European Journal of Ageing最新文献

In the context of population ageing, increasing long-term care needs and constraints on welfare spending, informal caregivers assume a pivotal role as providers of long-term care. This systematic review synthesises reported data on the diverse support policies implemented across the European Union (EU) to assist them. Findings from 35 studies and reports published between 2011 and 2025 suggest that, despite similar demographic challenges, policies diverge significantly, with some EU countries to have established mechanisms beyond financial assistance to support carers, while others, particularly those located in Eastern and Southern EU, to offer less comprehensive support. While the frameworks of defamilialisation (Nordic), supported familialism (Continental), and familialism by default (Southern and Eastern Europe) provide a useful analytical lens to our findings, the review also identifies significant heterogeneities within welfare regimes and even within countries, often driven by decentralisation and regional disparities. Across all models, financial support via cash-for-care schemes and in-kind respite care are the most common instruments, though their generosity and comprehensiveness vary substantially. In contrast, policies such as training, counselling, and flexible work guarantees are less developed, with their availability and access, however, varying significantly across the EU. Furthermore, the review identifies critical gaps in the geographical coverage of existing literature, with certain Southern and Eastern EU countries being particularly understudied. The synthesised evidence provides key implications for policymaking, thoroughly mapping the implementation of diverse social care policies as reported in the international literature.

Europe's rapidly ageing population places increasing pressure on long-term care (LTC) systems, with inequitable access standing out as a key challenge. While socio-economic disparities in LTC utilisation are well documented, inequalities in unmet needs-the gap between required and received care-are less studied. Using the 2019 European Health Interview Survey for Spain, we categorise unmet needs as fully unmet, partially unmet, or having no unmet needs and quantify the care gap in hours. We assess socio-economic inequalities and inequities in unmet needs, stratified by eligibility for publicly funded LTC and by limitation severity (number of limitations in activities of daily living). We observe that unmet LTC needs disproportionately affect women, individuals living alone, and the oldest old. In addition, we find inequality and inequity, with a disproportionate burden borne by poorer individuals and those with severe limitations. Our decomposition analysis reveals that health status, income, and living arrangement explain most of the observed inequality. Notably, among eligible individuals with more severe limitations, living arrangement emerges as the largest contributor, as having a spouse mitigates inequalities in unmet needs, while living alone exacerbates them. These results highlight the need to reduce inequalities that disproportionally affect the lowest socio-economic strata and to address disparities through more effective resource allocation and targeted policies. By using a continuous measure of unmet LTC need that allows for a more nuanced analysis of its socio-economic determinants, this study contributes to the broader debate on the fairness and efficiency of LTC provision in ageing societies.

Ageing involves changes across the life span in cognitive abilities, mental health, and personality traits. Although these domains are often studied separately, recent findings highlight their interdependence and dynamic interplay. To examine these relationships, we analysed data from the Human Connectome Project (HCP-Young and HCP-Aging datasets) divided into three age groups: Young (22-39; n = 230), Middle-aged (40-59; n = 242), and Older adults (60-79; n = 209). The interrelationships among 19 cognitive, psychological, and personality variables were investigated using a psychometric network approach, estimating one network per age group and examining how variables clustered into communities (exploratory graph analysis) and comparing the emerging networks using the network comparison test (NCT). We observed substantial differences across age groups. In younger adults, cognitive variables were split into two communities, separating lower from higher cognitive functions, whereas middle-aged and older adults did not present this separation. Two variables-delay discounting and emotion recognition -associated with cognition in younger populations clustered with personality traits and psychological factors in the Older Adults' network, suggesting an increased relevance of their affective significance. The NCT confirmed that the architectures of the Young Adults and the two older groups' networks were significantly different. Compared to the Young Adults, the Older Adults network also showed reduced overall association strength. Altogether, these findings support the view that ageing is associated with structural transformations in the relationships among cognitive, psychological, and personality domains, following a dedifferentiation trajectory across cognitive variables and a general reorganization of psychometric factors.

