Saving for a Rainy Day?

Comparative Optimism About

Disability in Old Age
Vrrn R:r:rix,
1
Ani M:N1si, Lio B:-D:vin, :Nn Jo:cnix Mrxr
Department of Industrial Engineering and Management
Ben-Gurion University of the Negev
Beer Sheva, Israel
This study examined young (n = 40) and middle-aged (n = 30) adults susceptibility
to comparative optimism and comparative pessimism regarding disability in old age
and their willingness to save for long-term care. Participants rated their risk of
diverse levels of disability in old age, compared to another similar person, and
indicated the amount of money they would be willing to save for future long-term
care. While middle-aged participants showed the same level of comparative opti-
mism for diverse disability levels, younger participants showed increasing levels
of comparative optimism with increasing disability. Participants comparative
optimism levels and age both predicted their intentions to save. The ndings are
discussed in terms of theories of judgment and behavioral decision making.jasp_747 1059..1082
Populations in western nations are rapidly aging. Disability prevalence
resulting from home accidents, acute and chronic disease, and dementia
increases with aging (for a review, see He, Sengupta, Velkoff, & DeBarros,
2005). Thus, the growth of elderly populations in developed countries leads
to an increase in the number of older people with one or more disabilities.
According to Manton and Gu (2001), 19.7% of the older population (over
age 65) cope with one or more disabilities affecting daily living; of them, 4.2%
are institutionalized.
Disability involves great expense. A disabled older persons medical
costs are 3 times higher than those of a nondisabled older person (He et al.,
2005). In Israel, for example, the government provides some support for
older persons with disability; however, the individual and the family pay
the larger part of the cost of care. Nevertheless, in spite of age-related
disability risks and the accompanying high costs, people often forgo pur-
chasing long-term care insurance (McCall, Mangle, Buer, & Knickman,
1998; Meier, 1999).
1
Correspondence concerning this article should be addressed to Joachim Meyer, Depart-
ment of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer
Sheva 84105, Israel. E-mail: Joachim@bgu.ac.il
1059
Journal of Applied Social Psychology, 2011, 41, 5, pp. 10591082.
2011 Wiley Periodicals, Inc.
Comparative Optimism and Comparative Pessimism
Comparative optimism and comparative pessimism are phenomena that
may affect the decision to prepare for future long-term expenses. Compara-
tive optimism refers to the belief that negative events are less likely and
positive events are more likely to occur to oneself than to others. Comparative
pessimism refers to the belief that negative events are more likely and positive
events are less likely to occur to oneself than to others. Comparative opti-
mism and comparative pessimism are measured by asking people to make
separate judgments for themselves and for others, or by asking them to
compare their personal risk to that of others. Comparative judgments are
characterized on a group level (Pahl, Harris, Todd, & Rutter, 2005), as on a
group level it is impossible for the majority of people in a group to have lower
or greater risks than average. The present paper focuses on comparative
judgments for negative events, specically, possible future disability.
Comparative optimism for negative events has been demonstrated for
diverse situations. This phenomenon is particularly strong for adolescents
(aged 1217 years) and for young adults (in their 20s). They exhibit com-
parative optimism for negative events, including automobile accidents,
unwanted pregnancy, divorce, and diverse health-related problems, such as
heart attacks (Avis, Smith, & McKinlay, 1989; sampled adults aged 2565
years), mortality related to smoking (e.g., Arnett, 2000; sampled individuals
aged 1217 and 3050 years), AIDS (Hoorens & Buunk, 1993; sampled high
school students), and environmental-related morbidity (e.g., Pahl et al., 2005;
sampled young adults with a mean age of 2122 years).
The relation between comparative optimism and the severity of events is
not clear. Several studies have shown that comparative optimism increases
for more severe events. Kirscht, Haefner, Kegeles, and Rosenstock (1966)
found an inverse correlation between a particular diseases perceived severity
and peoples perceived personal likelihood to contract the disease. Similar
severity effects were found for other negative events (Heine & Lehman, 1995;
Perloff, 1987). It has been argued that this effect of severity reects indi-
viduals attempts to minimize anxiety associated with a potential negative
event. In contrast, Taylor and Shepperd (1998) found that in certain con-
ditions, high levels of severity induced lower levels of comparative optimism.
Reviewing the literature, Helweg-Larsen and Shepperd (2001) stated that
most studies found no association between the two variables.
Past research has identied a number of conditions under which indi-
viduals tend to shift from an optimistic to a pessimistic outlook. These
studies have found increased pessimismwith regard to immediate, rather than
distant future events (Shepperd, Ouellette, & Fernandez, 1996), important
outcomes (Taylor & Shepperd, 1998), easily imaginable negative outcomes
1060 RAFAELY ET AL.
(Sanna, 1999), and outcomes perceived as uncontrollable (Shepperd et al.,
1996).
Comparative Optimism, Comparative Pessimism, and Behavior
Comparative optimism and comparative pessimism may render impor-
tant implications for an individuals well-being. Most health behavior models
assume that perceived susceptibility (or risk) is essential for motivating
behavior (Avis et al., 1989; Shepperd, Carroll, Grace, & Terry, 2002).
According to the theory of planned behavior (TPB; Ajzen, 1991), behavior
depends, in part, on beliefs about the likely consequences of the behavior and
beliefs about the ease or difculty of performing the behavior (i.e., perceived
behavioral control).
In the context of long-term care, the TPB implies that the more an
individual perceives the personal risk of necessitating long-term care, the
more positive will be the individuals attitudes about preparation (Stum,
2005). In contrast, nave optimism regarding risk may reduce compliance
