Taking a closer look at ageism: self- and other-directed ageist attitudes and discrimination

Older adults, perceived ageism, civic participation and mental health: a qualitative study

OBJECTIVES

This study has three objectives: A) To investigate the relationship of ageism on older adults' civic activities; B) To analyze the influence of ageism on mental health; and C) To explore the impact of civic participation on older adults' mental health.

METHOD

This qualitative study included 782 older people from three different nationalities (Portuguese, Brazilian, and English) ranging in age from 65 to 88. All the interviews went through the process of content analysis.

RESULTS

For the first objective, the findings encompass one high-level theme (Social and individual incompetence), which included social rejection (86%), reduced competence (84%), expectations of failure (83%), and not being able to contribute (77%). For the second objective, findings indicated two overarching categories: Perceived inability, including frustration and impotence (89%), incompetence (77%) and irrelevance (71%); and Perceived distress, including anger (81%), feelings of anxiety (68%); and emotional bursts (63%). For the third objective, the following two high-level themes emerged: Ego-oriented resources, which comprised the development of a sense of purpose (81%), learning cognitive skills (71%), and (A3) practising sense of agency (67%); and Social-oriented resources, encompassing feeling socially integrated (80%); and expressing emotionally (54%). Findings indicated that the most verbalized themes for the three objectives were the same across the three nationalities.

CONCLUSIONS

Ageism made it difficult for people to participate in civic life, which has been linked to better mental health. These findings emphasize the need to encourage inclusive civic involvement to improve older individuals' mental health.

Feeling discriminated means poor self-perceived health: a gender analysis using SHARE

Most part of the literature has highlighted the detrimental effects of discrimination on health. However, the influence of past and perceived discrimination on older workers' self-assessed health has been understudied. Firstly, we aim at studying whether reported discrimination is associated with self-assessed health among adults of working ages (50-65 years of age). Secondly, we analyze the existence of differences by gender. Data was retrieved from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to obtain the regular panel of questions, and the third and seventh waves of the SHARELIFE questionnaire, that includes information about discrimination (n = 30,019). We develop logistic regression models to determine the relationship of discrimination on male and female workers' self-assessed health separately. Our results show that 49.0% of our sample was composed of highly discriminated women, while the remaining percentage covered men and women (42.3% males and 8.7% females) that reported lower levels of discrimination. Our estimations reveal a significant association between discrimination and poor health status, especially in the case of men ranging from OR = 1.802 (95% CI 1.502-2.163) to OR = 1.565 (95% CI 1.282-1.910). In the case of women our results range from OR = 1.728 (95% CI 1.463-2.040) to OR = 1.196 (95% CI 0.992-1.442). These findings are essential to highlight the importance of tackling discrimination as a determinant of health that negatively affects both sexes, men and women.

Preliminary Validation of Experienced Ageism Measures With Four Populations in the United States

OBJECTIVES

Ageism appears widely across the globe and poses an important threat to older people's well-being and health. With respect to hearing health, experiences, perceptions, and fear of ageism can delay the diagnosis of hearing loss, reduce pursuit of hearing care, and fuel reluctance to wear a hearing device. Ageism intertwines with hearing loss stigma, which potentially deepens the negative effects of both; however, little evidence exists to quantify the effects of the intersection of ageism and hearing loss stigma. This lack of data on both hearing loss stigma and ageism, and their intersection, may stem from the lack of validated measures for both. Therefore, as part of a parent study to develop and preliminarily validate d/Deaf and hard of hearing stigma measures, we also adapted and preliminarily validated measures of both experienced and observed ageism.

DESIGN

We adapted four ageism measures through a literature review, expert discussions, and cognitive interviews and validated them in the United States through self-administered online surveys with convenience samples of (1) people aged 60 and older who became d/Deaf or hard of hearing (d/DHH) after developing language or in adulthood ("acquired" d/DHH), (2) care partners of people aged 60 or older who are d/DHH (acquired), (3) health care providers, and (4) the general population. For each of the scales, we applied exploratory factor analysis and estimated scale reliability with ordinal α.

RESULTS

For the population of persons over age 60 who are d/DHH (acquired) (N = 146), nine social stigma items and four employment discrimination items loaded well onto two separate factors, one which measures social stigma and one which measures employment discrimination. All loadings were >0.7. The two factors were moderately correlated at 0.428. For care partners of people aged 60 or older who are d/DHH (N = 72), nine items loaded well onto a single factor, with loadings between 0.650 and 0.936 and an ordinal α of 0.95. Among the general population (N = 312), 10 items loaded cleanly onto a single factor, with loadings between 0.702 and 0.919 and an ordinal α of 0.96. For the health care providers (N = 203), 11 items loaded well onto a single factor, with loadings between 0.541 and 0.874. For these three populations, each of the single factors measure social stigma.

CONCLUSIONS

Ageism threatens the health and wellbeing of older people in both high- and low-income countries. Validated measures of ageism are necessary to understand the relationship between ageism, d/DHH stigma and the well-being of older adults and to design effective ageism-reduction and mitigation interventions. This preliminary validated set of experienced ageism measures offers a starting point for more studies that not only further validate these measures but are larger in scale, occur in more diverse settings, and provide insights into the experience of ageism and its effects on the health and well-being of older adults.

Between Choice and Coercion? The Processes of Increased Economic Vulnerability Among Low-Income Older Workers

The social phenomenon of extended working age has been subject to broad scholarly and social policy interest, as part of such trends as the aging of the population, increased life expectancy, shortage of the labor force, and policy debates on pension reforms. A major question about extending working age, or working after retirement, is whether it is a matter of choice, taking control of one's later life, or is coerced, part of entering the precariat. This study provides a nuanced examination of the social processes that direct labor market participation among older workers by conducting an analysis of in-depth interviews with 42 low-income older workers in Israel. The study exposed several institutional constraints that increase their economic vulnerability, demonstrating how interrelated structural factors related to the labor market, gender, and immigration shape the precarity of the life of older workers and coerce their continuous labor market participation. We conclude by emphasizing the responsibility of governments to ensure that older workers' labor market participation truly represents their "choice and control," rather than being a matter of coercion.

