Determinants of automatic age and race bias: ingroup-outgroup distinction salience moderates automatic evaluations of social groups.

Introduction: The present research investigates whether ingroup-outgroup distinction salience moderates automatic intergroup bias (i.e., more positive evaluations of ingroup targets relative to outgroup targets) toward multiply categorizable social targets. Methods: In two experiments, we manipulated the salience of participants' social identity based on age vs. race, respectively. Afterwards, we measured automatic evaluations of social targets varying in age and race. Results: Young White participants exhibited higher automatic race bias when their racial identity (i.e., White in contrast to Black) was salient. Conversely, they exhibited higher automatic age bias when their age identity (i.e., young in contrast to old) was salient. Discussion: Going beyond previous research, we show that it is sufficient to direct participants' attention to their ingroup-identity in contrast to the respective outgroup to cause changes in automatic intergroup bias. This is important because it provides a strong test of the hypothesis that ingroup-outgroup distinction salience moderates automatic intergroup bias.

"I learned that ageism is a thing now": education and engagement to improve student attitudes toward aging.

Ageism is often neglected in higher education curriculum, leaving many students unaware of its harmful effects and how to address it. The purpose of this mixed methods study was to examine the benefits of education on ageism and intergenerational contact in a 1-credit seminar course on ageism. Participants included 21 students (experimental group) in an ageism course and 35 students (control group) in reading-based seminar courses unrelated to ageism. The baseline and posttests included the Expectations Regarding Aging Survey (ERA-38) and the Attitudes to Ageing Questionnaire (AAQ-24). Following the course, students from the experimental group participated in focus groups to further contextualize the quantitative data by capturing student perspectives and attitudes. Paired samples t-tests revealed significant increases in the experimental group on most measures, however, no change in the control group on any measure. Analysis of focus group data revealed students recognized ageist behavior, had positive outlook on aging, and a greater awareness of "normal" aging. A group project designed to combat ageism was a positive experience and enabled students to apply what they learned about aging and ageism. These promising results indicate potential benefits of 1-credit courses for education about aging, ageism and promoting engagement with older adults.

Intervention to reduce age bias in medical students' decision making for the treatment of older women with breast cancer: A novel approach to bias training.

Objectives: Despite NICE guidelines to 'treat people with invasive breast cancer, irrespective of age, with surgery and appropriate systemic therapy, rather than endocrine therapy alone', older patients receive differential treatment and experience worse outcomes. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and potentially perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as an explanatory factor in poorer outcomes for older breast cancer patients nor, consequentially, has removing age bias been considered as an approach to improving outcomes. Many organizations carry out bias training with the aim of reducing negative impacts from biased decision making, yet the few evaluations of these interventions have mostly seen small or negative effects. This study explores whether a novel intervention to address age bias leads to better quality decision making for the treatment of older women with breast cancer.Methods: An online study compared medical students' treatment recommendations for older breast cancer patients and the reasoning for their decision making before and after a novel bias training intervention. Thirty-one medical students participated in the study.Results: The results show that the bias training intervention led medical students to make better quality decisions for older breast cancer patients. The quality of decision making was measured by decreases in age-based decision making and increased efforts to include patients in decision making. These results suggest there is value in exploring whether if anti-bias training interventions could usefully be applied in other areas of practice where older patients experience poorer outcomes.Conclusions: This study evidences that bias training improves the quality of decision making by medical students in respect of older breast cancer patients. The study findings show promise that this novel approach to bias training might usefully be applied to all medical practitioners making treatment recommendations for older patients.

Feasibility of brain age predictions from clinical T1-weighted MRIs.

