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Response to Van Orden's Commentary on “COVID-19 Related Loneliness and Psychiatric Symptoms Among Older Adults: The Buffering Role of Subjective Age”

Published:August 25, 2020DOI:https://doi.org/10.1016/j.jagp.2020.08.014
      In a recent commentary
      • Van Orden K
      Considering the impact of research assessments: a commentary on “COVID-19 related loneliness and psychiatric symptoms among older adults:the buffering role of subjective age”.
      on our article
      • Shrira A
      • Hoffman Y
      • Bodner E
      • et al.
      COVID-19 related loneliness and psychiatric symptoms among older adults: the buffering role of subjective age.
      addressing the association between COVID-19 related loneliness and psychiatric symptoms in older adults and the moderating role of subjective age, concerns were raised both vis-à-vis the loneliness measure and possible negative effects of assessing subjective age.
      Concerning loneliness, we agree that multifaceted measures of loneliness could provide a richer perspective.
      • van Tilburg TG
      • Steinmetz S
      • Stolte E
      • et al.
      Loneliness and mental health during the COVID-19 pandemic: a study among Dutch older adults.
      Yet as our goal was to rapidly collect and publish the much needed data on older adults' reactions during the pandemic, we applied a brief and common loneliness measure, administering it during a lockdown period (items were accordingly framed), rendering likely that responses reflected COVID-19 loneliness.
      With regard to subjective age, beginning from the end, we endorse the author's
      • Van Orden K
      Considering the impact of research assessments: a commentary on “COVID-19 related loneliness and psychiatric symptoms among older adults:the buffering role of subjective age”.
      suggestion to consider how older participants feel about survey questions, and to ask them for suggestions to improve their experience. Nevertheless, we disagree with the notion presented in the commentary that subjective age assessment perpetuates ageism.
      Our data, as well as that of others, suggests that subjective age assessment does not reinforce internalized ageism or have other negative effects.
      • Bodner E
      • Shrira A
      • Hoffman Y
      • et al.
      Day-to-day variability in subjective age and ageist attitudes and their association with depressive symptoms.
      Assessing subjective age on a daily basis did not cause respondents to feel older; thus, there was no iatrogenic effect.
      • Bodner E
      • Shrira A
      • Hoffman Y
      • et al.
      Day-to-day variability in subjective age and ageist attitudes and their association with depressive symptoms.
      Furthermore, while one's ageist attitudes predicted feeling older on succeeding days, one's subjective age did not predict subsequent ageist attitudes.
      • Bodner E
      • Shrira A
      • Hoffman Y
      • et al.
      Day-to-day variability in subjective age and ageist attitudes and their association with depressive symptoms.
      Although it can be affected by ageist attitudes, subjective age cannot be reduced to a mere facet of ageism. Rather it should be broadly conceptualized as a biopsychosocial marker of aging, which is based on spontaneous self-reflection and regulation of one's own identity, development, resources, and stressors.
      • Stephan Y
      • Sutin AR
      • Terracciano A
      Determinants and implications of subjective age across adulthood and old age.
      For example, when older adults meet challenges, like young persons, they can either avoid or engage, but their attributions may be age related. An example of avoidance may be, "because of my age related arthritis I cannot hike safely anymore." Noticing the change from a prearthritis younger self to the negative implications of an "arthritic self," will likely lead to an older age identity. Yet via engaging adaptively to meet challenges successfully, for example, "hiking safely in a group with a medic," one may continue to enjoy the pleasurable activities enjoyed at younger ages, thereby maintaining a younger age identity. Indeed, an initial promising intervention shows both increased physical activity and younger subjective ages. This suggests that older adults benefit from resuming greater activity levels, as they did when they were younger.
      • Brothers A
      • Diehl M
      Feasibility and efficacy of the AgingPlus Program: changing views on aging to increase physical activity.
      To conclude, as the premise that subjective age assessment reinforces ageist attitudes (or other negative effects), lacks evidence, we call to continue researching subjective age. Not to do so, would be wrong, as subjective age is linked with multitude outcomes, such as coping with adversity and health outcomes.
      • Stephan Y
      • Sutin AR
      • Terracciano A
      Determinants and implications of subjective age across adulthood and old age.
      While we sincerely share in some of the concern regarding subjective age, these very claims also constitute a slippery slope, which can lead to the stance that it is ageist to study natural self-reflections on the passage of time and its inherent wear and tear.

      Disclosure

      No disclosures/conflict of interest to report.
      This project was not supported by funding.

      References

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        Considering the impact of research assessments: a commentary on “COVID-19 related loneliness and psychiatric symptoms among older adults:the buffering role of subjective age”.
        Am J Geriatr Psychiatry. 2020; 28: 1205-1207https://doi.org/10.1016/j.jagp.2020.08.003
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        • et al.
        COVID-19 related loneliness and psychiatric symptoms among older adults: the buffering role of subjective age.
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        Loneliness and mental health during the COVID-19 pandemic: a study among Dutch older adults.
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        Day-to-day variability in subjective age and ageist attitudes and their association with depressive symptoms.
        J Gerontol B-Psychol. 2020; https://doi.org/10.1093/geronb/gbaa125
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        Determinants and implications of subjective age across adulthood and old age.
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