Social determinants of health (SDH) impact older adults’ ability to age in place, including their access to primary and community care services. Yet, older service users are infrequently consulted on the design and delivery of health services; when they are consulted, there is scant recruitment of those who are Indigenous, racialized and/or rural. This study aimed to identify SDH for socially and culturally diverse community-dwelling older adults and to understand their views on how primary and community care restructuring might address these SDH. We recruited a diverse group of 83 older adults (mean = 75 years) in Western Canada and compared quantitative and qualitive data. The majority resided rurally, identified as women, lived with complex chronic disease (CCD), had low income and/or lived alone; nearly a quarter were Indigenous or Sikh. Indigenous status correlated with income; gender correlated with income and living situation. Thematic analysis determined that income, living situation, living rurally, Indigenous ancestry, ethno-racial minority status, gender and transportation were the main SDH for our sample. Income was the most predominant SDH and intersected with more SDH than others. Indigenous ancestry and ethno-racial minority status – as SDH – manifested differently, underscoring the importance of disaggregating data and/or considering the uniqueness of ‘BIPOC’ groups. Our study suggests that SDH models should better reflect ageing and living rurally, that policy/decision makers should prioritize low-income and ethno-racial minority populations and that service providers should work with service users to ensure that primary and community care (restructuring) addresses their priorities and mitigates SDH.

The global population is ageing rapidly, emphasising the need to understand the decision-making processes of older adults regarding potential care transitions. Gerontological research has focused on healthcare decisions, with less information on living situation choices of older adults. This review explored older adults’ experiences with their involvement in decision-making processes related to transitioning into care facilities in the United Kingdom. From a systematic search of articles, nine were reviewed using thematic narrative synthesis. Four themes with nine subthemes were identified: Involvement in decision-making (Exclusion of older adults, Usefulness of involvement), The necessity of moving (Triggers for moves, The role of family), Timely planning (Helpfulness of planning, Planning avoidance), and Factors for choosing a care home (Non-quality factors, Quality factors, Continuity of life). These themes highlighted the issue of inadequate involvement of older adults in decision-making, often resulting in negative consequences like regret and difficulty settling into new care settings. The necessity of moving arose from sudden events or increased support needs. Some older adults acknowledged the necessity due to declining health or to spare family burden, while relatives grappled emotionally, postponing the choice. Timely planning was found to be beneficial practically and emotionally, facilitating smoother transitions. However, participants would rarely plan and discuss such matters early. Older adults focused on personal experiences and trusted sources rather than publicly available information when considering Factors for choosing a care home. The findings show the need for greater inclusion of older adults in decisions related to their care and the importance of early planning and providing preferred types and formats of information to aid decisions. Future research should focus on a better understanding of older adults’ preferences for successful involvement in care decisions, with support and guidance for others involved in the decisions.

The ability to manage money is essential for independent functioning but highly sensitive to cognitive decline. Managing money involves more than deploying skills rationally; it is influenced by a range of emotional and psychosocial factors. There is relatively little knowledge about how older adults, families and care professionals working with older people navigate and experience potential challenges of declining mental capacity to manage money. This article draws on a UK-based study involving 13 older people and/or family members and 28 social sector professionals, and their experiences of supporting older people with cognitive decline to manage money, triangulated with public information resources from major national organisations across the health, care, consumer and charity sectors. It focuses on the emotive and personal nature of cognitive decline and money management. Declining mental capacity to manage money can strike at the core of people’s sense of who they are, leading to strong tensions and difficulties in discussing support. Support to manage money is often framed in discussions as ‘there if we need it’; this can be reassuring for people, but may be challenged if there are subsequent disagreements and changes in perspectives about the detail and timing of support. These nuances are not well reflected in public information resources, which largely emphasise administrative procedure. Financial organisations may lack empathy that declining mental capacity to manage money is extremely challenging. The article highlights a greater need for recognition of the emotional and psychosocial complexities presented by declining mental capacity to manage money in later life.

