Where are we now in relation to determining the prevalence of ageism in this era of escalating population ageing?

Exploring ageism and elderly care in dentistry: A comprehensive scoping review

OBJECTIVES

This scoping review aims to investigate the perceptions of dental professionals regarding aging and geriatric dentistry, as well as to identify studies focused on ageism in dental care.

DATA

The review followed guidelines from the Joanna Briggs Institute and PRISMA-ScR. A systematic search was conducted in the databases, covering the period from 2019 to 2024.

SOURCES

PubMed, Scopus, and Web of Science were searched.

STUDY SELECTION

Articles focusing on ageism or oral health in the elderly were included, while those with methodological flaws, duplicates, or unrelated content were excluded.

CONCLUSIONS

A total of 28 articles were included in the final analysis. The results reveal significant cultural differences in how ageism impacts dental care, with many dental professionals unprepared to treat elderly patients with physical and cognitive limitations. Geriatric dentistry remains underrepresented in dental curricula in some countries, leading to a shortage of specialized professionals. This review underscores the need for further research on the perspectives of practicing dentists and elderly patients to improve care and address the barriers caused by ageism.

CLINICAL SIGNIFICANCE

The review emphasizes the critical need to address ageism in dental care to enhance the quality of treatment for elderly patients. Effective strategies to counteract age-related biases can lead to improved clinical outcomes and more equitable care for all age groups.

Everyday ageism experienced by community-dwelling older people with frailty

PURPOSE

Ageism encapsulates stereotypes, prejudice and discrimination towards others or oneself based on age. While identified as the most frequent form of discrimination, relatively little work has captured the problem of day-to-day ageism faced by older people with frailty in community settings. The aim of this study therefore was to examine the prevalence of everyday ageism experienced by older people attending hospital-based ambulatory care services, and to clarify its association with measures of quality of life (QOL) and frailty.

METHODS

A consecutive series (n = 100) of patients aged ≥ 70 years attending ambulatory care completed focused interviews. Day-to-day experience of ageism was measured with the everyday ageism scale, QOL was measured with the control autonomy self-realisation pleasure scale.

RESULTS

Just over half of participants reported exposure to ageist messages; over 5/6 reported experiencing ageism in interpersonal interactions and 2/3 held some ageist beliefs themselves. Logistic regression demonstrated that experiencing ageism in interpersonal interactions was associated with a higher likelihood of internalised ageism [Adjusted Odds Ratio 6.02 (95% CI 1.70, 21.34); p = 0.005)]. Both ageism in interpersonal interactions [β = -5.22 (95% CI -9.52, -0.91); p = 0.018] and internalised ageism [β = -5.36 (95% CI -8.75, -1.97); p = 0.002] were associated with significantly lower QOL.

DISCUSSION

This study highlights the striking prevalence of everyday ageism experienced by a cohort of community-dwelling older people with frailty and multimorbidity. In the context of further projected demographic changes in coming decades, with increasingly higher proportions of older people worldwide, these findings highlight an important societal issue that needs to be addressed.

Psychometric properties of the Fraboni scale of ageism (FSA) applied to long-term caregivers in nursing homes

BACKGROUND

The aging society has resulted in enormous demand for long-term care services. However, ageism is a common phenomenon in long-term care facilities, which not only hinders the quality of care for the recipients but also negatively influences caregivers' well-being. In this paper, we first applied the Fraboni Scale of Ageism (FSA) to evaluate its reliability and construct validity among Chinese long-term caregivers in nursing homes. This study could contribute to assessing the prevalence of ageism in Chinese long-term caregivers, prompting facilities and the government to recognize the issue of ageism and explore necessary interventions to reduce ageism in long-term caregivers.

METHODS

This is a cross-sectional study. We recruited 392 long-term caregivers using a convenience sampling strategy in nursing homes from two cities in Chinese central and northern regions. Parameters included the demographic characteristics, Cronbach's alpha coefficients, and intraclass correlation coefficient. The construct validity was conducted by exploratory factor analysis and confirmatory factor analysis.

RESULTS

The Cronbach's alpha of FSA (Chinese version) was 0.856 and ICC was 0.871. The factor analysis identified 3 principal factors, explaining 43.95% of the total variance. The 3-factor model was confirmed to fit by confirmatory factor analysis.

