Ageism as a Risk Factor for Chronic Disease

"They forget that I'm a human being"-ward round communication with older patients living with frailty and informal caregivers: a qualitative study

PURPOSE

Skilful communication prompts quality patient care. Informal caregivers occupy a crucial role when caring for hospitalised older patients living with frailty. However, skilful communication with both patients and informal caregivers during ward rounds has not been studied. Thus, we aimed to explore communication preferences of patients and informal caregivers during ward rounds.

METHODS

We conducted semi-structured interviews with hospitalized patients and informal caregivers until information redundancy occurred. We used inductive coding of the transcribed interviews followed by a reflexive thematic analysis.

RESULTS

The study included 15 patients and 15 informal caregivers. Patients had a median age of 85 years (range 75-100 years) and seven patients were females. Informal caregivers' median age were 45 years (range 38-80 years) and 13 were females. Three themes were generated: (1) building relationships and conveying information, (2) alleviating informal caregiver strain and (3) sharing the decision-making process. Themes highlighted the importance of collaborative and empathetic approaches in healthcare interactions, emphasizing interpersonal communication skills, such as fostering professional relationships. The interviews unveiled informal caregiver burden stemming from disempowerment during hospital discharge process and managing mistrust within the healthcare system. The shared decision-making process should address patients' and informal caregivers' needs and circumstances.

CONCLUSIONS

Communication preferences of a population of older patients living with frailty and informal caregivers during ward rounds encompass interpersonal communication, demonstrating ample time, and being seen as a human being. Informal caregivers value being included in the decision-making process. Skilful communication includes for doctors to recognize informal caregivers' narratives and burdens.

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

OBJECTIVES

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

DESIGN

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

RESULTS

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

CONCLUSIONS

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

Latent profile analysis of depression and its influencing factors in older adults raising grandchildren in China

OBJECTIVE

To explore the latent profile of depression in older adults raising grandchildren in China, and to analyze the differences in the characteristics of the different profiles of the population and the factors influencing them.

METHODS

This study utilized the 2018 China Health and Retirement Longitudinal Study (CHARLS). Through a cross-sectional study, the latent profile analysis was used to analyze the potential classification of depression among older adults raising grandchildren, and using ordered multi-categorical logistic regression analyses to assess the effects of each factor on their different classifications.

RESULTS

The 1271 older adults raising grandchildren with depression symptoms were divided into three categories: low-level depression (55.4%), moderate-level depression (31.2%), and high-level depression (13.4%). Ordered multi-categorical Logistic results showed: Gender, marital status, pension insurance, physical health status, life satisfaction, and IADL were predictors of latent profile classification of depression symptoms in older adults raising grandchildren (P < 0.05).

CONCLUSIONS

In the future of primary care, it will be more meaningful to provide targeted interventions for different subgroups of depression in older adults raising grandchildren.

Perceived Ageism in Health Care: A Hybrid Concept Analysis

Identifying perceived ageism is a critical step in eliminating ageism. This hybrid concept analysis aims to describe the concept of perceived ageism in health care. In the theoretical phase, a scoping review was conducted. In the field phase, semi-structured interviews were conducted with nine community-dwelling older adults. In the final analytical phase, results from the theoretical phase were integrated with those from the fieldwork phase. The perceived ageism in health care includes four dimensions: self-internalization (self-denial, a sense of unease, and passivity of behavior in seeking health care), interpersonal interaction (perceived negative perceptions, neglected attitudes, and unfair care behaviors), organization system (perceived strangeness caused by unfamiliar technology, unsupportive environment, and inadequate resources), and procedure policy (perceived uniformity of healthcare process and lack of targeted practice policies). Research related to this concept has contributed to developing measurement tools for assessing perceived ageism in healthcare practice and subsequent research.

Internalized ageism as a risk factor for suicidal ideation in later life

OBJECTIVES

We examined the influence of ageism on suicidal ideation using the framework of the Interpersonal Theory of Suicide among a sample of older adults in the United States.

METHOD

Using Research Match, volunteers 65 and older in the United States were recruited to participate in an online survey. Demographics, perceived burdensomeness, thwarted belongingness and self-directed ageism (internalized and relational ageism) were examined. Data were analyzed using hierarchical logistic regression analysis.

RESULTS

A total of 454 individuals from over 30 states participated in the study. Twelve percent of respondents reported that they had experienced suicidal ideation in the past month. Results from the logistic regression demonstrated that older adults with higher age and higher internalized ageism had a higher risk of suicidal ideation.

CONCLUSION

Findings present implications for understanding an association between ageism and suicidal ideation. Results speak to the importance of recognizing and understanding the impact of ageism. Examining the development clinical guidelines and policies that address ageism as a risk factor for suicide is warranted.

Digital Health Interventions in Older Adult Populations Living With Chronic Disease in High-Income Countries: Protocol for a Scoping Review

BACKGROUND

Globally, around 80% percent of adults aged 65 years or older are living with at least 1 chronic disease, and 68% percent have 2 or more chronic diseases. Older adults living with chronic diseases require greater health care services, but these health care services are not always easily accessible. Furthermore, the COVID-19 pandemic has resulted in unprecedented changes in the provision of health care services for older adults. During the COVID-19 pandemic, digital health interventions for chronic disease management were developed out of necessity, but the evidence regarding these and developed interventions is lacking.

OBJECTIVE

In this scoping review, we aim to identify available digital health interventions such as emails, text messages, voice messages, telephone calls, video calls, mobile apps, and web-based platforms for chronic disease management for older adults in high-income countries.

