Elderly Americans Research Articles

THE IMPACT OF INFORMAL CARE ON FORMAL CARE UTILIZATION AMONG ELDERLY AMERICANS

Abstract Objectives This research aims (1) to examines the impact of informal care on the utilization of formal care among elderly Americans, and (2) to investigate how probable dementia affect this relationship. Method Using cross-sectional data from the National Health and Aging Trends Study (NHATS 2011 & 2015), we build a correlated Tobit model to analyze the quantity of informal and formal care received by elderly individuals, which not only handles the censored nature of the dependent variables, but also allows a more flexible error structure. To address endogeneity concerns, instrumental variables derived from the characteristics of the elderly’s children are incorporated. Result Participants who did not live in long-term care facilities (N = 7,090) were included. Our estimation results indicate that when monthly hours of informal care received are below 83 hours, the monthly hours of formal care decrease with an increase in informal care. Conversely, when monthly hours of informal care received exceed 83 hours, the monthly hours of formal care increase with additional informal care. Probable dementia increases the monthly hours of informal care by 31.2 hours and the monthly hours of formal care by 6.4 hours. Conclusion Informal care substitutes for formal care when elderly individuals require only a low to moderate level of informal care. However, informal and formal care become complementary when the elderly requires more intensive care. Probable dementia has a significant impact on both informal care and formal care.

‘Pocahontas’: a vigorous and highly productive American elderberry

‘Pocahontas’: a vigorous and highly productive American elderberry

"At the End I Have a Say": Engaging the Chinese Community in Advance Care Planning.

Despite the association of advance care planning (ACP) with improved patient and caregiver outcomes, Chinese American elders have low rates of ACP. Assess ACP facilitators/barriers in the San Francisco (SF) Chinese community and codesign, implement, and test community-based ACP-promoting pilot events. A Chinese Community Committee (N=19 community-based organization leaders, health system representatives, community members) conducted focus groups in Cantonese and English with Chinese older adults (age ≥55), caregivers, and community leaders. The Committee designed and implemented pilot events in-person and online. We analyzed focus group data using thematic analysis; assessed pre-to-post-event readiness to engage in ACP (validated survey; 14 scale, 4=most ready); and assessed event acceptability. A total of 34 people participated in six focus groups. Themes described Chinese community-specific importance of ACP (e.g., reduces family burden), barriers (e.g., younger generations lack tools to discuss ACP with elders and vice versa), and facilitators (e.g., intergenerational events, culturally/linguistically appropriate materials). Based on focus groups findings, the Committee developed a novel ACP tool and designed intergenerational events. A total of 195 participants attended 10 events; 95% were Chinese, 90% spoke Chinese languages, 80% were women. ACP readiness increased significantly (1.66 [SD 0.84] vs. 2.03 [SD 0.85]; P < 0.001); 94% of participants were comfortable attending and 96% would recommend events. Community-developed intergenerational events that highlight the value of ACP and address barriers are acceptable and increase ACP engagement in the Chinese community.

Can long-term care partnership programmes increase insurance coverage and reduce Medicaid costs?

ABSTRACT Although long-term care is a substantial financial risk for elderly Americans, only about 10% purchase insurance, with many of the remainder relying on Medicaid. Faced with rising Medicaid expenditure on long-term care, states introduced long-term care partnership programmes in the hope of reducing Medicaid spending by encouraging the purchase of private insurance. Using numerical optimization techniques, we show theoretically that partnership programmes will only modestly increase long-term care insurance coverage. Most of the benefits will go to those who would have purchased non-partnership policies. Thus, the potential costs to Medicaid will exceed the savings.

