P34: How does active ageing policies and practice reconfigure cognitive impairment? Findings from an ethnographic study.

Abstract

Objective:

Active ageing is the maintenance of positive subjective well-being, good physical, social and mental health in later life. It aligns with the ‘successful ageing’ narrative where obligation to undertake activities is deemed beneficial to health status (Swallow 2019). How this narrative plays out for people with mild cognitive impairment (MCI) which is not dementia has not been considered.

My PhD investigated experiences of people over 60 with MCI who engaged within an active ageing intervention. The APPLE-tree (AT) programme stands for Active Prevention in People at risk of dementia through Lifestyle, Behaviour change and Technology to build Resilience (Cooper et al 2019). It aims to facilitate active ageing in people who are limited by cognitive impairment. I explored how older people with memory impairments situate themselves within this active ageing health intervention and how policies and practices reconfigure MCI.

Methods:

I adopted an ethnographic approach, undertaking participant observations and semi structured interviews with participants. I followed two 20 week programs, undertaking 65 field notes and conducting 16 interviews with participants. I used reflexive thematic analysis to analyse the results through Nvivo.

Results:

Four themes with sub-themes were identified.

• Arrival into the intervention – learning, listening, knowing, and doing active aging. Participants navigated fears and uncertainties of MCI with their expectations of active ageing.

• Being an individual in a group experience – retaining a sense of self whilst embracing the collective unknown. Participants reconfigured their MCI through a tension between individual responsibility and a collective group experience.

• Managing uncertainly and attempting to create certainty through navigating knowledge. Active ageing changed how participants viewed and dealt with MCI with attempts to clarify knowledge of dementia risk.

• Being an active ager; actively able to be active and participate in active ageing. Individuals demonstrated engagement through sharing achievements, ability and inabilities.

Conclusion:

Active ageing is a collective habitus, with absence of clear knowledge and direction creating a mismatch between rhetoric and lived experiences of people with MCI. Ultimately results inform the development of concepts in social gerontological theory and active ageing