Ageism from a cross-cultural perspective: results from a national survey of Israelis over the age of 50

Rapid review to inform the selection of a set of brief set of universal indicators for use in large-scale cross-national ageism research

OBJECTIVES

Ageism occurs across the world, with negative consequences for individuals and societies. In 2016, WHO received a mandate from its Member States to lead the global campaign to combat ageism. To monitor, evaluate, and build evidence for reducing ageism, the availability of a brief, reliable and valid set of indicators of ageism experiences that can be used globally is essential.

METHOD

Building on previous reviews, the current review examines existing measures of ageism with a specific focus on suitability for meeting this need. Given the urgent need for indicators in the context of the global campaign to combat ageism, a rapid review methodology was adopted.

RESULTS

Results suggested that no measure met all desired criteria; however, the WHO ageism experiences scale was the most promising of available measures due to its focus on ageism as a multi-dimensional construct encompassing stereotypes, prejudices, and discrimination and self-directed, interpersonal, and institutional elements and the explicit consideration of cross-cultural universality in its development. Other promising measures included ESS Round 4 items along with its CIS and VQ variants, the Everyday Ageism Scale, the Perceived Ageism Questionnaire (PAQ), and the Ageism Survey.

CONCLUSION

Further cross-setting validation of this scale is recommended.

Social support and aging: psychometric analysis of the ENRICHD Social Support Instrument in a Chilean population over 50

BACKGROUND

Social support is relevant to studying well-being, quality of life, and health during aging, particularly in people over 50. Therefore, brief instruments that allow its measurement within the clinical evaluation and research processes are necessary. The ENRICH Social Support Scale (ESSI) is a brief and easy-to-use instrument that measures the perception of social support; however, its psychometric properties in people over 50 in the Chilean context have yet to be tested.

METHOD

This study had a non-experimental, longitudinal panel design in which a sample of 303 people over 50 years of age (M = 55.14 years, SD = 5.19; 52% women) were administered a survey incorporating sociodemographic variables, the ESSI and the Newsom Social Negativity Scale. 277 participants completed the follow-up survey (M = 56.75 years, SD = 5.15; 54% women). Confirmatory factor analysis (CFA), structural equation modeling (SEM), invariance analysis, and internal consistency tests were performed to determine the psychometric properties.

RESULTS

The six items from the scale load in a single-factor model obtained an excellent fit to the data and reliability coefficients (α = 0.902; ω = 0.904). The SEM analysis evidenced an inverse correlation between the ESSI and Newsom's social negativity scale, demonstrating evidence of construct validity. Furthermore, in the sex invariance analyses, the scalar level was reached, implying that the items' meanings are the same for men and women. Finally, the residual level was reached in the temporal invariance analyses, which means that the scale items are consistent in time.

CONCLUSIONS

The ESSI is a reliable and valid tool to be used in the Chilean context both in the clinical setting and in research on people over 50. The evidence obtained supports its usability to appropriately measure the perception of social support, which is relevant considering that it has been associated with reports of higher quality of life and lower mortality and morbidity during aging.

Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US

BACKGROUND

Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity.

METHODS

Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated.

RESULTS

Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age.

LIMITATIONS

The possibility of reciprocal effects cannot be excluded.

CONCLUSION

Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.

Community gender norms, mental health, and suicide ideation and attempts among older Japanese adults: a cross-sectional study

OBJECTIVES

Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes.

DESIGN

Cross-sectional.

SETTING

This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study.

PARTICIPANTS

In total, 25,937 participants aged 65 years or older in 61 municipalities.

MEASUREMENTS

Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as "You should/should not do XXX, because you are a man/woman."

RESULTS

The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes.

CONCLUSIONS

Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.

Eradicating ageism through social campaigns: An Israeli case study in the shadows of the COVID-19 pandemic

This study examined three social campaigns for the eradication of ageism that were undertaken in Israel during the COVID-19 pandemic (April, 2020-May, 2021). The documentation and analysis of the campaigns were undertaken via the lens of the Theory of Change and Five Key Principles for social campaigns: planning strategically, communicating effectively, fostering community engagement, implementing key activities, and using research. We conducted desk reviews and qualitative interviews with the campaigns' organizers. The Theory of Change implemented by the campaigns targeted self-ageism among independent older people and/or employers of older adults. All campaigns emphasized "active aging" and "successful aging," to decrease (self)-ageism. The focus on one dimension of active and positive aging may result in ageism and exclusion of older people who do not fit into the category of independent and active people. The complex timing of the campaigns had influenced the degree of implementation of the five key principles. The joining of forces of different organizations and the employment of more diverse representations of old age, may facilitate the achievement of campaign goals. Finally, an empirical evaluation of social campaigns' efforts is still necessary to gather evidence about the effectiveness of social campaigns.

Psychotherapy with older adults: Ageism and the therapeutic process

Objective This study explores how ageism in therapists is manifested in psychotherapy with older adults and how therapists deal with its impact on their therapeutic work. Method: Semi-structured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. Results: Findings clustered around two themes: (i) maintaining openness to change while acknowledging limitations; (ii) dealing with manifestations of ageism inside therapy by going beyond relating to older patients only in terms of their chronological age. Conclusions: Our findings indicate that while therapists maintain an optimistic view regarding the possibility of therapeutic change, the therapeutic encounter with older patients triggers certain ageist therapeutic biases and behaviors in therapists, even in experienced therapists who have competency in working with older adults. Our findings also indicate that dealing with therapists' ageism in psychotherapy with older patients requires therapists not only to be aware in advance of their ageist attitudes but also to continuously engage in the management of the manifestations of ageism inside treatment. We use the conceptual framework of countertransference to suggest an understanding of the relationship between therapists' ageism and the therapeutic process. Implications for training and practice are discussed.

Public awareness of legal decision-making capacity and planning instruments in dementia: implications for health care practitioners

The protection of a person facing difficulties with legal decision-making can be challenging; however, estate planning documents (EPDs) can offer safeguards. Little is known about the community awareness of EPDs and their perceived importance, including for people with dementia. Two-hundred and thirty adults read a mild dementia vignette, proposed a diagnosis for the vignette character (VC), and rated the VC's legal decision-making capacity (DMC). The effect on ratings about DMC under different conditions was explored (e.g., variation of VC characteristics and the decision). Awareness, and the personal importance, of EPDs were assessed. DMC was affected by the variations in the VC's age, diagnosis, and the decision, as high- or low-stakes, but not VC sex. Awareness of EPDs was low; however, planning importance was increased for dementia. Although the public understand that dementia affects DMC, they require further information about EPDs to validly enact them, thereby reducing potential vulnerability.