Breaking the links between ageism and health: An integrated perspective

Ageism refers to prejudice, stereotypes or discrimination based on a person's actual or perceived chronological age. While ageism can affect people at all stages of the human lifespan, ageism against older adults has emerged as the most pervasive and potentially harmful. Much is now understood about how ageism can impact older people's health and wellbeing via structural, organisational, and provider level biases that threaten the provision of equitable and ethical healthcare. Negative attitudes about age and ageing also contribute to workforce shortages in aged care sectors, such as residential aged care and nursing. However, often underappreciated is how self-directed ageism, which refers to ageism turned against oneself, can also be an important determinant of health and wellbeing. Relative to external sources of ageism, negative internalised ageist beliefs are not only experienced more frequently in older adults' everyday lives, but are also more strongly linked to their health and wellbeing. Here we highlight how this understanding means that eliminating ageism requires a multifaceted approach that targets not only health care systems and aged care professionals, but older people themselves. Because normal age-related cognitive changes in how we think, perceive and reason increase the risk of older people viewing themselves through a negative and ageist lens, we provide a novel discussion of how broader insights from cognitive ageing literature must play a central role in any agenda focused on breaking the links between ageism and health.

Perceptions of older adults and generativity among older citizens in Japan: a descriptive cross-sectional study

BACKGROUND

As the population ages worldwide, including in Japan, there is a growing expectation for older adults to remain active participants in society. The act of sharing one's experiences and knowledge with younger generations through social engagement not only enriches the lives of older individuals, but also holds significant value for our society. In this study, we examined both positive and negative perceptions of older adults and investigated the correlation between these perceptions and generativity among older citizens. Additionally, we evaluated the impact of life satisfaction on these factors.

METHODS

We conducted a survey of 100 older adults in Japan (mean age, 71.68 years) and utilized multiple regression analyses, using positive and negative perceptions of older adults, life satisfaction, and demographic factors as independent variables. The sub-categories of generativity-namely, generative action, concern, and accomplishment-were used as dependent variables.

RESULTS

Participants who held a more positive perception of older adults demonstrated a higher level of generative actions and concerns. Additionally, participants who reported higher levels of life satisfaction also exhibited more generative actions, concerns, and accomplishments. Conversely, those who held a more negative perception of older adults were found to have higher levels of generative actions.

CONCLUSION

Enhancing positive perceptions of older adults among them can boost the sub-categories of generativity. This study, which was conducted from an exploratory perspective, has several limitations, including a potential sampling bias. A more comprehensive examination of the relationship between perceptions of older adults and generativity is anticipated in future research.

Educating dental students to provide compassionate age friendly care for older adults

As the world population ages, the need for age friendly care increases. In dentistry, age friendly care requires an appropriate comprehension of multiple factors that can be categorized in socio-economic circumstances, systemic health problems, and oral health conditions. In addition to the understanding of these factors and its relationships among each other, the future dental workforce should also be aware of unconscious and pervasive societal stereotypical perception of older persons, aging, and being old, which results in ageism and ageist attitudes. Dental schools can play an important role on raising ageism awareness and combating ageism in healthcare, thus preparing the future of the dental workforce to provide compassionate age friendly care. This paper will discuss ageism in dental schools and learning strategies used to combat it and increase compassionate care delivery for older adults.

The cognitive tenacity of self-directed ageism

Ageism refers to prejudice or discrimination based on a person's age. When ageism is directed at older people, it is unique in two ways: it is socially condoned in a manner that other types of prejudice are not, and the animus is eventually self-directed. Of central interest here is why ageism becomes self-directed in late adulthood, despite its potentially harmful personal costs. We present a cognitive model in which negative ageist beliefs become increasingly accessible and difficult to eliminate owing to broader developmental shifts in mentation. Given that these effects are contingent on our social environment, systemic changes in societal conceptions of age and aging are needed if we are to reduce vulnerability to self-directed ageism.

Effects of Stereotype-Focused Imagined Contact on Young Adults' Intentions for Intergenerational Interaction

OBJECTIVES

Face-to-face intergenerational contact is associated with more positive attitudes toward older adults. However, such contact can be difficult to achieve, and poor contact experiences can have negative consequences for intergenerational relations. We examined whether mentally simulated intergenerational contact (which is more easily facilitated and controllable) could reduce young adults' inclinations to avoid intergenerational interactions by increasing their inclusion of the older outgroup in the self (IOS), and by enhancing their stereotypes of older adults' warmth and competence.