Spray drying to produce novel phytochemical-rich ingredients from juice and pomace of American elderberry

The cultivation and commercialization of American elderberries (Sambucus nigra subsp. canadensis), rich in acylated anthocyanins, is nascent. In this study, American elderberry juice and pomace extract were spray dried using soy protein isolate (SPI) or tapioca starch (TS) as carriers to develop functional food ingredients. Physicochemical, morphological, and bioactive properties were analyzed, and an in vitro gastrointestinal digestion model was used to study polyphenol bioaccessibility. An efficient spray drying process (solids recovery >60%) was established. Elderberry particles produced with SPI had higher solubility (60%–64%), lower porosity (69%–70%), and better flowability (22% Carr index, 1.29 Hausner ratio). Spray dried particles produced with tapioca starch showed significantly higher total polyphenol content (42–49 mg gallic acid equivalent/g sample), proanthocyanidin content (0.76–2.86 mg proanthocyanidin-B2/g sample), and anthocyanins (7.86–33.80 mg/g sample) for both elderberry juice and pomace extract, compared to SPI-derived ones. Particles of encapsulated elderberry juice or pomace extract with SPI had higher bioaccessibility compared to non-encapsulated elderberry juice or TS-derived particles. Overall, spray drying American elderberry juice and pomace extract is an effective and sustainable strategy to create novel ingredients for multiple food applications. These findings offer an industry-friendly technological solution to develop value-added ingredients for the emerging American elderberry market.

Association between Nonfood Pre- or Probiotic Use and Cognitive Function: Results from NHANES 2011-2014.

In this study, we collected data from the National Health and Nutrition Examination Survey (NHANES) for the years 2011-2014. Multiple linear regression and logistic regression were used to analyse the association between nonfood pro- or prebiotic use and cognitive function among elderly Americans. To estimate the potential unobserved results, propensity score matching (PSM) was used to analyse the causal effect. Nonfood pro- or prebiotic use was analysed through the Dietary Supplement Use 30-Day Study. Cognitive function was evaluated by the Digit Symbol Substitution Test (DSST), the Animal Fluency Test (AFT), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), and a composite Z-score calculated by summing the Z-scores of three tests. Male participants who used nonfood pro- or prebiotics tended to have higher comprehensive cognitive function (sum.z) with a β-coefficient of 0.64 (95% CI: 0.08-1.19). Probiotics or prebiotics may be a protective factor against cognitive impairment in males, with an odds ratio of 0.08 (95% CI: 0.02-0.29). Furthermore, the average treatment effect for the treated (ATT) with nonfood pro- or prebiotics (0.555) on sum.z in males was statistically significant (p < 0.05). Our research revealed that nonfood pre- or probiotic use was an effective method to improve cognitive function in elderly men from the USA.

Native American Elders’ Lived Experiences During the COVID-19 Pandemic

The purpose of this study was to explore the lived experiences of Native American elders aged 65 and older during the COVID-19 pandemic. A qualitative descriptive narrative approach using the Consensual Qualitative Research (CQR) process was used to capture the lived experiences of four Native American elders during the COVID-19 pandemic. The Nursing as Caring theoretical framework (Boykin &amp; Schoenhofer, 2001) guided the study in understanding Native American elder’s perspective during the pandemic. Using the CQR analytical approach and the Nursing as Caring framework, three key theoretical Nursing as Caring concepts corresponded with the following three themes that emerged from the participant responses: (a) staying connected, (b) navigating ways to engage, and (c) finding purpose. Elder Native Americans lived experiences, especially during crisis times such as COVID-19, are critical for developing an understanding of the meaningfulness of staying connected, navigating ways to engage, and finding purpose.