METHODS

We will follow the Arksey and O'Malley framework to conduct the scoping review. Our full search strategy was developed following a preliminary search on MEDLINE. We will include studies where older adults are at least 65 years of age, living with at least 1 chronic disease (eg, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and diabetes), and residing in high-income countries. Digital health interventions will be broadly defined to include emails, text messages, voice messages, telephone calls, video calls, mobile apps, and web-based platforms.

RESULTS

This scoping review is currently ongoing. As of March 2023, our full search strategy has resulted in a total of 9901 records. We completed the screening of titles and abstracts and obtained 442 abstracts for full-text review. We are aiming to complete our full-text review in October 2024, data extraction in November 2024, and data synthesis in December 2024.

CONCLUSIONS

This scoping review will generate evidence that will contribute to the further development of digital health interventions for future chronic disease management among older adults in high-income countries. More evidence-based research is needed to better understand the feasibility and limitations associated with the use of digital health interventions for this population. These evidence-based findings can then be disseminated to decision-makers and policy makers in other high-income countries.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49130.

Association Between Self-Perception of Aging and Long-Term Mortality in Elderly Patients with Hypertension in Rural China: A Possible Beneficial Effect of Nut Intake

Purpose

Previous research has consistently shown that self-perception of aging (SPA) is an important predictor of health and longevity, while Chinese rural elderly patients with hypertension had poorer SPA. Whether it was associated with their mortality kept unknown. The objective of this study was to investigate the long-term mortality and analyze the association between SPA and this mortality in the specific context of rural elderly patients with hypertension.

Patients and Methods

This study is a longitudinal investigation of the mortality in elderly patients with hypertension in rural Suzhou, China. Sociodemographic and clinical data, SPA, and six-year mortality were investigated. We used binary logistic regression and subgroup analyses to assess the effect of SPA at baseline on six-year mortality.

Results

A total of 280 hypertensive patients aged 60 years and older participated in the study, of whom 21 died, with a six-year mortality rate of 7.5%. After controlling for covariates, the "Emotional representation" dimension (OR=2.824, 95% CI:1.034-7.712) in SPA remained a risk factor for death. In subgroup analyses of the group aged 75 years and older, high scores on the "Timeline cyclical" (OR=14.125, 95% CI: 1.258-158.593) and "Emotional representations" (OR=2.567, 95% CI:1.066-6.182) dimensions were associated with a higher risk of death, while weekly nut intake may have mitigated the negative SPA effect on mortality.

Conclusion

Poorer self-perception of aging was associated with a high risk of mortality in rural elderly patients with hypertension, while the habit of weekly nut intake might help reduce this risk in the group aged 75 years or older.

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

BACKGROUND AND OBJECTIVES

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

RESEARCH DESIGN AND METHODS

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

RESULTS

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

DISCUSSION AND IMPLICATIONS

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

Aging Stigma and the Health of US Adults Over 65: What Do We Know?

This narrative review assessed the current state of research on aging stigma and health relevant to US adults ages 65 and older. We adopted a stigma framework to highlight aging stigma as a meaningful social construct and the complex ways in which it may be harmful for health. We identified 29 studies of various types (experimental, intervention, cross-sectional quantitative, longitudinal quantitative, and qualitative) published between 2010 and 2023 that investigated relationships between concepts related to aging stigma and health. Aging stigma was associated with poor short- and long-term health outcomes spanning cognition, psychological wellbeing, physical health, and hospitalizations. The premise that aging stigma is harmful to health was moderately well supported, while evidence that health influenced aging stigma was weak. Collectively, studies provided insight into several mechanisms through which aging stigma may affect the health of older US adults, while also highlighting areas for future research. Potential strategies for addressing aging stigma as a public health hazard were discussed.

Do we all perceive experiences of age discrimination in the same way? Cross-cultural differences in perceived age discrimination and its association with life satisfaction

Age discrimination is pervasive in most societies and bears far-reaching consequences for individuals' psychological well-being. Despite that, studies that examine cross-cultural differences in age discrimination are still lacking. Likewise, whether the detrimental association between age discrimination and psychological well-being varies across contexts remains an open question. In this study, therefore, we examined cross-cultural differences in perceived experiences of age discrimination and their detrimental association with a specific indicator of psychological well-being, which is life satisfaction. The sample was drawn from the Ageing as Future study and comprised 1653 older adults (60-90 years) from the Czech Republic, Germany, Hong Kong, Taiwan, and the USA. Participants self-reported their experiences of age discrimination and their life satisfaction. Findings indicated that participants from Hong Kong and Taiwan reported experiences of perceived age discrimination more often than participants from the Czech Republic, Germany, and the USA. Furthermore, experiences of age discrimination were negatively associated with life satisfaction. Cultural context moderated this relation: We found a smaller detrimental association between perceived experiences of age discrimination and life satisfaction in Eastern cultures, that is, in contexts where such experiences were perceived to be more prevalent. These findings highlight the importance of examining age discrimination across cultures. Experiences of age discrimination are clearly undesirable in that they negatively affect psychological well-being. Our results indicate that a higher self-reported prevalence of perceived age discrimination in the samples studied weakens this negative association. We discuss these findings in terms of adaptation (versus sensitization) in response to discrimination.

