Self-perceptions of aging (SPA) may influence very old adults’ death attitudes, yet evidence is limited. This study examined the relationship between SPA and death attitudes. Data are from a representative sample of very old German adults from the NRW80+ study (N = 1,863). SPA was measured using the Awareness of Age-Related Change scale (AARC-10SF). Death attitudes included mortality salience, fear of own death and dying (FDD) and death acceptance. Women reported higher mortality salience and greater fear of dying than men. Higher chronological age was related to greater death acceptance. Structural equation modeling showed that higher scores on both AARC-Gains and AARC-Losses were associated with higher mortality salience. Moreover, AARC-Losses showed a positive association with death acceptance, which in turn was associated with lower FDD. These findings highlight SPA as a double-edged phenomenon: they may intensify mortality salience while perceived AARC-Losses may accompany acceptance processes related to reduced FDD.
AbelE. L.KrugerM. L. (2009). Mortality salience of birthdays on day of death in the Major Leagues. Death Studies, 33(2), 175–184. https://doi.org/10.1080/07481180802138936
2.
AltıntaşH.Ercan ŞahinN. (2025). Attitudes to aging, depression, and death anxiety among community-dwelling older adults: A cross-sectional correlational study. BMC Geriatrics, 25(1), 454. https://doi.org/10.1186/s12877-025-05839-3
3.
Amuthavalli ThiyagarajanJ.MiktonC.HarwoodR. H.GichuM.Gaigbe-TogbeV.JhambaT.PokornaD.StoevskaV.HadaR.SteffanG. S.LienaA.RocardE.DiazT. (2022). The UN decade of healthy ageing: Strengthening measurement for monitoring health and wellbeing of older people. Age and Ageing, 51(7), afac147. https://doi.org/10.1093/ageing/afac147
4.
AppelbaumM.CooperH.KlineR. B.Mayo-WilsonE.NezuA. M.RaoS. M. (2018). Journal article reporting standards for quantitative research in psychology: The APA publications and communications board task force report. American Psychologist, 73(1), 3–25. https://doi.org/10.1037/amp0000191
5.
ArrowoodR. B.CoxC. R.KerstenM.RoutledgeC.SheltonJ. T.HoodR. W. (2017). Ebola salience, death-thought accessibility, and worldview defense: A terror management theory perspective. Death Studies, 41(9), 585–591. https://doi.org/10.1080/07481187.2017.1322644
BaltesP. B.LindenbergerU.StaudingerU. M. (2006). Life-span theory in developmental psychology. In EisenbergN.DamonW. (Eds.), Social, emotional, and personality development (pp. 569–664). Wiley. https://doi.org/10.1002/9780470147658.chpsy0111
8.
BarrettA. E. (2003). Socioeconomic status and age identity: The role of dimensions of health in the subjective construction of age. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58(2), S101–S109. https://doi.org/10.1093/geronb/58.2.S101
9.
BelskyD. W.CaspiA.HoutsR.CohenH. J.CorcoranD. L.DaneseA.HarringtonH.IsraelS.LevineM. E.SchaeferJ. D.SugdenK.WilliamsB.YashinA. I.PoultonR.MoffittT. E. (2015). Quantification of biological aging in young adults. Proceedings of the National Academy of Sciences of the United States of America, 112(30), E4104–E4110. https://doi.org/10.1073/pnas.1506264112
10.
BevanA. L.MaxfieldM.BultmannM. N. (2014). The effects of age and death awareness on intentions for healthy behaviours. Psychology and Health, 29(4), 405–421. https://doi.org/10.1080/08870446.2013.859258
11.
BrandtstädterJ.LindenbergerU. (Eds.), (2007). Entwicklungspsychologie der Lebensspanne: Ein Lehrbuch (1. Aufl.). W. Kohlhammer GmbH. https://doi.org/10.17433/978-3-17-022718-7
12.