METHOD

We conducted an online experiment with 373 young adults from the United States. Participants imagined talking with an older adult (aged 70-75 years) in the circumstances intended to make salient either the older adult's warmth or their competence.

RESULTS

Both manipulations increased young adult participants' IOS with respect to older adults, which in turn predicted more positive assessments of older adults' warmth and competence. IOS, along with ratings of warmth and competence, inversely predicted the desire to avoid future interaction with older adults.

DISCUSSION

Findings indicate the viability of a simple and accessible intervention to improve intergenerational relations, which can be tailored to address different goals (e.g., encouraging intergenerational friendships vs. encouraging support for equal rights of older members of the workforce).

Who will treat older patients? Should medical education focus more on activities aimed at displaying positive attitudes toward older people? The prevalence of ageism among students of medical and health sciences

In the conditions of an aging society, a justification is found to explain the issue of the attitude of future health care workers, who are to care for elderly people in the future, toward these people, which will make it possible to predict in advance what problems related to the care of seniors may soon arise. After clarifying this issue, it will be important to distinguish the individual factors influencing this attitude in order to determine which social phenomena will require special attention. Eight hundred and three medical and health sciences students participated in the research from various fields of medical studies. A Survgo system was used, where an online questionnaire was placed and then posted in social media. Only students of medicine and healthcare facilities participated in the study. The first questionnaire contained socio-demographic questions. Then, the KOAP questionnaire and Welch's t-test were used, and finally the proprietary questionnaire on contact with seniors. Analyses were conducted using the R Statistical language. Scores on the KAOP questionnaire ranged from 122.4 to 134.57. The highest scores were shown for physiotherapy students and the lowest for pharmacy students. The highest level of attitude toward elderly was reported in students of 1st to 3rd year of study. For 4th-5th year or supplementary level students, attitude levels were decreasing. Welch's t-test showed that the level of attitude toward old people in men was significantly higher than in women. There was no significant correlation between the age factor on the quotient scale and the KOAP score. Married individuals had significantly higher KAOP scores compared to singles and those in an informal relationship. No significant differences between the study stage factor and KAOP score have been found. Those who live and/or have regular contact with the elderly were characterized by higher KAOP questionnaire scores. The attitude toward the elderly depends on many factors, such as the chosen field of study, stage of education, contact with the elderly, gender or marital status. In order to develop proper contact with seniors, the solution may be to influence modifiable factors, especially the correct education of future health care workers.

Nurses' perspectives on caring for and attitudes towards adults aged eighty years and older

BACKGROUND

Adults aged 80 years and older form a vulnerable group regarding perceived ageism, because they are often stereotyped as being frail and dependent. Nurses often display biased behaviour and hold negative attitudes towards this age group, due to the fact that they have frequent contact with patients who need complex care. As this frequent contact can negatively influence the quality of care, we performed this study to assess nurses' attitudes towards adults aged 80 and older and their views regarding their care, as well as to identify factors that influence attitudes.

METHODS

A cross-sectional study design was used. A convenience sample of 1179 Austrian nurses was taken, and their attitudes were measured using the Ageing Semantic Differential (ASD) Scale. Their views on caring for older adults were assessed with the Perspectives on Caring for Older People (PCOP) Scale. Multiple linear regression was used to examine factors that influence nurses' attitudes. The Ethics Committee of the Medical University of Graz (EK Number 31-320 ex 18/19) gave their ethical approval for this study.

RESULTS

Nurses display neutral to positive attitudes towards adults aged 80+ and view caring for them positively. Positive attitudes were indicated, for example, by the factors of a positive view towards the care of older patients, a higher education and a personal relationship with older adults. Negative attitudes were indicated by the factors of being female and interacting more frequently with older care receivers.

CONCLUSIONS

Although the nurses' attitudes were not negative, they should be encouraged to view this patient population more positively. Educational interventions to alter nurses' attitudes and thus to improve the quality of care are recommended. As the ASD measures some aspects of ageism, it is recommended to consider qualitative methods in future studies to obtain a deeper knowledge of ageism in nursing care.