An individual's brain predicted age minus chronological age (brain-PAD) obtained from MRIs could become a biomarker of disease in research studies. However, brain age reports from clinical MRIs are scant despite the rich clinical information hospitals provide. Since clinical MRI protocols are meant for specific clinical purposes, performance of brain age predictions on clinical data need to be tested. We explored the feasibility of using DeepBrainNet, a deep network previously trained on research-oriented MRIs, to predict the brain ages of 840 patients who visited 15 facilities of a health system in Florida. Anticipating a strong prediction bias in our clinical sample, we characterized it to propose a covariate model in group-level regressions of brain-PAD (recommended to avoid Type I, II errors), and tested its generalizability, a requirement for meaningful brain age predictions in new single clinical cases. The best bias-related covariate model was scanner-independent and linear in age, while the best method to estimate bias-free brain ages was the inverse of a scanner-independent and quadratic in brain age function. We demonstrated the feasibility to detect sex-related differences in brain-PAD using group-level regression accounting for the selected covariate model. These differences were preserved after bias correction. The Mean-Average Error (MAE) of the predictions in independent data was ∼8 years, 2-3 years greater than reports for research-oriented MRIs using DeepBrainNet, whereas an R2 (assuming no bias) was 0.33 and 0.76 for the uncorrected and corrected brain ages, respectively. DeepBrainNet on clinical populations seems feasible, but more accurate algorithms or transfer-learning retraining is needed.

The effects of age bias on neural correlates of successful and unsuccessful response inhibition in younger and older adults.

Facilitating communication between generations has become increasingly important. However, individuals often demonstrate a preference for their own age group, which can impact social interactions, and such bias in young adults even extends to inhibitory control. To assess whether older adults also experience this phenomenon, a group of younger and older adults completed a Go/NoGo task incorporating young and old faces, while undergoing functional magnetic resonance imaging. Within the networks subserving successful and unsuccessful response inhibition, patterns of activity demonstrated distinct neural age bias effects in each age group. During successful inhibition, the older adult group demonstrated significantly increased activity to other-age faces, whereas unsuccessful inhibition in the younger group produced significantly enhanced activity to other-age faces. Consequently, the findings of the study confirm that neural responses to successful and unsuccessful inhibition can be contingent on the stimulus-specific attribute of age in both younger and older adults. These findings have important implications in regard to minimizing the emergence of negative consequences, such as ageism, as a result of related implicit biases.

Younger Than Ever? Subjective Age Is Becoming Younger and Remains More Stable in Middle-Age and Older Adults Today.

Little is known about historical shifts in subjective age (i.e., how old individuals feel). Moving beyond the very few time-lagged cross-sectional cohort comparisons, we examined historical shifts in within-person trajectories of subjective age from midlife to advanced old age. We used cohort-comparative longitudinal data from middle-age and older adults in the German Ageing Survey (N = 14,928; ~50% female) who lived in Germany and were between 40 and 85 years old when entering the study. They provided up to seven observations over 24 years. Results revealed that being born later in historical time is associated with feeling younger by 2% every birth-year decade and with less intraindividual change toward an older subjective age. Women reported feeling younger than men; this gender gap widened across cohorts. The association of higher education with younger subjective age became weaker across cohorts. Potential reasons for the subjective-rejuvenation effect across cohorts are discussed.

Contextual and own-age effects in age perception.

Our judgement of certain facial characteristics such as emotion, attractiveness or age, is affected by context. Faces that are flanked by younger faces, for example, are perceived as being younger, whereas faces flanked by older faces are perceived as being older. Here, we investigated whether contextual effects in age perception are moderated by own age effects. On each trial, a target face was presented on the screen, which was flanked by two faces. Flanker faces were either identical to the target face, were 10 years younger or 10 years older than the target face. We asked 40 older (64-69 years) and 43 younger adults (24-29) to estimate the age of the target face. Our results replicated previous studies and showed that context affects age estimation of faces flanked by target faces of different ages. These context effects were more pronounced for younger compared to older flankers but present across both tested age groups. An own-age advantage was observed for older adults for unflanked faces who had larger estimation errors for younger faces compared to older faces and younger adults. Flanker effects, however, were not moderated by own-age effects. It is likely that the increased effect of younger flankers is due to mechanisms related to perceptual averaging.

