Beyond the stethoscope: ageism in white coats and resident physicians' preferences for elderly patient care.

BACKGROUND: The global increase in life expectancy has significantly raised the elderly population. In Türkiye, the proportion of individuals aged 65 and over rose from 8.8% in 2018 to 10.2% in 2023. This demographic shift necessitates the planning of social and health services for the elderly. Ageism affects elderly health negatively and is prevalent in healthcare settings. This study aimed to determine the prevalence of ageism among resident physicians at Pamukkale University Hospital and identify factors influencing their preferences for providing healthcare to elderly patients. METHODS: This cross-sectional study was conducted at Pamukkale University Hospital between 6 June and 16 June, 2024. A total of 448 resident physicians were selected through simple random sampling. Data were collected using a self-administered questionnaire, which included sociodemographic information, factors affecting ageism, and the Fraboni Scale of Ageism (FSA). Descriptive statistics, Chi-square tests, and logistic regression were used to evaluate factors influencing healthcare preferences. RESULTS: The FSA score averaged 71.89 ± 7.87, indicating a 20.1% (95% CI:16.48-24.10) prevalence of age discrimination among resident physicians. Logistic regression analysis revealed that male participants (odds ratio (OR) = 1.519, P = 0.042), those with moderate to very poor perceived knowledge of elderly health (OR = 2.418, P < 0.001), and higher FSA scores (OR = 1.046, P < 0.001) were more likely to prefer not providing healthcare services to elderly patients. CONCLUSIONS: Ageism among resident physicians is prevalent, impacting their willingness to provide care to elderly patients. Gender, perceived knowledge, and ageist attitudes influence their preferences for providing healthcare to elderly patients. Addressing these factors is crucial for improving healthcare services for the elderly.

Psychological Well-Being and Self-Aging Attitudes Moderate the Association between Subjective Age and Age Discrimination in the Workplace.

Views of aging include peoples' assessment of their own aging process and their subjective age. Positive views of aging relate to a improved psychological well-being which predicts better physical and mental health. While these relationships were substantially studied, the moderating roles of self-aging attitudes and psychological well-being in the subjective age-age discrimination connection have been much less explored. The current study used a convenience sample of 568 participants (mean = 66.21y, SD = 11.95, age range 50-95), 55.8% women, 67.1% employed. In line with the hypotheses, young subjective age and psychological well-being were connected to less age discrimination in the workplace, and higher psychological well-being mitigated the subjective age-age discrimination at work connection. When the perception of old age as a period of loss was added to the model, adults who perceived old age as a period of loss and reported lower levels of psychological well-being demonstrated the strongest relationship between an increase in subjective age and an increase in age-related discrimination at work. The findings emphasize the importance of the psychological well-being of older employees as a resource for improving their attitudes towards their last years at work.

Exploring the Mechanism of Adult Users' Cyber-Aggression Against Adolescents: The Roles of Online Communication, Age Group Identity, and Online Moral Disengagement.

The increasing prevalence of adults' prejudice against adolescents on the Internet could cause opposing attitudes and even online aggression against teenagers. Yet, such age discrimination is less challenged compared to other social biases in cyberspace. Employing a social identity approach, this study aims to explore how features of online communication, teen-related personal experiences, and the dual identity of adult aggressors influence online moral disengagement (OMD), motives, and behaviors for cyber-aggression. We conducted an online survey of 767 Chinese adults in May 2023. The results demonstrated that perceived controllability of online speech, negative teen-related online experiences, and generation-based bias were positively associated with OMD. Next, adult respondents' self-serving motives positively predicted moderate and severe cyber-aggression, while educational motives only increased moderate cyber-aggression. Mediation analysis revealed that generation-based bias was the sole significant factor that amplified OMD, self-serving motives, educational motives, and cyber-aggression behaviors. In contrast, the effects of lifestage-based bias were insignificant. Our findings yield insights into individuals' moral transgressions in digital environments and shed light on the dynamics of the identity of adult aggressors in age-based discrimination. This study suggests that empathy from adults and age-appropriate prevention by online platforms are crucial to address online aggression against young generations.

Social media discourse on ageism, sexism, and racism: Analysis of 150 million tweets over 15 years.