Psychosocial predictors of young male workers’ discrimination against older workers in Japan: comparison of four models

To create environments conducive to the wellbeing of workers, especially older workers, it is important to gain insight into ageism among young workers as a distinct segment in the workplace. However, this ageism remains unclear. This study explored the psychosocial predictors of discrimination against older Japanese workers by their younger male counterparts. Four models – Intergroup Contact Theory (ICT), Knowledge–Attitude–Behaviour Model (KABM), Terror Management Theory (TMT) and Frustration–Aggression Theory (FAT) – formed the basis of the study. All the models included positive and negative dimensions of stereotypes as mediators between predictors and discrimination. Data from 874 participants were obtained through a voluntary web survey for employees aged 25–39 years who lived in the Tokyo metropolitan area. A scale describing interactions with older workers (supportive, uncomfortable and avoidance), Facts on Ageing quiz, fears of being an older worker and a job dissatisfaction survey were employed to examine the hypotheses based on the above theories. The results supported the hypotheses based on ICT and FAT but not KABM. Higher supportive contacts were significantly related to lower discrimination mediated by a higher positive and lower negative dimension of stereotypes. Contacts characterised by higher discomfort were significantly related to higher discrimination mediated by a lower positive and higher negative dimension of stereotypes. Higher job dissatisfaction was related to higher discrimination mediated by lower positive stereotypes. Interestingly, higher fear of being an older worker was significantly related to lower discrimination mediated by higher positive stereotypes, contrary to the TMT-based hypotheses. Thus, ICT and FAT regarding ageism can explain young male workers’ discrimination against older workers in Japan, which differs culturally from Western countries. Furthermore, the results of the study suggest that boosting the quality of interactions as well as reducing bad interactions with older workers contribute to lower discrimination.

We Were All Once Young: Reducing Hostile Ageism From Younger Adults' Perspective

The worldwide spreading pandemic, COVID-19, has caused hostile ageism toward older adults. We adopted a new intervention to reduce such hostile ageism. “Imagine that they were Young” referred to the imagination of what an older adult might look like, think, and behave when they were once young, which was a reversed but refined intervention of the widely-used method of “Imagine that you were old.” In the present study, intergenerational tension was primed, and then 205 younger adults in China aged 18–37 were randomly assigned to 3 different conditions (“Imagine that they were Young,” “Imagine that you were old,” and control condition), asking them to imagine (and then write down) once older adults were young, or a future aging self, or read an unrelated essay respectively as experimental manipulations. Then they should distribute medical funds worthy of Chinese 1 million to two patients with COVID-19 of 25 and 85 years old indicating their attitudes toward older adults (or hostile ageism). Finally, we measured their general attitudes and stereotypes toward older adults. Results verified the effectiveness of both interventions, such that younger adults who took either intervention distributed more medical funds and showed more positive aging attitudes toward older adults than those in the control group. Moreover, “Imagine that they were Young” was tested to be even more effective than “Imagine that you were old.” A series of relative mediation models revealed that the stereotype of warmth mediated the effect for both interventions on decreased hostile ageism behaviors, compared with the control condition. While “Imagine that they were Young” could additionally reduce hostile ageism through a higher level of “including the older adults in their self-group (the young).” This new intervention might be a good alternative to eliminate hostile ageism.

Anti-Ageism Social Actions: Lights and Shadows

Ageism refers to the stereotypes, prejudices and discrimination towards others or oneself due to age, and it is the most prevalent type of social disadvantage, even more so than those due to gender and race, with negative effects worldwide. Ageism is an evidently real social problem that needs to be addressed and fought. Our study has two main objectives: firstly, to study to what extent programmes, projects or actions have been developed to combat ageism around the world; and secondly, to what extent they have been evaluated via the positive outcomes registered by the participants. Two different information sources were used: (a) a literature review of ageism programmes or interventions; and (b) an online questionnaire sent to international and national institutions surveying their policies or programmes against ageism. Our results show a relatively high number of actions combating ageism but a lack of a systematic evaluation of the outcomes of those actions. In conclusion, first, it is necessary to develop programmes and actions combating ageism, and the evaluation of these programmes is urgently needed in order to identify strategies that truly and effectively tackle ageism. There is a need to urge institutions to perform external evaluations of their anti-ageism social policies and to encourage scientists to conduct randomized and controlled studies.

Age Discrimination in the Context of Motivation and Healthy Aging

Age discrimination can undermine older people's motivation to stay engaged with their lives and poses a major challenge to healthy aging. In this article, we review research on age discrimination in different life domains, including health and work. Motivation and health constitute potential antecedents as well as outcomes of age discrimination, with reduced motivation and impaired health increasing the likelihood of becoming a victim of age discrimination, but also resulting from age discrimination. Furthermore, high levels of motivation and health can also serve as buffers against the negative effects of age discrimination. Based on our literature review, we discuss possible strategies aimed at reducing age discrimination. Understanding and combating age discrimination can foster older people's motivation to participate in meaningful activities and promote healthy aging.

