The impact of life story groups on enhancing attitudes toward aging in older adults: a mixed methods study

Abstract

Background

With the increasing aging population, fostering a positive attitude toward aging is essential for enhancing psychological well-being and successful aging. Negative perceptions of aging, influenced by stereotypes and social biases, can impact self-identity and mental health. Life story group interventions provide a platform for older adults to reflect on life experiences, challenge aging myths, and strengthen social engagement. This study examined the effectiveness of a life story group intervention in improving older adults’ attitudes toward aging.

Methods

This study employed a mixed-methods design. A total of 108 participants (54 per group) were recruited from two randomly selected communities in Taiwan that were assigned to either the experimental or control group by lottery. The experimental group participated in an eight-week life story intervention, while the control group received no intervention. Quantitative data were collected using the Taiwan Attitude toward Aging Questionnaire and analyzed using paired t-tests and ANCOVA. Qualitative data from semi-structured interviews were analyzed thematically to explore participants’ experiences.

Results

After eight weeks, the experimental group showed a significant increase in attitude toward aging scores (t = 31.14, p = 0.001), whereas the control group showed no significant change (t = 1.99, p = 0.06). ANCOVA results confirmed a significant difference between groups (F = 817.56, p < 0.001). Qualitative analysis revealed three key themes: “Finding a new normal amidst loss,” “Dispelling myths and redefining self-worth,” and “A wonderful life that continues to bloom.” Participants reported a shift from viewing aging as decline to embracing adaptation and growth, alongside increased motivation for social participation.

Conclusions

The life story group intervention significantly improved older adults’ attitudes toward aging, supporting its use as a psychosocial intervention. Encouraging participation in narrative-based interventions may promote active engagement, self-identity, and resilience.

Clinical trial number

Not applicable.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-025-05900-1.

Introduction

Population aging is one of the most pressing challenges in contemporary society. However, negative attitudes and unfavorable perceptions toward older adults remain widespread, and such attitudes often serve as precursors to ageism [1]. Ageism frequently leads individuals to equate older adults with incompetence, helplessness, and illness [2]. Over time, these aging-related stereotypes may become internalized, further shaping individuals’ perceptions of their own aging process [3, 4].

Attitudes toward aging refer to individuals’ cognitive, emotional, and behavioral responses to their own or others’ aging processes. Stereotypes about aging acquired in youth tend to become internalized with age, often operating unconsciously and directly influencing functionality and health through multiple pathways [3]. Attitudes toward aging can be categorized into physiological, psychological, and social dimensions. Physiological aging attitudes involve perceptions of physical aging, such as changes in appearance and health status. Psychological aging attitudes pertain to individuals’ understanding of and adaptability to the aging process. Social aging attitudes reflect individuals’ perspectives on shifts in social roles and interpersonal relationships [5]. Research has shown that older adults with positive attitudes toward aging tend to better adapt to the aging process, exhibit better physical and mental health, and actively participate in social activities, thereby enhancing life satisfaction and well-being [4, 6–9]. Moreover, fostering positive attitudes toward aging has been associated with preventing physical decline in later life [10]. There exists a reciprocal relationship between social participation and positive aging attitudes, potentially forming a self-reinforcing cycle [11]. Conversely, individuals with negative attitudes toward aging are more prone to anxiety and depression, which may reduce health-promoting behaviors and social interactions, ultimately leading to deteriorating health and increased feelings of isolation [4, 6, 7, 12]. Social engagement with friends has been found to mitigate some of the negative effects of aging [13]. Given these findings, it is evident that attitudes toward aging have a profound impact on the physical and mental health of older adults, as well as their behavioral patterns. Research suggests that the effects of negative aging stereotypes on behavioral outcomes in older adults are significantly stronger than those of positive aging stereotypes [14]. Therefore, promoting positive attitudes toward aging is crucial for enhancing psychological well-being and overall quality of life.

Life story work is an intervention approach based on a life-course perspective, enabling individuals to express memories of specific situations, events, and emotions. Through this process, individuals can reassess their interpretations of self-defining events and emotional responses, ultimately enhancing self-acceptance and a sense of life meaning [15, 16]. By recalling and narrating personal past experiences, older adults can reevaluate and better understand their life journey [17], improve psychological well-being, and enhance life satisfaction [16–19]. This integrative and instrumental reminiscence approach has been shown to facilitate successful aging among older adults [20]. Sharing one’s life story serves as both acknowledgment and reflection, reinforcing a sense of personal achievement and reappraisal [21]. Research has shown that life story work-related activities help older adults recognize their self-worth, connect with life events and circumstances, and reaffirm the meaning of life [18, 22]. Recalling past experiences can enhance positive emotions, coping mechanisms, and adaptation to aging among older adults [23]. By sharing their life stories, older adults can re-examine their life experiences and rebuild their self-identity, which can help form a more positive attitude toward aging [24].

