At the end of the rainbow: ageing and place of LGBTQI+ people

Attitudes toward aging, active coping, and depressive symptoms among middle-aged and older Korean adults: How do they differ by age group?

ABSTRACTMeaningful intergenerational interactions between older and younger adults are rare outside of family relationships. Interventions to increase positive intergenerational interactions are growing, but finding appropriate measures of attitudes toward both younger and older age groups is difficult. Many measures assessing attitudes toward older adults can remind participants of negative stereotypes of aging and are rarely used to assess attitudes toward younger adults. We adapted Pittinsky, Rosenthal, and Montoya’s allophilia measure to assess attitudes toward younger (18–25 years old) and older (over age 65) adults. In the first study, 94 traditional college age and 52 older adults rated older and younger adults. The allophilia measure distinguished between younger and older adults’ attitudes toward each age group. In the second study, we compared the age-related allophilia measures with seven traditional measures of attitudes toward older adults. Forty-seven traditional college age students completed measures. As predicted, correlations between allophilia toward older adults and the traditional semantic differential measures were weak (i.e., r = |0.15|or less), whereas correlations with general attitudes toward older adults were more moderate (r = 0.59 or less). Correlations between allophilia toward younger adults and the traditional measures were primarily non-significant as predicted. The allophilia measure differentiated between the five domains of positive attitudes toward younger and older adults and was not highly correlated with measures of more negative attitudes toward older adults. Results suggest that the allophilia measure can fill a need for a measure of positive attitudes toward older and younger adults.

The present study aimed to understand how key risk factors of older adult suicide interact to ultimately lead to death by suicide using data collected post-mortem. A psychological autopsy was used to gather detailed information about psychiatric diagnosis, medical problems, social isolation, and negative attitudes expressed by the individual during the six months prior to their death. Interviews with next-of-kin, medical and psychiatric records, and the Cumulative Illness Rating Scale for Geriatrics were used. Subjects included 32 older adults who died by suicide and 45 older adults who died by natural causes. Hopelessness, depression, and negative health attitudes were strongly correlated with suicide. Older age was associated with social isolation, suggesting an indirect relationship with suicide via hopelessness, depression, and negative health attitudes. Physical illness did not increase risk. Multivariate analyses suggested that hopelessness fully mediated the effects of social isolation, negative health attitudes, and depression on suicide. Psychological factors played the largest role in suicide deaths compared to social isolation and physical illness. Suicide interventions aimed at older adults should ensure hopelessness, depression, and negative health attitudes are primary targets.

Though it is generally acknowledged that older adults are underserved in the area of mental health services, the impact of ageist stereotypes on mental health diagnosis and access to care, and on the provision of psychotherapy to older adults, has not been extensively studied. This chapter reviews the sparse literature on ageism and mental health services with the goals of examining current practice related to the assessment of mental health problems and barriers to optimal therapy of older adults from the social perspective of ageism. The chapter begins with a review of literature pertaining to attitudes of mental health clinicians towards psychotherapy of older adults, and focuses on possible contributing factors to the development of ageist attitudes among clinicians. Subsequently, we discuss older adults’ negative attitudes toward ageing, psychiatric diagnosis and psychotherapy, which may affect patients’ interpersonal encounters with a psychotherapist. We also address challenges and problems in the assessment and diagnosis of older mental health patients, and raise the possibility that ageist attitudes may be responsible for some of these issues. Finally, we discuss common difficulties in providing therapy to older adults with mental health problems and review different therapy approaches with older adults. Here again, we discuss the possibility that ageist attitudes might play a role in difficulties with the adaptation of these therapeutic methods for older adults. The chapter concludes with a discussion of possible prevention strategies to address ageist attitudes in mental health settings and makes recommendations regarding future research in this understudied area.

Sleep is an integral part of individuals' health and wellbeing. Despite evidence showing that social stressors are important contributors to older adults' sleep problems, how the accumulative stressful life events (SLEs) and ageing attitudes independently and jointly affect sleep quality among older adults in developing countries remains unclear. This study examined the effects of SLEs on subjectively rated sleep quality among older adults in China, and explored the potential mediating and moderating roles of positive and negative ageing attitudes on the above association. Using data from the 2014 China Longitudinal Ageing Social Survey, we had complete data for 7,780 older adults aged 60 and older. We employed logistic regression models and the Karlson–Holm–Breen decomposition method. Our findings indicated that SLEs significantly increased the risk of poor sleep quality, especially for those who had experienced two or more SLEs during the past year. Positive ageing attitudes were associated with lower odds of poor sleep quality, whereas negative ageing attitudes were related to higher odds of poor sleep quality. Moreover, the mediation analyses suggested that SLEs were associated with poor sleep quality via negative ageing attitudes. The moderating effects further documented that higher levels of positive ageing attitudes can significantly attenuate the deleterious impact of SLEs on sleep quality. The findings highlight the significance of SLEs for older adults' sleep quality and shed light on the importance of ageing attitudes to improve older adults' sleep in China as well as other low- and middle-income countries, where the social safety nets are still underdeveloped.