BrandtstädterJ.RennerG. (1990). Tenacious goal pursuit and flexible goal adjustment: Explication and age-related analysis of assimilative and accommodative strategies of coping. Psychology and Aging, 5(1), 58–67. https://doi.org/10.1037/0882-7974.5.1.58
13.
BrandtstädterJ.RothermundK. (1994). Self-perceptions of control in middle and later adulthood: Buffering losses by rescaling goals. Psychology and Aging, 9(2), 265–273. https://doi.org/10.1037/0882-7974.9.2.265
14.
BrothersA.GabrianM.WahlH.-W.DiehlM. (2016). Future time perspective and awareness of age-related change: Examining their role in predicting psychological well-being. Psychology and Aging, 31(6), 605–617. https://doi.org/10.1037/pag0000101
CicirelliV. G. (1999). Personality and demographic factors in older adults’ fear of death. The Gerontologist, 39(5), 569–579. https://doi.org/10.1093/geront/39.5.569
18.
CicirelliV. G. (2003). Older adults’ fear and acceptance of death: A transition model. Ageing International, 28(1), 66–81. https://doi.org/10.1007/s12126-003-1016-6
19.
DepaolaS. J.GriffinM.YoungJ. R.NeimeyerR. A. (2003). Death anxiety and attitudes toward the elderly among older adults: The role of gender and ethnicity. Death Studies, 27(4), 335–354. https://doi.org/10.1080/07481180302904
20.
DiehlM.WahlH.-W. (2010). Awareness of age-related change: Examination of a (mostly) unexplored concept. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65(3), 340–350. https://doi.org/10.1093/geronb/gbp110
21.
DiehlM.WahlH.-W. (2024). Self-perceptions of aging: A conceptual and empirical overview. Current Opinion in Psychology, 55(2), Article 101741. https://doi.org/10.1016/j.copsyc.2023.101741
22.
DoğanN.HacıköylüK. (2025). How are the attitudes towards aging and death anxiety in individuals over 65 years of age with chronic diseases? A cross-sectional and analytical study. Omega, Article 302228241312964, Advance online publication. https://doi.org/10.1177/00302228241312964
23.
DuttA. J.GabrianM.WahlH.-W. (2018). Awareness of age-related change and depressive symptoms in middle and late adulthood: Longitudinal associations and the role of self-regulation and calendar age. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 73(6), 944–953. https://doi.org/10.1093/geronb/gbw095
24.
EriksonE. H. (1959). Identity and the life cycle. International Universities Press.
GesserG.RekerG.WongP. T. P. (1987). Death attitudes across the life-span: The development and validation of the death attitude profile (DAP). OMEGA - Journal of Death and Dying, 18(2), 113–128. https://doi.org/10.2190/0DQB-7Q1E-2BER-H6YC
27.
GreenbergJ.PyszczynskiT.SolomonS. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In BaumeisterR. F. (Ed.), Public self and private self (pp. 189–212). Springer. https://doi.org/10.1007/978-1-4613-9564-5_10
28.
GreveW.WenturaD. (2003). Immunizing the self: Self-concept stabilization through reality-adaptive self-definitions. Personality and Social Psychology Bulletin, 29(1), 39–50. https://doi.org/10.1177/0146167202238370
29.
HansenS.KasparR.WagnerM.WoopenC.ZankS. (2021). The NRW80+ study: Conceptual background and design decisions. Zeitschrift fur Gerontologie und Geriatrie, 54(Suppl 2), 76–84. https://doi.org/10.1007/s00391-021-01970-z
HayesJ.SchimelJ.ArndtJ.FaucherE. H. (2010). A theoretical and empirical review of the death-thought accessibility concept in terror management research. Psychological Bulletin, 136(5), 699–739. https://doi.org/10.1037/a0020524
HeckhausenJ. (1997). Developmental regulation across adulthood: Primary and secondary control of age-related challenges. Developmental Psychology, 33(1), 176–187. https://doi.org/10.1037/0012-1649.33.1.176
HoffmannM. (2008). Mortalitätssalienz und Angstbewältigung im Kontext einer Krebserkrankung. [Doctoral dissertation, Universität Luxemburg] Pabst Science.
