Aging and the Body: A Review

Beyond wrinkles: ageing, graphic medicine, and Zidrou and Aimée de Jongh's Blossoms in Autumn

Ageing, an inevitable biological process, is often oversimplified, subjecting elderly individuals to both positive and negative sociocultural stereotypes. Elderly individuals are stigmatised as passive, suffering and asexual, while simultaneously being expected to embody an active, successful and productive approach towards ageing. Departing from these narrow perceptions, this article draws examples from Zidrou and Aimée de Jongh's graphic narrative Blossoms in Autumn to provide a nuanced perspective on the ageing process. Using the affordances of comics, this essay examines how Blossoms in Autumn addresses unarticulated aspects of ageing, including changing bodily features, sexuality and intimacy, among others. In so doing, this essay challenges the unilateral perceptions of ageing.

"My wife made me": motivations for body and beauty work among older Korean and Chinese migrant adults in Australia

This article examines how older Korean and Chinese migrants living in Perth, Australia, engage in various beauty, grooming and fitness practices to negotiate "successful ageing" in transnational contexts. Drawing on semi-structured interviews with 30 men and women aged between 60 and 89, we examine what social meanings are attached to these practices, and how the transnational context of living in Australia has influenced the participants' perceptions of ageing and presentation of self in later life. Migration in later life is often considered in relation to the 'host' countries values and social practices, which can make it difficult for individuals to settle and feel a sense of belonging especially in later life. In this article, we will illustrate how gender, class, and cultural dispositions intersect and link with possibilities for defining and redefining successful ageing in migrant contexts. This study illustrates how successful ageing emerges as a malleable concept that draws on ideas of an ideal ageing body from the cultural values of the 'home' country, rather than the 'host' country. The findings illustrate how in everyday lived experience, the transnational habitus does not always necessarily result in a 'divided habitus' where the values of the 'home' country and that of the 'host' country are in conflict - even when the migration experience is relatively recent. Quite the contrary, the way the participants utilise everyday beauty, fitness and grooming practices to maintain a future-focused self in the context of 'home' country's age-appropriate body ideals to perform signifiers of 'successful migrant living' point to the positive aspects that appearance management can have on an individual in later life, particularly in migrant contexts.

Bright-siding stigma: Older adults' experiences at a higher weight in Atlantic Canada

The lived experiences of higher-weight people vary; homogenous samples may fail to capture this diversity. This study develops an in-depth understanding of the lived experiences of higher-weight (Body Mass Index ⩾ 30) older adults (⩾60 years of age) in a Canadian Atlantic province. Participants (n = 11) were interviewed face-to-face using a semi-structured interview guide twice at 2-to-3-month intervals regarding their perceived treatment in social and health situations; how positive and negative healthcare experiences affected their health, lifestyles and healthcare seeking-behaviour; and recommendations in terms of patient experiences, access and inclusion. Participants infrequently reported negative experiences; however, participants' experiences were informed by uptake of moralistic, neoliberal discourses. Thematic content analysis identified two major themes: active citizenship (participants demonstrated internalisation of the imperative for weight loss, healthy lifestyles and active ageing) and bright-siding (participants expressed that a positive attitude could prevent/help cope with stigma). Results suggest that individualistic, rather than collective, political solutions to health and stigma have been taken up by higher-weight older adults in a Canadian Atlantic province, which may hinder attempts at structural reforms addressing stigma.

Exploring Characteristics of Self-Defining Memories in Older Adults

The aim of this descriptive study was to investigate the Self-Defining Memories (SDMs) in a large sample of 181 older adults (65-90 years; mean age = 73.0 years) and to target the relationships between their different dimensions. The sampling method was nonprobabilistic, based on voluntary participation. Participants were asked to recall three SDMs. They also completed the Mini-Mental State Examination, the Hospital Anxiety and Depression Scale, and a Self-esteem Scale. Almost half of the SDMs were specific and more than a quarter were integrated. Specificity, tension, redemption, contamination sequences, and affective response varied regarding thematic content. Specificity was positively correlated to tension whereas autobiographical reasoning was positively correlated to redemption and negatively linked to emotional response and depression. This research highlighted that identity is constituted by the main types of events that make up a life: interpersonal relationships, life-threatening events, achievement, and leisure.

Aging as Adaptation

In traditional gerontological terms, adaptation is usually understood as the production of physical aids to mitigate the impairment effects caused by age-related disabilities, or as those alterations organizations need to make under the concept of reasonable adjustment to prevent age discrimination (in the UK, e.g., age has been a protected characteristic under the Equality Act since 2010). This article will be the first to examine aging in relation to theories of adaptation within cultural studies and the humanities. It is thus an interdisciplinary intervention within the field of cultural gerontology and cultural theories of adaptation. Adaptation studies in cultural studies and the humanities have moved away from fidelity criticism (the issue of how faithful an adaptation is to its original) toward thinking of adaptation as a creative, improvisational space. We ask if theories of adaptation as understood within cultural studies and the humanities can help us develop a more productive and creative way of conceptualizing the aging process, which reframes aging in terms of transformational and collaborative adaptation. Moreover, for women in particular, this process of adaptation involves engagement with ideas of women's experience that encompass an adaptive, intergenerational understanding of feminism. Our article draws on interviews with the producer and scriptwriter of the Representage theater group's play My Turn Now. The script for the play is adapted from a 1993 coauthored book written by a group of 6 women who were then in their 60s and 70s, who founded a networking group for older women.

