Association between self-perception of aging, view of cancer and health of older patients in oncology: a one-year longitudinal study.

BACKGROUND: Identifying older people affected by cancer who are more at risk of negative health outcomes is a major issue in health initiatives focusing on medical effectiveness. In this regard, psychological risk factors such as patients' perception of their own aging and cancer could be used as indicators to improve customization of cancer care. We hypothesize that more negative self-perception of aging (SPA) and view of cancer could be linked to worse physical and mental health outcomes in cancer patients. METHODS: One hundred one patients diagnosed with cancer (breast, gynecological, lung or hematological) were followed for 1 year. They were evaluated on four occasions (baseline, 3, 6 and 12 months after the baseline). Their SPA, view of cancer and health (physical and mental) were assessed at each time of evaluation. RESULTS: Negative SPA and/or view of cancer at baseline are associated with negative evolution of patients' physical and mental health. Moreover, when the evolution of SPA and cancer view were taken into account, these two stigmas are still linked with the evolution of mental health. In comparison, only a negative evolution of SPA was linked to worse physical health outcomes. CONCLUSIONS: Such results indicate that SPA and view of cancer could be used as markers of vulnerability in older people with cancer.

A Validation of the French Version of the Attitudes to Aging Questionnaire (AAQ): Factor Structure, Reliability and Validity.

Introduction: The Attitudes to Aging Questionnaire (AAQ) was developed to measure attitudes toward the aging process as a personal experience from the perspective of older people. The present study aimed to validate the French version of the AAQ. Participants and methods: This study examined factor structure, acceptability, reliability and validity of the AAQ's French version in 238 Belgian adults aged 60 years or older. In addition, participants provided information on demographics, self-perception of their mental and physical health (single items), quality of life (WHOQOL-OLD) and social desirability (DS-36). Results: Exploratory Factor Analysis produced a three-factor solution accounting for 36.9% of the variance. No floor or ceiling effects were found. The internal consistency, measured by Cronbach's alpha coefficients for the AAQ subscales were 0.62 (Physical Change), 0.74 (Psychological Growth), and 0.75 (Psychosocial Loss). A priori expected associations were found between AAQ subscales, self-reported health and quality of life, indicating good convergent validity. The scale also showed a good ability to discriminate between people with lower and higher education levels, supporting adequate known-groups validity. Finally, we confirmed the need to control for social desirability biases when assessing self-reported attitudes toward one's own aging. Conclusion: The data support the usefulness of the French version of the AAQ for the assessment of attitudes toward their own aging in older people.

Facing the Next "Geriatric Giant"-A Systematic Literature Review and Meta-Analysis of Interventions Tackling Loneliness and Social Isolation Among Older Adults.

OBJECTIVES: Loneliness and social isolation are associated with adverse health outcomes, especially within the older adult population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice. DESIGN: Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS: Older adults (≥65 years). METHODS: A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression. RESULTS: Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: "promoting social contact," "transferring knowledge and skills," and "addressing social cognition". CONCLUSIONS AND IMPLICATIONS: Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.

Does caring lead to stigmatisation? The perception of older people among healthcare professionals and the general population: A cross-sectional study.

BACKGROUND: It is well recognised that healthcare professionals are particularly at risk for developing a negative perception of older people. Indeed, in addition to receiving education centred on a biomedical view of ageing, they are constantly exposed to the most vulnerable and dependent older individuals. AIM: The purpose of our study is to compare the perception of older people between health professionals, working in a nursing home and the general population. METHODS: This is a cross-sectional study. The perception of older people was measured using two different instruments: the image-of-ageing question and the Aging Semantic Differential (ASD) scale. We performed t-test to compare the perception of older individuals between the general population and healthcare professionals. RESULTS: The image-of-ageing question does not show any difference between the general population (n = 148) and healthcare professionals (n = 107). In these both groups, almost half of the words cited in reference to older individuals were negative. Concerning the ASD, results show that healthcare professionals have significantly more negative perceptions towards older individuals than the general population (with the control of age, gender and educational level). CONCLUSION: Healthcare professionals seem to have a more negative view of older people than the general population. Their regular contact with the frailest older adults could explain this finding. Another hypothesis could be a non-optimal quality of contact in nursing homes. IMPLICATIONS FOR PRACTICE: Such results highlight the importance to promote a more holistic view of ageing in educational programs of healthcare professional. Improving the quality of contact with nursing homes residents should be strongly considered to reduce ageism among healthcare professionals.

Impact of self-perception of aging on mortality of older patients in oncology.

OBJECTIVE: Several studies show that self-perception of aging (SPA) is a significant predictor of mental and physical health. In this study, we analyze the effect of SPA on mortality in the specific context of geriatric oncology. METHODS: The sample constituted of 140 individuals aged 65 years and older suffering from a recent nonmetastatic cancer (breast, lung, gynecological, or hematological), followed up to 6 years. We used Cox proportional hazards model to assess the effect of SPA at baseline on mortality. It was adjusted for age, gender, educational and cognitive level, oncological information (the site and kind of cancer), number of comorbidities, and physical and mental health at baseline. RESULTS: Patients were aged 73 years at diagnosis and were more often women (85.7%). Individuals with more negative SPA were 3.62 times more likely to die than those with a more positive SPA, with control of gender, age, education and cognitive level, mental and physical health, the category (breast, lung, gynecological, or hematological), and kind (initial or recurrence) of cancer. CONCLUSIONS: These findings suggest that SPA influence the mortality of older people in the particular context of oncology. Therefore, the need to change our attitudes toward aging and older people implied indirectly by these results is discussed.

Subjective Age in the Oldest Old: What is the Association with Disability and Sensory Impairment?

