European Journal of Ageing最新文献

The predictive value of patient-reported outcome measures (PROMs), such as self-esteem in advanced age in relation to biological age (frailty), remains to be elucidated. In a secondary analysis of a randomised controlled trial (RCT), 107 hospitalised patients (mean age 77.2 (SD 7.1) years, 56% female) underwent a comprehensive geriatric assessment (CGA). Assessments included the Multidimensional Prognostic Index (MPI), the Rosenberg Self-Esteem Scale (RSES), evaluation of geriatric syndromes and resources, the EQ-5D-5L quality-of-life scale, and the Geriatric Depression Scale (GDS). Follow-up data were collected via telephone six months later. After adjusting for age, sex, intervention, and MPI, baseline RSES were significantly associated with pressure ulcer risk (p = 0.009), nutritional status (p = 0.042), number of geriatric syndromes (p = 0.003), geriatric resources (p < 0.001), depressive symptoms (GDS, p < 0.001), and quality of life (EQ-5D-5L, p = 0.020). These findings show that self-esteem appears to be an independent mediator of multiple geriatric outcomes, including geriatric resources and syndromes, as well as of PROMs, beyond what is explained by MPI-based frailty. Incorporating self-esteem measures into CGA may enhance the identification of at-risk individuals and guide interventions.

Background: To explore whether the impact of community spiritual comfort service (CSCS) on cognitive function is mediated by social participation and moderated by genetic factors.

Methods: Data were derived from the Chinese Longitudinal Healthy Longevity Survey conducted in 2008, 2011, 2014, and 2018, involving 3598 participants. A Random Intercept Cross-Lagged Panel Model was utilized to determine the relationship between CSCS and cognitive function, as well as the mediating role of social participation and the moderating effect of genetics on the identified CSCS and cognitive function relationship.

Results: Lower levels of CSCS at earlier assessment points were significantly associated with lower cognitive function at subsequent assessment points. Social participation partially mediated the prospective relationship between CSCS and cognitive function. Distinct genetic polymorphisms showed significant differences in effect sizes, with the Val group experiencing a significantly greater impact of CSCS on subsequent social participation, and of social participation on subsequent cognitive function, compared to the Met group.

Conclusion: Enhancements in CSCS can predict subsequent improvements in cognitive function. The relationship between CSCS and cognitive function can be mediated by social participation and is moderated by genetic factors. Multidisciplinary interventions aimed at improving the quality of CSCS and enhancing social participation will benefit the cognitive and psychological health of the older adults.

Strengths-based models of care are increasingly popular with policymakers, but evidence of their effectiveness is currently limited. This study examines the impact that a strengths-based care programme-community led support (CLS)-has had on new and existing clients in England. Specifically, we used a difference-in-difference approach to estimate the treatment effect of CLS on care provision, reviews, and expenditure, using the Short and Long Term (SALT) dataset published by NHS Digital (2016 to 2021). Within local authorities that implemented CLS, we found evidence of changing care pathways for new clients, including a ten-percentage-point reduction in funded care provision-though evidence for increased signposting to alternative services in this dataset was mixed. For existing clients, we found evidence of general improvements in the quality of practice, as indicated by higher ratios of planned to unplanned care reviews. These improvements were also realised without concomitant increases in expenditure rates. We believe these results can contribute towards an evidence base for CLS and for strengths-based practice more generally.

Initial empirical evidence and theories suggest that decision-making may become more avoidant with age. However, recent studies provide inconsistent evidence for this effect. We conducted a systematic review and meta-analysis of 19 studies (N = 7969) to assess evidence for an association between age and avoidant decision-making style. We included studies that used the avoidant subscale of the General-Decision-Making Style (GDMS) questionnaire or the buck-passing subscale of the Melbourne Decision-Making Questionnaire (complete avoidance), or the dependent subscale of the GDMS (partial avoidance). We also assessed potential moderators of the effect, including age range for each sample, gender, culture, participant sample type, publication year, decision style subscale, and degree of avoidance (complete vs. partial). Surprisingly, the data revealed a small association between older age and less avoidant decision-making style. Moderator analysis revealed that this association applied to complete decision avoidance (the avoidant and buck-passing subscales) and not partial avoidance (the dependent subscale). Additionally, moderation by sample type suggests that decision style does not become less avoidant until after middle age. We discuss important future directions for research aimed at investigating nuances that may contribute toward avoidant decision-making style in older age.

Earlier research has found that adult children's caregiving for older parents is associated with a decline in life satisfaction. However, other research indicates that emotional stress in adult children might be related to the declining health and frailty of their older parents rather than caregiving per se. Hence, there is a possibility that the first set of findings (declining life satisfaction when giving care) reflects factors not specified in statistical models rather than the care provided by adult children. This study tests this possibility by investigating changes in life satisfaction among 3,094 adult children from panel data in Norway that includes multiple indicators of health and care needs in older parents, together with data on who is providing care. Declining life satisfaction was observed among daughters but not among sons, and these changes were driven by the frailty and care needs of their parents rather than caregiving per se. The findings indicate that it is not caregiving that affects life satisfaction but the circumstances leading to caregiving. In these situations, adult daughters may struggle with sources of distress beyond providing support and care. Further research should investigate these relationships in countries with different distributions of care between families and public care institutions.

