Let us move forward: Comment on "are generations a useful concept?"

Generational labels (e.g., Millennials and Baby Boomers) are widely used in daily life to represent the unique characteristics of groups of people. However, the existence of generational differences remains contentious. In their focal paper, Costanza et al. (2023) critically reviewed the literature on generational differences and proposed two future research directions: the social constructionist and lifespan development perspectives. In this commentary, we aimed to extend the proposed directions for future research on generational differences by integrating the two perspectives into one theoretical framework. Future research should investigate how proximal social relationships (e.g., intergenerational relations) and distal social norms (e.g., age norms) change over historical time and whether these historical changes shape individuals' development and aging. The theoretical framework that integrates the two proposed research directions may stimulate research on generational differences to progress beyond the concept of generations.

Ageism webinars: a needs-based continuing education training for the national aging network

To combat ageism, the National Resource Center on Nutrition and Aging (NRCNA) launched two Ageism Webinars (AWs). The study's aims were to 1) assess the effectiveness of the AWs for increasing participants' perceived familiarity (FAM) and knowledge (KNOW) and producing high behavioral intent to implement recommended action steps and quality among participants, and 2) practice equitable evaluation by ascertaining whether outcomes were fairly achieved by participants regardless of race, age, and education. A convenience sample of mostly educated non-Hispanic females with an average age of 52 years (n = 193) completed a retrospective online survey post-webinar. A retrospective Likert scale noted an overall increase in perceived FAM and KNOW (p < 0.001). However, these changes were significantly smaller (p < 0.05) among those from historically marginalized races and ethnicities. The theory of planned behavior (TPB) items predicted high intention to complete the recommended action step following the webinars. High satisfaction for webinars was reported, with 98.7% wanting to attend future NRCNA training. This study provides evidence of an effective training modality for addressing ageist perspectives, and the demonstrated differences provide insight into how to improve the AWs and the evaluation of future webinars.

[Ethics of a long life]

The increase in average life expectancy that has taken place since 1850 and is continuing globally to the present day can be seen as a major achievement of civilization. However, many are skeptical about demographic change and the continuing trend of increasing life expectancy beyond current limits. The reasons for this lie in deeply rooted cultural attitudes towards old age and the elderly.This article counters these attitudes with principles for a long life that emphasize the benefits of the first revolution of life extension. Research should be promoted that can ensure this gain and holds out the prospect of a further extension of the human lifespan as a result of a second revolution.

The Threefold Path to Equity: Approaches for Health and Aging Researchers

The authors present a model for pursuing equity in research on health and aging, in terms of: (a) community-driven research governance, with reference to examples inside and outside of the United States, (b) a focus on policy change, where policy is defined broadly in terms of all legislative and regulatory change, and (c) equity-focused research practices, at the level of measurement, analysis, and study design. The model is visualized as a "threefold path" that researchers may walk, to achieve changes within our field, and changes in how we interface with other fields, and communities.

Effects of Alzheimer's Diagnosis and Gender on Ageist Attitudes, Aging Anxiety, and Emotional Reactions to Older Adults

BACKGROUND AND OBJECTIVES

We investigated whether ageist attitudes, aging anxiety, and emotional reactions to older adults differ based on Alzheimer's disease (AD) diagnosis, older adult gender, and participant gender, as well as their interactions.

RESEARCH DESIGN AND METHODS

Using an experimental design, 291 participants (176 men, 115 women; 19-55 years) were randomly assigned to read 1 of 4 descriptions of an older adult that varied cognitive health and gender. Measures of ageist attitudes, aging anxiety, and emotional reactions to the older adult were completed online.

RESULTS

Relative to a cognitively intact older adult, an older adult with AD evoked less ageist attitudes, less aging anxiety, more compassion, and less emotional distance. A significant interaction between older adult gender and participant gender indicated women felt greater emotional distance from an older adult man than an older adult woman, while men showed no significant difference.

DISCUSSION AND IMPLICATIONS

The more positive emotions and less ageist responses to an older adult with AD could present as paternalistic and diminish older adults' agency. Women may prioritize shared gender identity over age, which has implications for caregivers and health professionals working with older adults.

A brief version of the Attitudes to Ageing Questionnaire for older Chinese adults: development and psychometric evaluation

BACKGROUND

Positive attitudes toward aging are considered essential for achieving psychological well-being in later life. However, there is currently a lack of a concise and comprehensive measurement tool specifically designed to assess attitudes toward aging among the elderly population in China. To address this gap, the present study aimed to develop a brief version of the Attitudes to Ageing Questionnaire tailored to older Chinese individuals and evaluate its psychometric properties.

METHODS

Initially, a sample of community-dwelling older adults (Sample 1: n = 442, aged 60-88) was utilized to establish a new scale format. Subsequently, two convenience samples (Sample 2: n = 311, aged 60-90; Sample 3: n = 164, aged 60-89) were employed to evaluate the psychometric properties of this scale, including factor structure, internal consistency, test-retest reliability, convergent validity, and discriminant validity.

RESULTS

We selected 12 items from the original questionnaire to create the brief scale. The brief scale maintained the three-factor structure of the full-format version, encompassing psychosocial loss, physical change, and psychological growth, and demonstrated adequate psychometric properties.

CONCLUSIONS

This development process shortens the administration time of the questionnaire while avoiding excessive loss of information. The newly developed scale serves as a reliable and valid assessment tool for measuring attitudes toward aging among older Chinese individuals and is well-suited for implementation in large-scale surveys that utilize an extensive array of questionnaires. This tool can be applied to assessing the effectiveness of interventions aimed at eliminating ageism.

The lived experience of frailty: beyond classification and towards a holistic understanding of health

PURPOSE

Frailty is characterised by decreased physiological reserves and vulnerability to stressors. Although scales, such as the Fried's Frailty Phenotype (FP), Frailty Index (FI), and Clinical Frailty Scale (CFS), are used to identify frailty, the lived experience of frailty remains understudied.

METHODS

This cross-sectional observational research involved participants aged 65 years and older from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA). Participants were categorised into four independent groups: three frail groups based on the aforementioned scales and a non-frail group. Quantitative variables, including self-rated health, CASP-19 quality-of-life score, and frequency of social activities, were analysed and described.

RESULTS

The study encompassed 1999 participants with an average age of 72 years, of whom 51% were women. FP exclusively identified 1.6% as frail (n = 32), FI 11.7% (n = 233), and CFS 6.8% (n = 135). More than 60% of all those classified as frail reported their health as good, very good, or excellent, with the lowest proportion (64%) being among frail by FI participants. Frail by FI participants exhibited the lowest mean average CASP-19 score, yet it remained relatively high at 39 out of 57 points. Over 77% of all frail individuals engaged in active leisure activities at least once a month.

CONCLUSION

This study underscores the need to comprehend frailty holistically beyond its mere identification. It challenges the prevailing belief that frailty inevitably leads to impaired quality of life and limited social engagement. The findings advocate for a reassessment of how both the general public and healthcare professionals perceive frailty.

[Occupational health policies in older workers: comparative analysis between Spain and Chile]

OBJECTIVE

To analyze and compare the current Spanish and Chilean regulations regarding occupational risk prevention, regarding the existence of specific indications that protect the occupational health and safety of people over 55 years of age.