Cognitive changes associated with aging bear both advantages and disadvantages for information processing that affect evaluations among older adults. Previous research showed that individuals evaluate objects more favorably when the object is framed positively (e.g. 85% success) rather than negatively (e.g. 15% failure). Evaluations are also sensitive to polarization levels of quantitative information (e.g. 90%/10% vs. 70%/30% success/failure). This paper examines how attribute framing and polarization levels moderate evaluations among older and younger adults. Study 1 examined older adults sampled from community centers for retired people and younger adults sampled in public places. The findings showed that older adults were more susceptible to attribute framing than younger adults, whereas their sensitivity to polarization levels was lower. To test older adults who are still working, Study 2 recruited both older and younger adults from an online panel. The findings replicated the effects of attribute framing and polarization level, but these effects were not significantly different across age groups. The difference between Study 1 and Study 2 in age-related effects suggests that chronological age is not the sole predictor of changes in evaluations and decision making among older adults. Future research should explore the contribution of cognitive – social aptitudes to these changes. The findings were interpreted in view of fuzzy-trace theory, suggesting that older adults rely more heavily on gist, owing to better experience-based abstractions, along with poorer verbatim representations, making them more susceptible to framing bias and less sensitive to polarization levels. Theoretical and practical implications are discussed.

Saudi Arabia is facing the challenge of an aging population. There is great demand to teach and train physicians in geriatric medicine.1, 2 Existing literature on the attitudes of medical trainees toward elderly adults shows a wide difference, ranging from negative to positive.3 A 29-question survey was distributed to medical residents at King Faisal Specialist Hospital and Research Centre to ask about their attitude toward older adults. Forty-two of 85 residents completed the questionnaire (49% response rate); 79.1% of residents preferred to see younger individuals, 55.8% were not interested in treating elderly adults because they are more difficult to treat and have multiple illnesses, 34.9% sometimes ordered restraints or medication for agitated individuals without evaluating them, 53.5% thought that taking a medical history from an elderly adult was difficult, 55.8% did not feel comfortable treating elderly adults or prescribing medications for them, 62.8% thought that treatment of chronically ill elderly adults did not not change the outcome, 32.6% paid little attention to the social or personal effect of an illness on an elderly adult, 65.1% did not think that the current structure of the King Faisal Specialist Hospital and Research Centre system was well suited to caring for elderly adults, 81.4% agreed that there was a need for a formal training program in geriatric medicine in Saudi Arabia, and 90.7% would not consider a career in geriatric medicine. The reasons for this negative attitude toward elderly adults could be the lack of instruction and training in geriatric medicine. There are no curricula covering geriatric medicine in medical schools or in residency programs in Saudi Arabia, and there has been no national geriatric fellowship program. In North America and Europe, there are well-structured rotations for geriatric medicine during medical school and residency training programs.4 This is important to ensure that future physicians are adequately prepared to care for older adults.5 Multiple studies have shown that geriatric education improves medical students' attitudes toward elderly adults.6 Educational strategies include direct care, bedside rounds, and lectures.7 The literature shows that an important means of tackling poor attitudes of staff toward older adults is through extensive and continued training. Swedish researchers reported that, after a year of special education, medical trainees came to view older adults with dementia as “unique human beings” rather than “a homogeneous group.8 Several authors have written about the importance of medical staff being exposed to healthy elderly adults, as well as to those who are ill. Staff who are trained and experienced in geriatrics will not only be better equipped to treat elderly adults, but also more sensitive to older adults' dignity and autonomy.9 Medical residents have negative attitudes toward older adults. This study shows the need for a comprehensive geriatric medicine curriculum in medical colleges and residency programs in Saudi Arabia to improve attitudes, knowledge, and skills in the care of older adults. Conflict of Interest: The author has no conflicts of interest in the research, no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work, and no other relationships or activities that could appear to have influenced the submitted work. Author Contributions: Muneerah M. Albugami is the sole author. Sponsor's Role: None.

Although technology can benefit service providers, caregivers, and the elderly, its application in an aging society can bring special challenges. This study looked at older adults' adoption of one technology that is highly prevalent in modern society--the automatic teller machine (ATM). The findings indicated that users and nonusers differed in mechanical reasoning skills and in attitudes toward ATM technology. Older adults with higher mechanical reasoning skills were more likely to be ATM users. Nonusers had more negative attitudes toward ATMs, and, among nonusers, those who had tried an ATM had more positive attitudes than those who had never tried one. The findings of this study are discussed in terms of factors that may affect the adoption of other technologies by older adults. Suggestions for increasing the acceptance of technologies by the elderly are also addressed.

