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This study aimed to systematically review the use of social networking sites (SNSs) from an older adult perspective (all papers had an average sample age of 65+ and samples ranged in age from 50 to 98). Characteristics of older adult SNS users, incentives and disincentives for use, and the relationship between SNS use, wellbeing and cognitive function were explored. From a systematic search, 21 papers met inclusion criteria and were subjected to a quality review. Paper quality was often low or medium, as rated by a standard quality assessment framework. Results indicated that older adult SNS users were more likely to have particular characteristics, including being female and younger. The main incentive for use was to maintain contact with family and friends. Disincentives included privacy concerns and lack of perceived usefulness. The relationship between SNS use, wellbeing and cognitive function was inconclusive. SNS use is a multi-dimensional phenomenon that needs to be understood in the context of broader communication practices, individuals’ social relationships, and individual preferences and characteristics.
Depression in later life is one of the most common mental disorders. Several instruments have been developed to detect the presence or the absence of certain symptoms or emotional disorders, based on cut-off points. However, the use of a cut-off does not allow identification of depression sub-types or distinguish between mild and severe depression. As a result, depression may be under- or over-diagnosed in older people. This paper aims to apply a model-driven approach to classify individuals into distinct sub-groups, based on different combinations of depressive and emotional conditions. This approach is based on two distinct statistical solutions: first, a latent class analysis is applied to the items collected by the depression scale and, according to the final model, the probability of belonging to each class is calculated for every individual. Second, a factor analysis of these classes is performed to obtain a reduced number of clusters for easy interpretation. We use data collected through the EURO-D scale in a large sample of older individuals, participants of the sixth wave of the Survey of Health, Ageing and Retirement in Europe. We show that by using such a model-based approach it is possible to classify individuals in a more accurate way than the simple dichotomisation ‘depressed’ versus ‘non-depressed’.
Previous research has shown an association between subjective wellbeing and incident diabetes. Less is known about the role of wellbeing for subclinical disease trajectories as captured via glycated hemoglobin (HbA1c). We aimed to explore the association between subjective wellbeing and future HbA1c levels, and the role of sociodemographic, behavioral and clinical factors in this association.
We used data from the English Longitudinal Study of Ageing for this study (N = 2161). Subjective wellbeing (CASP-19) was measured at wave 2 and HbA1c was measured 8 years later at wave 6. Participants were free from diabetes at baseline. We conducted a series of analyses to examine the extent to which the association was accounted for by a range of sociodemographic, behavioral and clinical factors in linear regression models.
Models showed that subjective wellbeing (CASP-19 total score) was inversely associated with HbA1c 8 years later after controlling for depressive symptoms, age, sex, and baseline HbA1c (B = −0.035, 95% CI −0.060 to –0.011, p = 0.005). Inclusion of sociodemographic variables and behavioral factors in models accounted for a large proportion (17.0% and 24.5%, respectively) of the relationship between wellbeing and later HbA1c; clinical risk factors explained a smaller proportion of the relationship (3.4%).
Poorer subjective wellbeing is associated with greater HbA1c over 8 years of follow-up and this relationship can in part be explained by sociodemographic, behavioral and clinical factors among older adults.
Whilst representations of old age and older people in traditional media have been well documented, examinations of such representations within social media discourse are still scarce. This is an unfortunate omission because of the importance of social media for communication in contemporary society. In this study, we combine content analysis and discourse analysis to explore patterns of representation on Twitter around the terms ageing, old age, older people and elderly with a sample of 1,200 tweets. Our analysis shows that ‘personal concerns/views’ and ‘health and social care’ are the predominant overall topics, although some topics are clearly linked with specific keywords. The language often used in the tweets seems to reinforce negative discourses of age and ageing that locate older adults as a disempowered, vulnerable and homogeneous group; old age is deemed a problem and ageing is considered something that needs to be resisted, slowed or disguised. These topics and discursive patterns are indeed similar to those found in empirical studies of social perceptions and traditional media portrayal of old age, which indicates that social media and Twitter in particular appears to serve as an online platform that reproduces and reinforces existing ageist discourses in traditional media that feed into social perceptions of ageing and older people.
This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana.
There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies.