The mediating role of self-directed ageism in sexual health among Jewish-Israeli older people

This article examines the relationships between physical health, personal resilience and healthy sexuality in older adults, and the mediating role of self-directed ageism in these relationships. Healthy sexuality, which encompasses sexual partnership satisfaction, sexual behaviors, successful sexual functioning, few negative changes, and few sexual health concerns, is important in old age. Five hundred Jewish-Israeli women and men, aged 60 years and over, participated in the study. Five questionnaires were administered that examined the number of diseases, level of resilience, self-perceptions of aging, and sexual relationships and activities. The data were analyzed using multiple linear and logistic regressions, and path analysis for the mediating role of self-directed ageism. The results showed that higher levels of resilience were positively related to aspects of sexual health, while reporting more diseases and higher self-directed ageism were negatively related to sexual health. Self-directed ageism mediated the relationships between resilience and number of diseases and sexual health. The findings supported the biopsychosocial model of healthy sexuality. It was concluded that sexual health in older age may be promoted by fostering resilience, promoting good health, and reducing self-directed ageism.

Factors Associated with Antiretroviral Therapy Adherence Among a Community-Based Sample of Sexual Minority Older Adults with HIV

Older sexual minorities (e.g., gay, bisexual) living with HIV are at risk for poor HIV outcomes due to their frequent experience with both psychosocial challenges and structural barriers to care. This study utilized a stochastic search variable selection (SVSS) approach to explore potential psychosocial and structural factors associated with HIV-related health outcomes among a community-based sample of older sexual minorities (N = 150) in South Florida, an U.S. HIV-epidemic epicenter. After SVSS, a forward entry regression approach suggested unstable housing, illicit substance use, current nicotine use, and depression were all associated with poorer ART adherence among older sexual minority adults living with HIV. No associations between potential correlates and biological measures of HIV disease severity were observed. Findings highlight a need to focus on multiple levels of intervention that target a combination of psychosocial and structural factors to improve HIV-care outcomes among older sexual minorities and achieve Ending the HIV Epidemic goals.

Ageing without senescence: A critical absence in social gerontology?

This paper addresses the absence of the term 'senescence' in recent social science literature on ageing. The significance of this omission is considered in light of the emerging standpoint of gero-science, which argues that the central processes defining ageing are concerned with the rising probability of functional decline, development of degenerative disease and death. From this perspective, the separation of ageing and senescence sustains the myth that there exist forms of ageing that are exempt from senescence. The persistence of this myth underlies ageing studies, the sociology of later life and most social gerontology. While there have been undoubted benefits arising from this bracketing out of senescence, the argument of this paper is that the continuing advances associated with this standpoint are outweighed by the need to seriously engage with the consequences of contemporary societal ageing and the centrality of the processes of senescence in establishing an adequate understanding of ageing, its correlates and contingencies and its personal and social consequences.

Awareness of age-related change and its relationship with cognitive functioning and ageism

 .Given ageism's negative impacts on older adults, the theoretical model for awareness of age-related change (AARC) hypothesized that experiencing ageism may mediate the relationship of cognitive functioning to AARC. We tested this hypothesis and alternatively proposed that cognitive functioning mediated the relationship of ageism to AARC. Analyses were conducted using measures of memory and inductive reasoning for 215 older adults (66-90 years) recruited online. Significant direct effects of ageism, memory, and inductive reasoning and significant mediated effects were found in both models, with more support for cognition mediating the relationship between ageism and AARC than for ageism mediating the relationship between cognitive functioning and AARC. This study added to the literature by empirically investigating theoretically proposed antecedents of AARC. Policymakers should address ageism to support healthy aging. Findings may assist therapists working to help older adults gain insights regarding how ageism impacts cognitive functioning and awareness of age-related changes.

Age Discrepancies Across Two Decades: Desiring to be Younger Is Associated with Daily Negative Affect Over Three Waves of Assessment

Negative perceptions of aging and older adulthood, including the idealization of youth, are common in the United States. Past work has found that holding negative perceptions of aging is closely associated with poor mental and physical health consequences, yet few studies have examined how these perceptions impact day-to-day experiences. The current study had two objectives: (1) investigate whether age discrepancy (specifically desiring to be younger than one's chronological age) was related to daily negative affect and (2) examine whether this relationship changed as participants aged over time. We utilized the Midlife in the United States (MIDUS) diary study, a longitudinal measurement burst study with three waves of 8-day daily diaries indexing approximately 20 years. Participants (N = 2398; Mage [baseline] = 46.85, SD = 12.24; 54.7% women; 92.4% White) reported their desired age as well as daily negative affect at each wave. Using multilevel modeling, we examined whether age discrepancy predicted daily negative affect across 3 waves of observation. Results supported a significant relationship between age discrepancy and daily negative affect. However, no interactions among age discrepancy and baseline age or time across study were found. This suggests that the relationship between age discrepancy and daily negative affect was consistent across waves and participants over a 20-year period and provides evidence for the pernicious effect of deidentifying with one's real age on daily life. Daily experiences can act as potential risk or protective factors and shape developmental trajectories. Reducing ageism through societal interventions or increasing personal acceptance of aging through targeted interventions are two potential pathways of promoting health and well-being across the lifespan.

Program Evaluation: exploring health disparities that impact chronic pain referrals within a VA Health Care System

Introduction

The present Program Evaluation study examines sociodemographic characteristics of Veterans in the Phoenix VA Health Care System who have back pain, and specifically the likelihood of those characteristics being associated with a referral to the Chronic Pain Wellness Center (CPWC) in the year 2021. We examined the following characteristics: Race/ethnicity, gender, age, mental health diagnosis, substance use disorder diagnosis, and service-connected diagnosis.