Is there evidence of age bias in breast cancer health care professionals' treatment of older patients?

OBJECTIVES: Despite NICE (2009; 2018) guidelines to treat breast cancer patients 'irrespective of age', older women experience differential treatment and worse outcomes beyond that which can be explained by patient health or patient choice. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and perhaps perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as an explanatory factor in poorer outcomes for older breast cancer patients. METHODS: This mixed methods study explored age bias amongst breast cancer HCPs through four components: 1) An implicit associations test (31 HCPs) 2) A treatment recommendations questionnaire (46 HCPs). 3) An attitudes about older patients questionnaire (31 HCPs). 4) A treatment recommendations interview (20 HCPs). RESULTS: This study showed that breast cancer HCPs held negative implicit associations towards older women; HCPs were less likely to recommend surgery for older patients; some HCPs held assumptions that older patients are more afraid, less willing and able to be involved in decision-making, and are less willing and able to cope with being informed of a poor treatment prognosis; and conditions which disproportionately affect older patients, such as dementia, are not always well understood by breast cancer HCPs. CONCLUSIONS: These results indicate that there are elements of age bias present amongst breast cancer HCPs. The study's findings of age-based assumptions and a poorer understanding of conditions which disproportionately affect older patients align with patterns of differential treatment towards older breast cancer patients suggesting that age bias may be, at least in part, driving differential treatment.

Moral Dilemmas in Hospitals: Which Shooting Victim Should Be Saved?

Moral judgments can occur either in settings that call for impartiality or in settings that allow for partiality. How effective are impartiality settings such as hospitals in suppressing personal biases? Portrayed as decision-makers in an emergency department, 431 college students made judgments on which of two victims of a mass shooting should receive immediate, life-saving care. Patients differed in ways that could reveal biases, e.g., age (8 vs. 80 years), kinship (stranger vs. cousin), gender (female vs. male), and villain/hero (shooter vs. policeman who stopped him). Participants rated each patient's moral deservingness to receive immediate care and the likelihood they would choose the patient. Both scales showed young favored over old, cousin (or daughter) over stranger, and policeman over shooter (largest difference). In a hospital-room scenario with high risk of injury from falling, age bias disappeared. With moderate fall risk, age bias reversed and kinship deservingness bias disappeared. Bias decreases when there is a decrease in severity of potential harm to the preferred stakeholder. Settings that call for impartiality are not reliable "boundary conditions" against expressions of bias. In the absence of explicit guidelines for allocating scarce resources, a systematic, objective method of random selection offers a potentially useful strategy.

Meditation in the Workplace: Does Mindfulness Reduce Bias and Increase Organisational Citizenship Behaviours?

Mindfulness is becoming increasingly popular in the workplace. This likely relates to a growing body of research linking mindfulness to a range of psychological outcomes such as reduced anxiety, depression and increased subjective wellbeing. However, while mindfulness has received a great deal of attention in clinical research, the evidence for workplace relevant benefits is less established. Additionally, outside of clinical research, mindfulness studies have rarely been replicated. Recent evidence suggests that the cognitive skills cultivated during meditation may be instrumental in reducing biased thinking and increasing prosocial behaviour, but these findings have not been previously tested in a workplace setting. Specifically, mindfulness has been linked to reductions in implicit age bias, sunk-cost decision-making bias and increases in organisational citizenship behaviours (OCB). In two experiments using a workplace and laboratory sample, the present investigation aimed to test the reliability and generalisability of previous findings that a brief mindfulness meditation can reduce age and sunk-cost decision-making biases. To more directly test the potential positive benefits of mindfulness in a workplace setting, this study also investigated the impact of a mindfulness intervention on intention to perform OCB. While meditation significantly increased OCB intent, predictions relating to bias were not supported. Considerations for the degree to which empirical evidence aligns with claims in popular culture, along with implications for the practical uses of mindfulness in the workplace are explored.

The effects of age-bias on neural correlates of successful and unsuccessful response inhibition.