I read with great interest Kawakami et al.'s paper, “Examining the combined effects of social isolation and oral dysfunction on cognitive decline in community-dwelling older Japanese adults”.1 The research highlights a significant association between social isolation (SI) and oral dysfunction (OD), individually and in combination, with cognitive decline in older adults. Although the paper effectively presents these relationships, I propose an additional layer of understanding: that SI and OD are deeply intertwined, forming a self-perpetuating vicious cycle that accelerates cognitive decline. The study's conclusion regarding the combined factors of SI and OD, and their association with cognitive decline is particularly insightful.1 My opinion is that this association is strengthened by a bidirectional relationship between SI and OD, creating a feedback loop that intensifies their negative impact on cognitive function. This vicious cycle unfolds as follows: oral dysfunction often leads to social isolation. Challenges with eating, chewing and speaking, common manifestations of OD, can cause embarrassment and discomfort, leading to a reluctance to participate in social activities, especially those involving food or conversation. Consequently, individuals might withdraw, increasing SI and loneliness. This withdrawal reduces vital cognitive stimulation, directly contributing to cognitive decline. Specific issues in geriatric dentistry, such as significant tooth loss, complexities with dentures and dry mouth (xerostomia) often induced by polypharmacy, severely impact an older adults' confidence and ability to engage socially, further driving isolation.2 Conversely, SI can profoundly worsen oral dysfunction. A lack of social engagement can diminish an individual's motivation or access to maintain diligent oral hygiene, seek regular dental checkups or address emerging oral health issues.3 Without social support, self-care, including oral health, might be neglected. The psychological stress and potential depression associated with prolonged SI can also indirectly impact oral health by altering immune responses or reducing health-seeking behaviors.4 This deterioration in oral health then perpetuates the isolation, making social interaction even more challenging. Existing barriers to dental care in older adults, such as financial constraints, transportation difficulties, and limited access to geriatric dental specialists, are exacerbated by SI, as isolated individuals might lack the support networks necessary to overcome these hurdles.5 Negative attitudes and misconceptions regarding oral health in older adults, even among some healthcare professionals, further hinder access and motivation for care for those who are socially isolated. This interplay between SI and OD creates a powerful negative synergy, amplifying cognitive decline (Figure 1). Social isolation deprives the brain of crucial cognitive stimulation and increases psychosocial stress, both well-established contributors to cognitive impairment. Simultaneously, oral dysfunction can lead to malnutrition and chronic oral inflammation, which negatively impacts brain health.6 When these factors reinforce each other, cognitive reserve erodes faster, making individuals significantly more vulnerable to cognitive decline and dementia. The combined burden of increased oral disease risk (e.g. gum disease, tooth decay) and challenges in maintaining oral hygiene due to physical or cognitive impairments creates a cascade of health issues that collectively undermine cognitive resilience.6 Understanding this vicious cycle is critical for developing more effective and holistic interventions. Beyond promoting general social engagement and improving overall oral health, a comprehensive approach must consider several intervening factors. Integrated care models are essential, where dental professionals screen for SI and cognitive decline, and social workers understand oral health's impact on social participation. Psychological support is crucial to address distress and embarrassment. Nutritional counseling can mitigate cognitive risks from malnutrition. Community-based programs combining social activities with oral health education and accessible dental screenings offer dual benefits.7 Technology-assisted interventions, such as virtual platforms for social connection or digital reminders for oral hygiene, can support homebound older adults.8 Caregiver education on the interconnectedness of these factors is also vital. Crucially, targeted geriatric oral health initiatives are needed to directly confront specific challenges: effective xerostomia management, robust support for managing tooth loss and dentures, adaptive tools for oral hygiene despite limitations, and dismantling financial/transportation barriers to specialized dental care.9 Efforts must also shift negative attitudes and misconceptions about older adults' oral health. In conclusion, Kawakami et al.'s paper provides a vital foundation for understanding the combined impact of social isolation and oral dysfunction on cognitive decline. By recognizing the potential for a vicious cycle between these two factors, and by proactively addressing the specific challenges inherent in geriatric dentistry, we can move toward more comprehensive and impactful interventions. These integrated strategies will be instrumental in promoting healthier aging, and significantly mitigating the risk of cognitive impairment and dementia. No funding was received. The author declares no conflict of interest. All aspects of this work were carried out by the sole author. Data sharing is not applicable to this article, as no new data were created or analyzed in this study.

