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Introduction: In Australia, there is a unique cohort of older (aged 60 and over) lesbian women and gay men who reached adolescence from as early as the 1940s up until the 1970s. Many have witnessed numerous social changes regarding the acceptance of lesbian and gay people in general society. Given the uniqueness of this cohort, it is important to have a comprehensive understanding of the histories of this group and how they perceive their lives today. Methods: This paper utilises the Iridescent Life-Course Perspective as a framework and draws on semi-structured interviews from 33 lesbian women and gay men aged 60 years and older residing in Australia to explore their reflections and perspectives on their lives from their younger years to today. Results: Participants recounted challenging coming out processes, relationship breakdowns, significant loss due to the HIV/AIDs epidemic, and experiences of discrimination. Despite this, participants on-the-whole expressed gratitude for the opportunity to age where they could reflect on their lives, as well as greater confidence and self-esteem. Conclusions: While older lesbian women and gay men experienced severe discrimination in their lives, they also demonstrated a degree of resilience, with many referring to gratitude and contentment in their lives. Policy Implications: Knowing the challenges as well as aspects of resilience is important for understanding how older lesbian and gay adults are experiencing life today. This is particularly important for policymakers and service providers in designing support programs that address challenges, build on strengths and seek to be fully inclusive and respectful of the diversity of the past and current life experiences of this population. [ABSTRACT FROM AUTHOR]

In this paper, we argue that the biggest challenge facing an Ageing Australia is care, specifically, the labour shortages in the care industry and the high demand for care, which exceeds the supply. We propose that this situation has arisen out of the extremely divergent discourses about the need for care, from feminist to neoliberal, managerialist responses. The aged care context in Australia is predominantly female, because women live longer than men, and 90% of formal and informal carers are women. We therefore see the continuing relevance of a gendered view of care and believe that the feminist ethics of care is a theory which offers much to our understanding of ageing in Australia. To illustrate key issues for older people and their families within the aged care system in Australia, a case study is presented and referred to throughout the paper. [ABSTRACT FROM AUTHOR]

A scoping review was undertaken to examine current Australian federal, state and territory government health policy documents to ascertain their relevance to midlife and older adult sexual health. It was found that the sexual health of midlife and older adults was not specifically referred to in most documents reviewed. Existing policy has a focus on risk, not wellbeing, in relation to sexual health, and an emphasis on reproduction, which excludes midlife and older people. This paper provides evidence of absence of sexual health policy relating to the needs of midlife and older adults in Australia. Without a policy that specifically addresses the sexual health of midlife and older adults, they will continue to be overlooked in health promotion planning and sexually transmissible infection testing strategies. We recommend the development of Australian sexual health policy that supports and promotes good sexual relationships and sexual health specific to the needs of midlife and older adults. [ABSTRACT FROM AUTHOR]

This paper describes differences in subjective social support between older male Italian-born immigrants in Australia and their Australian-born counterparts. Data came from 335 Italian-born and 849 Australian-born men aged 70 years and over who participated in the baseline phase of the Concord Health and Ageing in Men Project (CHAMP) in inner suburban Sydney, Australia. Social support was measured using the shortened (11 item) version of the Duke Social Support Index (DSSI). This index measures both social interactions and expressive social support. Logistic regression was used to examine differences in subjective social support between the two groups of men after controlling for other related factors. Italian-born men were about twice as likely to report low subjective social support compared to Australian-born men (unadjusted odds ratio (OR) = 1.8, p = 0.0002). This difference remained after adjustment for sociodemographic, socioeconomic, social network and health factors (adjusted OR = 2.1, p = 0.0007). Italian-born men were more likely to report that they had no non-family members in the local area to rely on. However, lack of non-family supports did not remain significantly associated with perceived social support after adjustment for social interactions and depressive symptoms. Italian-born men were more likely to report low subjective support despite the presence of several protective factors such as a greater number of local family supports and a high rate of home ownership. [ABSTRACT FROM AUTHOR]