BACKGROUND: Ageism is a major but oft-overlooked social determinant of health. In fact, it is widely accepted among scholars that ageism is one of the least acknowledged forms of inequality, although few empirical attempts have been made to substantiate this claim. This is the first study that quantifies the amount of discourse dedicated to ageism, sexism, and racism on Twitter. Specifically, we rely on the usage of hashtags as a proxy for the frequency of discussions surrounding each form of inequality over a 15-year period from 2007 to 2022. We also identify key events that triggered spikes in Twitter activity for each form of inequality. METHODS: Hashtags related to racism and sexism were extracted from past scholarship. We also employed a snowball sampling method whereby we queried the hashtags using Twitter's search function to identify other hashtags. As limited research has been conducted on ageism-related hashtags, we queried hashtags utilized by advocacy groups and adopted a snowball sampling method to compile other relevant hashtags. Tweets collected (N = 154,353,047) spanned 15 years, from August 23, 2007 to December 31, 2022. RESULTS: From 2007 to 2022, racism-related hashtags were used the most, followed by sexism-related hashtags and ageism-related hashtags. Racism-related hashtags (N = 99,250,348) were mentioned about 60 times more than ageism-related hashtags (N = 1,648,926). Sexism-related hashtags (N = 38,933,113) were mentioned 24 times more than ageism-related hashtags. The increasing linear trend of tweets associated with ageism (p < 0.001), sexism (p < 0.05), and racism (p < 0.05) reached significance. Incidents of racism and sexism often generated widespread public outrage. Conversely, instances of ageism rarely caused spikes in social media activity. Rather, these spikes were mainly observed during events such as the release of a report on ageism, a conference related to aging, or observances such as International Day of Older Persons. CONCLUSION: There is a need to hasten moves to raise awareness of ageism. To ensure that discussions on ageism are not confined to academic and policy circles, advocacy campaigns could be held to educate the public on the issue and its negative concomitants.

Too old to be included: age diversity statements foster diversity yet fall short on inclusion.

Older employees often face discrimination and exclusion from work teams. In two scenario studies, we tested the impact of age diversity statements on the representation and inclusion of older employees in teams. In Study 1 (N = 304), participants had to create a team and were either exposed to a diversity statement or not before selecting two teammates from a list of four differing in age and gender. Then, we measured participants' inclusive behavioral intentions towards a new, older member joining this team. Age diversity statements increased the representation but not the inclusion of older individuals in teams. In Study 2 (N = 518), we further manipulated the content of the statement (diversity or diversity and inclusion) and the organizational motive (reputation or change). We replicated the effects of diversity statements on representation. Moreover, statements also increased certain inclusive behaviors, but only when they targeted diversity and inclusion and reflected an organizational commitment to change. Taken together, these results suggest that age diversity statements foster diversity, yet fail to systematically increase inclusion.

Effects of Age Stereotypes of Older Workers on Job Performance and Intergenerational Knowledge Transfer Intention and Mediating Mechanisms.

The workforce is aging with the population aging. How to effectively manage and motivate older workers is significant for elderly human resources development and the sustainable development of enterprises in organizations. Age stereotypes of older workers refer to people's beliefs and expectations about a specific group of 45-65-year-olds in the workplace. This paper examines the effect of age stereotypes of older workers on job performance and intergenerational knowledge transfer intention. This study carried out two research designs, a questionnaire survey and an experimental study, to explore the effects of positive and negative age stereotypes of older workers on job performance and intergenerational knowledge transfer intention within an organizational context and underlying mediating mechanisms. The results showed that positive stereotypes of older workers significantly positively affected job performance and intergenerational knowledge transfer intention. In comparison, negative stereotypes of older workers significantly negatively affected job performance and intergenerational knowledge transfer intention, and self-perception of aging substantially mediates the effects. This study broadens the research field on the impact of positive and negative age stereotypes on older workers in organizational contexts. This study guides organizations in reducing age discrimination, creating an inclusive workplace environment, and achieving the successful aging of older workers.

GC/MS-based untargeted metabolomics reveals the differential metabolites for discriminating vintage of Chenxiang-type baijiu.

