Attitudes to Aging Questionnaire (AAQ)

Abstract

The Attitudes to Ageing Questionnaire (AAQ) is a comprehensive self-report measure designed to assess the subjective experience and multidimensional attitudes towards ageing held by older adults. Developed by Laidlaw and colleagues in 2007, the instrument consists of 24 items structured across three distinct domains: Psychosocial Loss, Physical Change, and Psychological Growth. The AAQ is intended for use in research and clinical settings to understand how individual perceptions of the ageing process influence well-being and adjustment. It is recognized for its robust psychometric properties, supporting its use as a reliable tool in Geriatric Psychiatry and psychology.

Keywords

Attitudes to Ageing Questionnaire, AAQ, psychological growth, psychosocial loss, physical change, subjective ageing, gerontology, psychometrics, well-being

Authors

Laidlaw, K., Power, M., Schmidt, S., Skevington, S., and T. W.-O. G.

Purpose

The primary purpose of the Attitudes to Ageing Questionnaire (AAQ) is to provide a standardized, cross-culturally validated measure of the positive and negative subjective attitudes individuals hold regarding their own ageing process. Prior to the AAQ, measures of attitudes toward ageing often focused solely on stereotypes or attitudes toward others, neglecting the individual’s personal experience.

By capturing the multidimensional nature of personal ageing, the AAQ allows researchers and clinicians to identify specific areas of strength (e.g., psychological growth) or challenge (e.g., psychosocial loss or physical change) that may affect an individual’s mental health and quality of life.

Construct

The AAQ measures attitudes across three distinct psychological constructs, each reflecting a specific domain of the ageing experience:

• Psychosocial Loss: This factor captures negative perceptions related to social engagement, emotional difficulties, loneliness, and feelings of exclusion or reduced societal involvement that may accompany older age.
• Physical Change: This factor measures attitudes toward physical health, energy levels, physical independence, and the perceived impact of health problems on daily functioning.
• Psychological Growth: This factor reflects positive subjective attitudes toward ageing, encompassing themes such as personal coping ability, wisdom, self-acceptance, life satisfaction, and the desire to mentor or pass on experience to younger generations.

Validity

The validity of the AAQ is supported by its clear three-factor structure, which aligns theoretically with the multidimensional experience of ageing. The scale has demonstrated strong construct validity through confirmatory factor analysis (CFA) across diverse populations. Furthermore, studies utilizing Mokken Scaling Analysis (Shenkin et al., 2014) confirmed that the three subscales—Psychosocial Loss, Physical Change, and Psychological Growth—form satisfactory unidimensional scales, indicating that the items within each subscale reliably measure the intended underlying construct.

Reliability

The AAQ exhibits strong reliability across its total score and subscales, supporting its consistent measurement of attitudes toward ageing. Internal consistency, measured using Cronbach’s alpha, was generally robust:

• Total Score: 0.81
• Physical Change: 0.75
• Psychosocial Loss: 0.74
• Psychological Growth: 0.62 (Note: This subscale demonstrated the lowest internal consistency, though still acceptable in some contexts.)

Test–retest reliability correlations, measured over time, were high and statistically significant (p < 0.001) for all measures, confirming the stability of the instrument:

• Total Score: r = 0.79
• Physical Change: r = 0.81
• Psychological Growth: r = 0.77
• Psychosocial Loss: r = 0.76

Factor Analysis

The development of the AAQ confirmed a three-factor model, reflecting the distinct domains of attitudes toward ageing. Further analysis, including the use of the Person Separation Index (PSI), provides additional evidence for the distinctiveness and reliability of these factors, particularly in the context of item response theory (IRT) and Mokken scaling:

• Psychosocial Loss PSI: 0.807
• Physical Change PSI: 0.809
• Psychological Growth PSI: 0.738

These PSI values indicate a good separation of individuals along the measured latent traits, suggesting the scale is effective at distinguishing between individuals who hold different levels of positive or negative attitudes within each domain. The three subscales are composed of specific items:

• Psychosocial Loss (8 items): 3, 6, 9, 12, 15, 17, 20, and 21.
• Physical Change (8 items): 7, 8, 11, 13, 14, 16, 23, and 24.
• Psychological Growth (8 items): 1, 2, 4, 5, 10, 18, 19, and 21.

