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There are few measures specifically on stressors specific to older adults. This entry reviews various stress measures that include at least some stressors relevant to older populations and we suggest two measures that are specific for older adults. 

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We have a growing aging population. Worldwide, it is estimated that by 2050, the 60+ population will double to ~2.1 billion people; longer life expectancies can be attributed to several factors including medical advancements and changes in physical/social environments (World Health Organization [WHO], 2022). The 65+ population the U.S. was 16.8% in 2020 (~1 of every 6 people), a product of steady growth across the 20th century, which was 5x faster than the overall population growth (Caplan, 2023). This drastic increase in population aging underscores the need to better understand experiences during this life stage, especially stressful experiences (of which there are several types, such as trauma and chronic stress). And while older adults appear to respond to stressors better (i.e., less exposure) than their younger counterparts (Almeida et al., 2023), stress in its many forms continues to be deleterious for health and well-being across the lifespan.

 

Two measures we are aware of have been developed from interviews with other adults: the Elders Life Stress Inventory (ELSI; Aldwin, 1990) and the Louisville Older Person Events Schedule (LOPES; Murrell & Norris, 1984), both of which are described below in further detail. Other types of stressors, like daily stressors (hassles), do not have specific measures for older adult samples, underscoring a gap in the field of stress and aging.  

 

We would like to increase the number of measures for daily stress for use with older adults and appreciate researchers sending us measures they have developed or found.  Below, we have defined and identified four types of stress—chronic stress, traumatic events, stressful life events, and daily stressors—and provided example measures for each, to assist researchers interested in studying stress in later life. 

 

Chronic stress/strain are ongoing circumstances (Dunkel-Schetter & Dolbier, 2011; Wheaton, 1994) and/or enduring problems linked to social roles (Perlin & Schooler, 1978), respectively. Unlike other types of stress, these events often occur without clear start and/or end points. Measures typically focus on specific types of events/experiences, which are especially applicable for older adults, such as the following: caregiving (Crosswell & Epel, 2018), financial strain (Prather, 2018), and discrimination (Berry Mendez, 2017). Discrimination can be experienced along a variety of sociodemographic characteristics, including age (ageism—prejudice, discrimination, and stereotypes based on age; WHO, 2018). An example of an ageism measure, which examines daily frequency of ageist experiences is The Everyday Ageism Scale (Allen et al., 2021). An example of an age stereotype measure is the Image of Aging Scale (Levy, Kasl, & Gill, 2004), which has been validated with older persons (e.g., Levy, Pilver, Chung, & Slade, 2014). 

 

Traumatic events are defined by the American Psychiatric Association (2013, p. 527) as witnessing or experiencing “actual or threatened death, serious injury, or sexual violence” (e.g., death of spouse/child, diagnosis of life-threatening illness). See Mayer and Crosswell’s (2018) Stress Measurement Network review for a list of measurement tools; timescales vary across measures and can include six-month, 1-year, or lifetime prevalence. Lifetime prevalence of exposure to traumatic events in adulthood increases with age (Bürgin et al., 2020), while older adults reported significantly lower rates of certain traumatic events (e.g., physical assault, sexual assault) in the past year compared with younger and midlife adults (Norris, 1992).   

 

Stressful life events/major life event measures have been previously complied by Mayer (2018). As noted earlier in this entry, there are two inventories developed specifically from and for use with older adult samples. ELSI was developed from the observation that existing life scale inventories included events that generally occurred more with younger adults (e.g., birth of child). The ELSI includes both egocentric (e.g., divorce) and nonegocentric events (e.g., child’s divorce or separation) that occurred in the past year; the measure includes prompts for both exposure and event severity.    

 

Daily stressors, or hassles, reflect challenges of daily living (Almeida, 2005). Although older age appears protective against exposure to hassles, severity ratings (Aldwin et al., 2014) and reactivity (Almeida et al., 2023) increase or remain stable, respectively. A possible explanation for these seemingly contradictory results are central to Charles’s (2010) strength and vulnerability integration (SAVI) model, which proposes that while older adults have accumulated age-related advantages that enable greater stressor avoidance, when a stressor must be encountered, such age advantages disappear or dampen.  

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Measures of daily stress include the Daily Inventory of Stressful Events (DISE: Almeida et al., 2002) and Hassles and Uplifts Scale-Revised (DeLongis et al., 1988); both assess events in the past day (i.e., 24 hours).  The DISE uses a phone interview approach to first gage exposure to the following types of daily events: interpersonal tensions; work/education; finances; health; home; network; and other. If participants indicate an event occurred, a variety of follow-up questions gage various aspects of the experiences: (1) who was involved (e.g., self, other); (2) threat (e.g., loss, frustration); (3) level of disruption (low or medium severity); (4) level of stressfulness (e.g., somewhat stressful), and; (5) primary appraisal across domains (e.g., health/safety, finances).   

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Physiological measures of stress reveal age differences. Beyond the psychological measures reviewed above, other entries in the Stress Measurement Network review biological indicators of stress responses. These physiological measures such as cortisol, heart rate variability, and measures associated with sympathetic/noradrenergic activity (e.g., salivary alpha amylase, plasma noradrenaline, sympathetic nerve activity) can be sensitive to age differences in stress-related systems. For instance, a meta-analysis indicates that older adults show a larger cortisol response to challenge than do younger adults (Otte et al., 2005). Age differences in cortisol responses tend to be stronger in women than men (Otte et al. 2005), which may be due to declines in estradiol levels after menopause (Herrera et al., 2017). In addition to cortisol and the hypothalamus-pituitary-adrenal axis, when examining stress and aging, the sympathetic and parasympathetic nervous systems and the locus coeruleus-noradrenergic system that coordinates arousal responses (Agorastos & Chrousos, 2022; Mather, 2020) may be of interest. Through midlife, parasympathetic activity declines dramatically while noradrenergic/sympathetic activity increases (Mather, 2024), a profile associated with chronic stress (Babisch et al., 2001; de Looff et al., 2018).  

 

Authors & Reviewers: Prepared by Maria Kurth, PhD, and David Almeida, PhD.  

Reviewed by Elissa Epel, PhD, Becca Levy, PhD, and Mara Mather, PhD.  

Version date: June 2024 

 

References 

 

Agorastos, A., & Chrousos, G. P. (2022). The neuroendocrinology of stress: the stress-related continuum of chronic disease development. Molecular Psychiatry, 27(1), 502–513. 

 

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Aldwin, C. M., Jeong, Y.-J., Igarashi, H., & Spiro, A. III. (2014). Do hassles and uplifts change with age? Longitudinal findings from the VA Normative Aging Study. Psychology and Aging, 29(1), 57–71. https://doi.org/10.1037/a0035042  

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Allen, J. O., Solway, E., Kirch, M., Singer, D., Kullgren, J. T., & Malani, P. N. (2021). The everyday ageism scale: Development and evaluation. Journal of Aging and Health, 34(2), 147-157. https://doi.org/10.1177/08982643211036131 

 

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Almeida, D. M., Rush, J., Mogle, J., Piazza, J. R., Cerino, E., & Charles, S. T. (2023). Longitudinal change in daily stress across 20 years of adulthood: Results form the National Study of Daily Experiences. Developmental Psychology, 59(3), 515-523. https://doi.org/10.1037/dev0001469

 

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