Breaking the links between ageism and health: An integrated perspective.

Ageism refers to prejudice, stereotypes or discrimination based on a person's actual or perceived chronological age. While ageism can affect people at all stages of the human lifespan, ageism against older adults has emerged as the most pervasive and potentially harmful. Much is now understood about how ageism can impact older people's health and wellbeing via structural, organisational, and provider level biases that threaten the provision of equitable and ethical healthcare. Negative attitudes about age and ageing also contribute to workforce shortages in aged care sectors, such as residential aged care and nursing. However, often underappreciated is how self-directed ageism, which refers to ageism turned against oneself, can also be an important determinant of health and wellbeing. Relative to external sources of ageism, negative internalised ageist beliefs are not only experienced more frequently in older adults' everyday lives, but are also more strongly linked to their health and wellbeing. Here we highlight how this understanding means that eliminating ageism requires a multifaceted approach that targets not only health care systems and aged care professionals, but older people themselves. Because normal age-related cognitive changes in how we think, perceive and reason increase the risk of older people viewing themselves through a negative and ageist lens, we provide a novel discussion of how broader insights from cognitive ageing literature must play a central role in any agenda focused on breaking the links between ageism and health.

The health impacts of blood donation: a systematic review of donor and non-donor perceptions.

BACKGROUND: The health and well-being of volunteer donors is of critical concern for blood collection agencies responsible for ensuring a stable supply of blood products. However, lay understandings of the impact of donating blood on health remain poorly understood. As lay perceptions are likely to influence critical decisions about donation, understanding these perceptions is key for informing evidence-based approaches to donor retention and recruitment. As such, we conducted a systematic review of the blood donation literature to identify donors' and non-donors' perceptions of the short and longer-term physiological health effects of whole-blood and/or blood product donation. MATERIALS AND METHODS: This review was conducted in line with PRISMA guidelines. Studies published from January 1995 to February 2021 were included. Perceptions were defined as both experiences and beliefs. Psychological effects were considered outside the scope of the review. RESULTS: A total of 247 studies were included. Most studies (89.5%) had donation-related health perceptions as a background rather than a central (10.5%) focus, and they were only assessed in relation to whole blood donation. More results focused on health-related beliefs than experiences (82 vs 18%), specific rather than general beliefs and experiences (80 vs 20%) and more frequently examined negative than positive beliefs and experiences (83 vs 17%). The most commonly studied and reported specific negative beliefs related to increased risk of infectious disease, reduced vitality, vasovagal reactions and low iron. Most studies examining specific negative beliefs were conducted in Asian countries. DISCUSSION: Findings reinforce that lay perspectives on how donation impacts health are under-researched, and it is difficult to know how important these are in informing critical decisions about donation for donors and non-donors. We suggest that further research with donation-related health beliefs and experiences as the central focus is needed to provide insights to inform communications with donors and the public.

Self-initiating and applying episodic foresight in middle childhood.

This study provides an important extension to the growing literature on prospection in children by providing the first test of whether one's ability to engage in the functional (as opposed to the purely phenomenological) aspect of episodic foresight improves across middle childhood. Of the various forms of prospection, episodic foresight has been proposed to be one of the most flexible and functionally powerful, defined as the ability to not only imagine future events (simulative aspect) but also use those imaginings to guide behavior in the present (functional aspect). The current study tested 80 typically developing children aged 8 to 12 years using an extensive cognitive battery comprising Virtual Week Foresight, the Autobiographical Interview, and a series of crystallized and fluid intelligence measures. Whereas data indicated age-related improvements in detecting future-oriented problems and taking steps in the present in service of solving these, all children in this age bracket demonstrated a similar capacity for problem resolution (i.e., the ability to subsequently solve successfully identified problems). Results also revealed the importance of broader crystallized and fluid intelligence, but not episodic memory or episodic future thinking, in engaging in this capacity. Research is now required to understand the real-life consequences of episodic foresight during this developmental period as well as the ways in which parents and teachers can help to foster this capacity and consequently help to support children's growing desire for independence during this time.