METHOD

Qualitative study in which a documentary content analysis was carried out using ATLAS/ti. The sample was 88 regulatory documents on occupational risk prevention for Spain and Chile. The guidance of the European Agency for Safety at Work (EU-OSHA) regarding age-critical risks was followed.

RESULTS

In global terms, 21.9% of the total Spanish documents analyzed show the explicit presence of considerations on aging, while for Chile this occurs in 9%. Both countries mention indications regarding ergonomic risks and noise. Shift work and psychosocial risks are considered only in Spain, while extreme temperatures, vibrations and geographical altitude appear exclusively in Chilean regulations. Neither country refers to issues inherent to working women (care responsibilities, menopause).

CONCLUSIONS

The Spanish regulations present a greater presence of indications on aging compared to the Chilean one. However, development in this area is insufficient in both countries. Chile and Spain have guides of recommendations, which are not mandatory, and their application is voluntary. This suggests that the prevention of occupational risks has a great pending challenge with people over 55 years of age.

Age as a Factor in Diversity, Equity, and Inclusion Initiatives in Higher Education

Demographic shifts and the growth of diversity, equity, and inclusion (DEI) initiatives are occurring simultaneously on college campuses. This study seeks to understand their intersection by focusing on age in DEI initiatives on college campuses. Findings from six focus groups suggest that age is not given much attention in DEI initiatives. Participants acknowledge the issue of age; but in general, they strive to keep other identities, like race and gender, in the forefront, especially in the face of low resources. While it may be difficult to elevate age in DEI initiatives on campuses, interventions were identified.

Age differences in emotional reactions to ageist memes and changes in age of one's Best Self

Memes on social media can carry ageist messages and can elicit reactions that are both emotional and self-evaluative. The present study investigates age-related differences in nine discrete emotions and in the evaluation of when individuals have been or will be their best selves. Participants (n = 360) representing young (m = 26 years), middle-aged (m = 39 years) and older adults (m = 63 years) were randomly assigned to view either non-ageist (animals) or ageist (e.g., incompetent older people) memes. After viewing memes, we assessed nine emotional reactions (i.e., fear, anger, sadness, happiness, anxiety, discomfort, disgust, surprise, enjoyment) and Best Self evaluations. Younger and middle-aged people reported more intense emotional reactions to memes than older people, with the exception that older people reported more discomfort and disgust in response to ageist versus non-ageist memes. Younger adults were less surprised by ageist memes (vs. non-ageist) and for all age groups ageist memes (vs. non-ageist) elicited less happiness and enjoyment and were less likely to be shared. With respect to evaluations of one's Best Self, older individuals were more likely to report being their best selves in the past, while after viewing ageist memes, younger individuals were more likely to report being their best selves in the future. Emotions of disgust and discomfort were related to identifying one's Best Self as further in the past. The current study adds to the literature on the impact of ageism by examining age-related differences in the emotions and self-evaluations experienced when confronted with memes on social media.

"We're still alive, much to everyone's surprise": The experience of trans older adults living with dementia in an ageist, cisgenderist, and cogniticist society

Trans and non-binary older adults living with dementia experience forms of marginalization, pathologization, and discrimination embedded in epistemic violence that leads them to be mistreated and dismissed as knowledgeable subjects. Based on empirical findings from a Canadian study examining the experiences of trans and non-binary people living with dementia and their carers, we combat this epistemic violence by focusing on the first-hand narratives of this population and their carers. Narrative interviews were conducted with six participants (N = 6): four carers of trans and non-binary adults living with dementia and two trans (binary) people living with dementia. Through a thematic analysis, we examine the unique aspects of living with dementia as a trans or non-binary person. First, the findings show how cogniticism impacts the experience of gender identity and cisgenderism, for example through blocked surgeries, excessive gatekeeping, and not being taken seriously by practitioners. Second, the findings discuss how dementia impacts gender identity and cisgenderism, for example, by increasing the need for formal care that can in turn increase vulnerability to structural violence. Third, the findings illustrate how cisgenderism and gender identity impact the experience of dementia and cogniticism, for example by limiting care options and the ability to advocate for oneself. Fourth, the findings highlight the silo mentality among practitioners, since most of them do not work with an intersectional lens. The article concludes by offering recommendations.

Is age discrimination a risk factor for frailty progression and frailty development among older adults? A prospective cohort analysis of the English Longitudinal Study of Ageing

BACKGROUND

With the increasing global burden of frailty on healthcare resources, it is important to understand the modifiable risk factors of frailty. This study examined perceived age discrimination as a potential risk factor for frailty progression and frailty development among older adults.

METHODS

Prospective cohort study using data from Waves 5 to 9 of the English Longitudinal Study of Ageing (ELSA). Data on perceived age discrimination was collected only in Wave 5 of ELSA and analysed as baseline data in this study. Frailty was defined using the Frailty Index (FI) scores (0 to 1), calculated using the multidimensional deficits (scores ≥ 0.25 were considered frail). Binomial generalised estimating equation models (GEE) were fitted in R studio using perceived age discrimination as the main predictor with age, gender, long-standing illness, cognition, subjective social status status (SSS) and psychological wellbeing as covariates. Odd ratios were reported with 95 % confidence intervals (CI).

RESULTS

A total sample of 2,385 ELSA participants were included in the analysis. 55.8 % (n = 1312) were female, mean age 71.9 (SD ± 5.27) years and baseline frailty prevalence was 12.1 % (n = 288). Perceived age discrimination was reported by 38.4 % (n = 916) of the participants. Both frailty progression (OR 1.50, CI [1.26- 1.70]) and frailty development (OR 1.39, CI [1.14-1.62]) were significantly associated with perceived age discrimination in the fully adjusted models. Age (80+ years) (OR 3.72, CI [2.84-4.86]) and long-standing illness (OR 5.45, CI [4.43-6.67]) had the strongest association with respondents' frailty progression.

CONCLUSION

Perceived age discrimination significantly increased the risk of frailty progression and frailty development among ELSA participants.

Ambiguous personhood: Paradoxes of social belonging in Danish nursing home care

In oldest old age (generally considered to be from 85 years onwards), personhood is often called into question, impacting well-being as a result. Based on ethnographic fieldwork, this article examines the well-being of oldest old nursing home residents at the intersections of ageism, fraying personhood and fragile social belonging in Danish nursing home care. In Denmark personhood hinges on both independence and social belonging; or "fællesskab." We examine how these concepts are practiced in nursing home care. Taking its starting point in the distinction between the "inside world" of the nursing home and the "real world" outside, the article examines how processes of othering occur in nursing home care, imperilling resident personhood and opportunities for social belonging. We consider how oldest old residents navigate social belonging, finding it in turn life-sustaining and vexatious. We argue that tacit ageism permeates the nursing home, to the detriment of resident well-being, despite the best intentions of an aged care system that is structured to specifically maintain personhood.