The Spanish Intergenerational Study: Beliefs, Stereotypes, and Metacognition about Older People and Grandparents to Tackle Ageism

Ageism can be seen as systematic stereotypes, prejudice, and discrimination of people because of their age. For a long time, society has accepted negative stereotypes as a norm. When referring to older adults, the United Nations Global Report on Ageism warns about a severe impact. The Intergenerational Study for a Healthy Aging, a questionnaire about believes, stereotypes, and knowledge about older people and grandparents, was administered to 326 Spanish biology and medical students. Here we report the results of stereotype analysis through adjective qualification of the youth and older people performed before the survey. Content analysis of two open questions about metacognition at the end of the survey is also presented. The results show that: (1) The questionnaire promoted metacognition; (2) Positive metacognition toward grandparents was higher than for the general old population; (3) Most participants were not conscious about ageism; (4) Gender was a key factor—male students were more ageist than females; (5) The feeling of guilt was higher in the questionnaire about older people; (6) The metacognition exercise elicited thoughts and, in few cases, the need to take action to tackle ageism. In conclusion, both activities promoted active thoughts about older people vs. grandparents and helped participants realize unconscious ageism—specifically toward the older population—serving as an awareness activity that may help tackle ageism.

Expanding Benevolent Ageism: Replicating Attitudes of Overaccommodation to Older Men

Background: Older adults are stereotyped in a paternalistic manner (warm, but incompetent), deserving of assistance regardless of their need; however, little is known about how gender contextualizes these attitudes. The purpose of this study was to extend previous work that examined the malleability of the paternalistic older adult stereotype using a two-part experimental vignette. The goals of the current study included: (1) to examine attitudes of benevolent ageist behavior toward a male target, (2) to confirm whether attributions made toward an older male target change if they defy or confirm the paternalistic stereotype, and (3) to examine the distinct roles of age and gender on an act of benevolent ageism. Method: In prior work, a female target was offered unnecessary assistance, which is replicated in the current study with a male target. The age (young vs. old), response (accepting vs. declining assistance), and gender (male vs. female) of the target were manipulated and then rated by a young adult sample (N = 698). Results: Our findings replicated earlier work in that overaccommodative behaviors were endorsed more so for the older target than the younger target, which corroborates support for the Stereotype Content Model in that older adults are viewed paternalistically. Additionally, the older male target and the older female target were viewed differently when they respectively defied the paternalistic stereotype indicating distinctness between benevolent ageism and benevolent sexism. Conclusions: These findings add to the growing body of benevolent ageism literature and highlight the intersection of gender and age.

Like Parent, Like Child? Aging Anxiety Among Married Korean Baby Boomers

OBJECTIVES

How intergenerational relationships influence individuals' views on aging remains understudied. This study investigated how multiple older family members' health and financial challenges may shape middle-aged adults' aging anxiety.

METHOD

Married Korean baby boomers (N = 1,389) from the Korean Baby Boomer Panel Study reported on their own aging anxiety and rated each of their living parents' and in-laws' health and financial conditions. Using structural equation modeling, we examined how parents' and in-laws' health and financial challenges are associated with one's aging anxiety, and whether gender and frequency of intergenerational contact moderate the link. We expected worse health or financial conditions to be associated with higher levels of aging anxiety, and the effect to be more pronounced for women and those with more contact.

RESULTS

A worse financial condition of the poorest parent/in-law was associated with higher levels of aging anxiety, while worse health condition of the unhealthiest parent/in-law was associated with lower levels of aging anxiety. The same results were found when we considered the sum of all living parents' and in-laws' financial and health conditions. Frequency of contact moderated the effect of the financial condition of the poorest parent/in-law, such that individuals reporting more contact with the poorest parent/in-law showed higher levels of aging anxiety than those with less contact. There was no moderating effect of gender.

DISCUSSION

The findings highlight the role family ties play in shaping one's aging anxiety. Interventions aimed at improving views on aging through intergenerational interactions should target the quality of the intergenerational experience.

