Perceived Ageism and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Analysis From...

Perceived ageism may affect health in later life, but longitudinal associations across diverse outcomes, particularly cognitive and functional outcomes, remain unclear. We examined these associations among community-dwelling older adults in Japan.

We conducted a secondary outcome-wide longitudinal analysis using data from the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort of community-dwelling adults aged 65 years and older. Perceived ageism was measured in 2019 as self-reported age-based discrimination experienced in the preceding 12 months. Participants were followed for 3 years, with outcomes assessed in 2022. A total of 47 outcomes across health and well-being domains were examined. Regression models adjusted for prespecified baseline covariates, including prior outcome measures when available, were used with Bonferroni correction. Sex-stratified and sensitivity analyses, including E-value analyses, were also performed.

Among participants with observed exposure data in the survey-based sample, 335 of 4299 (7.8%) reported perceived ageism. After correction for multiple comparisons, perceived ageism was significantly associated with lower happiness (β, -0.19; 95% confidence interval [CI], -0.27 to -0.11), increased depressive symptoms (β, 0.21; 95% CI, 0.14 to 0.29), and higher risks of incident dementia (odds ratio [OR], 1.77; 95% CI, 1.31 to 2.39), incident functional disability at any level (risk ratio [RR], 1.42; 95% CI, 1.21 to 1.67), and incident functional disability at Level 2 or higher (OR, 1.71; 95% CI, 1.26 to 2.30). Sex-stratified estimates suggested associations with functional disability at Level 2 or higher among men and with lower happiness and greater depressive symptoms among women, although multiplicative interaction tests by sex were not statistically significant and additive interaction findings were only nominal.

Perceived ageism was associated with adverse mental, cognitive, and functional outcomes over a 3-year period. These findings support recognizing ageism as a potentially modifiable social determinant of health and well-being in later life.