The Effects of Playing Versus Watching an Interactive Video Game Featuring an Older Adult Protagonist on State Empathy and Ageism Reduction

This study tested how increased modality interactivity (e.g., playing vs. watching a game) can augment empathy and reduce ageism toward older adults among college-aged students. An experiment (n = 201) examined the effects of playing a video game that featured an older adult protagonist. Relative to those who spectated the game, participants who played the game had increased state empathy on subfactors, including shared affect, empathic motivation, and helping motivation. Moreover, shared affect mediated the link between playing a game featuring an older adult protagonist and ageism. Participants with higher trait empathy showed lower state empathy after playing, whereas participants with lower trait empathy displayed increased post-game state empathy. Overall, the results supported the modality interactivity model suggesting fruitful avenues for future research.

Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men

The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.

Perceived Ageism is Associated With Recurrent Falling Among Older Colombian Adults

Literature on the association between ageism and falling among older adults is limited. Using data from the nationwide cross-sectional SABE (Salud, Bienestar y Envejecimiento) Colombia Survey in 2015 with 18,875 participants aged ≥60 years living in the communities, the study aims to evaluate the association between perceived ageism within the family, neighborhood, health services, and public services, and recurrent falling. Participants had a mean age of 69.2 ± 7.1; 56.1% were female. Recurrent falling prevalence was 15%, and experiencing any ageism was 10%. Multivariable logistic regression analyses showed higher odds of recurrent falling for any ageism (OR = 1.81, 95% CI 1.61-2.02, p < .0001). High depressive symptoms mediated 10.1% of the association between any ageism and recurrent falling, followed by low instrumental activities of daily living (9.7%) and multimorbidity (9.3%). Current findings open new areas of gerontological research by expanding the risk factors for falling among older adults to include ageism perceptions.

Generational Bias: Another Form of Ageism

Ageism includes discrimination toward both younger and older individuals. Discrimination based on generational cohorts can serve as a proxy for discrimination based on age and, therefore, can be argued as a form of ageism. This study examined the occurrence of generational ageism and its relationship to internalized and relational ageism. This cross-sectional study surveyed 913 individuals recruited through ResearchMatch. Analyses found that those in the Millennial and Gen Z groups reported experiencing the highest levels of discrimination based on generational cohort and reported feeling that their generational groups were viewed as less capable, more opinionated, and more selfish than other generations. Millennial and Gen Z groups also reported experiencing higher internalized and relational ageing anxiety levels than older cohorts. As our collective understanding of the manifestation and perpetuation of ageism grows, it is imperative to explore the impact and consequences of generational bias as a form of ageism.

"I tried to appreciate it in a different way": Older lesbian, bisexual, and queer women's body image and embodiment across the life course

We examined the life histories of older lesbian, bisexual, and queer women, focusing on the stories they told about their bodies and sexuality from early to later life. Guided by a narrative constructionist approach, a series of two life history interviews were conducted with 17 lesbian, bisexual, and queer women aged 65-86. Two themes were constructed through a narrative thematic analysis: Queering the Corset: Negotiating Gender Expression and (Aspirational) Aging Body Acceptance. Participants experienced body-related freedom through 'tomboy' expressions of physicality as children. This body autonomy was constrained in adolescence and adulthood due to heterosexist messages surrounding idealized femininity relayed by family and (heterosexual) men, which disrupted self-care yet catalyzed attuned, queer desire and positive embodiment. Women worked to accept their bodies as they aged; they experienced some body dissatisfaction in relation to age-related body changes, yet gratitude and pride in their older queer identities. The findings highlight concurrent positive and negative body image, and breadth of body-related experiences ranging from attunement and agency to discomfort and disruption throughout the life course. This work contributes to body image and embodiment research by moving beyond dominant (youthful) heteronormative perspectives by illuminating how ageism and heterosexism can shape body-related experiences.

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.

Older Men, The Patient-Physician Relationship, and Patient Involvement

Despite the fact that older adults interact frequently with physicians, there is little research examining their preferences, and perceptions of the patient-physician relationship. Research on this topic is particularly sparse when it comes to older men. This study investigates older men's experiences with physicians, their perceptions of the patient-physician relationship, and the extent to which they wished to be involved in their health care. In-depth, face-to-face interviews were conducted with 23 men 55-96 years of age. Findings reveal that older men want to participate in the medical encounter and be involved in their care, contradicting earlier work suggesting that older adults prefer to be passive patients. Preferred involvement, however, varied along a continuum ranging from "quasi-involvement" to "taking charge", with most participants being in the middle, preferring a "partnership" patient-physician relationship. Factors influencing patient involvement and potential to negotiate the patient-physician relationship are discussed.

The Next Critical Turn for Ageism Research: The Intersections of Ageism and Ableism

BACKGROUND AND OBJECTIVES

Aging includes multidimensional and multidirectional changes in biology, psychology, and social roles. With aging, individuals experience physiological changes that affect ability, stamina, and reserve capacity. Given the natural occurrence of physical decline accompanying aging, it is essential to understand if fear and prejudice toward disability (ableism) intersect and influence fear and anxiety about aging (ageism).

RESEARCH DESIGN AND METHODS

A cross-sectional survey study was conducted using ResearchMatch for study recruitment, 913 individuals responded to questions regarding 3 types of ageism, including affinity for older people, internalized ageism, and relational ageism, as well as internalized and relational ableism.

RESULTS

Internalized ageism was significantly associated with relational ageism, fear of physical disability, fear of cognitive disability, and affinity for older people. Relational ageism was associated with internalized ageism, relational ableism, fear of physical disability, fear of sensory disability, fear of cognitive disability, and affinity for older people.

DISCUSSION AND IMPLICATIONS

Examining the intersection of ageism and ableism represents the next pivotal juncture to developing effective anti-ageism interventions that address the root anxieties influencing negative attitudes about aging and fears of growing older. Public policy initiatives to address community-level interventions and targeted training to inform discourse that addresses the intersection between ageism and ableism are critical to addressing these issues and promoting age and ability inclusivity.

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.

Ageism, Racism, Sexism, and Work With Older Healthcare Clients: Why an Intersectional Approach Is Needed in Practice, Policy, Education, and Research

Women are subject to health disparities across the life course, owing to multiple factors, including sexism, ageism, and other forms of structural discrimination and mistreatment which have been linked with greater risks for sexual violence and related trauma as well as resulting problems with physical and mental health as well as overall wellbeing. Thus, a more intersectional approach to healthcare and social service delivery for older women is expressly needed, particularly since the COVID-19 pandemic, to address UN Global goals of advancing health and wellness, gender equality, less disparities altogether, and with this, greater justice. As such, in this article, timely needs for practice, policy, research, and education will be explored, to address intersectional prejudice and discrimination, chiefly among older women who are members of nondominant populations, to improve healthcare and social services and social justice, principally in later life.

