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Global reach of ageism on older persons' health: A systematic review.

ABSTRACT: OBJECTIVE:Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time. METHOD:A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857). RESULTS:Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism). CONCLUSION:The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

SUBMITTER: Chang ES

PROVIDER: S-EPMC6961830 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Global reach of ageism on older persons' health: A systematic review.

Chang E-Shien ES Kannoth Sneha S Levy Samantha S Wang Shi-Yi SY Lee John E JE Levy Becca R BR

PloS one 20200115 1

<h4>Objective</h4>Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal th ...[more]

PMID: 31940338

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Project description:ImportanceMajor incidents of ageism have been shown to be associated with poorer health and well-being among older adults. Less is known about routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their day-to-day lives, known as everyday ageism.ObjectiveTo examine the prevalence of everyday ageism, group differences and disparities, and associations of everyday ageism with indicators of poor physical and mental health.Design, setting, and participantsThis cross-sectional study was conducted using survey data from the December 2019 National Poll on Healthy Aging among a nationally representative household sample of US adults ages 50 to 80 years. Data were analyzed from November 2021 through April 2022.ExposuresExperiences of everyday ageism were measured using the newly developed multidimensional Everyday Ageism Scale.Main outcomes and measuresFair or poor physical health, number of chronic health conditions, fair or poor mental health, and depressive symptoms.ResultsAmong 2035 adults ages 50 to 80 years (1047 [54.2%] women; 192 Black [10.9%], 178 Hispanic [11.4%], and 1546 White [71.1%]; mean [SD] age, 62.6 [8.0] years [weighted statistics]), most participants (1915 adults [93.4%]) reported regularly experiencing 1 or more forms of everyday ageism. Internalized ageism was reported by 1664 adults (81.2%), ageist messages by 1394 adults (65.2%), and interpersonal ageism by 941 adults (44.9%). Mean Everyday Ageism Scale scores were higher for several sociodemographic groups, including adults ages 65 to 80 years vs those ages 50 to 64 years (11.23 [95% CI, 10.80-11.66] vs 9.55 [95% CI, 9.26-9.84]) and White (10.43 [95% CI, 10.20-10.67]; P < .001) and Hispanic (10.09 [95% CI, 9.31-10.86]; P = .04) adults vs Black adults (9.23 [95% CI, 8.42-10.03]). Higher levels of everyday ageism were associated with increased risk of all 4 negative physical and mental health outcomes examined in regression analyses (with odds ratios [ORs] per additional scale point as high as 1.20 [95% CI, 1.17-1.23] for depressive symptoms and b = 0.039 [95% CI, 0.029-0.048] for chronic health conditions; P values < .001). Internalized ageism was the category associated with the greatest increase in risk of poor outcomes for all health measures (with ORs per additional scale point as high as 1.62 [95% CI, 1.49-1.76] for depressive symptoms and b = 0.063 [95% CI, 0.034-0.092] for chronic health conditions; P values < .001).Conclusions and relevanceThis study found everyday ageism to be prevalent among US adults ages 50 to 80 years. These findings suggest that commonplace ageist messages, interactions, and beliefs may be harmful to health and that multilevel and multisector efforts may be required to reduce everyday ageism and promote positive beliefs, practices, and policies related to aging and older adults.

Project description:ObjectiveTo determine the association between country-level structural ageism and prevalence of violence against older persons.DesignCountry-level ecological study.SettingStructural ageism data were drawn from the nationally representative World Values Survey 2010-2014 (WVS), global databases from the WHO, United Nations and the World Bank. Violence data were based on the Global Burden of Diseases (GBD) study 2017.ParticipantsAnalysis of 56 countries that represented 63.1% of the world's ageing population aged 60 and over across all six of WHO regions.ExposureStructural ageism, following established structural stigma measures, consisted of two components: (1) discriminatory national policies related to older persons' economic, social, civil and political rights, based on the four core components of human rights protection in Madrid International Plan of Action on Aging and (2) prejudicial social norms against older persons, measured by negative attitudes toward older persons in 56 national polls in WVS aggregated to country-level. These components were z scored and combined such that higher score indicated greater structural ageism.Main outcomes and measuresPrevalence rates of violence per 100 000 persons aged 70 and over in each country was based on extensive epidemiological surveillance data, survey, clinical data and insurance claims in GBD and compiled by the Institute of Health Metrics and Evaluation, University of Washington.ResultsThere was a wide variation in levels of structural ageism across countries. As predicted, structural ageism was significantly associated with the prevalence rates of violence in multivariate models (β=205.7, SE=96.3, p=0.03), after adjusting for relevant covariates. Sensitivity analyses supported the robustness of our findings. That is, structural ageism did not predict other types of violence and other types of prejudice did not predict violence against older persons.ConclusionsThis study provides the first evidence of the association between higher structural ageism and greater violence against older persons across countries.

Project description:BACKGROUND:Finding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual's health assets-internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as health assets within personal, social, economic and environmental domains. METHODS:Systematic searches of databases were conducted for literature published in peer-reviewed journals between January 2000 and November 2016. Selection criteria included community dwelling populations aged 65 years and over and publications written in English. Data on study population, design, measures of health status, factors within the four previously stated domains and results were extracted. Study quality was independently assessed using an appraisal instrument. RESULTS:Twenty-three publications, including 78?422 participants, from more than 13 different countries were identified for inclusion in this review. There was strong evidence that higher scores of self-rated health, psychological well-being and life satisfaction were associated with better health in older age. Social network and contact with family and friends, and engagement in leisure and social activities were important support mechanisms. Education and financial resources consistently proved to be key economic health assets for older adults. CONCLUSIONS:Implementing an asset-based approach to health promotion uncovers the skills, knowledge, connections and potential of the individual and the community. This approach is an ideal opportunity for government health bodies and their partners to respond to the challenges faced by global ageing.Factors are often interdependent and cumulative, suggesting the potential for an instrument to measure the accumulated effect of health assets on health status in older adults.

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Global reach of ageism on older persons' health: A systematic review.

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Global reach of ageism on older persons' health: A systematic review.

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