Pathways from Ageism to Loneliness

A Pilot and Feasibility Study of the Aging Together Anti-Ageism Peer Support Program

Although the theory of relational ageism describes how ageism is reinforced through interpersonal interactions, it remains unknown whether peer support programs may help reduce ageism and enhance older adults' well-being. We conducted a pilot and feasibility study of a manualized anti-ageism peer support program facilitated by trained older adults called "Aging Together." Key components include peer support, education about ageism and health, and "tell your story of aging." Six small groups of five-to-eight participants (N = 48 total) met for ten, weekly, in-person (60-90 minute) sessions in a U.S. Midwest city. Results indicate the program was feasible and acceptable overall (attendance rate = 88.91%, attrition rate = 6.25%, M acceptability score = 4.23/5). Wilcoxon signed rank tests (N = 28) indicated a significant decrease in relational ageism (M = 2.73/6 to 2.19/6; p ≤ .01) and depressive symptoms (M = 8.61/30 to 6.57/30; p ≤ .01). Future research should scale this program across diverse, geographical settings and explore potential mediating relationships between internalized/relational ageism and psychosocial well-being.

Longitudinal Dyadic Associations Between Perceived Discrimination and Loneliness Among Midlife and Older Married Couples

BACKGROUND AND OBJECTIVES

Loneliness is a public health concern facing older adults. Although marriage protects against loneliness, a significant percentage of older married persons report feeling lonely. Perceived discrimination is associated with adverse physical and psychological outcomes across the life course among individuals, including loneliness. Limited attention has been paid to dyadic associations between perceived discrimination and loneliness in older populations.

RESEARCH DESIGN AND METHODS

The sample included 1,429 mixed-gender dyads who participated in 3 consecutive waves of the Health and Retirement Study (2010/2012, 2014/2016, and 2018/2020). Longitudinal dyadic structural equation modeling was used to determine whether perceived discrimination was associated with loneliness in oneself and/or loneliness in one's partner, and whether the "contagion" of loneliness may mediate the indirect effects of a partner's experience of perceived discrimination on one's own loneliness over time.

RESULTS

Findings showed that (a) perceived discrimination predicted increases to loneliness over time for individuals, (b) partner's loneliness predicted individuals' own loneliness over time, and (c) the partner effect of loneliness significantly mediated an indirect effect of one spouse's experiences of perceived discrimination at baseline with the other spouse's loneliness 8 years later, for both men and women.

DISCUSSION AND IMPLICATIONS

This work highlighted not only the influence of perceived discrimination on loneliness in oneself, but the dyadic implications of perceived discrimination for both partners. Future research should examine mechanisms for these effects, including whether perceived discrimination is experienced in isolation or as part of a couple, as well as its consequences for both partners.

Adults Aged 75+ Happy in Conventional Dwelling or Independent Living Facility but Associated With Thriving and Ageism

This study aimed to compare levels of happiness of older women and men living in conventional dwellings (CD) and independent living facilities (ILF), and examine happiness' associations with thriving, social participation, community integration and ageism (self-directed and discrimination). A cross-sectional survey was conducted with a random sample of 509 older adults in CD and 470 in ILF in Quebec, Canada. Participants' mean age was 82.22 ± 5.35, and two-thirds were women. Levels of happiness were similar in both sexes and settings. Greater happiness was associated with greater thriving for all (β = 0.28-1.48), social participation for women in CD (β = 0.67), community integration in CD (β = 0.42 for women and 1.18 for men), and reduced ageism, i.e., discrimination for women in CD (β = -1.02) and men in ILF (β = -0.28), and self-directed for men in CD (β = -0.21). The findings demonstrate that happiness was associated with factors related to the living environment and could be enhanced through targeted interventions.

Older adults' subjective aging perceptions, mentalization, and social relationships: a micro-longitudinal study

OBJECTIVES

Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link.

METHOD

Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days.

RESULTS

Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships.

CONCLUSION

The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

Comparison of subjective self-reported hearing and objective speech-in-noise perception as predictors of social isolation and loneliness in adults 60 years and older

OBJECTIVE

Hearing decline in ageing increases the risk of loneliness and social isolation. This correlation is most often observed when hearing is measured by subjective self-report, and less often for objectively measured speech listening ability, raising questions about differences between self-assessments and behavioural performance. This study compared self-reported hearing ability and objective speech-in-noise performance as predictors of loneliness and social isolation in adults older than 60.

DESIGN

This was an observational, cross-sectional online study. Participants were instructed to complete a speech-in-noise task to measure objective listening ability, as well as four questionnaires that measured subjective self-rated hearing, feelings of loneliness, perceived social support, and depression and anxiety.

STUDY SAMPLE

One-hundred fifteen individuals aged above 60 with no treated hearing loss.

RESULTS

No correlation was found between loneliness scores and subjective self-rated hearing or objective speech-in-noise perception after adjusting demographic variables and overall psychological distress (anxiety and depression). However, self-rated hearing was positively correlated with social support when anxiety/depression scores were low. When anxiety/depression scores were high, this relationship was attenuated. Objective speech-in-noise perception did not correlate with perceived social support.

CONCLUSIONS

Self-rated hearing ability positively predicts ratings of social support in older adults with low levels of psychological distress.

Social connection in long-term care homes: a qualitative study of barriers and facilitators

BACKGROUND

Social connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents.

METHODS

We used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada.

RESULTS

Themes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. 'Becoming familiar with life in the LTC home to support social connection' described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. 'Physical and virtual access beyond the LTC home as strategies to maintain contact' related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. 'Getting to know residents to deepen relationships' related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. 'Person-centred approaches to build social connection' included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs.