CONCLUSIONS

The findings confirm that the FSA is easy to use and has good psychometric properties. This study will contribute to improving the condition of ageism, thereby improving the quality of care for the elderly and retention of professional talents in the LTC system.

Investigating Health and Well-Being Challenges Faced by an Aging Workforce in the Construction and Nursing Industries: Computational Linguistic Analysis of Twitter Data

BACKGROUND

Construction and nursing are critical industries. Although both careers involve physically and mentally demanding work, the risks to workers during the COVID-19 pandemic are not well understood. Nurses (both younger and older) are more likely to experience the ill effects of burnout and stress than construction workers, likely due to accelerated work demands and increased pressure on nurses during the COVID-19 pandemic. In this study, we analyzed a large social media data set using advanced natural language processing techniques to explore indicators of the mental status of workers across both industries before and during the COVID-19 pandemic.

OBJECTIVE

This social media analysis aims to fill a knowledge gap by comparing the tweets of younger and older construction workers and nurses to obtain insights into any potential risks to their mental health due to work health and safety issues.

METHODS

We analyzed 1,505,638 tweets published on Twitter (subsequently rebranded as X) by younger and older (aged <45 vs >45 years) construction workers and nurses. The study period spanned 54 months, from January 2018 to June 2022, which equates to approximately 27 months before and 27 months after the World Health Organization declared COVID-19 a global pandemic on March 11, 2020. The tweets were analyzed using big data analytics and computational linguistic analyses.

RESULTS

Text analyses revealed that nurses made greater use of hashtags and keywords (both monograms and bigrams) associated with burnout, health issues, and mental health compared to construction workers. The COVID-19 pandemic had a pronounced effect on nurses' tweets, and this was especially noticeable in younger nurses. Tweets about health and well-being contained more first-person singular pronouns and affect words, and health-related tweets contained more affect words. Sentiment analyses revealed that, overall, nurses had a higher proportion of positive sentiment in their tweets than construction workers. However, this changed markedly during the COVID-19 pandemic. Since early 2020, sentiment switched, and negative sentiment dominated the tweets of nurses. No such crossover was observed in the tweets of construction workers.

CONCLUSIONS

The social media analysis revealed that younger nurses had language use patterns consistent with someone experiencing the ill effects of burnout and stress. Older construction workers had more negative sentiments than younger workers, who were more focused on communicating about social and recreational activities rather than work matters. More broadly, these findings demonstrate the utility of large data sets enabled by social media to understand the well-being of target populations, especially during times of rapid societal change.

Identifying Specific Gaps in Knowledge of Aging and Examining Its Relation to Biases Toward Older Adults

Accurate aging knowledge is key to reducing ageist attitudes that impact older adult well-being. We first investigated how aging knowledge and negative and positive age-bias indirectly expressed via aging knowledge responses were related to an explicitly negative ageism measure. We then identified specific gaps in the aging knowledge of emerging adults and middle-aged adults. More negative ageism correlated with less aging knowledge overall and in psychological and social, but not biological, domains. Negative ageism correlated with negative age-bias, but not positive age-bias, expressed via aging knowledge responses. Knowledge of aging was poorest regarding social and psychological aspects of aging and best regarding biological aging. Middle-aged adults had slightly, but significantly, more accurate aging knowledge and less negative age-bias than emerging adults; positive age-bias did not differ by age-group. These results suggest that effectiveness of anti-ageism educational interventions may be enhanced if focused on improving knowledge of social and psychological aging.

Development and validation of a scale to assess the belief that 'age causes illness'

OBJECTIVES

Self-directed ageism is the application of stereotypic age-related beliefs to oneself, and is known to negatively impact health-related motivation (Levy, 2003;  2022). This study focused on the specific self-directed stereotype that 'age causes illness' and aimed to develop and test a multi-item measure to assess this implicit, limiting belief.

METHODS AND MEASURES

Survey data was collected from N = 347 adults in southeastern Idaho (ages 45-65 years old, 60% female). A variety of measures were used to assess the discriminant, convergent and predictive validity of the Age Causes Illness scale including: socio-demographics (age, sex, education), psychosocial resources (personality, optimism, social support, depressive symptoms), health/aging expectations, and indicators of physical health.

RESULTS

The seven-item Age Causes Illness scale is reliable and shows an expected pattern of discriminant and convergent correlations with relevant socio-demographic, psychosocial, and aging-related measures. The belief that 'age causes illness,' as assessed with this new scale, is related to both objective and subjective indicators of physical health.