Response inhibition is important for adherence to social norms, especially when norms conflict with biases based on one's social identity. While previous studies have shown that in-group bias generally modulates neural activity related to stimulus appraisal, it is unclear whether and how an in-group bias based on age affects neural information processing during response inhibition. To assess this potential influence, young adults completed a Go/NoGo task incorporating younger face (in-group) and older face (out-group) stimuli while undergoing functional magnetic resonance imaging (fMRI). Our results replicated previous findings by demonstrating higher accuracy in successful Go compared to NoGo trials, as well as the engagement of nodes of the response inhibition network during successful response inhibition, and brain regions comprising the salience network during unsuccessful response inhibition. Importantly, despite a lack of behavioural differences, our results showed that younger and older face stimuli modulated activity in the response inhibition and salience networks during successful and unsuccessful inhibition, respectively. Interestingly, these effects were not uniform across networks. During successful response inhibition, in-group stimuli increased activity in medial prefrontal cortex and temporo-parietal junction, whereas out-group stimuli more strongly engaged pre-supplemental motor area. During unsuccessful response inhibition, in-group stimuli increased activity in posterior insula, whereas out-group stimuli more strongly engaged angular gyrus and intraparietal sulcus. Consequently, the results infer the presence of an age-bias effect in the context of inhibitory control, which has substantial implications for future experimental design and may also provide the means of investigating the neural correlates of implicit beliefs that contribute to ageism.

No evidence of spatial representation of age, but "own-age bias" like face processing found in chimpanzees.

Previous studies have revealed that non-human primates can differentiate the age category of faces. However, the knowledge about age recognition in non-human primates is very limited and whether non-human primates can process facial age information in a similar way to humans is unknown. As humans have an association between time and space (e.g., a person in an earlier life stage to the left and a person in a later life stage to the right), we investigated whether chimpanzees spatially represent conspecifics' adult and infant faces. Chimpanzees were tested using an identical matching-to-sample task with conspecific adult and infant face stimuli. Two comparison images were presented vertically (Experiment 1) or horizontally (Experiment 2). We analyzed whether the response time was influenced by the position and age category of the target stimuli, but there was no evidence of correspondence between space and adult/infant faces. Thus, evidence of the spatial representation of the age category was not found. However, we did find that the response time was consistently faster when they discriminated between adult faces than when they discriminated between infant faces in both experiments. This result is in line with a series of human face studies that suggest the existence of an "own-age bias." As far as we know, this is the first report of asymmetric face processing efficiency between infant and adult faces in non-human primates.

Recognition of younger and older faces in Korsakoff's syndrome.

The own-age bias refers to the observation that face recognition is typically superior for own-age faces compared with other-age faces. We investigated this bias in Korsakoff patients, as well as its relationship with social contact and episodic memory. Korsakoff patients and age-matched controls were exposed to older faces (own-age faces) and younger faces (other-age faces). In the recognition phase, they were invited to decide whether faces had been exposed in the encoding phase or not. Results revealed an own-age bias in control participants (i.e., high recognition of older than for younger faces), but not in Korsakoff patients (i.e., similar recognition of older and younger faces). Furthermore, both Korsakoff's syndrome and controls reported more social contact with old than with young individuals. Recognition of younger and older faces in Korsakoff patients was significantly correlated with episodic performance but not with social contact with younger and older people. We conclude that the lack of own-age bias in Korsakoff's syndrome is related rather to compromise of episodic memory than to diminished social contact with younger adults.

The personalized application of biomaterials based on age and sexuality specific immune responses.