Through life story work, older adults can assign new meaning to their life experiences, strengthen self-identity, and develop a more positive attitude toward aging. This reminiscence process can be conducted in either individual or group settings, with group sizes typically ranging from 7 to 12 participants. Sessions are held weekly for 4 to 16 weeks, with each lasting 30 min to 2 h. Tangible prompts such as historical artifacts, old photographs, videos, and songs are commonly used to evoke memories and stimulate conversations [16, 25]. This approach is not only cost-effective and relatively easy to implement but also has minimal side effects. Although previous studies have supported the positive effects of life story work on the psychological well-being of older adults [18, 19, 22], most research has focused on populations with dementia or depression [26, 27]. There is a lack of studies investigating whether life story work interventions can also improve psychological well-being in cognitively intact older adults. In particular, the impact of life story work on attitudes toward aging remains underexplored, highlighting the need for quantitative research to validate its potential effects. Aging is an integral part of life, and fostering self-worth and a positive attitude toward aging can help older adults adapt to later life stages. Therefore, this study aims to examine whether participation in life story groups can effectively improve older adults’ attitudes toward aging.

Methods

Study design

This study employed a mixed-methods research design, incorporating a randomized controlled trial (RCT), individual interviews, and participatory observation to examine the phenomenon from multiple research perspectives and to explore the complex relationships between different aspects of the research problem. A structured questionnaire was used to analyze the effectiveness of the intervention, while individual interviews and participatory observation were aimed at understanding the process of changing attitudes toward aging among older adults participating in the life story group intervention. The RCT adopted a pretest-posttest design with two groups. The study was conducted in Qidu District, Keelung City, Taiwan, which comprises 20 villages. Dubel Village and Zhengming Village were randomly selected by lottery. Subsequently, these two villages were again randomly assigned by lottery to either the experimental or control group.

The study was conducted between November 2022 and February 2023. The experimental group participated in an eight-week life story group intervention, while the control group received no intervention. Following the reminiscence therapy recommendations of Yen and Lin (2018) [25], the life story group intervention was conducted once a week, with each session lasting two hours, for a total of eight weeks. Figure 1 illustrates the research process. Before the intervention, both groups completed a pretest (T0) data collection. After the eight-week intervention, posttest (T1) data collection was conducted. Additionally, participants in the experimental group underwent face-to-face individual interviews upon completing the intervention.

Fig. 1.

Study process

Participants and sample size estimation

To control for potential confounding variables, strict inclusion and exclusion criteria were applied at the participant level. The inclusion criteria for participants in this study were as follows: individuals aged 65 years or older, able to communicate in Mandarin or Taiwanese, willing to participate in interviews, capable of walking independently without mobility impairments, and having a Barthel Index score of 91 or above, indicating a high level of independence in activities of daily living. The Short Portable Mental Status Questionnaire (SPMSQ) was used to assess the cognitive function of elderly individuals and identify potential intellectual impairment or dementia [28]. Participants who achieved a score of eight or higher were considered to have normal cognitive function and were included in the study. Individuals with cognitive impairments or inability to communicate effectively were excluded. The required sample size was estimated using G*Power 3.1.2 statistical software, applying the “ANOVA - Repeated Measures method” with a medium effect size (f = 0.25), statistical power = 0.80, and α = 0.05. The estimated sample size was 98 participants; considering a 10% dropout rate, the final target sample size was set at 108 participants, with 54 participants assigned to each group.

The life story group program

The life story work focused on recalling and evaluating significant events that occurred during different life stages, including childhood, adolescence, adulthood, and old age [16]. The life story group curriculum included topics such as childhood and adolescent memories, family and social relationships, career and achievements, major life events, the meaning of life, and future outlook. The instructional content was designed to introduce storytelling and reflection on life experiences as the primary approach, enabling older adults to develop a positive attitude toward aging by reflecting on their life experiences, aging process, and personal feelings. The sessions covered the following topics: “Icebreaker,” “My Time Machine,” “Telling Stories Through Photos,” “My Achievements and Contributions,” “Cherishing the Present,” “Embracing the Future,” “Story Preparation,” and “Gratitude and Blessings” (see Table 1).

Table 1.