Methods

Our study used cross sectional data from the Corporate Data Warehouse for 2021. 13624 records had complete data for the variables of interest. Univariate and multivariate logistic regression was used to determine the likelihood of patients' being referred to the Chronic Pain Wellness Center.

Results

The multivariate model found under-referral to be significant for younger adults and for patients who identified as Hispanic/Latinx, Black/African American, or Native American/Alaskan. Those with depressive disorders and opioid use disorders, on the other hand, were found to be more likely to be referred to the pain clinic. Other sociodemographic characteristics were not found to be significant.

Discussion

Study limitations include the use of cross-sectional data, which cannot determine causality, and the inclusion of patients only if the ICD-10 codes of interest were recorded for an encounter in 2021 (i.e., a prior history of a particular diagnosis was not captured). In future efforts, we plan to examine, implement, and track the impact of interventions designed to mitigate these identified disparities in access to chronic pain specialty care.

Resilience among older adults during the COVID-19 pandemic: A photovoice study

Older adults faced significant challenges during the COVID-19 pandemic but also demonstrated great resilience. Investigating these strengths may enhance and inform strategies to mitigate the impacts of the pandemic. To gain insight into the resilience processes of older adults during the first year of the pandemic, we conducted a photovoice study with 26 older adults (aged over 60) in the province of Quebec, Canada. Participants met online weekly for three weeks in small groups to discuss their photographs and share their resilience strategies. The thematic analysis revealed three interrelated themes. First, participants distanced themselves from the pandemic by engaging in activities that took their focus away from COVID-19 and that afforded much-needed respite. Second, participants regained their bearings by reorganizing their schedules and establishing new routines that bolstered occupation rather than rumination. Third, participants used the pandemic to self-reflect and revise their priorities, leveraging the pandemic as an opportunity for growth. Together, these themes demonstrate the strengths, coping strategies and resilience of older adults and contrast the stereotypes of older adults as vulnerable and resourceless. These findings have the potential to inform the implementation of strength-based health promotion initiatives to mitigate the harms of the pandemic.

Loneliness as a Potential Mechanism of the Association Between Ageism and Mental Health Outcomes in the Chilean Context

The negative impact of ageism on the mental health of older persons has been well studied, but the mechanisms underlying this relationship have not been explored in detail. The present study examines the relationship of ageism with depressive and anxious symptoms in older people, evaluating the indirect effect via loneliness. The analysis was carried out with a sample of 577 older adults living in Chile, using structural equation modeling to assess the direct and indirect effects of the proposed model.The results showed the direct and indirect association of ageism with mental health outcomes. Ageism is positively related to loneliness and, in turn, to increased depressive and anxious symptoms. We discuss how loneliness linked with an ageist context contributes to anxiety and depressive symptomatology in the older population and the need to reduce ageism to favor the mental health of this age group.

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

RATIONALE

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Does social participation make Thai psychologically abused elders happier? a stress-buffering effect hypothesis

This study investigates the influence of psychological elder abuse on life satisfaction levels in Thailand. This study also analyses the stress-buffering effect of social participation on the life satisfaction levels of Thai mentally abused elderly. Elder abuse has been proven to dramatically reduce Thai elders' levels of life satisfaction as their function in society shrinks owing to ageism. As a result, individuals are more likely to lose their independence and status and be forced to rely on others, increasing the danger of abuse. Elder abuse has a more significant negative impact on life satisfaction levels among Thai older women. Nonetheless, the mentally abused elderly who participate in social activities are happier than those who do not. Thai elders who live with their daughters are more satisfied in life than those who do not, but living with adult offspring does not assist psychologically abused elders in escaping their psychological suffering.

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

Purpose of Review

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

Findings

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

Summary

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

Community-level age bias and older adult mortality

RATIONALE

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Healthcare Professionals' Views and Perspectives towards Aging

Improving care for the older population is a growing clinical need in the United States. Ageism and other attitudes of healthcare professionals can negatively impact care for older adults. This study investigated healthcare professionals' (N = 140) views towards aging and characterized a confluence of factors influencing ageism perspectives in healthcare workers using path analysis models. These models proposed relationships between aging anxiety, expectations regarding aging, age, ageism, and knowledge. Aging anxiety had a less critical role in the final model than hypothesized and influenced ageism in healthcare workers through its negative effect (β = -0.27) on expectations regarding aging. In contrast, aging knowledge (β = -0.23), age (β = -0.27), and expectations regarding aging (β = -0.48) directly and inversely influenced ageism. Increased knowledge about the aging process could lower ageism amongst healthcare professionals and improve care for older adults. The results put forth in this study help to characterize and understand healthcare workers' complex views towards the aging population they often encounter. Moreover, these results highlight the need and utility of leveraging practitioner education for combating ageism in the clinical setting.