with recommended behaviors (also see Janz & Becker, 1984). A number of
studies have reported ndings consistent with this hypothesis (see Stum,
2005). For example, in Stums (2001) qualitative study, common reasons
people provided for lack of long-term care planning indicated
unrealistic optimism about the self (i.e., It wont happen to me).
Age Differences in Comparative Optimism and Comparative Pessimism
Comparative judgments vary with age. A study of adults (2255 years old)
by Mansour, Joini, and Napp (2006) found that as people reach midlife,
pessimism regarding nancial investment outcomes increases. Similarly, in a
study of a sample of adults aged 25 to 65 years (Avis et al., 1989), young
people were comparatively more optimistic than were older people regarding
the risk of certain medical conditions (e.g., heart failure).
In studying age differences in comparative optimism, Madey and Gomez
(2003) suggested distinguishing between age-related and non-age-related
medical conditions. They found that younger (1822 years of age), midlife
(3554 years of age), and older adults (5889 years of age) tended to exhibit
less comparative optimism as medical conditions were perceived as more
age-related (e.g., osteoporosis, stroke, Alzheimers disease). This reduction in
comparative optimism for age-related medical conditions was most pro-
nounced for middle-aged and older people and was less obvious for younger
individuals. Madey and Gomez argued that these ndings are consistent with
COMPARATIVE OPTIMISM ABOUT DISABILITY 1061
the proposal that midlife is a developmental phase in which individuals begin
to be more aware of age-related health problems; hence, they develop more
health-related self concepts (Hooker & Kaus, 1994).
The present study concerns age differences in ones susceptibility to com-
parative optimism/pessimism about the risk of disability in old age and the
need for long-term care. We hypothesize that young and middle-aged people
will differ in their susceptibility for disability-related comparative optimism
(or comparative pessimism) because of midlifers closer psychological dis-
tance to the possible negative state of disability. First, midlife adults have
lesser temporal distance from aging. Research has suggested that individuals
shift from optimism to pessimism as the temporal proximity of a possible
negative outcome increases (Shepperd et al., 1996; Taylor & Shepperd, 1998).
Because midlifers are relatively close to old ageand are more occupied with
health issues and aging (Hooker & Kaus, 1994)their level of optimism may
decline, while their level of either realism or pessimism may increase. Second,
midlifers may have more experience with long-term care than do their
younger counterparts, as the former are more likely to experience the long-
term care experiences of their aging parents or other relatives. Similarly,
Stum (2005) found that prior experience with long-term care (i.e., needing,
providing, paying for, or using long-term care for oneself or for someone
else) increased respondents awareness of long-term care risks and costs. The
experience-based account is consistent with the availability heuristic accord-
ing to which people tend to judge events as more probable if examples are
easily retrieved from memory or are easily imagined (Tversky & Kahneman,
1973).
Third, although midlifers may be more aware of the potential for age-
related disability and more occupied with health issues than younger people,
they appear to be less apprehensive about aging than are younger people
(Lynch, 2000). Thus, a person may be simultaneously very aware of the
potential health risks in aging and also less worried. One explanation for this
nding is that gained experience bestows midlifers with a more accurate view
of reality than that of younger people. Thus, they accept aging as an inevi-
table developmental stage and, hence, may show less comparative optimism
about potential disability in older age. This account is consistent with
emotion research and social psychological theories suggesting a general
decline in aging anxiety progressing through the lifespan (Lynch, 2000).
Fourth, middle-aged people are more likely to suffer chronic health condi-
tions (e.g., diabetes, hypertension) and may possess increased consciousness
of the long-term effects of chronic disease.
In addition to the aforementioned potential age differences in compara-
tive optimism, age differences in temporal discounting may also have a role
in long-term care enrollment decisions. Because the young are more tempo-
1062 RAFAELY ET AL.
rally distant from old age than are midlifers, the former may be focused on
present needs, discounting the benet of saving now for the future; a ten-
dency demonstrated by many of Stums (2005) respondents, who said they
were too young to worry about long-term care, which is far off in the future.
Furthermore, the Health Insurance Association of Americas (HIAA, 2001)
report found that employees who were enrolled in long-term care insurance
were older than those who were not enrolled in such insurance.
From an economic point of view, age should affect a persons willingness
to allocate resources for future disability planning. Indeed, the young have
more time to prepare and should discount future expenses accordingly.
However, for any investment by a mature person, there should be some
equivalent investment by a younger person, considering discounting. This
implies that if mature people allocate more money for future long-term care
for severe disability than for less severe disability, younger people should also
show the same trend, although they should allocate less money for saving
overall.
The Present Study
The present study addresses three related issues. First, it assesses the
extent of comparative optimism/pessimism regarding the risk of disability in
old age for disabilities with diverse severity levels. Second, the study intends
to provide some information about the degree to which comparative
optimism/comparative pessimism regarding disability in old age will differ
among age groups. Third, it examines younger and midlife adults willingness
to save and allocate monetary resources for future long-term care.
To address these issues, younger and middle-aged participants were pre-
sented with four scenarios, describing older people suffering with various