Although biomaterials are widely utilized in clinics, it still follows the "one-fits-all" strategy. Biological variables such as age and sexuality have an impact on the host immune response and are not fully considered in the practice guidelines of the biomaterial implantation. In this study, we investigated the immuno-material interactions of six commonly used biomaterials (agarose, alginate, chitosan, CMC, GelMA and collagen type I) and constructed a population (with different ages and sexes) based transcriptome atlas. Protein and polysaccharide-based biomaterials elicited distinctive immune responses that protein-based materials preferred the NKT pathway to activate innate and adaptive immune response, whereas polysaccharide-based materials activated the cDCs to present antigen. The atlas further revealed the sex/age-related variabilities on the immune response followed by the polysaccharide treatment. As for sex bias, alginate and agarose stimulation significantly increased the proportion of naive CD4+ T cells in the female group, accompanied by the Th1 differentiation tendency, compared to the male group. Age-biased transcript showed alginate and chitosan would impair the extracellular matrix remodeling and up-regulate the apoptosis process in the elderly groups, compared to the young group. More attentions on the ingredient, age and sexuality effect of biomaterial implants should be paid during the clinical practice, especially for the polysaccharide-based materials. This experimental result is of great significance for the selection of biomaterials, particularly the blood contact materials, such as vessel or cardiac device, drug vehicles and hemostatic materials.

Older Adults Automatically Detect Age of Older Adults' Photographs: A Visual Mismatch Negativity Study.

The human face is one of the most frequently used stimuli in vMMN (visual mismatch negativity) research. Previous studies showed that vMMN is sensitive to facial emotions and gender, but investigations of age-related vMMN differences are relatively rare. The aim of this study was to investigate whether the models' age in photographs were automatically detected, even if the photographs were not parts of the ongoing task. Furthermore, we investigated age-related differences, and the possibility of different sensitivity to photographs of participants' own versus different ages. We recorded event-related potentials (ERPs) to faces of young and old models in younger (N = 20; 18-30 years) and older groups (N = 20; 60-75 years). The faces appeared around the location of the field of a tracking task. In sequences the young or the old faces were either frequent (standards) or infrequent (deviants). According to the results, a regular sequence of models' age is automatically registered, and faces violating the models' age elicited the vMMN component. However, in this study vMMN emerged only in the older group to same-age deviants. This finding is explained by the less effective inhibition of irrelevant stimuli in the elderly, and corresponds to own-age bias effect of recognition studies.

"Finding an Emotional Face" Revisited: Differences in Own-Age Bias and the Happiness Superiority Effect in Children and Young Adults.

People seem to differ in their visual search performance involving emotionally expressive faces when these expressions are seen on faces of others close to their age (peers) compared to faces of non-peers, known as the own-age bias (OAB). This study sought to compare search advantages in angry and happy faces detected on faces of adults and children on a pool of children (N = 77, mean age = 5.57) and adults (N = 68, mean age = 21.48). The goals of this study were to (1) examine the developmental trajectory of expression recognition and (2) examine the development of an OAB. Participants were asked to find a target face displaying an emotional expression among eight neutral faces. Results showed that children and adults found happy faces significantly faster than angry and fearful faces regardless of it being present on the faces of peers or non-peers. Adults responded faster to the faces of peers regardless of the expression. Furthermore, while children detected angry faces significantly faster compared to fearful ones, we found no such difference in adults. In contrast, adults detected all expressions significantly faster when they appeared on the faces of other adults compared to the faces of children. In sum, we found evidence for development in detecting facial expressions and also an age-dependent increase in OAB. We suggest that the happy face could have an advantage in visual processing due to its importance in social situations and its overall higher frequency compared to other emotional expressions. Although we only found some evidence on the OAB, using peer or non-peer faces should be a theoretical consideration of future research because the same emotion displayed on non-peers' compared to peers' faces may have different implications and meanings to the perceiver.

Age bias in the criteria for antisocial personality disorder.

