Journal of Cross-Cultural Gerontology最新文献

The purpose of this study was to determine the healthcare utilization patterns in a national sample of older adults across several factors (ethnicity, gender, race, education) with normal and dementia/impaired cognition. We used datasets from the Health and Retirement Study (HRS, 2018) to evaluate healthcare utilization, including metrics such as hospital and nursing home stays, hospice care, and the number of visits to the doctor. Logistic models were used to predict healthcare utilization separately in those with normal cognition and dementia. Our final sample comprised 15,607 adults (mean age: 65.2 normal cognition, mean age 71.5 dementia). Hispanics with normal cognition were less likely to stay in a hospital than non-Hispanic respondents (OR: 0.52-0.71, p < 0.01). Being female was associated with a higher risk for shorter nursing home days (OR: 1.41, p < 0.01) and doctor visits (OR: 1.63-2, p < 0.01) in cognitively normal older adults. Being female was associated with a lower risk for hospital stay in those with dementia (OR: 0.50-0.78, p < 0.01). Respondents identifying as Black or other races with dementia were less likely to experience nursing home days (OR: 0.42, p < 0.04). Black respondents with normal cognition were less likely to experience doctor visits (OR: 0.32-0.37, p < 0.01). Those with more than a high school education in both groups were more likely to experience doctors' visits. The study points to the continued disparities in healthcare utilization linked to participants' characteristics and cognition.

The phenomenon of 'tiredness of life' (ToL) in older adults emerges in societal and political debates on euthanasia and assisted suicide (EAS) as well as in academia. However, the conceptualization of ToL is unclear and seems to be influenced by the socio-political context of studies (i.e., EAS debates). Also, lay perspectives are largely neglected in current conceptualizations, but appear important to assess their usefulness. The current study explored Belgian (n = 512) older adults' lay ideas on ToL and compared them to those of older adults from a different socio-political context, namely the U.S. (n = 144). Two sets of open-ended questions inquiring about conceptualization and personal experiences with ToL were asked. Directed content analysis was used to examine the fit of lay and current scientific ideas (defining ToL as boredom and aversion towards life, meaninglessness, fatigue). The influence of personal experiences with ToL as well as potential differences between the countries were also explored. Scientific and lay ideas were mostly overlapping. Boredom with life was the most frequent and aversion the least frequent component in both countries. Three additional components were identified in lay ideas. Participants with personal experience with ToL were mentioning most components more frequently. Interestingly, the Belgian codebook did not need to be adapted to fit the U.S. data. This study is a first indication of the usefulness of scientific ToL conceptualizations in different socio-political contexts. Ideas on ways to integrate additional insights into future research on ToL and tailor interventions are discussed.

As life expectancy rises globally, many older adults seek meaningful opportunities to remain active after retirement. One such role is that of the peer-educator, in which older adults contribute their knowledge and experience by teaching age-based peers within lifelong learning organizations. This qualitative, cross-cultural case study explores the experiences of 34 older adult peer-educators aged 61 to 84 in Porto (Portugal) and Florida (U.S.). Guided by the cross-cultural productive engagement model and using reflexive thematic analysis of semi-structured interviews, this study explored motivations for participation, perceived rewards and challenges, organizational factors shaping engagement and perceived impacts on well-being. Participants were predominantly highly educated, with many reporting prior professional or teaching experience. Across both contexts, peer-educators described sharing knowledge, building community and reciprocity as central motivators and rewards, while designing meaningful and inclusive classes as a common challenge. Suggested organizational improvements focused on infrastructure and outreach; alongside context-specific needs. Overall, findings position the peer-educator role as a form of productive engagement in later life, demonstrating how contributing through teaching can support psychological well-being, mental stimulation, and sustained social participation, while underscoring the importance of organizational and cultural contexts in shaping meaningful opportunities for continued engagement.

Traditional gerontology has often been shaped by Euro-Western biomedical paradigms that define aging through decline, dependency, and individual burden. These models frequently overlook the lived experiences, knowledge systems, and culturally grounded roles of Indigenous and racialized Elders. This narrative review explores Indigenous and community-led frameworks that are reshaping gerontology through relational ethics, land-based knowledge, Elder leadership, and knowledge sovereignty. It highlights models that redefine aging as a socially connected, spiritually grounded, and collectively governed process. Drawing on five diverse case studies from Canada, Australia, India, Alaska, and transnational Indigenous contexts, this review synthesizes literature grounded in participatory, community-led approaches. A critical Indigenous-informed lens guided the thematic synthesis-foregrounding ethical relationships, cultural continuity, and resistance to biomedical dominance. Across all cases, shared themes included Elder leadership, land-based healing, knowledge sovereignty, and culturally rooted definitions of wellness. These frameworks offer conceptual alternatives to dominant models by reframing aging through interdependence, relational resilience, and community accountability. This review defines decolonizing gerontology as a paradigmatic shift-from biomedical decline and individualism toward relational, cultural, and land-anchored understandings of Elderhood. Rather than supplementing dominant paradigms, Indigenous and community-led models propose distinct, actionable frameworks for equity-based aging research, policy, and care.