BACKGROUND AND PURPOSE: Disability and sensory impairment are particularly pronounced among the oldest old population (80 years and older). Considering these specificities, we analyzed the association of such parameters with subjective age, a strong predictor of health-related outcomes. We assumed that greater disability and sensory impairment (hearing and visual) would be linked with an older subjective age. RESEARCH DESIGN: Prospective population-based study. STUDY SAMPLE: Data were gathered from the 27th year follow-up of the PAQUID cohort, visit where the question on subjective age was collected. Our sample included 75 participants older than 93 years, with a mean age of 96 years. DATA COLLECTION AND ANALYSIS: Disability was assessed with Activities of Daily Living and sensory impairments by asking participants if they have visual or hearing difficulties. A multiple linear regression model was performed with subjective age as the dependent variable. Independent variables were functional disability and visual and hearing impairments. RESULTS: On average, the participants felt 12 years younger than their actual age. Multiple regression analyses controlled for age, gender, education, depression, and dementia indicated that self-reported hearing loss (p = 0.03) was associated with an older subjective age, whereas no significant associations were observed for disability (p = 0.42) and self-reported visual loss (p = 0.18). CONCLUSIONS: Hearing impairment, in contrast to visual impairment and disability, is associated with feeling older. These results are discussed in light of health consequences and age stigma carried by hearing impairment.

Independent recollection/familiarity ratings can dissociate: Evidence from the effects of test context on recognition of event details.

Bodner and Richardson-Champion (2007) found a dissociative effect of test context on binary remember/know judgments about a critical set of details from a film sequence. Details of medium difficulty were more likely to be judged "recollected" when preceded by a set of difficult details than a set of easy details, but were similarly likely to be judged "familiar." Using the same paradigm, we replicated this dissociation when participants independently rated recollection and familiarity. Our finding represents the first evidence that independent recollection/familiarity ratings can be dissociated. In contrast, previous studies using independent ratings have yielded parallel effects of variables that produce dissociative effects with binary judgments. Our discussion considers potential causes of this dissociation, whether test context influenced discrimination or response bias, and implications for interpreting subjective recognition experiences. Demonstrations that test context can affect recollection reports also have implications for designing and conducting eyewitness interviews. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The link between self-perceptions of aging, cancer view and physical and mental health of older people with cancer: A cross-sectional study.

OBJECTIVES: Older people may suffer from stigmas linked to cancer and aging. Although some studies suggested that a negative view of cancer may increase the level of depression, such an association has never been studied in the elderly population. Similarly, even though it is established that a negative self-perception of aging has deleterious consequences on mental and physical health in normal aging, the influence in pathological contexts, such as oncology, has not been studied. The main aim of this study is thus to analyze the effect of these two stigmas on the health of elderly oncology patients. MATERIALS AND METHODS: 101 patients suffering from a cancer (breast, gynecological, lung or hematological) were seen as soon as possible after their diagnosis. Their self-perception of age, cancer view and health (physical and mental) was assessed. RESULTS: Multiple regressions showed that patients with a more negative self-perception of aging and/or more negative cancer view reported poorer global health. We also observed that negative self-perception of aging was associated with worse physical and mental health, whereas negative cancer views were only linked to worse mental health. No interaction was observed between these two stigmas, suggesting that their action is independent. CONCLUSION: Older patients with cancer face double stigmatization, due to negative self-perception of aging and cancer, and these stigmas have impacts on global and mental health. Self-perception of aging is also linked to physical health. Longitudinal studies will be necessary to analyze the direction of the association between this double stigmatization and health.

Ageism in Belgium and Burundi: a comparative analysis.

BACKGROUND: Recent cross-cultural comparisons between Asian and Western cultures have shown that ageism arises more from the lack of availability of social and economic resources for older adults than from the culture itself. We tested this assumption by conducting a survey among people living in a least developed country compared with those living in a developed country. PARTICIPANTS AND METHODS: Twenty-seven Belgians living in Belgium, 29 Burundians living in Belgium, and 32 Burundians living in Burundi were included in this study. Their attitudes toward older adults were assessed using several self-reported measures. RESULTS: Statistical analyses confirmed that older people are more negatively perceived by Burundians living in Burundi than by Burundians and Belgians living in Belgium, whose attitudes did not differ from each other. CONCLUSION: Consistent with our hypothesis, our results suggest that the level of development of a country and more particularly the lack of government spending on older people (pension and health care systems) may contribute to their younger counterparts perceiving them more negatively.

Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads.

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people's mental and physical health in "normal" aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals' attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients' mental and physical health.

[Impact of double stigmatization in oncogeriatry: reviewing existing data]. / Impact de la double stigmatisation en oncogériatrie : état des lieux.

Cancer is a major health problem for which age is a proved risk factor. Paradoxically, elderly suffering from cancer are often excluded from clinical trials and undertreated compared to younger patients. Also, their psychosocial needs remain unknown. An explanatory factor for these observations is the age stigma (that is to say our stereotypes about age and so, ageism), age being currently cited as the main reason for discrimination. Besides these age-related stigmas, cancerous patients face pathology-related stigmas because nowadays cancer (especially some types of cancer such as lung cancer) still conveys a lot of negative representations. These observations bring us to the notion of double stigmatization in oncogeriatry. Moreover, the aim of this review is to present ageism phenomenon on the basis of several studies that had proved negative influence of ageism on elderly's mental and physical health and on the attitude of elderly's interlocutors. Afterwards, we will broach the way by which ageism and stigmatization linked to cancer is observed in the specific context of oncogeriatry, which will allow us to identify current shortcomings.