The "outstanding and unique aged aroma" of Chinese Chenxiang-type baijiu (CXB)-Daoguang 25 (DG25) mainly originates from a "extraordinary storage technology" of Mujiuhai (a wooden container), so it is mysterious and interesting. In this study, an untargeted GC/MS-based metabolomics was used to reveals the volatile differential metabolites for discriminating six different vintages of DG25 combing with chemometrics. A total of 100 volatile metabolites (including unknowns) were extracted and identified, including esters (41%), alcohols (10%) and acids (7%) so on. Finally, 33 differential metabolites were identified as aging-markers. Among them, 25 aging-markers showed a downtrend, including 17 esters such as ethyl acetate, ethyl hexanoate and ethyl palmitate so on. Moreover, it was interesting and to further study that furans showed a significant downtrend. Statistically speaking, ethyl benzoate played an important role in discriminating vintage of 1Y and 3Y, and the other 24 differential metabolites with downtrend discriminating the unstored (0Y-aged) DG25. Eight differential metabolites, such as ethyl octanoate, benzaldehyde, 3-methylbutanol and 1,1-diethoxyaccetal so on increased during aging of DG25, and they played a statistical role in discriminating the 5Y-, 10Y- and 20Y-aged DG25. This study provides a theoretical basis way for the formation mechanism of aging aroma for CXB.

Assessing age discrimination in workplaces: psychometric exploration of the Workplace Age Discrimination Scale (WADS-G).

In contemporary workplaces characterized by diverse age groups working collaboratively, the assessment of age discrimination as an interpersonal phenomenon has gained heightened significance. This study focuses on adapting and scrutinizing the psychometric properties of the German iteration of the Workplace Age Discrimination Scale (WADS-G). Comprehensive Confirmatory Factor Analysis (CFA) results affirm a robust fit for the unidimensional model. Convergent validity is established through correlations between WADS-G scores and related instruments, while discriminant validity is evidenced by its lack of association with extraversion. Noteworthy findings include a positive correlation with turnover intention and negative correlations with job satisfaction, occupational self-efficacy, and organizational affective commitment. Despite its merits, the predictive efficacy of the WADS-G is notably inferior when juxtaposed with the Workplace Incivility Scale. Its explanatory power for turnover intention is constrained when accounting for variables such as job satisfaction, work environment, neuroticism, and core self-evaluation. Although measurement invariance testing across gender groups reveals scalar to strict measurement invariance, the examination across age groups indicates metric invariance. However, Confirmatory Factor Analyses for the 18-30 and 50+ age groups, central to the research emphasis, reveal suboptimal model fit. These outcomes prompt a nuanced discussion on whether the WADS-G aptly captures age-discriminatory experiences across diverse age and gender cohorts among employees.

Age Differences in Unemployment Risk and Reemployment Outcomes in Late Working Life in Sweden.

Participation of older workers in the labor market depends, among other things, on older workers employment chances. This study examines age differences regarding risk of unemployment and reemployment outcomes in late working life in Sweden. Using Swedish registry data, we analyzed the probability of unemployment as well as work-related activity following unemployment (wage- or self-employment; exit; downward mobility) of all people born between 1954 and 1968 (aged 49-63) and registered in Sweden between the years 2012 and 2018. Results show that although risk of unemployment does not differ significantly across age groups, younger age groups are more likely to be reemployed as wage-employed while older age groups are more likely to be reemployed as self-employed or exit working life. After an unemployment period, older employees are more likely to have a lower wage than during their previous employment or become part-time unemployed. We conclude that different age groups have unequal chances in late working life in terms of reemployment, risk of exit, and risk of downward mobility following unemployment. Policies for extending working life and promoting inequality should include measures for increasing employability of older workers such as anti-discriminatory laws and dealing with skills mismatch.

Among older people, the risk of unemployment does not differ across age groups.Among older people, reemployment chances decrease by age.After unemployment, the probability of exit or self-employment increases by age among older people.Older employees have higher risk of downward mobility after unemployment.Policies for the demand side and employability of older workers are needed.

Sexual Violence in Later Life: A Widespread and Growing Yet Hidden Public Health Issue.

Sexual violence in later life and related trauma have been identified as a growing yet preventable public health crises, which disproportionately impact women. Research is limited and is continuing to emerge in this area, along with implications for addressing healthcare disparities, primarily among older women. In this paper, the prevalence of sexual violence in later life will be explored, along with survivor characteristics as they relate to structural inequality and health disparities. Consequences of sexual violence in later life will be explored as well, with implications for healthcare workers, focused on pressing needs for research, practice, policy and education at individual, relational, organizational and societal levels.

How do ageism, death anxiety and ageing anxiety among medical students and residents affect their attitude towards medical care for older patients: a systematic review.