Ageism Interventions: The Need for An Ecological Perspective

Ageism is a dynamic force of oppression that presents systemically within all levels of Bronfenbrenner's ecological system framework (microsystem, exosystem, mesosystem and macrosystem). Although ageism is a well-documented phenomenon with wide-reaching negative impacts, interventions to mitigate ageism's effects remain understudied. This internal evaluation conducted a deductive content analysis of 208 resources on an anti-ageism resource clearinghouse, OldSchool.info. Resources were organized using two coding schemes; to determine focal points based on the ecological systems theory and to ascertain the mechanisms of the intervention (e.g., active or passive approach). Results indicate the majority of ageism interventions are passive-oriented societal-level macrosystem approaches. Findings indicate active-oriented interventions at the personal and relational levels are lacking. Since ageism is embedded within all of the interacting levels of the ecological system, meaningful change in policy and practice will require multiple approaches to developing positive change toward building an age-inclusive society. An ecological approach to ageism can provide critical insights toward the development of policy and law to reduce or eliminate ageism, including promoting positive behaviors and attitudes at the individual level and raising awareness of anti-discrimination and human rights laws at the macrosystem level.

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

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

Older adults' perceptions and experiences of ageism during the COVID-19 pandemic

The current study investigates older adults' perceptions of ageism in the United States during the COVID-19 pandemic. Using tenets of Stereotype Embodiment Theory and the Behaviors from Intergroup Affect and Stereotypes Map framework, we sought to (a) examine whether older adults experienced ageism as self-relevant during the pandemic and (b) understand whether older adults experienced certain media messages and interpersonal behaviors during the pandemic and interpreted them as being motivated by potentialpaternalistic age stereotypes. Older adults aged 65 and older recruited from the community (n = 73) participated in a semi-structured interview about their perspectives on ageism toward older adults during the pandemic. Participants also completed an online survey about their experiences with a range of messages and interpersonal behaviors throughout the pandemic. We thematically analyzed interview data and identified three primary themes: self-relevance of age stereotypes; awareness of negative, overgeneralized portrayals of older adults; and defenses against self-relevance of age stereotypes. Survey responses were analyzed using descriptive statistics and frequency counts and suggest that participants attributed messages and behaviors potentially imbued with paternalistic ageism as motivated primarily by care and concern for older adults. The findings add to the field's understanding of older adults' experiences and perceptions of ageism in the media and in interpersonal behaviors in the context of COVID-19.

Social construction of visual ageism on Iranian news websites during COVID-19

Considering the popularity of websites in social contexts and their significant force in producing collective discourses, attitudes, and patterns of behaviors, this study critically examined the projection of visual ageism on news websites during the COVID-19 pandemic. The social semiotic theory of visual grammar developed by Kress and Van Leeuwen (2006, 2020) was the theoretical framework for the visual semiotic analysis of photographs. The search for data was conducted between March 2020 and July 2020. The study searching protocol included strings "older adults AND COVID-19", "the elderly AND coronavirus", "older people AND COVID-19", and "old people AND coronavirus" in Google led to retrieving 71 photographs of Iranian older adults from Iranian news websites. The semiotic analysis of the photographs showed that the Iranian new websites continue to embrace a mindset that degrades the old people.

Intergenerational programming during the pandemic: Transformation during (constantly) changing times

Intergenerational programs have long been employed to reduce ageism and optimize youth and older adult development. Most involve in-person meetings, which COVID-19 arrested. ​​Needs for safety and social contact were amplified during COVID-19, leading to modified programming that engaged generations remotely rather than eliminating it. Our collective case study incorporates four intergenerational programs in five US states prior to and during COVID-19. Each aims to reduce ageism, incorporating nutrition education, technology skills, or photography programming. Authors present case goals, participants, implementation methods, including responses to COVID-19, outcomes, and lessons learned. Technology afforded opportunities for intergenerational connections; non-technological methods also were employed. Across cases, programmatic foci were maintained through adaptive programming. Community partners' awareness of immediate needs facilitated responsive programming with universities, who leveraged unique resources. While new methods and partnerships will continue post-pandemic, authors concurred that virtual contact cannot fully substitute for in-person relationship-building. Remote programming maintained ties between groups ready to resume shared in-person programming as soon as possible; they now have tested means for responding to routine or novel cancellations of in-person programming. Able to implement in-person and remote intergenerational programming, communities can fight ageism and pursue diverse goals regardless of health, transportation, weather, or other restrictions.

PLAN: Preparing and Living for Aging Now; A descriptive study invesitigating older adults' readiness to plan for aging and frailty

OBJECTIVES

Many older adults want to age in place but do not make plans. Understanding how and under what conditions adults prepare/plan ahead is vital given population aging and increasing frailty. This study examines the stages of change and experiences (personal/others) related to readiness to plan for aging and frailty.

METHODS

Descriptive cross-sectional.

SETTING

Community-dwelling.

PARTICIPANTS

Adults aged 50-80(N = 252).

DATA COLLECTION

demographics, other characteristics, stages of change, experiences (personal/others) was assessed with survey questions.

DATA ANALYSIS

frequencies/percentages, McNemar test, Chi-square.

RESULTS

Among domains, participants' percentages in action/maintenance stages ranged from 28.2% (cognitive) to 68.7% (financial). Participants had increased experience with others across domains rather than self. Older participants (≥ 70) vs. younger (50-69) reported statistically significant greater planning in action/maintenance stages for all domains (p < .05) with the exception of cognitive.

DISCUSSION

Examining the concept of planning for aging and frailty provides a foundation for future work to develop/test interventions aimed at increasing readiness for aging.

