Physical appearance concerns and mental health in later life: testing the self-directed Ageism Pathway model

OBJECTIVES: Aging anxiety and self-directed ageism are increasingly recognised as key psychological processes shaping mental health in later life. However, little is known about how specific components of aging anxiety -particularly concerns related to physical appearance- interact with internalised ageist beliefs. This study tested the Self-Directed Ageism Pathway Model (SDA-PM), proposing that concerns about physical appearance exert their influence on mental health exclusively through self-directed ageism. METHOD: A cross-sectional survey was conducted with 601 adults aged 50 and older. Physical appearance concerns, self-directed ageism and perceived mental health were assessed using validated self-report measures. Structural equation modelling (SEM) with WLSMV estimators and bootstrap procedures was applied, including multigroup analyses by gender and age. RESULTS: Findings supported a complete mediation, indicating that physical appearance concerns did not directly predict mental health, but operated entirely through self-directed ageism. The model showed good fit indices and remained invariant across gender and age subgroups, showing that the underlying mechanisms operate consistently across sociodemographic subgroups. CONCLUSION: This study provides empirically validates the SDA-PM and promotes the integration between embodiment-based and cognitive theories of internalised ageism. By identifying self-directed ageism as the main link between ageing-related appearance concerns and poorer mental health, the findings highlight the importance of interventions that address internalised beliefs across clinical, educational and community settings.