Ageism and self-perceived ageism
The understanding of the concept "ageism" advanced considerably since 1969 when Dr. Robert Butler introduced the term to refer to the systematic discrimination against older people [1]. Lately, ageism has been conceptualized as a complex and multi-dimensional construct including cognitive (stereotypes), emotional (prejudice), and behavioral (discrimination) aspects, that can be expressed explicitly (consciously) or implicitly (subconsciously) and can be observed in the individual, social, and institutional levels. Furthermore, it is clear today that ageism can be directed to any age group, and not only against older people [2]. Ageism can be internalized and directed towards oneself (self-oriented ageism) or to others pertaining to the same age group (other-directed ageism), Finally, it can include positive attitudes as well (called perceived positive ageism), and not only negative biases and discrimination as originally considered (called perceived negative ageism) [3].
Despite these developments, research attention has mainly focused on perceived negative ageism (PNA), potentially because of its high prevalence and far-reaching deleterious ramifications in all areas of living [4, 5], such as subjective accelerated aging [6, 7], cognitive decline [8], increased social isolation and loneliness [9], increased stress, anxiety, and depressive symptoms [10, 11], poorer physical and mental health, and increased mortality [12–15]. This is rather surprising since perceived positive ageism may also have negative consequences, as is the case with so-called compassionate stereotypes, which can lead to overwhelming empathy or condescension ultimately increasing negative negative ageism [16]. One of the most harmful effects of ageism is the deterioration of older people's quality of life [4, 10, 17, 18].
Quality of life in old age and ageism
Quality of life (QoL) is a central concept in public health and its importance is continuously growing in research and public policy in general and for older people in particular. Although there is no unanimously accepted definition, QoL in old age is widely considered a multidimensional concept that covers many domains (e.g., physical, psychological, and social) [19].
The association between QoL and self-perceived ageism in older adults has been examined in different countries, using various samples and instruments. Despite these differences, all studies have reported a negative association between PNA and QoL [4, 17, 18, 20–25]. Much less is known about the effects of PPA. The few relevant studies reported a positive and weaker association of PPA with QoL (see Velainthal et al.,[25]). Thus, the first aim of this study was to expand knowledge regarding the relationship between negative and positive self-perceived ageism and QoL among older adults. Our specific hypotheses were:
H1: Self-perceived negative ageism (PNA) will be negatively and significantly associated with QoL
H2: Self-perceived positive ageism (PPA) will be positively and significantly associated with QoL
H3: The magnitude of the association will be stronger for negative rather than for positive self-ageism.
The Conservation of Resources (COR) theory and the association between ageism, QoL and psychosocial resources
The COR theory provides an adequate framework for reducing the effects of ageism on QoL. According to this theory, humans will struggle to gain and retain resources they value as well as to prevent and reduce the loss of these resources (Hobfol, 1989). In accordance with positive psychology assumptions, social and psychological resources are among the most valued assets a person can have. Studies have examined the effect of perceived social support – i.e., the belief of having friends and family who will provide all types of support if needed [26] – as the most common social resource, and reported positive correlations with QoL [27–29]. Thus, we also hypothesized that:
H4: A positive and statistically significant relationship will be found between social resources and QoL.
Psychological resources are intrapersonal attributes or personality factors that help individuals manage stress [30]. The most common psychological resources studied are self-efficacy, optimism, hope, and resilience [31]. Most studies have examined the association of QoL with different psychological resources separately (e.g., Kang & Kim, [10]; Wurm & Benyamini,[32]). However, recently it has been suggested that all these constructs share a common basis reflecting a person's reserve capacity and therefore, it is recommended to use an aggregated measure [33]. Thus, the psychological capital (PsyCap) measure has been introduced to embrace the positive psychological abilities of self-efficacy, optimism, hope, and resilience [31]. Since its introduction, the relationship between PsyCap and QoL has been well-established [34–36], though scant attempts have examined this relationship among older adults (e.g., Pramanik & Biswal,[37]). Thus, we hypothesized that:
H5: A positive and statistically significant relationship will be found between psychological capital (PsyCap) and QoL.
The moderating role of social and psychological resources
As knowledge about the adverse effects of ageism on QoL accumulates, researchers and clinicians try to identify factors that might mitigate these effects. Within the frame of stress theories in general and of the COR theory in particular, social and psychological resources have been widely considered as mediating the impact of life stressors on older persons' QoL [38], motivating, therefore, the efforts to retain them rather than to lose them. The few studies that have examined the role of social support in the relationship between ageism and QoL, have confirmed a moderating effect, particularly regarding perceptions of instrumental support [39–41].
Research about the role of psychological resources in understanding the association between ageism and QoLis much richer. The most common psychological resources examined in the area of ageism and QoL include optimism, positive emotions, confidence in the future, age proudness, and body self-confidence [10, 27, 32, 42], resilience and coping strategies [17]. Similar to social support, these studies have confirmed that psychological resources modify the effect of ageism on QoL.
Despite their importance, all studies till today have two important limitations. First, they are restricted to the examination of PNA, ignoring the associations with PPA. Second, as mentioned above, they examined different psychological resources separately and not as an aggregated measure. This study intends to address these gaps by examining the role of social and psychological resources as moderating factors of the associations of negative and positive ageism with QoL. Our hypotheses are:
H6: Social resources will moderate the effects of PNA on QoL so that the negative relationship will be weaker when levels of social support are high.
H7: Psychological resources will moderate the effects of PNA on QoL so that the negative relationship will be weaker when levels of psychological resources are high.
H8: Social resources will moderate the effects of PPA on QoL so that the negative relationship will be weaker when levels of social support are high.
H9: Psychological resources will moderate the effects of PPA on QoL so that the negative relationship will be weaker when levels of psychological resources are high.