Sex Specificity in the Mixed Effects of Blood Heavy Metals and Cognitive Function on Elderly: Evidence from NHANES

The way that males and females react to environmental exposures and negative impacts on their neurological systems is often different. Although previous research has examined the cognitively impairing effects of solitary metal exposures, the relationship between metal mixtures and cognitive function, particularly when considering an individual’s sex, remains elusive. This study aimed to investigate the sex differences in the association between multiple metal combinations and cognitive function in older Americans. This research employed the 2011–2014 NHANES survey of elderly Americans. The association between five mixed metals and four cognitive tests (the animal fluency test (AFT), the digit symbol substitution test (DSST), the instant recall test (IRT), and the delayed recall test (DRT)) were investigated with generalized linear regression model (GLM), Bayesian kernel machine regression model (BKMR), weighted quantile sum regression model (WQS), and quantile g-computation regression model (Qgcomp). A total of 1833 people, including 883 males and 950 females, enrolled in this cross-sectional study. We discovered that blood lead and blood cadmium were negatively associated with cognitive performance, while blood selenium demonstrated a positive association with cognitive function in older people. The negative relationship of heavy metal combinations on cognitive function might be somewhat reduced or even reversed via selenium. The IRT, AFT, and DSST are three of the four cognitive tests where men had more dramatic positive or negative results. There was a sex-specific connection between blood metal ratios and cognitive function among older Americans, as evidenced by the more significant relationship between mixed metals and cognitive performance in men (either positively or negatively). These results emphasize the impacts of ambient heavy metal exposure on cognitive function by employing sex-specific methods.

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

Understanding and honoring the needs of Native American elders

Overcoming barriers to care requires cultural sensitivity and resource access.

Sambucus Canadensis leaf extract mediated synthesis and analysis of antibacterial and photocatalytic degradation property of stannous oxide nanoparticles

Sambucus Canadensis leaf extract mediated synthesis and analysis of antibacterial and photocatalytic degradation property of stannous oxide nanoparticles

Elderberry Extracts: Characterization of the Polyphenolic Chemical Composition, Quality Consistency, Safety, Adulteration, and Attenuation of Oxidative Stress- and Inflammation-Induced Health Disorders.

Elderberry is highly reputed for its health-improving effects. Multiple pieces of evidence indicate that the consumption of berries is linked to enhancing human health and preventing or delaying the onset of chronic medical conditions. Compared with other fruit, elderberry is a very rich source of anthocyanins (approximately 80% of the polyphenol content). These polyphenols are the principals that essentially contribute to the high antioxidant and anti-inflammatory capacities and the health benefits of elderberry fruit extract. These health effects include attenuation of cardiovascular, neurodegenerative, and inflammatory disorders, as well as anti-diabetic, anticancer, antiviral, and immuno-stimulatory effects. Sales of elderberry supplements skyrocketed to $320 million over the year 2020, according to an American Botanical Council (ABC) report, which is attributable to the purported immune-enhancing effects of elderberry. In the current review, the chemical composition of the polyphenolic content of the European elderberry (Sambucus nigra) and the American elderberry (Sambucus canadensis), as well as the analytical techniques employed to analyze, characterize, and ascertain the chemical consistency will be addressed. Further, the factors that influence the consistency of the polyphenolic chemical composition, and hence, the consistency of the health benefits of elderberry extracts will be presented. Additionally, adulteration and safety as factors contributing to consistency will be covered. The role of elderberry in enhancing human health alone with the pharmacological basis, the cellular pathways, and the molecular mechanisms underlying the observed health benefits of elderberry fruit extracts will be also reviewed.

Patient-specific Risk Factors Increase Episode of Care Costs After Lumbar Decompression.

