Exploring the efficacy of sense of Okayness (SOK) as an antidote for stress in older adults: the role of SOK elevation intervention, heart rate variability (HRV), and cognitive performance in stressful and relaxing situations.

Sense of Okayness (SOK) is an emerging concept that describes a person's ability to remain stable and unshaken in the face of life transitions and hardships. This quality enables effective stress regulation and heightened tolerance to uncertainty. To investigate the possible role of the parasympathetic nervous system (PNS) in mediating the relationship between SOK and stress regulation among older individuals, an analytical sample of N = 69 participants (74% women) with a mean age of 78.75 years (SD age = 6.78) was recruited for a standardized cognitive assessment and stress induction. Baseline heart rate variability (HRV), measured via electrocardiogram (ECG), and SOK assessments were conducted prior to stress induction, along with a baseline cognitive evaluation. Subsequently, participants were subjected to a psychosocial stress paradigm, followed by either a 30-minute SOK elevation intervention (n = 40) or a control condition with nature sounds (n = 29). A second cognitive assessment was administered post-intervention, with continuous HRV measurement through ECG. The results revealed significant HRV changes due to the experimental intervention, though no significant differences were observed between the SOK intervention and control groups. Interestingly, individuals with high trait SOK displayed more stable HRV trajectories, exhibiting a smaller decline during the stress intervention and a milder increase during both the stressor and SOK intervention phases. Overall, these findings do suggest a significant association between SOK, parasympathetic activity, and stress reactivity. These results prompt further investigation into whether personality patterns, such as a strong SOK, may be linked to reduced vagal reactivity and better coping in old age.

Cultural Differences in Daily Coupling of Subjective Views of Aging and Negative Affect.

OBJECTIVES: The established link between subjective views of aging (VoA) and well-being shows variations across different cultures. Although VoA show daily fluctuations, little is known about cultural differences in such fluctuations and the daily coupling of VoA and well-being. We compared Israeli Arabs to Israeli Jews in the daily coupling of VoA and negative affect (NA). METHODS: Community-dwelling older adults (N=76, Mage=66.71) completed measures of subjective age, subjective accelerated aging, ageist attitudes, and NA over 14 consecutive days. RESULTS: Respondents reported higher daily NA when they felt older, reported to be aging faster, or had more ageist attitudes. The daily coupling between subjective age/subjective accelerated aging and NA was stronger among Israeli Arabs compared to Israeli Jews. There was no such interaction with ageist attitudes. DISCUSSION: It is important to adopt a cultural perspective when investigating daily fluctuations in VoA and their correlates. In applied contexts, this might help to identify cultural groups that are particularly sensitive to the effects of VoA.

Amplified psychological reaction to civil unrest among Holocaust survivor descendants.

The evidence regarding the intergenerational effects of the Holocaust points to a heightened sensitivity to traumatic and stressful events, as well as to threats. These effects were found across at least three generations: the survivors themselves, their children, and their grandchildren. More specifically, this sensitivity is manifested in increased psychological reactions to adverse circumstances, especially when such situations trigger associations with the Holocaust. During 2023 Israel has experienced unprecedented civil unrest and protests following the government's plan to promote a judicial overhaul. Many expressed fears for Israeli democracy and the integrity of the social fabric in Israel. The current study examined how Holocaust descendants (i.e., children and grandchildren of Holocaust survivors) experienced this prolonged social unrest. A web-based random sample of 706 Israeli Jews born after World War II completed questionnaires several months before the unrest began (Wave 1, 2022) and seven months into the unrest (Wave 2, 2023). Supporting most of our hypotheses, Holocaust descendants reported higher civil unrest salience (i.e., more preoccupation with the political and social upheaval) relative to comparison descendants (i.e., children and grandchildren of those not directly exposed to the Holocaust). Relative to comparison descendants, Holocaust descendants were also at a greater risk of reporting exacerbation in anxiety since the judicial overhaul was introduced, but not in depression or somatisation symptoms. Results remained significant after controlling Wave 1 distress level, background characteristics, level of engagement in civil unrest, and participants' viewpoint on the judicial overhaul. The findings further corroborate unique reactions to stress among Holocaust descendants, this time by highlighting increased preoccupation and increased exacerbation in anxiety during a period of prolonged political and social turmoil.

