Journal of Cross-Cultural Gerontology最新文献

Uncovering the factors that contribute to sustained healthy ageing is of significant interest as countries move towards ageing populations. Maintaining cognitive and physical fitness in later life is known to be influenced by factors including diet, physical activity, social connections and resilience. Healthy ageing is the lifelong process of developing and maintaining functional ability (the combination of an individual's physical and mental capacities, their living environments and the interactions among them) that enables wellbeing in older age. Leveraging on data from a longitudinal ageing study in Malaysia, Healthy Agers were interviewed to determine how their life experiences may have shaped their outlook and lifestyle choices to support their ageing process. Inductive thematic analysis following in-depth interviews revealed that these participants attributed their sustained health to four main themes; a) having a life's role and purpose, b) developing and maintaining independence, c) drive to maintain health and d) coping strategies and resilience. This study is especially insightful as it offers insights into the lived experiences of older adults born at a time of significant sociopolitical upheaval in a low-income country, highlighting the adaptive skills required to navigate major societal changes. As the first study to document insights from a select group of Malaysian Healthy Agers, lessons learnt can help to inform public health initiatives, highlighting how sustained health-related efforts and positive outlook in life is important to ageing well.

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.