CONCLUSIONS

This study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes.

CLINICAL TRIAL NUMBER

clinicaltrials.gov ID NCT05315960.

Ageist attitudes and psychological distress in older adults: The moderating role of reflective functioning

Ageist attitudes have been associated with various aspects of psychological functioning in older adults. According to Terror Management Theory, older adults may be seen as a reminder of human demise and death, and research has demonstrated links between ageist attitudes and compromised abilities to seek and maintain close personal relationships, which ward off awareness of one's mortality. Accordingly, the current work examined whether reflective functioning, or the ability to comprehend one's own and others' mental states, mitigates the negative psychological manifestations of ageist attitudes in older adults. Data was collected from 686 participants aged 60-94 (Mage = 72.64, SD = 6.28), who completed scales assessing ageist attitudes, reflective functioning, and psychological distress, as well as relevant socio-demographic information. Results indicated that ageist attitudes were linked with low levels of reflective functioning and enhanced psychological distress. Moreover, reflective functioning moderated the ageist attitudes-distress link, which was not significant in individuals reporting high levels of reflective functioning. This study provides insight into how the ability to comprehend others' mental states mitigates the adverse psychological effects of ageist attitudes and highlights the importance of examining relationship-enhancing personal factors within the context of negative ageing perceptions and psychological distress.

Subjective Age and Loneliness in Older Adults: The Moderating Role of Attachment Patterns

Loneliness in older adults has been associated with a myriad of undesirable physical and psychological consequences, as well as with negative age and aging perceptions. However, little is known regarding the effect of individual differences in the ability to seek, maintain, and benefit from close relationships in this context. Accordingly, we examined the associations between subjective age (i.e., how old/young one feels vis-à-vis his/her chronological age; SA), attachment patterns, and loneliness. Data were collected from 840 older adults in Israel (Mage = 74.75, SD = 5.50, range = 67-94), who provided information pertaining to SA, attachment anxiety/avoidance, and loneliness. Loneliness was associated with an older SA, as well as with high levels of attachment anxiety/avoidance. Moreover, the association between SA and loneliness was nullified for individuals with low levels of attachment anxiety/avoidance. The discussion highlights the importance of both age perceptions and attachment patterns for understanding the underlying mechanisms of late-life loneliness.

Internalized ageism as a risk factor for suicidal ideation in later life

OBJECTIVES

We examined the influence of ageism on suicidal ideation using the framework of the Interpersonal Theory of Suicide among a sample of older adults in the United States.

METHOD

Using Research Match, volunteers 65 and older in the United States were recruited to participate in an online survey. Demographics, perceived burdensomeness, thwarted belongingness and self-directed ageism (internalized and relational ageism) were examined. Data were analyzed using hierarchical logistic regression analysis.

RESULTS

A total of 454 individuals from over 30 states participated in the study. Twelve percent of respondents reported that they had experienced suicidal ideation in the past month. Results from the logistic regression demonstrated that older adults with higher age and higher internalized ageism had a higher risk of suicidal ideation.

CONCLUSION

Findings present implications for understanding an association between ageism and suicidal ideation. Results speak to the importance of recognizing and understanding the impact of ageism. Examining the development clinical guidelines and policies that address ageism as a risk factor for suicide is warranted.

Translation and validation of the ageism scale for dental students in Iran (ASDS-Persian)

AIMS

A longer life and the growing population of older adults are the achievements of the 20th century. The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. The aim of this study was to translate and validate the ageism scale for dental students in Iran (ASDS-Persian).

METHODS

The 27-question ASDS was translated from English into Persian (Farsi) and completed by 275 dental students from two universities in Isfahan, Iran. Principal component analysis (PCA), internal consistency reliability, and discriminant validity were estimated. Furthermore, in this study we conducted an analytical cross sectional study among dental students of Isfahan province (two universities) with the aim of proving data regarding their ageism beliefs and attitudes.

RESULTS

PCA revealed an 18-question, four-component scale with acceptable validity and reliability. The four components are 'barriers/concerns on dental treatment in older adults', 'opinions about older adults', 'practitioner's perspective,' and 'older adults' perspective'.

CONCLUSION

This preliminary validation of ASDS-Persian produced a new 18-question scale with four components with acceptable validity and reliability. This instrument could be further tested in larger samples in Farsi speaking countries.

Longitudinal Associations of Neighborhood Social Cohesion With Self-Perceptions of Aging and Loneliness

OBJECTIVES

One's aging experience is structurally embedded in the social aspects of the residential environment. However, it is largely unknown how this upstream contextual factor may shape self-perceptions of aging (SPA) and loneliness, critical aspects of later-life psychological well-being with profound health implications. This study examines the longitudinal association of neighborhood social cohesion with SPA and -loneliness, as well as the potential bidirectional associations between outcomes.

METHODS

This study used 8-year data from the Health and Retirement Study, with an analytic sample of 9,299 U.S. adults aged 50 or older. Latent growth curve models were implemented to assess the associations of baseline neighborhood social cohesion with trajectories of SPA and loneliness. Path analysis was conducted to examine the longitudinal mediation mechanisms connecting neighborhood social cohesion with SPA and loneliness.

RESULTS

Respondents from cohesive neighborhoods at baseline started with and maintained more positive initial SPA over time, but their positive perceptions decreased faster over time. Cohesive neighborhoods were associated with lower levels of loneliness over an 8-year study period, but also with slower rates of decline in loneliness. Path analysis revealed that neighborhood social cohesion indirectly affected SPA and loneliness, via bidirectional mechanisms.