levels of disability. Participants were asked to predict their risk of each level
of disability after age 65, compared to a person identical in age, gender, and
health status. Based on past research, we expect participants to exhibit higher
levels of comparative optimism as the seriousness of the disability increases.
We also expect that the midlifers will show lower comparative optimism
levels (or greater comparative pessimism levels) about disability risk and
needing long-term care in later life.
Measuring participants willingness to save for long-term care, we expect
the midlifers to demonstrate willingness to save more money for future
long-term care, compared to the younger group. However, across disability
levels, both groups are expected to demonstrate the same order of amounts.
Thus, we expect to identify an age effect with regard to the amounts partici-
pants will be willing to save for future long-term care, and that both groups
will demonstrate a main effect of disability.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1063
Method
Materials
Pilot study. We conducted a pilot study to ensure that the study scenarios
indeed differ in perceived disability severity range. We asked 35 students (17
men, 18 women) at Ben-Gurion University (age = 1929 years) to complete a
questionnaire with descriptions of four scenarios, each presented on a
separate page.
Each scenario described a person older than 65 years of age, requiring one
of several care levels. Consistent with the denition in the Americans With
Disabilities Act (U.S. Department of Labor, 1990), the scenarios described
the disability with respect to the individuals ability to perform activities of
daily living (ADL; i.e., bathing, eating, toileting, dressing, and transferring
from bed or chair) and instrumental activities of daily living (IADL; i.e.,
household management tasks, such as meal preparation, light housework,
money management, shopping, telephone use).
The described persons gender was not specied. In the rst disability level
scenario, the described older person has no difculties in performing either
IADL or ADL tasks, but uses a distress button should an emergency situa-
tion arise. In the second disability level scenario, a caregiver assists the person
in IADL tasks (i.e., household management). In these two scenarios, the
person is able to function independently. In the third and fourth disability
levels, the person is described as dependent on nursing care, and receives
assistance with ADL activities. The third disability level scenario describes a
person with an at-home, live-in caregiver to help with basic daily functions
(e.g., showering, dressing, eating). The fourth disability level scenario
describes a person living in a nursing home and receiving assistance with
daily functioning, identical to the person described in the third scenario.
The pilot study presented the scenarios in four different orders. Following
each scenario, participants were presented with the question To what extent
is the person described in the scenario disabled in everyday functioning?
Participants indicated the level of disability on a 6-point Likert-type scale
ranging from 0 (no disability at all ) to 5 (very high level of disability). In
general, participants perceived the distress-button scenario (M = 1.20,
SD = 1.02) and the IADL scenario (M = 1.91, SD = 1.15) as entailing very
low to low disability levels. They perceived the ADLhome (M = 4.67,
SD = 0.47) and the ADLinstitution scenarios (M = 4.77, SD = 0.43) as
involving very high levels of disability.
A repeated-measures ANOVA conrmed a main effect of disability sce-
nario, F(3, 102) = 190.59, p < .001. Post hoc paired t tests (with Bonferroni
correction, p < .016) conrmed a signicant difference in disability ratings
1064 RAFAELY ET AL.
between distress button and IADL, t(34) = -3.38, p = .002; and between
IADL and ADLhome, t(34) = -12.54, p < .001; but no difference between
ADLhome and ADLinstitution, t(34) = -1.00, ns. Thus, we decided to
include all four scenarios in the main studyincluding the third and fourth
scenariosbecause of differences in the expected cost of the latter two
scenarios.
Main study. The materials consisted of two questionnaires: One pre-
sented the disability scenarios, and the other included questions on personal
details. The scenarios questionnaire presented the four scenarios, ordered
from the lowest to the highest disability levels. Participants indicated for each
scenario the percentage of men and women (over 65 years) at each disability
level, estimated the monthly cost of each type of care described in the sce-
nario, and estimated the time period during which a person would need the
described care (between 1 and 6 months; 6 months to 1 year; 1 to 2 years; 2 to
4 years; 4 to 10 years; or over 10 years). Participants also indicated their own
probability of belonging to each described disability scenario (personal risk)
after they reach age 65 on a scale ranging from 0% to 100%. They also rated
their own risk of belonging to a disability scenario after age 65, relative to the
risk of another person of identical age and gender (comparative risk) on a
5-point scale ranging from 1 (much higher than the other person) to 3 (the same
as the other person) to 5 (much lower than the other person).
Finally, participants were asked to indicate whether they would be willing
to save each month to cover expenses for the care described in each scenario.
Respondents who indicated a willingness to save were asked to specify the
amount they would be willing to save each month.
The personal details questionnaire requested information about partici-
pants age, gender, education, perceived health status, perceived economic
status, and whether or not they had long-term care insurance. We collected
measures of perceived health and economic status because these variables
inuence peoples willingness to enroll in long-term care insurance (HIAA,
2001; Stum, 2005). To measure perceived health status, participants rated
their health on a 5-point scale ranging from 1 (very poor) to 5 (excellent).
Self-assessed health has been found to be strongly associated with mortality,
even after controlling for a range of psychosocial variables, such as social
support, psychosocial stressors, personality traits, and coping styles
