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Academic debate about social isolation and loneliness, and their adverse health and well-being implications, has resulted in many policy and programme interventions directed towards reducing both, especially among older people. However, definitions of the two concepts, their measurement, and the relationship between the two are not clearly articulated. This article redresses this and draws on theoretical constructs adapted from symbolic interactionism, together with the Good Relations Measurement Framework, developed for the Equality and Human Rights Commission in the UK, to challenge the way in which social isolation and loneliness are currently understood. It argues for a need to understand experiences of social relationships, particularly those which facilitate meaningful interaction, suggesting that opportunities and barriers to meaningful interaction are determined by wider societal issues. This is set out in a new conceptual framework which can be applied across the life course and facilitates a new discourse for understanding these challenging concepts.
Existing research on how older adults handle challenges associated with domestic housework, and in particular food work, almost invariably assumes that older adults are traditionalist, and that this affects the way they adjust to widowhood. This assumption is problematic, as decades of research have emphasised increasing gender equality in food work. In this paper, I explore how older adult men and women adjust to food preparation after the loss of a spouse. Interviews with 31 Danish widows and widowers aged between 67 and 86 years old suggest that the men have made culinary progress. However, I also show that the narratives around domestic food work among the older generations remain gendered: both men and women identify widowed men's domestic food work as something meriting acknowledgement, and men and women draw on traditional masculine and feminine ways of approaching domestic food work.
We assessed the relation between social pension benefits and health among poor older individuals in Colombia based on a qualitative case study (N = 51) using in-depth semi-structured interviews. Participants were beneficiaries of the Colombia Mayor social pension programme, recruited through snowball sampling in one rural and one urban area. Participants reported using cash benefits mainly for purchasing essential foods and medicines, as well as for paying for household utilities and satisfying personal needs. Beneficiaries of the programme view the latter as being positively associated with their health as it not only satisfies material needs but also increases their sense of autonomy, emotional wellbeing and also promotes a positive and cheerful attitude. Despite most beneficiaries perceiving the programme as positively associated with their health and wellbeing, results also highlight the importance of the various individual- as well as contextual-level factors in determining the relation between social pensions and health.
As an important source of income for elderly people, pensions have a great impact on their wellbeing. There are three different pension systems in China (the Old-age Insurance System for Government Agencies and Institutions (OISGAI), the Basic Old-age Insurance System for Urban Employees (BOISUE) and the Social Insurance of the Old-age Pension for Urban and Rural Residents (SIOPURR)). This study empirically analyses the impact of various pension types on the happiness of elderly people in China and further explores the potential impact mechanism using the 2014 China Family Panel Studies data. The study suggests that first, receiving pensions from OISGAI, BOISUE and SIOPURR is positively correlated with the happiness level of elderly people. Second, the sense of happiness of elderly people who receive BOISUE is higher than that of those receiving SIOPURR, which is mainly caused by the difference in the level of pension benefits. When the level of benefits is controlled for, there is no significant difference between these two groups. Third, when they have the same level of pension benefits, the happiness of elderly people who receive OISGAI is significantly higher than that of those who receive pensions from the other two systems, which is possibly related to the hidden ‘special’ government guarantee and the difference of the growth rate of the benefit level.
A growing number of older men are living alone. They are often referred to as an at-risk group in health-care systems. The purpose of this article is to establish an overview of these men's health and health-care utilisation. We do so by drawing on three sources: an online survey with health-care professionals, data from a national self-report health study and register-based data on health-care utilisation. The results show that older men living alone generally have lower health scores than older men co-habiting and that, among older men living alone, lower educational level is associated with lower health scores but also a greater use of free-of-charge health-care services. Health-care professionals conducting preventive home visits consider older men's social needs the most pronounced problem for the men's wellbeing and call for new services to be custom made for them. In this article, we discuss differences between older men living in rural and urban areas and between those who are single, divorced or widowed. We conclude that health and social care systems must differentiate between sub-groups of older men living alone when developing new services and that free-of-charge services, such as general practitioners and home care, should be considered as vehicles for addressing health inequities.
This article foregrounds the role of migration and transnational cultural exchange in the (trans)formation of cultures of ageing. It argues that sustained emigration and return to the Azores archipelago have contributed to the transnational production of hybrid cultures of ageing. The paper suggests that understanding transnational cultures of ageing in the context of return requires a broader field of enquiry that considers return migrants’ discursive framings in tension with transnational and local contexts. Returnees’ accounts of ageing, produced in relation to transnational exchange and local interactions, emphasise three intersecting themes – health and the ageing body, ageing and care, and mindset and work ethic in later life – which reveal a cultural shift towards forms of active ageing. The discussion shows that new, hybrid lexicons of ageing are articulated through practices and languages of othering and negotiating that are conducive to unsettling social relations and economic contexts in the homeland.