The study used data from the first wave of the World Health Organisation’s Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors.
Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile.
The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.
Dementia, a term that describes a variety of brain conditions marked by gradual, persistent and progressive cognitive decline, affects a significant proportion of older adults. Older adults with dementia are sometimes perceived less favourably than those without dementia. Furthermore, compared to persons without dementia, those with dementia are often perceived by others as having reduced personhood. This study was aimed at investigating whether differences in attitudes towards dementia and personhood perceptions vary as a function of age group, care-giver status, attitudes towards ageing, dementia knowledge, gender and education. In total 196 younger, middle-aged and older adults were recruited. Findings revealed that being a care-giver as well as having less ageist attitudes were predictive of being more comfortable around persons with dementia, having more knowledge about dementia and ascribing greater personhood to people with dementia. Those with more dementia knowledge (prior to the study) were less comfortable around people with dementia. Finally, when controlling this prior dementia knowledge, older adults were more comfortable around people with dementia compared to younger and middle-aged adults. Gender and education were not associated with any of the variables under study. Findings contribute to a better understanding of the role of age- and care-giver-related factors in the determination of attitudes towards dementia.
The prisoner population is ageing, and consideration is needed for how to best support those with age-related health conditions in the system. Existing work practices and organizational structures often fail to meet the needs of prisoners with dementia, and prison staff experience high levels of burden because of the increased needs of these prisoners. Little is known about the best method of responding to the needs of this growing subpopulation of prisoners.
A scoping review was conducted to answer the question: what are the perceived best care options for prisoners with dementia? To be included, publications had to be publicly available, reported on research findings, or viewed opinions and commentaries on care practices relevant to older prisoners with dementia. Searches were conducted in 11 databases to identify relevant publications. Data from the included publications were extracted and summarized into themes.
Eight themes were identified that could support better care practices for prisoners with dementia: (1) early and ongoing screening for older prisoners; (2) specialized services; (3) specialized units; (4) programs or activities; (5) adaptations to current contexts; (6) early release or parole for older prisoners with dementia deemed at low risk of reoffending; and (7) training younger prisoners (8) as well as staff to assist older prisoners with dementia. Besides practical strategies improving care practice, costs, prison-specific resources, and staff skills were highlighted as care barriers across all themes. A lack of empirical evidence supported these findings.
One of the implications of the international ageing prison population is the higher number of people living with dementia being incarcerated. Suggestions for best care approaches for prisoners with dementia now need to move from opinion to empirical approaches to guide practice.
Extra-care housing (ECH) has been hailed as a potential solution to some of the problems associated with traditional forms of social care, since it allows older people to live independently, while also having access to care and support if required. However, little longitudinal research has focused on the experiences of residents living in ECH, particularly in recent years. This paper reports on a longitudinal study of four ECH schemes in the United Kingdom. Older residents living in ECH were interviewed four times over a two-year period to examine how changes in their care needs were encountered and negotiated by care workers, managers and residents themselves. This paper focuses on how residents managed their own changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, the paper makes two arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be resisted, planned-for and managed by older people. Second, that operational practices within ECH schemes can function to facilitate or impede residents’ attempts to manage this boundary.
In the context of worldwide ageing, increasing numbers of older people are lonely, isolated and excluded, with serious implications for health, and cognitive and physical functioning. Access to good public transport can improve mobility and social participation among older adults, and policies that improve access and promote use, such as concessionary travel schemes, are potentially important in promoting healthy and successful ageing. Concessionary travel schemes for older people are in place in many countries but are under threat following the global financial crisis. Evidence regarding their success in encouraging activity and social participation is generally positive but based largely on qualitative or observational associations and, in particular, is often limited by the lack of appropriate comparison groups. We use changes in the English statutory scheme, in particular the rising eligibility age from 2010 onwards, as a natural experiment to explore its impact on older people's travel. A difference-in-difference-in-difference analysis of National Travel Surveys (2002–2016) compares three age groups differentially affected by eligibility criteria: 50–59 years (consistently ineligible), 60–64 years (decreasing eligibility from 2010) and 65–74 years (consistently eligible). Compared with 50–59-year-olds, bus travel by 60–74-year-olds increased year-on-year from 2002 to 2010 then fell following rises in eligibility age (annual change in weekly bus travel: −2.9 per cent (−4.1%, −1.7%) in 60–74- versus 50–59-year-olds). Results were consistent across gender, occupation and rurality. Our results indicate that access to, specifically, free travel increases bus use and access to services among older people, potentially improving mobility, social participation and health. However, the rising eligibility age in England has led to a reduction in bus travel in older people, including those not directly affected by the change, demonstrating that the positive impact of the concession goes beyond those who are eligible. Future work should explore the cost–benefit trade-off of this and similar schemes worldwide.