Beauty work or beauty care? Women's perceptions of appearance in the second half of life

The prevailing cultural emphasis on women's attractiveness being tied to youth raises questions about how women perceive their appearance in the second half of life. The current qualitative study addresses this issue by posing two questions: how do women over fifty perceive and describe changes in their appearance? And how do they cope with these changes? Five focus group meetings with 19 Israeli women aged 54-76 were held to examine the issue. The meetings were structured around viewing three film clips starring older characters, encouraging the reporting of attitudes and perceptions in response to the clips. Based on a latent thematic analysis, the findings led to the conceptualization of a five-attitude model in response to physical changes in women's appearance: Grief-over the loss of youth and attractiveness; Resentment-over gendered media representations and cultural norms; Avoidance-distancing from one's aged appearance; Care-maintaining grooming routines; and Acceptance-coming to terms with the changes in appearance. Differences in responses between women were interpreted as reflecting a distinction between internal and external locus of control. Those with an external locus of control internalized the judgmental gaze of others, thus, reporting a greater sense of loss. Those with an internal locus of control were better able to accept themselves and focus on grooming rather than conforming to an imagined ideal. Results suggest that the distinction between understanding women's relationship with their appearance in terms of beauty work or beauty care may depend on the woman's locus of control.

[Negative stereotypes of old age in new resident medical interns]

OBJECTIVES

To determine the presence of negative stereotypes of old age in new medical intern residents (MIR) of the Community of Madrid.

MATERIAL AND METHODS

A descriptive cross-sectional survey study of first year MIRs was carried out anonymously during the process of registration at the Madrid College of Physicians between 25/03 and 26/05 of 2023. The Questionnaire of Negative Stereotypes towards Old Age (CENVE) and the Let's Fight All Together Against Ageism (LTJCE) survey were used.

RESULTS

A total of 829 new MIRs were included, with a mean age of 26.0 (standard deviation [SD]=3.5) years. According to the LTJCE survey, 29.1% consider that in general older people are similar to each other; 47.5%, that deterioration of health in old age is inevitable, 26.8% that old age begins at 60 years; 30.5%, that age per se is a determinant when making clinical decisions and 31.0%, that aging is an obstacle that we must overcome in order to lead a healthy life. The mean total score of the CENVE scale (range 15-60) was 28.3 (SD=7.0) and the means of the different factors (range 5-20) were 8.6 (SD=2.8) for health; 9.8 (SD=2.6) for motivational-social; 10.0 (SD=2.7) for character-personality.

CONCLUSIONS

Most new MIRs do not present old age-related stereotypes.

"It´s like walking in a bubble", nursing students´ perspectives on age suit simulation in a home environment - group interviews from reflection seminars

BACKGROUND

Older persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.

METHODS

A qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.

RESULTS

The analysis generated three main themes; "It's like walking in a bubble", "An eye opener" and "Concerns about ageing and the current structure of geriatric care". The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.

CONCLUSIONS

Age suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.

"When somebody says this is a program for adults, it kind of smacks of pornography": Older adults' opinions on age labels in the public library

Chronological age is invariably used as a categorizing tool for spaces, collections, and programs in public libraries. Stemming from a larger project that seeks to bring attention to the ways in which public libraries engage with community-dwelling older adults, this paper explores older patrons' perspectives on the language (e.g. older adult, seniors, adult) assigned to older adults in library programs and which label best (or least) suits their sense of identity and, in turn, what language encourages or deters their engagement with library programs. Findings illustrate that age-based language describing older adult library programs is often at odds with patrons' perceptions of how library programming relevant to them ought to be labelled. Common to all participants was a clear dislike for the term "elderly". While most participants preferred "older adult" to "senior", others voiced no preference, as long as they felt heard and valued. Many participants linked the use of language used to describe library programs to being excluded from and treated differently from other library patrons. As such, the language used to group and describe different library populations directly shapes feelings of belonging (or exclusion) in library programs. Insights from this research contribute to our evolving understandings of the ways in which language connected to age can shape one's sense of identity. Results also serve to cultivate a more sensitive and critical approach to the question of age within library science, and, by extension, the experiences of older adults who frequent the library.

The "Mother of All Protests" Meets Israeli Older Persons: When Age and Gender Intersect in Political Protests

OBJECTIVES

The Israeli government's announcement of a judicial overhaul has resulted in ongoing protests and strikes starting in early 2023. The present study examines the intersection between age and gender in political protests.

METHODS

The present qualitative study is based on interviews with 13 men and 17 women over the age of 65 who participated in the protests. We conducted qualitative thematic analysis comparing and contrasting categories within and between interviews, while taking the gender perspective into account.

RESULTS

The study highlights patterns of gendered but also older-age protesting practices. Whereas men fought for the sake of past generations, women protested mainly for the sake of their children and grandchildren. In addition, men tended to capitalize on their past achievements as fighters, whereas women emphasized their current achievements as grandmothers.

DISCUSSION

Our findings suggest that under some circumstances, even stereotypical devalued attributes (e.g., being a grandmother) can be used as powerful tools to attract supporters and fight for a cause. Older men, on the other hand, tend to hold on to their past achievements as fighters, at the top of the hegemonic hierarchy to ensure their power and status in current protests. To ensure the appeal of political protests, heterogeneity in motives and protesting styles should be acknowledged.

The "Angry (Digital) Silver" in South Korea: The Rhetoric Around Older Adults' Digital Media Literacy

Naïve yet threatening is how the South Korean news media have characterized some older adults who have taken to social media to air their political views. Labeled as "angry (digital) silver," these older adults using YouTube and other social media platforms for political activity are portrayed as digitally illiterate and aggressive. This paper examines the rhetoric surrounding older adults' digital media literacy in scholarship and popular news media with a focus on the news media's portrayal of older adults' digital political activity. By analyzing the use of language and various rhetorical strategies, I argue that specific rhetoric of caution, which warns against older adults' so-called lower digital media literacy, is used to invalidate their digital political activity. I draw upon the case of the "Taegukgi squad"-a political group mainly composed of older adults in South Korea-and the evolution of their digital presence. Addressing the media's biased portrayal of older adults' digital media literacy, this paper further invites reflection on controversies around the role of age in digital political activities around the globe.

Cardiovascular risk burden, dementia risk and brain structural imaging markers: a study from UK Biobank

Background

Cardiovascular risk burden is associated with dementia risk and neurodegeneration-related brain structure, while the role of genetics and incident cardiovascular disease (CVD) remains unclear.

Aims

To examine the association of overall cardiovascular risk burden with the risk of major dementia subtypes and volumes of related brain regions in a large sample, and to explore the role of genetics and CVD onset.

Methods

A prospective study among 354 654 participants free of CVD and dementia (2006-2010, mean age 56.4 years) was conducted within the UK Biobank, with brain magnetic resonance imaging (MRI) measurement available for 15 104 participants since 2014. CVD risk burden was evaluated by the Framingham General Cardiovascular Risk Score (FGCRS). Dementia diagnosis was ascertained from inpatient and death register data.