"If this is what it means to be old…": a mixed methods study on the effects of age simulation on views on aging and perceptions of age-related impairments

Age simulation suits are a promising tool to increase empathy and to promote positive attitudes toward older adults. However, studies have largely focused on (young) healthcare professionals, are probably biased by social desirability, and have not addressed participants' views of the aging process triggered by the simulation. The current work combines two studies addressing effects of aging suits on both general and personal views on aging among heterogeneous samples, and exploring spontaneous associations during the simulation. In study 1, N = 165 adults (M = 37.1 years, SD = 15.4, range 18-74 years) answered questionnaires containing general views regarding older adults ("old people are…") as well as personal perceptions ("aging means to me…") before and after wearing an aging suit. In study 2, young adults (N = 22; M = 24.8 years, SD = 4.3, range 20-38 years) and middle-aged adults (N = 41; M = 60.8 years, SD = 6.9, range 40-75 years) carried out established geriatric assessments with and without aging suit, and spontaneous impressions on the instant aging experience were recorded. Findings indicated negative shifts in both general and personal views on aging measures in both age groups (d = .30 to d = .44). Analyses of qualitative data resulted in seven main themes, e.g., "strain/coordination", "future me", "empathy/insight". Group comparisons revealed higher frequencies of future-self related thoughts among middle-aged adults, whereas younger adults mentioned predominantly physical effects of the suit. In conclusion, applying age simulation suits might evoke unintended negative views on aging. In comparison with young adults, middle-aged adults showed broader reflections including thoughts related to emotions, future-self, and potential struggles of older people.

A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review

A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.

Physical activity interventions in older adults with a cognitive impairment: A critical review of reviews

This critical review explores the review material on physical activity combined with cognitive stimulation interventions in older adults with cognitive impairment and/or dementia. A critical, systematic, review of the review method was used, considering four electronic databases: WEB OF SCIENCE, SCOPUS, MEDLINE, and the COCHRANE ELECTRONIC LIBRARY. The search terms "exercise," "physical activity," "cognitive impairment," "dementia," and "systematic review" were used. All available reviews were marked against predetermined inclusion and exclusion criteria. There were 32 reviews that met the inclusion criteria. A combination of various types of training and aerobic exercises were the most frequently reported interventions; meanwhile, dual task training programs (combining physical exercise with cognitive stimulation), functional training programs along with exercises combination, aerobic exercise as well as strength, stretching, or balance workouts were also reported. The evidence is compelling; exercise can improve physical health by ensuring cognitive, psychological, and behavioral benefits. Overall, exercise can improve the physical and mental health of people living with dementia: there is sufficient evidence to recommend multimodal exercise.

Age and gender differences in misperceptions of body shape in a Taiwanese population

OBJECTIVES

Most studies of body size perception have been performed in adolescents, and most focus on gender differences in accurate perception of body size. This study investigated misperceptions of body sizes among males and females at different stages of adulthood in Taiwan.

DESIGNS

In-person home interviews were used to proportionally and randomly select 2095 adult men and women to answer the East Asian Social Survey. Participants were divided into 18-39, 40-64, and 65 + age groups. The main variables analyzed were self-perceived body size and standardized BMI.

RESULTS

Women, unlike men, were more likely to misperceive their body size as being overweight (OR = 2.92; p < .001). People with higher self-perceived social status were less likely to misperceive themselves as overweight (OR = 0.91; p = .01). People with college educations were 2.35 times more likely to overestimate their body size as being heavier than they were (p < .001) and less likely to underestimate it as being thinner than they were (OR = 0.45; p < .001). Women 18-35 and 36-64 years old were 6.96 and 4.31 times more likely (p < .001) to misperceive themselves as being overweight than women 65 or older, who were more likely to misperceive themselves as being too thin. There were no significant differences in body size misperceptions among the three age groups of adult men (p > .05). We found no different significant discrepancies between self-perceived body size and actual BMI between the older men and women (p = .16). However, younger and middle-aged men were 6.67 and 3.1 times more likely to misperceive themselves as being too thin than women in their same age groups (OR = 0.15 and OR = 0.32, respectively).

CONCLUSIONS

Age and gender affect self-perceptions of body size in Taiwan. Overall, women are more likely than men to misperceive themselves as being too big, and men are more likely than women to misperceive themselves as too thin. Older women, however, were more likely to misperceive themselves as being too thin. Clinicians and health educators should know that people's perceptions and concerns regarding their body size vary by age and gender.

Body image concerns in long-term head and neck cancer survivors: prevalence and role of clinical factors and patient-reported late effects

PURPOSE

Head and neck cancer (HNC) patients are at risk of long-term body image distress (BID). We aimed to investigate the severity of BID in long-term HNC survivors and to explore the associations between sociodemographic and clinical factors, patient-reported late effects, and cancer-related body image (BI) concerns.

METHODS

This cross-sectional study included quality of life and BI assessment in an 8-year (SD = 1.58) follow-up after treatment among 258 HNC survivors. Multinomial logistic regression analysis was used to investigate the relationship between three groups of BI concerns (no concerns, mild to moderate concerns, and BID) and patient-reported late effects. Sociodemographic and clinical variables were included in the model as covariates.

RESULTS

A total of 51.2% of participants had mild to moderate BI concerns, and 9.5% reported BID. Compared to those with no BI concerns, participants with BID were more likely to live without a partner, to have had radiotherapy and surgery, and to report worse emotional functioning and higher oral and throat pain. Compared to participants with no BI concerns, those with mild to moderate concerns reported higher oral and throat pain and speech problems.

CONCLUSIONS

Some level of cancer-related BI concerns persisted in the majority of HNC survivors many years after treatment, while a small proportion of survivors experienced BID. BI concerns were associated with treatment modality and patients' daily functioning and symptoms.

IMPLICATIONS FOR CANCER SURVIVORS

Insight into factors associated with BI problems may help to identify survivors at risk and may facilitate closer follow-up of survivors in need.

