1.4.1 Problems of Ageism Measurement

To examine the universality hypothesis, the construct and measurement of ageism must be reliable and valid across groups and societies: Ageism should be equivalent, that is, should be understood the same way by different individuals and in different contexts and cultures. One of the main challenges of equivalence is measurement invariance. Unfortunately, ageism research has not yet even found a standard instrument for identifying and measuring ageism. There is a wealth of different operationalizations under the umbrella term “ageism” (see, for instance, North & Fiske, Reference North and Fiske2015), including capturing stereotypes (such as rating the competence of older people), emotional prejudice (such as ratings of warmth or friendliness), and discrimination (such as not hiring a person for a job because of her chronological age). While some measures are directed toward older individuals, old age, or the aging process, other measures are directed toward the self (e.g., ratings of a person’s fear of cognitive decline, their contact with older people, or their experiences of age discrimination). Judgements of one’s own cultural attitudes, such as respect for older people, and attitudes in the media are also used as measurements to determine the level of ageism (Ng et al., Reference Ng, Chow and Yang2021).

Having a scale that can accurately measure ageism prevalence is key in a time of rapid and increasing population aging. Efforts to find a common, valid, and reliable scale are currently in progress (Murray & De La Fuente-Nunez, Reference Murray and De La Fuente-Nunez2023), and a scale that capture the multidimensional nature of ageism in varied contexts and cultures from the perspectives of the agents and the targets of ageism is currently being tested.

1.4.2 Patchwork of Research

So far, we have been trying to argue in a systematic manner, conceptually and theoretically. This top-down thinking makes up a matrix for empirical research. Manifestations and forms of ageism and its antecedents and consequences on micro, meso, and macro levels must be researched, and all this in respect to change, including individual development, transformation of ecological settings, and historical, cultural, and social change. This matrix of desired evidence is necessary to fully answer the question of whether ageism is universal. But do we have the evidence? The answer is a clear no. The bulk of ageism research has so far focused on individual-level ageism, with studies on the macro level having emerged only over the past decade or so. Moreover, most research has focused on ageism against older people. Also, the study of ageism, like the study of many social phenomena, has been broadly limited to the global North.

For this reason, in the remaining sections we will proceed in a bottom-up manner, presenting empirical findings and pointing out potential avenues for further research. We will start with findings on ageism across the lifespan (micro level: Section 2); then we turn to findings on ageism across settings and environments (meso level: Section 3); and then to historical and cross-cultural research on ageism (macro level: Section 4). At all levels, we will analyze the occurrence, conditions, and consequences of ageism.

2.4.1 Ableism

Ableism is described as stereotypes, prejudices, and discrimination toward people because of their bodily function. Ableism places value on certain abilities over disabilities or other abilities. This includes sensory, physical, and cognitive disabilities and chronic health conditions (Bogart & Dunn, Reference Bogart and Dunn2019). It has been argued that ableism can be an umbrella term covering many types of “isms” such as racism, ageism, or sexism. This is because ableism concerns not only biological bodily functions, but also cognitive and mental abilities as well as social structural aspects. Ableism can be used to justify a variety of power relations because it assigns ability or lack of ability to different groups and thus justifies differential treatment based on ability (Wolbring, Reference Wolbring2008).

Ableism has many overlaps with ageism; for example, people with disabilities and older people might both be considered a burden to society and have their contributions devalued, and when a person with a disability is also older, this person might experience double jeopardy attributed to both age and disability status. The fact that ageism is often concerned with the sense that physical and/or mental ability can diminish with age has led some researchers to ask whether part of ageism is ableism (Gendron et al., Reference Gendron, Camp and Amateau2023). Indeed, the authors of one study argue that relying on a definition which clearly distinguishes between ageism and ableism would have resulted in different findings of ageism prevalence and manifestation (van der Horst & Vickerstaff, Reference van der Horst and Vickerstaff2022). Differential treatment toward older people is often due to attitudes about real or perceived impairments of physical functioning rather than age per se, but the differential treatment is still labeled ageism. This results in a mismatch between the two concepts, which makes assessing their true intersectionality more challenging (van der Horst & Vickerstaff, Reference van der Horst and Vickerstaff2022). To help disentangle the link between ageism and ableism, one study asked a sample of 913 individuals a number of questions about these two “isms” (Gendron et al., Reference Gendron, Camp and Amateau2023). The authors found strong links between the two constructs and suggested that ageism and ableism cannot be examined separately because so much of the fear associated with aging concerns the perceived decline that comes with age. They found that a key part of ageism is actually ableism, and emphasized the importance of promoting age and ability inclusivity (Gendron et al., Reference Gendron, Camp and Amateau2023).

2.4.2 Lookism

Lookism also has many overlaps with ageism. Lookism is defined as prejudice, stereotypes, or discrimination toward people because of their physical appearance. It is directed toward those whose appearance is seen as unattractive. Despite the common proverb, “Don’t judge a book by its cover,” unconscious and conscious processes are often involved in our perception of individuals based on their looks (Granleese, & Sayer, Reference Granleese and Sayer2006).

Lookism can also be mistaken for ageism. This is especially the case for older women, who, like younger women, often find themselves being judged by their looks. Indeed, there is a well-documented intersection between ageism, sexism, and lookism, and a strong body of literature on women’s ongoing efforts to maintain a youthful identity, which is equated with beauty and attractiveness. Studies based on interviews with middle-aged and older women have found that they are constantly struggling to maintain visibility and relevance via beauty work (Clarke & Griffin, Reference Clarke and Griffin2008; Westwood, Reference Westwood2023). However, although lookism is clearly a common type of discrimination, which often intersects with sexism and ageism, research has tended to focus on the latter two “isms” in intersection and takes lookism as a given.

2.4.3 Sexism

Intersectionality is not always negative, even when it results in the combination of two marginalized identities, such as older age and female gender. Martin et al. (Reference Martin, North and Phillips2019) conducted an experimental study that explored the intersection between age and gender by randomly presenting respondents with vignettes that vary based on age and gender. The authors asked the respondents to make evaluative judgements about the vignettes to test two competing hypotheses. The first hypothesis suggested that having two marginalized identities puts one at a greater disadvantage (e.g., an older man may commonly be perceived as a wise elder, but an older woman might be perceived as a crone). The second hypothesis suggested that two simultaneous marginalized identities can have a protective effect in some circumstances. The authors found, for example, that men are often expected to cede power in older age, whereas the same is not expected of women, allowing them an “intersectional escape” in older age (Martin et al., Reference Martin, North and Phillips2019).

Intersectionality affects not only people’s exposure to discrimination, prejudice, and stereotypes, but also how they interpret discriminatory behaviors. In a study of both younger and older Americans (with an age range of 18 to 29 and 65+), participants were asked to imagine Black men and women and White men and women and to evaluate the levels of benevolent or hostile ageism they expected them to have been exposed to (Gans et al., Reference Gans, Horhota and Chasteen2023). The study’s younger respondents were most likely to view hostile ageist discrimination against older White men as acceptable (Gans et al., Reference Gans, Horhota and Chasteen2023). This suggests that in some circumstances ageism completely merges with other “isms” to the point that it becomes difficult to distinguish between them. Intersections of ageism with other biases can result in multiple disadvantages, but, according to some studies, intersections of marginalized social attributes can also have some protective effects. Because we all have more than a single identity or attribute, it is expected that ageism and its effects will vary widely depending on the multiple facets of one’s identity.

2.7.1 Intragroup Ageism among Older People

Other-directed ageism is harmful not only when it is directed toward older people by younger people, but also when it is directed by older people toward their own age group. One study polled 400 participants (216 university students and 184 senior community residents) and found that, while both students and residents perceived older people as less competent, the students considered older people to be warmer. The senior community residents considered young-old people (older people who were younger than them) to be the warmest. Research has consistently shown that there are high levels of ageism among active retirement community members, and that they often equate being old with being sick (Roth et al., Reference Roth, Keimig and Rubinstein2012). This suggests that the oldest old might be more likely to be the targets of ageism directed by older people themselves (Lagacé & Firzly, Reference Lagacé and Firzly2017).