Results

Over a median 12.0-year follow-up, 3998 all-cause dementia cases were identified. Higher FGCRS was associated with increased all-cause dementia risk after adjusting for demographic, major lifestyle, clinical factors and the polygenic risk score (PRS) of Alzheimer's disease. Comparing the high versus low tertile of FGCRS, the odds ratios (ORs) and 95% confidence intervals (CIs) were 1.26 (1.12 to 1.41) for all-cause dementia, 1.67 (1.33 to 2.09) for Alzheimer's disease and 1.53 (1.07 to 2.16) for vascular dementia (all ptrend<0.05). Incident stroke and coronary heart disease accounted for 14% (95% CI: 9% to 21%) of the association between FGCRS and all-cause dementia. Interactions were not detected for FGCRS and PRS on the risk of any dementia subtype. We observed an 83% (95% CI: 47% to 128%) higher all-cause dementia risk comparing the high-high versus low-low FGCRS-PRS category. For brain volumes, higher FGCRS was associated with greater log-transformed white matter hyperintensities, smaller cortical volume and smaller grey matter volume.

Conclusions

Our findings suggest that the positive association of cardiovascular risk burden with dementia risk also applies to major dementia subtypes. The association of cardiovascular risk burden with all-cause dementia is largely independent of CVD onset and genetic predisposition to dementia.

Geriatric competency and attitudes toward older adults among Turkish undergraduate social work students

The need for social workers educated about aging and eager to work with older adults will increase significantly as the older adult population rises rapidly. It is essential to determine the attitudes and competencies of social workers prepared to work in this field. This study aimed to evaluate Turkish undergraduate social work students' attitudes toward older adults and their geriatric social work competency. A cross-sectional descriptive correlational research design was used in the study. The study included 308 fourth-year undergraduate students attending a social work program. Participants were selected by convenience sampling. The results indicated that students had slightly positive attitudes toward older people. As for the geriatric competency, the students rated highest in applying "values, ethics, and theoretical perspectives" and lowest in the "aging services, programs, and policies." Geriatric social work competence was strongly associated with positive attitudes toward older adults. These findings indicate the need to implement new learning opportunities early in academic programs to improve social work students' attitudes toward older adults and increase their knowledge and skills to address the aging population's needs.

[Association between ageism and sexism in university students]

BACKGROUND AND AIMS

Ageism is the negative perception towards others based on age. The aim of this research was to analyze the levels of ageism and its association with sexism and other factors in university students.

MATERIALS AND METHODS

Cross-sectional study among the students of the University of Granada. The data was collected through an online survey. Information on sociodemographic and academic variables was collected together with the Negative Stereotypes Questionnaire towards Old Age (CENVE), the Ambivalent Sexism Scale (ASI), the Brief Version of the Big Five Personality Inventory (BFPTSQ), the Anxiety Scale for Aging (AE) and the Contact with the Elderly Scale (CPM). Ageism levels were determined and associations with other variables were analyzed. A logistic regression model explored ageism' associated factors.

RESULTS

Two hundred and sixty-three students participated. Most had low or very low levels of ageism (83.3%). The most ageist students showed higher hostile sexism (OR=1.07; p<.01) and higher aging anxiety (OR=1.10; p<.05) than students with high scores in ageism. Graduate students showed protector OR for ageism when compared to postgraduate students (OR=.31; p<.05).

CONCLUSIONS

Higher hostile sexism and aging anxiety are associated with higher ageism in students from the University of Granada. Universities must include in their study plans knowledge about this problem and develop programs aimed at avoiding discrimination in the elderly.

The Need to Appear Healthy: Concealment of Chronic Illness, Privacy, and Self-Sufficiency Among Chronically Ill Older Nigerians

Background and Objectives

Prior research has highlighted the beneficial impact of social networks and social support on older adults' physical and psychosocial well-being. However, the impact of the relationship between chronic illness and social networks on the psychosocial well-being of older Nigerians remains understudied. This study explored how older Nigerians with chronic illnesses navigate the physical, mental, and emotional changes due to their chronic disease diagnosis within their social contexts.

Research Design and Methods

The current qualitative study used semistructured in-depth interviews with 19 purposively sampled older adults, aged 50 years and over, chronically ill, and receiving clinical care to examine the role of social networks in how chronically ill older Nigerians cope with their diagnosis.

Results

Three main themes reflecting participants' experiences emerged from the findings: (1) closely knit circles, (2) privacy and self-sufficiency, and (3) body image. Results show that chronically ill older Nigerians prefer to keep the knowledge of their conditions strictly within their close family circles. It was considered horrific to inform friends, community members, and religious groups about one's chronic illness. Findings further reveal that the need to appear healthy to one's social network stems from the fear of being discriminated against and attempts to maintain some level of normalcy when interacting with others. Additionally, feelings of inferiority and shame limited their participation in social activities and social network maintenance.

Discussion and Implications

We discuss the implications of the results for the mental well-being and quality of life of chronically ill older Nigerians and make recommendations for policies and resources that can improve the well-being of chronically ill Nigerians.

"Stop acting like a child - you're immature": The reversed ageism of practicing self-injury as adult women and the reclaiming of our bodies

The practice of self-injury is considered deviant and pathological, and the stereotype of a self-injuring individual is a young, white, middle-class woman. By using an autoethnographic approach, I elucidate how four women and I, aged 35-51, with experiences of self-injury in adulthood, use, internalize, and speak through dominant discourses of self-injury. The practice of self-injury is an embodied one, and self-injury is stereotypically associated with immature, irresponsible, and emotionally unstable young women. As adult women who self-injure, we use and speak through this representation, which, to some extent, affects our self-image and identity as we are often "misrecognized" as full partners in everyday social interaction or when we represent our professions. Still, we resist the idea of self-injury as stemming from immaturity, and we work to reclaim our bodies and agency from the medicalized, ageist assumptions of the practice of self-injury. By doing this, we can also rewrite and transform the meaning of this practice. Our self-inflicted wounds or scars do not define who we are nor our level of maturity, intelligence, and attractiveness. Thus, we acknowledge that we have the right to our own bodies and what we do to that body.

A phenomenological, intersectional understanding of coping with ageism and racism among older adults

The aim of this qualitative, phenomenological study was to understand how older adults cope with experiences of ageism and racism through an intersectional lens. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated individually in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing enhanced credibility. Nine themes were organized by three umbrella categories: Coping with ageism: 1) distancing via self-determination/defying stereotypes, 2) distancing by helping others; Coping with racism: 3) resistance, 4) exhaustion; Coping with both ageism and racism: 5) increased awareness through aging, 6) healthy lifestyle, 7) education, 8) acceptance/ 'let it go', and 9) avoidance. Novel findings include how older adults may cope with ageism and racism via increased awareness through aging and with ageism specifically by helping peer older adults, although instances of internalized ageism were noted and discussed. The themes exemplify problem-focused (e.g., helping others) and emotion-focused (acceptance), as well as individual (e.g., self-determination) and collective (e.g., resistance) coping strategies. This study can serve as a resource for practitioners in applying a more nuanced understanding of the ways older adults cope with ageism and racism in later life.

Considerations of Intersectionality for Older Adults with Palliative Care Needs in the Emergency Department: An Integrative Review

Purpose of Review

We sought to identify current interventions, research, or non-research evidence that has direct or indirect consideration of intersectionality in the care of older adults in the emergency department (ED). An integrative review informed by Crenshaw's Theory of Intersectionality was conducted in accordance with Whittemore and Knafl's five-stage methodology. A rigorous review process determined appropriateness for inclusion, and articles were analyzed for areas related to direct or indirect relationship to intersectionality.