The Architectural Layout of Long-Term Care Units: Relationships between Support for Residents' Well-Being and for Caregivers' Burnout and Resilience.

With a growing need for long-term care facilities in general, and for specialized dementia units in particular, it is important to ensure that the architectural layouts of such facilities support the well-being of both the residents and the unit caregivers. This study aimed to investigate correlations between the support provided by the architectural layout of long-term care units for enhancing residents' well-being and for decreasing unit caregivers' burnout and increasing their resilience-as layouts may impact each party differently. The Psycho Spatial Evaluation Tool was utilized to assess the support provided by the layouts of seventeen long-term care units (ten regular nursing units and seven specialized dementia units) for the residents' physical and social well-being (five dimensions); a questionnaire was used to measure the unit caregivers' burnout and resilience. When analyzing layouts' support for residents' physical and social well-being, inconsistencies emerged regarding correlations with caregivers' burnout and resilience across the two types of long-term care units. Supporting residents' physical well-being was correlated with increased caregiver resilience in dementia units, and with increased burnout and decreased resilience in regular nursing units. Layouts supporting social well-being showed inconsistent correlations with caregivers' resilience indexes in dementia units, and with burnout and resilience indexes in regular nursing units. The findings underscore the role of the architectural layout of long-term care units in enhancing residents' well-being; the results also highlight the possible unintentional yet negative impact of the layout on the caregivers' burnout and resilience. This study emphasizes the need to identify and rectify design shortcomings as a means of enhancing residents' well-being, while increasing the unit caregivers' resilience and decreasing their burnout. These insights should be addressed when developing strategies and interventions for ensuring optimal care environments for all parties involved.

The Holocaust Experience and Its Role in the Association Between Meaning in Life, Depressive Symptoms and Life Satisfaction.

Holocaust survivors often reveal long-term depressive symptoms, while demonstrating life satisfaction. The present study examined the role of meaning in life (MIL) of Holocaust survivors in this context. Survivors (n = 44) and comparisons (n = 51) provided background information and completed MIL, depressive symptoms, and life satisfaction scales. MIL was associated with lower depressive symptoms and higher life satisfaction. Moreover, the MIL-depressive symptoms/life satisfaction links were stronger among Holocaust survivors. Results provide insight for tailoring treatment interventions for older adults who have been exposed to prolonged traumatic experiences or genocide, that focus on MIL, to enhance mental health.

Age differences in acute stress and PTSD symptoms during the 2023 Israel-Hamas war: Preliminary findings.

Traumatic exposure can result in acute stress symptoms in the immediate aftermath and post-traumatic stress disorder (PTSD) symptoms that persist beyond the initial weeks. Both short-term and long-term reactions require research and clinical attention. There is considerable evidence for age differences in PTSD, and older adults frequently present lower rates of PTSD compared to young adults. Much less is known concerning age differences in acute reaction or the extent to which age differences in PTSD are affected by age differences in acute stress. The current study examined acute stress and PTSD symptoms among young and older adult Israelis during the 2023 Israel-Hamas war. A web-based sample of 428 participants (mean age = 48.36 ± 16.29) completed retrospective accounts of pre-war psychological distress and acute stress in the first week of the war and further reported current PTSD symptoms. Rates of elevated levels of acute stress symptoms and probable PTSD were significantly higher among young adults (24.8% and 42.8%, respectively) compared to their older counterparts (3.7% and 13.7%, respectively). Age differences in probable PTSD remained significant even after controlling for other demographics, traumatic exposure, pre-war psychological distress, and acute stress symptoms. These preliminary findings further attest to the impressive resilience manifested by older adults during wartime. Moreover, as age differences in probable PTSD were not fully explained by acute reactions, unique mechanisms may be mobilized by older adults to cope with warfare trauma in the short- and long term.

Associations among loneliness, internal locus of control and subjective accelerated ageing in older adults who received the booster vaccination.

