Ageing is a diverse and multifaceted experience that is unique to each person. The process of ageing is lived differently according to each individual’s socio-cultural, historical, religious, and ...political context, among other factors. However, the stereotype of homogeneity is still one of the strongest aspects related to later life. This Special Issue covers manuscripts of original research that critically explore the experience of old age and the process of growing older from the social sciences and humanities perspectives. It also explores the topics pertaining to social gerontology, cultural and literary gerontology, environmental gerontology, gerotechnological studies, social anthropology, gender studies, body politics, sexuality, active and healthy ageing, space and place, age-friendly politics and other themes. The published articles collect arguments that show the variables and uniqueness of later life, and expand on the current theoretical frameworks in the field of age studies and beyond. The overall aim of this Special Issue was to broaden the gerontological scholarship and develop critical thought of old age and the life course beyond the merely biological processes of growing older and their sociocultural constructs. This Special Issue can be of interest to scholars, practitioners, stakeholders, care workers and individuals who are concerned with the dynamics of ageing as well as current and future dialogues on the unique experiences of ageing.
The global longevity revolution increased the older adult population, posing unique health and economic challenges with implications for healthcare, especially substance use disorders (SUD).
This was ...a retrospective cohort study of United States older adults, Hispanic and non-Hispanic, who got at least one mental and/or behavioral disorder diagnosis between 2017 and 2021 at age 65 or older. SUD prevalence, prescription frequency changes over time, and comorbidities associated with each medication were compared.
Electronic health records for 356,133 older adults (110,236 Hispanics and 245,897 non-Hispanics) were analyzed. Notably, 79% of Hispanics fell below the 100% federal poverty level, compared to 60% of non-Hispanics (P<.001). Non-Hispanics also had significantly more average encounters (P=.003) and diagnoses (P<.001). Regression analysis on alcohol-related disorders indicated that the odd ratios of being male (OR=2.93, P<.000), and having low income (OR=1.62, P<.000), increase the odds for this SUD, while being Hispanic and primarily speaking Spanish decreases the odds for all SUDs considered in this study.
This cohort study revealed significant disparities related to social determinants of health between Hispanic and non-Hispanic older adults and emphasizes the need for continuous surveillance of older adults as with SUDs. Differences in comorbidity patterns imply distinct risk factors within each population, influenced by demographic-specific elements. Recognizing these variations is essential for tailoring culturally sensitive prevention, intervention, and treatment strategies to each population's unique needs.
•Nicotine and alcohol related disorders were the most prevalent disorders•Hispanic elders have less healthcare for cardiovascular and central nervous system•Disparities in care, diagnosis, and medications were found between both groups•Comorbidity patterns suggest unique risk factors influenced by demographic elements•Stigma, substance access, and social norms impact substance use trends
The COVID-19 pandemic has led to an increase in the digitalisation of services that poses the risk of digital exclusion, especially among older adults. We examined the predictors of Internet use for ...services and its increase or decrease among a longitudinal population-based sample of 1426 older adults from Finland aged between 70 and 100 years, gathered in 2017 and 2020. High education and high income positively predicted the use of the Internet for services, and age, deteriorated health and deteriorated memory negatively. High age, low education and a change to living alone predicted a decrease in use. High education predicted the increased Internet use due to COVID-19. Thus, it seems that those older adults who have low education level are very old, whose health or memory has deteriorated and those who have changed to living alone are particularly in danger of digital exclusion. Actions targeted to these people are needed.
Inflammation is involved in the pathogenesis of stroke and depression. We aimed to investigate the association between the dietary inflammatory index (DII) and depression in American adults with ...stroke. Adults with stroke were enrolled in the National Health and Nutrition Examination Survey between 2005 and 2018 in the USA. The DII was obtained from a 24-h dietary recall interview for each individual. Multivariate regression and restricted cubic spline analyses were conducted to evaluate the association between DII and depression in adults with stroke. The mean age of the 1239 participants was 63·85 years (50·20 % women), and the prevalence of depression was 18·26 %. DII showed a linear and positive association with severe depression in adults with stroke (OR 1·359; 95 % CI 1·021, 1·810;
for non-linearity = 0·493). Compared with those in the lowest tertile of the DII, adults with stroke in the third tertile of the DII had a 3·222-fold higher risk of severe depression (OR 3·222; 95 % CI 1·150, 9·026). In the stratified analyses, the association between DII score and severe depression was more significant in older adults (
for interaction = 0·010) but NS with respect to sex (
for interaction = 0·184) or smoking status (
for interaction = 0·396). No significant association was found between DII and moderate-to-moderately severe depression in adults with stroke. In conclusion, an increase in DII score was associated with a higher likelihood of severe depression in older adults with stroke.