Investigating health and ageing with older adults with low socioeconomic status (SES) is challenging, because they seem to have trouble completing questionnaires containing abstract concepts such as health and ageing. Visual tools may be more suitable alternatives. Therefore, we had the following research questions: What are the perspectives of low-SES older adults on positive ageing? How do low-SES older adults experience the participant-driven photo-elicitation method? For this study, 21 Dutch participants (mean age 75 years) gathered a maximum of 10 photographs about positive ageing. Most participants collected photographs digitally, and two participants needed assistance. Two weeks later, they were interviewed and asked to reflect on their photographs and share their experience with this photo-voice method. Results showed that most photographed themes were Social Health (spending time with children and grandchildren), Activities, Nature and Animals (pets), and Foods and Drinks. Additionally, Mental Health (feeling happy and accepting losses) and Positive Ageing (focusing on the bright side of life) were also discussed. All participants said that the method was pleasant and interesting. For some it made it easier to talk about positive ageing. Perceptions concerning positive ageing involved a combination of spending time with loved ones, activities, nature, pets, eating and drinking, and also accepting losses and enjoying life. An integrated approach could be directed at these perceptions in positive health programmes for older adults with a low SES.

In many Western countries, divorce among older age groups has slowly increased. One potential explanation is the increase in the diversity of family structures, such as a blend of joint children, stepchildren and stepgrandchildren. We investigate the association between multigenerational family complexity and late-life divorce in Sweden (60 +). Multigenerational family complexity includes a couple's joint children/grandchildren and any children/grandchildren to whom one of the partners is a parent/grandparent, i.e. when the female partner, male partner or both partners have children/grandchildren from previous unions. Using Swedish register data, we find that couples with step relationships are more likely to divorce than those with only biological ties, that couples with only joint children or grandchildren have the lowest late-life divorce risk, and that couples with two sets of stepchildren face a higher risk than those with one. We also find that joint children in stepfamilies lower divorce risk among couples where the female partner has children from previous unions and for couples with both joint and step grandchildren, regardless of the stepchild's parental lineage. Lineage patterns of family complexity in the third generation operate somewhat differently than those in the second generation do. We provide novel insights into how biological and stepties as well as maternal and paternal lineages across generations are related to divorce risk later in life.

Although previous studies have addressed factors associated with current long-term care (LTC) use, little is known about older adults' care needs and life situation at the point of entry into formal LTC (e.g., home care, institutional care). Using data from the SNAC Stockholm Eldercare study, we identified all individuals aged ≥ 65 in the municipality of Stockholm who entered publicly funded LTC for the first time between 2015 and 2022 (n = 33,393). Descriptive statistics and regression models were used to examine: (1) temporal trends in sociodemographic characteristics and care needs among individuals entering LTC between 2015 and 2022; (2) factors associated with entering LTC with a high level of dependency; and (3) the type and amount of LTC granted.Sociodemographic characteristics remained largely stable over time, but the proportion entering LTC with high dependency increased from 21% in 2015 to 29% in 2022, suggesting a shift toward more extensive care needs at admission. Higher age (≥ 90), cohabiting, lower income, and at least weekly informal care significantly increased the likelihood of entering LTC with extensive needs. Most first-time users were granted home care (85-87%), although the predicted number of monthly hours slightly declined from 27 to 25, adjusted for sociodemographic and need-related factors. Entry into LTC reflects an interplay of care needs, care-seeking-behaviour, and policies and eligibility criteria. Our findings highlight the importance of further research into how attitudes and beliefs shape care-seeking behaviour, and whether earlier entry into LTC during functional decline could help prevent the development of more extensive needs.