BACKGROUND: Although the number of older patients requiring medical care is increasing, caring for older patients is often seen as unattractive by medical trainees (i.e., medical students, residents, interns, and fellows). Terror Management Theory states that people have a negative attitude towards older people, because they remind people of their own mortality. We hypothesize that ageism, death anxiety, and ageing anxiety among medical trainees negatively affect their attitude towards medical care for older patients. This review aimed to examine and generate an overview of available literature on the relationship between ageism, death anxiety, and ageing anxiety among medical trainees and their attitude towards medical care for older patients. METHODS: A systematic review was performed with a review protocol based on the PRISMA Statement. PubMed, Ebsco/PsycInfo, Ebsco/ERIC and Embase were searched from inception to August 2022, using the following search terms, including their synonyms and closely related words: "medical trainees" AND "ageism" OR "death anxiety" OR "ageing anxiety" AND "(attitude AND older patient)". RESULTS: The search yielded 4072 different studies; 12 eligible studies (10 quantitative and 2 qualitative) were identified and synthesized using narrative synthesis. Findings suggest that a positive attitude towards older people was related to a positive attitude towards medical care for older patients among medical students. The available literature on the relationship between death anxiety and/or ageing anxiety and attitude towards medical care for older patients among medical trainees was limited and had a heterogeneity in focus, which hindered comparison of results. CONCLUSION: Our findings suggest that a positive attitude towards older people in general is related to a positive attitude towards medical care for older patients among medical students. Future research should focus on further exploring underlying mechanisms affecting the attitude towards medical care for older patients among medical trainees.

Older Workers, Cognitive Impairment, and Discrimination.

An aging workforce is forcing employers to deal with the challenge of workers who may develop cognitive impairments. Federal law prohibits workplace discrimination based on age and disability and sets limits on permissible policies. Mandatory retirement, with only a few exceptions, has been eliminated, and age-related screening likely violates antidiscrimination statutes. Employers are permitted to target assessments at workers who show signs of impairment. Applying that rule in a fashion that is fair to employees, and protective of the interests of employers and the public, is the difficult, but vital, task ahead.

Is age discrimination a risk factor for frailty progression and frailty development among older adults? A prospective cohort analysis of the English Longitudinal Study of Ageing.

BACKGROUND: With the increasing global burden of frailty on healthcare resources, it is important to understand the modifiable risk factors of frailty. This study examined perceived age discrimination as a potential risk factor for frailty progression and frailty development among older adults. METHODS: Prospective cohort study using data from Waves 5 to 9 of the English Longitudinal Study of Ageing (ELSA). Data on perceived age discrimination was collected only in Wave 5 of ELSA and analysed as baseline data in this study. Frailty was defined using the Frailty Index (FI) scores (0 to 1), calculated using the multidimensional deficits (scores ≥ 0.25 were considered frail). Binomial generalised estimating equation models (GEE) were fitted in R studio using perceived age discrimination as the main predictor with age, gender, long-standing illness, cognition, subjective social status status (SSS) and psychological wellbeing as covariates. Odd ratios were reported with 95 % confidence intervals (CI). RESULTS: A total sample of 2,385 ELSA participants were included in the analysis. 55.8 % (n = 1312) were female, mean age 71.9 (SD ± 5.27) years and baseline frailty prevalence was 12.1 % (n = 288). Perceived age discrimination was reported by 38.4 % (n = 916) of the participants. Both frailty progression (OR 1.50, CI [1.26- 1.70]) and frailty development (OR 1.39, CI [1.14-1.62]) were significantly associated with perceived age discrimination in the fully adjusted models. Age (80+ years) (OR 3.72, CI [2.84-4.86]) and long-standing illness (OR 5.45, CI [4.43-6.67]) had the strongest association with respondents' frailty progression. CONCLUSION: Perceived age discrimination significantly increased the risk of frailty progression and frailty development among ELSA participants.

Reflection on the Elderly Discrimination in the Allocation of Scarce Medical Resources from the Age Restriction Phenomenon in ICU of a Certain Country / 中国医学伦理学

In March 2020, the outflow of age limited videos from ICU in Spain inspired us to rethink whether there is age discrimination in the allocation of scarce medical resources. This paper frist reflected on the problem of age discrimination caused by this phenomenon from four moral intuitions: the sacred view of life, the quality of life and values, public health ethics and Chinese culture, and then examined whether it is illegal from the legal level, finally pointed out the negative impact on the society, and put forward that taking age as the standard for the allocation of scarce medical resources is not suitable for China’s national conditions.