(Mackenbach, Simon, Looman, & Joung, 2002).
Perceived economic status was measured by indirect questions. Indirect
questions are commonly used in consumer research and are well established
as a valid measure (Fisher, 1993). The indirect measure of perceived eco-
nomic status was chosen because it is less affected than direct measures by
social desirability, as well as by temporary uctuations in actual income that
are common for students. The rst indirect question described a man (or a
COMPARATIVE OPTIMISM ABOUT DISABILITY 1065
woman, depending on the participants gender) who earns an average salary
(as dened by the Central Bureau of Statistics, 2006). Participants rated the
persons economic status on a 5-point scale ranging from 1 (very poor) to 3
(average) to 5 (excellent).
The second indirect question described a couple earning an average
salary. Participants rated the couples economic status similarly to the pre-
vious question. The use of such indirect economic status questions is based
on the assumption that people evaluate other peoples economic status by
comparing it to their own. Thus, higher ratings indicate that participants
have lower economic status than that described and vice versa.
Participants
Participants included 40 younger adults (19 men, 21 women; age
range = 2130 years) with a mean age of 26.4 years (SD = 2.0); and 30 middle-
aged adults (15 men, 15 women; age range = 4058 years) with a mean age of
50.0 years (SD = 6.4). The younger participants were all students at Ben-
Gurion University of the Negev, who received bonus credits in a course for
taking part in the study. The middle-aged participants were recruited using
convenience sampling. They all had at least an undergraduate degree.
All participants were generally healthy and reported having no signicant
health problems. The two age groups were chosen to represent early adult-
hood and middle adulthood phases, as described by Levinsons (Levinson,
Darrow, Klein, Levinson, & McKee, 1978) model of adult development.
Procedure
Two of the authors
2
approached participants and asked them to complete
a questionnaire examining their views about disability in old age. The
participants rst received the scenario questionnaire and then completed
the personal details questionnaire. Subsequently, they were debriefed and
thanked for their participation in the study.
Results
Description of the Sample
Table 1 summarizes the characteristics of each age group with regard to
perceived health status and perceived economic status. The latter is the mean
2
Adi Mantsur and Lior Bar-David.
1066 RAFAELY ET AL.
response for the two indirect questions, which could be used because
responses to them were moderately correlated (r = .60). The two age groups
did not differ in their perceived health. Regarding perceived economic status,
the younger group thought that persons earning an average income enjoy a
higher economic status, indicating that, compared with the middle-aged
group, their perceived economic status is lower than that of the middle-aged
group. In the young group, 5 people (12.5%) reported owning long-term
care insurance, whereas 13 people (43.3%) in the middle-aged group said
they owned such insurance. This difference in proportion was signicant,
c
2
(1, N = 70) = 8.53, p < .01.
The independent variables (i.e., perceived general risk, perceived personal
risk, comparative risk, estimated costs of long-term care, estimated duration
of long-term care, willingness to save) were analyzed using mixed 4 2
ANOVAs with disability level as the within-subject factor and age as the
between-subject factor. When the interaction between the two variables was
signicant, we performed independent-sample t tests (with Bonferroni cor-
rection, p < .012) to compare between the age groups at each severity level. In
addition, paired-sample t tests (with Bonferroni correction, p < .008) were
performed between two adjacent severity levels on the data of each age
group, separately. Table 2 summarizes the means, standard deviations, and
results of the ANOVAs performed on each of the dependent variables, and
the post hoc comparisons.
Estimates of General and Personal Risk
In the analysis of participants estimates of event probability for their
gender (i.e., general risk), participants thought that lower disability levels
(distress button and IADL) were more likely to occur in the population than
Table 1
Means of Perceived Health Status and Perceived Economic Status
Young group
(n = 40)
Middle-aged group
(n = 30)
t(68) M SD M SD
Perceived health 2.10 0.81 2.30 0.70 ns
Perceived economic status 3.33 0.71 2.88 0.74 2.53*
*p < .05.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1067
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1068 RAFAELY ET AL.
higher disability levels (ADLhome and ADLinstitution). Figure 1 shows
the mean personal risk estimates of the young and the middle-aged groups as
a function of disability level. Similar to the general risk estimates, partici-
pants personal risk estimates decreased as disability levels increased. The
analysis reveals an interaction between disability level and age. Repeated-
measures ANOVA performed on the young and middle-aged participants
data separately reveal a main effect of disability in the young group, F(3,
117) = 24.02, p < .001; and in the middle-aged group, F(3, 87) = 7.75,
p < .001. Independent-sample t tests found no signicant differences between
the age groups regarding any level of disability.
Comparative Risk
Participants considered their own risks as being lower (M = 3.73,
SD = 0.74) than those of another person of equivalent gender and health
status, showing comparative optimism. A one-sample t test, comparing par-
ticipants ratings to the value of 3 (representing no comparative optimism
or comparative pessimism) conrmed that, on average, participants ratings
were signicantly higher than 3, t(69) = 8.26, p < .001. The analyses revealed
a main effect of disability level, which was qualied by an interaction between
disability level and age, as shown in Figure 2. There was no main effect
of age.
To examine the interaction between disability and age, separate repeated-
measure ANOVAs were performed on the data of each age group. A main
0
20
40
60
80
100
Distress
button
IADL ADL-home ADL-
institution
Disability level
P
e
r
s
o
n
a
l