Cognition and Financial Decision-Making in Older Adult Spouses.

INTRODUCTION: Age-related decline in executive functioning has been found to negatively impact one's capacity to make prudent financial decisions. The broader literature also speaks to the importance of considering interrelatedness in older spouses' functioning, as these individuals typically represent one's longest and closest relationship that involves an extended history of shared experiences. Accordingly, the aim of the present study was to provide the first examination of whether older adults' financial decision-making capacity is impacted not only by their own but also by their partner's, level of cognitive functioning. METHOD: Sixty-three heterosexual spousal dyads comprising older adults aged 60-88 participated. The contribution of executive functioning and perceptions of partner's cognitive decline on financial decision-making behavior and financial competency was assessed through two actor-partner interdependence models. RESULTS: As predicted, for both genders, one's own executive functioning was predictive of one's own financial decision-making capacity. However, of particular interest was the finding that for females (but not males) perceiving greater cognitive decline in their spouse predicted their own (greater) financial competency. CONCLUSION: Examining whether partner interdependence extends to the realm of financial decision-making is not only a theoretically but also practically important question. These data provide initial insights that such a relationship does exist and highlight further important avenues for future research.

The cognitive tenacity of self-directed ageism.

Ageism refers to prejudice or discrimination based on a person's age. When ageism is directed at older people, it is unique in two ways: it is socially condoned in a manner that other types of prejudice are not, and the animus is eventually self-directed. Of central interest here is why ageism becomes self-directed in late adulthood, despite its potentially harmful personal costs. We present a cognitive model in which negative ageist beliefs become increasingly accessible and difficult to eliminate owing to broader developmental shifts in mentation. Given that these effects are contingent on our social environment, systemic changes in societal conceptions of age and aging are needed if we are to reduce vulnerability to self-directed ageism.

Affective forecasting in Parkinson's disease.

OBJECTIVES: While emotional responses experienced in-the-moment appear to remain intact in Parkinson's disease (PD), no study has tested whether this extends to the prediction of future emotional responses. The present study aimed to provide the first assessment of affective forecasting capacity in this cohort. METHODS: A positively and negatively valenced affective forecasting task and broader clinical battery were completed by a PD group (ns = 28 and 37, respectively) and a demographically matched neurotypical control group (ns = 38 and 39, respectively). RESULTS: No group differences emerged on the two tasks, with the two groups underestimating their level of happiness and overestimating their level of negative affect to a similar degree. Affective forecasting error scores were unrelated to clinical characteristics. CONCLUSIONS: Given that affective forecasting relies on self-projection into the future, a skill shown to often be disrupted in this cohort, impairments were expected. However, this study provides initial evidence that this may not be the case. These findings are potentially important given that how we think about and envisage the future affectively is a major determinant of goal-directed behavior. Further work is now needed to establish whether these findings are robust and generalize to other types of affective stimuli.

Parkinson's disease disrupts the ability to initiate and apply episodic foresight.

OBJECTIVE: While Parkinson's disease is associated with impairments in many aspects of prospective cognition, no study to date has tested whether these difficulties extend to problems using episodic foresight to guide future-directed behavior. To provide the first examination of whether people with Parkinson's disease are impaired in their capacity to initiate and apply episodic foresight. METHOD: People with Parkinson's disease (n = 42), and a demographically matched neurotypical comparison group (n = 42) completed a validated behavioral assessment that met strict criteria for assessing episodic foresight (Virtual Week-Foresight), as well as a broader neurocognitive and clinical test battery. RESULTS: People with Parkinson's disease were significantly less likely than the comparison group to acquire items that would later allow a problem to be solved and were also less likely to subsequently use these items for problem resolution. These deficits were largely unrelated to performance on other cognitive measures or clinical characteristics of the disorder. CONCLUSIONS: The ability to engage in episodic foresight in an adaptive way is compromised in Parkinson's disease. This appears to be a stable feature of the disorder, and one that is distinct from other clinical symptoms and neurocognitive deficits. It is now critical to establish exactly why these difficulties exist and how they impact on real-life functional capacity.