Recent Findings

Older adults aged 60 and above in the United States (US) account for more than 20% of ED visits annually, and half of older adults will visit the ED in their last year of life. There has been a growing focus on adapting the ED to meet the palliative care needs of older adults, but relatively little consideration has been given to older adults' intersectional identities.

Summary

Six articles were identified that provided indirect insights into the status of intersectionality in ED-based palliative care for older adults. Two areas of interest were identified: (1) intersectional elements or reference to such elements embedded within the studies; and (2) the challenges of adapting quantitative methodologies to incorporate variables and approaches that would allow for intersectional analysis. This review highlights areas for future research along with recommendations for adopting an intersectional framing into commonly used methodologies.

Leaving no one behind: successful ageing at the intersection of ageism and ableism

BACKGROUND

The concept of 'successful ageing' has been a prominent focus within the field of gerontology for several decades. However, despite the widespread attention paid to this concept, its intersectional implications have not been fully explored yet. This paper aims to address this gap by analyzing the potential ageist and ableist biases in the discourse of successful ageing through an intersectional lens.

METHOD

A critical feminist perspective is taken to examine the sensitivity of the discourse of successful ageing to diversity in societies. The paper analyzes how ageist and ableist biases can manifest in the ways we conceptualize ageing, drawing on examples in the context of mental health.

RESULTS

We argue that the conventional approach to successful ageing is limited in its ability to account for the experiences of people who have faced intersectional discrimination throughout their lives. Drawing on examples in the context of mental health, we explore among others the link between depression and disabilities. Furthermore, we shed light on the negative impact of ageist and ableist attitudes concerning the diagnosis and treatment of dementia.

DISCUSSION

We demonstrate how diversity is often overlooked in discussions of ageing well, and how ageist and ableist biases can manifest in the ways we conceptualize ageing. We argue that focusing solely on the health status as a means of achieving success fails to adequately counter ageism for all people. We further emphasize the role of structural factors, such as ageist attitudes, in shaping the experience of ageing and exacerbating health inequalities.

CONCLUSION

Overall, our findings emphasize the need for a more nuanced and inclusive understanding of ageing and therefore an intersectional approach to conceptions of ageing well that recognizes and addresses the biases and limitations of current discourses. Thereby, this paper offers valuable insights into the complex intersections between age and disabilities from a bioethical perspective, highlighting the need for a more inclusive and intersectional approach to ageing.

Do we all perceive experiences of age discrimination in the same way? Cross-cultural differences in perceived age discrimination and its association with life satisfaction

Age discrimination is pervasive in most societies and bears far-reaching consequences for individuals' psychological well-being. Despite that, studies that examine cross-cultural differences in age discrimination are still lacking. Likewise, whether the detrimental association between age discrimination and psychological well-being varies across contexts remains an open question. In this study, therefore, we examined cross-cultural differences in perceived experiences of age discrimination and their detrimental association with a specific indicator of psychological well-being, which is life satisfaction. The sample was drawn from the Ageing as Future study and comprised 1653 older adults (60-90 years) from the Czech Republic, Germany, Hong Kong, Taiwan, and the USA. Participants self-reported their experiences of age discrimination and their life satisfaction. Findings indicated that participants from Hong Kong and Taiwan reported experiences of perceived age discrimination more often than participants from the Czech Republic, Germany, and the USA. Furthermore, experiences of age discrimination were negatively associated with life satisfaction. Cultural context moderated this relation: We found a smaller detrimental association between perceived experiences of age discrimination and life satisfaction in Eastern cultures, that is, in contexts where such experiences were perceived to be more prevalent. These findings highlight the importance of examining age discrimination across cultures. Experiences of age discrimination are clearly undesirable in that they negatively affect psychological well-being. Our results indicate that a higher self-reported prevalence of perceived age discrimination in the samples studied weakens this negative association. We discuss these findings in terms of adaptation (versus sensitization) in response to discrimination.

Does Age Matter? Tweets About Gerontocracy in the United States

OBJECTIVES

Discussions on the political scene in the United States have been accompanied by the notion that the country has morphed into a gerontocracy, a system of governance where power is wielded predominantly by older individuals. With rising life expectancy, more as well as older candidates are likely to run for and stay in office. This study analyzes perceptions regarding the older political leadership of the United States.

METHODS

We collected 3,599 tweets containing the word "gerontocracy" which were uploaded between September 10, 2022 and November 10, 2022, a month prior to the midterm elections in the United States, when this topic was likely to have sparked considerable discussion. After applying our exclusion criteria, 1,266 tweets were retained. Our qualitative content analysis was performed inductively and deductively.

RESULTS

Seven themes emerged. Most tweets (24%; N = 304) highlighted that "Gerontocracy is a Problem" (Theme 1). Theme 2 (21%) focused on how "Democracy is a Sham" (N = 270). Theme 3 (19%) positioned "Old Age as the Problem and Youth as the Solution" (N = 234). Theme 4 (11%) was about how "The Future is at Stake" (N = 145). "Health Concerns" dominated Theme 5 (10%; N = 126). Theme 6 looked at "Structural Reforms" (9%, N = 115). Theme 7 "In Defense of the Gerontocracy" formed 6% of the data set (N = 72).

DISCUSSION

Attitudes toward older politicians are commonly tied to negative stereotypes surrounding old age. As the population ages, it is paramount that society focuses on potentially more important considerations in the evaluation of the actual caliber of a politician.

The mediating role of self-directed ageism in sexual health among Jewish-Israeli older people

This article examines the relationships between physical health, personal resilience and healthy sexuality in older adults, and the mediating role of self-directed ageism in these relationships. Healthy sexuality, which encompasses sexual partnership satisfaction, sexual behaviors, successful sexual functioning, few negative changes, and few sexual health concerns, is important in old age. Five hundred Jewish-Israeli women and men, aged 60 years and over, participated in the study. Five questionnaires were administered that examined the number of diseases, level of resilience, self-perceptions of aging, and sexual relationships and activities. The data were analyzed using multiple linear and logistic regressions, and path analysis for the mediating role of self-directed ageism. The results showed that higher levels of resilience were positively related to aspects of sexual health, while reporting more diseases and higher self-directed ageism were negatively related to sexual health. Self-directed ageism mediated the relationships between resilience and number of diseases and sexual health. The findings supported the biopsychosocial model of healthy sexuality. It was concluded that sexual health in older age may be promoted by fostering resilience, promoting good health, and reducing self-directed ageism.

Promoting the Well-Being of Older People in Ethiopia: Lost Opportunities Due to the Poverty of Policy

The world's population is aging with the fastest growth in the older population projected to take place in Africa. In this article, we present the challenges of the growing older population in Ethiopia, outline some key changes that are needed to address those challenges, and consider the opportunities that can come about when older adults' basic needs are met and they are supported in contributing to their communities. Older adults in Ethiopia are faced with multidimensional challenges that call for collaborative efforts from different stakeholders at local, regional, and national levels. However, some measures should be given the utmost priority: combating negative attitudes toward older people, strengthening geriatric/gerontology and social work education and research, and developing aging-specific policies and services. Although the challenges faced by older adults in Ethiopia seem like a problem of aging compounded by poverty, the root source of the problem is a poverty of policy fueled by ageism. If income support and appropriate health care was provided to older adults throughout Ethiopia, health and well-being in late life would improve, food and housing insecurity among older adults would lessen, and all Ethiopians could anticipate a dignified late life.