r
i
s
k

(
%
)
Young
Middle-aged
Figure 1. Mean personal-risk evaluations of young and middle-aged groups as a function of
disability level. IADL = instrumental activities of daily living; ADL = activities of daily living.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1069
effect of disability level was apparent in the young group data, F(3,
117) = 18.67, p < .001; but not in the middle-aged group data, F(3, 87) = 2.12,
p > .05. These ndings suggest that comparative optimism was stable across
disability levels in the middle-aged group, whereas the young group showed
higher levels of comparative optimism with increasing levels of disability.
One-tailed independent-sample t tests comparing ratings of the young and
middle-aged groups at each severity level revealed no differences between the
two groups on the distress-button level, t(68) = -0.66, and on the IADL level,
t(68) = 0.69. However, marginally signicant differences were found between
the two groups on the ADLhome level, t(68) = 1.83, p = .036; and on the
ADLinstitution level, t(68) = 1.58, p = .06. These ndings suggest that
the young group demonstrated somewhat more comparative optimism on the
higher levels of disability than did their middle-aged counterparts.
We conducted one-sample t tests to compare the ratings of each age group
to the rating of the same as the other person (i.e., rating of 3). The analyses
showed that both age groups rated their risks (for every level of disability)
signicantly lower than the risk for another person. These ndings indicate
that comparative optimism exists for both age groups across all levels of
disability.
Estimated Monthly Cost of and Duration of Long-Term Care
The greater the disability level, the greater were the costs that the par-
ticipants estimated. Neither the effect of age nor the interaction between
1
2
3
4
5
Distress
button
IADL ADL-home ADL-
institution
Disability level
C
o
m
p
a
r
a
t
i
v
e

r
i
s
k
Young
Middle-aged
Figure 2. Comparative risk as a function of disability level and age group. IADL = instrumental
activities of daily living; ADL = activities of daily living.
1070 RAFAELY ET AL.
disability level and age were signicant. To examine participants accuracy
regarding long-term care costs, we compared their estimated monthly cost for
each type of care to actual costs, using a one-sample t test. The actual costs
were based on information available on the Internet about the costs of
different types of care for older people in Israel (e.g., Yossi, 2008). We used
the minimum costs that were specied on these websites.
Figure 3 shows participants estimated monthly costs for each type of
care, in comparison to the actual (minimum) costs in New Israeli Shekels
(NIS). As can be seen in Figure 3, and as conrmed by one-sample t tests,
our participants were accurate in estimating the monthly cost of the distress
button, t(69) = 0.48, ns; but underestimated the costs of IADL, t(69) =
-10.67, p < .001; ADLhome, t(69) = -3.38, p = .001; and ADLinstitution,
t(69) = -12.31, p < .001. Participants estimated shorter periods for more
severe conditions. Neither the effect for both estimated costs and estimated
duration of care nor the interaction between severity and age was signicant.
Willingness to Save
Overall, more young than middle-aged participants declined saving.
Across all severity levels, out of all participants (including those who already
pay for insurance for long-term care), 60.0% of the young participants
and 43.3% of the middle-aged participants were unwilling to save for
future long-term care. However, this difference did not reach signicance,
c
2
(1, N = 70) = 1.91, p = .17.
0
2000
4000
6000
8000
10000
Disability level
M
o
n
t
h
l
y

c
o
s
t

o
f

c
a
r
e

(
N
I
S
)
Actual costs
Estimated costs
D
i
s
t
r
e
s
s

b
u
t
t
o
n
I
A
D
L
A
D
L
-
h
o
m
e
A
D
L
-
i
n
s
t
i
t
u
t
i
o
n
Figure 3. Mean estimated and actual cost (in New Israeli Shekels) of different types of care.
IADL = instrumental activities of daily living; ADL = activities of daily living.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1071
To compute the average savings, we included all participants, including
those who asserted unwillingness to save (in this case, 0 was entered as the
amount for saving). Because the two age groups differed signicantly in the
perceived economic status measure, this measure was entered as a covariate
in the analyses. We performed a 4 2 ANCOVA with perceived economic
status as a covariate. The covariate of perceived economic status was mar-
ginally signicant, F(1, 67) = 3.13, p = .08; and it signicantly interacted with
level of disability, F(3, 201) = 3.53, p < .05. The effect of disability was not
signicant. On average, middle-aged participants were willing to save more
money per month (M = 70.30 NIS) than were young participants (M = 7.55),
regardless of disability level. The analysis also shows a signicant interaction
between disability level and age. Repeated-measures ANOVA reveals a main
effect of disability in the young group, F(3, 117) = 3.21, p < .05; as well as in
the middle-aged group, F(3, 87) = 4.28, p = .001. Figure 4 shows the mean
monthly payment in NIS that young and middle-aged participants would be
willing to save for long-term care for each level of disability.
Independent t tests were performed for each disability level to com-
pare the amount of money young and middle-aged participants were willing
to save. Signicant between-group differences were found on ADL
institution, t(68) = -2.97, p < .01. Marginal differences were found on IADL,
t(68) = -2.15, p = .035; and ADLhome, t(68) = -1.90, p = .061. No differ-
ence was found on the distress button, t(68) = -1.54, ns.
To understand the interaction between the covariate of perceived eco-
nomic status and disability, we conducted a further analysis, using perceived
0
40
80
120
160
Distress
button
IADL ADL-home ADL-
institution
Disability level
M
o
n
t
h
l
y