2.7.2 Self-Directed Ageism in Old Age

There is plenty of evidence to show not only that self-directed ageism exists, but also that it has very negative effects on people’s health and well-being. Likewise, having positive views of aging has many beneficial effects (Kleinspehn-Ammerlahn et al., Reference Kleinspehn-Ammerlahn, Kotter-Grühn and Smith2008; Levy & Myers, Reference Levy and Myers2004; Levy et al., Reference Levy, Slade and Kasl2002). A recent systematic review of twenty-one studies shows that a positive self-perception of one’s own aging is associated with healthier outcomes over time, including better self-rated health, less obesity, longer life expectancy, improved physical functioning, reduced depressive symptoms, and improved cognitive functioning (Tully-Wilson et al., Reference Tully-Wilson, Bojack and Millear2021). Individuals with positive self-perceptions of aging are also more likely to engage in behaviors geared to improve their health (Levy & Myers, Reference Levy and Myers2004). A 2013 study that examined how self-perceptions of one’s own aging become a self-fulfilling prophecy showed that negative self-perceptions of aging, especially those related to physical loss, impair one’s health-related strategies that contribute to the maintenance of a healthy lifestyle (Wurm et al., Reference Wurm, Warner, Ziegelmann, Wolff and Schüz2013).

Self-directed ageism – the tendency to direct negative age stereotypes that have been internalized throughout the lifespan toward oneself – has been explained by the stereotype embodiment theory (Levy, Reference Levy2009). One outcome of self-directed ageism can be the discrepancy between chronological age and subjective age in older people. Research has shown that younger people tend to express a wish to be older than they are. They also tend to feel as if they are older than their chronological age. Older people, on the other hand, tend to feel younger than their chronological age (Kotter-Grühn & Hess, Reference Kotter-Grühn and Hess2012). A 6-year longitudinal study based on the Berlin Aging Study (BASE), conducted among people in the age range of 70–104 years, found that felt age (which represents one indicator of people’s self-perceptions of aging) remained on average 13 years below people’s chronological age, but, over time, people tend to report a decrease in their satisfaction with their age (Kleinspehn-Ammerlahn et al., Reference Kleinspehn-Ammerlahn, Kotter-Grühn and Smith2008). These studies and others suggest that older people prefer to adopt a younger age identity, possibly because of the devalued status of older age and their own negative perceptions of aging.

The discrepancy between one’s subjective age identity and one’s chronological age represents the paradox of self-ageism (Ayalon, Reference Ayalon2025). Although holding a younger subjective age is considered beneficial in many ways and has been associated with positive physical and mental health outcomes, it also demonstrates a tendency among older people to distance themselves from their own age group and to possibly hold negative ageist stereotypes toward other older people and toward themselves. This can be explained by the social identity approach, which stresses the importance of perceiving yourself as belonging to a valued social category. If one’s age group category is devalued, one way to increase self-value is by disassociating from the devalued group (Tajfel & Turner, Reference Tajfel, Turner, Jost and Sidanius2004).

3.1.1 Work Environments

One area where ageism is highly prominent is the workplace. The prevalence of age discrimination among older workers (55–64 years of age) is high. According to representative data from the German Ageing Study (DEAS, wave 2014), the prevalence of self-reported experiences of age-based discrimination at work or among people looking for work in the previous twelve months was about 73 percent (de Paula Couto & Rothermund, Reference de Paula Couto, Rothermund, Domsch, Ladwig and Weber2019). In the construction process of a standardized scale, the Workplace Age Discrimination Scale, it was found that workers experienced, on average, at least one incidence of workplace-related age discrimination in the previous twelve months (Funk & Lorenz, Reference Funk and Lorenz2024; Marchiondo et al., Reference Marchiondo, Gonzales and Ran2016), showing that most older workers experience unfair bias based on their age.

Ageism in the workplace can manifest at the institutional level in rules and regulations, in interpersonal relations, and internally, in older people’s stereotypes of their own cognitive and physical decline and dysfunction as workers. At the institutional level, one of the most prominent ageist policies is forced retirement, which is solely based on one’s chronological age (Brownell & Powell, Reference Brownell, Powell, Brownell and Kelly2013; Doron et al., Reference Doron, Numhauser-Henning, Spanier, Georgantzi, Mantovani, Ayalon and Tesch-Römer2018; Mikołajczyk, Reference Mikołajczyk, Ayalon and Tesch-Römer2018).Footnote ⁴ Forced retirement arbitrarily determines the time of departure from employment solely by the chronological age of a person. Consequently, it is expected that one’s skills, abilities, and experience should either be discarded or be given for free after a certain age, for instance in the context of volunteering. Advertisements inviting people to apply to work in a “young and dynamic company” also contain an implicit ageist message. Even though these advertisements do not explicitly state that older people are not welcome; by identifying as a young and dynamic work environment, these workplaces favor younger people over older people. There is also research showing that when people of different ages but similar work experiences apply for a job, younger people are more likely to be accepted (Berde & Mágó, Reference Berde and Mágó2022; Cebola et al., Reference Cebola, dos Santos and Dionísio2023).

Ageist attitudes and stereotypes depicting older people in a negative light are common in the workplace (Harris et al., Reference Harris, Krygsman, Waschenko and Laliberte Rudman2018), possibly resulting in microaggressions and conflicts between the generations. Age-related stereotype research indicates that older workers are generally viewed more negatively than younger workers, which can result in lower performance appraisals or older workers receiving harsher consequences for lower performance. Age-discrimination research has identified that older workers struggle to find employment, to receive training and development opportunities, and to advance their careers (Cadiz et al., Reference Cadiz, Pytlovany and Truxillo2017). Employers tend to have a strong preference for younger workers. They tend to view older workers more positively with regard to “soft qualities,” such as social skills or reliability, but more negatively with regard to willingness to learn and physical ability (Oude Mulders, Reference Oude Mulders2020). This is consistent with the Stereotype Content Model, which views older people as warm but incompetent (Cuddy et al., Reference Cuddy, Norton and Fiske2005). Yet, cost might be another reason for the preference of younger workers over older ones, as having less experience in a particular field (often associated with a younger chronological age) means lower costs to the employer.

3.1.2 Healthcare Systems

The healthcare system is another important domain of ageism manifested at the institutional and interpersonal levels (Wyman et al., Reference Wyman, Shiovitz-Ezra, Bengel, Ayalon and Tesch-Römer2018). At the institutional level, ageism in the healthcare system is manifested in various ways that neglect the needs of older people or deprive them of necessary services. This was most evident during the pandemic. Some countries, such as Italy and Switzerland, explicitly used chronological age as a sole basis for the exclusion of older people from emergency services during the pandemic. Other countries, such as Sweden, attempted to protect older people during the early days of the pandemic by keeping them behind closed doors while the rest of society was allowed to maintain at its everyday activities (Aloni & Ayalon, Reference Allen, Elias and Greenwood2023; Ayalon, Reference Ayalon2020). These extreme examples are also evident during normal routines of the healthcare system, when older people are often denied access to certain services and treatments merely because of their chronological age (Wyman et al., Reference Wyman, Shiovitz-Ezra, Bengel, Ayalon and Tesch-Römer2018).

At the interpersonal level, the provision of inadequate care is being driven by ageism among healthcare providers (Ben-Harush et al., Reference Ben-Harush, Shiovitz-Ezra and Doron2017). Ageism is manifested in differential treatment of older people, including the use of elderspeak – using a high tone and simplistic manner of speech when talking to older people – and the use of a less inclusive approach that does not consider older people’s treatment wishes, but instead paternalistically makes choices for them (Williams et al., Reference Williams, Shaw and Lee2017). Ageism is also manifested in the limited interest of healthcare professionals to work with older people (Bryant & Koder, Reference Bryant and Koder2015). This occurs even though older people are the ones who utilize healthcare services the most. Moreover, older and younger people are likely to receive different treatment even when this is not justified by current medical knowledge and practice. For instance, a study conducted in the United States found that physicians were less likely to offer treatment to an older person with suicidal ideation than to a younger person, even though older people are at a higher risk for death by suicide than younger people (Uncapher & Areán, Reference Uncapher and Areán2000).

3.1.3 Technology

Ageism in the case of digital technology occurs while creating design and policies within the social and organizational environment, and as a consequence of the practices, beliefs, and attitudes of the designers and developers (Köttl & Mannheim, Reference Köttl and Mannheim2021; Mannheim & Köttl, Reference Mannheim and Köttl2024). Ageism is evident in the design of new technologies, where designers often fail to take into consideration the unique needs of older people, and negatively stereotype older people as a group less likely to be interested in or capable of competently using technology, rather than appreciating their heterogeneity. Some older people are excluded not only from the design process but also by the use of technologies, which do not always fit their needs and abilities (Mannheim, Wouters, et al., Reference Mannheim, Wouters and Köttl2023). A systematic review of the design of digital technologies for older people found that older people often were not involved in the design process. When older people were included, there was an upper age limit for their involvement. The authors also found that the use of outdated, ageist language largely characterized design decisions in more than 70 percent of the studies reviewed (Mannheim, Wouters, et al., Reference Mannheim, Varlamova, van Zaalen and Wouters2023).