Examining health experiences and body dissatisfaction in two unique samples of patients with type 2 diabetes

Using cross-sectional data from two samples of adult patients with type 2 diabetes (n = 123 and n = 111), we used an embodiment perspective to examine whether health experiences were related to the extent of individuals' dissatisfaction with their bodies. The nature and strength of associations differed across the two unique samples examined, but weight status had the strongest and most robust association with body dissatisfaction in both samples. None of the associations differed as a function of gender or age. These findings contribute to an understanding of the complex relationship between physical and mental health in the context of diabetes.

"I'm still the queen and I'm still on my throne…": Women's reflections on gender and living with dementia

People with dementia have long been defined by the label of dementia, rather than by other aspects of their identities including gender. As a result, little research has focused on gender and dementia, particularly through the perspectives of those living with dementia. The purpose of this study was to explore the experiences and perspectives of women living with dementia. Specifically, we sought to understand how gender structured their experiences of receiving and coping with a diagnosis, services, and important relationships and supports. Utilizing a qualitative research approach, twenty-one women living with dementia participated in individual or group interviews. Women discussed the following aspects of gender and dementia: caregiver roles, perceptions of gender differences, the impact of dementia on families, and women's strength and resilience. The findings of this study indicate a clear need for further research to explore diversity and gendered experiences for those diagnosed with dementia.

Social Support and Body Image in Group Physical Activity Programs for Older Women

Physical declines with aging may negatively impact women's body image. Group physical activity can be a source of social support that may improve body image. We examined how social support experienced in group physical activity programs impacts older women's body image. Guided by interpretive description, we interviewed 14 women age 65 years and older who participated in group physical activity classes. Although women experienced both positive and negative body image, body image was generally positively impacted by physical activity. Four themes described social support processes that affected body image in the physical activity context: fitting in and being inspired through identifying with others; what is discussed and not discussed; providing comfort, understanding, and acceptance; and skilled and empathetic interactions with instructors. Understanding how social support in group physical activity can promote positive body image throughout aging can inform practical guidelines for facilitating and improving support in this context.

Body Satisfaction and Associated Predictors Among Baby Boomer Women in Rural and Urban Manitoba

Purpose: This study examines body satisfaction, weight attitudes, dieting behaviours, and aging concerns of baby boomer women (BBW; born 1946-1965) from rural and urban Manitoba.Methods: Primary data collection occurred November 2015, and 1083 participants completed the Body Image and Food Choice Survey. Four strata of BBW were represented to examine differences between older and younger BBW and location of residence. Multinomial logistic regression models were fit to determine predictors of weight and appearance satisfaction. Odds ratios and 95% confidence intervals were considered significant at p ≤ 0.05.Results: Fifty-three percent of participants were satisfied with their appearance, whereas only 34% were satisfied with their weight. Ninety-one percent desired to lose weight (29.9 ± 29.3 lbs). Aging anxiety was evident for 46% of participants and associated with appearance satisfaction (χ² = 27.46, df = 4, p < 0.001). Body work and dieting behaviours were used to mitigate body dissatisfaction, and media influence was associated with both appearance (χ² = 76.17, df = 6, p < 0.001) and weight satisfaction (χ² = 67.90, df = 6, p < 0.001). Desired weight change, appearance stress, appearance importance, and self-rated health predicted both weight and appearance satisfaction.Conclusions: There is a need for greater awareness of aging women's body image concerns and the need for age-appropriate tools/resources to help dietitians support women achieve a healthy body image.

Perception of dignity in older men and women in the early stages of dementia: a cross-sectional study

BACKGROUND

Dementia is a serious problem in old age, that impacts an individual's ability to function and may threaten personal dignity. Given the variable features of the illness and the diversity of life experiences, many factors may contribute to the perception of dignity by men and women with dementia. The purpose of the study was to explore the factors that contribute to dignity and its domains in men and women with dementia.

METHODS

This cross-sectional study involved 316 community-dwelling patients with early-stage dementia (aged ≥ 60) (PwD). We assessed the participants' sociodemographic and social involvement characteristics, health-related variables (pain, depression, physical performance, visual and hearing impairments), attitude to aging, and self-sufficiency in the activities of daily living (ADL). These factors were investigated as independent variables for the perception of dignity and of its domains in men and women.

RESULTS

Multivariate regression analysis showed that PwD experienced minor dignity problems in the early stages of dementia. In both men and women higher rates of depression, negative attitudes to aging, and pain were associated with reductions in the perception of dignity. In men, but not in women visual impairment had a negative effect on overall dignity, and on the associated domains of 'Loss of Autonomy' and 'Loss of Confidence'. In women, lowered self-sufficiency in ADL contributed to reduced self-perception of dignity and in the associated domains of 'Loss of Purpose of Life', 'Loss of Autonomy', and 'Loss of Confidence'. Sociodemographic and social involvement characteristics, hearing impairment, and physical performance did not influence the participants' self-perception of dignity.

CONCLUSION

The results suggested that several common factors (depression, attitudes to aging, and pain) contribute to the perception of dignity in both men and women. Other factors, visual impairments in men, and self-sufficiency in ADL in women, appear to be more gender specific. These differences might relate to their specific gender roles and experiences. The self-perception of dignity in PwD can be helped by supporting the individual, to the extent that their illness allows, in maintaining activities that are important to their gender roles, and that preserve their gender identity.

TRIAL REGISTRATION

NCT04443621.

Feminist embodiment, body talk, and body image among mothers and daughters

Guided by the developmental theory of embodiment, the current study explored feminist embodiment as a protective factor that may simultaneously promote more positive (and less negative) body talk and body image outcomes among mothers and their young adult daughters. Results from an expanded actor-partner interdependence model (APIM; N = 169 dyads) revealed that our construct of feminist embodiment, which was composed of feminist attitudes, mind-body connection, and psychological empowerment, has potential benefits for both mothers and daughters. Specifically, actor effects indicated that feminist embodiment was positively associated with both mothers' and daughters' body image, and it was indirectly associated with both women's own body image through more positive (and less negative) body talk. Additionally, partner effects revealed a number of direct effects between one's own body talk and the other's body image, and also that daughters' feminist embodiment was indirectly associated mothers' body image through daughters' positive body talk. This study highlights the empowering and supportive nature of mother-daughter relationships and suggests the potential body image benefits of women experiencing feminist embodiment.