The Subjective Experience of Ageism: The Perceived Ageism Questionnaire (PAQ)

Ageism as perceived by older individuals has been recognized as a potential risk factor for physical and mental health. We aimed to develop a comprehensive scale that can quantify perceived ageism among aging individuals (55+), including both positive and negative stereotypes, prejudices, and discriminations. This effort resulted in an 8-item Perceived Ageism Questionnaire (PAQ-8), with good psychometric properties and a two-factor structure distinguishing a positive (3 items) and negative (5 items) subscale (Analysis 1; n = 500). This dimensionality was confirmed in a separate cross-validation sample (Analysis 2; n = 500). The subscales’ correlation patterns with individuals’ self-perceptions of aging and mental health variables (i.e., quality of life, mental well-being, depression, anxiety, loneliness and perceived stress) accorded with theoretical hypotheses and existing knowledge of the concept of ageism. The PAQ-8 can help to gather more standardized data of the level, role and impact of perceived ageism.

Experiences of Everyday Ageism and the Health of Older US Adults

Importance

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

Objective

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

Design, Setting, and Participants

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

Exposures

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

Main Outcomes and Measures

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

Results

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

Conclusions and Relevance

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

Perceptions of older adults? Measuring positive, negative, and physical descriptors using the stereotype content and strength survey

The COVID-19 pandemic has disproportionately impacted the health of older adults. In addition to a higher risk for serious illness and death, the societal value of senescent adults was challenged. There have been conflicting results reported in the research literature regarding positive and negative stereotypes of older adults, and areliable and valid assessment tool to measure content (existence of astereotype) and strength (intensity of astereotype) is unavailable. To address issues with instruments employed to measure ageist stereotypes, researchers developed the Stereotypes Content and Strength Survey. University students (n=483) were directed to "think about their perceptions of older adults" and indicate how many they believed could be described using the terms listed on a5-point Likert-type scale from none-all. Response categories for each descriptive item were dichotomized into 1 = "some, most or all" and 0 = "none or few." Based on an odds analyses of 117 items, 84 met the content criteria to be considered astereotype regarding older adults. Using the criteria for strength, items were categorized into 36 "strong," 25 "moderate," and 23 "weak" stereotypes. Assessing the content and strength of stereotypic beliefs using this procedure may contribute to major bias influencing ageist perceptions.

Talking about chronic pain in family settings: a glimpse of older persons’ everyday realities

Background

The expression of chronic pain remains a delicate matter for those older persons who suffer from this condition. If many studies highlight the difficulties of putting pain into words, scarce are those that take into account how given social networks can facilitate or prevent its expression. Based on a qualitative study that explores the communication about chronic pain in older persons’ social network, this article reports on this key issue of talking about health in later life within family settings and provides clinicians with information about the way older persons with chronic conditions perceive their everyday realities and social relations.

Methods

A multidisciplinary research team (medicine, linguistics and psychology) interviewed 49 persons with chronic pain, all from the French-speaking part of Switzerland, aged 75 and older, without any major cognitive or auditory impairments. After transcription, the interviews were analyzed by combining content and discourse analysis with social network theories.

Results

Communication about chronic pain depends significantly on the position of the interlocutors within the family structure, with a preference for direct relatives or individuals with similar difficulties. In social networks, the ability to communicate about chronic pain is both a resource (by allowing older persons to get help or by strengthening interpersonal relations) and a challenge (by threatening their autonomy, social relations or self-esteem).

Conclusions

The study shows the predominance of the nuclear family (partner, children) in communication relating specifically to the everyday management of chronic pain. This state of affairs is, nevertheless, balanced by issues of (loss of) autonomy. These findings, in line with current trends in geriatrics, could benefit future reflections on the scope and limits of including relatives in the care of older patients with chronic conditions.

The Everyday Ageism Scale: Development and Evaluation

OBJECTIVES

Older adults regularly encounter age-based discrimination and stereotyping in their day-to-day lives. Whether this type of routine ageism negatively affects their health and well-being is unclear, in part due to the absence of validated scales that comprehensively measure this phenomenon and distinguish it from other sources of everyday discrimination.

METHODS

This study describes the development of a novel scale, the Everyday Ageism Scale, and its psychometric evaluation using a nationally representative sample of US adults age 50-80 from the December 2019 National Poll on Healthy Aging (N = 2012).

RESULTS

Exploratory factor analysis indicated a 3-factor structure comprised of ageist messages, ageism in interpersonal interactions, and internalized ageism. The ten-item scale was psychometrically sound and demonstrated good internal reliability.

DISCUSSION

Everyday ageism is a multidimensional construct. Preliminary evaluation of the Everyday Ageism Scale suggests its utility in future studies examining the prevalence of everyday ageism and its relationships with health.

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

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

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

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

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

Measuring Discrimination against Older People Applying the Fraboni Scale of Ageism

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

Longitudinal Associations Between Perceived Control and Health for American and Japanese Aging Adults

BACKGROUND AND OBJECTIVES

Research suggests longitudinal and reciprocal relationships between perceived control over life circumstances and health for Western populations; yet, such associations have not been fully understood for non-Western populations. The present study addresses cultural differences in these associations for American and Japanese aging adults.

RESEARCH DESIGN AND METHODS

For respondents aged 40 and older at 2 waves (Time 1 [T1] and Time 2 [T2]) of Midlife in the United States (N = 4,455) and Midlife in Japan (N = 827), cross-lagged path models were analyzed for T1 perceived control predicting change in each health measure (i.e., self-rated health, number of chronic health conditions, and functional limitations) from T1 to T2; and the matched T1 health measure predicting change in perceived control from T1 and T2. In these analyses, the effects of T1 age, T1 perceived control, and each T1 health measure were compared cross-nationally.

