Attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning

OBJECTIVE

To understand if attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning among older adults with medical conditions. We examined: (1) if these effects are reciprocal; (2) if attitudes to aging (psychological loss, psychological growth, physical change) play a mediating role in these effects.

DESIGN

A sample of 226 community-dwelling older adults (T1 age range = 65-94, mean age = 73.59, SD = 6.29) reporting at least one chronic medical condition completed two phone interviews across six months.

MAIN OUTCOME MEASURES

Background measures, health anxiety, physical functioning, and attitudes to aging at T1 and T2.

RESULTS

T2 attitudes to aging served as a mediator controlling for T1 attitudes. There was a direct effect of worse physical functioning at T1 on increased health anxieties at T2. Negative (but not positive) attitudes to aging mediated that effect. The reversed temporal sequencing (T1 health anxiety leading to T2 physical functioning) was significant only when mediated by negative attitudes to aging.

CONCLUSIONS

Findings suggest that viewing aging as mostly a time of losses (but not as a time of gains) serves as an important mechanism through which health anxieties and physical functioning affect each other among older adults having chronic medical conditions.

Factors Associated with Attitudes toward Aging among Taiwanese Middle-Aged and Older Adults: Based on Population-Representative National Data

In middle-aged and older adults, attitude toward aging (ATA) exerts significant influences on their current and future health. For health promotion to be successful, participants’ ATA requires health care providers’ attention. Knowing the factors associated with ATA can facilitate future studies to investigate effective interventions. The aim of this study was to identify the factors associated with ATA in middle-aged and older adults. This cross-sectional study analyzed data of a nationally representative sample of adults aged 58 years and older collected in a population-based longitudinal study: the Taiwan Longitudinal Study on Aging (TLSA). To identify the factors associated with ATA, we investigated demographic factors (age, gender, education, marital and cohabitation status, and financial satisfaction status) and health-related factors (number of co-morbidities, depression, physical function dependency) with bivariate analysis and multiple regression analysis. To identify the activities beneficial to ATA over and above demographic and health-related factors, various activities (exercise, volunteer service, and leisure activities) were each examined individually by multiple regression analysis. The factors detrimental to ATA were advanced age, a higher number of co-morbidities, living alone, depression, and dependence on physical function. Those beneficial to ATA were higher education, financial satisfaction, physical exercise, volunteer service, and six leisure activities.

Attitude towards ageing and perceived health status of community-dwelling older persons in a low resource setting: a rural-urban comparison

BACKGROUND

Older person's attitude to ageing is critical for their adjustment, acceptance of health-related behaviour, survival and choices. Their attitude influences how they cope with the challenges experienced while ageing, which affects their quality of life and health-related outcomes. Despite the increasing number of older persons in sub-Saharan Africa, there is limited information about their experience. This study examines the experience and attitude of older persons in Nigeria regarding the ageing process.

METHODS

A descriptive cross-sectional study among older persons aged 60 years and above was carried out in a selected rural and an urban community in Oyo State, south-western Nigeria. The study participants were selected using a multi-stage sampling technique. Trained research assistants collected data with the aid of an interviewer-administered, semi-structured questionnaire. The Attitude to Ageing Questionnaire (AAQ) was used to measure participants' perception of ageing in three domains (psychosocial loss, physical changes and psychological growth). Data were analysed using Stata version 14 at a level of significance p < 0.05.

RESULTS

A total of 1,180 participants (588 rural vs. 592 urban) were recruited for the study. The mean age was 73.2 ± 9.3 years. The majority (69.7 %) were females and still working (50.5 %). Overall, urban-dwelling participants had a better attitude to the ageing process in all the domains compared with rural-dwelling participants (psychological growth 32.5 ± 3.4 vs. 32.4 ± 3.3, p = 0.30; physical change 27.5 ± 5.1 vs. 26.9 ± 5.0, p = 0.03; and psychosocial loss 25.3 ± 5.7 vs. 25.0 ± 5.3, p = 0.60). Among the rural and urban-dwelling participants, good self-rated health was significantly associated with a positive attitude to ageing across the domains.

CONCLUSIONS

Older persons residing in urban communities had higher positivity to ageing than their rural older counterparts. The common factor significantly associated with a positive attitude to ageing in both groups was good self-rated health. This information can be used for the planning of targeted interventions and informing policy formation for improved provisions for community-dwelling older persons in Nigeria and other sub-Saharan African countries.

Ageist Attitudes Are Associated with Will-to-Live and Moderated by Age, Medical Conditions and Attitudes toward Aging

The extent to which older adults’ ageist attitudes associate with their will-to-live has barely been studied. Moreover, whether this effect is moderated by older adults’ age, medical conditions, and attitudes toward their own aging has not been investigated. These associations were examined by two studies. Study 1 examined the relationship between ageist attitudes and will-to-live among individuals aged 48–97, and the moderating roles of age and medical conditions on this connection. Study 2 reassessed this connection in a new sample of older adults (people aged 60–94 years) and examined the moderating role of their attitudes toward aging in this regard. In line with the hypothesis of the first study, ageist attitudes and will-to-live were negatively associated among older adults with more medical conditions. In accordance with the hypotheses of study 2, the ageist attitudes and will-to-live connection was reconstructed, and when regressed on the ageist attitudes × attitudes toward aging interaction, it remained significant only among those with increased ageist attitudes. These findings demonstrate the negative effect that ageist attitudes may have on will-to-live, especially among the very old, and particularly when their health deteriorates, and support the utility of interventions aimed at increasing their will-to-live.