CONCLUSIONS

The Age Causes Illness scale is a brief screening tool, potentially applicable in behavioral health settings as an initial step toward discussion of the implicit, and often unchallenged, belief that age alone determines the onset, progression, and offset of illness.

Masquerading their way to authenticity: Does age stigma concealment benefit older women?

As women age they can be subject to both sexism and ageism, and consequently be stereotyped as low in competence and irrelevant despite having a relatively young subjective age. Drawing on theories of stigma, we conducted a survey study of older women (N = 184) with a strong interest in fashion and their visual image. We used template thematic analysis to understand their experiences in relation to their age-changed appearance. Two major themes were identified: unfavourable experiences of ageism and efforts to evade these experiences through attention to appearance. Our participants employed masquerade to conceal or reduce the visible evidence of their age-both to avoid ageism and to align their outward appearance more closely with their inner, felt, authentic selves. We interrogate the benefits and penalties of concealment for a group whose stigmatised condition is dynamic, changing as their appearance grows increasingly dissimilar to societally favoured youthfulness. Masquerade may for this group of women produce more positive than negative outcomes, via effects on felt authenticity.

"With your age, what do you expect?": Ageism and healthcare of older adults in Spain

INTRODUCTION

Ageism could influence the relationship between older patients' meeting needs and healthcare professionals' answers.

AIMS

To highlight the experience of older adults with healthcare systems, how they perceive ageism from their healthcare providers, and to explore the relationship between perceived ageism and self-perception of aging (SPA).

METHODS

We conducted an exploratory qualitative study. The participants were 14 women over 65 who lived alone in their homes.

RESULTS

Professional responses ignored the expression of preferences of the older patients and excluded them from decision-making processes. These answers influenced older patients' use of health services. Moreover, the negative aspects predominated in a SPA influenced by the internalization of stereotypes and a relationship weighed down by ageist behaviors on the part of health professionals.

CONCLUSION

Explicit situations of ageism influence an imbalance in power relations between older patients and healthcare professionals, a misuse of health services, and a negative SPA.

Differences and Disparities in Ageism Affecting Older US Adults: A Review

Purpose of Review

This review summarizes findings from quantitative research studies published between 2010 and 2022 providing insight on sociodemographic differences and disparities in ageism among US adults ages 50 and older.

Findings

Across 21 studies, disparities in ageism were more consistently found such that those who were older (57% of studies), with less education (64%), and of lower socioeconomic status (100%) reported more ageism than their counterparts. Amount of ageism did not differ by sex in the majority (71%) of studies. Findings regarding race/ethnicity were mixed. Other possible differences in ageism, assessed in a small number of studies, were patterned by employment characteristics, geographic residence, religiosity, and political affiliation but not by marital or employment status.

Summary

Given that ageism is both common and associated with poor health outcomes, identifying disproportionately affected segments of the older adult population is a necessary prerequisite for developing targeted interventions to reduce negative outcomes linked to ageism and associated health disparities. Evidence within this review suggests that the patterning of ageism may deviate from that typically documented for other social and structural disadvantages. Some groups traditionally considered to be socially marginalized were found to report more ageism while others did not.

You gotta walk the walk to talk the talk: protocol for a feasibility study of the Happy Older Latino Adults (HOLA) health promotion intervention for older HIV-positive Latino men

BACKGROUND

Older Latinos living with the human immunodeficiency virus (HIV) have been disproportionately affected by the epidemic and experience compounded health disparities that have deepened over time. These health disparities are largely related to lifestyle and are either preventable or amenable to early detection or intervention. Despite existing resources to deliver an intervention to reduce this compounded health disparity, there is little information on the effects of health promotion interventions on indices of cardiometabolic risk in midlife and older Latinos living with HIV. The Happy Older Latinos are Active (HOLA) intervention is an innovative health promotion program that is uniquely tailored to meet the diverse needs and circumstances of older Latinos with HIV. The goal of this manuscript is to describe the protocol of a feasibility study of the HOLA health promotion intervention for older HIV-positive Latino men.

