Expression In Later Life Research Articles

Talking really does matter: Lay perspectives from older people on talking about suicide in later life.

The cumulative body of research on suicidality in later life describes its unique and complex features in older people when compared with that in other population groups. Yet significant gaps exist in how research informs the further development of suitable interventions. The perspectives of older people are also limited in research findings. Therefore, this exploratory study aimed to (1) identify potential barriers and enablers in discussing suicidal thoughts and their expression in later life from the perspectives of lay older people and (2) explore where opportunities might occur in approach, place, relationships, and language with older people to discuss suicidal thoughts and their expression. We conducted in-depth qualitative individual interviews with 15 people aged 70-89 years. This method helped explore older peoples' own lay perspectives on suicidal thoughts in later life and how these are expressed, and their understanding of where and how people might seek support. A total of three themes were generated from the dataset: (1) intergenerational and socio-cultural differences in suicide expression, (2) the normalization of suicidal thoughts in later life, and (3) the importance and difficulties of everyday discussion and opportunities to express suicidal thoughts. Suicidal thoughts and their expression appear commonly and are normalized in later life yet remain taboo and hidden. The participants revealed how such thoughts and behaviors are typically expressed through colloquial or "off-hand" remarks and comments and the importance of authentic listening. The findings highlight the importance of more informal discussions around these topics and how care professionals, practitioners, and providers might frame opportunities for dialogue with people who may want to access support. Further engagement with community-informed participatory research methods in which older people provide their own perspectives and experiences is important in addressing these gaps. There is a need for co-designing in developing screening, assessment, and signposting outside of clinical settings that can be used in everyday caring relationships with people in later life.

A scoping review exploring the ‘grey area’ of suicide-related expression in later life: Developing a conceptual framework for professional engagement

AbstractAs the body of research on suicide in later life has developed, so has its vocabulary. This has generated a high level of overlap in concepts and terminology used to articulate suicide and how it might present, as well as ‘grey area’ behavioural terms that are both specific to older adults and less well-defined (e.g. ‘hastening of death’ or ‘completed life’). A better understanding of individual experiences and pathways to suicide can help to inform assessment and interventions, and increase the potential to relate any theoretical concepts to the implementation of such. Here, we adopted a scoping review to search systematically literature on specific presentation, features, circumstances and outcomes of these grey areas of suicide in later life. Fifty-three articles (quantitative, qualitative and theoretical) were reviewed. A narrative approach was used to merge and translate this body of knowledge into a new conceptual framework based on four key themes: (a) a sense of completed life or existential loneliness; (b) death thoughts, wishes and ideation; (c) death-hastening behaviour and advanced directives; and (d) self-destructive or self-injurious behaviour. We discuss the importance of integrating this understanding into current knowledge and suicide prevention strategies for older adults. Recommendations are made for unifying research with policy themes on healthy ageing, person-centredness within service provision and citizen participation.

A biological approach to adult sex differences in skeletal indicators of childhood stress.

In previous work examining the etiology of cribra orbitalia (CO) and porotic hyperostosis (PH) in a contemporary juvenile mortality sample, we noted that males had higher odds of having CO lesions than females. Here, we examine potential reasons for this pattern in greater detail. Four non-mutually exclusive mechanisms could explain the observed sex differences: (1) sex-biased mortality; (2) sexual dimorphism in immune responses; (3) sexual dimorphism in bone turnover; or (4) sexual dimorphism in marrow conversion. The sample consists of postmortem computed tomography scans and autopsy reports, field reports, and limited medical records of 488 individuals from New Mexico (203 females; 285 males) aged between 0.5 and 15 years. We used Kaplan-Meier survival analysis, predicted probabilities, and odds ratios to test each mechanism. Males do not have lower survival probabilities than females, and we find no indications of sex differences in immune response. Overall, males have a higher probability of having CO or PH lesions than females. All results indicate that lesion formation in juveniles is influenced by some combination of sex differences in the pace of red-yellow conversion of the bone marrow and bone turnover. The preponderance of males with CO and PH likely speaks to the potential for heightened osteoblastic activity in males. We find no support for the hypotheses that sex biases in mortality or immune responses impacted lesion frequency in this sample. Sex differences in biological processes experienced by children may affect lesion formation and lesion expression in later life.