The characteristics of online gerontophobia expressions in South Korea

Recently, South Korea has been transitioning into a super-aged society. The purpose of this paper is to identify the patterns and underlying causes of gerontophobia expressions in South Korea. This paper refines the patterns of gerontophobia expressions into five types: "Fear of Aging," "Resource Burden," "Social Isolation," "Criticism of Social Behavior," and "Stereotypes of Political Orientation." Based on these types, this study develops a deep learning algorithm to detect the type of gerontophobia expressions. To do this, kc-BERT was used and 760,140 news comments (for six years from May 1, 2017, to June 31, 2021) in Naver news was used. The result shows that "Fear of Aging" type exhibited a significant decreasing trend, while the other types showed no meaningful changes. The results of topic modeling on news articles indicated that various aspects of elderly life, unresolved historical events, COVID-19, digital and financial exclusion, economic and social welfare, and other critical societal issues co-occur and contribute to gerontophobia. This study provides a framework to understand the characteristics of online gerontophobia, offering insights into its underlying causes, and providing practical implications for policy makers.

Everyday life experiences of Chinese community-dwelling oldest old who live alone at home

PURPOSE

Older adults aged ≥ 80 years living alone at home are more likely to experience challenges. Daily life experiences regarding living alone are still limited in the Asian context. This study explored the everyday life experiences of older Chinese residents living alone at home. Research questions included: (1) How do Chinese community-dwelling old people describe everyday life experiences related to living alone? (2) What kind of difficulties and needs do Chinese community-dwelling older people living alone face in everyday lives? (3) How do Chinese community-dwelling older people cope with challenges faced in their everyday lives related to living alone?

METHODS

This was qualitative descriptive research. Purposive sampling was adopted to recruit 13 participants aged 80-92 years of age from communities and one hospital. Semi-structured interviews were conducted to collect data which was analysed by conventional content analysis.

RESULTS

Three themes were identified: theme 1-difficulty in finding a sense of belonging, theme 2-striving to maintain independence, theme 3-hard to gain a sense of control.

CONCLUSIONS

This study provided novel insights into understanding the difficulties and needs of Chinese older people living alone at home. Three key challenges and associated strategies they used to cope with in daily lives were presented.

Internalization of negative societal views on old age into self-perceptions of aging: exploring factors associated with self-directed ageism

Introduction

A growing number of research has provided evidence for the negative impact of ageism on older people's health and well-being. Among the three different manifestations of ageism, namely institutional, interpersonal and self-directed ageism, significant ageism-health associations have been proved to be strongest for self-directed ageism. This supports stereotype embodiment theory, which maintains that lifetime exposure to negative age stereotypes leads to the internalization of ageism as a form of negative attitudes towards own aging and it adversely affects health and well-being in old age. However, little is known about how people internalize negative age stereotypes held in the society into self-perceptions of aging.

Methods

This study aimed to explore how socially shared beliefs about old age are internalized into self-perceptions of aging focusing on uncovering factors related to self-directed ageism. Data were derived from the survey that had examined citizen's attitudes towards old age and aging in Finland. Multinominal logistic regression models were performed to examine the association of sociodemographic and contextual factors with different combinations of societal age stereotypes and two indicators of self-perceptions of aging: subjective views on old age and personal feelings of own old age.

Results

The analyses showed that being female, attaining tertiary education, evaluating poor quality of life and awareness of institutional old age discrimination were related to holding negative views on aging towards both society and oneself.

Discussion

The findings from univariate and multivariate models suggest that it is not age per se, but structural and cultural circumstances shaped with growing older that turns socially shared negative age stereotypes into negative self-perceptions of aging. Even though the study addressed situations in one country, the findings have an important implication for other rapidly aging societies regarding how social and cultural contexts are closely linked to the formation of self-directed ageism.

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.

The paradox of subjective age: age(ing) in the self-presentation of older adults

OBJECTIVES

Studies have shown that when people grow older, the negative perceptions about age(ing) become self-directed. In this study, we examined if and how this assertion is expressed in the self-presentation of older adults.

DESIGN

To explore this issue, we undertook an online survey with 818 Israeli older adults (aged 65-90) who were asked to present themselves in writing, using an open question and to choose the age terms that they preferred, relying on a multiple-choice question. Responses were analyzed qualitatively and quantitatively using "word cloud" and linguistic inquiry.

RESULTS

The analysis indicated three ways of coping with the issue of age in one's self-presentation: Absence of old age - older people who blur their processes of aging; Camouflaged aging - older people who emphasize their age by using a line of self-ageism; Multiplicity of old age terms - the existing gap between what is being used by people and the ideal related to the use of existing age terms. The findings highlight the role of subjective age in one's self-presentations.

CONCLUSIONS

The results point to the ambivalence that older people feel in relation to their age(ing) and especially reflect the paradox of subjective age. That is, on the one hand studies have stressed the positive aspects of this practice, whereas on the other hand, subjective age possibly reflects a response to internalized negative stereotypes and prejudice about old age(ing). In this sense, this study expands the knowledge in the field of self-presentation and (subjective) age in the second half of life.

The role of chronological age in climate change attitudes, feelings, and behavioral intentions: The case of null results

Past research has stressed the role of age and generation in climate change discourse, worries, and willingness to act. Therefore, the present paper aimed to examine the role of chronological age (as an arbitrary factor, which represents ageism) in lay people's climate change-related attitudes, feelings, and behavioral intentions. Two experiments in different countries, Australia and Israel, were conducted for this purpose. The first study examined the impact of the age of the speaker, who provides information about the climate crisis and the second examined the impact of the age of the group being blamed for the situation. Outcome variables included perceived responsibility and motivation for the current climate situation in study 1 and perceived climate change-related attitudes, feelings, and behavioral intentions in study 2. In study 1 (n = 250, Australia), the age of the speaker, a climate activist, varied randomly to test the hypothesis that a younger activist would be more influential and increase motivation and responsibility to act compared to an older activist. In study 2 (n = 179, Israel), the age (young vs. old) of the group identified as being responsible for the climate crisis varied randomly, to test the hypothesis that people would be more willing to identify older people as being responsible for the current climate situation, and this would impact climate change-related attitudes, feelings, and behavioral intentions. Both studies resulted in null effects. Additionally, there was no interaction between the age of the respondent and the age of the source of the message or the age group being blamed by the message. The present study has failed to show that strategies that emphasize intergenerational conflict and ageism impact people's attitudes, feelings, and behavioral intentions towards the current climate situation. This possibly can serve as an instigator for strategies that emphasize intergenerational solidarity, rather than conflict, as a guiding principle in future campaigns that advocate climate change adaptation and mitigation measures.