Attitudes to ageing amongst health care professionals: a qualitative systematic review

OBJECTIVES

Older adults utilising healthcare may be vulnerable to systemic bias regarding ageing potentially affecting care. Primary aim is to systematically review the qualitative literature examining attitudes to ageing amongst health care professionals (HCPs). Secondary aim is to describe and compare attitudes to ageing between different professional groups.

METHODS

Studies examining attitudes to ageing of HCPs were identified using four databases. Original qualitative research with HCPs was included, excluding studies examining students alone, reviews, and grey literature. Three authors undertook standardised data extraction and quality rating for each study and thematic synthesis, with a fourth senior author reviewing. Quality appraisal followed the Attree and Milton guidelines (2006), including studies rated A-C.

RESULTS

Of 5869 citations, 13 met initial inclusion criteria. Synthesis of the 12 studies graded A-C followed (excluding one study rated-D). Nurses, doctors, and social workers were most frequently investigated. Identified themes included Attitudes towards older persons, The role of the older persons' family, Behaviour of HCPs towards older persons, Behaviour of older persons towards HCPs, and Definitions of an older person. An overarching theme emerged of the systemic context of attitudes to ageing. Common attitudes were found across disciplines, with doctors emphasising complexity and dependency and nurses the burden of care.

CONCLUSIONS

HCP's attitudes to ageing vary and are shaped by professional experiences and systemic factors. HCP attitudes may affect responses to and care of the older person. Therefore, interprofessional research, and systemic and service changes across disciplines are required to foster real and sustainable attitudinal change to support older peoples' care.

Views of Family Members Who Take Care of an Elderly Person they Live with on Ageism, Spirituality and Death in Turkey: A Qualitative Approach

This descriptive qualitative research examined the views of people caring for an elderly family member on ageism, spirituality, and death. A total of 12 people who lived in the same house as the elderly person they cared for made up the study sample. Data were collected via face-to-face, in-depth interviews using a structured interview format. The content analysis method was used for the data analysis. The analysis of the study data yielded three themes: the definition of ageism, the meaning of spirituality and its effects on care, and the position of death in life. The results indicated that living with and caring for an elderly individual made the lives of the family members providing care meaningful, spirituality was important in the care of elderly individuals, and caregivers could be considered at risk in terms of the burden of care. It is recommended that health professionals support caregivers sharing the same house with an elderly family member through training programs on the burden of care, spiritual care, and death.

Contact with grandparents and young people's explicit and implicit attitudes toward older adults

BACKGROUND

Given the dramatic rise in population aging and widespread negative attitudes toward older people, it is necessary to understand the factors that affect age-related attitudes among young people in order to improve intergenerational solidarity and reduce ageism. The current study examined young people's contact with their grandparents and attitudes toward older people on both explicit and implicit levels.

METHOD

The sample included 146 Chinese college students (Mage = 21.50 yrs, SD = 2.23, 101 females). Participants completed a questionnaire concerning contact with their grandparents(contact quantity and contact quality), perceived typicality of their grandparents, intergroup anxiety, inclusion of other in the self, and explicit attitudes toward older people (aged 65 years or older) in general. Participants were also invited to complete a single-category implicit association test (SC-IAT) to assess their implicit attitudes toward older people.

RESULTS

The findings indicated that both quantity and quality of contact with grandparents predicted better explicit attitudes toward older people, and contact effects were stronger when one's grandparents were perceived as being typical of older adults. Contact quantity (not quality) was associated with more favorable implicit attitudes only when one's grandparents were perceived as highly typical older adults. Contact effects on explicit attitudes were mediated by intergroup anxiety and inclusion of other in the self.

CONCLUSION

Our findings on the positive effects of contact with grandparents underscore the importance of promoting intergenerational contact within the family as a starting point to reduce prejudice toward older adults in age-segregated modern societies. Current results also provide insights on how to extend the benefits of grandparent-grandchild contact outside the family by promoting the perceived typicality of one's grandparents.

The Perceived Contribution of Older People to Climate Change Impact, Mitigation, and Adaptation: Measurement Development and Validation

Background and Objectives

To improve the understanding of ageism toward older people in the context of climate change, the present study developed and validated a new measure that examines the perceived negative and positive contributions of older people to climate change impact, mitigation, and adaptation efforts.

Research Design and Methods

Four studies (N = 774) were conducted to develop a new measure and evaluate its reliability and validity, relying on exploratory factor analysis, reliability analysis, confirmatory factor analysis, multiple-group analysis (Australia and India), discriminative validity, and convergent and divergent validity.

Results

A 2-subscale measure covering older people's perceived negative contribution to climate change effects (5 items) and perceived positive contribution to adaptation and mitigation measures (3 items; eg, negative, and positive ageism in the context of climate change) was supported by the data. The measure has demonstrated adequate validity and reliability.

Discussion and Implications

The measure highlights a relatively neglected area in current climate change discourse and may assist in identifying ways to improve intergenerational solidarity as part of climate change adaptation and mitigation efforts toward building a world for all ages under a healthy climate, which allows for healthy aging and healthy longevity. These objectives are in line with the current mission posed by the UN Decade of Healthy Ageing.

Character Strengths and Resilience in Older Adults during the COVID-19 Pandemic

During the pandemic, older adults were perceived as a vulnerable group without considering their various strengths. This study explored the associations between character strengths and resilience, and verified if some of these could predict resilience during the COVID-19 pandemic. A sample of 92 participants (women = 79.1%), ≥ 70 years of age (mean = 75.6 years), completed an online version of the Values in Action Inventory of Strengths - Positively keyed (VIA-IS-P) to assess 24 character strengths (grouped under six virtues) and the Connor and Davidson Resilience Scale. Results showed that 20 of the 24 strengths correlated positively and significantly with resilience. A multiple regression analysis revealed that the virtues of courage and transcendence, as well as attitudes toward aging, uniquely predicted the level of resilience. Interventions should be developed to improve certain strengths (e.g., creativity, zest, hope, humor, and curiosity), while reducing ageism, in order to promote resilience.

Who believes in cross-age friendship? Predictors of the belief in intergenerational friendship scale in young adults

Intergenerational contact is beneficial for both younger and older adults, but friendships that span across generations are uncommon. While this is partially due to situational factors, people's beliefs about the possibility of intergenerational friendship may also affect how they approach potential intergenerational interactions. In a sample of 209 students from a Canadian university, we validate the Beliefs in Intergenerational Friendship (BIGF) scale. Young adults were more likely to believe in intergenerational friendship if they had less ageist attitudes and if they were more conscientious, open, agreeable, and emotionally stable. Number of non-kin intergenerational social contacts (but not number of kin contacts) and closeness of an existing relationship with an older adult also predicted greater belief in intergenerational friendship. BIGF scores predicted willingness to regularly spend time with older adults and were a better predictor than either hostile or benevolent ageism. While not everyone believes that intergenerational friendships are possible, this novel scale may uniquely capture people's willingness to form relationships across generations.