p
a
y
m
e
n
t

(
N
I
S
)
Middle-aged
Young
Figure 4. Mean monthly payment (in New Israeli Shekels) that young and middle-aged partici-
pants claimed willingness to save for long-term care at each level of disability. IADL =
instrumental activities of daily living; ADL = activities of daily living.
1072 RAFAELY ET AL.
economic status as a categorical independent variable in the ANOVA. The
two groups were split into low and high perceived economic status by
using the 25
th
and 75
th
percentiles of the continuous measure. Participants
were willing to save more money for the more severe levels of disability,
F(3, 111) = 13.29, p < .001. This increase was stronger for participants with
lower than with higher levels of perceived economic status, F(3, 111) = 9.34,
p < .001. There was also an interaction between age and perceived economic
status, F(1, 37) = 10.07, p < .01.
The main effect of disability level and the interactions were qualied by a
three-way interaction between disability, economic status, and age, F(3,
111) = 8.77, p < .001. Figure 5 shows the mean monthly payment (in NIS)
that participants with perceived low and high economic status were willing to
save for long-term care at each disability level, in the young group (top panel)
and in the middle-aged group (bottom panel). As seen in Figure 5 and as
conrmed by 4 2 ANOVAs performed in each age group separately,
the interaction between disability and economic status was apparent in
the middle-aged group, F(3, 63) = 8.95, p < .001; but not in the young group,
F(3, 93) = 0.50, ns.
Correlations
To explore which variables were associated with participants willingness
to save for future long-term care, we computed Pearsons coefcient corre-
lations between willingness to save (WTS) now for future long-term care and
the estimate of general risk of own gender (GR), estimate of personal risk
(PR), comparative optimism (CO), estimated monthly cost of long-term care
(EMC), estimated duration of the care needed (CD), perceived economic
status, and age. These coefcients were computed for each level of disability
separately, as presented in Table 3.
Two variables (CO and age) were weakly correlated with WTS across
three out of four disability levels (i.e., IADL, ADLhome, and ADL
institution). The correlation between CO and WTS was negative; that is, the
greater the comparative optimism, the less money participants were willing to
save today for future long-term care. A positive correlation between WTS
and age suggests that with increasing age, participants were more willing to
save more money.
PR was weakly and positively correlated with WTS on the two highest
levels of disability, suggesting that the greater participants estimated per-
sonal risk, the more money they were willing to pay for future long-term
care. GR and EMC of care were positively and weakly correlated with WTS
on one of the highest levels of disability, suggesting that the higher the
COMPARATIVE OPTIMISM ABOUT DISABILITY 1073
estimated general risk and the higher the estimated cost, the more money
participants were willing to save. CO needed and perceived economic status
were not correlated with WTS on any of the disability levels.
To explore the relative contribution of the variables to the variance in
participants willingness to save for future long-term care, we conducted a
linear regression analysis using the variables means across all four levels
of disability. The dependent variable was the mean amount of money par-
ticipants said they would be willing to save. The independent variables
were those that signicantly correlated with WTS: perceived general risk
(GR), perceived personal risk (PR), comparative optimism (CO), estimated
0
100
200
300
400
500
D
i
s
t
r
e
s
s
b
u
t
t
o
n
I
A
D
L
A
D
L
-
h
o
m
e
A
D
L
-
i
n
s
t
i
t
u
t
i
o
n
M
e
a
n

a
m
o
u
n
t

t
o

s
a
v
e

(
N
I
S
)
Low status
High status
0
100
200
300
400
500
D
i
s
t
r
e
s
s

b
u
t
t
o
n
M
e
a
n

a
m
o
u
n
t

t
o

s
a
v
e

(
N
I
S
)
Low status
High status
Disability level
0
100
200
300
400
500
D
i
s
t
r
e
s
s
b
u
t
t
o
n
I
A
D
L
A
D
L
-
h
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e
A
D
L
-
i
n
s
t
i
t
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t
i
o
n
M
e
a
n

a
m
o
u
n
t

t
o

s
a
v
e

(
N
I
S
)
Low status
High status
0
100
200
300
400
500
D
i
s
t
r
e
s
s

b
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t
o
n
M
e
a
n

a
m
o
u
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t

t
o

s
a
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e

(
N
I
S
)
Low status
High status
0
100
200
300
400
500
D
i
s
t
r
e
s
s
b
u
t
t
o
n
I
A
D
L
A
D
L
-
h
o
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e
A
D
L
-
i
n
s
t
i
t
u
t
i
o
n
M
e
a
n

