Associations between older adults' attitudes to ageing, mental health, and quality of life: a systematic review.

The stereotype embodiment theory posits that negative age stereotypes, which are not self-relevant in early life, are internalised at a young age. Cognitive models suggest that such internalised attitudes present a latent vulnerability which can be activated with increasing age and contribute to mental health difficulties. Attitudes to ageing are proposed to be multidimensional, with individual domains exerting differential effects on health outcomes. This review therefore aimed to assess the relationship of general and domain-specific attitudes to ageing with depression, anxiety, and quality of life (QoL) in older adults. The protocol was preregistered on PROSPERO (CRD42024537940). PsycInfo, Embase, Medline, CINAHL, Scopus, and Web of Science databases were searched from inception to February 7, 2026. 22 articles including 41,882 participants were identified and synthesised using a narrative approach, with quality assessed using the AXIS tool. Papers investigated depression (n = 11), QoL (n = 10), and anxiety (n = 7). General negative attitudes to ageing were associated with increased psychopathological symptoms and lower QoL. Across individual domains, negative attitudes to psychosocial loss were most reliably linked with poorer mental health. Conversely, positive attitudes to psychological growth may be a protective factor. These findings are consistent with the stereotype embodiment theory and suggest that attitudes to ageing may present a novel intervention target. Interpretations are limited by the observational nature of the studies, and a priority for future research is the use of experimental approaches to clarify the causality of observed associations and clinical application of attitudes to ageing as a treatment target for older adults' mental health.