36.
IverachL.MenziesR. G.MenziesR. E. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34(7), 580–593. https://doi.org/10.1016/j.cpr.2014.09.002
37.
KasparR.GabrianM.BrothersA.WahlH.-W.DiehlM. (2019). Measuring awareness of age-related change: Development of a 10-item short form for use in large-scale surveys. The Gerontologist, 59(3), e130–e140. https://doi.org/10.1093/geront/gnx213
38.
KasparR.SchillingO. K.DiehlM.GerstorfD.RupprechtF. S.SabatiniS.WahlH.-W. (2023). Differences in self-perceptions of aging across the adult lifespan: The sample case of awareness of age-related gains and losses. Psychology and Aging, 38(8), 824–836. https://doi.org/10.1037/pag0000783
39.
KasparR.WahlH.-W.DiehlM. (2021). Awareness of age-related change as a behavioral determinant of survival time in very old age. Frontiers in Psychology, 12, Article 727560. https://doi.org/10.3389/fpsyg.2021.727560
40.
KasparR.WahlH.-W.DiehlM. (2023). Awareness of age-related gains and losses in a national sample of adults aged 80 years and older: Cross-sectional associations with health correlates. Innovation in Aging, 7(4), igad044. https://doi.org/10.1093/geroni/igad044
41.
KasparR.WennerJ.Tesch-RömerC. (2022). Einsamkeit in der Hochaltrigkeit (Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Ed.; D80+ Kurzberichte, issue 4). Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health. https://nbn-resolving.org/urn:nbn:de:0168-ssoar-77004-2
42.
KastenbaumR. (2006). The psychology of death (3rd ed.). Springer.
43.
Kotter-GrühnD.Kleinspehn-AmmerlahnA.GerstorfD.SmithJ. (2009). Self-perceptions of aging predict mortality and change with approaching death: 16-year longitudinal results from the Berlin aging study. Psychology and Aging, 24(3), 654–667. https://doi.org/10.1037/a0016510
44.
KrohneH. W. (1996). Angst und Angstbewältigung. Kohlhammer.
45.
KruseA. (2021) Vom Leben und Sterben im Alter: Wie wir das Lebensende gestalten können (1). Kohlhammer.
46.
LawtonM. P. (1975). The Philadelphia geriatric center morale scale: A revision. Journal of Gerontology, 30(1), 85–89. https://doi.org/10.1093/geronj/30.1.85
LevyB. R.AshmanO.SladeM. D. (2009). Age attributions and aging health: Contrast between the United States and Japan. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(3), 335–338. https://doi.org/10.1093/geronb/gbp002
49.
LittleT. D.SlegersD. W.CardN. A. (2006). A non-arbitrary method of identifying and scaling latent variables in SEM and MACS models. Structural Equation Modeling: A Multidisciplinary Journal, 13(1), 59–72. https://doi.org/10.1207/s15328007sem1301_3
50.
MacDougallE. E.FarrerasI. G. (2016). The multidimensional orientation toward dying and death inventory (MODDI-F): Factorial validity and reliability in a U.S. sample. Journal of Pain and Symptom Management, 51(6), 1062–1069. https://doi.org/10.1016/j.jpainsymman.2015.12.322
51.
MaxfieldM.BevanA. L. (2019). Aging and coping with mortality: Understanding attitudes about aging and age-related differences in coping with death. In RoutledgeC.VessM. (Eds.), Handbook of terror management theory (pp. 391–415). Elsevier. https://doi.org/10.1016/B978-0-12-811844-3.00017-2
52.
MaxfieldM.PyszczynskiT.GreenbergJ.PepinR.DavisH. P. (2012). The moderating role of executive functioning in older adults’ responses to a reminder of mortality. Psychology and Aging, 27(1), 256–263. https://doi.org/10.1037/a0023902
53.