This chapter explores ageism and prejudice against age as revealed in our language. We look at childism/adultism, middle age, and intergenerational battles of Boomers vs. Millennials. We discuss the way we talk about growing older. We investigate stereotypes and negative attitudes toward age and ageing, ageism in the workplace, and consider ageism as an intersectional form of discrimination that will ultimately affect us all.
Dietary protein is a pre-requisite for the maintenance of skeletal muscle mass; stimulating increases in muscle protein synthesis (MPS), via essential amino acids (EAA), and attenuating muscle protein breakdown, via insulin. Muscles are receptive to the anabolic effects of dietary protein, and in particular the EAA leucine, for only a short period (i.e. about 2–3 h) in the rested state. Thereafter, MPS exhibits tachyphylaxis despite continued EAA availability and sustained mechanistic target of rapamycin complex 1 signalling. Other notable characteristics of this ‘muscle full’ phenomenon include: (i) it cannot be overcome by proximal intake of additional nutrient signals/substrates regulating MPS; meaning a refractory period exists before a next stimulation is possible, (ii) it is refractory to pharmacological/nutraceutical enhancement of muscle blood flow and thus is not induced by muscle hypo-perfusion, (iii) it manifests independently of whether protein intake occurs in a bolus or intermittent feeding pattern, and (iv) it does not appear to be dependent on protein dose per se. Instead, the main factor associated with altering muscle full is physical activity. For instance, when coupled to protein intake, resistance exercise delays the muscle full set-point to permit additional use of available EAA for MPS to promote muscle remodelling/growth. In contrast, ageing is associated with blunted MPS responses to protein/exercise (anabolic resistance), while physical inactivity (e.g. immobilisation) induces a premature muscle full, promoting muscle atrophy. It is crucial that in catabolic scenarios, anabolic strategies are sought to mitigate muscle decline. This review highlights regulatory protein turnover interactions by dietary protein, exercise, ageing and physical inactivity.
Women's magazines are widely read in Canada. The popularity of such magazines is significant because critical gerontologists, primarily drawing on content analyses of the magazines, often argue that these publications convey problematic messages about ageing. This article broaches the subject of women's magazines and ageing from a different vantage point, that of the older woman reader herself. This audience-centred research draws on 21 semi-structured interviews with Canadian women over the age of 55. The study examines what older women say about the ageing-related content of women's magazines, along with what they say about how, when and why they read these magazines. Findings illustrate that participants are aware of the inadequate and unrealistic representations of older women in women's magazines. Nonetheless, they value the publications as a source of practical information on a variety of topics and as a light and undemanding source of entertainment and relaxation. The study reveals how participants assess and deploy magazine contents and characteristics in ways that contribute to, and are informed by, their lives and identities as older women. Against the broader cultural context of ageism, using and talking about women's magazines enables the participants to position themselves as knowledgeable and informed on a variety of topics and in multiple interactions, both in explicit reference to the magazines themselves and more generally in their lives.
Many recent pension reforms require individuals to make more decisions on supplementary savings, investment choices, etc. Governments and the pension industry try to assist individuals through pension communication but little is known about the effectiveness of such policies. This paper uses Dutch longitudinal data to analyse the causal links between communication, pension knowledge, and conscious pension decision-making. A robust finding is that pension knowledge has a positive causal effect on active pension decision-making. Providing an annual pension statement might have a small positive effect on pension knowledge, but this result is sensitive to the identifying assumptions.
Amino acid bioavailability is critical for muscle protein synthesis (MPS) and preservation of skeletal muscle mass (SMM). Ageing is associated with reduced responsiveness of MPS to essential amino acids (EAA). Further, the older adult population experiences anabolic resistance, leading to increased frailty, functional decline and depleted muscle mass preservation, which facilitates the need for increased protein intake to increase their SMM. This review focuses on the role of proteins in muscle mass preservation and examines the contribution of EAA and protein intake patterns to MPS. Leucine is the most widely studied amino acid for its role as a potent stimulator of MPS, though due to inadequate data little is yet known about the role of other EAA. Reaching a conclusion on the best pattern of protein intake has proven difficult due to conflicting studies. A mixture of animal and plant proteins can contribute to increased MPS and potentially attenuate muscle wasting conditions; however, there is limited research on the biological impact of protein blends in older adults. While there is some evidence to suggest that liquid protein foods with higher than the RDA of protein may be the best strategy for achieving high MPS rates in older adults, clinical trials are warranted to confirm an association between food form and SMM preservation. Further research is warranted before adequate recommendations and strategies for optimising SMM in the elderly population can be proposed.
