How aging shapes interoception: a multimodal, multidimensional analysis

Abstract Objectives Aging is known to influence perceptual sensitivity, yet its effects on interoception across the lifespan remain poorly understood. Prior research has largely focused on single interoceptive dimensions (e.g., interoceptive sensitivity) or modalities (e.g., cardiac interoception). Moreover, most studies have assessed interoception at rest, limiting insight into how individuals track real-time changes in interoceptive state. In this study, we examined age-related differences in both interoceptive sensitivity and sensibility across cardiac and respiratory modalities in healthy adults. Methods In a single session, participants (N = 78; aged 18–79 years; Mage = 49.10) were assessed for: (a) interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (Version 2); (b) cardiac interoceptive awareness using a heartbeat tapping task under baseline and breath-holding perturbations; and (c) respiratory interoceptive awareness using an inspiratory load estimation task with varying resistance levels. Using the noninvasive interoceptive perturbations, we elicited dynamic fluctuations in interoceptive signals. Associations between age-related differences in interoceptive awareness measures were examined using linear mixed-effects models. Results Our results revealed that older age was associated with reduced cardiac interoceptive sensitivity during breath-holding, while respiratory sensitivity remained stable across ages. Additionally, interoceptive sensibility increased with age, suggesting that task-based interoceptive performance and self-reported sensibility may follow divergent aging pathways. Discussion These findings demonstrate that interoceptive awareness does not decline uniformly with age but instead varies by modality and dimension. By identifying how aging differentially impacts interoceptive sensitivity and sensibility across systems, this study opens new avenues for characterizing age-related changes in interoceptive awareness and bodily regulation.