Of the almost two million older persons in Ghana, fewer than 300,000 receive pensions from the Social Security and National Insurance Trust (SSNIT), having contributed to the pension scheme during their working years. Since ageing is associated with several social, economic, and health adversities, it is important to ascertain the quality of life of this population to identify areas of their lives that may need improvement. Consequently, this study examined the quality of life of 437 pensioners benefiting from the SSNIT pension scheme in the Greater Accra Region of Ghana. The study employed mixed-methods and utilized the WHOQOL-BREF to measure the quality of life under the physical, psychological, social, and environmental domains. The findings suggested that the pensioners had at best a moderate social, physical, psychological, and environmental quality of life. Based on the findings, the study recommends policy actions aimed at enhancing pension adequacy, strengthening social support and community engagement opportunities, and improving access to health and welfare services for pensioners.

Caregivers' health status is important, given its importance for their own wellbeing and capacity to provide quality care. While single item self-rated health questions in surveys are an efficient measure, responses limit understanding of what people mean when they rate their health in a particular way, and do not address reporting heterogeneity. We draw on data collected in a mixed-method study on the informal caregiving of older people in rural northeast South Africa, which including a standard cross-sectional quantitative survey, an ethnographic survey, and longitudinal ethnographic observations. Results indicate that who becomes the caregiver, and the form of care provided, are influenced primarily by conventional expectations of gender, age, and kinship, and of caregiving alternatives. Caregivers invoke the social circumstances in which they provide care when describing and rating their own health and ability to care, and in determining what conditions they include or dismiss as indicators of health or illness. Social context influences respondents' evaluation of own health and capacity to care, future ability and needs, including as reported in response to different methods. We advocate carefully constructing health condition response categories to include functional impairments and to be informed by context.

Cognitive deficits such as attentional impairment and executive dysfunction significantly impact daily living activities in older adults with dementia. This study aimed to evaluate the efficacy of Cognitive Stimulation Therapy (CST) compared to Reality Orientation & Reminiscence Therapy (RO&RM) in improving attention, episodic memory, and executive functions in older Chinese adults with mild to moderate dementia. Additionally, it sought to explore the relationship between attention improvements and changes in executive functions. A retrospective observational pre-post study was conducted from September 2018 to July 2021, involving 160 participants aged 65 or above, diagnosed with dementia. Participants were divided into CST (n = 80) and RO&RM (n = 80) groups, receiving six weeks of daily 1-h sessions. Attention and episodic memory were assessed using the Kendrick Cognitive Test for the Elderly (KCTE), and executive functions were evaluated using the Chinese Disability Assessment for Dementia (CDAD). CST significantly improved attention (p = 0.002) and episodic memory (p = 0.010), with attention improvements being more pronounced. RO&RM showed no significant improvement in these areas. Overall, executive functions did not significantly change, but a positive correlation was found between improved attention and reduced decline in executive functions. CST demonstrated notable potential in enhancing attentional capacities and episodic memory in older Chinese adults with dementia. However, its impact on executive functions was inconsistent. Future research should involve larger sample sizes, longer follow-up periods, and explore combining CST with other therapies to maximise therapeutic potential. This study underscores the importance of culturally adapting CST to better fit the needs of the Chinese dementia population.

Contemporary societies are increasingly becoming diverse, and the needs of older people continue to emerge as a public health priority. Older migrants from low-and middle-income countries to high-income countries have been noted to have poorer health, ultimately affecting their quality of life. While social policymakers strive to achieve inclusivity in framing and implementing policies for older people, older migrants from low-and middle-income countries continue to be underrepresented in research, therefore, limiting their contribution to policy decisions regarding their well-being. Older migrants from low- and middle-income countries have unique experiences that can contribute to policy towards their welfare. The aim of this review is to explore the perceptions and experiences of aging among older migrants from low- and middle-income countries to high-income countries. Five databases were systematically searched for published literature. Twenty-four studies were included in the final synthesis. The included studies were synthesized using an overlapping three-phase approach of inductive coding, developing descriptive themes, and merging the descriptive themes into analytic themes. Five main analytic themes emerged: social support and network as facilitators and barriers to aging, aging between two worlds, fostering health and well-being, resilience of identity, and ensuring economic stability and empowerment. Older migrants can benefit from policy interventions that consider their experiences.

The older adult population in Türkiye is increasing, paralleling global trends; however, there is a lack of information regarding the prevalence of successful aging in the Turkish context. This study aims to fill this data gap by assessing both the objective and subjective prevalence of successful aging in Turkish adults aged ≥ 50 years. The study included 478 older adults (M = 72.11, SD = 10.43), categorized by age range (50-64, 65-74, 75-84 and ≥ 85 years) and residence status (nursing home residents and community-dwelling adults). Participants were compared based on successful aging criteria defined by Rowe and Kahn's model (1997) and a self-rated successful aging item. Descriptive analyses were conducted to assess the prevalence of successful aging. The overall prevalence of successful aging was found to be 6.3% according to Rowe and Kahn's criteria, while 55.2% of participants self-rated themselves as aging successfully. A significant decreasing trend in the prevalence of successful aging components was observed with increasing age, and community-dwelling older adults exhibited a higher prevalence of successful aging components compared to nursing home residents. The findings indicated that nursing home residency and increased age are inversely related to both objective and subjective successful aging. Furthermore, older adults in Türkiye tend to maintain fewer components of successful aging than their counterparts in other countries.