METHODS/DESIGN

HOLA, which is informed by Behavioral Activation and Social Learning theory is a community health worker (CHW)-led, multicomponent, health promotion intervention consisting of: (1) a social and physical activation session; (2) a moderately intense group walk led by a CHW for 45 min, 3×/week for 16 weeks; (3) pleasant events (e.g., going to brunch with friends) scheduling. Eighteen community dwelling Latinos living with HIV aged 50+ will be recruited for this feasibility study adapting the HOLA intervention. Participants will be assessed at three time points (baseline, post-intervention, and 3 months post-intervention) on measures of cardiometabolic risk factors (waist circumference, dyslipidemia, hypertension, and glucose), psychosocial functioning, and health-related quality of life.

CONCLUSIONS

If HOLA can be delivered successfully by CHWs, then the scalability, accessibility, and potential for dissemination is increased. Additionally, this study will inform feasibility and identify modifications needed in the design of a larger hypothesis testing study.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT03839212. Date of Registration: 8 February, 2019.

Does Ageism Exist Among Multidisciplinary Rehabilitation Students? Predictors of Attitudes Toward Older Adults

Background

With the growing population of older adults, the demand for health rehabilitation services has rapidly increased. Like many countries around the world, the older population in Saudi Arabia is increasing. Tackling ageism has powerful provenance for uncovering and changing the dynamics of contemporary aging in Saudi Arabia. This study examined the attitudes toward older adults and the potential predictors influencing these attitudes among multidisciplinary health rehabilitation students.

Methods

A total of 293 health rehabilitation students completed an online survey with a mean age of 21.1± 1.3 years. The survey included data about demographic and geriatric-related characteristics, attitudes toward older adults (UCLA-GA), knowledge of aging (FAQ) and aging anxiety (AAS).

Results

Most participants were female (70.3%), with 53% of the students specializing in physical therapy. The average score of attitudes toward older adults was 3.43 (0.40). The predictors of attitudes toward older adults were knowledge of aging (β = 0.34, p < 0.0001), living with older adults (β = 0.12, p = 0.02) and the importance of contact (very important, β = 0.31, p = 0.04).

Conclusion

These results provide further evidence to support that ageist attitudes among students can be overcome by enhancing knowledge of aging and promoting positive contact with older adults. With the demographic shift in Saudi Arabia, we propose that there is a great need for establishing a competency-based geriatric education and strategies to enhance positive contact with older adults.

Dietary Inflammatory Index and Associations with Sarcopenia Symptomology in Community-Dwelling Older Adults

Low-grade systemic inflammation is a key driver of muscle degeneration in older adults, and diets with pro-inflammatory properties may further contribute to loss of muscle mass, strength and function. Therefore, this research aimed to explore the associations between the inflammatory potential of the diet and measures of sarcopenia symptomology in community-dwelling older adults. Upper (handgrip strength, HGS) and lower extremity (sit-to-stand) muscle strength, physical performance (timed-up-and-go, TUG) and appendicular skeletal muscle mass (ASM) was assessed according to the European Working Group on Sarcopenia in Older People version 2 (EWGSOP2) criteria. Multiple 24-hr dietary recalls were used to calculate the Dietary Inflammatory Index (DII), which was then used to group participants into anti- and pro-inflammatory dietary groups. Multiple linear regression investigated associations between DII, muscle strength, physical performance, and muscle quantity adjusted for age, gender, comorbidities, waist circumference and physical activity. Adults 65-85 years (n = 110, 72.1 ± 4.7 years, 76.4% female) were recruited. One participant was identified with sarcopenia, 35.2% were pre-frail, or frail. More participants with a pro-inflammatory DII score had low muscle quantity than those with anti-inflammatory DII (3.4% vs. 6.4%, x² = 4.537, p = 0.043) and DII was negatively associated with HGS (β = -0.157, p = 0.016) and ASM (β = -0.176, p = 0.002) which remained significant after adjusting for covariates. In this population, DII was associated with less favorable muscle strength, physical performance, and muscle quantity.

Intergenerational contact during and beyond COVID-19

Intergenerational contact is crucial for promoting intergenerational harmony and reducing ageism. However, the COVID-19 pandemic has disrupted and changed the nature and frequency of intergenerational contact. In addition, research suggests that both ageism towards older adults and intergenerational threat regarding succession and consumption, have increased. Through the lens of the Temporally Integrated Model of Intergroup Contact and Threat (TIMICAT; Abrams & Eller, 2016), we explore the implications of these changing dynamics on ageism towards older adults during and beyond the COVID-19 pandemic. Our review reveals that research into intergenerational contact needs to articulate both the time course and salience of contact and threats before making predictions about their impacts on prejudice. The implications of understanding how contact and threat combine to affect ageism for policy and practice are discussed in relation to employment, education, and intergenerational contact programs. We highlight that policy makers play a key role in promoting intergenerational harmony through the reduction of narratives that inflame intergenerational tensions and threat.