Reducing negative attitudes toward older adults and increasing advocacy for policies to support older adults: Bayesian analysis approach

As the world's population is aging, it is necessary to create societies in which older adults and young people can live together comfortably. Reducing young people's negative attitudes toward older adults is a pressing issue. Given the unique characteristics of older adults, which most people will eventually become, we focused on how long people believe it will be before they become older adults (i.e., the subjective time of becoming older). To examine our hypotheses, we performed a Bayesian analysis, which has attracted considerable attention in psychological research in recent years. In Studies 1 and 2, even after controlling for variables such as youth identity and aging anxiety, those with a longer subjective time of becoming older had more negative attitudes toward older adults and lower advocacy for policies to support older adults. In Study 3, we examined the effect of shortening the participants' subjective time of becoming older by presenting an explanatory text on the stereotype embodiment theory and several related empirical findings. We observed decreased negative attitudes toward both the young-old and old-old groups and increased advocacy for policies to support older adults. In the supplemental experiment, the experimental manipulation used in Study 3 reduced participants' aging anxiety. Future studies should elaborate on the negative attitudes toward a broad subgroup of older adults, and examine the perceived relative importance of policies to support older adults compared with policies in other areas.

Consumption of health resources in older people with differentiated thyroid carcinoma: a multicenter analysis

OBJECTIVE

There is hardly any information on the consumption of healthcare resources by older people with differentiated thyroid cancer (DTC). We analyzed these consumptions in older patients with DTC and compared patients 75 years and older with subjects aged 60-74 years.

METHODS

A multicenter, retrospective analysis was designed. We recorded three groups of health resources consumption (visits, diagnostic procedures, and therapeutic procedures) and identified a subgroup of patients with high consumption of resources. We compared patients aged between 60-74 years (group 1) with patients aged 75 and over (group 2).

RESULTS

We included 1654 patients (women, 74.4%), of whom 1388 (83.9%) belonged to group 1 and 266 (16.1%) to group 2. In group 2, we found a higher proportion of patients requiring emergency department visits (7.9 vs. 4.3%, P = 0.019) and imaging studies (24.1 vs. 17.3%; P = 0.012) compared to group 1. However, we did not find any significant difference between both groups in the consumption of other visits, diagnostic procedures, or therapeutic procedures. Overall, 340 patients (20.6%) were identified as high consumers of health resources, 270 (19.5%) in group 1 and 70 (26.3%) in group 2 (P = 0.013). Multivariate logistic regression analysis showed that the risk of recurrence and mortality, radioiodine treatment, tumor size, and vascular invasion were significantly related to the high global consumption of resources. However, the age was not significantly related to it.

CONCLUSION

In patients with DTC over 60 years of age, advanced age is not an independent determining factor in the consumption of health resources.

Perceived Age Discrimination in the Second Half of Life: An Examination of Age, Period, and Cohort Effects

Background and Objectives

Ageism is defined as stereotypes, prejudice, and discrimination based on age. Perceived age discrimination (e.g., the behavioral component of ageism) is highly prevalent in society, as reported by 1 in 3 people in Europe. The present study examined variations in perceived age discrimination in the second half of life. We adopt a comprehensive approach that examines whether perceived age discrimination varies by age (chronological time from birth), period (the context when data were collected), or cohort (a group of people with shared life events experienced at a similar age) across gender and ethnic origin.

Research Design and Methods

We relied on psychosocial data from the Health and Retirement Survey between 2006 and 2018. We ran a set of age-period-cohort models to determine the separate effects of aging (age) factors, contextual (period) factors, and generational (cohort) factors on perceived age discrimination.

Results

Our findings show that perceived age discrimination increases with age but reaches a plateau around the age of 75. There also were some cohort effects, but they appeared minimal and inconsistent. No period effects were found.

Discussion and Implications

The findings attest to the consistent nature of perceived age discrimination, which is less likely to be affected by external contextual events. It also is less likely to be affected by gender or ethnicity. The findings also suggest that it is older persons who are more likely to report age discrimination, thus, interventions should address ageism in this age group.

Ageism in the Discourse and Practice of Designing Digital Technology for Older Persons: A Scoping Review

BACKGROUND AND OBJECTIVES

Involving older persons in the design process of digital technology (DT) promotes the development of technologies that are appealing, beneficial, and used. However, negative discourse on aging and ageism are potential underlying factors that could influence which and how DTs are designed and how older persons are involved in the design process. This scoping review investigates the explicit and implicit manifestations of ageism in the design process of DT.

RESEARCH DESIGN AND METHODS

Seven databases were screened for studies reporting on the design of DT with older persons between January 2015 and January 2020. Data regarding study and DT characteristics, discourse about older persons, and their involvement in the design process were extracted, coded, and analyzed using critical discourse analysis.

RESULTS

Sixty articles met the inclusion criteria and were included in the analysis. Various forms of exclusion of older persons from the design process were identified, such as no or low involvement, upper-age limits, and sample biases toward relatively "active," healthy and "tech-savvy" older persons. Critical discourse analysis revealed the use of outdated language, stereotypical categorizations, and/or design decisions based on ageism in 71.7% of the studies.

DISCUSSION AND IMPLICATIONS

A discrepancy was found between an "ideal" discourse regarding the involvement of older persons throughout the design process and actual practice. Manifestations of ageism, errors, and biases of designing DT with older persons are discussed. This article calls for more authentic inclusion of older persons and higher awareness toward the implications of ageism in the design process of DT.

Inconsistent and Arbitrary Age-Based Policies During the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic has forced countries to issue public measures to address threats to the safety of citizens and the healthcare system. The role of chronological age in the ways in which different countries coped with the pandemic is particularly intriguing. Based on pool of purposely selected twenty-one countries, this article compares a variety of urgent public health policies that have been enforced during the first wave of the pandemic. It analyzes the ways in which countries introduced instructions related to older people and/or chronological age in relation to: Lockdown, exit and triage policies. It also examined whether the issue of long-term care settings (LTCS) received special attention in the primary guidelines developed in response to the lockdown and exit strategies. The analysis demonstrates inconsistencies within and across countries in the enactment and implementation of age-based measures. Moreover, it suggests that both acts of omission and commission based on age can be interpreted as ageist, arbitrary, not based on evidence, too inclusive, and offensive toward older people and neglectful of specific risk groups.

Pension Tension: Retirement Annuity Fosters Ageism Across Countries and Cultures

Background and Objectives

Globally aging populations raise worldwide concerns about how an older population will be valued. Cross-culturally, many espouse that Eastern cultures revere their older adults more than Westerners, due to stronger collectivism and filial piety traditions. In contrast, this paper proposes a resource tension hypothesis, whereby rapid population aging causes pragmatic strain across all modernized societies, fostering ageism.

Research Design and Methods

Three studies supported this resource tension hypothesis, focusing on the pragmatic role of public pensions-a fundamental resource inherently pitting older versus younger generations-in fostering ageism. Study 1 tested the relationship between nation-level public pension rate and attitudes toward older adults by using World Values Survey and European Social Survey data sets. Study 2 further explored this relationship via priming both the pension-based resource scarcity and the intergenerational competition over the public pension. Study 3 offered an intervention-future-self-thinking via a photo ager-on reducing intergenerational tensions under pension scarcity conditions.