Content of life story groups

Week	Project Title	Goal	Activity Content
1	Icebreaker	To foster mutual acquaintance among group members and establish a safe and trusting group environment.	1. The facilitator will explain the objectives of the group activities, ensuring older adults understand the content and procedures for the 8-week program. 2. A ball is passed around while singing. The facilitator begins by introducing themselves. When the music stops, the person holding the ball introduces themselves. If the ball lands with the same person twice, it is passed to the next older adult. 3. Participants engage in a “Name Matching” game to enhance familiarity with one another.
2	My Time Machine	By reviewing past life experiences through videos, individuals can relive cherished memories.	1. Each session will commence with a 10-minute light exercise routine to promote physical well-being. 2. A vintage video depicting the participants’ childhood era will be shown to stimulate recall of youthful memories and initiate reminiscence. 3. Following the video presentation, participants will engage in small group discussions, encouraged to share anecdotes related to their childhood, educational experiences, work history, and family life. 4. Participants will be requested to bring photographs from various life stages (childhood, adolescence, adulthood, and old age) for the next session.
3	Telling Stories Through Photos	Using photographs to evoke participants’ spontaneous storytelling, encouraging them to share significant life events from that time.	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. In small groups, elderly participants will share their photographs and recount significant life events from different stages of their lives. Through group discussions, they will learn to view life transitions from multiple perspectives. 3. For the next session, participants are encouraged to bring a meaningful keepsake that represents their professional achievements, family milestones, or social contributions, such as an award certificate or a child’s graduation photo.
4	My Achievements and Contributions	Affirm self-worth by recognizing personal contributions to family and society.	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. In small groups, elderly participants will share their stories through meaningful keepsakes that represent their personal achievements. Through this activity, they will be guided to recognize their contributions to family and society.
5	Cherishing the Present	Learn to appreciate the beauty of the present moment and enjoy life.	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. Play music from the participants’ era to create a relaxed atmosphere, engaging them in a sensory experience accompanied by a tasting of selected foods. 3. Encourage participants to share the beautiful aspects of their daily lives with one another.
6	Embracing the Future	Explore aspirations and dreams for the future, bringing renewed vitality to later life.	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. Invite participants to share their aspirations for the future, such as traveling, engaging in social work, taking classes, etc. 3. Encourage participants to set goals that will infuse vitality into their later years.
7	Story Preparation	Organize and document life stories through various methods	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. Guide participants in selecting creative materials: Offer a variety of materials such as colored paper, old photographs, drawing paper, pens, scissors, etc., allowing participants to choose freely. 3. Demonstrate and explain creative techniques, such as cutting, drawing, and collage-making. 4. Encourage participants to combine their memories with handmade creations to craft a unique life storybook.
8	Gratitude and Blessings	Express gratitude and offer blessings to one another.	1. Begin each session with a 10-minute warm-up exercise to promote physical well-being. 2. Encourage each participant to express gratitude towards themselves, others, and life, and share the life storybooks created in the previous week. 3. Exchange gifts or cards to offer blessings to one another.

The life story group sessions were led by the second author, who has extensive experience in promoting community health for older adults. The intervention was conducted using a small-group format, with participants divided into six groups, each consisting of approximately nine members. Each session began with warm-up activities, such as singing and simple health exercises, to create a pleasant interactive environment and encourage active participation. The early sessions focused on building trust (e.g., icebreaker games and sharing childhood memories through videos and photos). Midway sessions encouraged older adults to recall and reflect on past events using meaningful objects—such as favorite songs, important documents, and photographs—to evoke memories of valuable achievements and help them regain a sense of life meaning. In the final week, participants were encouraged to share their life storybooks as a culminating activity. They also exchanged gifts or cards and offered blessings to one another, fostering a sense of connection, appreciation, and emotional fulfillment within the group.

Measures

This study adopted a mixed-methods approach to data collection. A structured questionnaire was used to analyze the effectiveness of the intervention, while individual interviews aimed to explore the process of attitude change toward aging among older adults following their participation in the life story group program.

Demographic and baseline characteristics

The collected data included age, gender, marital status, educational level, living arrangement, self-perceived economic status, number of chronic diseases, number of chronic disease medications taken, and depression score. The depression score was measured using the Geriatric Depression Scale - Short Form (GDS-SF), a 15-item self-report questionnaire designed to assess depressive symptoms over the past week. The GDS-SF is a widely used tool for evaluating geriatric depression [29]. Each “yes” response was assigned one point, while each “no” response was assigned zero points. The total score ranges from 0 to 15, with higher scores indicating a greater tendency toward depression.

Taiwan attitude toward aging questionnaire (TAAQ)

This study used the Taiwan Attitude toward Aging Questionnaire (TAAQ), developed by Wu et al. (2016), to assess attitudes toward aging [30]. Exploratory factor analysis identified two distinct factors: Negative Self-Perception of Aging (NSPA) and Positive Self-Perception of Aging (PSPA). The internal consistency reliability coefficients for these two factors were 0.78 and 0.80, respectively, with three-month test-retest reliabilities of 0.79 and 0.81. For validity testing, PSPA was positively correlated with the Philadelphia Geriatric Center Morale Scale (r = 0.39) and the Activities of Daily Living Scale (r = 0.25), while it was negatively correlated with the Brief Symptom Rating Scale (r = -0.33) and the Geriatric Depression Scale (r = -0.57). In contrast, NSPA showed the opposite pattern, indicating that the TAAQ demonstrates high reliability and validity. The confirmatory analysis supported this two-factor model with a good fit [30].