DISCUSSION

This study demonstrates the significant role of environmental factors beyond individual predictors and advocates for the potential of neighborhood environments as a target for interventions to foster positive aging perception and tackle loneliness. Furthermore, it indicates that loneliness and SPA could reciprocally influence each other in the context of neighborhood social cohesion, enriching our understanding of their dynamics.

Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging

As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.

Depression and loneliness symptoms in Brazilian older people during the COVID-19 pandemic: a network approach

OBJECTIVES

Depression and loneliness in older people were a global challenge during the COVID-19 pandemic. Causal mechanisms to trigger depression might vary across different life events. We aimed to apply network analysis in a sample of Brazilian older people during the first wave of the COVID-19 pandemic, to investigate if loneliness and depression symptoms were connected within a psychological network. We explored how symptoms manifested and interacted, to discuss possible interventions that could mitigate late-life depression and loneliness symptoms in face of the COVID-19 pandemic.

METHOD

We collected data from 384 Brazilian older people who answered an online protocol to assess sociodemographic data, loneliness symptoms (assessed by the short version of UCLA-BR), and depression symptoms (assessed by the PHQ-2).

RESULTS

'Lack of companionship' was the bridge symptom connecting loneliness and depression communities. 'I feel shut out and excluded by others' and 'People are around me, but not with me' were the most predictable symptoms of loneliness.

CONCLUSION

Interventions aimed to promote older people's social participation and skills, combined with strategies to expand their sources of social support and combat ageism, might be relevant to mitigate symptoms of loneliness and depression in older people during a crisis like the COVID-19 pandemic.

Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: A systematic review and meta-analysis

OBJECTIVES

Pandemics and their public health control measures have generally substantially increased the level of loneliness and social isolation in the general population. Because of the circumstances of aging, older adults are more likely to experience social isolation and loneliness during pandemics. However, no systematic review has been conducted or published on the prevalence of loneliness and/or social isolation among the older population. This systematic review and meta-analysis aims to provide up-to-date pooled estimates of the prevalence of social isolation and loneliness among older adults during the COVID-19 pandemic and other pandemics in the last two decades.

DESIGN

EMBASE, PsychoINFO, Medline, and Web of Science were searched for relevant studies from January 1, 2000 to November 31, 2021 published in a variety of languages. Only studies conducted during the COVID-19 pandemic were selected in the review.

RESULTS

A total of 30 studies including 28,050 participants met the inclusion criteria. Overall, the pooled period prevalence of loneliness among older adults was 28.6% (95% CI: 22.9-35.0%) and 31.2% for social isolation (95% CI: 20.2-44.9%). Prevalence estimates were significantly higher for those studies conducted post 3-month from the start of the COVID-19 pandemic compared to those conducted within the first 3 months of the pandemic.

CONCLUSIONS

This review identifies the need for good quality longitudinal studies to examine the long-term impact of pandemics on loneliness and social isolation among older populations. Health policymaking and healthcare systems should proactively address the rising demand for appropriate psychological services among older adults.

Educating dental students to provide compassionate age friendly care for older adults

As the world population ages, the need for age friendly care increases. In dentistry, age friendly care requires an appropriate comprehension of multiple factors that can be categorized in socio-economic circumstances, systemic health problems, and oral health conditions. In addition to the understanding of these factors and its relationships among each other, the future dental workforce should also be aware of unconscious and pervasive societal stereotypical perception of older persons, aging, and being old, which results in ageism and ageist attitudes. Dental schools can play an important role on raising ageism awareness and combating ageism in healthcare, thus preparing the future of the dental workforce to provide compassionate age friendly care. This paper will discuss ageism in dental schools and learning strategies used to combat it and increase compassionate care delivery for older adults.

Loneliness as a Potential Mechanism of the Association Between Ageism and Mental Health Outcomes in the Chilean Context

The negative impact of ageism on the mental health of older persons has been well studied, but the mechanisms underlying this relationship have not been explored in detail. The present study examines the relationship of ageism with depressive and anxious symptoms in older people, evaluating the indirect effect via loneliness. The analysis was carried out with a sample of 577 older adults living in Chile, using structural equation modeling to assess the direct and indirect effects of the proposed model.The results showed the direct and indirect association of ageism with mental health outcomes. Ageism is positively related to loneliness and, in turn, to increased depressive and anxious symptoms. We discuss how loneliness linked with an ageist context contributes to anxiety and depressive symptomatology in the older population and the need to reduce ageism to favor the mental health of this age group.

Validity and Reliability of Persian Version of the 12-Item Expectations Regarding Aging Survey

Objective:The present study was designed to assess the construct validity and reliability of the Persian version of the 12-item Expectations Regarding Aging (ERA) survey among the older adult Iranian population. Methods: The Persian version of this scale was developed using translation and revision in the current study. The construct validity was assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The reliability was assessed through internal consistency (Cronbach's alpha and McDonald's omega), composite reliability (CR), and maximal reliability (MaXR). The data compiled online was based on a sample of 400 older adults aged 65 years and older. Results: The Persian version includes 12 items loading onto three factors with 12 items explaining 46.633% of the total variance with excellent internal consistency and reliability. Conclusion: The Persian version of ERA is reliable and valid that can be used to assess the ERA concept among older adults.