Retrospective cohort analysis. To determine, which patient-specific risk factors increase total episode of care (EOC) costs in a population of Centers for Medicare and Medicaid Services beneficiaries undergoing lumbar decompression. Lumbar decompression is an effective option for the treatment of central canal stenosis or radiculopathy in patients unresponsive to nonoperative management. Given that elderly Americans are more likely to have one or more chronic medical conditions, there is a need to determine, which, if any, patient-specific risk factors increase health care costs after lumbar decompression. Care episodes limited to lumbar decompression surgeries were retrospectively reviewed on a Centers for Medicare and Medicaid Service reimbursement database at our academic institution between 2014 and 2019. The 90-day total EOC reimbursement payments were collected. Patient electronic medical records were then matched to the selected care episodes for the collection of patient demographics, medical comorbidities, surgical characteristics, and clinical outcomes. A stepwise multivariate linear regression model was developed to predict patient-specific risk factors that increased total EOC costs after lumbar decompression. Significance was set at P <0.05. A total of 226 patients were included for analysis. Risk factors associated with increased total EOC cost included increased age (per year) (β = $324.70, P < 0.001), comorbid depression (β = $4368.30, P = 0.037), revision procedures (β = $6538.43, P =0.012), increased hospital length of stay (per day) (β = $2995.43, P < 0.001), discharge to an inpatient rehabilitation facility (β = $14,417.42, P = 0.001), incidence of a complication (β = $8178.07, P < 0.001), and readmission (β = $18,734.24, P < 0.001) within 90 days. Increased age, comorbid depression, revision decompression procedures, increased hospital length of stay, discharge to an inpatient rehabilitation facility, and incidence of a complication and readmission within 90 days were all associated with increased total episodes of care costs.

Clinical outcome of Bioball universal adapter in revision hip arthroplasty

BackgroundRemoval of a well-fixed uncemented femoral component in revision hip arthroplasty is challenging. A modular head–neck adapter provides an option to optimise the femoral offset and anteversion, avoiding the need for femoral stem revision. AimTo present the clinical results following revision arthroplasty with the Bioball head-neck adapter in the elderly American Society of Anaesthesiologists (ASA) Grade II, III & IV patients. Materials and methodsA retrospective review of our database was performed, and all patients classed as ASA grades II, III, & IV treated with the Bioball Universal Adapter (BUA) for 10 years were included. The indication for revision, stem retention, type of adapter, and head size were identified. Patients were contacted by a research nurse to assess the Forgotten Joint Score (FJS), the Oxford Hip Score (OHS), and any symptoms of instability at a minimum of one year post revision surgery. ResultsOur study included 47 patients. 5 (10.6%) were ASA II, 19 (40.4%) were ASA III and 23 (49%) were ASA IV. The mean age was 74 years. The mean follow up was 52 months ± 28.4 SD. The median FJS was 86 ± 11.6 SD. The median OHS was 43 ± 6.2 SD. One patient (2.1%) developed recurrent dislocation following lumbar spinal fusion. None of the other patients experienced instability. The survival rate for the adapter was 98%. ConclusionThe BUA gives good clinical outcomes with very low post revision instability. It is a valuable option for the elderly because it avoids the morbidity and risks associated with the removal of a well-fixed femoral stem. Level of EvidenceLevel IV

Association between Serum Iron, Blood Lead, Cadmium, Mercury, Selenium, Manganese and Low Cognitive Performance in Old Adults from National Health and Nutrition Examination Survey (NHANES): A Cross-Sectional Study.

Cognitive decline is a public health problem for the world's aging population. This study was to evaluate the relationships between serum iron, blood lead, cadmium, mercury, selenium, and manganese and cognitive decline in elderly Americans. Data of this cross-sectional study was extracted from the National Health and Nutritional Examination Survey (NHANES 2011-2014). Cognitive performance was measured by the consortium to establish a registry for Alzheimer's disease (CERAD), Animal fluency, and digit symbol substitution test (DSST) tests. Weighted univariable and multivariate logistic regression analyses were used to assess the associations between six trace elements and low cognitive performance, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on diabetes and hypertension history were further assess the associations. A total of 2,002 adults over 60 years old were included. After adjusting covariates, elevated serum iron levels were associated with the decreased risk of low cognitive performance (OR=0.995, 95%CI: 0.990-0.999), as well as in the elderly without diabetes history (OR=0.992, 95%CI: 0.988-0.997) and with hypertension history (OR=0.993, 95%CI: 0.988-0.997) in the Animal Fluency test. High blood cadmium and blood manganese levels were associated with the odds of low cognitive performance in old adults with diabetes (OR=2.900, 95%CI: 1.311-6.417) and hypertension (OR=1.037, 95%CI: 1.009-1.066) history, respectively. In the DSST test, high blood lead levels were related to the odds of low cognitive performance (OR=1.102, 95%CI: 1.019-1.192), as well as in the elderly without diabetes (OR=1.126, 95%CI: 1.026-1.235) and hypertension (OR=1.121, 95%CI: 1.002-1.255) history. Elevated blood cadmium levels were connected with low cognitive performance in diabetic (OR=3.177, 95%CI: 1.323-7.27) and hypertensive (OR=1.896, 95%CI: 1.056-3.403) old people. High blood selenium levels were linked to the decreased risk of low cognitive performance in all the elderly (OR=0.987, 95%CI: 0.981-0.993). Appropriate iron, selenium supplementation and iron-, selenium-rich foods intake, while reducing exposure to lead, cadmium and manganese may be beneficial for cognitive function in the elderly.