McCoyS. K.PyszczynskiT.SolomonS.GreenbergJ. (2000). Transcending the self: A terror management perspective on successful aging. In TomerA. (Ed.), Death attitudes and the older adult: Theories, concepts, and applications (pp. 37–63). Brunner-Routledge.
54.
MenziesR. E.McMullenK.RiottoG. D.IliescuS.PetrovicB.RemfreyM. (2024). From dread to disorder: A meta-analysis of the impact of death anxiety on mental illness symptoms. Clinical Psychology Review, 113, Article 102490. https://doi.org/10.1016/j.cpr.2024.102490
55.
MenziesR. E.MenziesR. G. (2020). Death anxiety in the time of COVID-19: Theoretical explanations and clinical implications. Cognitive behaviour therapist, 13, Article e19. https://doi.org/10.1017/S1754470X20000215
56.
MenziesR. E.MenziesR. G. (2023). Death anxiety and mental health: Requiem for a dreamer. Journal of Behavior Therapy and Experimental Psychiatry, 78, Article 101807. https://doi.org/10.1016/j.jbtep.2022.101807
57.
MenziesR. G.MenziesR. E. (2018). Fear of death: Nature, development and moderating factors. In MenziesR. E.MenziesR. G.IverachL. (Eds.), Curing the dread of death: Theory, research and practice (pp. 21–40). Australian Academic Press.
58.
MisslerM.StroebeM.GeurtsenL.MastenbroekM.ChmounS.Van Der HouwenK. (2012). Exploring death anxiety among elderly people: A literature review and empirical investigation. Omega, 64(4), 357–379. https://doi.org/10.2190/OM.64.4.e
59.
MohammadpourA.SadeghmoghadamL.ShareiniaH.JahaniS.AmiriF. (2018). Investigating the role of perception of aging and associated factors in death anxiety among the elderly. Clinical Interventions in Aging, 13, 405–410. https://doi.org/10.2147/CIA.S150697
NeimeyerR. A. (2015). Death anxiety handbook: Research, instrumentation, and application. Routledge.
62.
NeimeyerR. A.WittkowskiJ.MoserR. P. (2004). Psychological research on death attitudes: An overview and evaluation. Death Studies, 28(4), 309–340. https://doi.org/10.1080/07481180490432324
63.
Nistoreanu-NeculauB.MăireanC.GavriloviciO. (2024). The relation between deviation from the balanced time perspective and quality of life among older people: The mediating role of death anxiety and the moderating role of awareness of aging. Omega, Article 302228241293822, Advance online publication. https://doi.org/10.1177/00302228241293822
64.
OfficerA.PautexS.BadacheA.BroersB.PrinaM. (2024). Systematic review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID-19. Archives of Gerontology and Geriatrics, 127, Article 105573. https://doi.org/10.1016/j.archger.2024.105573
65.
PhilippR.MehnertA.LoC.MüllerV.ReckM.VehlingS. (2019). Characterizing death acceptance among patients with cancer. Psycho-Oncology, 28(4), 854–862. https://doi.org/10.1002/pon.5030
66.
RayA.BlockS. D.FriedlanderR. J.ZhangB.MaciejewskiP. K.PrigersonH. G. (2006). Peaceful awareness in patients with advanced cancer. Journal of Palliative Medicine, 9(6), 1359–1368. https://doi.org/10.1089/jpm.2006.9.1359
67.
ReidickO. (2015) Sterben und Tod bei Hochaltrigen: Die Rolle von Persönlichkeit, Gesundheit und Religiosität (14). Peter Lang Academic. https://www.peterlang.com/?266465
68.
RothbaumF.WeiszJ. R.SnyderS. S. (1982). Changing the world and changing the self: A two-process model of perceived control. Journal of Personality and Social Psychology, 42(1), 5–37. https://doi.org/10.1037/0022-3514.42.1.5
SabatiniS.RupprechtF.KasparR.KlusmannV.KornadtA.NikitinJ.SchönsteinA.StephanY.WettsteinM.WurmS.DiehlM.WahlH.-W. (2024). Successful aging and subjective aging: Toward a framework to research a neglected connection. The Gerontologist, 65(1), gnae051, Advance online publication. https://doi.org/10.1093/geront/gnae051
71.