Effects of maternal exposure to a bacterial antigen and altered post-hatching rearing conditions on avian offspring behaviour

The early-life environment plays a crucial role in shaping morphological, physiological, and behavioural traits, with potential long-term consequences for fitness. Indeed, a set of factors experienced by offspring during prenatal and early post-natal development has been recognised to affect behavioural trait expression in later life. Several studies have shown that in birds, nutritional and social rearing conditions and maternal and/or neonatal immunisations may profoundly determine the development and establishment of behaviour in offspring. To our knowledge, no research has examined whether and how the interaction between immune-mediated maternal effects and post-hatching rearing conditions affects offspring behaviour. Here, we studied the effects of maternal exposure to a bacterial antigen and altered brood size on docility, breathing rate, and aggression in the offspring of great tit, Parus major. We used a 2 × 2 design to investigate the interactive effects of maternal immunisation and brood size manipulation on offspring behavioural development. We found no such interactive effect on offspring behaviour, although we observed it regarding to offspring body mass and tarsus length. Maternal immunisation itself did not affect offspring behaviour. However, we demonstrated that the offspring breathing rate and level of aggression were affected by brood size manipulation. Both breathing rate and aggression in offspring reared in enlarged broods were lower than those in offspring reared in non-manipulated broods. Our study did not confirm earlier reports that immune-mediated maternal effects modulate offspring behavioural development, but we showed that brood size during rearing might indeed be a factor that affects offspring behaviour.Significance statementThe early environment experienced by offspring constitutes a significant source of developmental plasticity, which may profoundly affect the establishment of their behavioural traits. Food availability, social conditions, and maternal or offspring infection are crucial factors shaping various behavioural traits in birds. However, there remains a lack of studies emphasising the potential interactive effects of early-life conditions on behavioural trait development in natural bird populations. Here, to our knowledge for the first time, we experimentally examined how maternal immunisation and altered post-hatching rearing conditions interact to determine the behaviour of fledged offspring. We found that maternal treatment and brood size manipulation interactively affected offspring body mass and tarsus length, but this interaction had no effect on offspring behaviour. Our findings suggest that different mechanisms may underlie the development of morphological and behavioural traits.

THE CENTRALITY OF GENDER EXPRESSION FOR TRANSGENDER ELDERS AND CONCEPTUALIZATIONS OF SUCCESSFUL AGING

Successful aging is a construct regularly addressed in the gerontological literature, most typically referred to as living in the best physical and cognitive health possible, experiencing the least amount of disease, and engaging actively within one’s social environment. There are, however, conceptually distinct aspects of aging for older adults who identify as transgender, particularly given lifelong experiences of marginalization and stigma. In order to identify factors transgender older adults consider most relevant to successful aging, a Theory-Generating Qualitative Meta-synthesis was conducted. The study utilized systematic methods and thematic analysis with qualitative data from empirical studies focusing on transgender aging experiences, particularly drawing upon data that amplified the transgender older adult point of view. Findings of this study indicate that although trans older adults do not minimize unique challenges inherent to aging as a gender minority, successful aging rests on the relief and resilience offered by authentic gender expression. As such, data from this study informed the development of a model of successful aging that centralizes the importance of gender expression. Understanding the central role of gender expression in later life can be especially impactful for social and health service providers, as it emphasizes gender affirming experiences as highly salient to one’s own assessment of quality aging. Furthermore, conceptualizing aging for transgender elders in a way that prioritizes the importance of identity can aid in preventing an unnecessarily deficits-based perspective for service providers, and supports the necessity of amplifying a culturally specific understanding of successful aging.

Attitudes and knowledge of social work students towards sexuality in later life

Background: Sexuality in later life may be compromised by restrictive attitudes, and lack of knowledge among professionals. This study examined social work students’ attitudes and knowledge towards sexuality and sexual expression in later life and investigated associated factors.Method: Undergraduate social work students from Israel (n = 375) completed the Attitudes and Knowledge towards Older Adult’s Sexuality Scale and questionnaires regarding contacts and exposure to older adults, prior sexual education and sociodemographic.Results: Attitudes and knowledge were correlated. First year students were the most conservative and demonstrated the least knowledge. No differences were found between men and women regarding attitude. However, men and married students had greater knowledge regarding older adults’ sexuality than women or non-married students did. Increased religious observance predicted more conservative attitudes. Age predicted more permissive attitudes and greater knowledge about sexuality in later life. A mediating process examined, suggested knowledge is a mediator variable between age and attitudes towards older adults’ sexuality.Conclusion: As the population in Israel and in Western countries ages, it is important to examine the knowledge and attitudes of social work students regarding older adults’ sexuality and to develop educational and interventional programs aimed at increasing awareness, knowledge, and positive attitudes in this area.