Social exclusion amongst rural-dwelling older adults and the role of the diversity of people and places in mediating the construction of that exclusion has not been adequately investigated or conceptualised in the international literature. Consequently, how ageing in a rural community can function to disadvantage or protect older people remains poorly understood. With the aim of advancing conceptual understanding on rural old-age social exclusion, this article explores how exclusion is manifest in the lifecourse experiences of rural-dwelling older adults and the role of mediating factors in the construction of exclusion in different kinds of rural places. The analysis draws on ten rural case-study sites across Ireland and Northern Ireland, encompassing five kinds of rural communities: dispersed rural; remote rural; island rural; village rural; and near-urban rural. Data come from 106 interviews with older people ranging in age from 59 to 93 years. Rural old-age social exclusion is confirmed as a multi-dimensional construct, involving: social relations; service infrastructure; transport and mobility; safety, security and crime; and financial and material resources. This analysis demonstrates that social exclusion for rural-dwelling older people is multi-layered, and its prevalence and form is shaped by four mediating factors: individual capacities; lifecourse trajectories; place; and macro-economic forces. The findings are used to present a conceptual framework that emphasises the role of mediating forces on rural old-age social exclusion.
Despite the well-documented health benefits of physical activity in older adults, participation levels remain low. With rapid global population ageing, intensive efforts are needed to encourage higher levels of participation to ameliorate the negative effects of physical inactivity for older individuals and society as a whole. The aim of this qualitative study was to inform future physical activity promotion interventions by examining factors contributing to low activity levels among older people undertaking less than half the recommended level of moderate-to-vigorous physical activity (MVPA). Semi-structured interviews were conducted with 102 (65% female) community-dwelling Western Australians aged 60+ years (mean = 71.52, standard deviation = 6.26) who engaged in ⩽75 minutes of MVPA per week as measured by accelerometers. Several modifiable and unmodifiable barriers were identified, of which poor health featured most prominently. Lifetime physical inactivity, caring duties, low motivation, misperceptions of physical activity and ageing, and a lack of affordable and attractive options were the other barriers identified. The results suggest that strategies are needed to raise awareness of current physical activity guidelines, normalise engagement in MVPA throughout the lifespan, develop initiatives to motivate participation, improve the availability of affordable physical activity programmes that are attractive to this population segment, and facilitate participation among those with intensive caring responsibilities.
The radical demographic change produced by the ageing population in the Western world has entailed a complete transformation of its popular culture. The cinema is one of the popular arts to have been especially affected by the so-called ‘longevity revolution’. In fact, an important part of Hollywood celebrity culture and the mainstream film audiences belong to the same ageing demographic. The increasing necessity to tell and consume stories of ageing for the big screen is not only reflected in the growing number of films that feature older characters in their lead roles, but also in the changes produced in the cinematic narratives themselves. Film scholars within the inter-disciplinary field of cultural gerontology have started to address this phenomenon from various perspectives. Building on from their critical consideration, this article focuses on the particular case of Michael Radford's Elsa & Fred, a contemporary film released in 2014 that, paradoxically enough, helps renovate the youth-oriented genre of the romantic comedy through a ‘silvering’ romance. Taking into account contemporary manifestations of the romantic comedy genre, the essay proves that Radford's comedy contributes to the development of the ‘gerontocom’ as a new sub-genre in which old age is central to the protagonists’ characterisations and storylines. By considering the interaction of the generic rules of the genre with the hyper-visibility of the protagonists’ agedness, this article also shows the ways in which the film overcomes polarised views of ageing and enhances the figures’ own process of becoming in the last stage of their lives.