Cost-effectiveness of Prophylactic Retropubic Sling at the Time of Vaginal Prolapse Surgery

ABSTRACT The increasing proportion of elderly Americans has brought about an anticipation of 50% rise in prolapse surgeries by 2050. It is anticipated that 25% to 40% of patients undergoing surgeries will develop de novo stress urinary incontinence (SUI) after prolapse repair. The Outcomes Following Vaginal Prolapse Repair with Midurethral Sling (OPUS) found a 36% reduction in the risk for de novo SUI, but also demonstrated increased risk of bladder perforations, urinary tract infections, and incomplete bladder emptying symptoms (N Engl J Med. 2012;366:2358–2367). As a result, pelvic reconstructive surgeons often vary their approach toward prophylactic MUS at the time of vaginal prolapse repair (VPR). Although a cost-effectiveness analysis found universal MUS placement to be the most cost-effective strategy over both selective and staged strategies (J Urol. 2013;190:1306–1312), this analysis did not include an arm for the less-costly option of using a selective approach via a prolapse-reduced cough stress test (CST). In addition, Richardson analysis of patients undergoing sacral colpopexy lacks generalizability for VPR surgeries (which account for two thirds of all prolapse surgeries). The manuscript described here therefore tested the cost-effectiveness of 3 generalizable MUS utilization strategies for preventing de novo SUI within 1 year post-VPR. Three approaches were compared: (1) staged strategy performing VPR with later MUS placement only for de novo SUI; (2) universal sling placement at the time of VPR; and (3) selective sling placement with MUS at the time of VPR when occult SUI was observed at the time of preoperative prolapse-reduced CST. A representative population of women with symptomatic pelvic organ prolapse (at least stage II) was modeled. Included in the VPR model was colpocleisis, apical suspension, or anterior colporrhaphy, with or without hysterectomy. The base assumption was that all VPRs were uncomplicated and anatomically successful. Subsequent treatment pathways were formed based on the 3 aforementioned options if de novo SUI was to occur. A 2017 systematic review by van der Ploeg was used for obtaining literature to gain point estimates concerning the risk for postoperative SUI (Int Urogynecol J. 2016;27:1029–1038). The search was performed via PubMed through January 2017, and exclusionary criteria were as follows: studies examining urodynamics preoperatively, abdominal prolapse repairs, duplicate studies, and studies lacking clear definitions for VPR, MUS, or SUI. Using data from 3 previous studies, for a selective MUS, the authors estimated the rate of de novo SUI after VPR with a negative preoperative CST to be 33.6%. The authors determined the existence of 4 possible adverse outcomes following MUS: (1) persistent SUI, (2) sling lysis required for voiding dysfunction, (3) mesh exposure requiring excision, and (4) anticholinergic medications required for de novo overactive bladder. Information on costs was gathered Physician Fee Schedules from the 2020 Centers for Medicare and Medicaid Services. Incremental cost-effectiveness ratio was the primary outcome modeled, defined as the ratio of the cost difference compared with the difference in quality-adjusted life years between scenarios. Results indicated that costs were as follows for various approaches: $1051.70 per patient for staged strategy, $1093.75 for selective MUS, and $1125.54 for universal MUS. The incremental cost-effectiveness ratio value for selective MUS calculated at $2664/quality-adjusted life years, rendering it the most cost-effective and preferred strategy. The variable with the greatest effect on model cost was the proportion of patients experiencing postoperative SUI electing to undergo repeat surgical intervention via MUS placement. Strengths of the study include its use of high-quality Centers for Medicare and Medicaid Services data for costs and point estimates. Because these data hails from the large portion of older Americans covered by Medicare (the most at risk for prolapse surgery), it avoids the inclusion of large variabilities innate to individual hospital systems. In addition, a 1-way sensitivity analysis was performed based on all case assumptions, thereby demonstrating the robustness of the study model. Limitations of the study included the expected hindrance of estimations and assumptions about event incidences. A 1-year time horizon was analyzed, although this may be reasonable because risks of complications dwindle over time. Furthermore, the study only considered women with de novo SUI to have the options of no treatment or MUS placement, disregarding costs of alternative procedures such as pelvic floor physical therapy, pessary, repeat MUS, urethral bulking, or other surgical interventions. Finally, all possible common outcomes after VPR were not included, such as urinary tract infections, pain, or postoperative urinary retention requiring short-term catheterization. In this study, the overall preference for treating de novo SUI via vaginal prolapse surgeries was the selective prophylactic midurethral sling. Patient counseling should occur to inform about the risks and benefits related to prophylactic sling surgeries (including the possibility of de novo SUI after VPR). Decisions regarding treatment strategy ought to be made using each patient’s priorities and treatment goals in discussion with her surgeon.