Short- and Medium-Term Effects of Ageism on Loneliness Experienced During the COVID-19 Pandemic

Loneliness, common in old age, may be partially attributed to ageism. The present study explored the short- and medium-term effect of ageism on loneliness experienced during the COVID-19 pandemic using prospective data derived from the Israeli sample of the Survey of Health, Aging and Retirement in Europe (SHARE) (N = 553). Ageism was measured before the COVID-19 outbreak and loneliness in the summer of 2020 and 2021 using a direct single question. We also tested for age differences in this association. In both the 2020 and 2021 models, ageism was related to increased loneliness. This association remained significant after adjusting for a host of demographic, health, and social variables. In the 2020 model, we also found that the positive association between ageism and loneliness was significant only in people aged 70+. We discussed the results with reference to the COVID-19 pandemic, which drew attention to two global social phenomena: loneliness and ageism.

The effect of laughter yoga on loneliness, psychological resilience, and quality of life in older adults: A pilot randomized controlled trial

This study aims to examine how laughter yoga affects the loneliness, psychological resilience, and quality of life of older adults living in a nursing home. The sample of this intervention study, made using a control group with a pretest/posttest design, consists of 65 older adults living in Turkey. The data were collected in September 2022 using the Personal Information Form, the Loneliness Scale for the Elderly, the Brief Psychological Resilience Scale, and the Quality of Life Scale for the Elderly. The intervention group (n=32) took part in laughter yoga twice a week for four weeks. No intervention was made with the control group (n=33). A statistically significant difference was found between the groups' mean post-test scores for loneliness, psychological resilience, and quality of life (p < 0.05) after the laughter yoga sessions. The eight-session laughter yoga program was found to reduce loneliness and increase resilience and quality of life in older adults.

Digital Intervention in Loneliness in Older Adults: Qualitative Analysis of User Studies

BACKGROUND

Loneliness is a significant well-being issue that affects older adults. Existing, commonly used social connection platforms do not contain facilities to break the cognitive cycle of loneliness, and loneliness interventions implemented without due processes could have detrimental effects on well-being. There is also a lack of digital technology designed with older adults.

OBJECTIVE

We aimed to iteratively design a user-centered smartphone app that can address loneliness in older adults. The aim of this study was to investigate the loneliness-related psychological processes that our conceptual smartphone app promotes. We also identified the emergent needs and concerns that older adults raised regarding the potential benefits and detriments of the app.

METHODS

We used technology probes to elicit older adults' reflections on the concept of using the app in 2 studies as follows: concept focus groups (n=33) and concept interviews (n=10). We then conducted a prototype trial with 1 week of use and follow-up interviews (n=12).

RESULTS

Thematic analysis explored the experiences and emergent challenges of our app through the design process. This led to the development of 4 themes as follows occurring in all 3 qualitative data sets: reflection on a digital social map is reassuring; app features encourage socializing; the risk of compounding loneliness; and individuals feel more control with mutual, socially beneficial activities.

CONCLUSIONS

Smartphone apps have the potential to increase older adults' awareness of the richness of their social connections, which may support loneliness reduction. Our qualitative approach to app design enabled the inclusion of older adults' experiences in technology design. Thus, we conclude that the older adults in our study most desired functionalities that can support mutual activities and maintain or find new connections rather than enable them to share an emotional state. They were wary of the app replacing their preferred in-person social interaction. Participants also raised concerns about making the user aware of the lack of support in their social network and wanted specific means of addressing their needs. Further user-centered design work could identify how the app can support mutual activities and socializing.

Ageism and the Pandemic: Risk and Protective Factors of Well-Being in Older People

The COVID-19 pandemic has particularly affected the older population both in terms of the high number of victims and the psychological impact. Moreover, the pandemic has made older people more vulnerable to isolation and loneliness, and victims of ageism. The aim of the present study was to investigate the risk and protective factors for the well-being of older people during the pandemic. The role of positive affect, confidence in the future, current physical health, social isolation, loneliness, and ageism were analysed. A self-report questionnaire was administered to 1301 participants (mean age: 77.3 years, DS: 5.46), almost equally distributed by gender (56.1% female). Descriptive and correlational analyses were performed, together with SEM. The results showed that perceived age discrimination positively predicts loneliness and negatively and indirectly predicts well-being. Furthermore, positive affect, confidence in the future, and current physical health are protective factors, while loneliness, social isolation, and ageism are risk factors. Future emergency policies must take into account the impact of such actions on the well-being of this segment of the population.

Loneliness, ageism, and mental health: The buffering role of resilience in seniors

Introduction

Ageism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied.

Aim

To assess the potential mediator role of resilience between the effects of ageism and loneliness on PD in seniors.

Methods

A sample of 349 Portuguese seniors aged 60 years and over was collected through an online survey and during the COVID-19 pandemic period. Seniors completed the Kessler Psychological Distress Scale (K6), the Short-Form of UCLA Loneliness Scale (USL-6), the Ambivalent Ageism Scale (AAS) and the Connor-Davidson Resilience Scale (CD-RISC-10). A mediation analysis model was developed with resilience as a mediating variable.

Results

There were moderate to high levels of PD and moderate levels of ageism, loneliness and resilience. Resilience fully mediated the effect of ageism on PD and partially mediated the effect of loneliness on PD.

Conclusions

Resilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed.