One Line of Sexual Decline? Growth Mixture Modeling for Midlife Sexual Satisfaction

Most research has shown that sexual satisfaction in long-term relationships tends to decline over time. Studies showing the average trajectory, however, are limited by only assessing one slope. With longitudinal data from the Flourishing Families Project, Marital Instability Dataset, and the Iowa Youth and Families Project, we utilized growth mixture modeling to assess what trajectories of sexual satisfaction exist in midlife marriages. In the three samples (one individual, two dyadic), we found clear evidence for heterogeneous sexual satisfaction trajectories, for both wives and husbands. Through the datasets, we found some trajectories did decline over time. We also found stably high, stably medium, stably low, and some trajectories that showed an increase in sexual satisfaction over time. Overall, trajectories were similar for wives and husbands, though some classes had one partner with variability while the other was stable, some classes had trajectories with wives having higher sexual satisfaction than husbands, and some classes had trajectories with husbands having higher sexual satisfaction than wives. Demographic variables were not strong distinguishers of these differing trajectories. Both marital satisfaction and perceived marital stability trajectories (based on sexual satisfaction classes) generally had similar patterns to sexual satisfaction trajectories, with a few exceptions. Both marital satisfaction and perceived marital stability were less likely to significantly change over time, have discrepancies between wives and husbands, and have either low marital satisfaction or high perceived marital instability, even if sexual satisfaction was low. These data can help couples recognize various possibilities for sexual satisfaction over time, perhaps helping them to avoid cultural myths of inevitably declining sexual satisfaction.

The decline in physical activity in aging people is not modified by gender or the presence of cardiovascular disease

BACKGROUND

A physically active lifestyle decreases the progression of atherosclerosis and consequently reduces cardiovascular mortality. However, activity levels are hampered by aging. The association between aging and physical inactivity might be gender-specific or be modified by the presence of cardiovascular disease (CVD). In this study, we investigated if the association between aging and physical inactivity was different between men and women and between primary and secondary prevention patients.

METHODS

We performed a cross-sectional analysis of three primary care samples including primary and/or secondary prevention patients (total n = 4726). Baseline data for sample 1 were collected in the years 2013-14, for sample 2 in 2009-10 and for sample 3 in 2009. Activity levels were measured by the patient reported Rapid Assessment of Physical Activity questionnaire. A multilevel regression analysis was used to explore the association between aging and physical inactivity, adjusted for confounders. We examined potential effect modification by gender and the presence of CVD on the association between aging and physical inactivity.

RESULTS

Multilevel regression revealed that aging was consistently associated with physical inactivity in three out of three samples. This association was, however, not modified by gender or the presence of CVD.

CONCLUSIONS

Cardiovascular risk management interventions should aim at increasing or maintaining physical activity levels in aging primary care population. This study does not support the notion that extra emphasis should be put in targeting men or women, or people with or without the presence of CVD.

Aging as a Productive Process: A Critical Analysis of Aging Policy in Newfoundland and Labrador, Canada

There has been a growing focus on healthy aging in the political agenda. Discourses contained within policy documents have the potential to shape our notions of healthy aging and well-being. This comprehensive critical document analysis of provincial aging policies in Newfoundland and Labrador (2006-2015) contributes to a larger research study exploring aging women's notions of health and the body in relation to the aging process. The findings highlight how healthy aging discourses focus on the concept of productivity and how a certain type of health is required for ongoing contribution. The paper concludes by arguing that if healthy aging is framed around one's ability to remain productive, notions of health will remain limited to an externalized measure of output versus subjective experience of well-being.

Needs-appropriate services for people with young onset dementia: The perspectives of healthcare professionals

Young onset dementia has become a growing challenge in national healthcare systems. Concerns about the situation have already been expressed; however, they mostly report the views of services end-users. Aimed at finding out useful further improvement, interviews documenting the working experiences of professionals addressing healthcare services to people with young onset dementia (YOD) were analysed qualitatively. The interviews resulted in four themes and twelve categories. The themes regarded services' complexity and responsiveness, the levels of education and knowledge on YOD, the impact that serving people with YOD reflects on staff working experience and quality of life, and a series of proposals aimed at improving services by giving people with YOD and families the provision of care they deserve. Although some of the themes recapped the ones reported in the previous literature, the mixture of internally and externally driven instances represented in the themes depict the complexity of care delivery in the services. Findings are discussed in the light of a pragmatical framework capable of suggesting what changes services should implement to be timely responsive.

Reduced to curtain twitchers? Age, ageism and the careers of four women actors

Cultural gerontology has developed critical work around cultural representations of age and aging and their role in the reproduction of ageism. However, the cultural industries as producers and disseminators of representations remain under researched. This paper draws on a focus group with four older women actors to argue that workforce allocation and assumptions about audience demographics intersect with cultural attitudes around women's aging to impact on older women actors' career opportunities. We argue that ageism within the cultural industries is limiting our ability to develop diverse and non-ageist cultural representation of women's aging.

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.