Associations between dietary and blood inflammatory indices and their effects on cognitive function in elderly Americans.

To determine the correlations between dietary and blood inflammation indices in elderly Americans and their effects on cognitive function. This research extracted data from the 2011-2014 National Health and Nutrition Examination Survey for 2,479 patients who were ≥60 years old. Cognitive function was assessed as a composite cognitive function score (Z-score) calculated from the results of the Consortium to Establish a Registry for Alzheimer's Disease Word Learning and Delayed Recall tests, the Animal Fluency test, and the Digit Symbol Substitution Test. We used a dietary inflammatory index (DII) calculated from 28 food components to represent the dietary inflammation profile. Blood inflammation indicators included the white blood cell count (WBC), neutrophil count (NE), lymphocyte count (Lym), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), neutrophil-albumin ratio (NAR), systemic immune-inflammation index [SII, calculated as (peripheral platelet count) × NE/Lym], and systemic inflammatory response index [SIRI, calculated as (monocyte count) × NE/Lym]. WBC, NE, Lym, NLR, PLR, NAR, SII, SIRI, and DII were initially treated as continuous variables. For logistic regression, WBC, NE, Lym, NLR, PLR, NAR, SII, and SIRI were divided into quartile groups, and DII was divided into tertile groups. After adjusting for covariates, WBC, NE, NLR, NAR, SII, SIRI, and DII scores were markedly higher in the cognitively impaired group than in the normal group (p < 0.05). DII was negatively correlated with the Z-score when combined with WBC, NE, and NAR (p < 0.05). After adjusting for all covariates, DII was positively correlated with SII in people with cognitive impairment (p < 0.05). Higher DII with NLR, NAR, SII, and SIRI all increased the risk of cognitive impairment (p < 0.05). DII was positively correlated with blood inflammation indicators, and higher DII and blood inflammation indicators increased the risk of developing cognitive impairment.