The Aging Perception Questionnaire (APQ) is an internationally recognized tool for measuring attitudes toward aging. The APQ assesses individuals’ multidimensional perceptions of aging, covering cognitive, emotional, and behavioral aspects [31]. While the APQ focuses on cognitive representations of aging based on the self-regulation model, the TAAQ is specifically designed to assess older adults’ attitudes toward their own aging within the Taiwanese cultural context. It aims to measure both emotional and behavioral attitudes toward aging, making it particularly suitable for evaluating the impact of life story group interventions on attitudes toward aging. The TAAQ consists of 16 items, with eight items measuring positive attitudes toward aging and eight items assessing negative attitudes toward aging. Responses were rated on a 5-point Likert scale, ranging from 5 (strongly agree) to 1 (strongly disagree), with higher scores indicating a more positive attitude toward aging [30]. In the present study, the Cronbach’s α for the TAAQ was 0.83.

Ethical approval

This study was approved by the Institutional Review Board of Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan (No: TYGH111057). Participation in the study posed no risk to the participants, and written informed consent was obtained from all participants.

Qualitative data collection

The qualitative data were collected through participant observation and individual interviews. Participant observation included monitoring older adults’ engagement in the sessions, their participation in group discussions, and their sharing experiences.

Individual interviews were conducted at the community activity center office after the post-intervention questionnaire assessment. A total of 25 older adults from the experimental group agreed to participate in the interviews, which lasted approximately 30 min each. To ensure consistency, all interviews were conducted by the same researcher (Author 2). With participants’ consent, the interviews were audio-recorded. A semi-structured interview guide (Table 2) was used to collect participants’ subjective experiences of the intervention. All interviews were transcribed verbatim within 24 h of completion.

Table 2.

Interview guide

Item	Content
1.	After participating in the life story group, have your thoughts about “aging” changed? If so, please provide examples.
2.	After participating in the life story group, do you feel more confident and energetic?
3.	After participating in the life story group, have you realized that you still have many abilities that you can utilize?
4.	After participating in the life story group, do you feel more inclined to make new friends and engage in community activities?
5.	After participating in the life story group, have your interpersonal relationships improved?
6.	After participating in the life story group, do you feel that your life has become more meaningful and goal-oriented?
7.	After participating in the life story group, has your relationship with family and friends improved?
8.	After participating in the life story group, do you feel less lonely, bored, or worried?
9.	After participating in the life story group, what do you consider to be your greatest gain?
10.	How do you feel when listening to the life stories of other elderly participants?

Data processing and analysis

The IBM SPSS software version 23.0 (IBM Corp., Armonk, NY, USA) was used for statistical data analysis. The chi-square test and t-test were used to compare differences in categorical and continuous variables between groups. The paired t-test was used to analyze differences in mean scores before and after the intervention within each group. One-way ANCOVA (Analysis of Covariance) was used to compare the differences between the experimental and the control groups on the posttest, where pre-test scores were set as the covariate variables and those between groups were set as the independent variables.

For qualitative data analysis, thematic analysis was employed. The source data were organized and coded by two study staff members (Author 1 and Author 2). They first read the transcripts multiple times to develop initial open codes, which were then compared and grouped into themes. Finally, common subthemes were summarized to form themes. To enhance the rigor of the analysis, Author 1 and Author 2 conducted independent reviews and held regular discussions, ensuring the credibility and consistency of the coding process.

Results

A total of 54 participants were initially recruited for both the experimental and control groups. In the experimental group, one participant missed two sessions, and three participants were unable to complete the full program due to hospitalization. Additionally, three participants withdrew from the control group. Consequently, 50 participants in the experimental group and 51 participants in the control group were included in the final effectiveness analysis.

Demographic and baseline characteristics of the participants

The mean age of participants in the experimental group was 74.93 (± 7.47) years, while the mean age of the control group was 73.09 (± 5.35) years. Before the intervention, there were no significant differences in sociodemographic characteristics, depression, and attitude toward aging scores between the two groups (Table 3).

Table 3.

