Recent research on young onset dementia (formal diagnosis at age <65) evidences emerging work around pre-diagnosis, diagnosis and the need to improve post-diagnostic support for this group. An increased awareness of young onset dementia has led to the establishment of peer-support groups, support networks and the involvement of people affected by dementia in research. However, the need to join up services at the systems level persists. Third-sector organisations that offer post-diagnostic support at the community level rely heavily on volunteers. Implications for policy and practice are that community-based commissioning of integrated services between health care, social care and the third sector would go a long way to providing the continuity and stability required in dementia support and care along the illness trajectory. This discussion document was written in collaboration with diagnostic services, the charity sector and conversations with people living with, and affected by, dementia.

Subjective age (SA) is a core indicator of the individual ageing experience, with important consequences for successful ageing. The aim of the current study was to investigate the directions of the longitudinal associations between domains of SA and subjective wellbeing and physical functioning in the second half of life. We used three-wave survey data (2002, 2007 and 2017) spanning 15 years from the Norwegian Lifecourse, Ageing and Generation Study, including 6,292 persons born between 1922 and 1961. SA was measured with felt-age and ideal-age discrepancies, wellbeing with the Satisfaction of Life Scale and physical functioning with the Short-Form 12. Three-wave cross-lagged panel models were applied to assess the temporal relationships between the different domains of SA, life satisfaction and physical functioning, adjusted for age, gender and education. Findings indicated that wanting to be younger was negatively associated with life satisfaction and physical functioning over time. Felt-age discrepancies did not predict subsequent wellbeing or physical functioning. The results did not reveal any evidence for reversed effects, i.e. from functioning or life satisfaction to SA. Our findings support the psychological pathway from satisfaction with age(ing) to subjective wellbeing and physical functioning over time. Small ideal-age discrepancies reflect positive self-perceptions of ageing, which may help to accumulate psychological resources, guide behavioural regulation and support health.

Intergenerational transfers measured in several currencies (e.g. co-residence, contact, proximity and support) have been always considered important indicators for family solidarity. Most of the studies on intergenerational transfers examine the structural characteristics of such exchanges (as distance, frequency, type, motives), emphasising the potential positive association between the structure and the quality of parent–child relationships. Additionally, while most surveys include questions on the structural indicators of family exchanges, it is still uncommon for them to contain assessments of the relationships between parents and their adult children as well. Using the Italian 2009 Family Survey, this study analyses the satisfaction of parent–child relationships for parents aged 65 and older. After examining the association of such a variable with the structural indicators of intergenerational exchanges (frequency of contact), we explored the individual factors associated with satisfaction of relationships with a child using multilevel multinomial models. Overall, older Italian parents report high satisfaction in their relationships with their adult children. Additionally, a not strong, but statistically significant association between structure (contact) and satisfaction was found. This study shows how high satisfaction of relationships with children is positively associated with being a mother and being married and negatively associated with bad health status. Some of the variables considered have different impacts between the sexes of parents. Additionally, a better appreciation of relationships with daughters compared to sons was found, especially for fathers.

This study examined the association between childhood conditions and arthritis among middle-aged and older adults in China. The data were derived from the 2015 wave and the life-history module of the China Health and Retirement Longitudinal Study. Face-to-face interviews were conducted with respondents age 45 and over across China. Multiple imputation was used to handle the missing data, generating a final analytic sample of 19,800. Doctor-diagnosed arthritis was the main outcome variable. Random-effects logistic regression models were used to test the proposed models. Approximately 8 per cent of the respondents had better family financial status in childhood than their neighbours. Close to 8 per cent had been hospitalised or encountered similar conditions (e.g. confined to bed or home) for at least one month in childhood. Around one-third reported better subjective health in childhood than their peers. The majority of the respondents (80%) reported that they had stable health resources, and that their mothers were illiterate during their childhood. Childhood family financial status, subjective health, mother's education, access to health care and medical catastrophic events were found to be significant factors associated with arthritis in later life, after controlling for adulthood and older-age conditions (family financial status: odds ratio (OR) = 0.885, 95 per cent confidence interval (95% CI) = 0.848–0.924; subjective health: OR = 0.924, 95% CI = 0.889–0.960; mother's education: OR = 0.863, 95% CI = 0.750–0.992; access to health care: OR = 0.729, 95% CI = 0.552–0.964; medical catastrophic events: OR = 1.266, 95% CI = 1.108–1.446). The study results highlight an important role that childhood conditions play in affecting the onset of arthritis in late life in China. Health-care providers may consider childhood conditions as a valuable screening criterion to identify risk populations, which could be used to guide health promotion and prevention programmes, and promote healthy ageing.