Social Frailty in Late Adulthood: Social Cognitive and Psychological Well-Being Correlates.

OBJECTIVES: Social frailty poses a major threat to successful aging, but its social cognitive and psychological well-being correlates remain poorly understood. This cross-sectional study provides initial insights into whether social cognitive difficulties in older age are associated with social frailty, as well as how social frailty is linked to psychological characteristics known to be important for health and well-being. METHOD: Ninety community-dwelling older adults completed measures of social frailty and social cognition (social perception, theory of mind, affective empathy, and informant-rated social behavior) as well as measures of psychological function known to be important for health and well-being, both positively (resilience and life satisfaction) and negatively (demoralization, social anxiety, and apathy). Measures of cognitive frailty, physical frailty, and depression were also administered to test the specificity of any observed relationships with social frailty. RESULTS: Both affective empathy and social behavior were predictive of increased social frailty, but social behavior emerged as the only unique predictor after controlling for covariates. Social frailty also predicted unique variance in all five measures of psychological well-being, and for three of these measures (demoralization, resilience, and life satisfaction), the effects remained significant even after adjusting for covariates. DISCUSSION: Findings are discussed in relation to models of socioemotional aging and frailty. Potential mechanisms linking social behavior to social capital in older age are identified, as well as how loss of social resources might both directly and indirectly impact well-being.

The antecedents and consequences of stereotype threat in Parkinson's disease.

OBJECTIVE: The aim of this study was to examine what factors make people with Parkinson's disease more susceptible to stereotype threat (i.e., the concern of being evaluated in line with negative group-based stereotypes) and the clinical consequences of this. METHOD: Forty-nine people with Parkinson's disease completed a measure of stereotype threat, as well as measures that indexed potential antecedents and clinical consequences of stereotype threat. RESULTS: Younger age and greater communication difficulties emerged as significant predictors of stereotype threat. Higher stereotype threat was also associated with increased emotional distress. CONCLUSIONS: These findings are an important first step in understanding stereotype threat in Parkinson's disease and may help to guide the development of intervention and educational efforts aimed at countering its effects.

Moving beyond basic emotions in Parkinson's disease.

OBJECTIVE: Emotion recognition is a fundamental neurocognitive capacity that is a critical predictor of interpersonal function and, in turn, mental health. Although people with Parkinson's disease (PD) often exhibit difficulties recognizing emotions, almost all studies to date have focused on basic emotions (happiness, sadness, anger, surprise, fear, and disgust), with little consideration of how more cognitively complex self-conscious emotions such as contempt, embarrassment, and pride might also be affected. Further, the few studies that have considered self-conscious emotions have relied on high intensity, static stimuli. The aim of the present study was to therefore provide the first examination of how self-conscious emotion recognition is affected by PD using a dynamic, dual-intensity measure that more closely captures how emotion recognition judgements are made in daily life. METHOD: People with PD (n = 42) and neurotypical controls (n = 42) completed a validated measure of self-conscious facial emotion recognition. For comparative purposes, in addition to a broader clinical test battery, both groups also completed a traditional static emotion recognition measure and a measure of self-conscious emotional experience. RESULTS: Relative to controls, the PD group did not differ in their capacity to recognize basic emotions but were impaired in their recognition of self-conscious emotions. These difficulties were associated with elevated negative affect and poorer subjective well-being. CONCLUSIONS: Difficulties recognizing self-conscious emotions may be more problematic for people with PD than difficulties recognizing basic ones, with implications for interventions focused on helping people with this disorder develop and maintain strong social networks. PRACTITIONER POINTS: This is the first direct investigation into how the recognition of self-conscious emotion is affected in Parkinson's disease using dynamic, dual-intensity stimuli, thus providing an important extension to prior literature that has focused solely on basic emotion recognition and/or relied on static, high-intensity stimuli. Results revealed preserved basic facial emotional recognition coexisting with impairment in all three self-conscious emotions assessed, therefore suggesting that the latter stimuli type may function as a more sensitive indicator of Parkinson's disease-related social cognitive impairment. Problems with self-conscious emotion recognition in people with Parkinson's disease were associated with poorer broader subjective well-being and increased negative affect. This aligns with the broader literature linking interpersonal difficulties with poorer clinical outcomes in this cohort.