BACKGROUND: A rise in loneliness among older adults since the COVID-19 outbreak, even after vaccination, has been highlighted. Loneliness has deleterious consequences, with specific effects on perceptions of the ageing process during the COVID-19 pandemic. Coping with stressful life events and the challenges of ageing may result in a perception of acceleration of this process. AIM: Studies have shown a buffering effect of an internal locus of control in the relationship between COVID-19 stress and mental distress. The current study examined whether loneliness predicts subjective accelerated ageing and whether internal locus of control moderates this relationship. METHOD: Two waves of community-dwelling older adults (M = 70.44, s.d. = 5.95; age range 61-88 years), vaccinated three times, were sampled by a web-survey company. Participants completed the questionnaire after the beginning of the third vaccination campaign and reported again 4 months later on loneliness, internal locus of control and subjective accelerated ageing level in the second wave. RESULTS: Participants with higher levels of loneliness presented 4 months later with higher subjective accelerated ageing. Participants with a low level of internal locus of control presented 4 months later with high subjective accelerated ageing, regardless of their loneliness level. Participants with a high level of internal locus of control and a low level of loneliness presented with the lowest subjective accelerated ageing 4 months later. CONCLUSIONS: The findings emphasise the deleterious effects of loneliness and low internal locus of control on older adults' perception of their ageing process. Practitioners should focus their interventions not only on loneliness but also on improving the sense of internal locus of control to improve subjective accelerated ageing.

The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults.

INTRODUCTION: Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly. METHODS: This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge. RESULTS: The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes. CONCLUSION: Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.

Reclaiming hope: Subjective nearness to death as a moderator between posttraumatic stress symptoms and hope among older adults.

Perceiving one's remaining time until death, can serve as a source of resilience when faced with adversity in the second half of life. The current work is based on a prospective study and examines whether subjective nearness-to-death (SNtD) moderates the association between posttraumatic-stress symptoms (PTSS) and hope among adults in the second half of life. The first wave was conducted after the end of a military conflict in the south of Israel, and included 170 participants (M = 66.61, SD = 9.16; age range 51-91), 115 of whom also participated in Wave 2. Participants filled out self-reported questionnaires regarding background information, PTSS, SNtD and hope. A moderation effect was found, revealing that high levels of PTSS predicted lower levels of hope among those who felt close to their death, but not among those who felt far from their death. We suggest that one's evaluation of little time remaining to live, especially in old age, may be a significant factor exacerbating the negative consequences of PTSS on hope. The importance of the results to the research field is discussed.

Echoes of ancestral trauma: Russo-Ukrainian War salience and psychological distress among subsequent generations in Holocaust survivor families.

OBJECTIVE: The Russo-Ukrainian War intensified when Russian troops invaded Ukraine in February 2022. The current study examined whether children (second generation; G2) and grandchildren (third generation; G3) of Holocaust survivors are more preoccupied with the war relative to comparisons. Moreover, whether there was more exacerbation in psychological distress in Holocaust survivor families relative to comparisons since the escalation of the war. METHOD: A random sample from a web-based survey company included 1,071 Jewish Israeli adults (297 Holocaust G2, 224 comparison G2, 379 Holocaust G3, and 171 comparison G3). The average age of the participants was 62.95 ± 10.25, 61.79 ± 10.13, 34.02 ± 8.65, and 33.55 ± 8.26, respectively. Participants answered questionnaires on background characteristics, Russo-Ukrainian War exposure, Russo-Ukrainian War salience, and general psychological distress before and since the escalation of the war. RESULTS: Findings showed that Holocaust G2 and G3, relative to comparisons, reported more Russo-Ukrainian War salience. Moreover, more psychological distress symptom exacerbation was found in Holocaust survivor families relative to comparisons since the escalation of the war. Finally, Holocaust G2 and G3 with more Holocaust survivors in the family showed higher anxious preoccupation with the war and Holocaust G3 with more survivor grandparents showed more exacerbation in psychological distress. CONCLUSIONS: Findings suggest a specific vulnerability due to intergenerational transmission of trauma in Holocaust survivor families, including increased preoccupation with and perceptiveness to potential threats of human-induced trauma. Strengthening previous recommendations, mental health practitioners should focus on reducing the preoccupation with threat and the increased psychological distress of Holocaust survivor families when faced with current adversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Let there be light: The moderating role of positive solitude in the relationship between loneliness and depressive symptoms.