This study aims to evaluate the temporal trends of mortality among frail versus non-frail older adult trauma patients during index hospitalization.
We performed a 3-year (2017-2019) analysis of ...ACS-TQIP. We included all older adult (age ≥65 years) trauma patients. Patients were stratified into two groups (Frail vs. Non-Frail). Outcomes were acute (<24 h), early (24-72 h), intermediate (72 hours-1 week), and late (>1 week) mortality.
A total of 1,022,925 older adult trauma patients were identified, of which 19.7 % were frail. The mean(SD) age was 77(8) years and 57.4 % were female. MedianIQR ISS was 94-10 and both groups had comparable injury severity (p = 0.362). On multivariable analysis, frailty was not associated with acute (aOR 1.034; p = 0.518) and early (aOR 1.190; p = 0.392) mortality, while frail patients had independently higher odds of intermediate (aOR 1.269; p = 0.042) and late (aOR 1.835; p < 0.001) mortality. On sub-analysis, our results remained consistent in mild, moderate, and severely injured patients.
Frailty is an independent predictor of mortality in older adult trauma patients who survive the initial 3 days of admission, regardless of injury severity.
Limited research has explored the relationship between falls, cognitive decline, and dementia onset in older adults with aging. Therefore, this study aimed to investigate the impact of cognitive ...function on the development of dementia and explore the association between falls and dementia among older adults. This study utilized data from the Korean Longitudinal Study of Aging, which tracked a sample group at 2-year intervals from the initial wave in 2006 to the eighth wave in 2020. Among the older adults (≥60 years) surveyed, 2829 were included in the analysis, and cognitive function and number of falls per year were recorded. We hypothesized that these variables were associated with dementia and tested the variables using dementia diagnosis data. The participants were assigned to either a dementia group (dementia diagnosis) or a control group (no dementia diagnosis). Analyses were performed to enhance generalizability of the hypothesis to all participants (≥45 years, n = 7130). Cognitive decline and dementia incidence increased with aging among older adults. The dementia group had a significantly higher rate of cognitive decline than the control group, as well as a higher number of falls and magnitude of annual changes in falls. The changes in falls were irregular regardless of cognitive function. Furthermore, falls were associated only with the development of dementia, not cognitive function. Similar trends were observed across the total participant group. Our findings highlight the importance of monitoring cognitive function and falls as potential markers for predicting dementia onset in older adults.
•We studied the association between falls and dementia in older adults.•Older adults with dementia showed a rapid increase in cognitive decline.•Significant correlation was found between cognitive decline, falls, and dementia.•Cognitive function and falls in older adults are markers of dementia.•Multifaceted approaches are needed to prevent dementia in older adults.
New technologies provide opportunities for the delivery of broad, flexible interventions with older adults. Focus groups were conducted to: (1) understand older adults' familiarity with, and barriers ...to, interacting with new technologies and tablets; and (2) utilize user-engagement in refining an intervention protocol.
Eighteen older adults (65-76 years old; 83.3% female) who were novice tablet users participated in discussions about their perceptions of and barriers to interacting with tablets. We conducted three separate focus groups and used a generic qualitative design applying thematic analysis to analyse the data. The focus groups explored attitudes toward tablets and technology in general. We also explored the perceived advantages and disadvantages of using tablets, familiarity with, and barriers to interacting with tablets. In two of the focus groups, participants had previous computing experience (e.g., desktop), while in the other, participants had no previous computing experience. None of the participants had any previous experience with tablet computers.
The themes that emerged were related to barriers (i.e., lack of instructions and guidance, lack of knowledge and confidence, health-related barriers, cost); disadvantages and concerns (i.e., too much and too complex technology, feelings of inadequacy, and comparison with younger generations, lack of social interaction and communication, negative features of tablets); advantages (i.e., positive features of tablets, accessing information, willingness to adopt technology); and skepticism about using tablets and technology in general. After brief exposure to tablets, participants emphasized the likelihood of using a tablet in the future.
Our findings suggest that most of our participants were eager to adopt new technology and willing to learn using a tablet. However, they voiced apprehension about lack of, or lack of clarity in, instructions and support. Understanding older adults' perceptions of technology is important to assist with introducing it to this population and maximize the potential of technology to facilitate independent living.