Artificial intelligence (AI) is a major area of concern because past research has shown how it can perpetuate bias regarding racism and sexism. In the case of ageism, it has been argued that AI can produce and reinforce biases (Chu et al., Reference Chu, Nyrup and Leslie2022). A comprehensive review of AI ageism found that it can manifest in a variety of ways (Stypinska, Reference Stypinska2023). For instance, AI databases and algorithms can facilitate the retrieval of ageist results from search terms that query about older people, perpetuating and spreading stereotypes about older age. In addition, AI developers may exclude older people from AI discourse and not take older people’s preferences and needs into consideration in the design process. AI may also result in discriminatory decisions being made on behalf of older people as a group, such as exposing them to or barring them from particular contents due to their age (Stypinska, Reference Stypinska2023).

3.1.4 Traditional and Social Media

Traditional media, such as print, television, and movies, features biased manifestations of ageism, including the underrepresentation of older people and their misrepresentation in a narrowly stereotypical way, which tends to be negative. A review that examined visual representations of older people in the media starting in the 1950s found a distinct change from underrepresentation to misrepresentation of older people over time. Although the oldest-old (eighty years and older) continue to be underrepresented in today’s media, young-old people (in their sixties and seventies) tend to be represented in overly positive ways (Loos & Ivan, Reference Loos, Ivan, Ayalon and Tesch-Römer2018). This misrepresentation has the potential of fostering unattainable standards of successful aging (Ayalon, Reference Ayalon, Tesch-Römer, Rattan. and Ayalon2021).

Ageism is also present in newspaper articles, which tend to depict older people in a negative way. An analysis of a 1.1-billion-word media dataset covering the United States and the United Kingdom found that negative descriptions of older people were six times more common than positive descriptions. The most ageist media form identified was magazines and the least ageist form was fiction (Ng, Reference Ng2021).

Ageism is evident in everyday communications between people over social and digital media as well (Meisner, Reference Meisner2021). One major difference between new media and traditional media is that new media allows for uncensored communication. For instance, the term “boomer remover” came into common use as a way to ridicule the heightened vulnerability of older people during the COVID-19 pandemic (Lichtenstein, Reference Lichtenstein2021). Even unrelated to the pandemic, social media communication concerning older people has shown high levels of ageism. A qualitative study that examined 354 tweets for their ageist content identified several ageist themes, including the portrayal of older people in a negative light and younger people in a positive light. Infantilization and othering of older people as well as internalized ageism and internalized microaggressions were also evident (Gendron et al., Reference Gendron, Welleford, Inker and White2015). These practices not only convey societal views of older people but also shape them. When people face ageist messages, they may eventually internalize them and accept them as given.

3.2.1 Work Environment

The accumulated evidence supports claims that workplace ageism has wide-ranging effects on individuals, groups, teams, organizations, and society. Perceived age discrimination is negatively associated with job satisfaction, a factor which predicts employee turnover (Macdonald & Levy, Reference Macdonald and Levy2016). A study that examined the effects of perceived age discrimination on older workers found that it is a direct contributor to older people’s wish to retire early (Thorsen et al., Reference Thorsen, Rugulies and Løngaard2012). Just as in other areas of life, ageism in the workplace has a detrimental effect on the health and well-being of older people affected by it (Kereri & Nyang’au, Reference Kereri and Nyang’au2024). Another study found that the experience of ageism was more predictive of life satisfaction than job-engagement and work-climate variables (McConatha et al., Reference McConatha, Kumar and Magnarelli2022).

A recent review of the literature, which examined fifty-eight peer-reviewed studies, concluded that ageism serves as an obstacle in the hiring process, and impacts the employability and performance evaluation of older workers (Cebola et al., Reference Cebola, dos Santos and Dionísio2023). This aspect of ageism also has meso-level consequences, potentially leaving organizations without adequate skills and expertise. In the absence of age diversity on the job, an organization is less likely to benefit from cumulative knowledge, flexibility, and creativity, which are more likely to characterize age-diverse work environments (Buttigieg, Reference Buttigieg, Parry and Tyson2011).

As the proportion of older people in society increases, ageism can serve as a major barrier to their inclusion in the workforce. This in return is likely to impact the productivity of the entire workforce, which, given demographic changes, is forced to rely more strongly on older workers. Ageism in the workplace also has a tremendous financial impact at the macro level, as governments are forced to support the pension years of older populations rather than maintain them on the job market. According to the AARP, the financial cost of ageism in the workforce amounted to $850 billion in 2018 (Terrell, Reference Terrell2020).

3.2.2 Healthcare Systems

Discriminatory ageist practices and stereotypes against older people often turn into self-fulfilling prophecies, when older people become less likely to engage in health-promoting behaviors following the experience of age-based discrimination in the healthcare system (Hooker et al., Reference Hooker, Mejía, Phibbs, Tan and Stevens2019). Moreover, there is plenty of research to show the negative impact of ageism not only on older people’s health and well-being but also on the healthcare system itself (Chang et al., Reference Chang, Kannoth and Levy2020; Levy et al., Reference Levy, Slade, Chang, Kannoth and Wang2018). A study that examined excess healthcare spending due to discrimination against older people, negative age stereotypes, and negative self-perceptions of aging on eight of the most expensive health conditions and the costs for treating these health conditions found that the one-year cost of ageism was $63 billion in the US healthcare system, or one of every $7 spent on the selected health conditions (Levy et al., Reference Levy, Slade, Chang, Kannoth and Wang2018).

3.2.3 Technology

Given its substantial impact both on older people and on society at large, digital access is now considered a human rights issue (Sanders & Scanlon, Reference Sanders and Scanlon2021). At the individual level, ageism and particularly self-ageism play an important role in older people’s use of technology, with research showing that self-perceptions of aging partially mediate the association between chronological age and use of technology (Mannheim, Varlamova, et al., Reference Mannheim, Varlamova, van Zaalen and Wouters2023).

Ageism amplifies the digital divide (Choi et al., Reference Choi, Kim, Chipalo and Lee2020), contributing to the exclusion of older people from social life by limiting their access to goods and services. As a result, older people may be less capable of obtaining accurate information and knowledge, including health information. Hence, in the long run, the digital divide increases inequalities in society and may result in poorer physical and mental health among older people.

3.2.4 Traditional and Social Media

The consequences of under-representation, misrepresentation, and negative stereotyping of older people, including online microaggressions, in the media are numerous. Exposure to negative stereotypes of older people results in the perpetuation of negative age stereotypes especially when they become self-relevant in older age (Levy, Reference Levy2009), so media exposure likely has a substantial impact on older people’s health and mental health. The media also has the power to shape societal views of older people. In the absence of balanced representations of older people, it is highly likely that the divide between young and old will intensify in years to come. As already noted, this divide has substantial health, mental health, and financial implications.

4.1.1 Ageism in Early History

In some texts in the Bible, old age seems generally to have been associated with wisdom and respect. For instance, in Proverbs, gray hair is described positively as a “crown of glory” (Proverbs 16:31). The Mosaic Law demands respect for older adults (“You shall rise before grey hair, honor the reputation of an old man and fear your God” [Leviticus 19:32]), as does the second commandment (“Honor your father and your mother, that your days may be long in the Land, which the Lord your God gives you” [Exodus 20:12]). These statements, advocating respect for one’s elders, can also be seen as rules written to ensure the welfare and protection of older people. It is likely that rules were developed in response to rising needs to protect older people. So while it is possible that attitudes, emotions, and behaviors toward older people in biblical times may have been positive, they may also have contained negative aspects, leading to the view of older people as requiring protection (Fernes, Reference Fernes, Gu and Dupre2022, p. 4752). Nonetheless, one may argue that protection also means high regard and positive attitudes toward older people.