New Zealand's ageing population and health inequities for Māori (Indigenous peoples) have prompted calls for innovative, culturally based approaches to improving health and wellbeing, and managing transitions in later life. This is particularly important for kaumātua (Māori elders) who, despite cultural strength and resilience, carry a significant burden in health, economic and social inequities. This paper describes the culture-centred development of a ‘tuakana‒teina’ (elder sibling‒younger sibling) peer support education programme designed to help kaumātua support other kaumātua experiencing transitions in later life. Taking a strengths-based approach that highlights ‘kaumātua mana motuhake’ (elder independence and autonomy), the study used kaupapa Māori (Māori approach, knowledge, skills, attitudes and values) and community-based participatory research methodology, to develop and pilot a culture-centred tuakana‒teina/peer education programme. Methods included establishing two advisory groups (one of kaumātua and one of sector experts); holding five focus groups with kaumātua; and running a pilot programme with 21 kaumātua. The findings demonstrate the value in a strengths-based approach that centralises Māori culture and kaumātua potential, capacity and ability, and recognises the continuing value and contribution of kaumātua to society. The study helps shift the focus from dominant stereotypes of ageing populations as a burden on society and shows the value of kaumātua supporting others during transitions in later life.
The life expectancy of people with Down syndrome (DS) has increased significantly over the last few decades. Consequently, they and their families face new ageing-related challenges, the first signs of which appear in people with DS around the age of 30. The goal of this study was to explore the perceptions of adults with DS regarding their own and their parents’ ageing and end of life, and to examine the views and concerns of the parents regarding the ageing of their children with DS. The unique approach used in our study was to convene not only the ageing people with DS but also their parents, to discuss the subject together. A total of 33 people with DS participated in the study. Most of them were interviewed with one or two parents. Participants with DS found it difficult to talk about their own old age and addressed the issue mainly through the decline in the functioning of an older person they knew. The parents emphasised the changes needed in terms of the official regulations, so as to ensure that their children with DS age with dignity and quality of life. Our study identifies the increasingly pressing need to prepare adults with DS for their own and their parents’ ageing and end of life in a timely manner.
Affective disorders are associated with poorer cognition in older adults; however, whether this association can already be observed in mid-life remains unclear.
To investigate the effects of affective symptoms over a period of 30 years on mid-life cognitive function. First, we explored whether timing (sensitive period) or persistence (accumulation) of affective symptoms predicted cognitive function. Second, we tested how different longitudinal trajectories of affective symptoms were associated with cognitive function.
The study used data from the National Child Development Study. Memory, verbal fluency, information processing speed and accuracy were measured at age 50. Affective symptoms were measured at ages 23, 33, 42 and 50 and used to derive longitudinal trajectories. A structured modelling approach compared a set of nested models in order to test accumulation versus sensitive period hypotheses. Linear regressions and structural equation modelling were used to test for longitudinal associations of affective symptoms with cognitive function.
Accumulation of affective symptoms was found to be the best fit for the data, with persistent affective symptoms being associated with poorer immediate memory (b = −0.07, s.e. = 0.03, P = 0.01), delayed memory (b = −0.13, s.e. = 0.04, P < 0.001) and information processing accuracy (b = 0.18, s.e. = 0.08, P = 0.03), but not with information processing speed (b = 3.15, s.e. = 1.89, P = 0.10). Longitudinal trajectories of repeated affective symptoms were associated with poorer memory, verbal fluency and information processing accuracy.
Persistent affective symptoms can affect cognitive function in mid-life. Effective management of affective disorders to prevent recurrence may reduce risk of poor cognitive outcomes and promote healthy cognitive ageing.