Dance Intervention Affects Social Connections and Body Appreciation Among Older Adults in the Long Term Despite COVID-19 Social Isolation: A Mixed Methods Pilot Study

The ability of dance to address social isolation is argued, but there is a lack of both evidence of such an effect and interventions designed for the purpose. An interdisciplinary research team at University of Calgary partnered with Kaeja d’Dance to pilot test the effects of an intervention designed to facilitate embodied social connections among older adults. Within a mixed methods study design, pre and post behavioral tests and qualitative surveys about experiences of the body and connecting were administered to thirteen participants along with test instruments of loneliness and body appreciation. In the short-term, no significant changes were found on quantitative tests. Exploratory analysis revealed intervention improvements on individual body appreciation questions only. This indication of change was strongly supported by converging qualitative data and identified as relating to: increased connection through task-based collaboration, increased awareness of interpersonal boundaries, and a shift to experiencing the body as responsive. These indications of increased relational capacity were deemed likely to cause further impact in the long term. Examining this possibility and the subsequently arisen factor of COVID-19 risks and restrictions, test instruments were administered again to 10 participants 4 and 5 months after the intervention. A significant increase in loneliness was found. Despite this negative impact of COVID-19 isolation, several positive intervention changes remained detectable and some continued to increase over time. Seventy percent of the participants, who made new social contacts during the intervention and later sought continued contact, improved significantly across all body appreciation measures over the full study. The qualitative data from the last two time-points revealed both consistent values and new, negative changes. While these preliminary findings speak to the durability of intervention changes, they also identify areas of urgent priority to help older adults restore embodied relational capacity that has declined during COVID-19. Within the limitations of a small-sample pilot study, converging mixed methods results support the hypothesis that dance interventions designed for the purpose can positively affect the social inclusion of older adults. Although we recommend further study, these promising results also indicate that dance interventions can help older adults recover from pandemic isolation.

Frailty indexed classification of Bangladeshi older adults' physio-psychosocial health and associated risk factors- a cross-sectional survey study

BACKGROUND

Frailty is associated with healthy ageing, and it has been identified as a means of measuring older adults' physio-psychosocial health. We know about the ageing trends and common diseases of older adults living in South Asia, but literature to date does not widely feature their health status based on frailty, especially in Bangladesh. This study aims to understand the prevalence of frailty in Bangladeshi older adults; classify their health status; and investigate associated risk factors.

METHODS

A cross-sectional study was conducted in the north-eastern region (i.e. Sylhet City Corporation) of Bangladesh. Four hundred participants aged 55 years and above were randomly selected, attended a health assessment session and completed a multi-indicator survey questionnaire. We developed a 30-indicator Frailty Index (FI30) to assess the participant's health status and categorized: good health (no-frailty/Fit); slightly poor health (mild frailty); poor health (moderate frailty); and very poor health (severe frailty). Pearson chi-square test and binary logistic regression analysis were conducted.

RESULTS

The participants' mean age was 63.6 years, and 61.6% of them were assessed in poor to very poor health (moderate frailty/36.3% - severe frailty/25.3%). The eldest, female and participants from lower family income were found more frailty than their counterparts. Participants aged 70 years and above were more likely (adjusted OR: 4.23, 95% CI: 2.26-7.92, p < 0.0001) to experience frailty (medical conditions) than the pre-elderly age group (55-59 years). Female participants were more vulnerable (adjusted OR = 1.487, 95% CI: 0.84-2.64, p < 0.0174) to frailty (medical conditions) than male. Also, older adults who had higher family income (Income>$473.3) found a lower risk (adjusted OR: 0.294, 95% CI: 0.11-0.76, p < 0.011) of frailty (poor health).

CONCLUSION

Our study results confirm the prevalence of frailty-related disorders in Bangladeshi older adults and highlight the importance of targeted clinical and community-led preventive care programs.

Effects of Appearance- and Performance-Enhancing Drugs on Personality Traits

Appearance- and performance-enhancing drugs (APEDs) are commonly used by adolescents and young adults in an effort to improve not only athletic performance but also physical and mental efficiency and sexual appearance. The rationale for using these drugs is grounded in the perceived importance of external appearance, the quest for health and youth, and the urge to boost one's sexual performances. Although APED users tend to be quite moderate overall, some specific subpopulations can display pathological use associated with high-risk behaviors. A wide and diverse range of APEDs is now easily accessible to almost anyone through backdoor online avenues. Common APEDs include anabolic-androgenic steroids, non-steroidal anabolics, anorectics, diuretics and ergo/thermogenics, nootropics or "cognition enhancers," licit and illicit psychostimulants, and finally, sexual enhancers. The use of APEDs appears linked to several psychopathological disorders of unclear prevalence, e.g., body image disorders and eating disorders, perfectionism, but also depression and loneliness. The role of personality traits related to APED use has been investigated in adolescents and young adults, in elite and amateur athletes, and in chemsexers and associated with the above-reported personality traits. The studies herein analyzed show that APED consumption in the general population is quickly growing into a public health concern. It is therefore essential to launch prevention and intervention projects aimed at promoting safe instrumental use of the body, not only in sports disciplines but also among the general population, and to promote psychological aid procedures for people with substance use issues, depression and anxiety, and body image disorders.

From double to triple standards of ageing. Perceptions of physical appearance at the intersections of age, gender and class

Since the 1970s, when Susan Sontag coined the term, discussions on the double standard of ageing has continued to evolve. Recently, scholars of feminist gerontology have called for an intersectional approach to address cultural norms of physical appearance and ageing. In this paper, we aim to investigate whether men and women internalise ageist norms differently; that is, double standards of ageing exist. Second, we explore whether self-identified social class affects the internalisation of these norms. To the best of our knowledge, the present study is the first to examine the double and triple standards of ageing with nationally representative data (N = 1600). Drawing from Bourdieusian capital theory, sociology of the body, consumer culture, and feminist gerontology, we suggest that the double standard of ageing exists for women who feel that ageing erodes their appearance, give more importance to their appearance than men, and fear looking old from an early age. Further, a 'triple standard' is also traced. Our results indicate that ageing working-class women are less confident about their appearances than upper-class women. Thus, upper-middle-class women seem less vulnerable to the negative aspects of ageing than women who have less social, cultural, and economic capital to enhance their ageing appearance. The triple standard extends to men as well: appearance is evaluated as equally important by upper-middle-class middle-aged men as by women of similar age and social background. Alternatively, our results could be interpreted as upper-middle-class people experiencing more restrictive norms regarding ageing; that is, such people are compelled to seek anti-ageing solutions and are not allowed to surrender to the natural ageing process.