Positive solitude (PS), the choice of being alone to engage in meaningful inner or physical, spiritual, mental, or cognitive activity/ experience, was recently suggested as a stand-alone phenomenon differentiated from loneliness and negative solitude. As loneliness was previously found to have adverse implications for mental health, the present study examined whether the ability to engage in PS can moderate the harmful effect of loneliness on depressive symptoms. The sample consisted of 520 community-dwelling older adults in Israel aged 68-87 (Mage = 72.66). Participants answered an online questionnaire through a survey company (Ipanel) assessing their background characteristics, depressive symptoms, loneliness, and PS. Loneliness was positively associated with depressive symptoms, whereas PS was negatively associated with depressive symptoms. Furthermore, PS moderated the relationship between loneliness and depressive symptoms, such that higher levels of PS weakened this association. The findings indicate that PS may serve as a buffering factor for mental health among older adults by augmenting coping with the adverse outcomes of loneliness. The results provide insight for tailoring future treatment interventions focusing on PS to enhance mental health among older adults.

Factors associated with ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder among older adults during the COVID-19 pandemic.

ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD have been understudied in the older population. The study focused on the associations between traumatic exposure before the pandemic, COVID-19 worries, depression, and loneliness with current PTSD and CPTSD among older adults. A random sample of five hundred and twelve Israeli older adults (Mage = 72.67 ± 3.81, range 68-87) was recruited using a Web-based survey company (Ipanel, Israel). Participants completed questionnaires of demographic details, self-rated health, COVID-19 worries, trauma exposure, depressive symptoms, level of loneliness, PTSD, and CPTSD. Univariate logistic regression revealed that trauma exposure, COVID-19 worries, depression, and loneliness were associated with PTSD. Multinomial regression revealed that only trauma exposure was associated with PTSD among older adults with PTSD compared with those not reaching the PTSD cutoff level. In the comparison between older adults suffering from CPTSD with those not reaching the PTSD cutoff level, being married, higher levels of trauma exposure, COVID-19 worries, depression, and loneliness were associated with a higher risk of CPTSD. Results suggest that specific factors may be significant psychological correlates of CPTSD symptoms among older adults during the COVID-19 pandemic. Identifying these factors could assist practitioners in tailoring more effective interventions.

Meaning reconstruction 70 years later: Processing older adults' unfinished business in a drama therapy group.

Unfinished business (UB), when individuals appraise their relationship with others or themselves as incomplete or unresolved, entails difficult emotions such as regret, remorse, and guilt. UB is often associated with bereavement and is considered to be a predictor of complicated grief. Here we report two case studies describing the processing of the sudden death of a significant other in the context of a randomized controlled study of 12-week drama therapy groups for older adults. The intervention followed the format of Playback Theater, an improvised form of theater based on personal stories, and a life review paradigm. A mixed-methods approach explored the course of individual therapy within the group and potential mechanisms of change. The participants completed mental health questionnaires in a pre-post-follow-up design. The qualitative data included video recordings and postintervention interviews. One participant reported a clinically significant (CS) change in depressive symptoms and psychological well-being on the post and follow-up measurement indices. The second reported a CS change in self-esteem and relationship satisfaction at the end of the intervention, but not at follow-up. The findings suggest that the drama therapy contributed to the resolution of UB through restorative work in the three domains defined in meaning reconstruction theory: the "event story" of the loss, the "back story" of the relationship with the deceased, and the "personal story" of self. The results point to the need for additional research on meaning reconstruction in the context of drama therapy and encourage the broader application of performative techniques to treat complicated bereavement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trauma-related and risk factors associated with perceived exacerbation in psychological distress due to the Russo-Ukrainian war.