One of the main health-related worries for older adults is becoming dependent. Even healthy older adults may worry about becoming dependent, generating guilt feelings due to the anticipation of future needs that others must solve. The guilt associated with self-perception as a burden has not been studied in older adults, and there is no instrument available to measure these feelings.
To adapt the Self-Perceived Burden Scale (SPBS; Cousineau et al., 2003) for the assessment of feelings of guilt for perceiving oneself as a burden for the family in older adults without explicit functional or cognitive impairment.
Participants were 298 older adults living independently in the community. Participants completed the assessment protocol, which included measures of guilt associated with self-perception as a burden, depressive and anxious symptomatology, self-perceived burden, and sociodemographic information.
Results from exploratory, parallel and confirmatory factor analyses suggest that the scale, named Guilt associated with Self-Perception as a Burden Scale (G-SPBS), has a unidimensional structure, explaining 57.04% of the variance of guilt. Good reliability was found (Cronbach’s alpha = .94). The results revealed significant (p < .01) positive associations with depressive and anxious symptomatology.
These findings suggest that the G-SPBS shows good psychometric properties which endorse its use with healthy community older adults. Also, guilt associated with perceiving oneself as a burden seems to be a relevant variable that can contribute to improving our understanding of psychological distress in older adults.
Across the globe, there has been a marked increase in longevity, but significant inequalities remain. These are exacerbated by inadequate access to proper nutrition and health care services and to reliable information to make the decisions related to nutrition and health care. Many in economically developing as well as developed societies are plagued with the double-burden of energy excess and undernutrition. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity, increased medical costs and reduced quality of life. While adequate nutrition is fundamental to good health at all stages of the life course, the impact of diet on prolonging good quality of life during ageing remains unclear. For progress to continue, there is need for new and/or innovative approaches to promoting health as individuals age, as well as qualitative and quantitative biomarkers and other accepted tools that can measure improvements in physiological integrity throughout life. A framework for progress has been proposed by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health. Here, we focused on the impact of nutrition within this framework, which takes a broad, person-centred emphasis on healthy ageing, stressing the need to better understand each individual's intrinsic capacity, their functional abilities at various life stages, and the impact of their mental, and physical health, as well as the environments they inhabit.
This article explores subjective perceptions of retirement in France, using original quantitative data on the customers of a not-for-profit insurance company. The sample contains individuals aged 40–84, who are either in the labour force (N = 923) or retired (N = 705). Perceptions of retirement are measured using closed questions on views of the retirement transition (these views can be positive, negative or neutral) and definitions of retirement (retirement can be interpreted as a period of freedom, boredom, greater risk of precariousness, etc.). Using a number of different social indicators, we examine whether differences in social conditions translate into heterogeneous perceptions. We also investigate whether social differences in perceptions fade away with increasing age. Both working-age individuals and retirees generally have a positive view of the retirement transition and often define retirement as a period of freedom. Perceptions of retirement are shaped by social conditions: a higher level of education and income, greater wealth, better health and stronger social involvement go hand in hand with rosier perceptions. Moreover, we uncover a strengthening of this social gradient with increasing age. Finally, perceptions are positively correlated with satisfaction in various domains, for retirees.
From midlife to old age, women are influenced differently by developmental transitions compared with men. These transitions range from menopause to subjective experiences such as appearance-related changes and caregiving responsibilities. More importantly, cultural and personal factors may impact how people understand these transitions. As such, cultural differences may be reflected in the expression, subjective experiences, and consequences of these developmental transitions. Concerning menopause, cultures influence the expression of menopausal symptoms and their psychological consequences. Moreover, cultural factors also impact women’s perceptions of appearance-related changes, and their appraisals of the caregiving experiences. Future developmental studies on women might focus on the moderating role of culture in the ways women interpret and cope with developmental changes in the second half of life.
To propose malnutrition screening methods for the elderly population using predictive multivariate models. Due to the greater risk of nutrition deficiencies in ageing populations, nutritional assessment of the elderly is necessary in primary health care.
This was a cross-sectional study. Multivariate models were obtained by means of discriminant analysis and binary logistic regression. The diagnostic accuracy of each multivariate model was determined and compared with the Chang method based on receiver operating characteristic curves. The optimal cut-point, sensitivity, specificity and Youden index were estimated for each of the models.
The province of Cordoba, Spain.
Two hundred fifty-five patients over the age of 65 years from three health centres and three nursing homes.