The Role of Country-Level Availability and Generosity of Healthcare Services, and Old-Age Ageism for Missed Healthcare during the COVID-19 Pandemic Control Measures in Europe

Objectives: The effects of the COVID-19 outbreak on non-COVID-19-related healthcare need further investigation. Methods: Using the Survey of Health, Ageing and Retirement in Europe's COVID-19 module (2020) (N = 57,025), country-level data from the European Social Survey (2008) and OECD (2020), and logistic regressions, this study examines predictors of older Europeans' forgone, postponed, and denied healthcare during the pandemic. Results: Country-level availability of physicians, healthcare systems' generosity, and beliefs that older persons burden healthcare systems all increased forgone healthcare. Healthcare system generosity increased postponed and denied healthcare. Greater medical resources decreased denied healthcare. Furthermore, missed healthcare varied by individual-level gender (higher rates among women), age, education, and health. Discussion: This study reveals predictors of missed healthcare during the pandemic. To decrease unintended health consequences of a pandemic, both individual-level determinants, such as gender and health, and contextual-level determinants, such as healthcare systems' characteristics, should be considered in research and practice.

Experiences of Everyday Ageism and the Health of Older US Adults

Importance

Major incidents of ageism have been shown to be associated with poorer health and well-being among older adults. Less is known about routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their day-to-day lives, known as everyday ageism.

Objective

To examine the prevalence of everyday ageism, group differences and disparities, and associations of everyday ageism with indicators of poor physical and mental health.

Design, Setting, and Participants

This cross-sectional study was conducted using survey data from the December 2019 National Poll on Healthy Aging among a nationally representative household sample of US adults ages 50 to 80 years. Data were analyzed from November 2021 through April 2022.

Exposures

Experiences of everyday ageism were measured using the newly developed multidimensional Everyday Ageism Scale.

Main Outcomes and Measures

Fair or poor physical health, number of chronic health conditions, fair or poor mental health, and depressive symptoms.

Results

Among 2035 adults ages 50 to 80 years (1047 [54.2%] women; 192 Black [10.9%], 178 Hispanic [11.4%], and 1546 White [71.1%]; mean [SD] age, 62.6 [8.0] years [weighted statistics]), most participants (1915 adults [93.4%]) reported regularly experiencing 1 or more forms of everyday ageism. Internalized ageism was reported by 1664 adults (81.2%), ageist messages by 1394 adults (65.2%), and interpersonal ageism by 941 adults (44.9%). Mean Everyday Ageism Scale scores were higher for several sociodemographic groups, including adults ages 65 to 80 years vs those ages 50 to 64 years (11.23 [95% CI, 10.80-11.66] vs 9.55 [95% CI, 9.26-9.84]) and White (10.43 [95% CI, 10.20-10.67]; P < .001) and Hispanic (10.09 [95% CI, 9.31-10.86]; P = .04) adults vs Black adults (9.23 [95% CI, 8.42-10.03]). Higher levels of everyday ageism were associated with increased risk of all 4 negative physical and mental health outcomes examined in regression analyses (with odds ratios [ORs] per additional scale point as high as 1.20 [95% CI, 1.17-1.23] for depressive symptoms and b = 0.039 [95% CI, 0.029-0.048] for chronic health conditions; P values < .001). Internalized ageism was the category associated with the greatest increase in risk of poor outcomes for all health measures (with ORs per additional scale point as high as 1.62 [95% CI, 1.49-1.76] for depressive symptoms and b = 0.063 [95% CI, 0.034-0.092] for chronic health conditions; P values < .001).

Conclusions and Relevance

This study found everyday ageism to be prevalent among US adults ages 50 to 80 years. These findings suggest that commonplace ageist messages, interactions, and beliefs may be harmful to health and that multilevel and multisector efforts may be required to reduce everyday ageism and promote positive beliefs, practices, and policies related to aging and older adults.

Age Discrimination and Employability in Healthcare Work: A Double-Edged Sword for Older Workers?