4.1.2 Ageism in Ancient Greece and Rome

In the ancient world of Greece and Rome, it was not the norm to grow older than 60 years old, although it has been estimated that, in the first century AD, about 6–8 percent of the population of the Roman Empire was 60 or older, and some, especially among the nobility, reached into their 90s or 100s (Parkin, Reference Parkin and Thane2005). Although not the norm, old age was not uncommon, but views of old age had some notable differences between Greece and Rome. Minois (Reference Minois1989), for example, argues that in youth-oriented Greece old age was equated negatively with lack of youthfulness and therefore sadness, while in Rome old age was positively associated with greatness – an association that declined over the course of the Roman Empire. Looking into literature, philosophy, medical writing, and law, a more varied picture emerges (Thane, Reference Thane2000, p. 31–43).

In Greek mythology, one finds arguably the most negative depiction of old age: the story of Tithonus. The goddess Eos asks Zeus to give her mortal husband Tithonus immortality but forgets to request eternal youth. Tithonus slowly gets older but never dies. He becomes so frail, forgetful, and confused that Eos locks him away in a cupboard or, in another version of the myth, transforms him into a cicada, and his wailing becomes the cicada’s chirr.

Older people were also often portrayed negatively in Greek comedies and satires. In The Wasps by Aristophanes, old Philokleon is described as childish and dependent, being obsessed with serving as a juryman. Aristotle’s Rhetoric also depicts older people negatively, as pessimistic, suspicious, malicious, narrow-minded, petty, anxious, and constantly on guard, however, while still loving life to the last (Parkin, Reference Parkin and Thane2005) (admittedly, in his description of the phases of life, Aristotle also depicted youth negatively, sparing only middle adulthood for positive remarks).

Not all depictions of old age in Greek writing were negative, which is not surprising given that some of the greatest works of Greek literature were written by older artists. Sophocles wrote Oedipus at Colonus when he was about ninety; Euripides wrote Bacchae when he was in his seventies and Iphigenia in Aulis when he was about eighty; and Plato was also around eighty when he wrote the Laws. Prominent examples of positive literary depictions of old age include Odysseus’ strong and intelligent adviser Nestor in Homer’s Iliad and wise Cephalus who depicts old age as an opportunity to beak free of desires which characterizes the experiences of youth at the beginning of Plato’s Republic. The appraisal of old age as depicted in constitutions and other writings also varied to some degree from city to city. Unlike that of youth-oriented Athens, which to the most part stressed the ugliness and unappealing nature of older age, Sparta’s constitution contained elements of a gerontocracy, a political ruling of older people, demonstrating the respect Spartans had for older age (Thane, Reference Thane2000, p. 38).

In ancient Greece, in all social classes, the fate of older people depended primarily on one factor: how long they were able to remain a functioning member of society (Parkin, Reference Parkin and Thane2005). In a society without a social security system, responsibility for the welfare of older people fell to their immediate relatives. That older parents were not always valued by their own offspring might be seen in Greek laws which prescribed children to honor and care for their parents, indicating there might have been a need to encode such behavior (Thane, Reference Thane2000, p. 41). Whereas such laws might reflect the fact that intergenerational solidarity was not always a matter of course, they might also reflect the fact that people considered caring for older people important enough to encode into law.

Ancient Roman texts also vary in their attitudes toward old age. While Cicero’s Cato Maior de Senectute (Cato the Elder on Old Age) is often cited as the most influential positive treatise on old age in history (Thane, Reference Thane2000, p. 38), it can be argued that it is actually an apology for a negative view of old age. Cicero cites four common reasons why old age is considered unfortunate: Old age interferes with one’s ability to do business; it makes the body and the mind weaker; it deprives one of almost all pleasures; and it brings a person closer to death. Cicero’s recipes against the ailments of old age are familiar to modern aging research: For him, as for many modern “successful aging” advisers, fitness in old age depends on activity levels throughout life, character, social status, and financial resources. Emphasizing the conditions under which old age can be productively enjoyed implies that old age might generally have been considered unfortunate and devalued in ancient Rome. Those who were poor, physically sick, and without resources to change their living conditions probably did not experience a fulfilled old age, and this might have been especially true for older women (Parkin, Reference Parkin and Thane2005). In Roman society, the “paterfamilias,” the male head of the family, was generally revered, respected for his wisdom and experience. But when the Roman legal scholar Callistratus wrote around 200 AD, “Old age has always been honoured in our state,” Parkin (Reference Parkin and Thane2005) suggests that he might have been referring only to older men with high social status (p. 5). In ancient Rome, as in ancient Greece and so many other cultures and periods of history, there seem to have been conflicting attitudes about old age. Despite some evident reverence for older men of a higher social standing, ageism might have been a reality for many older people, but given the limited writing about old age that exists from ancient times, we can only speculate.

4.1.3 Ageism in the Middle Ages

During the Middle Ages, Europe was deeply religious. Living a life of high moral worth was seen, among other things, as preparation for a good position in the afterlife. Consequently, the medieval European imagination was very much concerned with the “ages of man,” the stages of the life-course. It was at this time that a distinction “between an ‘old age,’ when powers were diminished but not lost, and the final stage of decrepitude” (what today we call “young old age” versus “old old age”) seems to have been made (Thane, Reference Thane2000, p. 47). Each life stage had certain normatively prescribed characteristics and strengths, such as romantic love in youth and wisdom in old age. Reaching old age was not necessarily seen as a positive process of continuing growth, as Chaucer noted in The Canterbury Tales’ Reeve’s Prologue: “With olde folk, save dotage, is namoore” (for older people there is nothing left except for senility; Reeve’s Prologue, verse 3898).

During the Middle Ages, the percentage of older people was estimated to be as low as it was in ancient Greece and Rome, between 5 percent and 8 percent of the general population (Shahar, Reference Shahar and Thane2005). To live an independent life in old age, it was necessary to make provisions on one’s own. Affluent citizens of towns and cities in Northern and Central Europe could negotiate a so-called corrody with a religious house, monastery, or hospital based on a gift or a promised inheritance. This corrody might comprise accommodation, clothing, and food in old age (Thane, Reference Thane2000, p. 81). Mostly in rural areas, retirement contracts were made between older landowners and members of the younger generation, even within the same family. These contracts were legal documents, sealed before the courts having jurisdiction in these matters, and their existence shows that respect and care for older parents were by no means a given (Shahar, Reference Shahar and Thane2005). Though others may argue the opposite: that respect and care for older parents were considered important enough to codify.

There were social groups of older people who enjoyed high esteem in the Middle Ages, however. In the early Middle Ages, for example, members of the clergy had high social status in general; and those in the higher echelons of the church tended to be men past the age of fifty, because it took many years to reach those higher positions. The high social status of older members of the church hierarchy rested upon the assumption that these older men had acquired moral worth directly as a result of their being at an older stage of life (Gilleard, Reference Gilleard2009). Members of the nobility were often highly respected in older age, as well. This was not only true for noble men (e.g., the Doges in Venice, who were often elected in their sixties and seventies), but also for noble women. For instance, Mathilda, the widow of the East Frankish King Henry the Fowler, founded Quedlinburg Abbey, a house of secular canonesses, in 936. Mathilda, who died at the age of seventy-six, and the abbesses who followed her, who were also older women, served as de facto rulers over the city of Quedlinburg, and held positions of great prestige and influence in the medieval East Frankish Empire.

Medieval thinking reflects the same ambivalence toward older age that we see in other periods of history, where it is not only associated with wisdom, but also characterized by frailty. In the European Middle Ages, a high moral status did not necessarily come automatically with old age but had to be strived for: “Every old person – man or woman, saint, warrior or king – was … expected to meet certain standards of behavior and, ideally, had to find some way to overcome the physical repercussions of age” (Porck, Reference Porck2019, p. 236).

4.1.4 Ageism in Europe from the Sixteenth to the Eighteenth Centuries

From the sixteenth to the eighteenth centuries in Europe – during the Renaissance, Reformation, and Enlightenment – art and culture flourished with new expressions in painting, literature, and philosophy. During the Renaissance, painters began depicting individual people, breaking away from the more generalized forms of medieval styles. It is notable how many differentiated older people were painted by Michelangelo, da Vinci, Titian, Tintoretto, and Cranach in the sixteenth century, by Rembrandt, de La Tour, Maes, Rigaud, and Riley in the seventeenth century, and by Liotard, Chardin, Reynolds, and Seybold in the eighteenth century, among others.