Policy Initiatives to Address the Challenges of an Older Population in the Workforce

Today's working population is expected to experience a longer and healthier life than previous generations did. This, combined with a currently shrinking workforce, means the participation of older adults in the labor market is expected to positively contribute to national economic and social development. Policymakers have therefore implemented a series of reforms to motivate and encourage both employers and employees to embrace the prospect of an aging workforce and to respond to the associated challenges of such a demographic change in the workplace. This paper aims to provide an overview of recent policy initiatives in this context and to identify the role of technology in major international initiatives in overcoming the key challenges faced by developed countries. We have conducted a scoping review to obtain large volumes of peer-reviewed and gray literature. Our findings suggest that the stakeholders (researchers, government agencies, employers, and communities) are not only aware of the current issues relating to the aging population but also understand the importance of policies in terms of retaining older people in the workforce. In particular, our results indicate that technology, in both the public and private sectors, can be leveraged as a tool to facilitate older adults' participation in the workforce.

The AgeSmart Inventory©: A Multifaceted Tool to Understand Age Bias

Ageism has been recognized as a global problem leading to poorer health, isolation, and workplace discrimination toward people based on their age. Consequently, there are several tools that measure levels and types of ageism with a focus on the quantification of degrees and types of ageism. While such quantification is valuable, this paper describes the development of an inventory, created over four stages, designed to foster introspective and collaborative thinking about age-directed values. In Stage 1, 34 items were identified through a comprehensive literature review. In Stage 2, the items were evaluated and revised via a focus group discussion. In Stage 3, the revised ASI was administered to a representative U.S. sample (N = 513). Based on factor and conceptual analysis, a revised version was tested on a second sample (N = 507) (Stage 4) and again revised. The final ASI consists of 35 age-related statements: 22 psychometrically linked to one of four domains, six related to identity, and seven that, although not aligned with statistical results, are conceptually important. Rather than provide an ageism score, the ASI is a tool for introspection and reflection about individual values and judgements about age which can lead to customized strategies to address potential age biases.

Individual differences among older adults with mild and moderate dementia in social and emotional loneliness and their associations with cognitive and psychological functioning

Background

Loneliness is a major health issue among older adults. The aim of this study was to assess the relationship between loneliness, in its social and emotional facets, and the cognitive (language), and behavioral/psychological functioning as well as quality of life (QoL) in people with mild and moderate dementia, i.e., considering dementia severity as an individual characteristic.

Methods

This cross-sectional study involved 58 people with mild dementia and 55 people with moderate dementia. Participants completed the Social and Emotional Loneliness scale, along with measures assessing their language skills, the frequency and severity of their behavioral and psychological symptoms, and their QoL.

Results

Socio-demographic characteristics and depression, but not loneliness or its social and emotional facets, contributed to explain participants’ behavioral and psychological symptoms, regardless of dementia severity. Loneliness explained, though to a small extent (8% of variance), language skills in people with moderate dementia, with social loneliness only accounting for language skills (18% of variance) in this group. Loneliness also modestly accounted for dysphoria symptoms in both the mildly and moderately impaired (6% and 5% of variance, respectively) individuals with social loneliness predicting dysphoric mood in the former group only (7% of variance). Loneliness also explained, to a larger extent, QoL in both the mildly impaired and moderately impaired individuals (27% and 20% of variance, respectively), its social facet predicting QoL in the mildly impaired (30% of variance), and its emotional facet in the moderately impaired (21% of variance) group.

Conclusion

These findings suggest that loneliness and its facets have a clear impact on perceived QoL, and influence the language skills and dysphoria symptoms of people with dementia, to a degree that depends on dementia severity. The assessment of loneliness and its facets in people with dementia considering dementia severity, and the promotion of social inclusion to reduce it should be considered by professionals.

Changing Relationships Between Social Contact, Social Support, and Depressive Symptoms During the COVID-19 Pandemic

OBJECTIVES

Given the longstanding consensus that social contact can promote older adult well-being, many have focused on how social contact changed during the pandemic. Less is known, however, about whether the link between social contact and health changed during the pandemic. This study sought to understand how associations between social contact, social support, and depressive symptoms changed during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

Data from 2 waves of the Health and Retirement Study were used. Respondents reported both virtual and in-person social contact, as well as perceived positive and negative social support. Path models were used to estimate relationships between social contact, social support, and depressive symptoms. Bootstrapping was used to estimate the change in associations between 2016 and 2020.

RESULTS

Estimates show that associations between positive social support and depressive symptoms, as well as between in-person social contact and depressive symptoms, attenuated during the pandemic. Virtual social contact played a relatively minor role in determining outcomes such as social support and depressive symptoms, compared to in-person social contact.

DISCUSSION

Findings suggest that researchers and policymakers should not only focus on the changing quantity of social interactions when events such as the COVID-19 pandemic happen, but also the changing content and efficacy of the social interactions that remain.

The Subjective Experience of Ageism: The Perceived Ageism Questionnaire (PAQ)

Ageism as perceived by older individuals has been recognized as a potential risk factor for physical and mental health. We aimed to develop a comprehensive scale that can quantify perceived ageism among aging individuals (55+), including both positive and negative stereotypes, prejudices, and discriminations. This effort resulted in an 8-item Perceived Ageism Questionnaire (PAQ-8), with good psychometric properties and a two-factor structure distinguishing a positive (3 items) and negative (5 items) subscale (Analysis 1; n = 500). This dimensionality was confirmed in a separate cross-validation sample (Analysis 2; n = 500). The subscales’ correlation patterns with individuals’ self-perceptions of aging and mental health variables (i.e., quality of life, mental well-being, depression, anxiety, loneliness and perceived stress) accorded with theoretical hypotheses and existing knowledge of the concept of ageism. The PAQ-8 can help to gather more standardized data of the level, role and impact of perceived ageism.

Self-esteem as a mediator in the relationship between perceived age stigma and emotional well-being among Korean older adults: the moderation effect of marital status

OBJECTIVES

This study examined whether self-esteem mediates the association between perceived age stigma and emotional well-being (loneliness and emotional isolation) among Korean older adults and how these processes differ by marital status.