A review of whole-blood donors' willingness, motives, barriers and interventions related to donating another substance of human origin.

Diversification of blood collection agencies' (BCAs) core business requires donors to donate substances of human origin (SoHO) beyond whole-blood. Whole-blood donors are assumed to be willing to convert to donate other SoHO as well as whole-blood. However, no reviews consider the evidence on conversion (i.e., willingness/intention, behaviour, retention, attrition). This rapid review provides a narrative synthesis of whole-blood donors' conversion to another SoHO, characteristics contributing to conversion, motives and deterrents, and interventions encouraging conversion. Sixty-five studies were reviewed. Most were cross-sectional and examined whole-blood donor conversion to organ (willingness/pledge for deceased donation), plasma or stem cell donation. Most examined conversion rather than characteristics contributing to conversion, motives, deterrents or interventions. Whole-blood donors appear willing to donate another SoHO, yet conversion rates are unclear. Besides self-efficacy, there is little consistency in reported characteristics of donors converting, and few theories applied to understand characteristics encouraging conversion. Intrinsic (altruism, self-esteem, curiosity) and extrinsic (perceived need, service experience, direct requests) motives and barriers (lifestyle, fearing reduced health) appear important and require further research. Interventions encouraging conversion need replication and may include in-person, in-centre approaches, raising awareness of the functional benefits of other SoHO (high need, usefulness), and developing promotional materials that pique donors' curiosity, invite questions, and encourage donor-initiated conversations about conversion. Centralising BCAs as a single business or partnering with other organisations appears mutually beneficial to encourage conversion and sustainable panels/resources. Research is needed to understand the impact of encouraging conversion on donors and organisations, and identify optimal management strategies for multi-SoHO donors.

Affective empathy in neurodegenerative disorders: The importance of measurement type.

In recent years, there has been increasing attention focused on affective empathy in neurodegenerative disorders (NDs). However, prior studies have identified discrepancies not only between, but sometimes within, specific NDs. These discrepancies may reflect methodological differences in how affective empathy has been operationalized, with three quite distinct approaches to assessment possible (self-report, informant-report and performance-based). Therefore, we conducted the first meta-analytic review of affective empathy in people with NDs, that considered the potential moderating role of measurement type. Across 27 studies that included 1456 people with NDs and 832 controls, the results showed that most NDs are associated with impaired affective empathy, but that the magnitude of these difficulties differs meaningfully across disorders. However, most importantly, the results indicated that measurement type is a critical consideration in this literature, with substantive differences emerging for self- versus informant-rated measures. These results are discussed in relation to their practical implications for clinical assessment, as well as how they help to inform current theoretical understanding of affective empathic processing.

Visual attentional orienting by eye gaze: A meta-analytic review of the gaze-cueing effect.

Given limitations in the amount of visual information that a person can simultaneously process through to conscious perception, selective visual attention is necessary. Visual signals in the environment aid this selection process by triggering reflexive shifts of covert attention to locations of potential importance. One such signal appears to be others' eye gaze. Indeed, a gaze-cueing effect, whereby healthy adults respond faster to targets that are presented at locations cued rather than miscued by eye gaze has been consistently observed in the empirical literature. Critically though, the influences of task and cue features on this effect are not well understood. To address this gap, we report a meta-analytic integration of 423 gaze-cueing effects using a multilevel approach. A gaze-cueing effect emerged across all levels of the assessed task and cue features, indicating that others' eye gaze reliably directs observers' attention. We found that the magnitude of the gaze-cueing effect was moderated by whether direct gaze cues preceded directional gaze cues or not; the cue-target stimulus onset asynchrony (SOA), whether participants had to detect, localize, or categorize targets; and the cue's facial expression. Whether or not the gaze cue remained on screen after the target appeared, and whether schematic faces, computer-generated faces, or images of real faces were used as cues, did not appear to reliably function as moderators. The theoretical implications of these findings are discussed, particularly in relation to the social attention system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Empathy and Theory of Mind in Alzheimer's Disease: A Meta-analysis.