Demographics and baseline data of participants by group (n = 108)

Variables	Experimental Group (N = 54)		Control Group (N = 54)		x²/ t p
	n(%)	Mean (SD)	n(%)	Mean (SD)
Age		74.93(7.47)		73.09(5.35)	1.46	0.15
Gender					0.08	0.48
Male	19(35.2)		17(31.5)
Female	35(64.8)		37(68.5)
Marital status					1.71	0.31
Married	36(66.7)		40(74.1)
Single	18(33.3)		14(25.9)
Education level					1.00	0.94
Literate	7(13.0)		7(13.0)
Elementary school	26(48.1)		24(44.4)
Junior high school	13(24.1)		13(24.1)
Senior high school or higher	8(14.8)		10(18.5)
Residential status					1.94	0.43
Living alone	6(11.1)		4(7.4)
Living with spouse	11(20.3)		8(14.8)
Living with children	37(68.6)		42(77.8)
Financial condition					1.59	0.66
Poor	4(7.4)		7(13.0)
Average	36(66.6)		32(59.3)
Sufficiently well off	14(26.0)		15(27.8)
GDS-SF		1.30(1.19)		1.13(1.05)	0.77	0.44
Number of chronic diseases (items)		1.07(0.84)		1.02(0.79)	0.35	0.72
Number of drugs taken (tablets)		2.50(2.19)		2.15(1.91)	0.89	0.38
Attitudes toward aging		47.35(4.23)		46.87(4.30)	0.59	0.56

GDS-SF: Geriatric depression scale-short form

Comparison of pretest and posttest changes in the experimental and control groups

The mean scores for attitude toward aging at pretest (T0) and posttest (T1) for both groups are presented in Table 4. Following the life story group intervention, the experimental group demonstrated a significant increase in mean attitude toward aging scores compared to pretest values (t = 31.14, p = 0.001). However, in the control group, the mean attitude toward aging scores did not show a statistically significant change (t = 1.99, p = 0.06).

Table 4.

The comparison of the two groups’ average scores of the pre-test and the posttest

Group	Variable	n	Pre-test (T0)	Post-test (T1)	t	p
			Mean(SD)	Mean(SD)
Experimental	Attitudes toward aging	50	47.70 (4.49)	74.48 (4.48)	31.14	0.001
Control	Attitudes toward aging	51	46.76 (4.38)	45.29 (4.89)	1.99	0.06

Comparison of posttest changes between the experimental and control groups

Before analyzing covariance (ANCOVA), a homogeneity test of within-group regression coefficients was performed. The results indicated that the regression coefficients of pretest scores within each group were homogeneous (p > 0.05). Additionally, the Shapiro-Wilk test confirmed that attitude toward aging scores followed a normal distribution, satisfying the assumptions for ANCOVA. Therefore, one-way ANCOVA was used to evaluate the intervention effect.

After controlling for pretest scores, the results (Table 5) indicated a statistically significant difference in posttest attitude toward aging scores between the experimental and control groups (F = 817.56, p < 0.001). The adjusted posttest mean scores further revealed that, after controlling for pretest differences, the experimental group exhibited significantly higher posttest scores on attitude toward aging compared to the control group (71.19 vs. 44.67) (Table 6).

Table 5.

One-way ANCOVA analysis

Variables	Variance	SS	Df	MS	F
Attitudes toward aging	Between groups	16711.21	1	16711.21	817.53***
	Within groups	2002.68	98	20.44
	Total	362284.0	101

***p < 0.001

Table 6.

Adjusted post-test score averages of the two groups

Group	Pre-test (T0)	Before adjusted Post-test (T1)	After adjusted Post-test (T1)
	Mean(SD)	Mean(SD)	Mean(SE)
Experimental
Attitudes toward aging	47.70 (4.49)	74.48 (4.48)	71.19 (1.3)
Control
Attitudes toward aging	46.76 (4.38)	45.29 (4.89)	44.67 (4.51)

Changes in the attitudes of the elderly towards aging after intervention

Qualitative data analysis identified three themes, which are summarized as follows:

Finding a new normal amidst loss

Although participants still acknowledged the challenges of aging, such as chronic illnesses, physical decline, and memory deterioration, following their participation in the life story intervention, a shift in perspective was evident. Rather than viewing aging solely as a process of decline, participants began to accept and adapt to these changes, integrating them into their lives as a “new normal.” For instance, one participant (Participant 15) stated:

“I know that as I age, my walking speed slows down, but I have learned to pay more attention to my steps to ensure my safety.”

This statement reflects an awareness of physical limitations and an active effort to modify daily habits to mitigate risks. Additionally, participants re-evaluated previous stereotypes about aging and attempted to challenge negative labels. Participant 2 shared:

“I used to think that aging meant losing energy and no longer being able to do what I used to enjoy. But now, I have started to explore new interests, like reading and learning new skills, to keep myself engaged.”