The depiction of older people as individuals in paintings and literature in early modern history may suggest that old age had become an accepted and anticipated part of the lifespan. Self-portraits, such as those of Anna Dorothea Therbusch (1721–1782), showed individual self-reflections on the aging process (Troyansky, Reference Troyansky and Thane2005). Lady Sarah Cowper (1644–1720) wrote a diary from the ages of fifty-six to seventy-two, describing her own process of growing old in contrast to others (Botelho, Reference Botelho and Thane2005).

Despite these more positive, reflective attitudes about older age, reservations about the process of growing old remained. A major example of these reservations is the legend of the Fountain of Youth, a mythical spring which supposedly restores youth to anyone who drinks from it or bathes in its waters. Although the legend is originally much older, it gained prominence in the sixteenth century, when it became associated with the Spanish explorer Juan Ponce de León (1474–1521), who, according to popular legend, discovered Florida while searching for the Fountain of Youth. Lucas Cranach the Elder’s painting The Fountain of Youth (1546) takes an ironic look at the myth. From the left side of the scene, older people are brought to the fountain. On closer inspection, all these people are older women, who turn young by crossing the fountain to the right side. Older men, by contrast, are depicted on the right side of the fountain, where they rejuvenate themselves by dancing and making love to the younger women. Cranach’s painting can be seen as a sarcastic comment on the desire for eternal youth, the association of youth with beauty, and the inherent gender inequality in the quest for enduring beauty.

The economic inequalities present in the Middle Ages persisted into the early modern era. The history of old age remained a history of poverty: While the rich had more opportunities to stay healthy and youthful even after their sixties, poor people often appeared old at the age of forty or fifty due to hard physical labor and poor nutrition (Botelho, Reference Botelho and Thane2005). In England the Poor Relief Act, or Poor Law, was one of the first measures taken in Europe, if not to prevent, then at least to alleviate poverty in old age. The Poor Law granted needy older people the equivalent of a pension, and those who were not yet old, but not sufficiently healthy to work, were given occasional sums of money and various benefits. It has been stated that up to the beginning of the nineteenth century, “the Poor Law provided a very basic safety net for the aged who were very poor, but rarely more” (Thane, Reference Thane2000, p. 158). Despite its shortcomings, this law acknowledged the responsibility of society for the needs of older citizens, and it was one of the central models for the development of modern social security systems in Europe.

4.1.5 Ageism in the Nineteenth, Twentieth, and Twenty-First Centuries

The nineteenth century saw industrialization, urbanization, and the rise of the bourgeois class in Europe. On the one hand, the process of modernization undermined the status of older people (as an example see the Futurism, an artistic movement of the early twentieth century that glorified modernity and rejected the past including the values and contributions of older generations). On the other hand, many social policies from the nineteenth to the twenty-first centuries aimed to improve the living situation of older people through entitlements and rational regulations. In Germany, for example, the Bismarckian old age pension introduced in 1889 was meant to replace income from gainful employment while preserving social status, while in England, the old age pension system aimed to prevent poverty in old age (Thane, Reference Thane2000). During the late nineteenth and early twentieth centuries, health insurance systems began to be introduced in Europe, which was also very important to the well-being of older people, as the risk of morbidities increases with age. In the beginning, these social security systems did not fulfill all their expectations, but after World War II, and after a number of reforms, it was concluded that “the dramatic reduction in old-age poverty is one of the greatest achievements of the postwar welfare state in the affluent democracies” (Anderson, Reference Anderson, Obinger and Schmidt2019).

However, the social achievement of a pension system came at a price: the introduction of a chronological age for (forced) retirement. Such an age boundary was meant to help future retirees plan for their future, for employers to manage their workforce, and for actuaries to calculate further life expectancies to balance pension contributions and benefits. However, age limits divide people into productive workers and unproductive retirees, regardless of their motivations and competencies – the original sin of ageism.Footnote ⁵ It has been argued that social policies play an important role in the ever-changing construction of old age: Age boundaries in social policies are used to build social categories for resource distribution and rationing (Walker, Reference Walker2000), which, in turn, influence images and self-images of older people (Hendricks, Reference Hendricks2004). While granting resources for a decent life in old age, social policies can also be seen as managing societal views on old age and aging. Moreover, it has also been argued that social policies on old age pensions have been blind to social inequality, as poverty in old age is not a consequence of growing old, but a function of low economic status over the life-course (Walker, Reference Walker1981).

Interestingly, an analysis of public discourse from the beginning of the nineteenth century shows that there were more positive attitudes concerning old age in the early nineteenth century and more negative views of old age at the beginning of the twenty-first century. Large linguistic datasets, such as the Corpus of Historical American English and the Corpus of Contemporary American English, allow a direct analysis of ageism since the beginning of the nineteenth century. One study that analyzed the trends and narratives of a 600-million-word dataset, which represents a corpus of 150,000 texts from diverse genres from between 1810 and 2019, found that narratives that describe aging and older people have become more negative over time. Illness, death, and burden have become quite synonymous with older age, whereas positive terms describing heroism and kinship that characterized earlier periods have become less common over time (Ng & Chow, Reference Ng and Chow2020). Analyzing a similar corpus of historical American English, which consisted of 400 million words, over a period of 200 years (1810–2009) (Ng et al., Reference Ng, Allore, Trentalange, Monin and Levy2015), also shows that age stereotypes have become more negative in a linear way over the years. Some argue that the medicalization of aging and the increasing proportion of older people in society serve as potential explanatory factors, associated with more negative age stereotypes over time, because older people often have more demands for medical care, which potentially shape their stereotype as a burden to the medical system and to society at large (Ng et al., Reference Ng, Allore, Trentalange, Monin and Levy2015). The nineteenth century was shaped by rapid social, economic, and technological changes, and this societal modernization – the industrial revolution, urbanization, and shifting cultural values – had a profound impact on attitudes toward aging. This is consistent with predictions made by the modernization theory (Cowgill & Holmes, Reference Cowgill and Holmes1972), which posits that with increased levels of modernization, older people’s status declines. We detail this theory in Section 6.

There are specific periods in time during which ageism, particularly in its negative form, seems to have intensified. One such period was during the COVID-19 pandemic, which is thought to have produced a parallel pandemic of ageism (Previtali et al., Reference Previtali, Allen and Varlamova2020). One reason for the increase in ageism during the pandemic concerns the fact that older people were susceptible to the virus, regardless of their premorbid physical or mental conditions. Hence, in contrast to the general understanding advocated by the field of gerontology of older people as a highly heterogeneous group, susceptibility to the virus automatically categorized people based on their chronological age. The already shaken status of healthcare systems worldwide and the scarce resources available to treat people during high demand resulted in a need to make choices and compromises. The allocation of resources during the COVID-19 pandemic was often not only based on need but based on rigid, arbitrary criteria, such as chronological age (Previtali et al., Reference Previtali, Allen and Varlamova2020). In this case, because older people were known to be susceptible to the virus, need and chronological age were linked, but prescriptive age stereotypes created the expectation that older people should give the right of the way to younger people and not consume too many shared societal resources (North & Fiske, Reference North and Fiske2013).

In keeping with the push and pull of attitudes about older people throughout history, and despite a bias against older people that was evident during the pandemic, one cannot ignore a recent trend toward gerontocracy throughout the world. In the past, gerontocracy was often employed as a formal method to ensure the ruling of older people, whereas in the modern era, informal (supposedly unplanned or dictated by law) gerontocracy is the norm. Regardless of the mechanism behind the selection of older leaders to positions of power, throughout the world and throughout history, political leaders tend to be substantially older than their constituents (Magni-Berton & Panel, Reference Magni-Berton and Panel2021). This trend continues to recent times, as is evident in the last two presidents of the United States, Joe Biden (inaugurated at seventy-eight) and Donald Trump (first inaugurated at age seventy and second term age seventy-eight years and seven months). Likewise, the president of Russia, Putin, is seventy-three years old; the president of Turkey, Erdogan, is seventy-one years old; and Benjamin Netanyahu, the prime minister of Israel, is seventy-six years old.

Although it does not provide a full historical account, a study using data from the Health and Retirement Survey disentangled the differential effects of age, cohort, and period of perceived age-based discrimination in the United States between 2006 and 2018 (Ayalon & Bramajo, Reference Ayalon and Bramajo2023). The authors found that perceived age discrimination increased with age but reached a plateau around the age of seventy-five. There were only minimal cohort effects (e.g., differences in people of different generations) and no period effects (related to the time in which data were collected). These findings suggest that overall perceived age discrimination is more likely to be associated with age, rather than a reflection of recent sociocultural changes, such as the campaign to combat ageism or other events that potentially increase awareness to the topic of ageism in society (Ayalon & Bramajo, Reference Ayalon and Bramajo2023).