METHODS

Using the 2018 Age Integration and Generation Integration Survey, a cross-sectional national survey of Korean adults, we analyzed data from 266 adults aged 60 and older.

RESULTS

Older adults who perceived greater age stigma reported higher levels of loneliness and emotional isolation. Self-esteem played a significant indirect role in the association between perceived age stigma and the two emotional well-being outcomes. Moderated mediation analyses further revealed significant differences by marital status: self-esteem was a more powerful mechanism among unmarried older adults relative to their married counterparts.

CONCLUSIONS

The findings suggest that efforts to minimize public and internalized stigmatization of older adults and improve their self-esteem may be critical for their emotional well-being.

Self-perceptions of aging and depressive symptoms: the mediating role of loneliness

Objectives: Depression is a major health concern for both individuals and societies. Hence, understanding the risk factors for depression is of importance. As individuals grow older, the way in which they perceive the aging process may have a significant influence on their physical and mental health. More negative perceptions of aging could put individuals at risk for social withdrawal, causing loneliness and resulting in higher levels of depressive symptoms.Methods: We use the Health and Retirement Survey, a large and longitudinal dataset spanning over a period of 8 years, to examine a model in which loneliness mediates the relationship between self-perceptions of aging and depressive symptoms.Results: Our findings suggest that loneliness indeed mediates the relationship between self-perceptions of aging and depressive symptoms.Conclusions: The results highlight to the importance of the way people view the aging process in shaping their social and mental well-being. Practitioners may want to address self-perceptions of aging when helping older adults cope with loneliness and depressive symptoms.

Social Disconnectedness and Loneliness: Do Self-Perceptions of Aging Play a Role?

OBJECTIVES

Research suggests that self-perceptions of aging (SPA) have effects on physical, mental, cognitive, and emotional well-being among older adults. Few studies have examined the effects of SPA on social well-being. This study investigates the association of SPA with trajectories of social disconnectedness and loneliness in older Americans and explores mechanisms linking SPA and the 2 forms of social isolation.

METHODS

We conducted Latent Growth Curve Modeling and path analysis using 3-wave data spanning 8 years (2008/2010-2016/2018) from the Health and Retirement Study. The sample included respondents aged 65 and older (N = 3,597) at baseline (2008/2010). SPA was measured by the Attitudes Toward Own Aging Scale. Social disconnectedness was an index including 6 indicators of social networks and social engagement. Loneliness was measured using the 11-item UCLA Loneliness Scale.

RESULTS

Older adults with more negative SPA at baseline were more lonely but had slower rates of increase in loneliness during the 8-year study period. More negative SPA also predicted greater social disconnectedness but was not significantly related to the rate of change in social disconnectedness over time. The effects of SPA on social disconnectedness were primarily indirect through loneliness, whereas SPA had direct effects on loneliness. Overall, SPA had a stronger association with loneliness than with social disconnectedness.

DISCUSSION

The results suggest that older adults with negative SPA are at risk of loneliness which then leads to social disconnectedness. Asking about SPA during individual assessment with older adults may help to discern issues with loneliness.

COVID-19 and the Elderly's Mental Illness: The Role of Risk Perception, Social Isolation, Loneliness and Ageism

For almost two years, populations around the globe faced precariousness and uncertainty as a result of the COVID-19 pandemic. Older adults were highly affected by the virus, and the policies meant to protect them have often resulted in ageist stereotypes and discrimination. For example, the public discourse around older adults had a paternalistic tone framing all older adults as "vulnerable". This study aimed to measure the extent to which perceived age discrimination in the context of the COVID-19 pandemic, as well as the sense of loneliness and social isolation, fear and perception of COVID-19 risks, had a negative effect on older adults' mental illness. To do so, a self-report questionnaire was administered to 1301 participants (average age: 77.25 years old, SD = 5.46; 56.10% females, 43.90% males). Descriptive and correlational analyses were performed, along with structural equation modelling. Results showed that perceived age discrimination in the context of the COVID-19 pandemic positively predicts loneliness and also indirectly predicts mental illness. In addition, loneliness is the strongest predictor of mental illness together with fear of COVID-19 and social isolation. Such results highlight the importance of implementing public policies and discourses that are non-discriminating, and that favour the inclusion of older people.

Loneliness in Myanmar's older population: A mixed-methods investigation

OBJECTIVES

Little is known about loneliness in lower- and middle-income countries. This study investigates loneliness in the older population of Myanmar using a mixed-methods approach.

METHODS

To identify predictors of loneliness, hierarchical regression models were used to analyze data from the Myanmar Aging Survey 2012 (N = 3,618, 57% women). In a mixed-methods sequential explanatory design, quantitative data were integrated with qualitative data from semi-structured interviews with older adults in Myanmar in 2019.

RESULTS

The prevalence of loneliness varied by between-person characteristics. Health impairments, lower income, being widowed, not having children, and living with fewer household members were each associated with loneliness. Qualitative findings suggested that the physical presence of family members was especially protective against loneliness. Religion had mixed associations with loneliness, depending on the type of religious practice, demographic characteristics, health status, and community engagement.

DISCUSSION

The findings contribute to a better understanding of individuals' experiences of loneliness and may inform the design of interventions to prevent loneliness in Myanmar and globally.