This response demonstrates a proactive approach to maintaining a sense of purpose and engagement in later life. Beyond physical changes, participants also acknowledged shifts in social relationships and the weakening of social connections. However, instead of lamenting these changes, they chose to actively engage with their evolving social environment. Participant 22 noted:

“Young people today prefer using smartphones, so I have started learning how to use them too. This way, I can communicate with them more easily.” Similarly, Participant 10 expressed:

“Although I no longer have a job after retirement, I plan to participate in community activities where I can contribute my experience and wisdom.”

Such transformations indicate that older adults are finding new ways to maintain social engagement and reaffirm their sense of self-worth and societal contribution. Overall, the life story intervention facilitated a more adaptive and positive outlook on aging among participants. While they acknowledged the losses associated with aging, they also actively sought new ways to restore balance and redefine their self-worth through their life narratives.

Dispelling myths and redefining self-worth

Following participation in the life story group intervention, older adults demonstrated a heightened awareness and transformation in their perceptions and misconceptions about aging. Participants no longer regarded disease, functional decline, or dementia as inevitable consequences of aging. Participant 7 reflected:

“I used to think that aging automatically meant a decline in physical abilities… but after joining the program, I realized I shouldn’t judge a person’s health solely based on their age.”

This statement illustrates how participants began to challenge ageist stereotypes and develop a broader perspective on aging diversity. Similarly, Participant 19 shared:

“I used to believe that older adults were slow, had white hair, and were covered in wrinkles. But after interacting with my peers, I realized these are just superficial traits…”.

This response highlights how group interactions enabled participants to rediscover themselves and their peers, ultimately breaking free from rigid stereotypes about aging. More importantly, through sharing their life stories, participants rediscovered their own value and abilities, shifting away from viewing themselves as a burden to society toward recognizing their potential as sources of wisdom and experience. Participant 16 stated:

“Through my past experiences, I have gained confidence and a sense of pride. I can help others learn from my experiences, and passing down this knowledge makes me feel truly valuable.” Likewise, Participant 20 expressed:

“Even at my age, I can still learn new things and share my life experiences with younger people or others. This makes my life feel rich and interesting…”.

These reflections suggest that narrative-based interventions can foster self-affirmation, allowing older adults to experience a sense of accomplishment through generativity and legacy-building. Furthermore, the study observed that participants demonstrated a greater willingness to engage in social activities and developed a deeper sense of respect and understanding in their interpersonal interactions. Participant 20 mentioned that older adults could experience a sense of purpose and value by participating in “community activities, church groups, and volunteer services.” This underscores a positive attitude toward social engagement among older adults. Similarly, Participant 25 noted:

“I have become more open to respecting different cultures and values. I am now more willing to learn and understand others’ backgrounds. I believe that diverse perspectives and experiences enrich society and make coexistence easier.”

During group discussions, participants also actively engaged and demonstrated openness toward differing viewpoints. Participant 12 reflected:

“Through group discussions, I was surprised to learn how differently each of us views aging. It was eye-opening. Engaging in discussions helped us understand each other better, and this experience made me reflect on my own perceptions of aging. I have learned a lot.”

Through the life story group intervention, older adults not only challenged negative misconceptions about aging but also rediscovered their agency in later life. This process ultimately reshaped their sense of meaning and purpose, reinforcing a more empowered and fulfilling outlook on aging.

A wonderful life that continues to bloom

Following participation in the life story group intervention, older adults generally exhibited a more positive and proactive attitude toward their self-worth and future life. Through narrating their life stories, they not only reaffirmed their past experiences and wisdom but also discovered new possibilities, transforming these realizations into concrete actions. For instance, Participant 1 shared:

“I feel like my life experiences could fill a book…”.

This statement reflects not only a strong affirmation of their life journey but also a recognition that their experiences hold value for transmission and sharing. Expanding on this idea, Participant 1 further stated:

“I used to be a flower arrangement teacher, and I still can use my expertise. Now, I can continue teaching others who share my interests in our community, and that makes me really happy.”

This example highlights how older adults can reclaim their expertise, contribute to society, and fulfill their sense of self-worth by engaging in meaningful activities. Additionally, the analysis revealed that the life story group fostered an expanded perspective on life and facilitated new social connections. Participant 19 expressed:

“I used to think that I was old and that retirement meant I had no value… But now I feel like I can still travel with others. My second half of life is just beginning, and I can live a different kind of life.”

This statement illustrates how participation in the group inspired a willingness to embrace new experiences and adopt a more open attitude toward the future. Similarly, Participant 16 stated:

“The people in this group have all become my good friends, and I will continue to participate in these activities in the future.”