A systematic review of tools used to assess body image, masculinity and self-esteem in men with prostate cancer

OBJECTIVE

Masculinity, body image and self-esteem are important interlinked factors affecting prostate cancer (PCa) patients' quality of life. The aim of this systematic review was to identify and evaluate all tools measuring these domains in men with PCa.

METHODS

This review was conducted according to PRISMA guidelines with a priori protocol registered. Pubmed, Embase, Medline and Psychinfo were searched from inception to May 2020. Studies using a predefined tool which measured any body image, self-esteem or masculinity construct in men with PCa were included, as well as validation studies of these. Reliability, validity and responsiveness of tools identified were objectively evaluated against the COSMIN taxonomy of measurement properties.

RESULTS

From 1416 records screened, a final 46 studies consisting of 17 different tools were included in the systematic review. Seven tools were identified assessing body image, nine masculinity and one self-esteem, varying widely in their number of items, possible responses and domains assessed. Most tools had evaluated internal consistency through Cronbach's alpha analysis; however, structural and discriminative validity, and responsiveness were lacking for many. Additionally, only one tool identified was specifically developed and evaluated in patients with PCa: The Masculinity in Chronic Disease Inventory.

CONCLUSIONS

Numerous tools have been used for the measurement of body image, masculinity and self-esteem in men with PCa. However, few were developed specifically for these patients. More research is therefore needed to ascertain specific factors affecting these outcomes in PCa patients, so valid, reliable and clinically relevant tools can be developed.

Pleasure and time in senior dance: bringing temporality into focus in the field of ageing

Population ageing and discourses on healthy ageing have led to a growing interest in social dancing for seniors. While senior dance has been described as both common and contributing to good health, the fundamental connection between bodily and temporal dimensions has been fairly neglected. As a result, there is a risk of portraying dance among older adults as a general practice, while at the same time the senior dance's potential to shed light on relations between temporality and ageing is not utilised. Based on qualitative interviews with 25 women and eight men, aged 52–81, in Sweden, whose main leisure activity was dancing, this article sheds light on this knowledge gap by illustrating the pleasurable experiences of senior dance. The results illustrate that the pleasurable experiences of dancing can be understood as three different experiences of temporality: embodied experience of extended present, an interaction with synchronised transcending subjectivities and age identities with unbroken temporality. The results also highlight the central role that temporal aspects play in processes around subjectivities in later life, as well as the close connection between ageing embodiment and temporality. They also illustrate the ability of dance to create wellbeing, not only through its physical elements, but also through the sociality that constitutes the core of dancing. In light of these results, the article argues that the temporal processes relate to individuals’ diverse relationship with the world and that they therefore play a central role in subjective experiences of ageing.

Discussing the effects of prostate cancer beyond biographical disruption and new normalcy: the experiences of men with prostate cancer in Germany

The concept of biographical disruption has been used to explain the experience of a cancer diagnosis. Studies on cancer experience increasingly suggest that people diagnosed in older age may not have such disruptive experiences. Prostate cancer is diagnosed more often in older men and is often considered a disease of old age; furthermore, the signs of illness in prostate cancer and the signs of ageing might become convoluted. With this in mind, this paper aims to explore how 42 men with prostate cancer who participated in an interview study respond to and make sense of bodily changes. The sample was selected using a maximum variation strategy in order to describe a range of possible experiences with prostate cancer. Analysis was conducted thematically. The men's narratives tell of the constant process of dealing with ageing-related and/or cancer-related changes to both their bodies and their social interactions, and their struggle to disentangle the related effects of ageing and/or cancer on their bodies. We describe how men "muddle through" problems of urinary leakage, potency and loss of libido. We then identify how men attributed changes as part of ageing and/or cancer to (better) manage the experiences of loss.

"No matter how old I am, I don't like what my stomach looks like." Lifespan perspective on the changes in self-assessment of attractiveness and life satisfaction in women

The study aimed to examine the association between self-assessment of attractiveness and life satisfaction in women, where age was a potential moderator of this relationship. A cross-sectional study of 360 women aged 18 to 89 was performed. Participants assessed their overall attractiveness, the attractiveness of their individual body parts, and their life satisfaction. The relationship between the assessment of attractiveness of particular body parts and life satisfaction depended on age. The results indicate that not only overall self-attractiveness, but also the perceived attractiveness of particular body parts (different in each distinguished age group: 18-25, 30-45 and 60+) can be considered predictors of life satisfaction in women.

The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countries

Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60-75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further.

Body image satisfaction and loneliness among young adult and older adult age cohorts

BACKGROUND

Lower body image satisfaction has been linked with greater loneliness among young adults, but this relationship has not been investigated among older adults.

OBJECTIVE

The purpose of the current study was to investigate the relationship between body image and loneliness among young and older adult age cohorts as well as explore stigma consciousness as a mediator between body image dissatisfaction and loneliness among older adults.

METHODS

Participants consisting of 459 young adults and 353 older adults over the age of 59 completed a cross-sectional survey regarding health and perceptions of aging from fall 2017 through spring 2018.

RESULTS

Young adults had lower levels of body image satisfaction and higher levels of loneliness in comparison to older adults. The relationship between loneliness and body image satisfaction was stronger among young adults when compared to older adults. Among older adults, stigma consciousness mediated the relationship between body image satisfaction and loneliness.

CONCLUSION

Older adults lower in body image satisfaction may be more conscious of age-based stigmas and thereby have greater loneliness.