There is little visibility for the voices of indigenous and Afro-descendant women in Latin America and the Caribbean (LAC), meaning that few studies offer information on mental health for this group. This study takes the Living Well (Buen Vivir) approach as a basis to examine the prevalence of depressive symptoms and their associated individual physical and social/cultural dimensions. Based on a national study involving the participation of a majority of Chilean peoples, 774 women identifying as indigenous (569 Andean indigenous and 146 other indigenous people) and Afro-descendant (59) were interviewed. The findings show that Andean and Afro-descendant women are more at risk of suffering depressive symptoms and that in general terms mental health should be understood from a holistic perspective, in addition to its being underpinned by several associations. Lower levels of depression were associated with older age, having a partner, independence in activities of daily living, social support from partner and being resilient. In contrast, higher levels of depression were associated with health problems, poor-quality relationship with grandchildren and loneliness. Out of the dimensions examined, resilience had a key influence on mental health among women. The findings are discussed in the context of a comprehensive view of wellbeing among ethnic minorities.

Recent years have seen increasing interest in social robots, including pet robots, and their use in the care of people with dementia. Most research has focused on formal care-givers’ perspectives. There is a lack of qualitative research on the use of social robots in embedded practice and how people with dementia react to and interact with social robots. This study explores the use of pet robots in everyday life in a nursing home for people with dementia and how playfulness and disruptions characterized many interactions among the people with dementia, the pet robots and the researcher. It draws on five months of ethnographic fieldwork in a Danish nursing home for people with dementia including 11 residents, 13 staff members and 3 family members. We found that pet robots opened people up for playful interactions, allowing people with dementia to express themselves and have fun in a way that flattened hierarchies and enabled these individuals to be active instigators of joyful interactions. In the article, we argue that agency is distributed and that residents, robots, researchers and other actors both instigate and disrupt playful interactions. Playful interactions in the nursing home can be fun and rebellious in an everyday life that is otherwise focused on fitting in and keeping calm. Therefore, playfulness and fun can be viewed as a way of coping with institutional life. Further, playful interactions with pet robots can provide opportunities for residents to be active instigators rather than merely passive recipients of care and activities.

Increasingly, older adults are redefining retirement by combining part-time employment with pension benefits, that is, becoming ‘working retirees’. This trend highlights socio-economic inequalities: some working retirees use part-time employment as a bridge to full retirement, while others must remain employed to prevent old-age poverty. However, little is known about how these work-retirement transitions unfold over time or the socio-economic factors that shape them. This knowledge gap is problematic because understanding the socio-demographic influences on these trajectories is essential for addressing inequalities in later-life employment and retirement security. This study examines transitions from work to retirement by following individuals from their 50s into their 70s and analysing the socio-demographic factors that differentiate these trajectories. It identifies the various pathways that older workers take when exiting the labour force and analyses how prior life course factors – including education, occupational status, career field, civil status, number of children and disposable income – predict the likelihood of following each work–retirement trajectory. The results reveal two distinct work–retirement trajectories: one reflects status maintenance, with higher income and education, white-collar and often men; the other reflects financial necessity, with lower income, children at home, no partner and often women. More advantaged working retirees experience greater employment changes in late life, highlighting the diversity of late-life careers. These findings suggest a broader range of extended work–life pathways than previously recognized and emphasize the need for policies that account for gendered and economic disparities in work and family responsibilities to ensure equitable and sustainable retirement transitions.

Despite the recognized importance of older adults ageing in their own homes, the role of public financing in mitigating unmet and under-met home care needs remains under-explored. This study addresses this gap by examining the impact of public financing on home care adequacy among English adults aged over 50, utilizing data from waves 6–9 (2013–2019) of the English Longitudinal Study of Ageing. Longitudinal fixed effects and pooled cross-sectional modelling are used to explore the impact of public financing of home care on the unmet and under-met needs of older people. Findings show that individuals with greater limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), as well as those experiencing cognitive decline, are more likely to receive home care. Importantly, while receipt of publicly financed care is associated with a reduction in unmet needs, it does not necessarily translate to fully met needs, resulting in under-met need and highlighting a crucial distinction between access to and adequacy of care. Comparatively, transitioning from use of publicly financed home care to exclusively informal care is linked with lower odds of reporting under-met needs, suggesting variance in the quality of care provided across funding types. This study not only enriches the existing literature by describing the specific impact of different home care financing mechanisms (publicly financed care versus other types of care) on the unmet and under-met needs of older adults but also underscores the need for policies that ensure care adequacy, not just accessibility.