Explaining the process of formation of ageism among the iranian older adults

BACKGROUND

Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people.

METHODS

The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding.

RESULTS

Fear of loneliness and rejection striving to tackle ageism "was identified as the core category of the study. Concepts such as "family context" and "cultural context" were relevant. After identifying the strategies used by the older adults in response to the context ("maintaining integrity", "socio-cultural care" and "proper health care", "striving to tackle ageism") was the most important process in ageism by the Iranian older adults.

CONCLUSION

Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.

Reprint of: Community-level age bias and older adult mortality

RATIONALE

As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention.

OBJECTIVE

We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities.

METHODS

Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142).

RESULTS

Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association.

CONCLUSIONS

Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.

Combatting ageism through virtual embodiment? Using explicit and implicit measures

OBJECTIVES

Ageism is defined as stereotypes, prejudice, and discrimination towards people because of their age. Although ageism can be directed towards people of any age group, most research has focused on ageism towards older people. Ageism towards older people is known to have a significant impact on their health and wellbeing and to even result in higher healthcare costs. The present study evaluated the use of virtual embodiment (VE) to reduce self- and other-directed ageism.

DESIGN, SETTING, AND PARTICIPANTS

We randomized 80 individuals between the ages of 18 and 35 years to one of two conditions: VE as an older or a younger avatar.

RESULTS

No differences were found on explicit measures of ageism. Once multiple comparisons were accounted for, a nonsignificant reduction in implicit age bias following exposure to the older avatar (Cohen's d = .75, p = .02) also was found.

CONCLUSIONS

Past research has established the effectiveness of VE in relation to implicit measures. However, once both explicit and implicit measures are included and multiple comparisons are accounted for, neither explicit nor implicit measures of ageism show a significant effect. Given the multidimensional nature of ageism, further research is needed to establish the effectiveness of VE once multiple measures of ageism are considered.

Negative ageism and compassionate ageism in news coverage of older people under COVID-19: how did the pandemic progression and public health responses associate with different news themes?

Previous studies have found negative ageing narratives in the media during the COVID-19 pandemic. However, few have focused on compassionate ageism and how the news responded to the progression of the COVID-19 pandemic. We investigated (a) media themes of negative and compassionate ageism and (b) their relationships with COVID-19 parameters and the public health response. The sample included 1,197 articles relevant to COVID-19 and older people in Hong Kong published between January and December 2020. We used thematic analysis to identify themes from the news articles and structural equation modelling to explore these themes' relationship with the number of older people infected, effective reproduction number, number of COVID-19 deaths and public health response parallel in time. Pandemic-related variables were lagged for a day – the time needed to be reflected in the news. Two negative ageism themes portrayed older people as vulnerable to COVID-19 but counterproductive in combating the pandemic. Two compassionate ageism themes depicted older people as a homogenous group of passive assistance recipients. The theme blaming older people was associated with the number of confirmed infections (β = 0.418, p = 0.002) but vulnerability of older people was not associated with pandemic-related variables. The theme helping older people was negatively associated with the percentage of older people in confirmed infections (β = −0.155, p = 0.019). The theme resources available was negatively associated with confirmed infections (β = −0.342, p < 0.001) but positively associated with the Containment and Health Index (β = 0.217, p = 0.005). Findings suggested that negative and compassionate ageism were translated into narratives about older people in the media as the pandemic evolved but did not address the actual risk they faced. Media professionals should be aware of the potential negative and compassionate ageism prompted by the news agenda and promote adequate health behaviours and responses.

Community-level age bias and older adult mortality

RATIONALE

As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention.

OBJECTIVE

We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities.

METHODS

Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142).

RESULTS

Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association.

CONCLUSIONS

Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.

Perceptions About Discrimination in a Rural, Older, Racially and Ethnically Diverse Cohort

Purpose

The purpose of this pilot study was to examine perceptions of discrimination among a small cohort of rural older, retired minority Florida farmworkers. Potential sources of discrimination were explored, such as health literacy, age, sex, gender, racial/ethnic background, or rural residency.

Sample

The study occurred in a rural area that is designated as a "hot zone" due to its HRSA designation as a medically underserved area (MUA), health provider shortage area (HPSA), and medically underserved population, despite lying only 50 miles due west of the affluent town of Palm Beach, Florida. More than 40% of residents live below the poverty level, and only 65% have received a high school diploma.

Method

A descriptive, correlational pilot study was conducted to investigate potential contributors to discrimination. Independent variables examined were age, sex, gender, rural residency, racial/ethnic background, and health literacy, using the Rapid Estimate of Health Literacy in Medicine, short form (REALM-SF) (Arozullah, 2007). The incidence of self-reported discrimination was investigated. Chi-square and Pearson correlation analysis were employed to examine survey results. Findings were supplemented with a brief narrative inquiry, and responses were analyzed using Saldaña's (2015) model of cyclical coding.

Findings

Twenty-five residents in a subsidized housing unit agreed to participate in this study. This convenience sample was 96% racially/ethnically diverse (68% African American, 24% Haitian Creole, and 4% Hispanic American.) Most (78%) were retired field workers, and largely self-identified as female (72%). The residents' average reading level was 4th-6th grade. Health literacy (44%) and rural residency (24%) were the greatest sources of discrimination. Female gender discrimination was associated with ethnicity discrimination (r = 0.6, p = .002).

Conclusions

Providers are strongly encouraged to assess their patients' health literacy levels and experiences with discrimination to inform effective care delivery.