Fourteen models for predicting risk of malnutrition were obtained, six by discriminant multivariate analysis and eight by binary logistic regression. Sensitivity ranged from 55·6 to 93·1 % and specificity from 64·9 to 94 %. The maximum and minimum Youden indexes were 0·77 and 0·49, respectively. We finally selected a model which does not require a blood test.
The proposed models simplify nutritional assessment in the elderly and, except for number 2 of those calculated by binary logistic regression, have better diagnostic accuracy than the Spanish version of the Mini Nutritional Assessment screening tool. The selected model, whose validation is necessary for the future with other different samples, provides good diagnostic accuracy, and it can be performed by non-medical personnel, making it an accessible, easy and rapid tool in daily clinical practice.
Older people now currently drink alcohol more frequently than previous generations, indicating a need to understand how this influences health and wellbeing in older adults. However, knowledge and awareness of the changing role alcohol plays in the lives of older people is not necessarily widely understood by allied health professionals in acute hospital contexts. In turn, conversations about drinking alcohol in later life may not be routinely addressed as part of practice, limiting an older person's choice to make informed decisions about their drinking. This paper qualitatively examines when occupational therapists (N = 17) in an acute hospital setting will initiate a conversation with older people (65+ years) about their drinking, guided by a theoretical lens that encompasses both person-centredness and collective occupation. Adopting a qualitative methodology, this study illustrates a typology of reasoning describing how, and in what circumstances, therapists ask older people about their alcohol use. Three themes were generated that provide further insight into the typology, these being ‘hesitancy in practice’, ‘failure to link life transitions to alcohol use’ and ‘challenges of focusing on healthfulness’. These findings provide a potentially useful tool for therapists, services and organisations to self-assess their approach to asking older people about alcohol use; a necessary element of professional health-care practice as social trends in alcohol use continue to increase.
Evidence on how gender intersects with relevant social constructs in later phases of life is scarce. This investigation examined gender inequalities in perceived health status (self-perceived general health; SPGH) by Portuguese elderly community-dwellers while considering psycho-social and socio-demographic determinants. This study used data from a representative sample of community-dwellers aged ≥65 years (N = 920), who were enrolled in the Portuguese Elderly Nutritional Status Surveillance System (PEN-3S) project. Associations between SPGH and socio-demographic and psycho-social variables, functionality and self-reported morbidity were tested; indirect effects of relevant predictors on SPGH were also tested using a bootstrap method. Gender inequalities in health were found: women significantly rated their health worse than men; overall, participants rated their health as fair. Education, functional status, depression symptoms and self-reported morbidity significantly predicted SPGH among women, whereas only the latter two were associated with SPGH among men. For both genders, depression was the strongest predictor of SPGH. Mediation analyses detected indirect effects of cognitive function and loneliness feelings on SPGH among older adults. Results herein provide insights on the predictive role of psycho-social variables on SPGH and support the need for considering the context when addressing the correlates of SPGH among Portuguese older adults. Altogether, these findings might support cost-effective interventions targeting the most vulnerable groups of the population to inequalities in health and its predictors.
This paper develops knowledge of the logistics of moving house amongst older people living in insecure housing. These people typically do not move once and settle into a new house, but face ongoing moves driven by factors including housing affordability, tenure conditions and eviction. The paper identifies four domains of experience faced by people undergoing cumulative, involuntary residential moves: the material (process of relocating oneself and possessions), economic (costs of moving house), embodied (physical experience) and affective (how relocation is experienced and felt). The logistics of relocation are examined through the experiences of single older women living in insecure housing in the greater Sydney region of Australia. The accounts of these women foreground the costs and challenges of insecure housing that are a consequence of relocation. Conceptually this work contributes to understandings of mobility-based disadvantage in older age through drawing out the ways that the logistics of moving house – of relocating oneself and possessions – contribute in distinct ways to mobility-based disadvantage through risks to identity and senses of home. Empirically it addresses gaps in gerontological and housing scholarship through developing knowledge of the logistics and experiences of ongoing, involuntary residential moves.
One third of older adults in Canada are foreign-born, yet there is a dearth of literature on this population. When our team set out to engage in a mixed-methods study on the physical activity and mobility of foreign-born older adults (FBOAs), we found limited guidance. The objective of this Research Note is to share the lessons that we learned in implementing a mixed-methods study in five languages, with 49 visible minority FBOAs from diverse ethno-cultural groups. With an emphasis on practical implementation, here we share our reflections on early community engagement, linguistic accessibility and literacy considerations, facilitating communication with the research team, creating a support role for multilingual family members, organisational suggestions, and working with interpreters and monolingual transcribers. The older Canadian population is projected to become increasingly diverse in the coming decades, and it is our hope that this note will further facilitate research in this understudied area.