Older Adult Employment Status and Well-Being: A Longitudinal Bidirectional Analysis

Mixed findings in the literature on the effects of older adult employment on well-being and the reciprocal influence of well-being on employment suggest the need for more careful methodology in teasing out this relationship. Moreover, as previous research has shown that different domains of well-being relate to constructs differently, more nuanced definitions of well-being may be appropriate. The present study examined the longitudinal bidirectional associations of employment and different domains of well-being, controlling for stable within-person variables. The present study sampled older adults from the Midlife Development in the US study at three timepoints on employment status and well-being, specifically psychological, social, and subjective well-being. A Random-Intercept Cross-lagged Panel Model (RI-CLPM) approach was employed to determine the longitudinal bidirectional influence of employment and domains of well-being. Results showed that employment status was not associated with various well-being domains at a later time point. Results also showed that greater well-being, specifically in meaningfulness of society and personal growth, was associated with being employed at a later time point.

Relationship between negative stereotypes toward aging and multidimensional variables in older people living in two different social environments

BACKGROUND

Ageism is studied extensively in community-dwelling older adults, but remains poorly understood in institutionalized older adults. Here, we compared the physical, psychological, and social variables associated with self-reported age-based biases in community-dwelling older adults and in those living in nursing homes (NHs).

MATERIAL AND METHODS

Participants (n = 272) in this descriptive cross-sectional study lived in NHs (n = 126) or in their homes (n = 146), were 60 years or older, and had no cognitive or serious functional impairments. Those in NHs had been institutionalized for at least six months. The dependent variable was negative stereotypes toward aging (CENVE). We developed generalized linear models (GLMs) by place of residence and sex following the Comprehensive Geriatric Assessment´s (CGA) methodology.

RESULTS

There is a statistically significant relationship between negative stereotypes of aging and different multidimensional variables. These variables differ between institutionalized and non-institutionalized adults and between men and women. While some variables are non-modifiable (age and sex) others are potentially modifiable (educational level, participation in activities, length of NH stay, hand strength, autonomy, and depression).

CONCLUSIONS

This study compared, for the first time, levels of ageism in older people living in two different social environments. Because most of the significant variables are modifiable in both environments, our results provide a framework to combat this type of discrimination. Promising strategies include anti-ageism policies and laws, educational interventions, and increased intergenerational contact.

Exploring the Reciprocal Associations of Perceptions of Aging and Social Involvement

OBJECTIVE

Positive perceptions of aging are known to have beneficial effects for older adults' health and well-being, but less is known regarding their social correlates. The current study aimed to disentangle the bidirectional associations of perceptions of aging with informal and formal social involvement.

METHOD

Data for this study came from the 2008 and 2014 waves of the German Ageing Survey (DEAS). Informal social involvement was assessed as the frequency of providing advice and emotional support to others. Formal social involvement was measured as the number of groups and organizations one participates in and the frequency of attending them. A latent change score model was used to assess the bidirectional links between the constructs.

RESULTS

Adults with more positive aging perception at baseline were likely to become more informally and formally socially involved over time. Informal social involvement predicted better perceptions of aging, but not formal social involvement. These trends were consistent across age groups.

CONCLUSIONS

The results suggest that having positive expectations regarding one's aging might encourage adults to maintain a more engaged and socially productive lifestyle. In addition, informal social involvement, characterized by the provision of advice and support to others, is beneficial for experiencing the aging process more positively.

Perceived Ageism During the Covid-19-Crisis Is Longitudinally Related to Subjective Perceptions of Aging

Ageism in media and society has increased sharply during the Covid-19-crisis, with expected negative consequences for the health and well-being of older adults. The current study investigates whether perceived ageism during the crisis longitudinally affects how people perceive their own aging. In June 2020, N = 611 older adults from Luxembourg [aged 60–98 years, M_age(SD) = 69.92(6.97)] participated in a survey on their perception of the crisis. In October 2020, N = 523 participated in a second measurement occasion. Participants reported on perceived ageism during the crisis in different domains, their self-perceptions of aging and subjective age. In latent longitudinal regression models, we predicted views on aging at T2 with perceived ageism at T1, while controlling for baseline views on aging and covariates. Perceived ageism at T1 increased self-perceptions of aging as social loss and yielded a trend for physical decline, while there were no effects on subjective age and self-perceptions of aging as continued growth. Views on aging are powerful predictors of well-being and health outcomes in later life. Our data suggest that being the target of ageism during the crisis negatively affects older adults' self-perceptions of aging and this impact may be felt beyond the current crisis.

The epidemiology of social isolation and loneliness among older adults during the last years of life

BACKGROUND

Social isolation and loneliness are critical to the health of older adults, but they have not been well-described at the end of life.

OBJECTIVES

To determine the prevalence and correlates of social isolation and loneliness among older adults in the last years of life.

DESIGN

Nationally representative, cross-sectional survey.

SETTING

Health and Retirement Study, 2006-2016 data.

PARTICIPANTS

Adults age > 50 interviewed once in the last 4 years of life (n = 3613).

MEASUREMENTS

We defined social isolation using a 15-item scale measuring household contacts, social network interaction, and community engagement, and frequent loneliness using the 3-item UCLA Loneliness Scale. We used multivariable logistic regression to determine their adjusted prevalence by time prior-to-death and by subgroups of interest.

RESULTS

Approximately 19% experienced social isolation, 18% loneliness, and 5% both in the last 4 years of life (correlation = 0.11). The adjusted prevalence of social isolation was higher for individuals nearer to death (4 years: 18% vs 0-3 months: 27%, p = 0.05) and there was no significant change in loneliness (4 years: 19% vs 0-3 months: 23%, p = 0.13). Risk factors for both isolation and loneliness included (p < 0.01): low net-worth (Isolation: 34% vs 14%; Loneliness: 29% vs 13%), hearing impairment (Isolation: 26% vs 20%; Loneliness: 26% vs 17%), and difficulty preparing meals (Isolation: 27% vs 19%; Loneliness: 29% vs 15%). Factors associated with loneliness, but not social isolation, included being female, pain, incontinence, and cognitive impairment.