RESULTS

A cross-national difference emerged in that T1 perceived control predicted change in chronic health conditions only for Americans. Similar tendencies were found between the 2 nationalities for T1 perceived control predicting changes in self-rated health and functional limitations. Reciprocal relationships between perceived control and health measures were found for Americans, but neither age nor any of the T1 health measures predicted change in perceived control for the Japanese respondents.

DISCUSSION AND IMPLICATIONS

The findings suggest cultural differences and similarities between the 2 nationalities, which have implications for potential health benefits of enhancing perceived control among American and Japanese aging adults. Building on these findings, the present study also indicates future directions of research.

Addressing Ageism and Ethnocultural Diversity With a Photo Essay Project

BACKGROUND

By 2050, the percentage of older adults in the United States will double. By 2060, nonmajority individuals will comprise nearly half of our older adult population. Therefore, nursing students must have learning experiences that prepare them to care for a diverse population of older adults when they enter practice.

METHOD

Photo-elicitation and a photo essay project was initiated in an Aging and Health in Global Communities course in which 75 students created and presented photo essays of a diverse group of older adults.

RESULTS

Through spending time with older adults to create a photo essay, students ably portrayed lives rich in meaning and ethnocultural heritage.

CONCLUSION

The natural intersection of aging and diversity that occurred in the photo essays enlightened students to the rich experience of age and the similarities and unique differences in the lives of the older people portrayed. [J Nurs Educ. 2021;60(1):44-47.].

Ageism in COVID-Related Newspaper Coverage: The First Month of a Pandemic

Objectives

Media sources have consistently described older adults as a medically vulnerable population during the coronavirus disease 2019 (COVID-19) pandemic, yet a lack of concern over their health and safety has resulted in dismissal and devaluation. This unprecedented situation highlights ongoing societal ageism and its manifestations in public discourse. This analysis asks how national news sources performed explicit and implicit ageism during the first month of the pandemic.

Method

Using content and critical discourse analysis methods, we analyzed 287 articles concerning older adults and COVID-19 published between March 11 and April 10, 2020, in 4 major U.S.-based newspapers.

Results

Findings indicate that while ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns (e.g., frequent use of the term “elderly,” portrayals of older adults as “vulnerable”). Infection and death rates and institutionalized care were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. The older “survivor” narrative offers a positive alternative by suggesting exceptional examples of resilience and grit. However, the survivor narrative may also implicitly place blame on those unable to survive or thrive in later life.

Discussion

This study provides insight for policy makers, researchers, and practitioners exploring societal perceptions of older adults and how these perceptions are disseminated and maintained by the media.

Quality of Gerontological Nursing and Ageism: What Factors Influence on Nurses' Ageism in South Korea?

With the aging of the population, age-related problems are emerging, which has caused age discrimination. Particularly, most nurses care for a large number of old patients in the clinical setting. Nurses' attitude toward the clients has a significant effect on the quality of nursing, so it is time to identify their perspective to the aged. The quality of nursing could greatly depend on who provides and how to provide care. If older patients meet nursing staff with an ageist perspective, whether intentionally or unintentionally, they experience negative attitudes toward them during served health care, and trust cannot be formed, resulting in a deterioration in the quality of medical services. This study aimed to identify factors influencing nurses' ageism attitudes. A total of 162 general hospital nurses completed a questionnaire consisting of the Wong and Law Emotional Intelligence Scale (WLEIS), the Contact with Elderly People (CEP), the Anxiety about Aging Scale (AAS), and the Fraboni Scale of Ageism (FSA). Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc, Pearson's correlation coefficients, and stepwise multiple regression using SPSS/WIN 26.0 program. The average score of FSA was 2.63 ± 0.36 (range 1-4); FSA showed a statistical difference according to cohabitation with an old adult in the past (t = 2.42, p = 0.017). Factors influencing FSA were the fear of old people (β = 0.34, p < 0.001) and fear of loss (β = 0.28, p < 0.001) of the AAS; and these variables explained 21.1% of FSA (F = 22.56, p < 0.001). Based on these results, the development and application of nursing education focused on intergenerational contact is needed in order to reduce the anxiety about aging and to acquire a high quality of gerontological nursing with a reduction of ageism.

Ageism and the Factors Affecting Ageism among Korean Nursing Students: A Cross-Sectional Study

With the increasing population of older adults, ageism is an obstacle to health equity and can negatively affect older adults’ quality of life and nursing care. This study aims to examine the level of ageism and the factors associated with ageism among nursing college students, who will become the main workforce for gerontological nursing. A cross-sectional survey was conducted among 238 nursing students in two nursing colleges in South Korea. The total score for ageism was 37.06 (SD 5.94) out of a maximum of 72. In the multiple regression model, the predictors of ageism were aging anxiety (β = 0.420, p < 0.001), frequency of contact (β = −0.204, p < 0.001), preference for gerontological nursing (β = 0.150, p = 0.003), age (β = 0.145, p = 0.003), and quality of contact (β = −0.143, p = 0.030), revealing that these were factors influencing ageism in the evaluated nursing students. The results suggest that tailored gerontological education programs or community link programs in the nursing curriculum are necessary to share feelings of contact, increase positive experiences with older adults, and reduce anxiety about aging.