4.2.1 Similarity in Ageism across Cultures

Before looking into cross-cultural variations of ageism, it is worth determining whether ageism is a worldwide phenomenon. Large comparative studies help to provide an answer to this question. As already noted, a systematic review of ageism has confirmed the worldwide presence of ageism (Chang et al., Reference Chang, Kannoth and Levy2020). Moreover, in contrast to other “isms,” such as sexism and racism, most people will likely experience ageism at some time in the lifespan, either because a person is “too young” or “too old” (Iversen et al., Reference Iversen, Larsen and Solem2009). Both the World Value Survey and the European Social Survey included an ageism module which allows researchers to compare prevalence rates of ageism in different regions. These studies generally conclude that ageism is very common (Officer et al., Reference Officer, Thiyagarajan, Schneiders, Nash and de la Fuente-Núñez2020) and is substantially higher than reports of exposure to sexism or racism (Ayalon, Reference Ayalon2014), thus highlighting ageism as a global problem of substantial presence in the lives of people of varying ages.

With respect to age differences in the experience of ageism, a study based on the European Social Survey showed that in fourteen of the twenty-eight countries that participated in the survey, perceived age discrimination was higher among the young and subsequently declined with age. Most of the remaining countries showed a pattern in which younger people reported the highest levels of perceived ageism, and older people reported lower, but still high, levels of ageism. In a few countries older people reported the highest levels of perceived ageism (Bratt et al., Reference Bratt, Abrams, Swift, Vauclair and Marques2018). Even though it might be that younger people are more likely to report ageism, a systematic review of ageist stereotypes has found that older people’s stereotypes are more negative than stereotypes directed toward younger people (Kite et al., Reference Kite, Stockdale, Whitley and Johnson2005). For instance, compared with older people, younger people were rated less stereotypically and were evaluated as being more attractive. Younger people also were seen as being more competent than older people.

Apparently, ageism is widespread across many different countries and cultures worldwide, and ageism against older people seems to be more severe than ageism against younger age groups. The fact that older people report ageism less often than their younger counterparts may be because the experience of ageism is not perceived as worthy of mention in the eyes of older people; it may be perceived as simply being a part of this stage of life. In addition, increasingly, generations are raised to be vocal about their complaints, discomfort, and what they perceive to be injustices, in a way that previous generations were not. In fact, not complaining/speaking up for yourself used to be highly valued – the exact opposite of today.

It should also be mentioned that, even though awareness of ageism and age discrimination is growing, many of the phrases used to portray older people in both global and local policy documents – such as “dependency rate” (automatically assuming that people over a certain age are dependent) and “premature death” (automatically assuming that death after a certain age is “on time”) – themselves represent ageist assumptions about older people (Townsend, Reference Townsend, Bernard and Scharf2007). Even organizations such as the WHO, which is responsible for leading the global campaign against ageism, may use ageist terminology in reference to older people, thus emphasizing the internalization of ageism even at the macro-institutional level.

4.2.2 Culture and Ageism

One important question to investigate is whether there are variations between societies and cultures in the extent and type of ageism. For example, one might expect that in collectivistic and interdependent cultures, older people are better safeguarded against negative attitudes, emotions, and actions, because old age is held in higher esteem and older people are better integrated into social networks than in individualistic or independent cultures (Hofstede, Reference Hofstede2011; Triandis, Reference Triandis2001). However, studies have found mixed results.

In a large comparative study involving sixty-eight countries, which examined implicit (uncontrolled) response to age stereotypes (Ackerman & Chopik, Reference Ackerman and Chopik2021), the authors found that in collectivistic cultures age bias was smaller and feelings of warmth toward older people was higher than in individualistic cultures, concluding that the extent of ageism is lower in collectivistic cultures. Similar results were found in a study using a linguistic corpus from more than twenty countries with a wide range of cultural values (Ng & Lim-Soh, Reference Ng and Chow2020). Researchers examined an eight-billion-word corpus in search of cross-cultural differences in the manifestations of ageism. The authors identified three synonyms of older people – “aged,” “elderly,” and “older people.” They then identified 6,000 words co-located with those terms and compiled the top 300 words most frequently associated with them. By rating the co-located terms, the authors concluded that the UK (a society with a largely individualistic culture) had the highest ageism score, whereas Sri Lanka (a society with a largely collectivistic culture) had the lowest ageism score. The authors found that higher levels of masculinity (e.g., the positioning of women as tender and men as emotionally tough) and long-term orientation (e.g., the extent to which the culture encourages delayed gratification of needs and wishes) were associated with ageism (broadly defined as the use of negative adjectives to describe older people and old age), even after other cultural dimensions, demographics, and financial status were controlled for. They concluded that cultural factors (e.g., masculinity and long-term orientation) account for variations across cultures in ageism (Ng & Lim-Soh, Reference Ng and Chow2020).

A study that focused on ageism during the COVID-19 pandemic also found evidence for the association of cultural factors with the extent of ageism. This study examined twenty-eight million newspapers and magazine articles published in twenty countries and found that in all twenty countries, as the COVID-19 pandemic became more prominent and difficult to control, the description of older people and aging became more negative (Ng et al., Reference Ng, Chow and Yang2021). They found that the level of ageism reported in the media was not related to COVID-19 incidence rates and mortality, but rather to cultural variables. Cultures characterized by higher levels of individualism, masculinity, uncertainty avoidance, and long-term orientation were all associated with higher levels of ageism (Ng et al., Reference Ng, Chow and Yang2021).

Contrary to the findings earlier, a large meta-analysis (North & Fiske, Reference North and Fiske2015) did not confirm the assumption that collectivistic cultures are uniformly lower in ageism than individualistic cultures. This meta-analysis was based on 37 papers, involving more than 20,000 participants from 23 countries and diverse measurement instruments. The authors found that negative ageism was higher in the global East than in the global West (North & Fiske, Reference North and Fiske2015). They also found that the cultural dimension of individualism was related to higher positivity toward older people. However, they also found substantial regional differences within collectivistic cultures, with stronger ageism in East Asia (e.g., China, South Korea) than in Southeast Asia (e.g., India, Vietnam). In Continental European countries (e.g., France), ageism was found to be more pronounced than in Anglophone countries (e.g., the UK, the USA, Australia). In a study of twenty-six countries, it was pointed out that differences in perceptions of aging between Asian and Western countries may not reflect cultural values per se, but may instead be related to differences in population structure with more negative views of aging being associated with a greater percentage of older people in society (Löckenhoff et al., Reference Löckenhoff, De Fruyt and Terracciano2009).

4.2.3 Cross-Country Differences in Communication Patterns

In addition to cross-country studies that examine the prevalence or incidence of ageism in different cultures, there are also in-depth studies that examine ageism in a variety of cultural contexts, not by imposing the researchers’ standards of what ageism looks like but by examining evidence for ageism in the specific communication patterns of a given culture. These studies necessarily point out areas of divergence between people of different countries, which, in turn, possibly points to cultural differences in experiences and perceptions of ageism. An example of how ageism is manifested differently in different countries and cultures can be seen in a comparison of language trends on Twitter and its Chinese counterpart Weibo during the COVID-19 pandemic. As shown earlier, the pandemic has often been portrayed as a period in which ageism became a pandemic itself (Previtali et al., Reference Previtali, Allen and Varlamova2020). However, whereas a study that examined language used to describe older people on Twitter during this period found a surge of very negative terms, such as “boomer remover” (a strongly derogatory slang term for the coronavirus) and “coffin dodger” (derogatory slang for an older person) (Lichtenstein, Reference Lichtenstein2021), another study reported that the most common theme found on Weibo during the same period was older people’s positive contribution to society (Xi et al., Reference Xi, Xu, Zhang and Ayalon2021).