Due to the aging workforce, older workers, especially in the healthcare industry, must remain employable. However, older healthcare workers may face age discrimination that can limit their employability chances. In this study, we examined (a) the causal direction of the relationship between age discrimination and internal employability and (b) differences between age groups (young (≤30), middle-aged (31–44), and older (≥45) healthcare workers) in this relationship. Based on the Selection Optimization Compensation theory, we postulated that (i,ii) internal employability and age discrimination are inversely negatively related to one another over time and that (ii–iv) this relationship would be strongest for older employees compared to other age groups. We conducted a two-wave complete panel study among 1478 healthcare professionals to test these hypotheses. The results of our multi-group structural equation modeling analyses suggested that internal employability is a significant negative predictor of age discrimination. Moreover, results suggested that internal employability and age discrimination have a reciprocal relationship among older workers but are unrelated for younger and middle-aged workers. Theoretical and practical implications of our results are discussed.

Psychometrics of Persian Version of the Ageism Survey Among an Iranian Older Adult Population During COVID-19 Pandemic

Background: Studies have revealed an increase in discrimination, neglect, and abuse among the older adult population during this period. This study assessed the validity and reliability of the Persian version of the ageism survey instrument tested on a sample of the Iranian older adult population during coronavirus disease (COVID-19) pandemic. An important move in counteracting ageism is to classify the ageism scale comprehensively by employing adequate psychometrics.

Methods: The Persian version of the ageism scale was developed using a two-step procedure. The first step involved translating and revising the original scale to develop a Persian version of the ageism scale. The second step involved assessing the psychometric features of the newly adapted scale using construct validity through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and thereafter assessing the reliability through the average inter-item correlation (AIC), Cronbach's alpha. The sample consisted of 400 older adults (age 65 and older), who were recruited through online data collection, with samples for EFA and CFA randomly selected from the total samples.

Results: The Persian version of the ageism survey has three factors: age-related deprivation with five items, dignity with three items, and employment with three items; all of which explained 57.02% of the total variance. The outcome of the EFA was verified by the CFA, with internal consistency reliability being excellent (Cronbach's alpha was 0.725, 0.698, and 0.708 for the three factors).

Conclusion: This study specifically offers a restructured three factors Persian version of the ageism survey for Iranian older adults with acceptable construct validity and reliability.

Measuring Discrimination against Older People Applying the Fraboni Scale of Ageism

The progressive aging of developed societies, caused by profound demographic changes, brings with it the necessity of confronting the subject of discrimination against older people. In the last 50 years, many scales of ageism have been developed to measure beliefs and attitudes towards older adults. The purpose of our study was to adapt the full Fraboni Scale of Ageism (FSA) to Hungarian language and assess its reliability, validity, and psychometric properties. The sample of the study was representative of the Hungarian population, and the data collection took place online. In our study, we compare the dimensions of the scale with other international studies and present the attitudes and biases of the Hungarian population against the older people. The results of the study indicate that attitudes toward older people are more positive among women, older people, and people living in villages. In this study, we concluded that the Hungarian version of the Fraboni Scale of Ageism is a suitable instrument for both measuring the extent of ageism in the Hungarian population and contributing to further testing the international reliability, validity, and psychometric properties of the Fraboni Scale of Ageism.

Understanding how stress responses and stress-related behaviors have evolved in zebrafish and mammals

Stress response is essential for the organism to quickly restore physiological homeostasis disturbed by various environmental insults. In addition to well-established physiological cascades, stress also evokes various brain and behavioral responses. Aquatic animal models, including the zebrafish (Danio rerio), have been extensively used to probe pathobiological mechanisms of stress and stress-related brain disorders. Here, we critically discuss the use of zebrafish models for studying mechanisms of stress and modeling its disorders experimentally, with a particular cross-taxon focus on the potential evolution of stress responses from zebrafish to rodents and humans, as well as its translational implications.

Age discrimination at work against health-related professionals in Portugal

BACKGROUND

Age discrimination affects older and younger workers, and prevents equal access to opportunities.

OBJECTIVE

This study aimed to characterize age discrimination at work in health-related professionals, and to explore its association to demographic variables.

METHODS

Exploratory cross-sectional, web-based questionnaire survey, including the Workplace Age Discrimination Scale (WADS), performed amongst 369 Portuguese health-related professionals. Participants were classified in two groups: physicians (medical doctors) and non-physicians (all other health-related professions).