Body satisfaction and self-esteem among middle-aged and older women: the mediating roles of social and temporal comparisons and self-objectification

Objectives: The relationship between body satisfaction and self-esteem among older women is understudied, in particular the potential mechanisms underlying the relationship. The purpose of this study was to investigate social and temporal comparisons and self-objectification, their relationship to body satisfaction and self-esteem, and the extent to which they mediated the relationship between body satisfaction and self-esteem.Method: Women (N = 180) between the ages of 55 and 91 (mean age = 66 years) completed questionnaires assessing body satisfaction, self-esteem, social and temporal comparisons, and self-objectification.Results: Most correlations between body satisfaction, social and temporal comparisons, self-objectification, and self-esteem were highly significant in the expected directions. Upward temporal comparison was used most frequently followed by downward social comparison. Upward temporal comparisons most often targeted the 30 s and 40 s, while social comparisons most often targeted same age peers. Women were more likely to endorse competence-based over appearance-based self-objectification items. Upward and downward social comparison mediated the relationship between body satisfaction and self-esteem, with the strongest indirect effects among younger women.Conclusion: This study highlights the importance of temporal and social comparison in maintaining body satisfaction among middle-aged and older women and their tendency to emphasize competence versus appearance in evaluating their bodies. Results are discussed in the context of developmental and cohort effects that influence body satisfaction among older women.

Feeling Old, Body and Soul: The Effect of Aging Body Reminders on Age Identity

OBJECTIVES

Although changes in body functioning and appearance signal the aging process to ourselves and others, studies give limited attention to the effect of bodily experiences of aging on age identity. Our study examines the effect on age identity of 3 categories of aging body reminders: everyday body problems, body repairs, and body aids.

METHODS

Hierarchical linear models are run using 5 waves of the National Health and Aging Trends Study (2011-2015). Models predict the effect on age identity of change in the count of everyday body problems (e.g., pain), body repairs (i.e., surgeries and medications), and body aids (e.g., hearing aids).

RESULTS

Increases in everyday body problems and body repairs (in particular, medications) predict older identities, with the strongest average effect found for everyday body problems. These results are observed in models controlling on health, suggesting that body reminders exert independent effects.

DISCUSSION

Our study reveals a realm of aging experiences-bodily experiences-that influence age identity. Avenues for further research include examinations of other aging body reminders, as well as variation across individuals.

Improvement of Body Satisfaction in Older People: An Experimental Study

Aging typically manifests itself in a variety of physical and cognitive alterations and challenges that are not always easily accepted. Feeling dissatisfied with these changes can also affect the mood and self-esteem of older people causing body image problems. The present study focuses on body satisfaction in Spanish older people (176 participants; M and SD = 64.03 ± 1 8.06; age range 50 to over 75) by employing experimental research to test whether psychosocial interventions may have a positive impact. Our aims are threefold: (1) To describe the body satisfaction of older people considering intervening variables, such as age, gender, having a stable partner, time of the year, and place of residence; (2) to compare body satisfaction improvement in older people participating in a specific body satisfaction program designed for this purpose versus a non-specific program run by the Spanish Red Cross; and (3) to examine the relationship between age, gender, having a stable partner, time of the year, place of residence, body satisfaction and participating in the experimental condition. The IMAGINA specific body image program yielded a significant improvement in body satisfaction when compared with the non-specific program in both men and women regardless of marital status and in some age groups: 50 to 54 years old, 60 to 64 years old, and 65 to 69. Male participants, as well as singles, were more satisfied with their bodies, and the contrary was true for divorced and separated. The IMAGINA program was particularly useful in participants with more body image problems. As shown, the pressure to fit beauty standards and related problems do not go away with age, a fact that is embodied and experienced differently in men and women.

Demographic aging and biopower

The aging of the world's population is an unprecedented recent phenomenon in human history, as for millennia - at least from the Neolithic to the mid-18th century - the age structures of human populations have changed little. The question posed by this anthropological perspective seems at first sight quite simple: how did this aging come to be? We will see that from a demographic point of view, the answer seems trivial: a basic shift in population structure is at the origin. However, we will go further by exploring the historical and political conditions of this transition by mobilizing the Foucauldian notion of biopower. We argue that this notion has the heuristic advantage of linking several core processes at work in the demographic transition. Although our analysis focuses on France to illustrate the notion of biopower in Foucault's work, we also discuss several non-western societies to explain why demographic aging is inevitable across the globe due to biopower strategies and "dispositifs". This article also constitutes a reflexive analysis on our practices as gerontologists and on the widespread "successful aging" concept.

"I Have to Listen to This Old Body": Femininity and the Aging Body

BACKGROUND AND OBJECTIVES

This study explores how older women with low socioeconomic status living in rural Tanzania give meaning to their (aging) body in relation to the ideals of femininity.

RESEARCH DESIGN AND METHODS

Ten qualitative in-depth interviews and 10 focus group discussions (N = 60) were conducted among women aged 60 and older.

RESULTS

The findings reveal that older women perceive their aging body as "a burden." This characterization of the body is linked to the inability of the aging body to live up to the women's gendered lives. The conflict between their physical limitations and the desire to perform gendered tasks (internalized feminine habitus) affect the women's process of self-identification. This led to emotional distress and subsequently threatened their survival and well-being.

DISCUSSION AND IMPLICATIONS

The results suggest that older women need to be supported through interventions that are tailored to their cultural and socioeconomic context.