Improving the sexual lives of older Australians: Perspectives from a qualitative study.

To examine older Australian's perspectives on how their sexual lives can best be supported and/or improved. Fifty-three, semi-structured interviews were conducted with Australian men (n = 30) and women (n = 23) aged 60 and over. Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including normalising the occurrence of sex and sexual desire in later life; increasing and improving on the quality of, cultural representations of older adults; introducing policy, educational and practice-based changes in age care facilities to support the consensual sexual expression of residents; and ensuring that sexual health campaigns and education are inclusive of older people. Our findings present clear implications for further developing sexuality education and public health campaigns, training and education of health-care professionals, and generating social and cultural change pertaining to the acceptability of the diversity of sexual expression in later life.

Sexual Consent Capacity Assessment with Older Adults.

Many healthcare providers have a limited knowledge of sexual and intimate expression in later life, often due to attitudinal and informational limitations. Further, the likelihood of an older adult experiencing cognitive decline increases in a long-term care (LTC) setting, complicating the ability of the providers to know if the older adult can make his or her own sexual decisions, or has sexual consent capacity. Thus, the team is left to question if and how to support intimacy and/or sexuality among residents with intimacy needs. Psychologists working with LTC need to be aware and knowledgeable about sexual consent capacity in older adulthood to be prepared to conduct evaluations and participate in planning care. Limited research is available to consult for best practices in sexual consent capacity assessment; however, models of assessment have been developed based on the best available evidence, clinical judgment, and practice. Existing models will be discussed and an integrated model will be illustrated via a case study.

Relationships and sexual expression in later life: a biopsychosocial perspective

The literature on sexual activity and ageing has grown substantially in the past 20 years. Until recently, a medicalized perspective dominated. In the past decade research based on a social-relational perspective has emerged. We summarize recent work from both perspectives. In addition to the effects of disease on sexual functioning of men and women over the age of 50, this review emphasizes sexual expression among older couples, newly emerging topics such as human immunodeficiency virus (HIV) in the older adult, and older lesbian and gay sexuality. Sexual functioning in both males and females continues in later life, while sexual satisfaction within their relationships is dependent upon individual responses to age-related changes. As the life course continues, some older married couples begin to desire emotional intimacy, stability, and continuity in addition to or instead of penetrative sex. This also appears to be characteristic of relationships involving two (older) women. As the world's population over 50 continues to grow there is an increasing interest in older adult's sexuality. This signals progress toward understanding healthy sexual relationships.

Sexual Expression in Later Life: A Review and Synthesis

In the past decade, researchers have begun to study the sexual functioning of typical older persons. This review summarizes literature on the sexuality of men and women over age 50 as researched by social and health scientists. Research on the relationship of biological factors (changes accompanying aging), health (physical, mental, and medication use), psychological factors (attitudes, information about sex), relationship factors (status, satisfaction), and sexual functioning (desire, dysfunctions, treatment) to sexual behavior is reviewed. The review suggests that (a) men and women remain sexually active into their 70s and 80s, (b) aging-related physical changes do not necessarily lead to decline in sexual functioning, and (c) good physical and mental health, positive attitudes toward sex in later life, and access to a healthy partner are associated with continued sexual activity. In turn, regular sexual expression is associated with good physical and mental health. Progress in understanding later life sexuality requires development of comprehensive theoretical models, a broad focus on intimacy, attention to measures and samples, and research on couples. Progress in understanding is especially important, given the aging of populations.

A review and commentary on the factors that influence expressions of sexuality by older people in care homes

The aim of this paper is to review the literature on factors that influence the expression of sexuality by older people in care homes. Sexuality is an intrinsic part of what we are, however there is evidence to suggest that the sexual needs of older people are often overlooked, particularly in long-term care settings. Whilst there is information about sexuality and its expression in later life, questions remain as to how this influences and is influenced by the behaviours and experiences of residents and staff in care homes. A systematic search of online databases. Databases using keyword and bibliographical searches in a specified timeframe were undertaken. Research studies ranging from 1996-2009 were selected for inclusion on the basis that they addressed issues relating to expressions of sexuality by older people in care homes. Forty articles were included in the review. The review revealed a dearth of rigorous research on sexuality amongst older people in general and care home residents in particular. Issues identified in the literature were categorised into four broad thematic areas: sexuality and ageing, expression of sexuality in care homes, attitudes of staff and sexuality in dementia. There is a dearth of rigorous research on the factors influencing sexual expression by care home residents. Attitudes of staff in care homes influence their perceptions about the extent to which the expression of sexuality by residents is considered to be problematic. This, in turn influences the emotional and behavioural responses of staff to the resident. There is need for nurses and other care staff to gain a better understanding of and insight into late life sexuality. This involves change at an educational level but also at an organisational and cultural level in long-term care settings.