Ageism has become a social problem in an aged society. This study re-examines an ageism affirmation strategy; the designs and plans for this study were pre-registered. Participants were randomly assigned to either an experimental group (in which they read an explanatory text about the stereotype embodiment theory and related empirical findings) or a control group (in which they read an irrelevant text). The hypothesis was that negative attitudes toward older adults are reduced in the experimental group compared with the control group. Bayesian analysis was used for hypothesis testing. The results showed that negative attitudes toward older adults were reduced in the experimental group. These findings contribute to the development of psychological and gerontological interventions aimed at affirming ageism. In addition, continued efforts to reduce questionable research practices and the spread of Bayesian analysis in psychological research are expected.

Ageism has become a social problem in an aged society. This study re-examines an ageism affirmation strategy; the designs and plans for this study were pre-registered. Participants were randomly assigned to either an experimental group (in which they read an explanatory text about the stereotype embodiment theory and related empirical findings) or a control group (in which they read an irrelevant text). The hypothesis was that negative attitudes toward older adults are reduced in the experimental group compared with the control group. Bayesian analysis was used for hypothesis testing. The results showed that negative attitudes toward older adults were reduced in the experimental group. These findings contribute to the development of psychological and gerontological interventions aimed at affirming ageism. In addition, continued efforts to reduce questionable research practices and the spread of Bayesian analysis in psychological research are expected.

Literature about views on aging and preparation for late life indicates the pivotal role of attitude towards aging in planning for post-retirement reemployment. However, it still remains unclear whether negative age stereotypes impede post-retirement re-employment among retired and unretired older adults. Using a cross-sectional design, 317 Hong Kong older adults (50 – 80 yrs, mean age 60.99 ± 6.17, 54% females, 113 unretired) were recruited by using a convenience sampling method. We found that unretired older adults’ negative attitudes toward older population in personality and mental health predicted a lower likelihood of post-retirement employment planning at a marginally significant level (p = .07), even after controlling socioeconomic status. Retired older adults’ negative attitudes toward older adult population in their societal participation were significantly associated with a lower likelihood of actual post-retirement employment (p = .03 < .05). Meanwhile, negative attitudes toward the older adult population in their physical aspects were significantly associated with a higher likelihood of actual post-retirement employment (p = 0.002 < .01). Findings suggest that societal expectations about older adults’ vulnerability in personality, mental health and social participation may hamper their productivity in late life. Future studies are warranted to further examine how self-perceptions about aging in different domains shape post-retirement employment planning in a larger sample.

Background/Objectives: Negative attitudes towards ageing, depressive symptoms, and impairment in instrumental activities of daily living (IADL) are associated with worse health outcomes in older adults, including increased risk of dementia. Little is known about the longitudinal impact of depressive symptoms and functional impairment on ageing attitudes in older people. Identifying the relationships between these risk factors may help inform interventions targeting early dementia. The aim of this study was to determine whether depressive symptoms and functional impairment are associated with ageing attitudes over 6 years. Methods: Participants included 172 community-dwelling adults aged 76-96 years without dementia from the Sydney Memory and Ageing Study who were followed up over 6 years. Multiple linear regression models were used to examine prospective relationships between depressive symptoms, IADL (informant-reported or performance-based) and ageing attitudes. Results: After adjusting for potential confounding variables, more baseline depressive symptoms were associated with more negative ageing attitudes towards physical change (B = -0.10, 95%CI -0.18 to -0.02, p = 0.021) and psychological growth (B = -0.09, 95%CI -0.17 to -0.01, p = 0.037), and worse informant-reported IADL was associated with more negative ageing attitudes towards psychosocial change (B = -0.36, 95%CI -0.64 to -0.09, p = 0.010) over 6 years. Conclusions: The results highlight the importance of assessing and treating depressive symptoms and functional decline in older people, as they are significantly associated with negative attitudes about the ageing process, a known risk factor of worse health outcomes, including dementia.

The purpose of this study was to determine the influence of three college courses on attitude change toward older adults. To measure attitude change the Kogan Attitudes Toward Old People Scale (1961) was administered to 221 college students at the beginning and end of the semester. Participants were enrolled in one of three college courses: Child Development, Human Development, and Aging and the Family. The three courses varied in content regarding older adults and the aging process. Findings revealed that students' negative attitudes toward older adults significantly decreased and positive attitudes increased after taking the Aging and the Family class. It appeared that a combination of factors and teaching techniques lessened students' negative attitudes. The lecture-based course included small group discussion, problem-solving activities, participation in an aging awareness simulation activity, an interview with an older adult, and covering a wide variety of topics related to aging. The Human Development class, which included a two-week segment on aging issues, did lessen students' negative attitudes toward older adults, however, their attitudes did not become more positive as a result of the course. There was no significant change in students' attitudes in the Child Development class. However, there was no difference expected given that this class acted as the control group and no class time was given to aging issues. Further exploration into exactly what lessens negative attitudes as well as what increases positive attitudes is critical to assisting educators in planning and evaluating interventions that target improving attitudes toward older adults.

Negative attitudes of healthy older adults toward unhealthy older adults: Focus on the subjective health