Evaluating an abbreviated three-factor version of the Eating Disorder Examination Questionnaire in three samples

A brief, three-factor structure for the Eating Disorder Examination-Questionnaire (EDE-Q) has been identified that has stronger psychometric properties than the original four-factor EDE-Q structure. However, there is a need for independent replication of the brief version in different samples, and examination of how comparable the brief version is in women and men of diverse ages. This study compared factor structure fit and other psychometric properties between the original and brief versions in three independent samples of adults to evaluate the reliability and validity of this brief version. It also examined measurement invariance across gender in a middle-aged community sample. Participants included university women (N = 659), university women and men (N = 358), and crowdsourced community women and men (N = 544). Across samples, compared to the original version the brief version demonstrated greater internal consistency, somewhat less item overlap, and superior model fit in confirmatory factor analyses, although some fit indices fell below recommended cut-offs. Separate confirmatory factor analyses of the brief version in community women and men suggested the brief version may better fit community men than women, and measurement invariance across gender for the brief version was not supported for the community sample. This independent replication supports the factorial validity of the brief version in three samples of students and crowdsourced community adults, and highlights the importance of further examination of the psychometric properties of this brief three-factor version across gender and age categories, among others sample characteristics.

Sexual Orientation and Gender Differences in Aging Perceptions and Concerns Among Older Adults

Background and Objectives

Ageism (negative attitudes and behavior toward older adults) is a serious social issue and is of growing concern as the population of older adults continues to increase. Research demonstrates that negative aging perceptions and aging concerns are associated with poor health and well-being among older adults; yet, few studies have examined sexual orientation or gender differences in aging perceptions and concerns among older adults.

Research Design and Methods

The current online study examined aging perceptions and concerns among a national community sample of 821 (female = 464) participants (76 lesbian, 159 gay, 88 bisexual, 498 heterosexual participants) ranging from 45 to 80 years of age (M = 55.56).

Results and Discussion

Older women reported more aging anxiety and endorsement of aging stereotypes while older sexual minority individuals reported heightened general aging concerns compared to their heterosexual peers. Among sexual minority participants, discrimination based on age and sexual orientation predicted greater sexual minority-specific aging concerns, anxiety, and depression. Experiencing sexual orientation discrimination buffered age discrimination’s impact on sexual minority-specific aging concerns, suggesting that experiencing discrimination based on one stigmatized identity (sexual minority) may promote effective coping with discrimination based on another stigmatized identity (older adult). Conversely, age and sexual orientation discrimination had multiplicative effects on anxiety and depression.

Implications

Overall, findings point to the importance of examining sexual orientation and gender differences in aging perceptions and concerns to more fully understand the experiences, health, and well-being of the growing older population. Implications for future directions are discussed.

Age-related changes in the sense of body ownership: New insights from the rubber hand illusion

How do age-related changes affect the sense of body ownership? This study tackles this issue by means of the rubber hand illusion (RHI), a widely used experimental tool for investigating the sense of body ownership. There is ample literature on the RHI in young populations, but research on age-related changes in the RHI is still scarce. Here we extend the use of the RHI to examine the changes in the sense of body ownership related to healthy aging. Subjective reports (i.e., questionnaire) and proprioceptive drift were compared among young (n = 22, age range 20-22 years), middle-aged (n = 22, age range 44-55 years), and older adults (n = 22, age range 60-72 years). A stronger subjective experience of illusion was observed in the young and older adults as compared to the middle-aged. No differences in proprioceptive drift were found between the three groups. These findings are discussed in relation to: 1) different stages of development of perceptual and cognitive components of the sense of body ownership, and 2) compensatory mechanisms.

Resistance and acceptance: Ambivalent attitudes toward the aging body and antiaging practices among older Korean migrants living in New Zealand

Using intersectionality as a conceptual framework, this study investigated how older Korean women living in New Zealand perceived their aging bodies, antiaging practices and/or products, and how they used such products. Thematic analysis identified three themes: tension between acceptance of the aging body as an inevitable process and transformation of the aging body into a healthy body, juggling between abstinence and use of antiaging products and practices, and redefining natural aging. The findings challenge binary interpretations between "acceptance" of and "resistance" to the experiences of the aging process and the use of antiaging practices.

A lifeworld phenomenological study of the experience of living within ageing skin

Understanding people's experience of skin ageing as it is lived can enable sensitive approaches to promoting healthy skin and to care in general. By understanding the insider perspective, what it is like for individuals, a way to sensitise practice for more humanly sensitive care is offered. Through interviews with seventeen community-dwelling older people, the essential meaning of living within ageing skin was illuminated as a state of managed inevitability. The skin is inevitably changing, and ageing skin is a marker of change over time but the person within remains. Constituents of the phenomenon comprise the experience of unfamiliar sights and sensations given by ageing skin; facing and accepting bodily changes and seeing this back and forth in family connections; taking care of the skin "to face" the world; and to present oneself to others and a different place in the world, same person, changed body. Findings point to why and how nurses can treat older people as persons by not over emphasising a view on ageing bodies or bodies with aged skin alone, but in tempering this view with deeper existential insights, meeting the older person with a skin care need as a person and not just as a physical entity.

Unacknowledged distinctions: Corporeality versus embodiment in later life

The focus upon the body in the social sciences has had a growing influence in recent years on aging studies. Various terms have been used to explore the relationship between the body and society, of which 'corporeality' and 'embodiment' have taken pride of place. In this paper, we present the case for drawing a clear distinction between these two terms and the consequences that follow from it for the study of the body in social and cultural gerontology. Central to this distinction is the place of social agency. Corporeality, we suggest, refers to the role of the body as a set of structures whose identity and meaning is mediated by culture and society. Embodiment, in contrast, refers to the processes by which social actors realise distinction, identity and lifestyle through the medium of the body. Making this distinction sharpens the difference between studies that address self and others' reactions to physical changes in bodily function attributable to aging and/or age associated illness and impairment and studies that focus on the 'performance' of aging and the contested realisations of identity and lifestyle in later life. While the latter primarily reflects the concerns of 'third age' studies the former addresses the concerns more directly associated with 'fourth age' studies.