This study examined trauma-related and other potential risk factors associated with perceived exacerbation in psychological distress among Israelis due to the Russo-Ukrainian War. Specifically, we assessed how vulnerability factors such as previous traumatic exposure, having relatives and friends affected by the war, media exposure, having a Holocaust familial background, lower levels of resilience, and probable posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) are associated with perceived exacerbation in psychological distress. A random sample of 845 Israeli Jews aged 18-75 who reported exposure to at least one traumatic event participated in the study. Univariate logistic regression showed that Holocaust familial background, previous exposure to trauma, media exposure to the Russo-Ukrainian War, and probable diagnosis of PTSD or CPTSD are the main factors associated with perceived exacerbation in psychological distress. These results suggest that various traumatic factors associate with perceived higher psychological vulnerability to international conflicts, even when there is no direct personal threat. Practitioners should be aware of these factors among individuals exposed to trauma.

Dental anxiety and ageing anxiety: Moderated mediation roles of Oral Health-Related Quality of Life and subjective accelerated ageing.

BACKGROUND: Oral health and its relation to ageing is an important topic often neglected among geriatric populations. Proper oral rehabilitation may aid in alleviating mental health burdens in such populations. OBJECTIVES: The present study aimed to explore the association between dental anxiety and ageing anxiety, with regard to the interplay of Oral Health-Related Quality of Life (OHRQoL) as mediator and subjective accelerated ageing as a moderator. METHODS: A total of 577 participants with mean age 72.78 years (SD = 3.832, range = 68-87) were recruited via a survey company in Israel. They completed a self-report battery of questionnaires about dental anxiety, OHRQoL, subjective accelerated ageing and ageing anxiety, along with their informed consent. RESULTS: The findings revealed that dental anxiety was positively associated with ageing anxiety (direct effect), and that OHRQoL mediated the link between dental anxiety and ageing anxiety (indirect effect). Additionally, subjective accelerated ageing moderated the positive link between dental anxiety and OHRQoL, as well as the positive link between OHRQoL and ageing anxiety. CONCLUSIONS: The results provide insight for the roles of OHRQoL and subjective accelerated ageing among older adults between dental anxiety and ageing anxiety. Tailoring oral rehabilitation interventions that focus on these factors are warranted to improve older adults' dental health.

Sow in tears and reap in joy: Eye tracking reveals age-related differences in the cognitive cost of spoken context processing.

Older adults have been found to use context to facilitate word recognition at least as efficiently as young adults. This may pose a conundrum, as context use is based on cognitive resources that are considered to decrease with aging. The goal of this study was to shed light on this question by testing age-related differences in context use and the cognitive demands associated with it. The eye movements of 30 young (21-27 years old) and 30 older adults (61-79 years old) were examined as they listened to spoken instructions to touch an image on a monitor. The predictability of the target word was manipulated between trials: nonpredictive (baseline), predictive (context), or predictive of two images (competition). In tandem, listeners were asked to retain one or four spoken digits (low or high cognitive load) for later recall. Separate analyses were conducted for the preceding sentence and the (final) target word. Sentence processing: Older adults were slower than young adults to accumulate evidence for target-word prediction (context condition), and they were more negatively affected by the increase in cognitive load (context and competition). Target-word recognition: No age-related differences were found in word recognition rate or the effect of cognitive load following predictive context (context and competition). Although older adults have greater difficulty processing context, they can use context to facilitate word recognition as efficiently as young adults. These results provide a better understanding of how cognitive processing changes with aging. They may help develop interventions aimed at improving communication in older adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self and Perceived Others' Views of Aging and Their Association with Mental Health in the Second Half of Life.

This study focuses on the concepts of subjective age and subjective nearness-to-death (views-of-aging) and examines the association between individuals' chronological age, self, and others' perceptions of these variables and mental health. A total of 267 participants aged 40-95 M = 64.33 provided sociodemographic information and filled out scales assessing self and others' views-of-aging, depressive symptoms, and their well-being. After controlling for covariates, age was not related to the dependent variables, whereas young/far from death self, and perceived others' views-of-aging was related to better mental health. The interaction between young age and young/far from death perceived others', but not self, views-of-aging was associated with lower depressive symptoms and higher well-being. Finally, the interaction between young/far from death self and perceived others' views-of-aging was associated with lower depressive symptoms but not with well-being. These findings provide an initial glance at the complex relations between two types of personal views-of-aging and emphasize the importance of how individuals appraise others' perceptions of their own aging process and life expectancy.