Ageing-in-place for persons with dementia and informal care-givers is encouraged by governments and society. However, individuals with non-Western migration backgrounds are at higher risk of dementia yet underrepresented in research and care. This study aims to identify ageing-in-place care preferences of persons with dementia and their informal care-givers in the Netherlands. Semi-structured interviews (n = 8 participants with dementia, n = 20 informal care-givers) were analyzed using reflexive thematic analysis. Findings reveal that informal care-givers feel a strong duty to care, assisting with various daily tasks. While they desire shared care with professionals, identifying concrete care needs is challenging, highlighting the need for proactive professional support. Participants also emphasized the importance of culturally sensitive in-home care, home adaptations, social care and accessible dementia information. Additionally, the emotional impact of dementia on care recipients and care-givers underscores the need for emotional support. These insights enhance understanding of the care preferences of persons with dementia and their informal care-givers, aiding more efficient and culturally responsive health service planning.

The present study relied on internet memes as a tool to possibly fight ageism and shape public views in a positive manner. Data collection took place between May and June 2024, recruiting 160 Israeli Arabs, aged 13 to 16, from 3 different schools. In total, 105 memes addressed ageism towards older people. Visual and written contents were described, followed by more interpretative analysis. The memes were classified into two main themes. The first concerned negative ageist stereotypes of older persons (n = 66). The second theme concerned attempts to combat ageism (n = 39). Even though students received explicit instructions to fight ageism via their meme production, most students produced memes which depicted older age and ageing in a negative stereotypical light. The study highlights the relatively high levels of ageism in this group of participants and points to areas needing further attention in future interventions to alleviate ageism. The present findings are important as they question the current thinking of the Arab population as characterized by familistic values of high levels of respect towards older persons.

The ageing population is anticipated to encounter several challenges related to sustainability. While policies such as ageing in place can benefit older adults in terms of familiarity and independence, these policies can also lead to increased social isolation. To facilitate ageing in the right place, it is crucial to understand how the design of environments promotes social sustainability. This article presents a scoping review of empirical research focused on the characteristics of housing and surrounding environments that support social integration, cohesion and participation of older adults. The search strategy was conducted in five databases, resulting in 20,477 articles. After screening 7,550 titles and abstracts based on predetermined inclusion and exclusion criteria, 19 articles were selected. The findings of these articles are presented across three themes: (1) housing environments, (2) environments beyond the home and (3) the social environment. Although there is no one-size-fits-all housing model for older adults, the authors suggest that ageing in place policies should be reconceptualized as ageing in ‘places’ and ‘spaces’, emphasizing the diversity of social needs of older adults. Understanding the environmental characteristics, the role of accessible and safe environments beyond the home, and how people and culture support a sense of belonging provides a policy direction for how to design socially sustainable environments for older adults in the future.

Offspring’s education can serve as a valuable channel of resource transfer and social mobility for older parents, especially those with lower socio-economic status owing to its potential impact on health. However, there is a notable gap in research exploring the health consequences of intergenerational educational mobility, particularly across different ages and genders. This study considers the market and family spheres, and proposes a dual-axis model of resource allocation. Utilizing data from the China Longitudinal Aging Social Survey from 2014 to 2020, it investigates the impact of intergenerational educational mobility on the health of rural older Chinese parents and the underlying mechanisms by which the different impacts work. It reveals that intergenerational educational mobility affects the health of older parents through the dual axes of market and family-based economic resource transmission. Senior parents suffer more negative effects from downward mobility than younger contemporaries, and older mothers benefit more from upward mobility than fathers. Upward educational mobility could improve the health of older parents through increased offspring income, whereas significant intergenerational financial support has only a substantial impact on older health when the educational mobility distance is greater. This underscores the importance of considering intergenerational educational mobility in understanding health outcomes and provides new insights into the relationships between mechanism variables. It suggests that policy makers should focus on improving the educational environment, supporting parental investment in education and expanding educational opportunities for younger generations, to enhance the health and wellbeing of older generations by fostering positive intergenerational dynamics and resource allocation.

