The oldest-old: how do they differ from the old-old?

Factors associated with loneliness among individuals aged 80 years and over: Findings derived from the nationally representative "Old Age in Germany (D80+)" study

OBJECTIVES

To clarify the factors associated with loneliness in individuals aged 80 years and older in Germany (also stratified by sex).

METHODS

Data from the nationally representative "Old Age in Germany (D80+)" were employed. The analytic sample equaled 10,031 individuals. The D80+ study included community-dwelling and institutionalized individuals ≥ 80 years in Germany. Multiple linear regressions were used (with sociodemographic and health-related explanatory factors). The collection of data occurred between November 2020 and April 2021 (written questionnaire).

RESULTS

Higher loneliness was significantly associated with not being married (e.g., widowed compared to being married, β=0.37, p<.001), being institutionalized (β=0.33, p<.001), low education (high education compared to low education, β=-0.07, p<.01), a higher number of chronic conditions (β=0.02, p<.001), poor self-rated health (β=-0.19, p<.001) and greater functional impairment (β=0.15, p<.001). Sex-stratified regressions produced comparable results. However, low education was only associated with higher loneliness among men, but not women (with significant interaction: education x sex).

CONCLUSION

Several sociodemographic and health-related factors can contribute to loneliness among the oldest old in Germany, with sex-specific associations between education and loneliness. Overall, such knowledge can aid to address individuals with higher loneliness levels.

The home environment: influences on the health of young-old and old-old adults in Australia

The physical and societal characteristics of home have been established as important in influencing the health and wellbeing of older adults, yet these have rarely been explored together. There is also limited research into variation across age groups, with older adults often examined as a homogenous group of those 65 years and over. This study advances the knowledge base by using the concept of person–environment (P-E) fit to analyse differences in personal and home environment (physical and societal) characteristics between young-old (65–74 years) and old-old (75 and above) age groups, and to assess how these characteristics influence their self-perceived health. This cross-sectional study draws upon survey data from 1,999 older adult participants from the Australian Housing Conditions Dataset. Descriptive statistics and inferential analysis were used to assess for significant differences between age groups and a binomial logistic regression was utilised to examine influences on health. The analysis found that the factors which influence health varies appreciably between age groups. For the young-old financial strain, being on the fixed-income pension and hypertension were important contributing factors, in contrast for the old-old gender (being male), having depression and the home being modified for disability were key influences. For both age groups heart disease was a contributing factor to perceived health. The results indicate the important contribution to knowledge of incorporating a wide range of person and environment characteristics when exploring P-E fit for older adults. The inclusion of societal aspects, such as financial strain, fixed-income pension, tenure and access to community aged care services when exploring influences on health, arises as a key conclusion of the study. In terms of impact, this research is significant given rising inequalities globally and specifically in the Australian context, the need for policy measures to address income inequality, and its health and social implications for older households.

The role of domain-general cognitive control in language comprehension

What role does domain-general cognitive control play in understanding linguistic input? Although much evidence has suggested that domain-general cognitive control and working memory resources are sometimes recruited during language comprehension, many aspects of this relationship remain elusive. For example, how frequently do cognitive control mechanisms get engaged when we understand language? And is this engagement necessary for successful comprehension? I here (a) review recent brain imaging evidence for the neural separability of the brain regions that support high-level linguistic processing vs. those that support domain-general cognitive control abilities; (b) define the space of possibilities for the relationship between these sets of brain regions; and (c) review the available evidence that constrains these possibilities to some extent. I argue that we should stop asking whether domain-general cognitive control mechanisms play a role in language comprehension, and instead focus on characterizing the division of labor between the cognitive control brain regions and the more functionally specialized language regions.

Perceptions of negative stereotypes of older people in magazine advertisements: comparing the perceptions of older adults and college students

Negative stereotypes not only affect how older people feel about themselves, but also how younger people feel about old age and their prospect of growing old. The research reported in this paper has examined the negative and potentially harmful stereotypes of older people portrayed in magazine advertisements in the United States, as perceived by groups of older and young people. Q-methodology sorts of 40 advertisements with negative images of older people, along with personal interviews, were used to probe older people's and college student's feelings and attitudes about the images. The subjects were placed in four categories: ‘moralists’, ‘objectors’, ‘ageing moralists’ and ‘resentfuls’. Regardless of whether stereotypes were used, the older people liked the advertisements that showed them as being clever, vibrant and having a sense of humour. Neither the older people nor the students liked advertisements that ridiculed or poked fun at older people, or presented them as being out of touch with reality and unattractive. Both groups rated the stereotypes dealing with the real problems associated with ageing as inoffensive. The comparison of the two age groups showed a strong consensus about which images were acceptable and which offensive.