RESULTS

82%of the professionals experienced age discrimination at work, non-physicians being the ones who most often experienced it (WADS 20.1 vs. 17.6). They have been more frequently passed over for a work role, evaluated less favourably and blamed for failures or problems due to their age.

CONCLUSION

Non-physicians, with less experience in the profession, and with lower quality of life may experience age discrimination more frequently. They need to be closely monitored for discrimination. A key policy priority should be to plan for age diversity teams where older and younger professionals may work together and where older can teach/mentor younger colleagues.

Lethal ageism in the shadow of pandemic response tactics

Aim

This paper examines aspects of pandemic policy responses to the COVID‐19 and SARS‐CoV‐2 variants and presents an integrated view of the consequences of response tactics at national and health service levels for older adults.

Background

Nurses are positioned at the intersection of health service and policy implementation; therefore, their influence on clinical protocols and health policy directions post pandemic is crucial to preventing further premature deaths in the 65+ years age group and others.

Sources of evidence

Perspectives presented here are based on a critical evaluation of the many published reports, comments, research and insights concerning the pandemic. That evidence, combined with my experience in various fields of study and professional service, enables me to envisage what some decisions and policies may mean for older people, nurses and societies worldwide.

Discussion

Established information on world population patterns and the location and health of national groups has been made less reliable by population shifts caused by years of geo‐political conflicts and now the impact of the pandemic. Added to this already chaotic context, the pandemic has further disrupted societies, health services and economies. Ageist responses by these systems have further disadvantaged older people and generated trust deficits that need to be resolved.

Conclusion

When the pandemic recedes, policy and management decisions taken by governments and hospital administrators will be a telling indicator of whether the established systematic ageism exposed during the pandemic will continue to compromise the health and longevity of older adults.

Implications for nursing, health and social policy

The ascendency of nursing influence within the health and social policy environment must be further strengthened to enable nurses to champion equity and fairness in the pandemic recovery effort.

Workplace Age Discrimination and Affecting Factors in Turkey: A Validation Study

Objective: This study was undertaken to adapt Workplace Age Discrimination Scale (WADS) to Turkish. Methods: The sample of the study was composed of 465 volunteered women and men (18+ years) who had an active working life. Corrected item total correlation and Cronbach's alpha internal consistency coefficient were calculated for reliability of WADS. High order confirmatory factor analysis was performed to test the theoretical suitability and construct validity for Turkish context. Results: In this study, WADS has one factor construction. Cronbach's Alpha Reliability Coefficient was found as 0.904 for WADS. Predictors of workplace age discrimination in Turkish population were determined as age, hierarchical structure, job satisfaction, and income satisfaction Conclusion: These results showed that the Turkish version of WADS may be used as a valid and reliable tool in determining workplace age discrimination and in other relevant research. Exploring the validity and reliability of the scale should be repeated in groups who have different socio-demographics and health situations.

Gendered ageism and gray hair: must older women choose between feeling authentic and looking competent?

Aging women frequently use hair dye to disguise their age in order to avoid being stigmatized as "old". Recently, however, some have chosen naturally gray hair. Informed by Goffman's theory of stigma, we investigated why they would do so in the face of age-discrimination, and their experiences of the process. We identified two major, oppositional themes, competence and authenticity. Despite wanting to avoid perceptions of old-thus-incompetent, women risked gray hair in order to feel authentic. However, they employed other beauty practices to mitigate the effects of gray hair, indicating conflict between a (subjectively) authentic appearance and societal perceptions of competence.

The secular trends in the use of medications for osteoporosis in South Korea using Intercontinental Medical Statistics Health Sales Audit 2006-2018

Objectives

Osteoporosis medications are widely available in South Korea, and well reimbursed by the Government Health Insurance; however, some expensive drugs are not reimbursed. The prescription of anti-osteoporosis drugs (AODs) are increasing for the elderly and for postmenopausal women. We investigate the secular trends of AODs in South Korea.

Methods

We used the Intercontinental Medical Statistics Health Sales Audit between January 1, 2006 and December 31, 2018. We analyzed the total sales costs and market share of AODs including bisphosphonates, selective estrogen receptor modulators (SERMs), parathyroid hormone (PTH), calcitonins, and denosumab using the number of days of therapy (DOT). Changes of prescription patterns including original versus generic drugs, vitamin D combination, and types of medical institutions were also analyzed.