Amid rapid population ageing and the high-speed progress of information and communications technology, use of smart electronics can improve older people's quality of life by helping them to stay connected, active and independent, which may, in turn, increase their overall happiness and sense of social belonging. Taking a gender perspective, this paper aims to understand variations in digital exclusion among older people. Using data from the 2016 China Longitudinal Ageing Social Survey, it finds that digital exclusion seems to vary by gender, with rural female older people being most excluded, possibly because they have the lowest capital endowment. The gender difference in the digital divide is even more salient with all other things being equal. Digital exclusion in the information era may further exacerbate gender inequality, particularly for those who are already most vulnerable. Since digital inclusion is somewhat inherent in the concept of intelligent old-age support, it should be considered an urgent necessity to help older people, especially rural women, become familiar with smart electronic products.

Living standards capabilities are an important determinant of healthy ageing. The Living Standards Capabilities for Elders scale (LSCAPE) is the main instrument available to assess living standards capabilities among older adults based on Sen's Capability Approach. The objectives of this study were: (a) to adapt and validate LSCAPE for use in the Spanish population; (b) to examine the dimensionality, validity and reliability; and (c) to establish the convergent validity of LSCAPE using self-reported measures of quality of life and income. The LSCAPE was administered to 441 Spanish seniors aged 65 and over. Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability. Discriminant and convergent validity of the model were assessed using Average Variance Extracted (AVE). Reliability was shown by Composite Reliability (CR) and Cronbach's alpha. Convergent validity was tested by correlating the LSCAPE scales and sub-scales with the Short-form Health Survey (SF-12) sub-scales. CFA showed that the LSCAPE Six-factor Model fits well to the data, showing Standardised Root Mean Square Residual < 0.09 (0.084), Comparative Fit Index and Tucker–Lewis Index > 0.9 (0.925 and 0.917, respectively). LSCAPE showed also good reliability (CR indices > 0.7) and validity (AVE > 0.5) measures. Finally, LSCAPE had moderate to strong associations with SF-12 sub-scales (>0.6) and a moderate relationship with income (>0.3). Thus, LSCAPE has been demonstrated to be a reliable and valid instrument in measuring living standards capabilities among the Spanish older population.

Maintaining physical, psychological and social wellbeing is integral to older adults being able to age well in their community. Therefore, an environment that facilitates and supports ageing well is imperative. The aim of this study was to explore the views of older people about their preparation for ageing well in a rural community. Forty-nine community-dwelling older people aged between 65 and 93 years participated in a semi-structured and digitally recorded interview. The resulting qualitative data were analysed using a thematic approach. Three main themes were identified: (a) ‘sensible planning: the right place and the right people’; (b) ‘remaining independent: “it's up to me”’; and (c) ‘facing challenges: “accepting my lot”’. Findings from this study identify that across all age groups, these older people were actively and realistically preparing for ageing well. All valued their independence, believing individually they were responsible for being independent and planning for their future. Consequently, environmental planners, policy makers and practitioners need to understand that older people are a heterogeneous group and ageing policies should be geared towards older people's individual abilities and circumstances. Consideration of diversity enables inclusion of older people with a wide range of abilities and needs to achieve the perceived goals of ageing well.

Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our systematic review was to provide an analysis of existing mechanisms and measures for evaluating fall risk in older adults. The 43 included FRATs produced a total of 493 FRAT items which, when linked to the ICF, resulted in a total of 952 ICF codes. The ICF domain with the most used codes was body function, with 381 of the 952 codes used (40%), followed by activities and participation with 273 codes (28%), body structure with 238 codes (25%) and, lastly, environmental and personal factors with only 60 codes (7%). This review highlights the fact that current FRATs focus on the body, neglecting environmental and personal factors and, to a lesser extent, activities and participation. This over-reliance on the body as the point of failure in fall risk assessment clearly highlights the need for gathering qualitative data, such as from focus group discussions with older adults, to capture the perspectives and views of the older adults themselves about the factors that increase their risk of falling and comparing these perspectives to the data gathered from published FRATs as described in this review.

This article examines how older adults make decisions about their medications through interconnected axes of trust that operate across social networks. Trust is negotiated by older adults enrolled in a deprescribing programme which guides them through the process of reducing medications to mitigate risks associated with polypharmacy. Habermas’ work on the significance of communicative action in negotiating trust within social relationships informs our analysis, specifically in-depth semi-structured interviews with older adults about their medication use and the role of social networks in managing their health. Participants were age 70+ and experiencing polypharmacy. Our analysis discusses the social nature of medication practices and the importance of social networks for older adults’ decision-making. Their perspective reflects the critique of late-modern society put forward by Habermas. Negotiating trust in pharmaceutical decision-making requires navigating tensions across and between system networks (health-care professionals) and life-world networks (family and friends). This study contributes to our knowledge of how distinct forms of trust operate in different social spheres, setting the context for the way health-care decisions are made across social networks. Our analysis reinforces the need for older adults to engage meaningfully in health-care decision-making such that a convergence between system-world and life-world structures is encouraged. This would improve deprescribing programmes’ efficacy as older adults optimise their medication use and improve overall quality of life.