a
m
o
u
n
t

t
o

s
a
v
e

(
N
I
S
)
Low status
High status
0
100
200
300
400
500
D
i
s
t
r
e
s
s

b
u
t
t
o
n
M
e
a
n

a
m
o
u
n
t

t
o

s
a
v
e

(
N
I
S
)
Low status
High status
I
A
D
L
A
D
L
-
h
o
m
e
A
D
L
-
i
n
s
t
i
t
u
t
i
o
n
Figure 5. Mean monthly payment (in New Israeli Shekels) that participants with low and high
perceived economic status said they would be willing to save for long-term care at each level of
disability, in the young group (top panel) and the middle-aged group (bottom panel).
1074 RAFAELY ET AL.
monthly cost of the long-term care (EMC), and age. The model accounted for
approximately 30% of the variance in WTS and was statistically signicant,
F(5, 69) = 5.46, p < .001.
Table 4 shows the results of the linear regression analyses. CO appears to
be a signicant predictor, with a negative coefcient (b = -.36, p = .002),
suggesting that greater levels of comparative optimism were related to lower
levels of willingness to save for future long-term care. Age (b = .30, p = .006)
and estimated cost of long-term care (EMC) (b = .25, p = .021) also predicted
WTS, with positive coefcients. CO and age were the best predictors of WTS,
followed by EMC. GR did not predict participants WTS.
Discussion
Participants demonstrated comparative optimism in all four disability
level scenarios. Neither age group demonstrated comparative pessimism.
Contrary to our hypothesis, we did not nd signicant age differences in
susceptibility to comparative optimism, although the young group tended to
show slightly stronger comparative optimism in the two scenarios entailing
Table 3
Summary of Results of Pearson Correlations Between Variables and Willing-
ness to Save for Each Level of Disability
Variable
Disability level
Distress
button IADL ADLhome
ADL
institution
General risk estimates (GR) -.07 .11 .13 .26*
Personal risk estimates (PR) .05 .19 .27* .28*
Comparative optimism (CO) -.22 -.34** -.29* -.31**
Estimated monthly cost
of long-term care (EMC)
-.07 .09 .32** .14
Estimated care duration (CD) .12 .16 .12 .09
Perceived economic status -.21 .12 .16 .08
Age .15 .26* .25* .33**
Note. N = 70. IADL = instrumental activities of daily living; ADL = activities of
daily living.
*p < .05. **p < .001.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1075
the highest levels of disability severity. Yet, whereas the middle-aged group
showed equivalent levels of comparative optimism across all levels of disabil-
ity, the magnitude of comparative optimism exhibited by the young group
increased for more serious disabilities.
It should be acknowledged that although we asked participants about
disability events in old age (by stating that the person described is over 65
years of age), we did not specify the cause of the disability. Thus, the dis-
ability may be either age-related or nonage-related. Therefore, we do not
know whether our participants assumed that the persons disability in each
scenario was age-related. Nevertheless, the studys ndings contribute to
the existing literature on age differences in comparative optimism (e.g.,
Avis et al., 1989; Madey & Gomez, 2003) by demonstrating age differences
in the effect of severity on comparative optimism for the risk of disability
in old age.
It should be noted that in this study, as well as in previous studies, event
severity varied with event frequency; that is, perceived general risk (Helweg-
Larsen & Shepperd, 2001). Participants in both age groups judged more
severe disability levels as less frequently occurring than lower levels of dis-
ability, while exhibiting greater levels of comparative optimism for higher
levels of disability. These ndings are consistent with the relationship
between perceived frequency and comparative optimism that has been
reported in past research (e.g., Price, Pentecost, & Voth, 2002; Weinstein,
1980). However, in the present study, the correlation between perceived
frequency (measured as perceived general risk) and comparative optimism
was signicant only at one level of disability (i.e., IADL; see Table 3).
Our ndings are consistent with various explanations. According to the
temporal distance account, younger peoples greater temporal distance from
Table 4
Results of Linear Regression to Predict the Amount Participants Are Willing to
Save Each Month (in NIS)
Predictor B SE B Beta t p
Perceived general risk (GR) 51.07 69.11 0.11 0.74 ns
Estimated monthly cost of
long-term care (EMC)
0.02 0.01 0.25 2.37 .021
Perceived personal risk (PR) -10.98 70.43 -0.03 -0.16 ns
Comparative optimism (CO) -40.96 12.80 -0.36 3.20 .002
Age 2.02 0.71 0.30 2.85 .006
1076 RAFAELY ET AL.
aging may result in higher levels of optimism with increased disability sever-
ity. The experience-based account assumes that younger people have less
experience with age-related disability requiring long-term care; therefore,
they may be less able to imagine themselves in a situation of needing such
care, particularly with respect to more severe forms of disability. However,
because we did not collect data on participants experience with long-term
care, we cannot ascertain this possible explanation.
According to the aging anxiety account, younger participants increasing
comparative optimism with increased disability level may reect their greater
apprehension about these conditions in old age. This effect of disability
severity on comparative optimism for young participants is consistent with
past research ndings reporting the effects of perceived seriousness of future
adverse events for divorce (Perloff, 1987) and disease (Kirscht et al., 1966) on
comparative optimism.
Another explanation involves the notion of perceived situation control-
lability. Roese and Olson (2007) proposed that people are more likely to
show self-serving comparisons (e.g., comparative optimism) in situations that
are not under their direct control. According to Roese and Olson, when
people feel that they have nothing to do about a situation (i.e., they do not
have the money to save, particularly for potential events that involve high
costs, such as the ADL scenarios), the self-serving comparison functions as a
re-construal of the situation in order to make it look better. In the context of
our study, the costs of higher disability levels (i.e., the ADL scenarios) may be
considered uncontrollable, while the costs of the lower ones (i.e., distress
button, IADL) could be seen as in reach. Younger peoples limited nancial
resources may yield feelings of lack of control. Future research should
examine the relative contribution of each explanation to the different age
patterns in comparative optimism in the context of disability in old age.
Although the two age groups differed in the effect of disability severity on
comparative optimism, no such pattern emerged in estimates of personal risk.
These results demonstrate that two measures of perceived personal risk (i.e.,
comparative risk, personal risk) were differently affected by the seriousness
of the disability.
The ndings also show that the age groups did not differ in their cost
estimates of long-term care for different disability levels. Both age groups
estimated increased expenses for long-term care as the level of disability
increased, but relative to the middle-aged group, the young group was willing