This is the first study to investigate instrumental activities of daily living in older autistic adults. We conducted interviews with fifteen adults (mean age = 60.1, SD = 7.4, range = 50–73) from Australia with no intellectual disability. Analysis included both deductive and inductive steps, to categorise responses using the Occupational Performance Model Australia and identify themes across participants' experiences. Strengths and challenges were unique to the individual, as were the methods they had developed to manage tasks. Challenges occurred mostly at the interaction between aspects of the environment (sensory, cognitive, social and cultural) and personal factors such as health conditions and sensory sensitivities. Enhanced person-environment fit is needed, as is a shift in wider sociocultural attitudes to enable comfort and autonomy in later life. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) is an important outcome measure when considering medical treatment; however, the impact of polypharmacy on trajectories of HRQoL over time is unknown. This study aimed to investigate the association between polypharmacy status and trajectories of HRQoL in older adults. Methods: A longitudinal cohort study of 2181 community-dwelling adults, 65 years and older, who participated in the 2013 to 2017 waves of the Household Income and Labour Dynamics in Australia (HILDA) Survey. Polypharmacy was defined as the regular use of ≥ 5 prescription medications. Polypharmacy status was categorised into no polypharmacy, in 2013 only (baseline only polypharmacy), in 2017 only (incident polypharmacy) or at both time points (persistent polypharmacy). HRQoL was assessed through the SF-36 questionnaire generating two summary scores: physical component summary (PCS) and mental component summary (MCS). Linear mixed-effects models stratified according to polypharmacy status and change in comorbidities were used to assess trajectories of HRQoL. Results: Older adults with persistent polypharmacy had lowest scores for HRQoL measures from 2013 to 2017. After adjusting for all covariates, those with incident polypharmacy had the steepest annual decline in both the PCS and MCS: − 0.86 in PCS and − 0.76 in MCS for those with decreasing or stable comorbidities, and − 1.20 in PCS and − 0.75 in MCS for those with increasing comorbidities. Conclusions: Polypharmacy was associated with poorer HRQoL, even after adjusting for confounders. Incident polypharmacy was found to be associated with a clinically important decline in HRQoL and this should be considered when prescribing additional medication to older adults. [ABSTRACT FROM AUTHOR]

Background: Older people use many medications, but combinations of medications used among the oldest old (≥ 80 years) are not commonly reported. Aims: This study aimed to determine common combinations of medications used among women aged 77–96 years and to describe characteristics associated with these combinations. Methods: A cohort study of older women enroled in the Australian Longitudinal Study on Women's Health over a 15-year period was used to determine combinations of medications using latent class analysis. Multinomial logistic regression was used to determine characteristics associated with these combinations. Results: The highest medication users during the study were for the cardiovascular (2003: 80.28%; 2017: 85.63%) and nervous (2003: 66.03%; 2017: 75.41%) systems. A 3-class latent model described medication use combinations: class 1: 'Cardiovascular & neurology anatomical group' (27.25%) included participants using medications of the cardiovascular and nervous systems in their later years; class 2: 'Multiple anatomical group' (16.49%) and class 3: 'Antiinfectives & multiple anatomical group' (56.27%). When compared to the reference class (class 1), the risk of participants being in class 3 was slightly higher than being in class 2 if they had > 4 general practitioner visits (RRR 2.37; 95% CI 2.08, 2.71), Department of Veterans Affairs' coverage (RRR 1.59; 95% CI 1.36, 1.86), ≥ 4 chronic diseases (RRR 3.16; 95% CI 2.56, 3.90) and were frail (RRR 1.47; 95% CI 1.27, 1.69). Conclusion: Identification of combinations of medication use may provide opportunities to develop multimorbidity guidelines and target medication reviews, and may help reduce medication load for older individuals. [ABSTRACT FROM AUTHOR]

Purpose: The influence of social capital has been shown to improve health and wellbeing. This study investigates the relationship between changes in social capital and health outcomes during a 6-year follow-up in mid to later life in Australia.Methods: Nationally representative data from the Household, Income and Labour Dynamics in Australia (HILDA) survey included participants aged 45 years and over who responded in 2006, 2010 and 2012 (N = 3606). Each of the three components of social capital (connectedness, trust and participation) was measured in Waves 2006 and 2010 and categorised as: 'never low', 'transitioned to low', 'transitioned out of low' and 'consistently low'. Health outcomes in 2012 included self-rated overall health, physical functioning, and mental health based on the Short Form 36-item health survey (SF-36). Multivariable logistic regression assessed changes in social capital (measured in 2006 and 2010) predicted poor health (measured in 2012), adjusting for covariates.Results: Consistently low trust was significantly associated with higher odds of transitions into poor physical functioning (AOR 1.54; 95% Confidence Interval 1.06-1.22), poor mental health (AOR 1.59; 95% CI 1.08-2.36) and poor self-rated health (AOR 1.86; 95% CI 1.27-2.72). Transition into low trust was also a predictor of poor self-rated health after adjusting for covariates (AOR 1.74; 95% CI 1.11-2.73). Changes in social connectedness in both directions (transitioned out of and into low) were statistically associated with poor self-rated health (AORs 1.40; 95% CI 1.00-1.97 and 1.61; 95% CI 1.11-2.34, respectively) after adjusting for confounders as well as other social capital components.Conclusions: Our longitudinal findings reveal social capital dynamics and effects on health in mid to later life. Social trust and connectedness could be important enablers for older persons to be more active in the community and potentially benefit their health and wellbeing over time. [ABSTRACT FROM AUTHOR]

Purpose: Telomere length is a biomarker of cellular ageing, with longer telomeres associated with longevity and reduced risk of chronic disease in older age. Consumption of a healthy diet may contribute to longevity via its impact on cellular ageing, but studies on diet and telomere length to date have been limited and their findings equivocal. The aim of this study was to examine associations between three indices of diet quality and telomere length in older men and women.Methods: Adults aged 57–68 years participating in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 679), completed a postal survey including an 111-item food frequency questionnaire in 2012. Diet quality was assessed via three indices: the Dietary Guideline Index, the Recommended Food Score, and the Mediterranean Diet Score. Relative telomere length was measured by quantitative polymerase chain reaction. Associations between diet quality and telomere length were assessed using linear regression adjusted for covariates.Results: After adjustment for age, sex, education, smoking, physical activity, and body mass index (BMI), there were no significant associations between diet quality and relative telomere length.Conclusions: In a sample of older adults residing in Victoria, Australia, men and women aged 57–68 years with better-quality diets did not have longer telomeres. Further investigation in longitudinal studies will determine whether diet can influence telomere length over time in an ageing population. [ABSTRACT FROM AUTHOR]

Age-related loss of skeletal muscle is associated with increased risk of functional limitation and cardiovascular (CV) mortality. In the elderly abdominal aortic calcification (AAC) can increase CV risk by altering aortic properties which may raise blood pressure and increase cardiac workload. This study investigated the association between low muscle mass and AAC in community-dwelling older Australians. Data for this cross-sectional analysis were drawn from a 2010 sub-study of the Melbourne Collaborative Cohort Study in the setting of community-dwelling older adults. Three hundred and twenty-seven participants [mean age = 71 ± 6 years; mean BMI = 28 ± 5 kg/m(2); females n = 199 (62 %)] had body composition determined by dual-energy x-ray absorptiometry (DXA) and AAC determined by radiography. Participants were stratified into tertiles of sex-specific BMI-normalised appendicular lean mass (ALM). Those in the lowest tertile were considered to have low relative muscle mass. Aortic calcification score (ACS) was determined visually as the extent of calcification on the aortic walls between L1 and L4 vertebrae (range: 0-24). Severe AAC was defined as ACS ≥ 6. Prevalence of any AAC was highest in participants with low relative muscle mass (74 %) compared to the middle (65 %) and upper (53 %) tertiles (p trend = 0.006). The lower ALM/BMI tertile had increased odds (Odds ratio = 2.3; 95 % confidence interval: 1.1-4.6; p = 0.021) of having any AAC; and having more severe AAC (2.2; 1.2-4.0; p = 0.009) independent of CV risk factors, serum calcium and physical activity. AAC is more prevalent and severe in community-dwelling older adults with low relative muscle mass. Maintaining muscle mass could form part of a broader primary prevention strategy in reducing AAC. [ABSTRACT FROM AUTHOR]

Older people have justifiably been highlighted as a high-risk group with respect to heat wave mortality and morbidity. However, there are older people living within the community who have developed adaptive and resilient environments around their home that provide some protection during periods of extreme heat. This study investigated the housing stock and self-reported thermal comfort of a group of older people living in a regional town in Australia during the summer of 2012. The results indicated that daily maximum living room temperature was not significantly correlated with outdoor temperature, and daily minimum living room temperature was very weakly correlated with outdoor temperature. Residents reported feeling comfortable when indoor temperature approximated 26 °C. As living room temperature increased, indoor thermal comfort decreased. Significant differences between indoor temperatures were noted for homes that were related to house characteristics such as the age of the house, the number of air-conditioning units, the pitch of the roof, home insulation and the number of heat-mitigation modifications made to the home. Brick veneer homes showed smaller diurnal changes in temperature than other building materials. With population ageing and the increasing focus on older people living in the community, the quality of the housing stock available to them will influence their risk of heat exposure during extreme weather. [ABSTRACT FROM AUTHOR]

Local gambling venues are an important contemporary context for older people's gambling in many parts of the world typically being more accessible to this segment of the population than traditional, centralised gambling venues, such as casinos. This study, undertaken in South East Queensland, analyses older people's electronic gaming machine (EGM) behaviour and motivations, specifically in the context of licensed social and recreational clubs-a popular local gambling venue in many parts of Australia. The study gathered data via a postal survey of 80 managers of licensed clubs, interviews with Gambling Help services and a survey of 414 people aged 60+ who regularly play EGMs, self-administered on site at local clubs. The analysis undertaken suggests that certain age-related circumstances of older people- such as being without a partner, having a disability that impacts on everyday activities, having a low annual income, and no longer participating in the workforce-are associated with higher overall levels of motivation for playing EGMs and greater reliance on EGMs to meet social, recreational and mental health needs. Over a quarter of the older people surveyed (27%) reported drawing on their savings to fund their EGM gambling. Certain categories of older people, including those who were without a partner and those with a disability, were more likely to report drawing on their savings to fund EGM play and betting more than they could afford to lose, pointing to agerelated vulnerabilities older people may experience to the negative impacts of gambling given the greater likelihood of their dependency on smaller, fixed incomes. The explanatory contribution of a range of demographic and motivational variables on problem/moderate risk gambling status was computed via a logistic regression model. Younger age (60-69), male gender, single marital status and being motivated to play EGMs to experience excitement and to win money all emerged as significant predictors in the model. [ABSTRACT FROM AUTHOR]