Ageism and Behavior Change During a Health Pandemic: A Preregistered Study

The COVID-19 pandemic has led to a suspected surge of ageism in America and has imposed critical health and safety behavior modifications for people of all ages (Ayalon et al., 2020; Lichtenstein, 2020). Given that older adults are a high-risk group, maintaining their safety has been paramount in implementing preventive measures (i.e., more handwashing, social distancing); however, making such behavior modifications might be contingent on how one views older adults (i.e., ageist stereotypes). Therefore, the goal of the current pre-registered study was to explore if hostile and benevolent ageism relate to pandemic-related fear and behavior change. An online survey assessing responses to the pandemic was taken by 164 younger and 171 older adults. Higher hostile ageism predicted lower pandemic-related behavior modification. Those high in benevolent ageism reported lower behavior change, but also reported higher pandemic-related fear; however, when pandemic-related fear was considered a mediator between the two, the directionality between benevolent ageism and behavior change switched, indicating a suppression effect. These findings highlight that ageist attitudes do predict responses to the pandemic and that hostile and benevolent ageism are distinct facets that have unique implications during a health pandemic.

Pre-pandemic Ageism Toward Older Adults Predicts Behavioral Intentions During the COVID-19 Pandemic

OBJECTIVES

During the coronavirus disease 2019 (COVID-19) pandemic, older adults have been disproportionately affected by high rates of health complications and mortality. Reactions toward older adults included a mix of prosocial behaviors and ageist responses, consistent with the history of positive and negative views and treatment of older adults in the United States.

METHODS

In a two-part study (n = 113, Mage = 18.49, SD = 0.50; range 18-19), we examined whether pre-pandemic ageism among undergraduates predicts prosocial behavioral intentions toward older adults both specific to COVID-19 and in general.

RESULTS

Pre-pandemic ageism toward older adults predicted less intentions to help older adults generally and specific to COVID-19. Whereas viewing older adults as incompetent predicted greater intentions to help specific to COVID-19.

DISCUSSION

These results reflect the complexity of predicting helping behaviors and suggest that even supportive behaviors toward older adults during the COVID-19 pandemic may be rooted in negative ageist stereotypes. Implications and directions for future research are discussed.

When Grandparents Move In

Abstract. This paper explores the impact of growing up with an older adult in the home on one’s attitudes toward older adults. We surveyed 309 participants for their opinions on older adults, whether they grew up living with an older adult, and whether the older adult they lived with was ill. Those who grew up with an older adult had significantly lower opinions of the elderly but had less anxiety around their own aging process. This negative impact of contact seemed especially pronounced if the older adult was ill. Results indicate that although contact in and of itself can have a positive benefit on opinions toward the elderly, the nature of the relationship impacts the effectiveness of the contact.

Factors Moderating the Influence of Intergenerational Contact on Ageism: A Systematic Review

The authors conducted a systematic review of factors that moderate the influence of intergenerational contact on ageism. MEDLINE (using PubMed), EMBASE, Scopus, Web of Science, and Proquest databases were searched, using terms and keywords including intergenerational conflict, intergenerational relation, intergeneration gap, and ageism, and no date restrictions. The search yielded a total of 247 articles, of which 23 met eligibility criteria for the review. Findings revealed that the experience of ageism for older adults is widespread and highly prevalent in Western and Eastern countries. In addition, culture, age, and gender played important roles in young people's decisions to contact older adults. These factors were important moderators of intergenerational relationships and ageism. Robust, trans-disciplinary research is needed to examine factors related to intergenerational relations, particularly with older adults in clinical populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 48-55.].

Overlooked and Underestimated: Experiences of Ageism in Young, Middle-Aged, and Older Adults

OBJECTIVES

Although the prevalence of ageism against older people has been well-established, less is known about the characteristics of those experiences or the experiences of young and middle-aged adults. The present study addressed these gaps by examining young, middle-aged, and older adults' self-reports of an ageist action they experienced.

METHODS

Participants' descriptions were coded for the domain in which the ageist experience occurred, the perpetrator of the ageist experience, and the type of ageist experience.

RESULTS

Young adults most commonly reported experiencing ageism in the workplace with coworkers as perpetrators. Middle-aged and older adults also reported ageism in the workplace; however, they also frequently reported experiencing ageism while seeking goods and services. Perpetrators of ageism varied more widely for middle-aged and older adults. Regardless of one's age, ageism was commonly experienced in the form of a lack of respect or incorrect assumptions.

DISCUSSION

The findings enhance our understanding of ageism across adulthood by considering the domains, perpetrators, and types of ageist expressions that adults of all ages encounter. They also suggest that interventions to reduce age bias will require multifaceted approaches that take into account the different forms that individuals experience across the life span.