoided (Becker 1962, 1973), but this is merely a self-preservation instinct (see “Terror Management Theory and Implications for Older Adults”). It is only natural to avoid a situation that presents a threat to survival (Greenberg et al. 1986). Older people are stark reminders that aging is inevitable and that life is finite. This knowledge provokes a deeply held anxiety that one likely feels compelled to suppress. Some research evidence supports TMT in explaining aging fears. For example, college students reported greater death anxiety after they were shown pictures of older people and also sought to increase their social distance from them (Martens et al. 2004). Aging anxiety, including both outward appearance and fears associated with loss, has been shown to predict death anxiety (Benton et al. 2007), and death anxiety helped explain fears of looking old in another study (Chonody and Teater 2016).
Culture and anxiety about death may be contributors to aging anxiety, but the consequences of this anxiety impact individuals differently in part depending on their age and gender. Overall, younger people tend to have more negative attitudes toward aging than older people do (Laidlaw et al. 2018), and this may be manifested in a variety of different ways. To help alleviate aging anxiety, albeit temporarily, purchasing and using products aimed at reducing the signs of aging may be sought out, which are primarily marketed to young and middle-aged women (see “Anti-Aging Strategies”). Even when women are critical of antiaging messages found in the media, they still purchased these antiaging products according to one study (Muise and Desmarais 2010). This suggests that it is hard to escape the cultural messages and expectations even when it is clear that they are false. Evidence from other studies suggest that aging anxiety is also associated with eating disorders. That is, fears about physical and psychological losses associated with aging were predictors of disordered eating in a study of women aged 18–39 (Mahoney 2018), and related studies suggest that body dissatisfaction is greater among those with increased aging anxiety (Gendron and Lydecker 2016).
While the well-being of both young (Barrett and Toothman 2016) and older people can be negatively impacted by fears of the aging process, additional emotional responses may occur when older people are experiencing aging anxiety. This substantive area of research in not well-developed (Bryant et al. 2012), but negative attitudes toward aging have been found to be correlated with depression (Chachamovich et al. 2008), and in another study, personal distress was found to predict higher levels of aging anxiety (Allan et al. 2014). It is challenging to establish the order in which these emotional reactions occur, but it appears the association between anxiety and quality of life are linked (see “Quality of Life”). In a study of older adults in Australia, research indicated that positive attitudes toward aging were associated with higher levels of life satisfaction, better self-reported physical and mental health, and lower levels of both depression and anxiety (Bryant et al. 2012). In a qualitative study that explored how older adults perceive the aging process, the issue of aging anxiety was found to temper the positive attitudes of participants. That is, older adults celebrated a sense of freedom associated with aging in which they stopped caring if others would accept them, yet this sense of freedom was truncated by fears associated with decline in health and economic losses (Shaw and Langman 2017).
Moreover, when older adults are experiencing a negative event associated with aging (e.g., age-related illness), anxiety associated with aging may be more prevalent. In one study of older people, it was found that those with dementia compared to those without dementia more strongly agreed that aging was a time of a loss (Trigg et al. 2012), which is one indicator of aging fear or anxiety. These findings are echoed in another study, which found that attitudes toward aging among older adults were influenced by depression, perception of health, quality of life, and limitations in activities (Janecková et al. 2013). Taken together, these results indicate that the relationship between depression, anxiety, personal distress, and aging anxiety is a complex issue.
Future Directions for Research
Additional research is needed to disentangle how these emotional factors relate to or predict one another in the experience of anxiety about aging, particularly among older people who may be more vulnerable to negative outcomes to their health and well-being. Greater understanding of the factors that fuel anxiety about aging across the developmental life-span would inform interventions that can be tailored to the concerns and needs of various age groups. Longitudinal research that seeks to investigate how prevention of aging anxiety could positively impact both the aging process and one’s outlook as an older person could be very valuable in maintaining health and well-being. Future research should also seek to delve deeper into how antiaging culture impacts men as there is increased social pressure for them to maintain middle-aged standards of appearance and performance. Everyone is currently in the process of aging; thus, garnering evidence on what helps thwart anxiety about it can facilitate a healthier and happier population.
Anxiety about aging is detrimental to the individual, and collectively, it has a negative effect on society. It is something that can be experienced by people of any age, and its impact ultimately leads to a distancing and fear of the aging process and those who represent it, that is, older people. For younger people, aging anxiety can support ageism, death anxiety, and a focus on antiaging products and procedures. For older people, their health and well-being can decline when aging anxiety is high. Social messages that promote the value of individuals across the age-spectrum would be one positive step forward in change, but examining personal biases and beliefs is an immediate way to start making changes that will contribute to a better outlook on the aging process.
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