Understanding the process of seeking long-term care (LTC) in old age helps identify what contributes to delays and inequalities in accessing it. Current research highlights the roles of individual and policy factors, but pays little attention to how these factors interact. This qualitative study aims to fill this gap by identifying facilitating factors and mechanisms in the initial approaches to LTC policies. It examines care-seeking in two towns in northern Italy, where a demand-based approach, high fragmentation and poor coordination pose significant challenges. In a bottom-up approach to policy implementation, the experiences and perspectives of both care-seekers and professionals are integrated. Indeed, the data collection (April 2023–May 2024) triangulates 100+ hours of participant observation and semi-structured or vignette-based interviews. The study finds that care-seeking entails three interrelated steps: recognising care needs, being willing to receive LTC, and reaching an entry point. At each stage, three mechanisms operate at intrapersonal and interpersonal levels and can be promoted by LTC policies to facilitate care-seeking, especially for those experiencing barriers. The mechanisms are (1) taking the initiative to raise awareness of care needs and share information about available solutions; (2) fostering trust between professionals and care-seekers, who often rely on confidential relationships to discuss care arrangements; and (3) combining primary information with tailored guidance on the local offer, enabling care-seekers to make informed decisions. The findings provide actionable insights into policies and practices that facilitate care-seeking, and offer a conceptual framework that explains the driving factors behind this process and its mechanisms.

People from different ethnic minorities in the UK are experiencing a steeper increase in dementia diagnosis compared to their white counterparts but are more likely to have a higher risk of dementia, to be diagnosed at a younger age and to die earlier from the condition. These disparities suggest the need for urgent interventions to prevent and reduce dementia risk. Despite the significant presence of Chinese people in the UK, there has been little dementia research involving them, so this study is the first in the UK to focus on Chinese communities living in five major cities. Using a cultural adaptation theoretical framework, we adapted Alzheimer’s Research UK’s virtual dementia prevention campaign Think Brain Health to meet the needs of Chinese people. We used a mixed methods approach to evaluate knowledge of dementia and brain health activities, and intention regarding help-seeking. We performed descriptive, chi-square and thematic analysis; 54 Chinese people completed the intervention, with 85 per cent aged over 60 years. Over half (56%) could not speak, read or write in English. Our results showed significant improvements in knowledge of dementia and brain health, and an improved intention to seek help and information. All participants reported a positive experience of the culturally tailored intervention and valued working with dementia researchers who were able to deliver the intervention in Chinese languages. Future work involving Chinese communities in the UK will need to identify an appropriate but non-stigmatizing Chinese term for dementia.

Despite consensus that quality of life (QoL) in later adulthood is multi-dimensional, scholars’ perceptions of the dimensions the construct comprises differ. Under the premise that models and measures of QoL should correspond with lay perspectives to have relevance to the targeted population, we investigated the constituents of QoL in later adulthood as perceived by middle-aged and older laypersons. We fielded a factorial design vignette experiment among 2,544 respondents aged 50+ participating in the Dutch Longitudinal Internet studies for the Social Sciences panel to assess how 11 dimensions identified from four established QoL instruments designed for older people (WHOQOL-OLD, CASP-19, OPQOL, ICECAP-O) influence QoL evaluations. The study extends prior work on lay perspectives on QoL by combining the internal validity of an experiment with the external validity of a true population sample. All dimensions considered significantly impacted the QoL ratings in the expected direction. Enjoyment and social participation had a significantly larger contribution than the other dimensions. Models stratified by age group showed a strong degree of similarity, suggesting a high level of consensus across age groups about the constituents of QoL in later adulthood. The study highlights the necessity of capturing a broad range of dimensions when conceptualizing QoL in later adulthood. Our finding that dimensions that were omitted in selected established instruments still contributed substantially to QoL evaluations arguably implies that these instruments may have suboptimal content validity. The insights gained from this study are important for developing and evaluating policies aimed at improving QoL for the ageing population.

Colonization and ongoing colonial policies and practices are contributing to increased dementia rates in Indigenous populations. This health inequity could be addressed by implementing culturally safe dementia interventions specifically designed for Indigenous people. We conducted a scoping review of culturally safe dementia care interventions for Indigenous populations. Databases searched included OVID (Medline, PsycINFO, Embase, Healthstar), Informit Indigenous Collection, JBI EBP, Scopus/Elsevier and PubMed. Eligibility criteria included studies in English, interventions designed specifically for Indigenous persons living with dementia and evaluative outcomes of the intervention. In total, 2,259 articles were identified. After removing duplicates, 1,394 titles and abstracts were screened and 54 studies were screened for eligibility. Of these, no studies were eligible for inclusion. This empty review reveals a massive and inexcusable gap in knowledge around developing, implementing and evaluating culturally safe Indigenous-specific dementia care interventions. Future directions for research include working with Indigenous peoples to determine what culturally safe interventions for dementia look like, implementing high-quality studies with evidence-based measures and outcomes, and improving efforts to get this important work published to inform future studies.