Differential methylation of the gene encoding myo -inositol 3-phosphate synthase ( Isyna1 ) in rat tissues

Myo-inositol levels are frequently altered in several brain disorders. Myo-inositol 3-phosphate synthase, encoded by the Isyna1 gene, catalyzes the synthesis of myo-inositol in cells. Very little is known about the mechanisms regulating Isyna1 expression in brain and other tissues. In this study, we have examined the role of DNA methylation in regulating Isyna1 expression in rat tissues. Transfection analysis using in vitro methylated promoter constructs, Southern blot analysis of genomic DNA from various tissues digested with a methylation-sensitive enzyme and CpG methylation profiling of genomic DNA from different tissues were used to determine differential methylation of Isyna1 in tissues. Transfection analysis using plasmids harboring mutated CpG residues in the 5'-upstream region of Isyna1 was used to identify critical residues mediating promoter activity. The -700 bp to -500 bp region (region 1) of Isyna1 exhibited increased methylation in brain cortex compared with other tissues; it also exhibited sex-specific methylation differences between matched male and female brain cortices. Mutation analysis identified one CpG residue in region 1 necessary for promoter activity in neuronal cells. A tissue-specific differentially methylated region (T-DMR) was found to be localized between +450 bp and +650 bp (region 3). This DMR was comparatively highly methylated in spleen, moderately methylated in brain cortex and poorly methylated in testis, consistent with mRNA levels observed in these tissues. Rat Isyna1 exhibits tissue-specific DNA methylation. Brain DNA was uniquely methylated in the 5'-upstream region and displayed gender specificity. A T-DMR was identified within the gene body of Isyna1. These findings suggest that Isyna1 is regulated, in part, by DNA methylation and that significant alterations in methylation patterns during development could have a major impact on inositol phosphate synthase expression in later life.

Sexual Behavior in Later Life

This research tests the influences of age, biological, and psychosocial factors on sexual expression in later life. The American Association of Retired Persons Modern Maturity Sexuality Survey collected data on diagnosed illnesses, treated illnesses, sexual desire, sexual attitudes, partner circumstances, and sexual behavior from 1,384 persons ages 45 and older. Ordered logistic regression models estimate the associations of age, biological, and psychosocial factors with the frequency of five sexual behaviors. Diagnosed illnesses and treatments are generally unrelated to frequency of sexual activity. Sexual attitudes are related to frequency of partnered behavior and sexual desire is related to frequency of masturbation among both women and men. Satisfaction with the physical relationship with a partner is strongly related to behavior. Age remains significant after all other factors are controlled. The authors conclude that the nature of sexual expression in later life reflects the interplay of body, mind, and social context.

Older adults and the arts: the importance of aesthetic forms of expression in later life.

The purpose of this study was to examine the importance of aesthetic forms of expression in a randomly selected Swedish population age 65 to 89. Data were based on semi-structured interviews with 166 participants. Results revealed dance, music, literature, and pictures were important for this group of elderly individuals in promoting successful aging, and the connection to their everyday life was apparent. Participants considered viewing natural scenes and looking in a photo album as important aesthetic activities. The aesthetic forms of expression contributed to physical and intellectual activities, as well as to interaction with other individuals. Aesthetic experiences were related to feelings of timelessness and spacelessness, and served as sources of gratification.

THE CONTRIBUTORY AND CHANGING ROLES OF OLDER ADULTS IN THE CHURCH AND SYNAGOGUE

Older members of churches and synagogues constitute a major resource to religious organizations in American society. In many congregations this age group is not provided with adequate opportunities to demonstrate their rich inventory of knowledge and skills. The historical roles of older persons in preindustrial America provide a precedent for the creation of new contributory roles for the elderly in the twenty‐first century. In order to correct the current underutilization of older members and prepare for future ministry needs, six roles are described to illustrate the type of intramural and extramural contributions older congregational members can make. Religious educators are alerted to three structural barriers to productive role expression in later life, and the concept of career is introduced as a framework for the design of sequential role configurations for the older member. Implications of the need for a career oriented approach to innovative role making for religious education programming are ad...