Health-Related Expectations Regarding Aging among Middle-Aged and Older Japanese: Psychometric Performance and Novel Findings from the ERA-12-J

Michael Annear*, Yasuo Shimizu, Tetsuhiro Kidokoro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and objectives: Health-related expectations regarding aging is a gerontological construct that is potentially predictive of morbidity and mortality in later life. The Expectations Regarding Ageing scale (ERA-12) is a widely used measure of health-related expectations, although it has not previously been administered in Japanese. The present research aimed to elucidate the psychometric properties of the first Japanese translation of the ERA-12 and evaluate health-related expectations among middle-aged and older Japanese. Research design and methods: Repeated online surveys were conducted with representative quota samples of middle-aged and older adults in Tokyo during 2021 (N = 1600). Primary outcome measures included total and subscale scores on a Japanese translation of the ERA-12 (ERA-12-J) addressing perceptions of physical, mental, and cognitive health. Standard measures were also used to gather information regarding respondent demographic details, general health, and health-related behavior. Results: The ERA-12-J and associated subscales showed acceptable test-retest reliability (t(1598) = 0.60, p = 0.63), internal consistency (α > 0.80), inter-item correlation (r = 0.21–0.78) and item-total correlation (r = 0.53–0.73). Confirmatory Factor Analysis verified the hypothesized three-factor structure and construct validity on four common indices of fit (GFI = 0.968; CFI = 0.978; AGFI = 0.950; RMSEA = 0.059). ERA-12-J scores among Japanese respondents revealed prevailing negative sentiments concerning physical and cognitive health, with less negative sentiment regarding mental health. Significant and independent differences emerged concerning gender and age cohort, with middle-aged adults and females holding more negative expectations about their future health. Discussion and implications: The ERA-12-J provides a sound basis for the elucidation of health-related expectations about aging in Japan and a useful tool for international comparative studies. Education and workplace intervention may be required in Japan to address age and gender disparities in health-related expectations.

Original languageEnglish
Article number13509
JournalInternational journal of environmental research and public health
Issue number20
Publication statusPublished - 2022 Oct


  • Asia
  • Japan
  • cognitive function
  • health expectancy
  • healthy aging
  • mental wellbeing
  • physical health

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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