Validity and reliability of the expectations regarding aging (ERA-12) instrument among middle-aged Singaporeans

ABSTRACT

<p><b>INTRODUCTION</b>The 12-item Expectations Regarding Aging (ERA-12) instrument measures expectations that individuals have about how their health and cognitive function will be when they age. To date, primarily assessed among older adults in Western settings, expectations regarding ageing have been associated with physical activity and healthcare seeking behaviour. It has been suggested that it may be possible to develop interventions that promote positive expectations about ageing. Assessment of expectations regarding ageing among today's middle-aged population would allow for earlier interventions to help give them positive (but realistic) ageing expectations, and age successfully. We assess the reliability and validity of ERA-12 for middle-aged Singaporeans.</p><p><b>MATERIALS AND METHODS</b>A questionnaire that included ERA-12 was administered to 1020 patients aged 41 to 62 years attending 2 SingHealth polyclinics in Singapore. Data from 981 respondents who completed the ERA-12 instrument were analysed. ERA-12's construct validity was determined using Exploratory Factor Analysis (EFA), and through its correlation with depressive symptoms, and self-rated health and education. Internal consistency reliability was assessed using Cronbach's alpha.</p><p><b>RESULTS</b>EFA confirmed that the ERA-12 consisted of 3 factors (each with 4 items)--expectations regarding physical health, mental health and cognitive function, together explaining 64% of the variance in ERA-12 total score with high factor loadings (range, 0.6 to 0.8). The ERA-12 total score was positively correlated with self-rated health (r = 0.13) and education (r = 0.19), and negatively correlated with depressive symptoms (r = -0.25). Cronbach's alpha exceeded 0.7 for ERA-12 overall, and for each subscale.</p><p><b>CONCLUSION</b>ERA-12 can be used to evaluate expectations regarding ageing not only among elderly populations in the West, but also among middle-aged Singaporeans.</p>