This response underscores how group activities facilitated the development of mutual support networks, thereby reducing social isolation and enhancing a sense of belonging. Through participation in the life story intervention, older adults were able to integrate their past (“who I was”), present (“who I am”), and future (“who I will become”), fostering a stronger sense of life meaning, enhanced self-confidence, and greater self-worth.

Discussion

This study employed a life story group intervention, utilizing personal memories, photographs, objects, and past experiences to facilitate reminiscence and shared storytelling among older adults. Through group discussions on attitudes toward aging, participants provided mutual feedback and reflections, fostering a stronger sense of positive aging through the collective power of group dynamics. The results indicated that after eight weeks of participation in the life story group intervention, the mean attitude toward aging scores in the experimental group showed a significant increase. Furthermore, compared to the control group, this improvement was statistically significant, suggesting that life story group interventions effectively enhance older adults’ positive attitudes toward aging.

Acceptance of aging: from “decline” to “adaptation and growth”

The quantitative findings confirmed the effectiveness of the life story group intervention in enhancing older adults’ attitudes toward aging. Previous studies suggest that when older adults reframe their perceptions of aging, balancing self-acceptance, life satisfaction, later-life engagement, and personal growth, they are more likely to view aging as a process of adaptation and growth rather than inevitable decline, which in turn fosters a more positive psychological state [32]. The qualitative findings in this study further support this perspective. While participants still experienced age-related physical limitations, such as chronic illnesses, decreased physical strength, and memory decline, their mindset shifted from passive acceptance to active adaptation. For example, some participants demonstrated increased awareness of aging-related changes and made active efforts to adapt through behavioral modifications. Others reported exploring new interests and learning new skills, such as reading, which reflects a more positive and proactive attitude toward aging, which aligns with the quantitative results showing an improvement in attitude toward aging.

These findings indicate a psychological shift from perceiving aging as mere decline to recognizing it as a process of continuous adaptation and growth. This perspective aligns with Kim and Park’s (2017) concept of “successful aging,” which emphasizes disease and disability prevention, maintaining high cognitive/psychological/physical function, active engagement in life, and psychological adaptation to later life. Among these factors, psychological adaptation to aging is considered the most crucial [33]. The present study provides empirical support for this notion, illustrating how narrative-based interventions can foster a more adaptive and growth-oriented outlook on aging.

Challenging aging myths and stereotypes

The quantitative findings of this study showed that participation in the life story group intervention resulted in a more positive attitude toward aging among older adults. Previous research has indicated that age-related stereotypes and implicit ageism can significantly impact older adults’ self-identity and mental well-being, subsequently influencing their attitudes toward aging [3]. Our qualitative analysis further supported this finding by indicating that participants experienced a shift in perspective toward aging-related stereotypes. Some participants reported that they no longer viewed aging solely as a process of physical decline but recognized it as a multifaceted phenomenon shaped by lifestyle, mindset, and social interactions. This suggests that guided discussions and group interactions helped participants adopt a more balanced and objective view of aging.

Previous research has emphasized that successful aging is not solely about maintaining physical health but also involves active engagement in life and a positive outlook [34]. Our qualitative findings aligned with the significant changes observed in the quantitative results, demonstrating that life story interventions effectively reshape older adults’ negative perceptions of aging, allowing them to adopt a more balanced and objective perspective on the aging process. Additionally, through sharing life stories, participants rediscovered their self-worth, which may explain the observed improvement in attitudes toward aging in the experimental group. Previous research has suggested that narrative therapy helps older adults reinterpret their life experiences, reinforcing self-identity and a sense of personal value [17]. This process of storytelling appears to foster self-affirmation, helping older adults recognize their own value and promoting a more positive attitude toward aging.

Active social engagement and reconnection

The qualitative analysis revealed that the life story group intervention not only transformed older adults’ perceptions of their own aging but also enhanced their motivation for social participation, aligning with the significant improvements observed in the quantitative results. Research has shown that social connections and participation are closely linked to psychological well-being in older adults [35], the size and frequency of social network connections can stimulate social participation and emotional support, thereby indirectly influencing key aspects of successful aging [36]. Findings from this study indicated that many participants became more aware of the importance of social participation and interpersonal interactions as a result of the intervention. Some participants reported feeling a greater sense of value and purpose through participating in community activities, church groups, and volunteer services. This aligns with the successful aging model proposed by Carr and Weir (2017) and Kim and Park (2017), which emphasizes active engagement in life as a critical factor in successful aging [33, 34].

A study in mainland China found that social participation significantly improved people’s attitudes toward aging by improving mental health literacy and reducing stigma [11]. This finding is consistent with our observation that older adults’ motivation to participate in social activities significantly increased after the life story group intervention. These findings highlight the importance of social participation in maintaining psychological well-being and self-identity among older adults. In contrast to traditional Chinese values, which emphasize social participation as a collective activity, Western research tends to emphasize individual autonomy and independent living in shaping attitudes toward aging, with life satisfaction and self-esteem being important predictors of aging attitudes among older adults [37, 38]. This finding reflects unique cultural characteristics and is possibly influenced by Eastern collectivist values and generational support.