Results

Bisphosphonates were the most frequently used drug during the study period although its DOT declined from 92.5% in 2008 to 80.0% in 2018. SERMs were the second-most used medication, and has maintained around 13% since 2015. The proportion of calcitonins has decreased since 2011, mainly due to malignancy risk. In contrast, the DOT of PTH and denosumab increased to 0.8% and 4.7% in 2018, respectively. The use of generics, vitamin D combination, and intravenous bisphosphonates has been increasing throughout the study period.

Conclusions

Prescription patterns using DOT are changing probably due to the increase in older adult patients and severely osteoporotic patients. There are other issues including safety and the launching of new drugs.

Associations of perceived poor societal treatment among the oldest-old

BACKGROUND

Previous studies of perceived ageism among older people have focused on younger age groups with the respondents' mean age far below 80.

OBJECTIVE

To explore the perceptions of poor societal treatment of older people among home-dwelling people aged 75-100+ and how their perceptions are associated with demographic characteristics, health, functioning, and wellbeing.

METHODS

In the Helsinki Aging Study, a random sample of 2,917 home-dwelling people aged 75-104 received a postal questionnaire inquiring about their health, wellbeing and experiences. The response rate was 74%. We asked: 'How in your opinion are older people treated in Finland?' (well/moderately/poorly) and categorized the respondents according to their responses. A multivariable forward stepwise ordered logistic regression model was used to determine the independent associations of the variables on the ordinal level of perceptions of treatment.

RESULTS

Of the participants, 1,653 responded to the index item. Of these, only 13% thought that older people are treated well in society, and 66% and 21% were of the opinion that older people are treated moderately or poorly in society, respectively. Perceived poor societal treatment was more common among women, the younger respondents, and those with lower incomes, as well as family caregivers and those with lower self-rated health and lower psychological wellbeing. Those who were able to walk outside unassisted and those with a regular hobby perceived poor societal treatment more often.

CONCLUSIONS

Several demographic factors, self-rated health, psychological wellbeing and better functioning were associated with perceptions of poor treatment among the oldest-old.

Psychometric properties of a Chinese version of the Fraboni scale of ageism: evidence from medical students sample

BACKGROUND

The increasing of older adults has led to enormous demand for medical care. However, as a group with unique needs and characteristics, older adults are often discriminated against in the medical field. In this paper, we aimed to translate the Fraboni Scale of Ageism (FSA) into Chinese and examine its construct validity, content validity, and reliability in Chinese mainland medical students. In order to evaluate the prevalence of ageism in Chinese medical students and prompt medical college to adopt necessary teaching methods to mitigate ageism in medical students.

METHODS

By Brislin's translation guidelines, FSA was translated to Chinese. The convenient sampling method was used to select samples for this survey, including 1,974 students from two medical schools in central and north China. Construct validity was verified by the exploratory and confirmatory factor analysis. The content validity index (CVI) was used to assess content validity. The Cronbach's alpha coefficients and intraclass correlation coefficient (ICC) were used to estimate reliability.

RESULTS

The alpha coefficients for FSA (Chinese version) was 0.81 and ICC was 0.87. The CVI was 0.93. Three factors were identified by exploratory factor analysis explaining 34.84% of the total variance and a three-factor model was confirmed to fit by confirmatory factor analysis.

CONCLUSIONS

FSA (Chinese version) is a reliable and valid scale for measuring discrimination degree against older adults in Chinese medical students.

Attitudes Toward Aging: A Glance Back at Research Developments Over the Past 75 Years

With global aging, it is crucial to understand how older adults and the process of aging are viewed by members of society. These attitudes can often influence how older adults are treated. Since the Journal of Gerontology was founded, we have gained increasing insights into attitudes toward aging, with several notable research developments, including clearer conceptualization of different types of aging attitudes (e.g., life-domain-specific attitudes and self-perceptions of aging), a wider variety of measurements, better understanding of how different social determinants shape aging attitudes, and more sophisticated investigations of cultural variance and invariance in aging attitudes. In this article, we highlight these major shifts in the field of aging attitudes in the past 75 years, discuss the contributions of these developments, and point to potential future directions.

A systematic review of existing ageism scales

Ageism has been shown to have a negative impact on older people's health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the 'Expectations Regarding Aging' met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the 'stereotype' dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing.