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As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned. Treating high blood pressure remains important as people age and reduces strokes and heart attacks. That said, a more personalised approach to blood pressure may be even more important as people age to lower blood pressure to tight targets where appropriate but avoid overtreatment in vulnerable groups. As people age, more people experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This can predispose them to falls. The papers in this collection provide an insight into blood pressure and orthostatic hypotension. They highlight areas for further research to understand blood pressure changes and management in the ageing population. Inpatient clinical care of older people with heart attacks differs from younger people in UK national audit data. People aged over 80 had improved outcomes in survival after heart attack over time, but had lower rates of specialist input from cardiology compared with younger people. This may partly reflect different clinical presentations, with heart attacks occurring in the context of other health conditions, frailty and multimorbidity. The care and outcomes of acute and chronic cardiovascular disease are impacted by the frailty and health status of an individual at baseline. The research included in this collection reinforces the wide variations in the ageing population and the necessity to focus on the individual needs and priorities, and provide a person-centred multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to share how the Centre for Ageing and Dementia Research co-designs research within a national programme of work to improve the lives of older adults and those affected by dementia. Through examples of this work, the authors identify the barriers and enablers to participatory approaches and lessons to inform future involvement activities. Design/methodology/approach: This study reflects on implementing the UK National Standards for Public Involvement into practice. Of international relevance, the observations span the research process from research prioritisation and design to research implementation and knowledge exchange. Findings: This study demonstrates the importance of using a relational approach, working toward a common purpose and engaging in meaningful dialogue. Only through offering choice and flexibility and actively learning from one another can co-design lead to synergistic relationships that benefit everyone. Research limitations/implications: Key implications for researchers engaged in patient and public involvement are be receptive to other people's views and acknowledge expertise of those with lived experience alongside those with academic expertise. Training, resources and time are required to effectively support involvement and meaningful relationships. A nominated contact person enables trust and mutual understanding to develop. This is an ongoing collective learning experience that should be embedded throughout the entire research process. Originality/value: This paper demonstrates how the standards are implemented with people who are often excluded from research to influence a national programme of work. [ABSTRACT FROM AUTHOR]

Transformers are one of the most strategic components in balancing the voltage levels and hence a high priority is given to their performance [1]. It is established that, insulation technology plays a critical role in judging the performance and service life in oil filled apparatus [2]. Performance of the insulation system depends mainly on the deterioration behavior of insulation oil and paper. The mechanisms that are responsible for premature aging of oil/paper insulation are almost the same in all the oil filled apparatus. Yet, there will be a significant difference in the intensity of the aging mechanisms in different apparatus. This intensity is attributable to rating, design, and duration of operation for different machines. The detailed discussions on these mechanisms are presented in the subsequent sections of this paper. However, aging of service insulants is unavoidable and is to be maintained at a lower rate or arrested to the greatest possible extent, such that, catastrophic failures and unscheduled outages may be mitigated [3]. Normally, utilities follow scheduled condition monitoring activities to avoid the consequences of premature aging. Hence, knowledge on these in-service condition monitoring activities will be helpful in understanding the exact deterioration rate of the insulation system. Real time in-service experience of several transformer fleets that belong to United Kingdom utilities are reported in [4]. An early degradation of insulation is noticed through increase in acidity and furan concentration in oil for several transformers in the fleet. Authors investigated this early degradation in different perspectives including loading conditions, manufacturers, and oil chemistry changes. It is inferred that changes in oil chemistry is an important attribute for early degradation and hence utilities are advised to adopt different asset management strategies for affected and unaffected transformers in a fleet. Recently, failure rate data of service aged transformer fleets of an Australian utility were analyzed to establish the relationship between aging and different failure types [5]. It is noticed that degradation of the insulation system will be rapid after 20 years of service aging thus entailing the frequent condition monitoring activities after 20 years to identify premature aging failures. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

Background: Long-term air pollution exposure is a major health concern, yet its associations with thyroid dysfunction (hyperthyroidism and hypothyroidism) and biological aging remain unclear. We aimed to determine the association of long-term air pollution exposure with thyroid dysfunction and to investigate the potential roles of biological aging., Methods: A prospective cohort study was conducted on 432,340 participants with available data on air pollutants including particulate matter (PM 2.5 , PM 10 , and PM 2.5-10 ), nitrogen dioxide (NO 2 ), and nitric oxide (NO) from the UK Biobank. An air pollution score was calculated using principal component analysis to reflect joint exposure to these pollutants. Biological aging was assessed using the Klemera-Doubal method biological age and the phenotypic age algorithms. The associations of individual and joint air pollutants with thyroid dysfunction were estimated using the Cox proportional hazards regression model. The roles of biological aging were explored using interaction and mediation analyses., Results: During a median follow-up of 12.41 years, 1,721 (0.40 %) and 9,296 (2.15 %) participants developed hyperthyroidism and hypothyroidism, respectively. All air pollutants were observed to be significantly associated with an increased risk of incident hypothyroidism, while PM 2.5 , PM 10 , and NO 2 were observed to be significantly associated with an increased risk of incident hyperthyroidism. The hazard ratios (HRs) for hyperthyroidism and hypothyroidism were 1.15 (95 % confidence interval: 1.00-1.32) and 1.15 (1.08-1.22) for individuals in the highest quartile compared with those in the lowest quartile of air pollution score, respectively. Additionally, we noticed that individuals with higher pollutant levels and biologically older generally had a higher risk of incident thyroid dysfunction. Moreover, accelerated biological aging partially mediated 1.9 %-9.4 % of air pollution-associated thyroid dysfunction., Conclusions: Despite the possible underestimation of incident thyroid dysfunction, long-term air pollution exposure may increase the risk of incident thyroid dysfunction, particularly in biologically older participants, with biological aging potentially involved in the mechanisms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: This paper aims to highlight lessons from the COVID-19 pandemic for planning for the future of our ageing society. It looks at trends, changes in our society and implications for people of all ages. It focusses on the importance of planning and whether COVID-19 will lead to long-term changes. Design/methodology/approach: This paper draws on the author's experiences running an intergenerational organisation during the pandemic and other work associated with ageing well. Findings: This paper highlights some of the risks and unknowns we face going forwards and points to lessons and opportunities for "building back better". Research limitations/implications: This paper is based on a review of published articles and viewpoints. Practical implications: The COVID-19 pandemic has challenged people of all ages in different ways, some of which have tested intergenerational solidarity. At the same time, the pandemic has raised issues which we must all address going forward: planning for future pandemics, planning for an ageing society and ensuring that future planning works for all generations. This paper explores all these themes in the light of lessons from COVID-19. Firstly, despite much risk assessment and scenario planning, we were not well placed in the UK or across the world to respond to the multiple challenges of COVID-19. Have we learned the lessons to be able to deal better with the inevitable pandemics that will follow in the future? It is also well documented that the pandemic has exacerbated existing inequalities in our society. What will the long-term impact be for longevity and will less healthy lives reverse the trend of increasing life expectancy? Secondly, what are the lessons for our ageing society? As life expectancy rises, what will the quality of life be like in those added years? Many of today's babies can expect to have a 100-year life. What does that mean for the way we lead our lives and can we ensure that everyone can age well? Third, these are not just issues for older people, but for people of all ages and generations. The Covid-19 experience has been different for younger and older people – whether it has been health or job security, income, taxation or housing. Questions of intergenerational fairness have again raised their heads, alongside the longer term impact for future generations. Social implications: Firstly, despite much risk assessment and scenario planning, we were not well placed in the UK or across the world to respond to the multiple challenges of COVID-19. Have we learned the lessons to be able to deal better with the inevitable pandemics that will follow in the future? It is also well documented that the pandemic has exacerbated existing inequalities in our society. What will the long-term impact be for longevity and will less healthy lives reverse the trend of increasing life expectancy? Secondly, what are the lessons for our ageing society? As life expectancy rises, what will the quality of life be like in those added years? Many of today's babies can expect to have a 100-year life. What does that mean for the way we lead our lives and can we ensure that everyone can age well? Thirdly, these are not just issues for older people, but for people of all ages and generations. Measures that bring older and younger people together and encourage meaningful mixing will help increase understanding and awareness between generations. This has huge implications for our society and communities. Originality/value: This paper reaches two main conclusions. Firstly, the well-known saying: "failing to plan is planning to fail". This applies to all the issues discussed in this paper re future pandemics, our ageing society and future generations. Secondly, the experience of the COVID-19 pandemic should be the catalyst for changing the way we live and lead to new beginnings. We cannot just carry on as before. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight current finding issues relating to the provision of hospice care services which are largely provided by the independent sector and heavily reliant on charitable fund raising. The primary focus is on the UK, but it is an issue of relevance to many other countries around the world. Design/methodology/approach: The paper is an opinion piece informed by contemporary reports, official publications and research findings, as well as the author's own work within the hospice sector. Findings: As with many other countries around the world, the bulk of hospice funding in the UK comes from charitable donations of various kinds. However, the impact of COVID-19 highlighted both the fragility of this funding model and the precarious nature of hospice sector finances currently. Practical implications: This is an issue of growing importance that affects older people and their families not only in the UK but in all countries with ageing populations. Hospices play an important role in providing end-of-life care and, with demand for services steadily rising due to demographic trends, there are important questions about the sustainability of the current hospice funding model. Social implications: Issues of funding require a much higher level of engagement from policymakers if hospice care is going to continue to play a significant part in achieving a good death for people from all sections of society. Originality/value: Although hotly debated within the hospice sector and in official reports, this issue has yet to be properly examined within academic circles. [ABSTRACT FROM AUTHOR]

Despite the identification of social inclusion as a key objective of age-friendly policies and programs, there is limited research evidence as to either the extent to which this has been achieved or how it might be realized. Gaps remain in our understanding of how age-friendly programs might involve different groups of older people and the possible barriers that might be encountered. This paper seeks to address this gap by drawing on evidence from the Ambition for Aging program in Greater Manchester, UK, which implemented a range of projects designed to tackle social isolation in later life. The paper argues that due to its co-production approach and spatial lens, Ambition for Aging was able to involve sections of the older population that otherwise might have remained excluded. In providing further insights relevant to age-friendly programs, the paper also considers some of the barriers experienced by the Ambition for Aging program and builds a case that taking a spatial justice perspective to age-friendly work may help identify and overcome obstacles to achieving social inclusion. [ABSTRACT FROM AUTHOR]

Recent political processes have rendered people with dementia an increasingly surveilled population. Surveillance is a contentious issue within dementia research, spanning technological monitoring, biomarker research and epidemiological data gathering. This paper explores surveillance in the relationships of people affected by dementia, how older relatives both with and without diagnoses are surveilled in everyday interactions, and the importance of expectations in guiding surveillance. This paper presents data from 41 in-depth interviews with people affected by dementia living in the community in the United Kingdom. Agedness was a key contributor to expectations that a person may have dementia, based on previous experiences, media accounts and wider awareness. Expectations provoked surveillance in interactions, with participants looking for signs of dementia when interacting with older relatives. Older people also enacted self-surveillance, monitoring their own behaviour. Various actions could be attributed to dementia because interpretation is malleable, partly vindicating expectations while leaving some uncertainties. Expectant surveillance transformed people's experiences because they organised their own actions, and interpreted those of others, in line with pre-existing meanings. The ability to interpret behaviours to fit expectations can bring coherence to uncertainties of ageing, cognition and dementia, but risks ascribing dementia to many older people who straddle those uncertainties. [ABSTRACT FROM AUTHOR]

Purpose: The Village model, most extensively developed in the USA, is an innovative response to ageing populations and older adults who wish to remain living independently within their community. The "Urban Villages" participatory action research study aimed to test the potential of the Village model to work with groups of older adults in two economically deprived, inner-city neighbourhoods in Manchester, UK. Design/methodology/approach: Participatory methods were used to work with residents to, first, adapt the Village model to the Manchester setting, and second, to develop and deliver community projects that supported ageing in place. The study aimed to involve marginalised individuals and groups in the co-design, leadership and implementation of the projects. Ethnographic methods were applied to observe and reflect on the development of "Urban Villages". Interviews and focus groups were organised to gather the views of the residents involved in the community projects. Findings: Residents were supported to develop and test seven projects, all aimed at reducing social isolation and supporting ageing in place. The study provides new insights into challenges related to co-production with older people in deprived neighbourhoods. These challenges are presented under the following headings: individual capacity and expectations; collective capacity including communication and knowledge; and the capacity of place. Originality/value: To date, only a limited amount of literature is available showing how co-production with older adults can be realised when working with marginalised groups and deprived communities. The paper explores the potential of participatory approaches to develop age-friendly initiatives through strengthening the capacity of older adults to age in place. [ABSTRACT FROM AUTHOR]

Extra-care housing (ECH) has been hailed as a potential solution to some of the problems associated with traditional forms of social care, since it allows older people to live independently, while also having access to care and support if required. However, little longitudinal research has focused on the experiences of residents living in ECH, particularly in recent years. This paper reports on a longitudinal study of four ECH schemes in the United Kingdom. Older residents living in ECH were interviewed four times over a two-year period to examine how changes in their care needs were encountered and negotiated by care workers, managers and residents themselves. This paper focuses on how residents managed their own changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, the paper makes two arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be resisted, planned-for and managed by older people. Second, that operational practices within ECH schemes can function to facilitate or impede residents' attempts to manage this boundary. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore how supervision is applied in the context of National Health Service services for older adults, with particular regard to the profession of clinical psychology and psychotherapy. Design/methodology/approach: The clinical supervision theories that are considered in this exploration are the Seven-Eyed Model (Hawkins and Shohet, 2012) and the Cyclical Model (Page and Wosket, 2015). The discussion also integrates an overview of psychological dynamics as presented by the existing literature with the author's reflections on the influence of ageing stereotypes in the therapeutic work with older adults. Findings: The theoretical models of clinical supervision considered can offer a robust framework and pathway for supervisory work in psychology and psychotherapy for older people. However, this alone seems insufficient and needs to be combined with the supervisor's knowledge on psychology of ageing as well as their own self-reflection on internalised ageing stereotypes. Practical implications: The paper suggests a need for health care professionals, providing clinical supervision on older adult therapeutic work, to be familiar with the aspects analysed. Originality/value: Clinical supervision handbooks overlook aspects related to age as an issue of difference. This paper adds value to the clinical work with older people through a novel attempt to link implications of ageing stereotypes with the therapeutic and supervisory practice. [ABSTRACT FROM AUTHOR]

Access to social protection in old age is crucial and yet contingent upon negotiations between the social structures of the welfare states and the personal networks within which individuals are embedded. International migration, changing family dynamics, and the transformation of care and other welfare policies in the global North make it challenging for older migrants to negotiate social protection. Drawing on 45 semi-structured interviews with first-generation older Turkish migrants in London and 13 semi-structured interviews with professional service providers for the community, the paper aims to investigate the assemblages of formal and informal social protection in the lives of older migrants. Findings indicate the complexity in accessing informal social protection and the navigation of formal care support in the UK for first generation older Turkish migrants and the contingency of access to formal care services on informal support networks for participants. It has been demonstrated that built infrastructure and policies aimed at older adults have great influence on assemblages of care, highlighting the need for more age-friendly and integrated policies to facilitate access to social protection for diverse groups of older adults. [ABSTRACT FROM AUTHOR]

Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions. This study aimed to explore older TGNC people's social support networks, key concerns and unmet needs during the COVID-19 'lockdown'. A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants. The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance. Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks. [ABSTRACT FROM AUTHOR]

Increasing longevity has led to a rising number of adult children who are at higher ages when they provide care for their parents. Drawing on the lifecourse approach and exchange theory, the paper addresses similarities and differences in parent care between late middle-aged and older adult children. The study uses the UK Household Longitudinal Study, restricting the analysis sample to individuals aged 50 and older with a living parent or parent-in-law. It presents multivariate models to examine differences between late middle-aged (aged 50–64) and older (aged 65+) children in being a parent carer, providing intensive care, the duration of parent care and providing selected types of help to parents. The involvement in parent care increases among women up to the end of their seventh decade of life and for men up to their eighth decade of life. At higher ages, the proportion of parent carers decreases more strongly for women than men. Older carers have shorter care-giving episodes than younger carers, but there is no significant difference in the type of care provided. Even past retirement age, parent care remains classed and gendered, with women from lower social classes having the highest likelihood of providing intensive parent care in old age. Having dependent children or living in a non-marital union depress the likelihood of caring for a parent even past retirement age. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore how the next government could develop a better deal in relation to work, pensions and poverty. The paper argues that given the changing face of poverty, the next government should focus on creating better jobs if it is really to encourage people to work longer and save more for retirement. Furthermore, it could do more to support those who are currently under-saving for retirement. Design/methodology/approach - The paper draws on evidence from a number of recent qualitative and quantitative JRF research reports and government statistical data. Findings - The paper suggests policy recommendations for the next government focused on creating better jobs and helping those on lower incomes increase their pension pots. This includes: ensuring that the minimum wages is set with regard to the changing price of essentials and changing average earnings; raising awareness of the Living Wage and playing a leadership role; industrial strategies for low paid sectors; mid-life career reviews and increased rights for those aged 60 and over; the redistribution of tax relief on pension contributions and the auto-escalation of workplace pensions. Originality/value - This paper looks at the issue of an ageing society, work and pensions through a poverty lens. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach -- The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one "invisible" group each and comparisons and conclusions were then made collaboratively. Findings -- Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to bemore research to identify the scale of any problems and how they may be solved. Research limitations/implications -- This is not a systematic review but a preliminary account of the problem. Practical implications -- There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications -- There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value -- There is little written which brings together the lack of attention paid to these groups as a whole. [ABSTRACT FROM AUTHOR]

Purpose: The 8.3 million babies who were born during the 1960s in the UK are 48-57 years old. With growing concern about population ageing, and the oldest of this large cohort on the brink of later life, it is timely to provide an overview of selected characteristics of this cohort in order to help predict likely needs and choices for services and products in later life. The paper aims to discuss these issues. Design/methodology/approach: A synthesis (non-systematic) of the academic and grey literature plus data from various sources including the Office for National Statistics was used to construct a picture of the 1960s baby boomer. Findings: Characteristics with the potential to signify lifestyle changes among this, compared with previous, cohorts of older people include: a higher probability of living alone in old age due to high rates of childlessness and divorce; a possibly larger proportion of their lives spent with one or more chronic conditions, although the prevalence of disability affecting activities of daily living is lower than for previous cohorts; high levels of home ownership; increased rates of employment at older ages; but reduced wealth compared with previous cohorts. Originality/value: The term baby boomer is generally used to denote people born in the undifferentiated surge of births that occurred in the USA between 1946 and 1964. In the UK, post Second World War spike in births was followed by a separate, broad surge in births across the 1960s but there has been very little analysis specifically of the 1960s cohort in this country. This paper addresses that gap, by bringing together the available evidence and data on this specific cohort in the UK. [ABSTRACT FROM AUTHOR]

Purpose Suicide can be an emotive, and at times, controversial subject. The purpose of this paper is to reflect on the social, health, personal, and cultural issues that can arise in later life and the potential reasons for suicide. It will analyse already recognised risk factors of suicide in older adults and focus on improving knowledge about the social meaning and causation of suicide for older people. It will also consider suicide prevention policies, their practice implications, and whether they are successful in protecting this potentially vulnerable cohort.Design/methodology/approach A synopsis of available literature in the form of a general review paper of suicide of older adults.Findings There is evidence that the ageing process often leads to a set of co-morbidities and a complex and diverse set of individual challenges. This in turn equates to an increased risk of suicide. There is no easy answer to why there is evidence of a growing number of older adults deciding that suicide is there only option, and even fewer suggestions on how to manage this risk.Social implications The entry of the “baby boom” generation into retirement will lead to the potential of an increase in both suicide risk factors and older adults completing suicide. This is on the background of a demographic surge which is likely to place additional pressures on already under-resourced, and undervalued, statutory and non-statutory services.Originality/value A literature search found very little information regarding older adults and suicide risk, assessment, treatment or prevention. [ABSTRACT FROM AUTHOR]

While death features widely in various humanities and some social science disciplines, to date it has not been given the attention it deserves in social policy discourse or research. This paper sets out to begin to rectify that omission. Outlining a range of policy areas affected by death, it argues that budget and outcome-driven priorities in the UK have resulted in the evolution of disconnected and inconsistent policy responses to death. The paper begins by outlining death rates and characteristics of population ageing before focussing on social divisions in death and associated policies. It considers the death and UK social policy agenda before outlining the key characteristics involved in developing a coherent policy response and policy analysis in this field. It argues for a more comprehensive, consistent and joined up policy response to death, and corresponding academic study of death, which acknowledges and supports individuals preparing to die, when they die and those left behind. [ABSTRACT FROM AUTHOR]

Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population. [ABSTRACT FROM PUBLISHER]

The UK's ageing population has generated contradictory policy responses. On the one hand, facing the lack of specialist housing for the elderly, older people are incentivised to 'age in place'; on the other, to move to smaller homes to free-up family housing, reducing pressure on housing supply. This 'downsizing' discourse is presented as a 'win-win' situation which benefits older people and the rest of society. However, a survey and interviews conducted with over 55 s in England reveals more nuanced patterns of residential moves, behaviours and aspirations than suggested by 'downsizing'. Only a minority of older households choose to downsize. This paper looks into this mismatch between observed housing choices and the construction of downsizing as a policy goal. It suggests that theoretically speaking, the very notion of downsizing is problematic and difficult to define and is an over-simplistic concept which in reality applies to a heterogeneous group of people. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to review the literature on the role that mindfulness meditation can play in supporting people with dementia to live well. Design/methodology/approach – This paper reviews the literature in a structured way, focussing first on the general effectiveness on mindfulness and then going on to assess its role in attention, emotion regulation, cognitive decline, physical changes in the brain, prevention, and quality of life. Findings – Spirituality has been defined as a process of personal transformation which in many cases can involve a blend of humanistic psychology and esoteric traditions. Meditation, even if practised in a secular fashion can be said to fit within this definition of spirituality. The paper reviews the evidence for the relevance of mindfulness meditation in supporting people to live well with dementia. Research limitations/implications – The evidence is not yet conclusive; however, there is nevertheless a growing body of evidence which suggests that this is a fruitful area for further research. Practical implications – There are numerous implications for practice: if sufficient self-reported benefit from the application of mindfulness to people with dementia to warrant this being offered more generally. If further research substantiates the quality of life benefits then this could be an important development to accompany early diagnosis of dementia. If mindfulness were found to have a preventative effect then that would be of huge practical importance. Social implications – Mindfulness gives people more control of their emotional and thought processes and therefore this could be a significant development for empowering people with dementia and their carers. Originality/value – This is one of the first times that the literature regarding mindfulness and dementia has been reviewed in a systematic way. [ABSTRACT FROM AUTHOR]

In recent years, there has been an increasing interest in researching ageing ethnic minority populations in the West. However, older people from such minority communities have received comparatively little attention in wide-ranging discussions on appropriate research methodologies. By a process of critically reflecting on our experiences of undertaking fieldwork for our Economic and Social Research Council New Dynamics of Ageing study of ‘Families and Caring in South Asian Communities', this paper maps out the key methodological and ethical challenges we faced and, in the process, highlights the importance of developing socially appropriate research methodologies and ethical frameworks for research with such populations. With a reflexive approach, we specifically explore the significance of gender, age, time and space to the fieldwork processes and the ‘field’ relationships formed at various stages of the research process. In particular, we explore three key emergent issues which conflicted with our formal research protocols and presented particular challenges for us and our older Pakistani Muslim participants: (a) structuring of time in daily life; (b) gendered use of public and private spaces; and (c) orality of informal social contexts and relationships. Using illustrations from our fieldwork which reveal the particular significance of these issues to our fieldwork experiences and performativities of public/private identities, we highlight important tensions between formalised ethical and methodological dimensions of conducting funded research and the realities of being in ‘the field’. We conclude the paper by emphasising the need to explore further not only the ways in which researchers can adopt more socially and culturally sensitive data collection processes and methodologies at the micro level of their interactions with research participants, but also contextualising the particular challenges experienced by researchers and their participants in terms of the wider research frameworks and agendas as well as the broader social contexts within which they live and work. [ABSTRACT FROM PUBLISHER]

Research on minority ethnic ageing remains a neglected area within mainstream race and ethnicity studies as well as that of social gerontology. This paper examines the background and reasons for this, arguing that a focus on minority ethnic issues provides a reminder of the complexity of the lifecourse, and of the diversity of ageing as a cultural, economic and social construction. The discussion reviews definitions of ethnicity and their relevance to work in social gerontology. The paper provides an account of early studies of minority ethnic ageing, identifying the strengths and limitations of this research. Later work is then considered, notably that focusing on issues connected with the rise of transnational communities and the changing character of neighbourhoods in urban environments. The paper argues that developing research on minority ethnic ageing has become especially important for understanding the impact of globalisation on re-defining communities, relationships and identities, within and beyond nation states. Globalisation, it is suggested, can be seen as a product of the movement of ethnic groups; equally, ethnic groups are themselves transformed by the possibilities created by global change. The paper concludes with a number of suggestions for embedding work on ethnicity within research in social gerontology. [ABSTRACT FROM PUBLISHER]

Purpose - The purpose of this paper is to expand upon the Intergenerational Foundation (IF) presentation given at the "Portraying of Ageing" conference, which was organised by the British Library and held in London in April 2014. Design/methodology/approach - Changing demographics, wealth distribution, government debt and voting patterns are examined in order to question whether current government policy should continue to protect older generations at the expense of younger and future generations. Findings - IF provides statistically robust evidence that, in spite of increasing wealth, older generations continue to be protected by government policy while younger generations are targeted for cuts from liabilities built up, but not paid for, by previous generations. Social implications - Government policy may have tipped too far in favour of older wealthier cohorts, many of whom receive automatic benefits based on reaching a certain age. Governments should consider replacing age as a proxy for need with means-testing in order to rebalance benefits more fairly across the generations. Originality/value - There have been limited research studies comparing the incidence of wealth amongst older generations and the scale of liabilities being passed on to younger and future generations. This paper will be of value to policy-makers interested in rebalancing the interests of all generations more equitably. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to highlight some of the benefits and issues relating to arts participation in later life. Design/methodology/approach - The paper draws on literature relating to older people's arts participation, and also includes discussion of the author's doctoral research into arts and ageing. The research was a qualitative study, influenced by narrative approaches and life-course perspectives. It involved interviews with 24 participants who have connections with a case-study town in the English Midlands. Findings - The paper focuses on the findings from six participants belonging to a male voice choir. The themes that are discussed include the importance of continuity; issues of identity; mutual support; impact of ill health and the sustainability of group activities. Research limitations/implications - This is a small-scale study, based in one case study town. Care should therefore be taken in generalising to different populations and areas. Potential for future research includes: other geographical locations, including larger urban areas. Specific focus on choir participation, or other art form. Involving people from a wider range of ethnic backgrounds. Social implications - This study adds to a growing body of evidence about the value of arts and culture to society. Originality/value - This study is original in adopting life-course perspectives to understand later life arts participation. It also offers original insights into the nature of arts-generated social capital and how this may be viewed within a wider context of resourceful ageing. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to highlight the strategic role of housing for older people and how it can address some of the key challenges facing politicians. The paper aims to encourage decision-makers and service providers to collaborate in new ways locally. Design/methodology/approach - The paper seeks to highlight the strategic role of housing for older people and how it can address some of the key challenges facing politicians. It aims to encourage decision makers and service providers to collaborate in new ways locally. Findings - The paper argues that: Housing for older people is rising up the political agenda, but as a niche issue rather than one of strategic and economic importance. A multi-agency and outcomes-based approach to the wellbeing of older people, based on place-shaping principles, needs to be mainstreamed locally. Older people have not escaped the impact of austerity measures and this has heightened the need for a range of high quality housing options, in supportive communities, in later life. Good housing options for older people could address the key issues vexing politicians, but there are obstacles to older people accessing such options. Originality/value - The paper suggests a radical, systemic approach is required to ensure better outcomes for older people and, in turn, to generate savings for the public purse. [ABSTRACT FROM AUTHOR]

Purpose - Increasing longevity, while welcome, has far-reaching implications for the social contract between generations. These include eye-watering costs for health and social care, intense pressure on the old-age dependency ratio, changing power relations in politics and voting, and increasing pressure on in-work families. In a period of austerity, policy makers have chosen to protect older generations' benefits and paid for this by slashing benefits for the young, in spite of growing evidence that wealth distribution has changed with older generations becoming wealthier than once thought. The paper concludes that age alone can no longer be used as a proxy for need. The paper aims to discuss these issues. Design/methodology/approach - This discussion paper uses original quantitative research and analysis undertaken by the Intergenerational Foundation (IF) (www.if.org.uk) which includes Freedom of Information requests to government departments. It brings together the think tank's research into demographics, ageing, policy, government debt and liabilities, benefit reform and spending patters in order to investigate the changing distribution of wealth across the generations. Findings - It is clear that with changing distributions of wealth that age alone can no longer be used as a proxy for need. While older generations are becoming wealthier younger generations are becoming increasingly burdened by debt, with poorer prospects and being asked to maintain the current status quo. Originality/value - The paper contains original research conducted by the IF (www.if.org.uk) into spending patterns across the generations and annual public sector pensions. [ABSTRACT FROM AUTHOR]

Background/objectives: Sedentary behavior (SB), defined as sitting (nonexercising), reclining, and lying down (posture), or by low energy expenditure, is a public health risk independent to physical activity. The objective of this systematic literature review was to synthesize the available evidence on amount of SB reported by and measured in older adults. Data source: Studies published between 1981 and 2014 were identified from electronic databases and manual searching. Large-scale population studies/surveys reporting the amount of SB (objective/ subjective) in older adults aged ≥ 60 years of age were included. Appraisal and synthesis was completed using MOOSE guidelines. Results: 349,698 adults aged ≥ 60 within 22 studies (10 countries and 1 EU-wide) were included. Objective measurement of SB shows that older adults spend an average of 9.4 hr a day sedentary, equating to 65-80% of their waking day. Self-report of SB is lower, with average weighted self-reports being 5.3 hr daily. Within specific domains of SB, older adults report 3.3 hr in leisure sitting time and 3.3 hr watching TV. There is an association with more time spent in SB as age advances and a trend for older men to spend more time in SB than women. Conclusion/ implications: Time spent sedentary ranges from 5.3-9.4 hr per waking day in older adults. With recent studies suggesting a link between SB, health, and well-being, independent of physical activity, this is an area important for successful aging. Limitations: Different methodologies of measurement and different reporting methods of SB made synthesis difficult. Estimated SB time from self-report is half of that measured objectively; suggesting that most self-report surveys of SB will vastly underestimate the actual time spent in SB. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to extensively report the implications of the global trend of declining fertility rates and an increasingly ageing population. The experiences of childless men are mostly absent from gerontological, psychological, reproduction, and sociological, research. These disciplines have mainly focussed on family formation and practices, whilst the fertility intentions, history, and experience of men have been overlooked. Not fulfilling the dominant social status of parenthood provides a significant challenge to both individual and cultural identity. Distress levels in both infertile men and women have been recorded as high as those with grave medical conditions.Design/methodology/approach The aim of this paper is to provide some insight into the affect involuntarily childless has on the lives of older men. This auto/biographical qualitative study used a pluralistic framework drawn from the biographical, feminist, gerontological, and life course approaches. Data were gathered from in-depth semi-structured biographical interviews with 14 self-defined involuntary men aged between 49 and 82 years from across the UK. A broad thematic analysis highlighted the complex intersections between involuntary childlessness and agency, biology, relationships, and socio-cultural structures.Findings Diverse elements affected the men’s involuntary childlessness: upbringing, economics, timing of events, interpersonal skills, sexual orientation, partner selection, relationship formation and dissolution, bereavement, and the assumption of fertility. The importance of relationship quality was highlighted for all the men: with and without partners. Quality of life was affected by health, relationships, and social networks. Awareness of “outsiderness” and a fear of being viewed a paedophile were widely reported.Research limitations/implications This is a study based on a small self-selecting “fortuitous” sample. Consequently care should be taken in applying the findings to the wider population.Originality/value Health and social care policy, practice and research have tended to focus on family and women. The ageing childless are absent and excluded from policy, practice, and research. Recognition of those ageing without children or family is urgent given that it is predicted that there will be over two million childless people aged 65 and over by 2030 (approximately 25 per cent of the 65 and over population). The consequences for health and social care of individuals and organisations are catastrophic if this does not happen. [ABSTRACT FROM AUTHOR]

Housing options for older people in the United Kingdom (UK) have been rather limited to remaining living 'independently' in one's own home and some variant of institutionally provided, pre-established and age-exclusive housing such as retirement communities, extra-care or sheltered housing. However, interest in alternative forms of housing and living which align more closely with the expectations of those currently entering later life is steadily growing. In this paper, we present some findings from original, mixed-methods research on the UK's only established example of senior co-housing, which also happens to be women only. Through thematic analysis, we explore two key questions about this important social experiment: (a) is this a model merely for the dedicated, activist and privileged few, as is often presumed; and (b) what might it tell us about post-traditional ageing. Is it merely a retirement lifestyle choice and identity project, grounded in logics of age denial, activity, choice, individualism and risk management? Our findings cannot be conclusive at this stage, but they do suggest a new model of later-life dwelling for the UK based on more collectivist values of inter-dependence, commitment, learning and, even, love. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide qualitative evidence from the experience of Chinese service users in the UK to expand the literature on the use of intersectionality analysis in research on the mental health of ethnic minority groups.Design/methodology/approach Repeated in-depth life-history interviews were carried out with 22 participants. Interviews were analysed using the constant comparative method.Findings Four areas of life are identified for their possible negative impact on mental health for this minority group: labour market and work conditions, marriage and family, education, and ageing. The findings illustrate how these intersecting variables may shape the social conditions this ethnic minority group face. For this ethnic minority group in the UK, inequalities can intersect at national as well as transnational level.Originality/value This paper highlights how power relations and structural inequalities including class, gender, age and ethnicity could be drawn upon to understand the interplay of determinants of mental health for ethnic minority groups. As the multi-factorial social forces are closely related to the emergence of poor mental health, it is suggested that interventions to reduce mental health problems in ethnic minority communities should be multi-level and not limited to individualised service responses. [ABSTRACT FROM AUTHOR]

Projections suggest that in 50 years' time there will be an additional 8.6 million people over 65 years old in the UK. As a consequence, England will see an increase in older people who have higher levels of dependency, dementia, and comorbidity. People living with dementia are likely to have on average, an additional 4.6 chronic conditions. However, the true extent of comorbidities experienced by people with dementia may be unreported and underdiagnosed as a result of their difficulties in communicating their symptoms or in others failing to observe them. There is evidence to suggest that people with dementia are less likely to access effective treatment and monitoring of their comorbid conditions compared to people without dementia who have the same comorbid conditions. This impacts negatively on their health and wellbeing. This second paper of the series relating to dementia considers some of the complications that may arise when trying to support people with dementia and comorbid conditions, and how this impacts upon the two families introduced in the first paper. [ABSTRACT FROM AUTHOR]

Purpose: A decline in participation in research studies as people age is inevitable as health declines. This paper aims to address this by collecting data from a group of participants to examine their reasons for declining attendance and suggestions for maintaining attendance as participants age. Design/methodology/approach: This research used a postal self-completed questionnaire including open and closed questions. The questionnaire was sent to those participants who have declined to attend further clinic visits. Results were analysed using thematic content analysis. Findings: The study had a 51% response rate. Participants reported difficulty with travelling to the clinic, and health as the main issues in addition to family demands and a lack of understanding regarding the continuing participation of a singleton twin. Research limitations/implications: This study could only include data from responding participants, answers to open question also included comments from participants regarding their twin. Practical implications: An anonymous questionnaire was sent to all individuals in the Keeping Together project. It was therefore not possible to identify if responses were from both members of a twin pair. Originality/value: Maintaining participation in longitudinal studies is of crucial importance to enhance the value of data. Retention of participants in studies may change as people age and health becomes impaired. Suggestions for maintaining and improving the retention of older participants have been identified and are generalisable to other longitudinal studies of ageing. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider the likely needs and priorities of the 1960s baby boomers in later life (defined as those born in this country between 1960 and 1969 inclusive), based on their characteristics outlined in the accompanying paper. Design/methodology/approach: A non-systematic search of academic and grey literature plus key policy and statistical data from sources including the Office for National Statistics to identify studies and data relevant to people born in the 1960s in the UK. Findings: The 1960s baby boomers are characterised by high levels of education and technological proficiency and a youthful self-image. They have longer working lives and display greater levels of consumption than previous cohorts. These attributes will likely make this a highly demanding group of older people. Maintaining their health and function is important to this group so there is a scope for products that enable active and healthy ageing. Relatively high levels of childlessness may give rise to innovative housing solutions. At the same time, products that help the baby boomers stay independent at home will help alleviate pressure on social care. Originality/value: There has been little examination of the needs of the 1960s baby boomers in the UK. Given that they stand on the brink of later life, it is timely to consider their likely needs as older people. In view of the size of this cohort, this group's requirements in later life provide a significant opportunity for businesses to fill the current gaps in the market. Moreover, in the context of increasing neoliberalism, innovations that reduce the dependence of this large cohort on the state and facilitate self-reliance will benefit individuals and society. [ABSTRACT FROM AUTHOR]

The current generation of older people who are approaching or recently experiencing retirement form part of a unique generational habitus who have experienced a cultural shift into consumerism. These baby boomers are often portrayed as engaging in excessive levels of consumption which are counter to notions of sustainable living and to intergenerational harmony. This paper focuses on an exploration of the mechanisms underpinning the consumption patterns of baby boomers as they retire. We achieve this through an understanding of the everyday practices of grocery shopping which have the potential to give greater clarity to patterns of consumption than the more unusual or ‘extraordinary’ forms of consumption such as global travel. In-depth interviews with 40 older men and women in four locations across England and Scotland were conducted at three points in time across the period of retirement. We suggest that the grocery shopping practices of these older men and women were influenced by two factors: (a) parental values and upbringing leading to the reification of thrift and frugality as virtues, alongside aspirations for self-actualisation such as undertaking global travel, and (b) the influence of household context, and caring roles, on consumption choices. We conclude with some tentative observations concerning the implications of the ways baby boomers consume in terms of increasing calls for people to live in more sustainable ways. [ABSTRACT FROM AUTHOR]

This paper considers the lack of choice in sheltered housing and residential/nursing care provision for older lesbian, gay and bisexual ( LGB) individuals in the UK. While there is a growing body of knowledge about their concerns about current options, the precise kinds of alternative provision which older LGB individuals would prefer are not yet well understood. This article reports on a qualitative study conducted in 2012 which aimed to explore ageing, gender and sexuality from an equalities perspective. The study deployed semi-structured interviews with 60 older LGB individuals living in the UK, and used a thematic analysis approach to the data. This paper describes one aspect of the data, relating to participants' concerns about health and social care provision. The analysis identified several key themes underpinning older LGB individuals' concerns about mainstream sheltered accommodation and residential care, namely: lack of visibility, risky visibility, unequal openness and compulsory co-occupation of care spaces. It highlights the significance of gender for housing/care preferences, with a greater proportion of older LGB women wanting gender- and/or sexuality-specific provision compared with men. The social policy, equality and human rights implications of these findings are considered. [ABSTRACT FROM AUTHOR]

With increasing numbers of older migrants adopting a transnational lifestyle or returning to their country of origin following retirement, the sense of attachment to and identification with the places they inhabit remains an under explored field of enquiry. Through an ethnographic approach, this paper seeks to raise awareness of the diversity within a group of older migrants, given the heterogeneity of affective bonds established with places. By highlighting the perspective of older Italian migrants living in Newcastle upon Tyne, UK, this paper illustrates the role of a sense of identification with the context of migration in later life. In referring to migration as a process of transformation, some older Italians re-define their identities, as these become interwoven with the characteristics of the places in which they grow older. However, older migrants' sense of attachment to places also reveals the complexity of aging in the context of migration, when a sense of identification with these is never fully achieved in older age. This paper argues that the notion of aging that these older Italian migrants uphold is not only altered by their experience of migration, but also shaped through their identification with the places they inhabit, given formal and informal practices of identification. Thus, by addressing the determinants for a positive experience of aging in the context of migration, this paper challenges the ways in which older migrant groups are conceptualized in gerontological scholarship., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: This paper describes the development of a novel mobile health (mHealth) educational intervention, called m2Hear, designed for first-time hearing aid users based on previously developed educational multimedia videos, or reusable learning objects (RLOs), branded C2Hear. Design: The development of m2Hear used theoretical and ecologically valid approaches. The COM-B model and associated Theoretical Domains Framework were employed to identify specific components (or "active ingredients") of the original RLOs that facilitate hearing aid use. An mHealth platform was then developed following an iterative, user-centred and participatory design approach. Study sample: Fifteen existing hearing aid users completed synchronous, real-time Think Aloud interviews. A sub-group of these participants (n = 5), along with patient and public involvement panel members (n = 4), subsequently reviewed the usability of the mHealth platform. Results: While factors associated with Capability featured strongly across all RLOs, topics relating to Opportunity and Motivation were also incorporated. The RLOs were broken-down into 42 shorter mobile-enhanced RLOs (or mRLOs). Each mRLO was labelled with a specific user-centred question generated from the Think Aloud interviews. The final mHealth platform was developed following four separate usability iterations. Conclusions: Overall, m2Hear provides greater opportunities for individualised learning and encourages greater interaction to facilitate self-management in first-time hearing aid users. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data. Design/methodology/approach: Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried's phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England. Findings: A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population. Originality/value: To the best of authors' knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH. [ABSTRACT FROM AUTHOR]

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts' suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore. [ABSTRACT FROM AUTHOR]

Prison populations across the world are increasing. In the United Kingdom, numbers have doubled in the last two decades, and older prisoners now constitute the fastest growing section of the prison population. One key reason for this shifting prisoner demographic is the growing numbers of men convicted of 'historic' sexual offences, many of whom are imprisoned for the first time in old age, and housed in prisons not suited to their needs. These demographic changes have profound consequences, including increased demand for health and social care in prison, and rising numbers of anticipated deaths in custody. Using the findings from a recently completed study of palliative care in prison, this paper proposes that older prisoners face a 'double burden' when incarcerated. This double burden means that as well as being deprived of their liberty, older people experience additional suffering by not having their health and wellbeing needs met. For some, this double burden includes a 'de facto life sentence', whereby because of their advanced age and the likelihood that they will die in prison, they effectively receive a life sentence for a crime that would not normally carry a life sentence. There has been little popular or academic debate concerning the ethical and justice questions that this double burden raises. Drawing on the work of Wacquant and others, the paper proposes that these changes are best understood as unplanned but reasonably foreseeable consequences of neoliberal penal policies. Although the paper focuses on the UK (which by comparison with other European countries has high rates of imprisonment), many of the challenges discussed are emerging in other countries across the world. This paper illustrates starkly how neoliberal policies and discourses have shaped the expansion and composition of the prison population with its consequent implications for health and justice., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Our sense of belonging rarely stands still, yet the research literature has hitherto paid little attention to the temporal nature of belonging. Based on an analysis of 62 Mass Observation Project (MOP) accounts written by people living in the UK aged from their 20s to their 90s, this paper argues that as people age, how they locate belonging in time shifts. This has to do with changing concerns related to belonging, but also to metaphysical issues of temporality and mortality, namely how people experience their own finite lifetime. The paper thus offers an illustrative example of how time can be empirically researched in sociology, with a particular focus on the important role that the future plays in how people construct their 'functional present' (Mead ). The central argument put forward is that time itself can be an important source of belonging, but one that is unequally accessible to people of different ages because of contemporary cultural scripts that present life as a linear progression into the future and construct the future as a more meaningful temporal horizon than the past., (© London School of Economics and Political Science 2017.)

Background: legislation places an onus on local authorities to be aware of care needs in their locality and to prevent and reduce care and support needs. The existing literature overlooks ostensibly 'healthy' and/or non-users of specific services, non-health services and informal assistance and therefore inadequately explains what happens before or instead of individuals seeking services. We sought to address these gaps by exploring older adults' accounts of seeking assistance in later life., Methods: we conducted semi-structured qualitative interviews with 40 adults aged 68-95. We invited participants to discuss any type of support, intervention, or service provision, whether medical, social, family-provided, paid or unpaid., Findings: this paper reports older people's accounts of how they evaluated their need for assistance. We found that the people in our sample engaged in a recursive process, evaluating their needs on an issue-by-issue basis. Participants' progression through this process hinged on four factors: their acknowledgement of decline; the perceived impact of decline on their usual activities and independence; their preparedness to be a recipient of assistance; and, the opportunity to assert their need. In lieu of seeking assistance, participants engaged in self-management, but also received unsolicited or emergency assistance., Conclusions: older people's adaptations to change and attempts to meet their needs without assistance mean that they do not present to services, limiting the local authority's knowledge of their needs and ability to plan appropriate services. Our findings offer four stages for policymakers, service providers and carers to target to address the uptake of assistance.

Background: Anxiety and depression are common among older people, with up to 20% reporting such symptoms, and the prevalence increases with co-morbid chronic physical health problems. Access to treatment for anxiety and depression in this population is poor due to a combination of factors at the level of patient, practitioner and healthcare system. There is evidence to suggest that older people with anxiety and/or depression may benefit both from one-to-one interventions and group social or educational activities, which reduce loneliness, are participatory and offer some activity. Non-traditional providers (support workers) working within third-sector (voluntary) organisations are a valuable source of expertise within the community but are under-utilised by primary care practitioners. Such a resource could increase access to care, and be less stigmatising and more acceptable for older people., Methods: The study is in three phases and this paper describes the protocol for phase III, which will evaluate the feasibility of recruiting general practices and patients into the study, and determine whether support workers can deliver the intervention to older people with sufficient fidelity and whether this approach is acceptable to patients, general practitioners and the third-sector providers. Phase III of the NOTEPAD study is a randomised controlled trial (RCT) that is individually randomised. It recruited participants from approximately six general practices in the UK. In total, 100 participants aged 65 years and over who score 10 or more on PHQ9 or GAD7 for anxiety or depression will be recruited and randomised to the intervention or usual general practice care. A mixed methods approach will be used and follow-up will be conducted 12 weeks post-randomisation., Discussion: This study will inform the design and methods of a future full-scale RCT., Trial Registration: ISRCTN, ID: ISRCTN16318986 . Registered 10 November 2016. The ISRCTN registration is in line with the World Health Organization Trial Registration Data Set. The present paper represents the original version of the protocol. Any changes to the protocol will be communicated to ISRCTN.

The aging of the population, together with the need for more inclusive and responsive policies and services, has contributed to a burgeoning interest in co-production and co-research with older people. To date, however, only a limited number of studies have addressed how the participation of older persons as research partners can be practically realized in community-based research. The purpose of this article is to provide insights into the process of co-producing a research project with older residents living in low-income neighborhoods in Manchester, United Kingdom. The project was unique in involving and training eighteen older people as co-researchers who took a leading role in all phases of a study aimed at developing "age-friendly" communities. The co-researchers also completed 68 interviews with residents aged 60 and over who were experiencing social isolation within their neighborhood. This paper describes the methodological approach developed for the study together with a description of the recruitment and training of co-researchers. It then presents findings based upon four reflection meetings with the co-researchers, focusing on their motivations for working on the project and their relationship with the interviewees. The article concludes with a discussion of the implications of the findings for developing co-production work with older people in age-friendly research, policy and practice., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Aims: This study is the first to systematically document histological features of fractures of known age in infants (≦12 months). It has been used to develop a tabulated database specifically to guide histopathologists to age fractures in children considered to have suffered accidental or non‐accidental injury (NAI). Currently in the United Kingdom there are insufficient pathologists with experience in histological ageing of fractures to meet the medicolegal need for this examination. This study provides a practical tool that will allow those skilled paediatric and forensic pathologists currently involved in assessing infants for evidence of accidental or non‐accidental injury a basis for extending their assessment into this area of unmet need. Methods and results: One hundred and sixty‐nine fractures of known age at death were obtained from 52 anonymised infants over a period of 32 years (1985–2016 inclusive). Sections stained using haematoxylin and eosin (H&E) and Martius scarlet blue (MSB) were used to identify specific histological features and to relate them to fracture age. In 1999 the data were entered into a tabulated database for fractures accumulated between from 1985 to 1998 inclusive. Thereafter cases were added, and at 2‐yearly intervals the accumulated data were audited against the previous database and adjustments made. Conclusions: This paper describes the final data set from the 2017 audit. The study was terminated at the end of 2016, as there had been no material changes in the data set for three consecutive audits. [ABSTRACT FROM AUTHOR]