Results

Study 1 found a significant link between nation-level public pension rate and negative older adult attitudes across 39,700 World Values Survey, and 29,797 European Social Survey data points. Study 2 further supported the pension-ageism link via experimental methods. Participants who were reminded of the scarcity of pensions and intergenerational competition exhibited more negative attitudes toward older adults. Study 3 confirmed the effect of the future-self intervention on enhancing attitudes toward older adults even despite scarce pension resources.

Discussion and Implications

The findings support a resource explanation in driving perceptions of older adults, implicate pensions as a key mechanism driving intergenerational attitudes, and identify future-self thinking as a critical intervention. The present studies open up new research pathways for understanding and accommodating the globally aging population.

And What About Self-Ageism? "Inner Work" as a Fifth Strategy for the Eradication of Ageism

In response to the World Health Organization Report on ageism and the spread of ageism during the COVID-19 pandemic, varied actions to combat ageism have taken place, worldwide. To examined what older people think about combating ageism, 731 Israelis, ages 60-85, responded to an online survey. Thematic analysis of their responses identified that the two main reasons for combating ageism rely on "moral-social justification" and "financial-employment justification." Respondents suggested various strategies to combat ageism including, "changes in law and adjudication," "inter-generational ties," "educational activities," and "campaigns." Respondents also identified "inner work" as the fifth and most important way to eliminate self-ageism. The results of this qualitative study contribute to the global campaign to combat ageism because of the emphasis on "inner work" of older people as a strategy in and of itself. Moreover, the study demonstrates the importance of including older adults in all stages of the global campaign to reduce and eliminate ageism.

Turning age into agency: A qualitative longitudinal investigation into older jobseekers' agentic responses to ageism

Despite existing laws prohibiting age discrimination in employment and hiring practices, ageism creates inequalities between jobseekers because of their age. Deeply manifested ageist practices take place in everyday interactions within the labor market, complicating changes in career trajectories during late working life. Bringing the time dimension into studies on ageism and individual agency, we narratively examined qualitative longitudinal interviews with 18 older jobseekers from Finland to better understand the role of time and temporality in agentic practices that older jobseekers employ to counteract forms of ageism. Older jobseekers exhibited various resilient, and reworked strategies in response to ageism depending on their diverse social and intersectional positions. As their positions changed over time, jobseekers employed different strategies, highlighting the relational and temporal dimensions of individual agency in labor market decisions. The analyses suggest that acknowledging the dynamics between temporality, ageism, and labor market behavior is vital for creating effective and inclusive policies and practices to tackle inequalities in late working life.

Combatting ageism in the Western Pacific region

The present viewpoint examines the manifestation of ageism, defined as stereotypes, prejudice and discrimination towards people because of their age, in the Western Pacific region. Research is still equivocal concerning the nature of ageism in the Western Pacific region, especially in East and South-East Asia (e.g., Eastern countries). There has been plenty of research to support as well as question the general notion of Eastern cultures and countries as being less ageist compared to Western cultures and countries at individual, interpersonal, and institutional levels. Although varied theoretical explanations have aimed to explain East-West differences in ageism such as the modernization theory, the pace of population aging, the proportion of older people in the country, cultural hypothesis, and GATEism, none of these theories fully accounts for the mixed findings. As such, it is safe to conclude that targeting ageism should be an important step in ensuring a world for all ages in Western Pacific countries.

Do media portrayals of super-agers reduce or increase ageism toward older adults?

Super-agers are older adults with exemplary cognitive and/or physical abilities. However, the impact of media portrayals of super-agers is unknown. This study examined whether exposure to mass media stories about "moderate" super-agers (exemplary cognitive and physical skill levels) versus "extreme" super-agers (most extreme cognitive and physical skill levels) impacts young adults' ageism. Undergraduate participants exposed to media portrayals of moderate super-agers reported greater agreement with positive age stereotypes toward older adults, whereas participants exposed to extreme super-agers reported lower levels of ageism as compared to control participants. Based on these findings, young adults may perceive super-agers in a positive manner as super-agers highlight positive attributes. Since super-agers are often portrayed as defying negative stereotypes through diligence and a positive outlook (less so through good genes or access to healthcare), exposure to super-agers could have negative effects, which is an important future direction.

Age-based exclusion is common and multifactorial in spinal RCTs: a systematic review and quantitative analysis

Most diseases of the spine disproportionately impact older persons, with the modal (i.e., commonest) patient a female in their 8th decade of life. We examined the corpus of spinal RCTs to determine how many included "average" spine patients. We searched PubMed for randomized clinical trials published in the top 7 spine journals over a period of 5 years from 2016 to 2020 and extracted nominal upper age cut-offs and the distribution of ages actually recruited. We identified 186 trials of 26,238 patients. We found that only 4.8% of trials could be applied to an "average" 75-year-old patient. This age-based exclusion was not dependent on funding source. Age-based exclusion was exacerbated by explicit upper age cut-offs, however, the age-based exclusion went beyond explicit age cut-offs. Only few trials were applicable to older patients even amongst trials with no age cut-off specified. Age-based exclusion from clinical trials starts at late middle age. The mismatch between spinal patient's age seen in clinical practice and spinal patient's age in trials was so severe that over the 5 years (2016-2020) almost no RCT evidence was produced applicable to the "average" aged-patient across the body of literature available. In conclusion, age-based exclusion is ubiquitous, multifactorial, and happens on a supratrial level. Eliminating age-based exclusion involves more than an arbitrary lifting of explicitly stated upper age cut-offs. Instead, recommendations include increasing input from geriatricians and ethics committees, establishing updated or new models of cares, and creating new protocols to facilitate further research.

An "ultimate partnership": Older persons' perspectives on age-stereotypes and intergenerational interaction in co-designing digital technologies

AIM

There is often a gap between the ideal of involving older persons iteratively throughout the design process of digital technology, and actual practice. Until now, the lens of ageism has not been applied to address this gap. The goals of this study were: to voice the perspectives and experiences of older persons who participated in co-designing regarding the design process; their perceived role in co-designing and intergenerational interaction with the designers; and apparent manifestations of ageism that potentially influence the design of digital technology.

METHODS

Twenty-one older persons participated in three focus groups. Five themes were identified using thematic analysis which combined a critical ageism 'lens' deductive approach and an inductive approach.

RESULTS

Ageism was experienced by participants in their daily lives and interactions with the designers during the design process. Negative images of ageing were pointed out as a potential influencing factor on design decisions. Nevertheless, positive experiences of inclusive design pointed out the importance of "partnership" in the design process. Participants defined the "ultimate partnership" in co-designing as processes in which they were involved from the beginning, iteratively, in a participatory approach. Such processes were perceived as leading to successful design outcomes, which they would like to use, and reduced intergenerational tension.

CONCLUSIONS

This study highlights the potential role of ageism as a detrimental factor in how digital technologies are designed. Viewing older persons as partners in co-designing and aspiring to more inclusive design processes may promote designing technologies that are needed, wanted and used.