Perceived age discrimination in the second half of life: an examination of age-, period-, and cohort-effects

Background and Objectives: Ageism is defined as stereotypes, prejudice, and discrimination based on age. Perceived age discrimination (e.g., the behavioral component of ageism) is highly prevalent in society, reported by one in three people in Europe. The present study examined variations in perceived age discrimination in the second half of life. We adopt a comprehensive approach which examines whether perceived age discrimination varies by age (chronological time from birth), period (the context when data were collected), or cohort (a group of people with shared life events experienced at a similar age) across gender and ethnic origin. Research Design and Methods: We relied on psychosocial data from the Health and Retirement Survey between 2006 and 2018. We ran a set of age-period-cohort (APC) models to determine the separate effects of aging (age) factors, contextual (period) factors and generational (cohort) factors on perceived age discrimination. Results: Our findings show that perceived age discrimination increases with age but reaches a plateau around the age of 75. There also were some cohort effects, but they appeared minimal and inconsistent. No period effects were found. Discussion and Implications: The findings attest to the consistent nature of perceived age discrimination, which is less likely to be impacted by external contextual events. It also is less likely to be affected by gender or ethnicity. The findings also suggest that it is older persons who are more likely to report age discrimination, thus, interventions should address ageism in this age group

Contemporary Perspectives on Ageism

This open access book provides a comprehensive European perspective on the concept of ageism, its origins, the manifestation and consequences of ageism, as well as ways to respond to and research ageism. The book represents a collaborative effort of researchers from over 20 countries and a variety of disciplines, including, psychology, sociology, gerontology, geriatrics, pharmacology, law, geography, design, engineering, policy and media studies. The contributors have collaborated to produce a truly stimulating and educating book on ageism which brings a clear overview of the state of the art in the field. The book serves as a catalyst to generate research, policy and public interest in the field of ageism and to reconstruct the image of old age and will be of interest to researchers and students in gerontology and geriatrics

Psychometric Properties Of Responses By Clinicians And Older Adults To A 6-Item Hebrew Version Of The Hamilton Depression Rating Scale (HAM-D6)

Background The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D6 is used most widely in large degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale. Methods A total of 153 Israelis 75 years of age on average participated in this study. The HAM-D6 was examined using confirmatory factor analytic (CFA) models separately for both patient and clinician responses. Results Reponses to the HAM-D6 suggest that this instrument measures a unidimensional construct with each of the scales’ six items contributing significantly to the measurement. Comparisons between self-report and clinician versions indicate that responses do not significantly differ for 4 of the 6 items. Moreover, 100% sensitivity (and 91% specificity) was found between patient HAM-D6 responses and clinician diagnoses of depression. Conclusion These results indicate that the Hebrew HAM-D6 can be used to measure and screen for depressive symptoms among elderly patients

Ageism: an old concept from new perspectives.

This article is an introduction to the special issue "New horizons in ageism research: innovation in study design, methodology and applications to research, policy and practice". This special issue aims to offer a broad and innovative perspective on ageism. The first section addresses new developments in the conceptualization of ageism. This section focuses not only on the negative side of ageism, but also on benevolent ageism, which is manifested in protective attitudes and behaviors towards older persons because of their age, following the stereotype of older persons as a vulnerable group that needs protection. The second section concerns the manifestation of ageism: between traditional and underexplored arenas. The third section concerns innovative methods to explore the concept of ageism. This section relies on innovations in qualitative and quantitative methods to explore nuances in the manifestations of ageism. The next section addresses interventions to reduce or prevent ageism

A systematic review of existing ageism scales

Ageism has been shown to have a negative impact on older people’s health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the ‘Expectations Regarding Aging’ met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the ‘stereotype’ dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing

A healthy planet for a healthy mind

The evidence base connecting planetary and human health is growing, but thus far the research community has primarily focused on the physical health implications. This Voices asks: how does environmental degradation affect mental health, and what are the emerging needs and research priorities

Ageism in the third age

In the developed world, later life has brought more opportunities to contribute to society and pursue personal goals outside the role of paid work, combined with less stigma and greater recognition of the worth of older people. These values do not necessarily extend to the “oldest old” where some people in the fourth age (people 80 years old and over) continue to face increasing stigma and societal stereotypes from those in the third age (people 60–79 years old). Ageism between these two cohorts is rarely discussed in the literature. Potential ageism involves stereotypical perceptions of the oldest old and may prove detrimental to those transitioning from the third to the fourth age if a resultant resistance to maintain their engagement and independence into older age occurs. This chapter explores the subtleties of these inter-cohort ageist discourses particularly from a health and social care perspective and considers the implications for transitions of older people between the third and fourth age. It addresses the challenges and adjustments needed to ensure continuing and inclusive engagement in society, in order to support independence to grow old without the fear of discrimination

Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.

OBJECTIVES: Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ≥10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. STUDY DESIGN AND SETTING: Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. RESULTS: A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 ≥10 prevalence was 24.6% (95% confidence interval [CI]: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); and pooled difference was 11.9% (95% CI: 9.3%, 14.6%). The mean study-level PHQ-9 ≥10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 ≥14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8% for PHQ-9 ≥14 (95% prediction interval: -13.6%, 14.5%) and 5.6% for the PHQ-9 diagnostic algorithm (95% prediction interval: -16.4%, 15.0%). CONCLUSION: PHQ-9 ≥10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Objective: To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. Design: Individual participant data meta-analysis. Data sources: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). Inclusion criteria: Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. Results: Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. Conclusions: PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. Registration: PROSPERO CRD42014010673