COVID-19 Booster Vaccination Bellwethers: Factors Predictive of Older Adults' Adoption of the Second Booster COVID-19 Vaccine in Israel: A Longitudinal Study.

Israel became the first country to offer the second COVID-19 booster vaccination. The study tested for the first time, the predictive role of booster-related sense of control (SOC_B), trust and vaccination hesitancy (VH) on adoption of the second-booster among older adults, 7 months later. Four hundred Israelis (≥60 years-old), eligible for the first booster, responded online, two weeks into the first booster campaign. They completed demographics, self-reports, and first booster vaccination status (early-adopters or not). Second booster vaccination status was collected for 280 eligible responders: early- and late-adopters, vaccinated four and 75 days into the second booster campaign, respectively, versus non-adopters. Multinomial logistic regression was conducted with pseudo R2 = .385. Higher SOC_B, and first booster early-adoption were predictive of second booster early-vs.-non-adoption, 1.934 [1.148-3.257], 4.861 [1.847-12.791]; and late-vs.-non-adoption, 2.031 [1.294-3.188], 2.092 [0.979-4.472]. Higher trust was only predictive of late-vs.-non-adoption (1.981 [1.03-3.81]), whereas VH was non-predictive. We suggest that older-adult bellwethers, second booster early-adopters, could be predicted by higher SOC_B, and first booster early-adoption, 7 months earlier.

Attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning.

OBJECTIVE: To understand if attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning among older adults with medical conditions. We examined: (1) if these effects are reciprocal; (2) if attitudes to aging (psychological loss, psychological growth, physical change) play a mediating role in these effects. DESIGN: A sample of 226 community-dwelling older adults (T1 age range = 65-94, mean age = 73.59, SD = 6.29) reporting at least one chronic medical condition completed two phone interviews across six months. MAIN OUTCOME MEASURES: Background measures, health anxiety, physical functioning, and attitudes to aging at T1 and T2. RESULTS: T2 attitudes to aging served as a mediator controlling for T1 attitudes. There was a direct effect of worse physical functioning at T1 on increased health anxieties at T2. Negative (but not positive) attitudes to aging mediated that effect. The reversed temporal sequencing (T1 health anxiety leading to T2 physical functioning) was significant only when mediated by negative attitudes to aging. CONCLUSIONS: Findings suggest that viewing aging as mostly a time of losses (but not as a time of gains) serves as an important mechanism through which health anxieties and physical functioning affect each other among older adults having chronic medical conditions.

Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients.

INTRODUCTION: The current study aimed to find reciprocal effects between subjective age and functional independence during rehabilitation from osteoporotic fractures and stroke and whether these effects can be mediated by indicators of well-being. METHODS: Participants were 194 older adults (mean age = 78.32 years, SD = 7.37; 64.8% women) who were hospitalized following an osteoporotic fracture or stroke. Participants completed measures of subjective age and well-being (i.e., optimism, self-esteem, and life satisfaction) several times during rehabilitation. Functional Independence Measure (FIM) was completed by nursing personnel at admission and at discharge. RESULTS: Younger subjective age at admission predicted higher FIM scores at discharge. The reverse effect, that is, of FIM scores at admission on subjective age at discharge, was nonsignificant. Optimism during hospitalization mediated the effect of subjective age on subsequent FIM scores while self-esteem and life satisfaction did not. Sensitivity analyses further showed that the effect of subjective age on FIM was significant for both fracture and stroke patients. DISCUSSION: The findings highlight the effect of subjective age on rehabilitation outcomes among osteoporotic fractures and stroke patients and suggest several potential mechanisms behind this effect. Rehabilitation outcomes following osteoporotic fractures or strokes could improve if subjective age and an optimistic outlook are taken into consideration.