Do older adults expect to age successfully? The association between expectations regarding aging and beliefs regarding healthcare seeking among older adults

OBJECTIVES: To measure expectations regarding aging among community-residing-older adults, identify characteristics associated with having low expectations regarding aging, and examine whether expectations regarding aging are associated with healthcare-seeking beliefs for age-associated conditions. DESIGN: Self-administered mail survey. SETTING: Greater Los Angeles. PARTICIPANTS: Four hundred twenty-nine of 588 (73%) randomly selected community-residing adults aged 65 to 100 (mean age 76) cared for by 20 primary care physicians; 54% were women, and 76% were white. MEASUREMENTS: The Expectations Regarding Aging Survey, a validated survey measuring expectations regarding aging; 13 items measuring care seeking beliefs; and validated measures of health status. RESULTS: More than 50% of participants felt it was an expected part of aging to become depressed, to become more dependent, to have more aches and pains, to have less ability to have sex, and to have less energy. After adjusting for sociodemographic and health characteristics using multivariate regression, older age was independently associated with lower expectations regarding aging (P < .001), as was having lower physical and mental health-related quality of life. Having lower expectations regarding aging was independently associated with placing less importance on seeking health care (P = .049). CONCLUSIONS: Most older adults in this sample did not expect to achieve the model of successful aging in which high cognitive and physical functioning is maintained. Older age was independently associated with lower expectations regarding aging. Furthermore, having low expectations regarding aging was independently associated with not believing it important to seek health care.