Reelin' In The Years: Age and Selective Restriction of Liberty in the COVID-19 Pandemic.

During the COVID-19 pandemic, focused protection strategies including selective lockdowns of the elderly were proposed as alternatives to general lockdowns. These selective restrictions would consist of isolating only those most at risk of COVID-19 hospitalization and subsequent use of healthcare resources. The proposal seems to have troubling implications, including the permissibility of selective lockdown on the basis of characteristics such as ethnicity, sex, disability, or BMI. Like age, these factors also correlated with an increased risk of hospitalization from COVID-19. In this paper, we argue that age has meaningful differences as a morally relevant characteristic in the justification for selective restrictions of liberty. Thus, it might justify selective freedom restrictions in a way in which other factors might not. We offer four moral domains that separate age from other proxies: empiricism, operationality, discrimination, and disparity.

Explicating Ageism in the Productive Aging Framework.

This essay argues for a fuller integration of ageism and age discrimination into the productive aging framework. We briefly review the productive aging scholarship and the extent to which ageism has been considered in regards to working, volunteering, education, and caregiving. We suggest that ageism has not been adequately considered, and we identify how it permeates productive engagement in later life. We introduce modifications to the productive aging framework to more directly capture the roles of ageism and age discrimination in activity engagement and the outcomes achieved. We argue for the integration of key concepts from minority stress theory and critical race theory that may yield important insights for an increasingly diverse older population. We conclude with research directions that will guide intervention development to reduce ageism at the societal, organizational and individual level.

Metabolomics approach to growth-age discrimination in mountain-cultivated ginseng (Panax ginseng C. A. Meyer) using ultra-high-performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry.

Mountain-cultivated ginseng is typically harvested after 10 years, while ginseng aged over 15 years is considered wild ginseng. This study aims to differentiate mountain-cultivated ginseng by age, as the fraudulent practice of selling low-aged cultivated ginseng disguised as high-aged one is damaging the market. In this study, LC-MS analyzed 98 ginseng samples, and multivariate statistical analysis identified patterns between samples to select influential components. Machine learning models were developed to identify ginseng samples of different ages. The untargeted metabolomic analysis clearly divided samples aged 4-20 years into three age groups. Twenty-two potential age-dependent biomarkers were discovered to differentiate the three sample groups. Three machine learning models were used to predict new samples, and the optimal model was selected. Some biomarkers could determine age phases according to the differentiation of mountain-cultivated ginseng samples. These biomarkers were thoroughly analyzed for variation trends. The machine learning models established using the screened biomarkers successfully predicted the age group of new samples.

Combatting ageism in the Western Pacific region.

The present viewpoint examines the manifestation of ageism, defined as stereotypes, prejudice and discrimination towards people because of their age, in the Western Pacific region. Research is still equivocal concerning the nature of ageism in the Western Pacific region, especially in East and South-East Asia (e.g., Eastern countries). There has been plenty of research to support as well as question the general notion of Eastern cultures and countries as being less ageist compared to Western cultures and countries at individual, interpersonal, and institutional levels. Although varied theoretical explanations have aimed to explain East-West differences in ageism such as the modernization theory, the pace of population aging, the proportion of older people in the country, cultural hypothesis, and GATEism, none of these theories fully accounts for the mixed findings. As such, it is safe to conclude that targeting ageism should be an important step in ensuring a world for all ages in Western Pacific countries.

[Effect of renal artery stenting on the clinical and geriatric status of elderly patients with vasorenal hypertension.]

The study consists in determining the effect of renal artery stenting in patients with arterial hypertension in combination with renal artery stenosis on the dynamics of clinical and geriatric status in terms of such indicators as the number of drugs taken, cognitive status, determined by the MMSE scale, prevalence of the frequency of falls, psycho-emotional status by the Beck scale, the quality of sleep on the VAS scale, the index of age discrimination according to the E.Palmore ageism questionnaire, the quality of life according to the SF 36 questionnaire. The study involved 72 elderly patients with arterial hypertension in combination with renal artery stenosis. According to the results of the study, as a result of stenting of the renal arteries, there is a decrease in the number of drugs taken, an improvement in the cognitive status on the MMSE scale, a decrease in the frequency of falls, an improvement in the psycho-emotional status on the Beck scale, an improvement in the quality of sleep on the VAS scale, a decrease in the level of age discrimination, an increase in the quality of life according to questionnaire SF-36 on all scales.