OBJECTIVE: A large literature now shows that Alzheimer's disease (AD) disrupts a number of social cognitive abilities, including social perceptual function and theory of mind (ToM). However, less well understood is how the specific subcomponents of ToM as well as both the broader and specific subcomponents of empathic processing are affected. METHOD: The current study provides the first meta-analytic review of AD that focuses on both empathy and ToM as broad constructs, as well as their overlapping (cognitive empathy and affective ToM) and distinct (affective empathy and cognitive ToM) subcomponents. RESULTS: Aggregated across 31 studies, the results revealed that, relative to controls, AD is associated with large-sized deficits in both cognitive ToM (g = 1.09) and affective ToM/cognitive empathy (g = 0.76). However, no statistical differences were found between the AD participants and controls on affective empathic abilities (g = 0.36). CONCLUSIONS: These data point to a potentially important disconnect between core aspects of social cognitive processing in people with AD. The practical and theoretical implications of these findings are discussed.

Empathy and theory of mind in Parkinson's disease: A meta-analysis.

In contrast to well-documented deficits in the core social cognitive domains of social perception and theory of mind (ToM), how Parkinson's disease (PD) affects one's empathic capacity remains poorly understood. The current study provides the first meta-analytic review of both ToM and empathy as broad constructs, and also breaks these constructs down to clearly differentiate their overlapping (affective ToM and cognitive empathy) and distinct (affective empathy and cognitive ToM) components. A total of 38 studies contributed to these analyses, with results revealing that, relative to controls, PD is associated with significant and substantial deficits in the domain of cognitive ToM (g = -0.78), as well as the overlapping domains of affective ToM/cognitive empathy (g = -0.69). However, no group differences were identified for affective empathy (g = -0.08). These data speak to there being a potential preservation of affective empathic processing in PD, but because of the relatively limited research base on this topic, recommendations for future research are highlighted.

A meta-analytic review of prospection deficits in Parkinson's disease.

Parkinson's disease (PD) is one of the most common neurodegenerative disorders, and is associated with prominent motor deficits. However, neurocognitive impairment is also a common clinical feature that can contribute greatly to the overall disease burden. In the current study, a meta-analysis was conducted to gain a clearer understanding of how PD affects one of the most functionally important domains of cognition: prospection. The results indicate that, relative to controls, PD is associated with a large deficit in the capacity to engage in planning (g = -0.81, K = 25) and a moderate-sized deficit in prospective memory (g = -0.57, K = 16). Sub-analyses indicated that these deficits are evident for both time and event-based prospective memory, as well as for prospective memory tasks that have relatively limited ecological validity. Significant impairment was also evident for both medicated and non-medicated PD sub-groups, but for planning, these deficits were substantially greater in the unmedicated sub-group. The theoretical and practical implications of these findings are discussed.

Social perceptual function in parkinson's disease: A meta-analysis.

Social perceptual impairment is a common presenting feature of Parkinson's disease (PD) that has the potential to contribute considerably to disease burden. The current study reports a meta-analytic integration of 79 studies which shows that, relative to controls, PD is associated with a moderate emotion recognition deficit (g = -0.57, K = 73), and that this deficit is robust and almost identical across facial and prosodic modalities. However, the magnitude of this impairment does appear to vary as a function of task and emotion type, with deficits generally greatest for identification tasks (g = -0.65, K = 54), and for negative relative to other basic emotions. With respect to clinical variables, dopaminergic medication, deep brain stimulation, and a predominant left side onset of motor symptoms are each associated with greater social perceptual difficulties. However, the magnitude of social perceptual impairment seen for the four atypical parkinsonian conditions is broadly comparable to that associated with PD. The theoretical and practical implications of these findings are discussed.