Determinants of Ageism against Older Adults: A Systematic Review

Ageism is a widespread phenomenon and constitutes a significant threat to older people's well-being. Identifying the factors contributing to ageism is critical to inform policies that minimise its societal impact. In this systematic review, we gathered and summarised empirical studies exploring the key determinants of ageism against older people for a period of over forty years (1970-2017). A comprehensive search using fourteen databases identified all published records related to the umbrella concept of "ageism". Reviewers independently screened the final pool to identify all papers focusing on determinants, according to a predefined list of inclusion and exclusion criteria. All relevant information was extracted and summarised following a narrative synthesis approach. A total of 199 papers were included in this review. We identified a total of 14 determinants as robustly associated with ageism. Of these, 13 have an effect on other-directed ageism, and one on self-directed ageism. The quality of contact with older people and the positive or negative presentation of older people to others emerged as the most robust determinants of other-directed ageism; self-directed ageism is mostly determined by older adults' health status. Given the correlational nature of most studies included in this review, inferences on causality should be made cautiously.

Cultural Adaptations to the Measurement of Attitudes to Ageing: Psychometric Assessment of the Malay Reactions to Ageing Questionnaire

The aims of this study were to culturally adapt the Reactions to Ageing Questionnaire (RAQ) for a non-Western (Malay) population, and explore attitudes to ageing in relation to age, gender, and education. Eight new culturally relevant items were generated by asking Malay-speaking participants about their reactions to ageing. A Malay version of the extended 35-item RAQ was then administered to 911 Malaysian participants aged 18 to 60 years. Exploratory factor analysis revealed four factors. Three of the factors were similar to those identified in the original RAQ, while "Family and Religion" emerged as a new factor. More negative attitudes to ageing were observed in younger and female respondents. There were no effects of education. This culturally adapted RAQ exhibits robust psychometric properties, and could be used to assess attitudes to ageing in Malaysia and other Southeast Asian countries. Moreover, we have identified a "core set" of RAQ items that could be applicable worldwide.

Development of a short form of the Attitudes to Ageing Questionnaire (AAQ)

OBJECTIVES

The original 24-item Attitudes to Aging Questionnaire (AAQ) is well established as a measure of attitudes to aging, comprising domains of psychosocial loss (PL), physical change (PC), and psychological growth (PG). This paper presents a new 12-item short form Attitudes to Aging Questionnaire (AAQ-SF).

METHODS

The original field trial data used to develop the 24-item AAQ (AAQ-24) were used to compare 6-item, 9-item, and 12-item versions of AAQ-SF (sample 1, n = 2487) and to test the discriminative validity of the selected 12-item AAQ-SF (sample 2, n = 2488). Data from a separate study reporting on the AAQ-24 (sample 3, n = 792) verified the analyses.

RESULTS

The 12-item AAQ-SF reported adequate internal consistency in both sample 1 (PL α = .72, PC α = .72, and PG α = .62) and sample 3 (PL α = .68, PC α = .73, and PG α = .61). The AAQ-SF functioned consistently with the profile of the AAQ-24 in that subscales in both formats of this measure discriminate between respondents on key parameters such as depression, subjective health status, and overall quality of life in sample 2. Sample 3 also demonstrated the AAQ-SF can detect the differences in attitudes toward aging between individuals experiencing anxiety and depression and those without psychological symptoms. Confirmatory factor analysis confirmed that the structure of the AAQ-SF mirrors that of the original 24-item AAQ.

CONCLUSIONS

The AAQ-SF is a robust measure of attitudes toward aging, which can reduce respondent burden when used within longer questionnaire batteries or longitudinal research. Copyright © 2017 John Wiley & Sons, Ltd.

Factors associated with attitudes toward the elderly in a sample of elderly caregivers

BACKGROUND

The number of elderly caregivers is increasing in the world. It is important to know the attitudes toward the elderly, because they can influence a range of behaviors. Our aim was to determine factors associated with attitudes toward the elderly in a sample of older carers.

METHODS

Three hundred and thirteen elderly caregivers (75.4% women, mean age 69.7 ± 7.1) who cared for a dependent older person at home completed a cross-sectional household interview. In addition to the four domains of the Neri Scale to Assess Attitudes Toward the Elderly, participants were evaluated regarding the demographics, care recipient (CR) characteristics, functional and cognitive status, general health, life satisfaction, perceived stress, and depressive symptoms.

RESULTS

Overall, attitudes toward the elderly were neutral in this sample. More negative attitudes in some Neri Scale domains were associated with being older, living in an urban setting, taking more medications per day, caring for an elderly dependent in basic Activities of Daily Living (ADLs), being "more or less" satisfied with life, and having higher levels of perceived stress. There was a negative association between positive attitudes and educational level.