Instrument

Test Type: Self-report Psychological Scale

Format: 24-item questionnaire utilizing a 5-point Likert-type scale.

Language Available: Developed in English, with translations available in multiple languages due to its international validation.

Population Group: Older adults and general adult population.

Age Group: Typically utilized for middle-aged and older adults (e.g., 50 years and above).

Population Details: The initial development and validation included samples of older adults from diverse community and clinical settings.

Test Methodology: Respondents rate their agreement with each statement using a 5-point scale where 1 reflects strongly disagree or not at all true, and 5 reflects strongly agree or extremely true. The descriptive labels provided are: Not at all true, Not so true, Moderately true, Rather True, Absolutely right. Items 1, 2, 4, 5, 7, 8, 10, 11, 13, 14, 16, 18, 19, 21, 23, and 24 are reverse-scored to maintain consistent directionality within the subscales.

Keywords

AAQ, psychological growth, psychosocial loss, physical health attitudes, self-perception of ageing, test-retest reliability, Cronbach’s alpha, gerontology research

Authors

Author ORCID Identifier: Information not provided in source content.

Affiliation Email addresses: Information not provided in source content.

Correspondence Address: Information not provided in source content.

Permissions & Fee and Test Year

The Attitudes to Ageing Questionnaire (AAQ) was first published and validated in 2007. Information regarding current fees and formal permissions should be sought from the primary authors or the publishing journal, International Journal of Geriatric Psychiatry.

The instrument is widely accessible in academic literature. Further details on the scale and its application can be found via the following sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043998/ and https://hqlo.biomedcentral.com/articles/10.1186/1477-7525-6-5.

Reference’s

• Laidlaw, K., Power, M., Schmidt, S., Skevington, S. and T. W.-O. G. (2007). The attitudes to ageing questionnaire (AAQ): development and psychometric properties. International Journal of Geriatric Psychiatry, 22(4), 367–379.
• Shenkin, S.D., Watson, R., Laidlaw, Ken., Starr, J.M., and Deary, I. J. (2014). The Attitudes to Ageing Questionnaire: Mokken Scaling Analysis. PLoS ONE 9(6): e99100. doi:10.1371/journal.pone.0099100.
• Laidlaw, K., Kishita, N., Shenkin, S.D., Power, M.J. (2017). Development of a short form of the Attitudes to Ageing Questionnaire (AAQ). International Journal of Geriatric Psychiatry. Abstract available at: http://onlinelibrary.wiley.com/doi/10.1002/gps.4687/abstract

Items of the Attitudes to Ageing Questionnaire (AAQ)

1. As people get older they are better able to cope with life
2. It is a privilege to grow old
3. Old age is a time of loneliness
4. Wisdom comes with age
5. There are many pleasant things about growing older
6. Old age is a depressing time of life
7. It is important to take exercise at any age
8. Growing older has been easier than I thought
9. I find it more difficult to talk about my feelings as I get older
10. I am more accepting of myself as I have grown older
11. I don’t feel old
12. I see old age mainly as a time of loss
13. My identity is not defined by my age
14. I have more energy now than I expected for my age
15. I am losing my physical independence as I get older
16. Problems with my physical health do not hold me back from doing what I want to do
17. As I get older I find it more difficult to make new friends
18. It is important to pass on the benefits of my experience to younger people
19. I believe my life has made a difference
20. I don’t feel involved in society now that I am older
21. I want to give a good example to younger people
22. I feel excluded from things because of my age
23. My health is better than I expected for my age
24. I keep myself as fit and active as possible by exercising