SabatiniS.DritschelB.RupprechtF. S.UkoumunneO. C.BallardC.BrookerH.CorbettA.ClareL. (2023). Rumination moderates the longitudinal associations of awareness of age-related change with depressive and anxiety symptoms. Aging & Mental Health, 27(9), 1711–1719. https://doi.org/10.1080/13607863.2023.2176820
72.
SabatiniS.TurnerS.BrookerH.BallardC.CorbettA.HampshireA. (2023). Physical and mental health conditions account for variability in awareness of age-related changes. Frontiers in Psychiatry, 14, Article 1152177. https://doi.org/10.3389/fpsyt.2023.1152177
73.
SabatiniS.WahlH.-W.KasparR.HuntleyJ. (2023). Editorial: Research topic international evidence on predictors and outcomes of awareness of age-related change. Frontiers in Psychiatry, 14, Article 1128531. https://doi.org/10.3389/fpsyt.2023.1128531
74.
SabatiniS.SilarovaB.MartyrA.CollinsR.BallardC.AnsteyK. J.KimS.ClareL. (2020). Associations of awareness of age-related change with emotional and physical well-being: A systematic review and meta-analysis. The Gerontologist, 60(6), e477–e490. https://doi.org/10.1093/geront/gnz101
75.
SabatiniS.UkoumunneO. C.BallardC.BrothersA.KasparR.CollinsR.KimS.CorbettA.AarslandD.HampshireA.BrookerH.ClareL. (2020). International relevance of two measures of awareness of age-related change (AARC). BMC Geriatrics, 20(1), 359. https://doi.org/10.1186/s12877-020-01767-6
76.
SadeghiA.MohamadzadehM.ShorakaH. R.PirouzehR.Rahimi Khalifeh KandiZ. (2024). The relationship between the perception of aging and death anxiety in the older adults of Eastern Iran during COVID‐19. Health & Social Care in the Community, 2024(1), Article 3236251. https://doi.org/10.1155/2024/3236251
77.
SAS Institute Inc. (2016). Base SAS® 9.4 procedures guide: high-performance procedures (6th ed.). SAS Institute Inc.
78.
SaßA.-C.WurmS.ZieseT. (2009). Alter = Krankheit? Gesundheitszustand und Gesundheitsentwicklung. In BöhmK.Tesch-RömerC.ZieseT. (Eds.), Gesundheit und Krankheit im Alter. Beiträge zur Gesundheitsberichterstattung des Bundes. Statistisches Bundesamt Deutschland, Deutsches Zentrum für Altersfragen. Robert Koch-Institut.
79.
ShawB. A.LiangJ.KrauseN. (2010). Age and race differences in the trajectories of self-esteem. Psychology and Aging, 25(1), 84–94. https://doi.org/10.1037/a0018242
80.
StephanY.SutinA. R.TerraccianoA. (2018). Subjective age and mortality in three longitudinal samples. Psychosomatic Medicine, 80(7), 659–664. https://doi.org/10.1097/PSY.0000000000000613
81.
SteverinkN.WesterhofG. J.BodeC.Dittmann-KohliF. (2001). The personal experience of aging, individual resources, and subjective well-being. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56(6), P364–P373. https://doi.org/10.1093/geronb/56.6.P364
82.
StruppJ.KönekeV.RietzC.VoltzR. (2021). Perceptions of and attitudes toward death, dying, grief, and the finitude of life: A representative survey among the general public in Germany. Omega, 84(1), 157–176. https://doi.org/10.1177/0030222819882220
83.
TangC. S.-K.WuA. M. S.W.YanE. C. (2002). Psychosocial correlates of death anxiety among Chinese college students. Death Studies, 26(6), 491–499. https://doi.org/10.1080/074811802760139012
84.