Older Age is Associated With Lower Utilization of Living Donor Kidney Transplant

Introduction

Older adults (65 years or older) constitute a substantial and increasing proportion of patients with kidney failure, potentially needing kidney replacement therapy. Living donor kidney transplant (LDKT) offers superior outcomes for suitable patients of all ages. However, exploring LDKT and finding a living donor could be challenging for older adults. Here, we assessed the association between age and utilization of LDKT and assessed effect modification of key variables such as ethnicity and language.

Methods

This is a retrospective cohort study of patients with kidney failure referred for kidney transplant (KT) assessment in Toronto between January 2006 and December 2013. The association between age and having a potential living donor identified was assessed using logistic regression and the association between age and the receipt of LDKT was assessed using Cox proportional hazards models.

Results

Of the 1617 participants, 50% were middle-aged (45-64 years old), and 17% were ≥65 years old. In our final multivariable adjusted models, compared to young adults, middle-aged and older adults had lower odds of having a potential living donor identified (odds ratio [OR], 0.47; confidence interval [CI], [0.35-0.63]; OR, 0.30; CI, [0.20-0.43]; P < 0.001, for middle-aged and older adults, respectively), and were less likely to receive LDKT (hazard ratio [HR], 0.79; CI, [0.63-0.99]; P = 0.04; HR, 0.47; CI, [0.30-0.72]; P = 0.001, for middle-aged and older adults, respectively.).

Conclusion

Age is an independent predictor of receiving LDKT. Considering that nearly 90% of patients with kidney failure in Canada are >45 years of age, these results point to important and potentially modifiable age-related barriers to LDKT.

Discrimination, Mediating Psychosocial or Economic Factors, and Antihypertensive Treatment: A 4-Way Decomposition Analysis in the Health and Retirement Study

Untested psychosocial or economic factors mediate associations between perceived discrimination and suboptimal antihypertensive therapy. This study included 2 waves of data from Health and Retirement Study participants with self-reported hypertension (n = 8,557, 75% non-Hispanic White, 15% non-Hispanic Black, and 10% Hispanic/Latino) over 4 years (baselines of 2008 and 2010, United States). Our primary exposures were frequency of experiencing discrimination, in everyday life or across 7 lifetime circumstances. Candidate mediators were self-reported depressive symptoms, subjective social standing, and household wealth. We evaluated with causal mediation methods the interactive and mediating associations between each discrimination measure and reported antihypertensive use at the subsequent wave. In unmediated analyses, everyday (odds ratio (OR) = 0.86, 95% confidence interval (CI): 0.78, 0.95) and lifetime (OR = 0.91, 95% CI: 0.85, 0.98) discrimination were associated with a lower likelihood of antihypertensive use. Discrimination was associated with lower wealth, greater depressive symptoms, and decreased subjective social standing. Estimates for associations due to neither interaction nor mediation resembled unmediated associations for most discrimination-mediator combinations. Lifetime discrimination was indirectly associated with reduced antihypertensive use via depressive symptomatology (OR = 0.99, 95% CI: 0.98, 1.00). In conclusion, the impact of lifetime discrimination on the underuse of antihypertensive therapy appears partially mediated by depressive symptoms.

Ageism from a cross-cultural perspective: results from a national survey of Israelis over the age of 50

OBJECTIVES

We examined differences across three groups in Israel to test the double jeopardy versus the intersection escape hypotheses-which evaluate whether being older and belonging to an underrepresented group serves as a double burden, exposing older minorities to higher levels of perceived ageism or on the contrary, older age serves as a protective factor, especially for underrepresented groups.

DESIGN

A cross-sectional, nationally representative sample, consisting of three groups: Veteran Israelis, Israeli Arabs and immigrants from the Former Soviet Union. The latter two groups represent underrepresented (minority) populations in Israel.

SETTING

Community-dwelling Israelis over the age of 50.

PARTICIPANTS

The sample was composed of 1570 participants.

MEASUREMENT

To examine the double jeopardy versus the intersectional escape hypothesis, self-perceptions of aging (SPA) and perceived age-based discrimination in the healthcare system were examined as outcome variables.

RESULTS

Among Israeli Arabs, being older was related to better SPA, whereas among the immigrants being older was related to worse SPA. As immigrants became older, they were more likely to report ageist experiences. Israeli Arabs reported higher levels of ageist experiences, regardless of their age.

CONCLUSIONS

The findings point to certain groups that require education about ageism and the aging processes and might require further protection from the experiences of ageism. The findings also point to the relevance of different theoretical paradigms that advocate for the consideration of culture and group membership in the understanding of the experiences of ageism.

Vulnerable, recalcitrant and resilient: a Foucauldian discourse analysis of risk and older people within the context of COVID-19 news media

Risk is an innate and integral part of everyday life and is present in simple, everyday occupations and complex actions. Age-related stereotypes can mean older people have little opportunity to engage in activities that present some degree of risk. The present study explores the discourse around risk and older people in the context of the COVID-19 pandemic. We investigated news media as a reflection of the dominant public discourse around older people's behaviour to identify how risk is represented in relation to occupational engagement. Texts relating to older people and COVID-19 were sourced from the West Australian newspaper for a period of two months. Seventy texts were subject to Foucauldian discourse analysis to identify subject positions, location of risk and discursive features. Findings indicate that older people were segregated from the rest of society, with their behaviours framed in mostly negative ways. We identified three areas of discourse: vulnerable, and in need of protection; recalcitrant, and in need of management; and resilient, deserving of respect. While we recognise competing representations, implicit within the dominant discourse was the premise that older people were not capable of mediating risks and required ‘management’. These findings highlight the role of surveillance in restricting occupational engagement for older people and carry implications for older people, the public and therapists.

Ageism: the importance of the linguistic concept for the construction of the experience

This study investigated if people are acquainted with the term ‘ageism’, and to what extent acquaintance with this term corresponds with reports of discrimination, due to age. The study included an online survey, answered by 1,025 Israeli respondents. The questionnaire began by asking the respondents to define ‘What is ageism?’ (gilanut in Hebrew) and then to mark ‘If and what types of discrimination they experienced in the last year’. Subsequently, we defined and demonstrated the term ageism and asked participants to share experiences of this phenomenon; 457 (45%) participants were not familiar with the term. In the group that was unfamiliar with the term, only 46 (10%) reported that they had such experiences. In the group that was acquainted with the term, 208 (30%) reported that they had experienced ageism. In contrast, once the term, ageism, was defined and demonstrated in the survey, 638 (62%) respondents shared experiences of ageism in their lives. Of those who shared their experiences of ageism, 202 (31%) were initially unfamiliar with the term. The study's results show that there is an association between the linguistic representation of the phenomenon of ageism and reports of ageism. In the wider sense, the study shows that language and words have the power to help people understand and interpret social and human experiences.