4.2.4 Within-Country Differences

Cultural differences within countries are substantial and can be influenced by a variety of demographic variables, such as gender, age, and ethnicity. A review of quantitative studies conducted in the United States between 2010 and 2022 found that older people with lower levels of education and lower socioeconomic status reported experiencing higher levels of ageism, but there were no differences relating to gender, and findings regarding race/ethnicity were mixed (Allen et al., Reference Allen, Elias and Greenwood2023). In an in-depth study of ageism among Jews and Arabs in Israel, it was found that Arabs in Israel believed that their cultural background had helped them be more tolerant toward older people and that they perceived the contribution of older people to society as greater than Israeli Jews did (Bergman et al., Reference Bergman, Bodner and Cohen-Fridel2013). Another study conducted in Israel found that among Israeli Arabs being old was associated with better self-perceptions of aging than among Israeli Jews, but among immigrants to Israel the opposite link was found. On the other hand, and in contrast to what one might expect, Israeli Arabs reported higher levels of ageist experiences regardless of their age (Ayalon & Cohn-Schwartz, Reference Ayalon and Cohn-Schwartz2022). Likewise, a study conducted in Australia argued that First Nation Australians hold different aging priorities compared with the majority culture (Yashadhana et al., Reference Yashadhana, Howie and Veber2022). For example, for First Nation Australians, aging well is rooted in their cultural identity and their profound ties to ancestral land, while mainstream Australians focus on individualistic aspects associated with their physical health, active engagement, and cognitive capacity. Overall, this shows that certain population groups within a country might be more susceptible to the experience of ageism than others, thus highlighting possible subcultural variations of ageism within the dominant culture of a society.

4.2.5 Demographic Composition and Ageism

The age composition of a society may be related to the extent of ageism within that society. The demographic burden hypothesis posits that if the proportion of older people in the total population is high, there might be social conflicts over resources along age lines. Hence, one might expect to have higher levels of ageism in demographically older societies. In contrast, the demographic contact hypothesis argues that opportunities for intergenerational contact are higher in populations with a high proportion of older people, and that contact, interaction, and joint activities between older and younger people might result in less ageism.

Evidence supporting the demographic burden hypothesis comes from two studies. In a study involving twenty-six countries, negative perceptions of aging were associated with the greater proportion of people sixty-five years and older in the total population (Löckenhoff et al., Reference Löckenhoff, De Fruyt and Terracciano2009). In the already cited meta-analysis (North & Fiske, Reference North and Fiske2015), not demographic composition per se, but speed of demographic aging emerged as a predictor of negative ageism. Hence, recent and fast increases in the proportion of older people in the countries examined may have been responsible for the perception of potential conflicts over societal resources, which, in turn, may have led to higher ageism.

Contrary evidence comes from a recent study comparing ageist attitudes in fifty-seven countries from around the world (Officer et al., Reference Officer, Thiyagarajan, Schneiders, Nash and de la Fuente-Núñez2020). Based on the World Value Survey (WVS), an ageism score was constructed from nine items (e.g., acceptance of younger vs. older supervisors; seeing older people as a burden to society). Three classes of individuals emerged: individuals with low, moderate, and high levels of ageist attitudes. Countries varied widely in the prevalence rates of these groups. In some countries, such as Australia, Sweden, and Japan, the percentage of individuals with high ageist attitudes was below 10 percent, while in other countries, such as Nigeria, Bahrain, and India, the percentage of individuals with high ageist attitudes exceeded 50 percent. Analyzing societal macro-indicators, the study showed that “increases in healthy life expectancy” and “larger proportions of older people in the population” were related to lower ageist attitudes (Officer et al., Reference Officer, Thiyagarajan, Schneiders, Nash and de la Fuente-Núñez2020). These results speak against the demographic burden hypothesis in support of the demographic contact hypothesis.

Apparently, the demographic composition of a society may not be consistently related to societal ageism. Quite often, societies with a large proportion of older people differ in other characteristics from societies with a smaller proportion of older people. Societal wealth has been found to be highly associated with demographic composition, and also with speed of demographic change. Some argue that, while some societies of the Global North “get rich before getting old,” many societies of the Global South “get old before getting rich” (see, for example, Johnston, Reference Johnston2021). Hence, a look at the relationship between societal wealth and ageism is necessary.

4.2.6 Societal Wealth and Ageism

It might be hypothesized that, in societies with more resources, conflicts about their distribution along age lines should be less severe than in societies with fewer resources, given similar age compositions of the respective populations. If intergenerational conflicts are the basis for societal ageism, it should follow that higher societal wealth is associated with lower societal ageism.

Some studies have used indicators of economic wealth as control variables for ageism in some studies. In a 2020 study, Officer et al. showed that in economically advanced, high-income countries, the proportion of individuals with high ageist attitudes was lower than in low- and middle-income countries (Officer et al., Reference Officer, Thiyagarajan, Schneiders, Nash and de la Fuente-Núñez2020). In contrast, in a study testing the impact of culture on ageism, an indicator of societal wealth (GDP per capita) did not show substantial associations with ageism (Ng & Lim-Soh, Reference Ng and Lim-Soh2021). A systematic review and meta-analysis of 422 studies and more than 7 million participants found a greater prevalence of significant associations between ageism and poor health in less developed countries (Chang et al., Reference Chang, Kannoth and Levy2020). If one assumes that societal resources moderate the relationship between poor health and ageism, this result speaks for the hypothesis that societal wealth reduces ageism. In sum, empirical evidence does not give a clear picture regarding the relationship between societal wealth and ageism.

4.2.7 Policy Measures and ageism

Finally, we would like to mention a field that is of theoretical interest, but about which, to our knowledge, no systematic studies have yet been conducted. Policies and regulations may influence ageism at the societal level (Tesch-Roemer & Ayalon, 2023). The European Council Directive 2000/78/EC, for instance, established a general framework for equal treatment in employment and occupation, explicitly prohibiting age discrimination in the context of gainful employment and vocational training. Nevertheless, this directive allows for exceptions. For example, under Article 6, age discrimination is permissible if it serves a legitimate aim and the means to achieve that aim are appropriate and necessary. Anti-discrimination laws have developed unevenly across European nations, influenced substantially by judicial decisions (European Union Agency for Fundamental Rights, 2018, p. 190). Examining variations in anti-age discrimination laws may reveal cross-country differences in societal ageism. However, although the WHO has argued that policy measures are effective as a tool to reduce ageism (World Health Organization, 2021), empirical evidence is scarce and somewhat scattered.

4.2.8 Methodological Problems of Cross-Cultural Research on Ageism

Cross-cultural research is highly ambitious. Methodological pitfalls, like problems of conceptual, operational, functional, and measurement equivalence, are a substantial obstacle to comparative aging research (Tesch-Römer & von Kondratowitz, Reference Tesch-Römer and von Kondratowitz2006). Hence, some of these problems should be discussed before summing up the findings on historical and cross-cultural research on ageism.

5.1.1 Micro-Level Theories: Fear, Survival, and Otherness

Micro-level theories arguing for the strong universality hypothesis of ageism focus on fear, survival, and otherness. Older people are feared because they symbolize the finite nature of life, they are seen as jeopardizing the survival of the tribe, and they are categorized as the “other” – a category younger people (and also older people) do not want to belong to. As these mechanisms are thought to apply to all human beings, these theories support the strong universality hypothesis of ageism.

5.1.2 Macro-Level Theories: The Succession of Generations

Macro-level theories highlight different consequences of the succession of generations, like changes of worldviews, conflict over resources, and age grading. They posit that ageism might not be so much a problem related to chronological age, but a problem associated with shifting generational perspectives and relations. As societies necessarily build upon the succession of generations, these theories (with the exception of conflicts over scarce resources) support the strong universality hypothesis.

5.2.1 Micro-Level Theories: Lack of Contact and Knowledge

5.2.2 Meso-Level Theories: Institutional Practices

In meso-level settings, ageism is perpetuated not only by ingrained cultural attitudes that favor youth over older people but also by institutional practices and policies. The wide range and diversity of ageism in different settings have been outlined earlier (see Section 3). The theoretical argument refers to the assumption that organizational and institutional practices are neither completely reducible to the sum of the personal attitudes of an organization’s members nor fully explainable by the culture they are embedded in. Institutional practices have a life of their own, and they may exacerbate or mitigate ageism. A highly relevant example is triage practices in the healthcare system, when old age is used in an overgeneralized manner as a decision criterion, even if medical guidelines or legal regulations do not justify it (Podhorecka et al., Reference Podhorecka, Husejko, Pyszora, Woźniewicz and Kędziora-Kornatowska2022). Another example concerns hiring practices, where young candidates are often given preference over older applicants despite the fact that in most countries nondiscriminatory regulations exist (Batinovic et al., Reference Batinovic, Howe, Sinclair and Carlsson2023).