CONCLUSIONS

The results highlight the need for public policies to promote more positive attitudes toward aging and change negative stereotypes usually used to designate older people. These public policies can try to modify some predictors of negative attitudes, such as perceived stress, which was associated with all four domains of Neri Scale.

PREVALENCE OF FALLS AND ASSOCIATED RISK FACTORS AMONG AGED POPULATION: COMMUNITY BASED CROSS-SECTIONAL STUDY FROM TURKEY

AIM

The aim of the study was to examine the prevalence and risk factors of falls among persons aged 65 years and older in Qanakkale, Turkey.

METHODS

A community based cross-sectional study was conducted between May-September 2013. A total of 1,001 elderly living in Çanakkale city centre were included into our study. The research was carried out with face-to-face interviews and survey forms. The survey form consists of seven sections: demographic characteristics, significance of ageing, daily activities, quality of life and social network in old age, use of health services and health problems, bad habits, and the European Health Impact Scale. Data analysis was performed using the SPSS software version 19.0. For data investigation the chi-square and logistic regression analyses were used.

RESULTS

The prevalence of falls at home or outside was 32.1% among elderly in the last six months period. The prevalence of falling for women at home as well as outside was statistically significantly higher than for men (p < 0.05). According to multivariate analysis results the risk of falling at home or outside was increased by 2.7 times in women (95% CI: 1.90-3.75), by. 2.1 times in those who cannot take care of themselves (95% Cl: 1.33-3.29), and by 1.7 times in those who have low quality of life (95% Cl: 1.24-2.43).

CONCLUSIONS

This community based cross-sectional study showed that prevalence of falling was high in aged persons living in centre of Çanakkale located in the western part of Turkey. Moreover, the risk was increased in women, those who cannot take care for themselves, and those with low standard of living.

Blood levels of lead, cadmium, and mercury in the elderly living in institutionalized care in the Czech Republic

BACKGROUND

There is limited research examining the chemical load of toxic metals in the elderly. The aim of the present study was two-fold: to determine the body burden of lead, cadmium and mercury in association with age, gender, locality, lifestyle factors and potential health impacts among this population and to compare the values with blood values from the general Czech population aged 18-64 years.

METHODS

Lead, cadmium and mercury were examined in the blood of institutionalized senior citizens (46 males, 151 females aged 61-100 years) from two localities in the Czech Republic (Prague and Teplice) from 2009 through 2011. Measurements were made using inductively coupled plasma mass spectrometry (Pb, Cd) and a single purpose spectrometer AMA 254 (Hg).

RESULTS

Geometric means (GM) of whole blood lead (B-Pb), cadmium (B-Cd) and mercury (B-Hg) levels were 25.3μg/l, 0.55μg/l and 0.21μg/l, respectively. No age-related differences were found for B-Pb and B-Cd levels but a negative correlation with age was observed for B-Hg levels (p=0.04). B-Pb levels in men were significantly higher than in women (GM 29.9μg/l vs. 24.1μg/l). B-Cd was significantly higher in women (GM 0.57μg/l) than in men (0.50μg/l) (p=0.007) and in smokers (GM 1.29μg/l) than in nonsmokers (GM 0.53μg/l) (p=<0.001) and in seniors from Prague (GM 0.60μg/l) compared to those from Teplice (GM 0.43μg/l) (p=<0.001). Seniors with a history of chronic kidney disease, stroke and those using psycho-pharmaceuticals had higher B-Pb levels (p=0.008, 0.04 and 0.05, resp.), seniors diagnosed with atherosclerosis had higher B-Cd levels (p=0.002) and seniors using psycho-pharmaceuticals had higher B-Hg levels (p=0.07). B-Hg levels were also positively correlated with blood albumin levels (p=0.015).

CONCLUSIONS

This study provides data on levels of heavy metals in a group of elderly people. Such information is very scarce. Associations with diseases should be the subject of further investigation.

Aging in the Czech Republic

The goal was to provide an overview of main issues relevant to aging in the Czech Republic. The Czech Republic is a former Eastern Bloc nation of about 10.5 million. Older adults are overrepresented relative to those under age 15. Life expectancy currently hovers around 78 years (75 for men/81 for women), a number slightly higher than most of Eastern Europe but lower than most of Western Europe. Cardiovascular diseases account for about 50% of all mortality, which is one of the highest rates in Europe and therefore of particular concern. Lifestyle habits, especially high alcohol consumption, a high rate of smokers, and high-fat diet relative to most other European countries and the United States, combined with relatively low expenditures for health promotion, appear important in the context of high cardiovascular mortality. Long-term care is funded mostly by state and local governments. The country has tried to address issues associated with insufficient capacity and low quality in long-term care, a particularly prominent problem in the Czech Republic compared with other European countries. The recently established International Clinical Research Center brings new possibilities for collaborative research in the Czech Republic, including research specific to aging. Improving long-term care and establishing methodologically sound longitudinal data sets are among the most pressing issues, although sustaining the pension system strained by increasing life expectancy, low retirement age, and extensive government-sponsored benefits has also recently emerged as a critical issue.