Precarious ageing in a global pandemic – older adults' experiences of being at risk due to COVID-19

Health authorities worldwide address older adults as a risk group for more serious illness and health complications associated with COVID-19, while social gerontologists have warned that addressing older adults as a risk group of COVID-19 bears the risk of reinforcing ageism. This paper empirically explores to what extent older adults perceive themselves as part of a COVID-19 risk group and how these perceptions influence their everyday lives and experiences of age and ageing. This paper draws upon data from a mixed-methods study on older adults' risk perceptions during COVID-19 in Lower Austria, including a representative survey on 521 adults (60+ years) and data from 20 semi-structured interviews. Approximately two-thirds of the respondents consider themselves at risk of COVID-19 and name age, in addition to pre-existing illness, as a contributing factor in this risk perception. Older adults with health constraints, and especially older men, have a higher probability of perceiving risk due to COVID-19. Additionally, older adults report that they experience being ‘suddenly seen as old’ or ‘being put into a box’ during the pandemic, which influenced their experiences and images of ageing. Our study provides insights into how perceived COVID-19 risk affects the everyday lives of older adults. Age-based categorisations of risk contribute to a shift in images of age and ageing, drawing on insecurity and risk, rather than successful and active ageing, to conceptualise later life.

Ageism and Psychological Well-Being Among Older Adults: A Systematic Review

Ageism may have harmful effects on the psychological well-being of older adults, leading to mental health issues, such as depression and anxiety. However, there are insufficient data to establish this hypothesis, and most work on the subject has appeared only in the form of conceptual or theoretical papers. This study reviewed quantitative studies of the relationship between ageism and psychological well-being of older adults. We conducted a comprehensive review using searches of academic databases, the grey literature, hand searches, and reference mining. A total of thirteen articles were selected using the inclusion criteria. All the reviewed studies showed a negative association between ageism and the psychological well-being of older adults. The study confirmed a negative association between ageism and older adults’ psychological well-being, finding that older adults with a high level of psychological well-being may be less negatively affected by ageism, especially those who were proud of their age group, experienced less negative emotions, were more optimistic about aging and their future, were more self-confident about their bodies, and were flexible in setting goals. The identified mediators of the association can inform intervention development to the effects of ageism and improve older adults’ psychological well-being.

The Wounded Lion - Ageism and Masculinity in the Israeli Film Industry

One of the intriguing issues connected to power relations in the world of cinema that has yet to be adequately explored is what has happened over the years concerning the dominance and privilege of masculinity as signifying preferred social status. This qualitative study explores this subject based on transcribed semi-structured interviews with 13 award-winning Israeli directors over the age of 55. The research examines two questions: How has the film industry changed its relation to leading, award-winning film directors as they grow older? And, what challenges confront the directors, in terms of their own self-perceptions? These questions capture the collisional intersection between hegemonic masculinity and ageism, because they examine the loss of power attributed to men in the film industry as they reach the second half of their lives. The findings led to the formation of a theoretical model of ageism within the cinematic industry, allowing for the dismantling of the different factors that create obstacles for directors as they get older. The four layers of the model are: arbitrary ageism, manifested in the demands of a rapidly changing industry in a changing world; passive ageism, expressed through encounters with negative attitudes; active ageism, reflected in preventing older directors from receiving funding and from screening their films; and self-ageism, manifested in the directors' attitudes toward themselves.

Addressing Ageism-Be Active in Aging: Study Protocol

Ageism refers to stereotyping (how we think), prejudice (how we feel), and discrimination (how we act) against people based on their age. It is a serious public health issue that can negatively impact older people's health and quality of life. The present protocol has several goals: (1) adapt the Ambivalent Ageism Scale for the general Portuguese population and healthcare professionals; (2) assess the factorial invariance of the questionnaire between general population vs. healthcare professionals; (3) evaluate the level of ageism and its predictors in the general population and evaluate the level of ageism and its predictors in healthcare professionals; (4) compare the levels of ageism between groups and the invariance between groups regarding the explanatory model of predictors of ageism. This quantitative, cross-sectional, descriptive, observational study will be developed in partnership with several Healthcare Professional Boards/Associations, National Geriatrics and Gerontology Associations, and the Universities of the Third Age Network Association. The web-based survey will be conducted on a convenience sample recruited via various social media and institutional channels. The survey consists of three questionnaires: (1) Demographic data; (2) Ambivalent Ageism Scale; (3) Palmore-Neri and Cachioni questionnaire. The methodology of this study will include translation, pilot testing, semantic adjustment, exploratory and confirmatory factor analysis, and multigroup analysis of the Ambivalent Ageism Scale. Data will be treated using International Business Machines Corporation (IBM®) Statistical Package for the Social Sciences (SPSS) software and Analysis of Moment Structures (AMOS). Descriptive analysis will be conducted to assess the level of ageism in the study sample. The ageism levels between the two groups will be compared using the t-student test, and two Structural Equation Modeling will be developed to evaluate the predictors of ageism. Assessing ageism is necessary to allow healthcare professionals and policymakers to design and implement strategies to solve or reduce this issue. Findings from this study will generate knowledge relevant to healthcare and medical courses along with anti-ageism education for the Portuguese population.

Influence of Ageism on Physical Activity Prescription for Prediabetes Management

This study used a randomized online survey design to examine the potential influence of ageism on physical activity (PA) prescription for hypothetical patients with prediabetes of different chronological ages. Participants included 356 kinesiology students who were randomly assigned to one of four conditions. Each condition presented a clinical case study of a hypothetical patient with prediabetes referred to the participant as a qualified exercise professional for a PA intervention. Case studies were identical except for the reported patient's chronological age. Participants provided recommendations for PA support, frequency, duration, and intensity. Significant main effects were observed for PA duration, F(3, 352) = 8.62; p < .001, and intensity, F(3, 352) = 16.20; p < .001. The older patient was prescribed significantly lower PA duration and intensity compared to younger patients and no-age control. This study provides evidence for the presence and independent influence of ageism against older patients in PA prescription for prediabetes management.