Elder financial abuse is a growing problem, with significant consequences for society. It is unclear if differences exist in the clinical and legal approach to financial abuse across Canada, thus the ...purpose of this review. Five databases were searched during the primary literature search. Secondary literature search involved searching grey literature and handpicking references from selected articles. Only articles in English were included. From 10,260 articles initially screened, 30 were included in the review. No literature was identified describing differences in the clinical approach to financial abuse, and no single definition or legislation on financial abuse was identified. Mandatory reporting is required for individuals in a hospital or care facility by only five provinces. This review has identified several important knowledge gaps on the differences in the clinical management of financial abuse, and a lack of definition, legislation and overall mandatory reporting across Canada, which requires further research.
Protein supplementation has shown to improve muscle mass in older adults. However, its effect may be influenced by supplementation dose, frequency and timing. This systematic review aimed to assess ...the effect of dose, frequency and timing of protein supplementation on muscle mass in older adults. Five databases were systematically searched from inception to 14 March 2023, for randomised controlled trials investigating the effect of protein supplementation on muscle mass in adults aged ≥65 years. Random effects meta-analyses were performed, stratified by population. Subgroups were created for dose (≥30 g, <30 g/day), frequency (once, twice, three times/day) and timing of supplementation (at breakfast, breakfast and lunch, breakfast and dinner, all meals, between meals). Heterogeneity within and between subgroups was assessed using I2 and Cochran Q statistics respectively. Thirty-eight articles were included describing community-dwelling (28 articles, n=3204, 74.6±3.4 years, 62.8 % female), hospitalised (8 articles, n=590, 77.0±3.7 years, 50.3 % female) and institutionalised populations (2 articles, n=156, 85.7±1.2 years, 71.2 % female). Protein supplementation showed a positive effect on muscle mass in community-dwelling older adults (standardised mean difference 0.116; 95 % confidence interval 0.032–0.200 kg, p=0.007, I2=15.3 %) but the effect did not differ between subgroups of dose, frequency and timing (Q=0.056, 0.569 and 3.084 respectively, p>0.05). Data including hospitalised and institutionalised populations were limited. Protein supplementation improves muscle mass in community-dwelling older adults, but its dose, frequency or timing does not significantly influence the effect.
•Protein supplementation improves muscle mass in community-dwelling older adults.•This is not associated with the dose, frequency, or timing of supplementation.•Research on protein supplementation and muscle mass gain should target hospitalised and institutionalised populations.
To assess the bidirectional association between chronic pain and depressive symptoms among middle-aged and older adults from two prospective cohort studies.
We used prospective data (12y of ...follow-up) from the English Longitudinal Study of Ageing (n = 9149, 5018 women, 65.0 ± 10.2y) and the Health and Retirement Study (n = 16,883, 9810 women, 66.9 ± 10.3y), including data from seven waves of each cohort between 2006 and 2018/2019. Depressive symptoms were assessed using the Centre of Epidemiological Studies Depression scale, while chronic pain was estimated using questions about the frequency of being troubled with pain. We used random-intercept cross-lagged panel models to assess the bidirectional association between pain and depressive symptoms, adjusting for potential confounders.
There was a cross-lagged effect of chronic pain on depressive symptoms (ELSA: β: 0.038; 95%CI: 0.011–0.066. Standardized coefficient (B): 0.021. SHARE: β: 0.044; 95%CI: 0.023–0.065. B: 0.023–0.024) as well as depressive symptoms on pain (ELSA: β: 0.010; 95%CI: 0.002–0.018. B: 0.017–0.019. SHARE: 0.011; 95%CI: 0.005–0.017. B: 0.020–0.021). Moreover, there were auto-regressive effects of both chronic pain (ELSA: β: 0.149; 95%CI: 0.128–0.171. SHARE: β: 0.129; 95%CI: 0.112–0.145) and depressive symptoms (ELSA: β: 0.149; 95%CI: 0.130–0.168. SHARE: β: 0.169; 95%CI: 0.154–0.184).
We identified a modest bidirectional association between depressive symptoms and chronic pain, using two large prospective ageing cohorts.
•The stable trait variances of both chronic pain and depressive symptoms were correlated in both cohorts.•There is a relatively low bidirectional relationship between chronic pain and depressive symptoms.•Strategies to address both conditions are needed in middle-aged and older adults.