The prevalence of antisocial personality disorder (ASPD) decreases with age. As such, research regarding ASPD typically focuses on children and younger adults. The apparent age-specific prevalence of ASPD may be due, in part, to diagnostic criteria informed by research excluding older adults. The present study sought to better understand the manifestation of ASPD in older adults and investigate potential age bias in the diagnostic criteria. Item response theory methods were used to the diagnostic criteria for ASPD with data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III. The measurement of three ASPD criteria showed uniform differential item functioning (DIF), suggesting that older adults were less likely to endorse the item than younger adults despite having the same level of underlying personality disorder. The items with DIF are related to the following criteria for ASPD: Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest (3 items with DIF); irritability and aggressiveness, as indicated by repeated physical fights or assaults (1 item with DIF); and consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations (1 item with DIF). Results of the present study can be used to inform the development of criteria that better capture the age-specific experience of this disorder. Improved criteria will result in increased diagnostic accuracy, systematic estimation of the prevalence, improved assessments, and more effective treatment options for this complex population.

Cross-Cultural Comparisons in Implicit and Explicit Age Bias.

Most research documenting bias against older adults has been conducted in individualistic and industrialized cultures. In the current study, we examined cultural variation in attitudes toward older adults and subjective age in a large sample of 911,982 participants (Mage = 27.42, SD = 12.23; 67.6% women) from 68 different countries (Msize = 12,077; Mdnsize = 425.5). We hypothesized that age bias would be lower among those living in highly collectivistic countries. We found that living in collectivistic countries was associated with less implicit and explicit age bias, and greater feelings of warmth toward older adults compared with highly individualistic countries. Given the impact of age bias and prejudice on both the targets and perpetrators of bias, further research is needed to examine the causes of and interventions for bias against older adults.

Stable middle-aged face recognition: No moderation of the own-age bias across contexts.

The own-age bias (OAB) has been proposed to be caused by perceptual expertise and/or social-cognitive mechanisms. Investigations into the role of social cognition have, however, yielded mixed results. One reason for this might be the tendency for research to focus on the OAB in young adults, between young and older adult faces where other-age individuation experience is low. To explore whether social-cognitive manipulations may be successful when observers have sufficient other-age individuation experience, we examined biases involving middle-aged other-age faces and the influence of a context manipulation. Across four experiments, young adult participants were presented with middle-aged faces alongside young or older adult faces to remember. We predicted that in contexts where middle-aged faces were positioned as other-age faces (alongside young adult faces), recognition performance would be worse than when they were positioned as relative own-age faces (alongside older adult faces). However, the context manipulations did not moderate middle age face recognition. This suggests that past findings that context does not change other-age face recognition holds for other-age faces for which observers have higher individuation experience. These findings are consistent with a perceptual expertise account of the OAB but more investigation of the generality of these results is required.

Age specific recruitment and retention to a large multicentre observational breast cancer trial in older women: The Age Gap Trial.

INTRODUCTION: Recruitment and retention are two of the most important factors in successfully running clinical trials. Many trials encounter problems with both, causing delays or preventing study progress. These issues are greater in older adults and patients with cancer. MATERIALS AND METHODS: We assessed recruitment and retention in a large, multicentre, observational breast cancer study in older female patients (>70 years, N = 3440). Data collected by the Age Gap study were used to assess rates of, and reasons for, patients not being recruited or retained. Statistical analysis assessed the impact of age as a predictor of recruitment and retention. RESULTS: Between February 2013 and June 2018, 6876 patients were screened and 3456 were consented across 56 United Kingdom (UK) breast units. Reasons for non-recruitment included ineligibility, clinician issues, staffing resource issues, patients' lack of interest or time and trial burden. In comparison with the age demographics of patients with breast cancer in the UK, women aged 70-75 years were over-represented compared to older age groups. Logistic regression demonstrated that older age significantly reduced the odds of consent (OR = 0.96, CI: 0.938-0.982; p < 0.001). Multivariate analysis showed that age (p < 0.001), markers of poor functional ability (Eastern Cooperative Oncology Group Performance Status (p = 0.011)) and instrumental activities of daily living (p = 0.026) were significant predictors of withdrawal. DISCUSSION: This study has demonstrated that selection and attrition bias for age are apparent despite a range of 'age friendly' study design measures. Exploration of the underlying reasons for this and development of measures to address this should be the focus of further research.