New interest in late-life creativity has arisen in gerontology. To date, such research has mainly focused on the positive impact creativity has on older adults, but has scarcely contextualised older adults’ creative engagement. Drawing on the sociology of valuation, this article aims to contextualise late-life creativity by critically exploring how creativity gains, stabilises and loses its value and how these processes are related to perceptions, images and discourses addressing old age. Data from 13 interviews with older (60+) adults involved in creative practices in Austria are used to explore these topics. Interviews examined perceptions of creative production, everyday routines and personal attitudes towards ageing. Interviews transcripts were analysed using the documentary method. The analysis revealed three registers of valuation in late-life creativity: economic value, in which valuable creativity was given away at a high revenue; field value, where valuable creativity was appreciated by institutions or other artists in the field; and lifecourse value, in which doing a creative activity for a long time meant being able to produce a creative product that was high in value. This article emphasises late-life creativity as a process of value production that is structured by the making and evaluating of creative products and adds to the current critique that the narrow view of late-life creativity in its associations with wellbeing present a reductionist picture of the capacities that the arts and creativity have for older adults. The results demonstrate the potential for valuation studies in gerontology as they highlight the circumstances and practices by which the activities of older adults are (de)valued. For policy and practice, this article suggests imagining arts-based interventions for older adults beyond the realm of health and wellbeing, and encourages thinking about how valuable artistic experiences can be supported in later life.

Many care home residents lack opportunities for meaningful activity and social connection, resulting in poor physical and emotional wellbeing. Providing residents with varied activities and social opportunities can improve their quality of life. In this paper, we examine the potential for film to provide a meaningful, social activity. The limited existing research on film in care homes has predominantly examined the use of film clips and materials in stimulating reminiscence for people with dementia. In this paper, we adopt a broader, trans-disciplinary perspective of film, drawing on evidence from Film Studies that shared spectatorship has social and emotional benefits for the viewer. We offer the first qualitative study of care home residents’ social, emotional and embodied engagement with feature-length film and identify the key benefits of film in this setting. We ran social film screenings in two Scottish care homes over six weeks. Underpinned by psycho-cinematic theory, we collected and analysed observational data alongside interviews with care home staff and discussion groups with residents. Our findings identified three ways in which film screenings benefit residents and supports social connection: prompting reminiscence; enhancing residents’ experiences in the present; and creating a shared future and intergenerational connections. The paper offers useful insights into the rich potential for film to enhance the care home community, facilitate social connectivity and promote resident wellbeing.

Animal therapy has been shown to have both physiological and psychological benefits for older people, including improvements in outlook and social interaction. Volunteer-led animal visitation programmes are common within residential aged care facilities in New Zealand. Visits by animals and handlers are intended to improve the quality of life of people in residential care. Very little research has been conducted on the informal animal visitation programmes typical in care facilities in New Zealand. This project examined the experience of animal therapy in two residential aged care homes that receive animal visits from an animal welfare organisation. In-depth interviews were conducted with seven older people about their experiences of the programme and analysed using narrative analysis. Three overarching narratives were identified: animal therapy as a fleeting pleasure, residential care as a sad environment, and identity outside residential care as highly valued. Older people in residential care do value animal therapy, but it is narrated as a fleeting pleasure, rather than having a long-lasting or far-reaching impact on the daily experience of residential care. In some ways, the structure of the animal therapy programme may underscore the challenges to everyday autonomy and identity experienced in residential aged care. These findings can be used to develop animal visiting programmes which recognise the importance of a valued social identity in later life.

Little is known about the experiences of people living alone with dementia in the community and their non-resident relatives and friends who support them. In this paper, we explore their respective attitudes and approaches to the future, particularly regarding the future care and living arrangements of those living with dementia. The study is based on a qualitative secondary analysis of interviews with 24 people living alone with early-stage dementia in North Wales, United Kingdom, and one of their relatives or friends who supported them. All but four of the dyads were interviewed twice over 12 months (a total of 88 interviews). In the analysis, it was observed that several people with dementia expressed the desire to continue living at home for ‘as long as possible’. A framework approach was used to investigate this theme in more depth, drawing on concepts from the existing studies of people living with dementia and across disciplines. Similarities and differences in the future outlook and temporal orientation of the participants were identified. The results support previous research suggesting that the future outlook of people living with early-stage dementia can be interpreted in part as a response to their situation and a way of coping with the threats that it is perceived to present, and not just an impaired view of time. Priorities for future research are highlighted in the discussion.