"The Internal Police Officer Has Not Retired but Has Slowed Down": Israeli Women Reframe Their Aging Experiences in the Second Half of Life

Compared with gains, losses have received a substantial amount of research and public attention. The present study aims to shed light on the positive gains associated with older age from the perspective of older women. Five focus groups with 19 Israeli women over the age of 54 were conducted. Trailers of three different films were used to stimulate discussion about old age and aging and allow for reflections on societal norms in light of personal experiences. Focus group interviews were analyzed thematically. Respondents identified four contexts, characterized by reframing their experiences against societal norms. These included gender stereotypes, physical appearance, interpersonal relations, and employment. This study represents an opening to a different discourse around old age, which is characterized by gains and possibilities brought about by changes in reframing one’s experiences, while distancing oneself and exerting free will vis à vis social norms.

The Relationship Between Perceived Age Discrimination in the Healthcare System and Health: An Examination of a Multi-Path Model in a National Sample of Israelis Over the Age of 50

OBJECTIVES

The present study aims to examine possible pathways that potentially account for the relationship between perceived age discrimination in healthcare settings (as one form of ageism) and health outcomes.

METHODS

We relied on 1570 complete surveys, which constitute a representative national sample of adults aged 50 and above in Israel.

RESULTS

We found a direct link between perceived age discrimination and health outcomes. This link was partially mediated by self-perceptions of aging and subsequently by health behaviors (e.g., eating vegetables) and preventive health behaviors (e.g., medical check-ups). The link between perceived age discrimination and health behaviors was moderated by age, thus, particularly detrimental for older people over the age of 65 as compared with those between the ages of 50 and 65.

DISCUSSION

This study adds to the literature as it examines comprehensive mechanisms to account for the path between perceived age discrimination and health status. Our findings point to the unique aspects associated with perceived age discrimination, which potentially make older people more susceptible to its negative effects.

Exploring gaps in positive solitude perceptions: older adults vs. gerontology professionals

OBJECTIVES

The aim of this study was to explore old persons' experiences of positive solitude (PS) and the gaps between their experience and professional caregivers' perceptions of older adults' experiences of PS. Moreover, we attempt to understand the basic mechanism that may explain these gaps.

DESIGN

A qualitative method was used.

PARTICIPANTS

Fourty-one older adults (aged 65-103 years) and 2 groups of professionals: 16 occupational therapists with a specialization in gerontology and 41 gerontology graduate students from other occupations.

MEASUREMENT

Four open-ended questions about PS were asked. The older adults described their views on PS and experiences during solitude. The two caregiver groups, who are familiar with older adults, answered the questions twice, referring once to themselves and once to older adults in general.

RESULTS

A. Gaps exist between old peoples' and caregivers' perceptions and experience of PS. B. The caregivers believe that older adults cannot easily enjoy PS. C. Caregivers believe that there are certain preconditions for older adults' experience of PS. D. Differences in attitude toward older adults between the caregiver groups were found.

CONCLUSIONS

Although old people occasionally prefer PS, culture and age bias may prevent caregivers from accepting older adults' need for PS. Practical implications include the need to raise awareness of age bias among caregiving staff, in particular regarding their acceptance of older adults' PS experiences. This may improve the staff's willingness to enable older adults to experience PS without interruption.

The Relationship between Ageism and Well-Being as Mediated through COVID-19-Related Experiences and Discourses

Both COVID-19 and ageism can have a negative impact on the well-being of older people. Yet, our knowledge on the links between COVID-19, ageism and well-being is still emerging. The present study aimed to contribute to this knowledge by exploring the lived experiences of older adults during the COVID-19 pandemic. To do so, we analyzed older persons' subjective experiences and perceptions of ageism arising from COVID-19-related policies and discourses in two country contexts-Austria and Ireland-and the implications of these experiences for personal well-being. Based on the thematic analysis of 27 interviews with older adults, we found that participants perceived and encountered a discriminatory homogeneous representation of older people as a group. Three specific forms of this homogenization, namely stigmatization, paternalism, and scapegoating, were identified as impact on well-being. Moreover, our analysis showed how these forms of ageism challenge both the individual and social identities of older people, revealing older participants' different attitudes in responding to this challenge. With reference to the international research literature, we discussed the impact of these experiences on the well-being of older people and the possible legal and socio-political implications of our findings.

Intersectional Discrimination and Change in Blood Pressure Control among Older Adults: The Health and Retirement Study

BACKGROUND

Associations between multiple forms of discrimination and blood pressure control in older populations remain unestablished.

METHODS

Participants were 14582 non-institutionalized individuals (59% women) in the Health and Retirement Study aged at least 51 years (76% Non-Hispanic White, 15% Non-Hispanic Black, 9% Hispanic/Latino). Primary exposures included the mean frequency of discrimination in everyday life, intersectional discrimination (defined as marginalization ascribed to more than one reason), and the sum of discrimination over the lifespan. We assessed whether discrimination was associated with change in measured hypertension status (N=14582) and concurrent medication use among reported hypertensives (N=9086) over four years (2008-2014).

RESULTS

There was no association between the frequency of everyday discrimination and change in measured hypertension. Lifetime discrimination was associated with higher odds of hypertension four years later among men (OR: 1.21, 95% CI: 1.08, 1.36) but not women (OR: 0.98, 95% CI: 0.86, 1.13). Only among men, everyday discrimination due at least two reasons was associated with a 1.44 (95% CI: 1.03, 2.01)-fold odds of hypertension than reporting no everyday discrimination; reporting intersectional discrimination was not associated with developing hypertension among women (OR: 0.91, 95% CI: 0.70, 1.20). All three discriminatory measures were inversely related to time-averaged antihypertensive medication use, without apparent gender differences (e.g., OR for everyday discrimination-antihypertensive use associations: 0.85, 95% CI: 0.77, 0.94)).

CONCLUSIONS

Gender differences in marginalization may more acutely elevate hypertensive risk among older men than similarly aged women. Experiences of discrimination appear to decrease the likelihood of antihypertensive medication use among older adults overall.