Ageism and psychosocial variables during the COVID-19 pandemic: a scoping review protocol

OBJECTIVE: To map studies that focused on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the mental health, well-being, self-perception of aging, and intergenerational relationships of older adults, and how ageism affected these psychosocial variables in this population during the pandemic. METHODS: We will use the Joanna Brings Institute (JBI) methodology and search for indexed literature published in English, Portuguese, and Spanish in 12 databases. Two authors will independently screen titles, abstracts, and full texts according to the following eligibility criteria: studies that focused on samples of older adults (minimum age 60 years old), considering community-dwelling older adults, and studies using (quantitative designs, whether cross-sectional or longitudinal). In addition, at least one variable and its relationship with the COVID-19 pandemic must be presented in the study. RESULTS: The results will be presented in a tabular format with a narrative summary.

The psychometric properties, confirmatory factor analysis, and cut-off value for the Fraboni scale of ageism (FSA) in a sampling of healthcare workers

PURPOSE

The Fraboni scale of ageism (FSA) is one of the scales used to determine ageism, which is the expression of prejudice toward the elderly because of their age through attitudes and behaviors. The purpose of this study is to determine the psychometric properties, factor analysis, and cut-off value for the FSA in a sampling of healthcare workers.

DESIGN AND METHODS

The sampling of this study was conducted methodologically in a descriptive and relationship-seeking type of research and comprised 814 healthcare workers employed at a university and state hospital.

FINDINGS

As a result of the exploratory and confirmatory factor analyses, it was found that the FSA comprised 29 items and three subdimensions, that these three factors explain approximately 30.23% of the total variance, and that the cut-off value is 78.

PRACTICE IMPLICATIONS

This study determined that the Turkish adaptation of the FSA is a suitable tool to measure the ageism of healthcare workers.

Training Program for Care Professionals in Nursing Homes: Effectiveness and Feasibility

The aim of the current study was to analyze the effectiveness and feasibility of a training program for care professionals at two nursing homes, investigating the impact on their beliefs, attitudes, and knowledge regarding aging. Twenty-three formal caregivers at a private nursing home and 10 formal caregivers at a philanthropic nursing home participated in the training program, which consisted of five weekly meetings, each lasting 1.5 hours. Characterization of the sample was performed and effectiveness and feasibility of the intervention were analyzed. The training program improved participants' knowledge about older adults; however, their attitudes and beliefs regarding old age were not affected. Results also indicated that the intervention program was feasible at both nursing homes. The positive results of the study underscore the importance of training and continuing education of professionals who work with older adults, especially staff at nursing homes. [Journal of Gerontological Nursing, 46(11), 37-47.].

Cognitive control beliefs and cognitive functioning in mid- to late-life

OBJECTIVES

Older adults experience age-related cognitive declines and often feel as if the severity of these declines is out of their control. Recent research suggests, though, that control beliefs may be related to less age-related declines. The aim of the current study was to investigate cognitive domain-specific control beliefs and the link between those cognitive control beliefs and cognitive functioning among a nationwide sample of adults (N = 3,670), as well as to explore whether cognitive control beliefs moderated the relationship between age and cognitive functioning.

METHOD

The aims were addressed using data from the national Midlife in the United States study (MIDUS II). Cognitive functioning was assessed using the Brief Test of Adult Cognition by Telephone (BTACT), and cognitive control beliefs were assessed with the Personality in Intellectual Aging Contexts (PIC) Inventory Control Scales.

RESULTS

Regression analyses revealed that adults with higher control beliefs demonstrated better cognitive functioning. Moderation analyses indicated cognitive control beliefs moderated the relationship between age and executive functioning, but not the association between age and episodic memory.

CONCLUSION

Results suggested that the relationship between age and executive functioning was weaker at high levels of cognitive control beliefs. Future research should establish the directionality of the effect between cognitive control beliefs and cognition and investigate the association between control beliefs and cognition in samples at higher risk for substantial cognitive decline, including the oldest-old.

Age and Gender Stereotypes Reflected in Google's "Autocomplete" Function: The Portrayal and Possible Spread of Societal Stereotypes

BACKGROUND AND OBJECTIVES

Google's autocomplete function provides "predictors" to enable quick completion of intended search terms. The predictors reflect the search trends of a population; they capture societal beliefs and perceptions about a variety of subjects. This study explores the predictors provided by Google United States when searching for information about older men and women.

RESEARCH DESIGN AND METHODS

The Google search engine of the United States was used to record predictors in response to 720 search terms. Inductive content analysis method was used to categorize and interpret the results.

RESULTS

There was prevalence of age and gender stereotypes in the predictors offered by Google. Queries about older men were primarily associated with romance and sexuality whereas those for older women centered on changes in the body as well as sexual and reproductive health.

DISCUSSION AND IMPLICATIONS

The appearance of such predictors in response to a potential search query may lead to the spread of harmful stereotypes about older adults.

You’re Not Old as Long as You’re Learning: Ageism, Burnout, and Development Among Italian Teachers

The purpose of this study was to explore the buffering role of opportunities for professional development within the frame of the indirect relationship between workplace age discrimination (as a job demand) and job performance on a sample of N = 325 Italian teachers. Results of moderated mediation analysis indicated that emotional exhaustion mediates the relationship between workplace age discrimination and impaired job performance. Furthermore, the relationship between workplace age discrimination and performance through the mediation of emotional exhaustion became stronger at lower levels of professional development. Although professional development is recognized as a crucial job resource, this study sheds light on its protective role among teachers dealing with discrimination caused by their age. Fostering of professional development could prevent teachers from feeling emotionally exhausted and, in turn, from the occurrence of impaired performance.