There are considerable interindividual differences regarding when individuals perceive someone as "old" (i.e., perceived individual onset of old age). Individuals might also differ in when they believe that society considers someone as "old" (i.e., perceived societal onset of old age). We investigated how multiple indicators of views on aging (age stereotypes, subjective age, age knowledge, perceived ageism), socio-demographic factors (age, sex, education, region of residence), and self-rated health are related to perceptions of individual vs. societal onset of old age and with the difference between both measures in an age-heterogeneous sample. In the Age_ISM Germany survey, a representative sample of 2,000 Germans was recruited (age range 16-96 years, M = 56.6 years). We ran structural equation models with sampling weights and found that individuals report a perceived individual onset of old age that was on average more than eight years later than their perceived societal onset of old age. Perceived ageism was associated with an earlier perceived individual and societal onset of old age as well as with a greater discrepancy between both indicators. Feeling younger was associated with a later perceived individual onset of old age. Associations of views on aging, socio-demographics, and self-rated health with perceived individual onset of old age did not vary across age groups, whereas age-group differences emerged for perceived societal onset of old age. Our findings advance theoretical frameworks on views on aging by demonstrating a meaningful discrepancy between perceived individual and societal onset of old age, which are uniquely associated with views on aging.

Ageing in place, which refers to the idea of supporting older adults to remain living in their homes and communities for as long as they wish, has emerged as a dominant approach in public policy. However, the wider urban context influencing how people age in place, together with the pressures on the places in which people age, has been the subject of much less discussion. In response, this article reviews different ways of supporting ageing in place, exploring this theme in the context of issues associated with widening urban inequalities, austerity policies, and the privatisation of services and spaces within cities. Building on this analysis, the paper assesses the potential of initiatives which can empower and support groups within the older population, highlighting developments such as the village model, naturally occurring retirement communities, cohousing, and compassionate communities. Reflecting on the strengths and limitations of these initiatives, the paper examines the possibilities for developing new approaches to ageing in place as a collaborative venture, drawing on the collective resources of older people themselves, transforming as a result the urban environments in which they are themselves key actors.

Age-related stereotype threat-the fear of being judged based on negative age stereotypes-can affect physical performance in older adults. This study postulated that stereotype threat influences sports motor performance and that self-perceptions of aging (SPA), specifically subjective age (SA) and awareness of age-related change (AARC), reinforce this relationship. A total of 86 adults aged 65 and over participated in the study (65-85; M = 72.10, SD = 5.94). Participants were randomly assigned to either an experimental group with stereotype threat or a control group. Physical performance was assessed using the advanced version of the sports motor test for adults. SPA (SA, AARC losses and gains) were measured by self-report. The results indicated that compared to the control situation, stereotype threat did not result in lower performance in individual sports motor domains (coordination, mobility, strength, endurance), but only in total performance. Greater AARC losses predicted lower performance in the strength domain. No moderating effect of SA was observed, but a moderating effect of AARC gains was identified in the coordination domain. Stereotype threat only led to lower performance in interactions with AARC gains and in tasks that required both cognitive and physical components. Our findings show that compared to SA, AARC appears more relevant to stereotype threat and physical performance. Finally, the impact of stereotype threat on motor performance is not universally detrimental, but rather domain-specific and only partially moderated by individual differences in SPA.

Self-directed care is a model that allows older adults with disabilities to arrange home- and community-based services flexibly. This study examines the impact of England's self-directed care-Direct Payments-on older adults' well-being and explores how the effects vary among individual characteristics. This study used data from the English Longitudinal Study of Ageing (ELSA, 2012-2023) on adults aged 65 and older who used Direct Payments and managed care (N = 568). We used propensity score matching methods to estimate the impact of Direct Payments on unmet needs, depressive symptoms, and quality of life. Direct Payments reduced unmet needs and had non-significant effects on depressive symptoms and quality of life. The beneficial effects of Direct Payments were more salient among older adults who were younger, had experienced less physical loss, and had reported met needs in the preceding survey. Our findings suggest that Direct Payments effectively improve older adults' care outcomes by addressing their unmet needs, with individuals possessing greater health capital being more likely to benefit from using them. Policymakers and practitioners should support the disadvantaged and mitigate disparities in well-being.

Retirement marks a significant life transition that is often accompanied by profound changes in perceived quality of life (QoL). The direction and magnitude of those changes depend on multiple factors whose combined effects remain under-researched. This study analyses the association between retirement timing and perceived changes in overall QoL and looks at how this association is mediated by changes in self-rated health, coping, satisfaction with leisure time, social relationships, and income adequacy. We use a register-supplemented cross-sectional survey conducted in 2022 among 2 212 old-age retirees who were previously employed and who retired in 2020 or 2021. Change in QoL and its domains is measured by comparing current perceptions with retrospective assessments of QoL pre-retirement. We apply the KHB method to decompose the association of retirement timing with QoL into direct and indirect parts to evaluate the role of each mediator. Before retirement, QoL was lowest for those retiring at the earliest eligibility age and highest for those who postponed retirement by at least 12 months. QoL increased most among the former and remained nearly unchanged among the latter. Most of the increase in QoL for those retiring at the earliest eligibility age was explained by improved coping and increased satisfaction with the amount of leisure time. Our results add to the multidisciplinary knowledge on retirement and suggest that retirement timing can act as a mechanism to improve QoL once employees have reached their statutory retirement age.