Reconstructing self-worth and looking toward the future

Through participation in the life story group intervention, older adults not only transformed their perceptions of aging but also reestablished confidence and optimism for their future. Many participants expressed that reflecting on their life experiences through the intervention helped them recognize the value of their past and discover new meaning in life. This suggests that the life story intervention encouraged older adults to reexamine their past, affirm their self-worth, and develop a more positive outlook on aging. These findings align with previous studies by Lai et al. (2018, 2019) [18, 22], which demonstrated that life story work enables older adults to integrate their life experiences and reaffirm their sense of meaning. According to Disengagement Theory, older adults naturally withdraw from social roles and activities as they age, reducing social interaction and psychological well-being [39]. However, the life story intervention appeared to counter this tendency by encouraging participants to engage in reflective storytelling and group interactions to reestablish a sense of connection and purpose.

Additionally, a systematic review by Yen and Lin (2018) highlighted that reminiscence group interventions effectively enhance social interactions among older adults, improve coping with life challenges, and contribute to better psychological well-being and life satisfaction [25]. These findings resonate with our study, which revealed that life story sharing activities facilitated the formation of mutual support networks, thereby reducing social isolation and fostering connectedness and emotional support among older adults. Activity Theory posits that maintaining social roles and active engagement in life are essential for successful aging and psychological well-being [40]. The life story intervention provided a structured platform for older adults to actively engage in discussions, share life stories, and support one another. This process not only enhanced participants’ sense of belonging and self-worth but also reinforced the importance of social participation and meaningful activity in later life.

Limitations

Although this study demonstrated significant effects of the life story group intervention on older adults’ attitudes toward aging, several limitations should be acknowledged. First, the findings are limited to a single community and may not be generalizable to older adults in different community settings. The sample was recruited from Qidu District, Keelung City, which represents a semi-urban area. As a result, the findings may not fully capture the diversity of older adults living in rural or densely urbanized regions or reflecting the socioeconomic diversity of Taiwan’s older adult population. To enhance the generalizability of the findings, future studies should consider expanding the study design to include a more geographically and socioeconomically diverse sample. This approach would allow a more comprehensive understanding of how life story groups impact attitudes toward aging across different demographics and community settings.

In addition, data collection was conducted only at the conclusion of the intervention, which may not capture the long-term effects of the program. It remains unclear whether the improved attitudes toward aging persist over time or diminish after the intervention ends. Future studies should consider extending follow-up periods and incorporating objective measures (e.g., health status, social participation) to evaluate the effectiveness of the life story group intervention.

Conclusion

The findings of this study indicate that life story group interventions can effectively enhance older adults’ attitudes toward aging. This study not only supports the effectiveness of life story groups as a psychological health intervention for older adults but also demonstrates that narrative-based approaches can foster positive self-identity and future outlook among older individuals. In an era of rapidly aging populations, cultivating a positive attitude toward aging is of paramount importance. Life story group interventions provide a practical and effective means of achieving this goal.

From a policy perspective, integrating life story group interventions into existing community-based aging programs could improve older adults’ self-perceptions of aging. Furthermore, encouraging intergenerational programs and public campaigns to reshape societal attitudes toward aging could amplify the positive impact of these interventions. Community healthcare providers should encourage greater participation in storytelling groups as a means to promote active and successful aging, ultimately contributing to enhanced well-being and social engagement among older adults.

Electronic supplementary material

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Abbreviations

ANCOVA

Analysis of covariance

APQ

Aging perceptions questionnaire

GDS-SF

Geriatric depression scale - short form

NSPA

Negative self-perception of aging

PSPA

Positive self-perception of aging

RCT

Randomized controlled trial

SPMSQ

Short portable mental status questionnaire

TAAQ

Taiwan attitude toward aging questionnaire

Author contributions

MCT and PTH designed the research question. YFH and PTH were responsible for this study’s conceptualization and methodology. MCT is responsible for leading the Life Story group course and data collection. MCT and PTH did the quantitative data analyses. YFH and MCT gave the interpretation of the qualitative data. YFH drafted the first version of the manuscript, MCT, and PTH gave critical advice. All co-authors read the final manuscript, gave their critical appraisal, and approved the final version.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

The datasets used and analyzed during the present study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan (No: TYGH111057). Participation in the study posed no risk to the participants. All participants provided written informed consent to participate in this study. Data were anonymized and deidentified at the time of collection (linked only to study identification numbers). This study adheres to the principles of the Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.