Immigration Enforcement and the Institutionalization of Elderly Americans

Immigration Enforcement and the Institutionalization of Elderly Americans

Effects of Packing Density and Inoculation with Lactic Acid-Producing Bacteria to Evaluate the Potential for North American Elderberry (Sambucus canadensis L.) Fodder as Silage

Commercial elderberry production requires complete pruning in late fall to maintain productive canes. For integrated farms (livestock and crops), this biomass has potential as ensiled fodder for ruminant livestock. The objectives of this study were to determine the forage nutritive value of late-season (November) pruned elderberry (Sambucus canadensis L. “Rogersville”) fodder when ensiled. A 2 × 2 factorial laboratory silo experiment was conducted testing two packing densities with or without inoculation with lactic acid-producing bacteria silage inoculant to determine effects on silage nutritive values and fermentation parameters. Pre-ensiled elderberry fodder, composited from plants over 2000 m2, averaged 5.6% crude protein, 62.5% acid detergent fiber (ADF), 72.5% neutral detergent fiber, 11.4% non-fiber carbohydrates, 53% total digestive nutrients, and 52% relative feed value (RFV). The two packing densities were 160.2 kg dry matter/m3 and 240.3 kg dry matter/m3. Packing density did not affect any nutrient characteristics of the ensiled fodder. Acid detergent fiber was greater (p = 0.01) in un-inoculated silage, resulting in lower (p &lt; 0.01) RFV for un-inoculated silage. Only lactic acid concentration was affected by packing density with greater concentrations (p = 0.04) in high-density silos. Inoculant affected several fermentation parameters with greater concentrations of (p &lt; 0.01) propanediol, (p = 0.01) propanol, and (p &lt; 0.01) acetic acid, while un-inoculated silages had greater concentrations of (p = 0.03) ammonia-nitrogen, (p &lt; 0.01) lactic acid, (p = 0.02) succinic acid, and (p &lt; 0.01) ethanol. Overall, late-season elderberry fodder was successfully ensiled, but nutritive value was low. Packing density did not affect nutritive value but did increase lactic acid concentration. Inoculation improved the RFV by reducing ADF, and though acetic acid production was greater in inoculated silage, total acid concentration was not affected.

At Her Age: An Anthropological Analysis of the Construct of Age in the TV Series "Muddy Tires "

&#x0D; This anthropological analysis of the Serbian TV series Muddy Tires (Kaljave Gume), which aired in the spring of 2021 on the Radio Television of Serbia, aims to point out the principal meanings which can be subsumed under the three dominant problems faced by the protagonist Vesna when she finds herself in situations that demand a reexamination of previously accepted norms regarding older members of contemporary Serbian society. The analytical procedure, also applied to film, involved the construction and study of an ethnography which consists of production, content and reception, with primary emphasis on the first two elements. In this way, it was possible to distinguish several of the more important themes that underpin the basic plot structure, which, very briefly, follows the everyday life of a sixty-year-old former pianist who, following the death of her husband with whom she had an unhappy marriage, leaves for California to visit her son, daughter-in-law and grandchildren. Her relocation from the environment in which she has spent her entire life has thus created the conditions for her to embark on a new relationship with an elderly American whom she met online, but also for the process of conflict with and resistance to norms which have typically dictated to her, as a widow, certain emotions, and actions in accordance with them, while challenging others. This process in which her age is foregrounded in contrast to actions which are labelled "out of time" and therefore inappropriate, even unacceptable for those closest to her, also involves actions by opponents dressed up in the specific form of ageism such as the so-called well-meaning ageism, when an older person is forced to accept unwanted expressions of "concern" and "assistance". Finally, a subsidiary but haunting motif is the motif of suicide of older members of society (in the series committed by Vesna’s brother-in-law Jovan), which functions as a reflection of easier acceptance and understanding by one’s community, unlike the decision to continue life in a new, late-life relationship following the death of a spouse. Finally, it should be observed that the attitudes, actions and censure of the adult members of one’s family are dominant.