Perceived Ageism During the Covid-19-Crisis Is Longitudinally Related to Subjective Perceptions of Aging

Ageism in media and society has increased sharply during the Covid-19-crisis, with expected negative consequences for the health and well-being of older adults. The current study investigates whether perceived ageism during the crisis longitudinally affects how people perceive their own aging. In June 2020, N = 611 older adults from Luxembourg [aged 60–98 years, M_age(SD) = 69.92(6.97)] participated in a survey on their perception of the crisis. In October 2020, N = 523 participated in a second measurement occasion. Participants reported on perceived ageism during the crisis in different domains, their self-perceptions of aging and subjective age. In latent longitudinal regression models, we predicted views on aging at T2 with perceived ageism at T1, while controlling for baseline views on aging and covariates. Perceived ageism at T1 increased self-perceptions of aging as social loss and yielded a trend for physical decline, while there were no effects on subjective age and self-perceptions of aging as continued growth. Views on aging are powerful predictors of well-being and health outcomes in later life. Our data suggest that being the target of ageism during the crisis negatively affects older adults' self-perceptions of aging and this impact may be felt beyond the current crisis.

Ageism and older people's health and well-being during the Covid-19-pandemic: the moderating role of subjective aging

In the Covid-19 pandemic, being older means being in a special focus: Probabilities for severe infections and mortality rise with increasing age and protective measures for this population group have been increased. This was accompanied by public discourse that portrayed older adults stereotypically as vulnerable and frail but also highlighted the hardships younger people have to endure to protect them. Given the possibly detrimental effects of ageism on individuals and societies, we were interested in older adults' perception of ageism in the Corona-crisis and its relation to their health and well-being. Furthermore, we were interested in subjective aging variables as moderators in the ageism-health relationship. In June 2020, N = 611 independently living people aged 60 + from the Grand Duchy of Luxembourg were recruited via a survey research institute and interviewed online or by phone. They reported on perceived ageism in different contexts, their life satisfaction, subjective health, subjective age and self-perceptions of aging. Depending on context, ageism was perceived by around 20% of participants, and overall negatively related to subjective health and life satisfaction after the onset of the pandemic. Moderated hierarchical regressions showed that a younger subjective age buffered the negative effect of ageism on subjective health, while perceiving aging as social loss increased its effect on life satisfaction. We discuss the importance of addressing and reducing ageism (not only) in times of crisis and the consequences for individuals and societies.

Media representation of older people's vulnerability during the COVID-19 pandemic in China

Older adults have gained great media attention during the COVID-19 pandemic, as they were believed to be vulnerable to the novel virus based on clinical data and epidemiological evidence. The high volume of media coverage played an important role in calling for improved public health services for the older population. Nevertheless, problematic media representations of older people might evoke or amplify ageism during the pandemic. Therefore, drawing on empirical data collected from five mainstream Chinese media outlets between January 3 and May 3, 2020, this study examined how the media constructed the vulnerability of older adults and its underlying ageist thinking during the pandemic. The findings showed that the media had clear preferences in constructing older people as passive recipients while seeking resources from families, public institutions and governments at various levels to cope with the COVID-19 pandemic. Notably, the media adopted a biomedical-centred framework presenting older people as a homogenous group that was vulnerable to the pandemic. In addition, we found that the media representations of older adults intensified the dichotomised relationship between the young and the old, causing the younger generations to perceive older people as a 'threat' to public health. Moving beyond the Chinese case, this article appeals to the media to be socially responsible by avoiding the stereotyping of the older population and uniting the whole society to combat COVID-19. The findings of this study will help raise awareness among policymakers and care service providers, which is crucial to eliminating ageist attitudes across society and to further allowing the values of older individuals to be fully recognised.

Reproductive agency, assisted reproductive technology & obstetric violence

In this article, I draw on ethnographic research I conducted in the UK and Spain. I analyse the experiences of women who chose to become mothers with the assistance of reproductive technologies (ART). All the women intended to have a natural birth in hospital and they reported that hospitals categorised their pregnancies as high-risk on the basis of their age (35-47 years) and the use of ART. How do these women deal with their reproductive treatment? How does hospital culture impact on women's birthing bodies and psyche? What are the struggles they undergo to defend their wish to have a "natural" birth?

Does Perceived Ageism Widen the Digital Divide? And Does It Vary by Gender?

BACKGROUND AND OBJECTIVES

Existing literature presents a widening digital divide among older adults in addition to the consideration of the potential adverse impacts of ageism on internet use among the older adult population. Our study aimed to investigate (a) whether older adults' perceived ageism will be associated with their use of the internet and (b) whether the relationship between perceived ageism and internet use will be moderated by age groups and binary gender.

RESEARCH DESIGN AND METHODS

Using the data from the 2016 Health and Retirement Study, regression analyses were separately performed by gender. Two measures of perceived ageism were considered: (a) self-perception of aging and (b) perceived age discrimination.

RESULTS

Our findings suggested that greater exposure to ageism is generally related to less use of the internet. In addition, we found divergent patterns in the relationship between ageism and internet use by gender. For women, a lower level of internet use was predicted by more negative perceptions of aging, whereas men's internet use was associated with the experience of age discrimination. Furthermore, interaction effects between age groups and ageism varied across gender. The negative perception of aging was more strongly associated with less internet use in older women than middle-aged women. In comparison, the perceived age discrimination predicted less internet use in middle-aged men than older men.

DISCUSSION AND IMPLICATIONS

Our findings suggest that perceived ageism is significantly associated with internet use, and its association differs by gender.

Expanding the Role Repertoire While Aging: A Drama Therapy Model

Drama therapy has been found to improve various facets of mental health while aging. It provides opportunities for personal growth and creative expression and enhances group relationships. Drama therapy is a widely acknowledged way to explore the life stories in late life. However, only a handful of studies have empirically explored the value of drama therapy for the aging population. This conceptual analysis was designed to address this need by developing a new integrative model of drama therapy. The analysis is based on the review of the results of four studies that explored the integration of life-review and playback theater as a drama therapy approach for older adults. The therapeutic process focused on the exploration of life-crossroads stories, a short unique technique which enables the participants to craft a harmonious view of their life stories in a short-term dramatic creative group process. Combining the four results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life story, the evolution of improvised dramatic expression, and the expansion of social engagement. The transformative routes are described through the lens of role theory in drama therapy.