to save less money for future long-term care. Regardless of the between-
group differences in the amounts of money they were willing to save, one
would expect that both age groups would demonstrate a willingness to save
different amounts of money for future long-term care as a function of
disability level. Indeed, both age groups showed this pattern of results.
COMPARATIVE OPTIMISM ABOUT DISABILITY 1077
However, the amounts the young group was willing to save each month were
less affected by disability level than the amounts the middle-aged group was
willing to save. These differences in the amounts participants were willing
to save cannot be explained by between-group differences regarding the
estimated cost of long-term care for the different levels of disability or the
estimated duration of needed care, as the two age groups did not differ on
these variables.
The regression analysis ndings suggest that the amount of money par-
ticipants were willing to save was best predicted by comparative optimism
(i.e., the greater the comparative optimism, the less money participants were
willing to save) and age (i.e., mature participants were more willing to save
than were younger participants). The estimated care costs and the expected
duration also predicted the amount participants were willing to save (i.e., the
higher the estimated cost and the longer the care is expected to last, the more
money people are willing to save), but to a lesser extent. However, taken
together, these variables (i.e., comparative optimism, age, estimated cost,
expected duration of care) explained only 30% of the variance in the amounts
participants were inclined to save for future long-term care. Future research
should investigate what other variables could potentially predict the amount
of money people are willing to save for future long-term care. For example,
prior experience with long-term carewhich appeared to be related to per-
ceived risk of needing such care (McGrew, 2000) and to awareness of care
costs (Stum, 2005)may contribute to the amount of money people would
be willing to save for future long-term care. In addition, people who suffer
chronic health conditions (e.g., diabetes, hypertension) may be more aware of
their risk of future disability and, hence, may be willing to save more for
future care.
Based on these ndings, it is apparent that comparative optimism com-
prises one explanation for the reduced amounts of money young people are
willing to invest in the present in anticipation of a future event. This nding
is consistent with the TPB, according to which an individuals beliefs about
the likely consequences of an action inuence ones intentions to perform the
action.
Other differences between the two age groups may also have a role in
explaining the reduced funds that young people are willing to invest. For
instance, consistent with a further aspect of the TPB hypothesisaccording
to which an individuals beliefs about his or her ability to perform the
behavior (e.g., save for future long-term care) contribute to his or her inten-
tion to carry out the behavioryoung people, whose resources may be
limited, may be more inclined to use available resources for present needs
than for uncertain future needs. However, although the young and the
middle-aged groups differed with respect to perceived economic status,
1078 RAFAELY ET AL.
young peoples limited resources cannot adequately account for group dif-
ferences in the amounts participants were willing to save, since these between-
group differences were apparent, even when controlling for perceived
economic status.
An interesting pattern emerged with respect to the variable of perceived
economic status. In the middle-aged group, differences were found between
participants who perceived their economic status as low, as opposed to high.
Middle-aged participants with low perceived economic status were willing to
save more money than were those with high perceived status, particularly for
higher levels of disability. However, no such difference was apparent in the
young group. These ndings seem to contradict the expectation that people
with greater nancial resources would be willing to save more money for a
rainy day, as they have more resources at present, enabling them to put
money aside. However, it also seems reasonable that those with limited
resources may feel less condent in their future ability to cover potentially
high expenses and, therefore, may be more inclined to save in order to
prepare for such a situation. A oor effect may explain the lack of differences
between young people with low and high perceived economic status. That is,
young participants, regardless of perceived status, are in the present willing to
save very little, if anything at all, for the future.
Another potential between-group difference that may account for dispari-
ties in the amounts participants were willing to save is related to the fact that
the younger a person is, the less money he or she needs to allocate each month
(or pay a lower insurance premium) for future long-term care. Between-
group differences in temporal discounting may also explain disparities in the
amounts of money people are willing to save for the future.
It should be acknowledged that the two age groups differed with respect
to within-group age diversity, whereby the young group consisted of partici-
pants who were 21 to 30 years old, while the middle-aged group ranged from
40 to 58 years old. To better understand the developmental changes in risk
perception and its relation to planning for disability in old age, future studies
should examine these issues using more age groups, each having a more
conned age range.
To conclude, we found different patterns of risk perception, comparative
optimism, and behavior intention as a function of disability seriousness and
respondents ages. When directly comparing personal risk to that of another
person, participants from both age groups believed that they were less likely
than another person to suffer disability in old age. In the young group, this
which was tendency was more pronounced as the level of disability increased;
a nding not apparent in the middle-aged group. Behavioral intentions also
differed between the two age groups. Relative to the middle-aged group, the
young group was inclined to save less money for future care. Importantly,
COMPARATIVE OPTIMISM ABOUT DISABILITY 1079
our ndings demonstrate the essential role that comparative optimism and
age play in peoples intentions to plan for their futures.
The comparative optimism about disability in old age demonstrated in
this study and its role in peoples willingness to save for the future has
important implications for the well-being of individuals and their families.
Our ndings point to the need to develop educational programs incorporat-
ing information about disability risks in old age, as well as information about
long-term care costs so that young people today can better prepare for
tomorrow. Specically, such programs could inform young people about the
prevalence of disability in the aging population, and the implications of
disability in terms of the necessary care and its costs at different disability
levels.
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