An increasing number of older adults require residential care. Concurrently, older adults’ alcohol use is increasing. This review explored the perspectives of all relevant stakeholders on older adults’ alcohol use within residential care settings, through a systematic review and thematic synthesis of qualitative studies. Eight databases were searched for qualitative studies focusing on older adults’ alcohol consumption (defined as aged ≥ 50) within residential care settings, sampling any involved stakeholders, published up until January 2024. Quality appraisal utilised the Critical Appraisal Skills Programme checklist and included 15 studies of mainly moderate quality across seven high-income countries, reporting data from a range of stakeholders and representing varied older adults’ alcohol histories. Three themes were identified: alcohol use by older adults is socially acceptable and purposeful in residential care settings; alcohol helps in the pursuit of an ‘ideal’ outcome; and decision-making around older adults’ alcohol use varies depending on the involvement, knowledge, skills and beliefs of the participating stakeholders, who also vary. Reports of problematic alcohol use were rare and older adults in residential care settings should be supported to exercise their own choice in determining their alcohol use. However, residential care settings face particular challenges in managing the alcohol intake of older adults with limited mental capacity and alcohol dependency; owing to a lack of guidance, front-line staff make subjective decisions. Future research should develop guidance that involves all relevant stakeholders, including family members. Limitations include lack of generalisability to low- and middle-income countries and limited availability of raw data.

The older population is increasing. As age increases, many changes occur in individuals’ lives, physically, socially, psychologically, and this situation varies from individual to individual. The uncertainty about how this period will pass can cause anxiety in individuals. Therefore, valid and reliable tools are needed to investigate ageing anxiety and potential factors that increase this anxiety, especially in the ageing population. This article presents the results of a Turkish validity and reliability study of the Aging Anxiety Scale for Middle-Aged Adults. The study sample consisted of 293 middle-aged adults. Content validity, face validity and construct validity methods were applied to measure validity. Item analysis, Cronbach’s alpha and test-retest methods were used to measure internal consistency in the reliability analysis. The content validity index of the Aging Anxiety Scale for Middle-Aged Adults was found to be 0.97 based on expert opinion. Model fit indices were calculated as χ2 = 473.583, df = 275, χ2/df = 1.722, CFI = 0.95, GFI = 0.89, IFI = 0.95, TLI = 0.94, RMSEA = 0.05, RMR = 0.06 and SRMR = 0.05. The analysis results indicated that the scale model values were within accepted limits and that the 5-sub-factor and 26-item structure of the scale was confirmed. It was concluded that the Turkish version of the Aging Anxiety Scale for Middle-Aged Adults was a valid and reliable measurement tool to enable Turkish society to determine middle-aged individuals’ ageing concerns.

Despite internet use potentially reducing loneliness among older adults during the Covid-19 pandemic, quantitative research in this area is limited. Our study addresses this gap by exploring how internet use affects loneliness worsening in old age across Europe from a gendered perspective. We adopt a comprehensive approach, considering individual and contextual factors. Using multi-level modelling, we analyse data from the Survey of Health, Ageing and Retirement in Europe (Wave 8 and Corona Survey 1), supplemented by the Oxford Covid-19 Government Response Tracker and the Eurostat Digital Agenda Scoreboard Key Indicators. The empirical analysis has revealed gender-specific differences in the relationship between internet use and the worsening of loneliness among older people during the pandemic, with internet use contributing to increased loneliness for older women, but not for men. In addition, our study indicates that while the contextual factors, namely the severity of the contingency measures and the quality of the internet connection, are not moderators of the relationship between internet use and loneliness worsening, the stringency index specifically exacerbates loneliness in women. These findings contribute to the development of more effective and targeted interventions to combat loneliness worsening and promote wellbeing among older women, particularly in the context of global health crises such as the Covid-19 pandemic.