Not all organizations and institutions apply the same practices. This variability in the extent of institutional ageism may offer opportunities to change meso-level practices and policies. Age is one factor in workplace ageism (e.g., based on the attitude that older workers are seen as warm and/or incompetent), but so is being a member of a certain generation (e.g., belonging to the “Baby Boomers”), being tenured (e.g., number of years in the organization), and having or not having relevant experience. It has been argued that thinking about generations, age, tenure, and experience should be incorporated into future studies to better understand ageism in the workplace. This is because it is not based only on age, but rather concerns all these various domains and may also vary by culture (North, Reference North2022).

5.2.3 Macro-Level Theories: Culture, Modernization, Demography, Wealth, and Public Policies

A rich treasure trove of macro-level theories on the conditional universality hypothesis of ageism stems from comparative research. If certain cultural values are present, if modernization has changed society, if a population is aging, if societal wealth is low, if anti-discrimination laws are lacking – then ageism prevails. All these if-then relationships point to potentially universal mechanisms for the emergence of ageism, and, in some cases, also point out the path for remedies.

6.1.1 Micro-Level Interventions

In the literature, two types of micro-level interventions against ageism are discussed: education and intergenerational contact (and their combination).

• – Educational interventions: It has been argued that one reason for the development of ageism is limited knowledge about aging. Stereotypical misinformation about aging is prevalent; therefore, by presenting people with more balanced information about aging, they may change their way of thinking (Apriceno & Levy, Reference Apriceno and Levy2023). Likewise, there is also an assumption that by teaching people about ageism, they may become more aware of their biases and may refrain from behaving in ageist ways (Suberry et al., Reference Suberry, Okun and Ayalon2025).

• – Intergenerational contact: These interventions tend to pair younger people with older people around common tasks, under the assumption that collaborative contact between parties can increase affection and reduce barriers between age groups. The leading theory behind intergenerational contact is contact theory (Allport, Reference Allport1954), which postulates that under preferred conditions, intergroup contact can reduce prejudice.

Both educational and intergenerational contact interventions aim to reduce ageism directed toward older people, with the agents of ageism being mainly younger persons. These two interventions have received considerable research attention and are supported by empirical evidence (Apriceno & Levy, Reference Apriceno and Levy2023). These ageism interventions have been found to have a significant effect on attitudes about, knowledge of, and comfort with being around older people (although no significant increase in the wish to work with older people was found) (Burnes et al., Reference Burnes, Sheppard and Henderson2019). Although educational and intergenerational contact interventions can be administered separately, their combined effect has been found to be particularly strong (Burnes et al., Reference Burnes, Sheppard and Henderson2019). Although evidence concerning the effectiveness of these two interventions to reduce ageism is ample, there are variations that should be noted. For instance, these interventions seem to be more effective in reducing ageism among females and younger people (Burnes et al., Reference Burnes, Sheppard and Henderson2019). These variations further allude to the conditional universality hypothesis and also reflect the need to develop interventions that are equally effective among males and older people.

A third type of micro-level intervention aims to reduce self-directed ageism among older people by changing a person’s attitudes toward himself or herself as an aging person. These interventions have received considerably less research attention and, as a result, were not included in the WHO global report on ageism. Nevertheless, it is essential to address self-directed ageism (Okun & Ayalon, Reference Okun and Ayalon2024b) because of its substantial impact on older people and society at large (Chang et al., Reference Chang, Kannoth and Levy2020). To date, only a handful of interventions to address ageism among agents of ageism in the second half of life have been developed and assessed. However, despite some evidence for the effectiveness of subliminal interventions (Levy et al., Reference Levy, Pilver, Chung and Slade2014), exercise interventions (Steward & Hasche, Reference Steward and Hasche2021), and mindfulness interventions (Lester & Murrell, Reference Lester and Murrell2021) to reduce self-directed ageism, there is still a need for further empirical support to establish their use. In general, these interventions aim to provide older people with positive information about age and aging, either explicitly or implicitly, in line with the conditional universality hypothesis.

6.1.2 Meso-Level Interventions

The micro-level interventions presented earlier are designed to reduce ageism regardless of the setting in which ageism takes place. However, there have been concerted efforts to develop interventions that address ageism in specific domains or contexts. These meso-level interventions are context-specific, thus operating under the conditional universality hypothesis. Here we present examples from the workplace and the healthcare system – two of the most prevalent sites of ageism against older people.

• – Workplace interventions: A systematic review has identified four possible interventions to prevent or mitigate the negative effects of ageism in the workplace: “de-biasing” interventions that aim to reduce behavioral or affective ageism by providing people with information or conditions that challenge their a priori set of beliefs; “brief attitudinal interventions,” which present videos or articles addressing cognitive or affective ageism; “age diversity workshop interventions,” which bring together people of different generations; and “structural or contextual interventions” that mirror the impacts of a particular effective organizational context or policy. Most studies examining at least one of these strategies demonstrated an improvement in explicit ageist stereotypes toward older people immediately after the intervention (Sinclair et al., Reference Sinclair, Joffe, Ginnivan, Parker and Anstey2023).

• – Healthcare interventions: In recognition of the important role of ageism in the health of older people, the Carta of Florence against ageism was published by an international board of geriatrics experts. The authors outline several actionable steps that must be taken to address ageism in the healthcare system. These include addressing internalized ageism via education to the general public; enacting policies that ensure the topic of ageism is mainstreamed into health and social care education; prioritizing healthcare prevention and healthy lifestyle early in life and across the lifespan; providing treatment that is patient-centered and aligns with older people’s goals and priorities; moving away from a focus on chronological age to biological age and function in the development of treatment goals; including older people in clinical trials; integrating health and social care networks; expanding the role of primary and community care; transitioning into age-friendly environments including in the healthcare system; ensuring access to healthcare systems especially to those older people at the highest levels of need; and addressing technological challenges faced by older healthcare consumers (Ungar et al., Reference Ungar, Cherubini and Fratiglioni2024).

6.1.3 Macro-Level Interventions

To date, older people and aging have rarely been incorporated under human rights legislation. The Universal Declaration of Human Rights (1948), the European Convention on Human Rights (1950), the American Convention on Human Rights (1969), and the African Charter on Human and Peoples’ Rights (1986) prohibit discrimination on numerous grounds, including race, color, sex, language, religion, political or other opinions, national or social origin, property, birth, or other status. The one domain which is consistently missing from human rights discourse is the explicit acknowledgment of chronological age as an unjust basis for discrimination. It is only in more recent human rights documents that “age” is explicitly recognized. Notably, the Charter of Fundamental Rights of the European Union (2000) added age to its enumerated social categories. Likewise, in 2014, the Council of Europe acknowledged the rights of older people to be free of discrimination. The UN Independent Expert on the Enjoyment of All Human Rights by Older Persons has recently advocated for the eradication of age discrimination and ageism. Following the WHO report on ageism, combating the injustice of ageism has become one of the four pillars of the UN Decade of Healthy Ageing. These growing efforts attest to the strong universality of ageism, given the fact that all 194 nations gave a mandate to combat ageism, recognizing its negative impact on their nations and constituents.

The two interventions discussed here – policy and social campaigns – target the entire population. Although they operate under the assumption that something is needed or missing, thus conforming to the conditional universality hypothesis, they target the entire population, assuming that whatever is needed or missing applies equally to all, thus conforming to the strong universality hypothesis.

• – Current international policy measures: According to the WHO global report on ageism, policy is an effective tool to reduce ageism. Reportedly, policies not only dictate how to behave but also have the power to shape norms concerning what is considered ageist (World Health Organization, 2021). However, although the global report identified policies as an effective tool to combat ageism, our own review concluded that evidence is still equivocal (Tesch-Roemer & Ayalon, 2023). Moreover, many times, policies result in counter-indicated consequences, contributing to the spread of ageism, rather than its abolishment. Hence, further research is needed to determine the true effects of policies to counter ageism.

• – Social campaigns: A mechanism identified by the global report as not having enough research evidence is social campaigns. Although social campaigns are often used to change public attitudes toward various social issues because they reach a large number of people and are relatively cost-effective, evidence concerning their effectiveness is still scarce (World Health Organization, 2020). In the case of ageism, the authors determined that successful campaigns should rely on research to develop and evaluate the campaign, ensure community engagement, communicate effectively, and develop a strategic plan which incorporates the various aspects of the campaign.