With extended life expectancy, middle-aged and older adults have become more involved in multiple types of caregiving. This study aimed to investigate the patterns of multiple caregiving on the basis of the level of participation in parent care, spouse care, and grandchild care and to determine whether these patterns predict follow-up depressive symptoms. Data were obtained from the 2011-2018 waves of the China Health and Retirement Longitudinal Study. A total of 11,775 participants aged 50 years and older in 2011 were included in the latent class analysis to identify the patterns of multiple caregiving. A regression model was used to analyse the associations between baseline caregiving patterns and subsequent depressive symptoms. The results revealed four caregiving patterns: "part-time care for all," "full-time parent care and grandchild care," "part-time spouse care," and "full-time spouse care." Compared with the "part-time care for all" group, the "full-time spouse care" group and the "part-time spouse care" group reported significantly greater depressive symptoms seven years later, whereas the "full-time parent care and grandchild care" group did not significantly differ. The use of categorising multiple caregiving could vividly describe middle-aged and older adults' engagement in caregiving activities and provide a comprehensive prediction of mental health outcomes. Social services should be tailored to sandwiched caregivers in certain caregiving patterns.

Cognitive decline is influenced by factors such as inflammation, reduced physical activity, chronic pain, and depression. Osteoarthritis (OA), the most prevalent form of arthritis, may contribute to cognitive impairment through these mechanisms. The objectives of this study are: (1) To assess cognitive trajectories in older adults (≥ 65 years) over a 7-year period; (2) to explore the relationship between OA and cognitive decline; and (3) to investigate the potential mediating effect of depressive symptoms. Using the longitudinal dataset of Progetto Veneto Anziani (Pro.V.A), data on inflammation, and cognitive status (Mini-Mental State Examination-MMSE, Geriatric Depression Scale-GDS) were collected. OA was diagnosed based on clinical evaluations and medical records. Active follow-ups were carried out after 4.4 and 7 years from baseline. Group-based trajectory modeling identified cognitive trajectories, and multivariable logistic regression assessed factors associated with these trajectories. Structural equation modeling explored whether depressive symptoms mediated the OA-cognitive trajectories relationship. The sample included 2945 older adults (63.3% having OA). Participants with OA were older, more likely to be female, and had higher GDS and lower MMSE scores at baseline. Over 7 years, three cognitive trajectories were identified: severe cognitive decline (n = 261, 8.9%), moderate decline (n = 865, 29.3%), and stability (n = 1819, 61.8%). OA was more prevalent in participants with greater cognitive decline. Logistic regression showed that OA was significantly associated with moderate cognitive decline trajectory (OR = 1.31, 95% CI: 1.03-1.71, p = 0.039). OA influenced cognitive decline both directly and indirectly through depression, with depression mediating 30% of the total effect. OA seem to be associated with cognitive decline trajectory directly and indirectly through depression, highlighting the need to address mental health in OA management. KEY POINTS: Osteoarthritis is linked to moderate cognitive decline in older adults, with depression acting as a partial mediator. About 30% of OA's total effect on cognition is explained by depressive symptoms. Early intervention targeting both physical and psychological health may help prevent cognitive deterioration in this population.

Ageism remains a pervasive societal issue that significantly affects individuals with dementia, influencing cognitive performance, healthcare access, and social inclusion. This systematic review synthesizes existing research on the implications of ageism for people with dementia, focusing on its impact on cognitive function, stigma, and healthcare disparities. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane, Web of Science, and Scopus, adhering to PRISMA guidelines. After screening 515 articles, 13 studies met the inclusion criteria and were analyzed for key findings on ageism's effects. Findings indicate that age-related stereotypes negatively impact cognitive assessments, often leading to misdiagnosis and unnecessary anxiety regarding cognitive decline. Studies show that exposure to negative aging stereotypes correlates with poorer cognitive performance, reinforcing stereotype threat. Additionally, ageism in healthcare settings results in differential treatment, with older adults facing delays in diagnosis and limited access to specialized care. Social stigma further compounds these challenges, contributing to social isolation and decreased well-being among individuals with dementia. Research highlights the role of intergenerational programs and public awareness campaigns in mitigating these effects, promoting inclusivity and reducing ageist attitudes. Addressing ageism requires a multifaceted approach, including policy changes, caregiver training, and societal initiatives to reshape perceptions of aging and dementia. Future research should explore long-term interventions that foster positive aging attitudes and equitable healthcare practices. This review underscores the necessity of dismantling ageist biases to enhance the quality of life and care for individuals with dementia, advocating for a more inclusive and respectful societal framework.