Tesch-RömerC.WahlH.-W. (2017). Toward a more comprehensive concept of successful aging: Disability and care needs. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 72(2), 310–318. https://doi.org/10.1093/geronb/gbw162
85.
TomerA. (2000). Death-related attitudes: Conceptual distinctions. In TomerA. (Ed.), Death attitudes and the older adult: Theories, concepts, and applications (pp. 87–94). Brunner-Routledge.
TomerA.EliasonG. (2000). Beliefs about self, life, and death: Testing aspects of a comprehensive model of death anxiety and death attitudes. In TomerA. (Ed.), Death attitudes and the older adult (pp. 137–153). Taylor & Francis.
88.
WesterhofG. J.Nehrkorn-BaileyA. M.TsengH.-Y.BrothersA.SiebertJ. S.WurmS.WahlH.-W.DiehlM. (2023). Longitudinal effects of subjective aging on health and longevity: An updated meta-analysis. Psychology and Aging, 38(3), 147, 166, Advance online publication. https://doi.org/10.1037/pag0000737
89.
WettsteinM.SchillingO. K.ReidickO.WahlH.-W. (2015). Four-year stability, change, and multidirectionality of well-being in very-old age. Psychology and Aging, 30(3), 500–516. https://doi.org/10.1037/pag0000037
90.
WittkowskiJ. (1996). Fragebogeninventar zur mehrdimensionalen Erfassung des Erlebens gegenüber Sterben und Tod (FIMEST): Handanweisung. Hogrefe.
91.
WittkowskiJ. (2001). The construction of the multidimensional orientation toward dying and death inventory (MODDI-F). Death Studies, 25(6), 479–495. https://doi.org/10.1080/07481180126858
92.
WittkowskiJ. (2005). Einstellungen zu Sterben und Tod im höheren und hohen Lebensalter. Zeitschrift für Gerontopsychologie and -Psychiatrie, 18(2), 67–79. https://doi.org/10.1024/1011-6877.18.2.67
93.
WittkowskiJ. (2016). Coping and attitudes toward dying and death in German adults. OMEGA - Journal of Death and Dying, 72(4), 316–339. https://doi.org/10.1177/0030222815575283
94.
WittkowskiJ.MenziesR. (2021). Death-related attitudes and perspectives. In Servaty-SeibH.ChappleH. (Eds.), Handbook of thanatology: The essential body of knowledge for the study of death, dying, and bereavement (pp. 38–63). Association for Death Education and Counseling.
95.
WittkowskiJ.SchröderC. (Eds.), (2008). Angemessene Betreuung am Ende des Lebens: Barrieren und Strategien zu ihrer Überwindung: mit 3 Tabellen. Vandenhoeck & Ruprecht.
96.
WongP. T. P.RekerG. T.GesserG. (1994). Death attitude profile-revised: A multidimensional measure of attitudes towards death. In NeimeyerR. A. (Ed.), Death anxiety handbook: Research, instrumentation, and application (pp. 121–148). Taylor & Francis. https://doi.org/10.4324/9781315800813
WroschC.MillerG. E.ScheierM. F.de PontetS. B. (2007). Giving up on unattainable goals: Benefits for health?Personality and Social Psychology Bulletin, 33(2), 251–265. https://doi.org/10.1177/0146167206294905
99.
WurmS.Tesch-RömerC.TomasikM. J. (2007). Longitudinal findings on aging-related cognitions, control beliefs, and health in later life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62(3), P156–P164. https://doi.org/10.1093/geronb/62.3.P156
ZankS.WoopenC.WagnerM.RietzC.KasparR. (2022). Lebensqualität und Wohlbefinden hochaltriger Menschen in NRW (Repräsentativbefragung NRW80+): Querschnittsbefragung Welle 1. GESIS Datenarchiv. ZA7558 Datenfile Version 2.0.0. GESIS Data Archive. https://doi.org/10.4232/1.13978
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