CONCLUSIONS

Social isolation and loneliness are common at the end of life, affecting 1 in 4 older adults, but few experience both. Rates were higher for older adults who were poor and experienced functional or sensory impairments. Results can inform clinical efforts to identify and address end-of-life psychosocial suffering and health policies which prioritize social needs at the end of life.

Loneliness in older age: What is it, why is it happening and what should we do about it in Australia?

Loneliness is an important health issue facing older people due to its association with poor quality of life and poor health outcomes. This paper aimed to clarify key issues around loneliness among older adults and draw attention to innovative programs and the translation of emerging research into practice. Loneliness is a mismatch between a person's actual and desired social connections, experienced as negative emotions. Older adults are vulnerable to loneliness because of changes associated with ageing. As such, identifying as older is often seen as a burden, negatively impacting self-esteem, sense of purpose and relevance, culminating in loneliness. Interventions combatting loneliness can target individuals, relationships, communities or societies. We advocate for an intersectoral approach to support healthy ageing and reduce loneliness. This will require further research to evaluate new approaches with loneliness as the primary outcome, and additional funding to translate evidence into an integrated multi-level approach to addressing loneliness.

HIV and Aging: Double Stigma

Purpose of Review

HIV and ageism continue to be key public health challenges in the USA and globally. Older people living with HIV may experience intersectional stigma resulting from HIV and ageism. The current review summarizes the scientific literature and focuses on social isolation and lack of social support as key factors in experiencing HIV-related and aging-related stigma.

Recent Findings

Social isolation and social support are key social determinants of health, which may have a bidirectional relationship with HIV-related stigma and ageism. Stigmatization may also result in health care providers not paying enough attention to the mental health and sexual health needs of older adults.

Summary

Current research suggests that the intersection of HIV-related stigma and ageism is a complex issue. Future research should focus on the design and feasibility of implementing stigma reduction interventions addressing HIV-related stigma and ageism.

Why visiting one's ageing mother is not enough: on filial duties to prevent and alleviate parental loneliness

As people grow old, many risk becoming chronically lonely which is associated with e.g. depression, dementia, and increased mortality. Whoever else should help to protect them from this risk, various philosophers have argued that any children that they might have will often be among them. Proceeding on this assumption, this article considers what filial duties to protect ageing parents from loneliness consist of, or might consist of. I develop my answer by showing that a view that may be intuitively plausible, namely that they simply require children to visit their ageing parents regularly when they can do so at reasonable cost and call, text, and/or email them from time to time, is defective in three respects. First, it ignores children's potential responsibilities to encourage and/or facilitate social interaction between their parents and third parties. Second, it ignores their potential responsibilities to help provide their parents with non-human companionship. Third, it elides over their duties to coordinate their efforts to offer loneliness protection with others. What I end up proposing instead, then, is an approach for protecting ageing parents from loneliness that is multi-faceted.

Translation and validation of the ageism scale for dental students in Romanian (ASDS-Rom)

AIMS

The aim of this paper was to validate the Romanian version of an ageism scale for dental students.

MATERIALS AND METHODS

The initial 27-item ageism scale was translated into Romanian and administered to 210 dental students in Craiova. The data were analysed using principal components analysis (PCA) with an orthogonal, Varimax rotation. The answers were then compared across several demographic variables using a combination of independent samples t tests and one-way between-subjects analysis of variance (ANOVA).

RESULTS

Adequate factorability was confirmed with a Kaiser-Meyer-Olkin (KMO) of 0.676 and a Bartlett's Test of Sphericity yielding P < 0.001. PCA revealed a 10-item scale distributed into three components that accounted for 58% of the overall variance. The first component contained 4 items related to the cost-benefit of providing care to older patients (α = 0.80). The second contained 3 items that revolved around the perceptions about older people and their value in the society (α = 0.59). The third contained 3 items related to gerodontology training (α = 0.46). Discriminant validity showed differences in the first component based on whether a student had an older family member.

CONCLUSIONS

The 10-item, three components scale demonstrated acceptable validity and reliability.

Understanding the psychological drivers of loneliness: the first step towards developing more effective psychosocial interventions

Purpose

The purpose of this paper is to outline the need to develop a more balanced approach to addressing the loneliness experience by older people by recognising the psychological and emotional dynamics which cause it. It proposes a more holistic psychosocial approach to loneliness.

Design/methodology/approach

This paper draws on and reviews the published literature on the psychological aspects of loneliness.

Findings

Although not extensive, there is sufficient evidence to begin to develop and test more psychosocial approaches to addressing loneliness.

Research limitations/implications

The evidence base is not extensive and a fair degree of it has not been fully trialled with older people.

Practical implications

There is an a priori case for using the evidence that exists to develop and test out new psychosocial interventions for addressing loneliness.

Social implications

It is possible that a more psychosocial approach to loneliness will enable more to be done to address the significant distress of older people experience severe and chronic loneliness. It may also be possible to develop more effective preventative strategies which build resilience in older people.

Originality/value

The field of loneliness practice and research is overwhelmingly based on sociological analysis and social interventions. This paper is one of the first to explicitly highlight the value in drawing from psychological data in order to develop psychosocial approaches.