Drawing on the revived literature on the subjective dimension of ageing, this paper investigates whether people aged 65+, usually defined as old, do actually feel old and which events they associate with feeling old. Logistic models are used on unique data from the 2013 survey called ‘I Do Not Want to Be Inactive’, conducted on individuals aged 65–74 in Italy (N = 828). It is found that a large proportion of respondents do not feel old at all. The analyses show that women are more likely than men to feel old and to think that society considers them old. While men feel old mainly when they retire, women associate this feeling with loneliness, loss of independence and death of loved ones. Higher-educated people are less likely to associate feeling old with loneliness and boredom than their lower-educated counterparts. The findings have important implications for the conceptualisation of ageing. Most people who are old according to the standard threshold of 65 do not consider reaching this age as a distinctive marker of old age in their lifecourse. This suggests that absolute thresholds for setting the start of old age are questionable. Feeling old seems to be mainly influenced by events, such as retirement and death of loved ones, hinting to the importance of the social construction of ageing in addition to its biological dimension. Researchers and policy makers are encouraged to give more attention to layperson views on ageing.
Men's Sheds are entrenched throughout Australian and international communities due to their popularity in attracting mainly older men to come together and undertake various social and workshop activities. A growing body of research has emerged where men associate regular Shed participation with improved social, emotional and physical wellbeing. However, few studies have examined Aboriginal men's engagement in Men's Sheds. This article reports on a study that investigated how a cohort of older Aboriginal men from one rural Tasmanian community consider the benefits of engaging in their local Shed. A community-based participatory research approach was developed in consultation with Aboriginal community leaders to ensure the study supported the community's expectations. Interview data from ten Aboriginal men combine to represent the Shed environment as an enabling therapeutic landscape, with key themes represented as domains of belonging, hope, mentoring and shared illness experiences. Shed activities were premised on these men co-creating an informal, culturally safe and male-friendly community environment to enjoy the company of other men. The created Shed environment was mutually beneficial as the participants reported improved wellbeing despite living with the effects of declining health and ageing. The findings inform Aboriginal communities and health-care stakeholders to consider the unique role of Men's Sheds for enhancing the health of an ageing male population.
China has been undergoing dramatic socio-economic and demographic changes in the last few decades. The rapid growth of the ageing population will pose tremendous challenges to its public health and social welfare system. This study aims to examine how urbanisation has impacted cardiovascular disease (CVD) risks among middle-aged and older Chinese in two decades, from 1991 to 2011. Data were drawn from a nationwide longitudinal data-set of the China Health and Nutrition Survey (CHNS) (sweeps 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011). Participants aged ⩾45 years old were included. A dynamic urbanisation index was created for each community (village or neighbourhood) based on community-level data that can reveal the heterogeneity within and across places and capture dimensions of social, economic and physical characteristics of urban living over time and space. Multi-level modelling analyses (level 1: occasions; level 2: individuals; level 3: households; level 4: communities) were performed on outcomes of CVD risks such as body mass index, waist circumference, and systolic and diastolic blood pressure. The results show upward trends in all CVD risks for both genders over 20 years of urbanisation after adjustment for socio-economic and demographic confounders. Urbanisation in China is associated with absolute increases in CVD risks over time among its middle-aged and older people, despite its contribution to relative reduction of the rural–urban gap over time. This is particularly true for women from the least urbanised areas. It is relevant to inform policy-making processes to target the most vulnerable groups of older people in China during its rapid urbanisation process. There is a possibility for policy intervention to reduce inequality during the process of China's planned urbanisation.
There is a growing population of ageing individuals living with the human immunodeficiency virus (HIV). Older adults living with HIV often contend with intersecting stigmas including HIV stigma, ageism and, for some, homonegativity and/or racism. Although the HIV stigma literature is quite robust, research on the relationship between HIV stigma, social support and mental wellbeing among older adults living with HIV is limited. This study begins to address this gap by examining how intersectional stigma affects social support and mental wellbeing among rural-dwelling older adults living with HIV. Qualitative interviews were conducted by phone with 29 older adults living with HIV, over the age of 50, living in rural areas of the United States of America. Interviews were transcribed verbatim and analysed using thematic content analysis in MAXQDA qualitative analysis software. Analysis revealed three primary themes. The first had to do with gossip and non-disclosure of HIV status, which intersected with ageism and homonegativity to exacerbate experiences that fell within the remaining themes of experiences of physical and psychological isolation and loneliness, and shame and silence surrounding depression. The prevalence of social isolation and the effects of limited social support among older adults living with HIV are prominent and indicate a need for tailored interventions within the HIV care continuum for older adults living with HIV.