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