The use of age as a criterion for the allocation of medical resources has been extensively debated internationally. This paper describes a study of the significance of age for the quality of life (QoL) of older and younger people with end-stage renal failure (ESRF) and in receipt of renal replacement therapy (RRT). The study has two components: a structured literature review to characterise the QoL and health-status measurement instruments that have been developed for use with all or specifically older RRT patients; and a longitudinal survey of the QoL domains nominated by older RRT patients by their age and duration of treatment. The literature review found that no validated QoL instrument had been developed specifically for use with older RRT patients. Moreover, there was little correspondence between the QoL domains used in the instruments described in the published literature and those mentioned by the survey participants. Older and younger patients nominated different domains, and their nominations changed with the duration of treatment. No significant differences in QoL scores were found between older and younger patients, but the scores improved significantly between 6–12 and 18–24 months of treatment. The findings suggest that using older age as a criterion for refusing full access to healthcare resources in ESRF is a simplistic and potentially erroneous strategy.

For the older individual, leisure activities are a resource that helps to maintain health and engagement with life. This article investigates change over 10 years in the level of participation of older people in leisure activities in Sweden, and the factors associated with these changes. The data are from nationally representative samples of the Swedish population aged 77 or more years in 1992 and 2002. The level of participation was higher at the later date, and among four major groups of activities, social and cultural activities increased the most, while physical and intellectual activities increased only among women. Ordered logistic regressions enable variations in the level of participation by age, gender, level of education, disability and fatigue to be described. Participation in most kinds of activities, including the overall level, was more common at the younger ages (the late seventies and early eighties) and among those with full mobility and more education. Since average health was worse in 2002 than in 1992, it cannot explain the higher level of participation. Other possible explanations, such as cohort differences, improved accessibility, and changing gender roles, and the implications for health promotion programmes are discussed.

This article presents an analysis of the factors that were associated with preferences for ‘early retirement’ or ‘late exit’ from paid work in Sweden. It draws upon special questions that were added to the country's Labour Force Survey of 2001 and were put to a sample of more than 1,000 people aged 55–64 years who were (self-) employed. Separate models of the factors influencing women's and men's preferred retirement age were calibrated, using variables that described current working conditions, whether the respondents perceived themselves as being appreciated as employees, and their attitudes to work and to private or home life. Among the findings, a positive attitude towards work motivated both women and men to stay in work beyond the normal retirement age, while positive attitudes towards private life promoted an early exit. Poor working conditions generated negative attitudes towards work (and vice versa). The strengths of various push and pull factors were gender-specific: for women, a trying job tended to push them out of the labour market; for men, a socially-rewarding job tended to keep them in the labour force. The more that men worked mainly for pecuniary reasons, the stronger their wish for an early exit. Men who felt that they were unappreciated at work preferred early retirement: in some of these cases, the ‘push’ factor was related to ageism. As people approach retirement age, many appear to reconceptualise more positively their life outside the work place.