Examining subjective views of the aging process in older adults: a systematic review following the COSMIN methodology

This systematic review is intended to identify, categorize, and evaluate instruments assessing generalized and personal views of aging (VoA) in older adults as well as how these instruments have addressed views of changes in cognition with aging. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review was preregistered in PROSPERO (CRD42023407986). Studies presenting VoA instruments, also including a specific focus on views of changes in cognition with aging, were identified using the Scopus, PsycINFO, and Web of Science databases. Based on the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, risk of bias and GRADE assessments were conducted for each instrument. Of the 3,578 records emerged, 77 studies assessing measurement properties of 26 VoA instruments in samples of older adults were included. These instruments reflected diverse generalized and personal VoA concepts; few ones assessed or included items depicting views of changes in cognition with aging, with memory being the most frequently addressed cognitive domain. Notwithstanding psychometric and measurement issues, this review provides a comprehensive summary of existing instruments assessing subjective VoA, which have clinical and applied utility in promoting healthy aging, especially for older adults at risk of pathological aging. The development and validation of new VoA scales, particularly to assess views on age-related cognitive changes with aging, is warranted.