Older people's views of prioritization in health care

BACKGROUND AND AIMS

The aim of this study was to investigate and compare older people's views of prioritization in health care with specific regard to age, gender and HRQoL.

METHODS

The sample was collected from a prospective longitudinal cohort study, the GAS project (Good Ageing in Skane) that is in progress in Sweden. For this study, 902 persons, 424 men and 478 women, aged between 60 and 93 years, were invited consecutively over a period of 17 months to participate in an additional structured interview based on an interview manual. Socio-demographic and HRQoL data were collected from the GAS project. For the analysis, the sample was divided into age groups: young-old, old-old, and oldest-old.

RESULTS

Older people in general did not want age as a criterion for prioritization in health care. When pain was added as a criterion, age became even less important than when it was the sole criterion. The oldest-old, to a higher degree than the other age groups, prioritized younger patients, as did men, while women, more than men, preferred "old age" as an indicator for prioritization. The respondents' views on prioritization were also more associated with age and gender than HRQoL.

CONCLUSIONS

Older people's views of priorities seem to differ from previous population-based studies, in that age per se as a criterion for selection between patients was not favored; health and wellbeing were more important. Differences were, however, found within the group of older people, as regards both age and gender.

Do Middle School Students Really Have Fixed Images of Elders?

OBJECTIVE

The purpose of this study was to determine whether combinations of characteristics, abstracted from drawings of elders made by middle school students, grouped together to form cohesive perceptions, or stereotypes, of human aging.

METHODS

We abstracted 49 characteristics from drawings of elders made by 1,944 students at two middle schools in San Antonio, Texas, at the beginning of the 1998-1999 school year. Correlational and factor analyses were used to determine if there was an underlying structure or grouping to the characteristics. Logistic regression was used to determine the variables associated with the investigators' classification of the images as positive, neutral, or negative.

RESULT

The standardized alpha coefficient for the 49 variables was low (alpha = 0.37). The Spearman rho correlations between the variables were also low, with 90.2% of the 1,176 comparisons being < 0.10. Exploratory factor analyses did not provide a useful grouping of characteristics drawn by the students, including analyses stratified by gender and restricted to the most common 34 characteristics. Among the 49 characteristics that emerged from the drawings, 11, 4, and 11 traits were directly associated with classifying the drawings as positive, neutral, or negative, respectively.

DISCUSSION

These analyses indicate that middle school students have not formed strong images regarding aging: No clear cohesive stereotypes of elders emerged from the images drawn by these children. Absence of stereotypic views implies that middle school students may not have a built-in bias toward older people and age-associated changes. This suggests that young adolescents are at a point where instruction including gerontological content can be used to effectively teach about aging and health promotion.

Benefits and challenges of research with the oldest old for participants and nurses

The Klamath Exceptional Aging Project is a longitudinal aging study of people 85 and over, the "oldest old," in rural Oregon. Although conducting research with those 85 and over can be challenging, it is increasingly more important that this group be included in research studies given their importance in society. Benefits for the oldest old participating in research include an opportunity for altruism, productivity, and generativity and the expression of power and control. Benefits for nurses conducting research with this group include gaining a unique understanding of the world of the elderly, the honor of being a confidante for them, and the opportunity to provide truly caring nursing to a vulnerable age group. There is also a great sense of satisfaction in adding to the knowledge base needed to attain successful aging.

Successful aging families--a challenge for nurses

This nation's view of older-adult families and their care needs reform. Changing trends in the longevity of our population will mean changes in family structures and relationships. This article examines lessons from studies of successful aging to illuminate strategies that may promote successful later-life families. The focus is on changes that nurses can make with older-adult families in dispelling aging stereotypes, increasing the numbers of nurses educated and specializing in the care of older adults, changing the educational approach for new nurses, and calling for social policy changes.