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The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [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]

A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 30 years of clinical research and practice using the MNA® worldwide. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Population aging is an important and increasingly relevant area of study for demographers. A growing body of research seeks to determine how long-term changes in births, mortality, and migration—the three drivers of any demographic process—have shaped the present aging situation. Using variable-r decomposition and cohort data, this research note presents a formula for the change in the old-age dependency ratio to determine the extent to which relative changes in births, as well as in mortality and migration rates, contribute to aging. This perspective provides a careful and in-depth picture of aging and contributes to the debate concerning whether changes in births or mortality have had the strongest effect on population aging. When applied to Australia, the United States, and several European populations, the decomposition of the old-age dependency ratio shows that aging occurred in all populations and that changes in both births and mortality contributed to this aging. Analysis of these populations demonstrates that although they differed regarding which of these factors contributed more, changes in births prevailed as the more significant factor. In nearly all populations, migration decreased the rate of population aging. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to outline learning and good practice across Europe on the deployment of asset based approaches for promoting active ageing and intergenerational solidarity. Design/methodology/approach – The paper draws on a wide ranging review of good practice across Europe distilled from desktop analysis and two European roundtable sessions with key stakeholders. Findings – The paper analyses the current level of volunteering by older people across Europe and the evidence for its benefits to the health and wellbeing of older people. It then goes on to provide analysis and good practice regarding area and individual based asset approaches, as well those relevant to addressing the social exclusion faced by people with dementia. Practical implications – The analysis and good practice examples in the report provide resources for developing effective asset based approaches to promoting active ageing and intergenerational solidarity. Originality/value – The review of European experience is particularly original. There has been little if any European review of asset based approaches to active ageing and intergenerational solidarity. Learning from practice elsewhere enables more confident initiatives to be taken up and developed. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the level of awareness of prostate cancer (PCa) among the general public and PCa patients in Europe and North America. A survey was undertaken across four European countries (UK, Germany, Italy and Spain), and across the United States and Canada in late 2007. In total, 1008 men with PCa and their partners (the ‘prostate sample’), and 911 men without PCa and their partners (the ‘well sample’) participated in the survey, all aged 50 years. Interviews were conducted through telephone, pen and paper, and online. Many people surveyed (53%) thought that breast cancer is more common than PCa. Moreover, 1 in 10 people from the well sample (10%) thought that PCa affects both men and women. When the prostate sample was asked about their perceived level of risk of PCa before diagnosis, 50% believed that they/their husband or partner were previously at low or very low risk, before they were diagnosed. Awareness of the major risk factors for PCa (age and family history) was generally good, but respondents were less clear about the role of other potential factors, such as smoking and drinking alcohol. This international survey, thought to be largest of its type, shows that although patient and public awareness of PCa is generally satisfactory, there is still a considerable lack of clarity about PCa risk factors, and a danger for people to underestimate their own/their partner's perceived risk for PCa. Programmes to responsibly educate and inform men and their partners about risk factors, prevalence and screening tools for PCa are required. [ABSTRACT FROM AUTHOR]

Objectives: To extend existing research on the US health disadvantage relative to Europe by studying the relationships of disability with age from midlife to old age in the US and four European regions (England/Northern and Western Europe/Southern Europe/Eastern Europe) including their wealth-related differences, using a flexible statistical approach to model the age-functions. Methods: We used data from three studies on aging, with nationally representative samples of adults aged 50 to 85 from 15 countries (N = 48225): the US-American Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE). Outcomes were mobility limitations and limitations in instrumental activities of daily living. We applied fractional polynomials of age to determine best fitting functional forms for age on disability in each region, while controlling for socio-demographic characteristics and important risk factors (hypertension, diabetes, obesity, smoking, physical inactivity). Results: Findings showed high levels of disability in the US with small age-related changes between 50 and 85. Levels of disability were generally lower in Eastern Europe, followed by England and Southern Europe and lowest in Northern and Western Europe. In these latter countries age-related increases of disability, though, were steeper than in the US, especially in Eastern and Southern Europe. For all countries and at all ages, disability levels were higher among adults with low wealth compared to those with high wealth, with largest wealth-related differences among those in early old age in the USA. Conclusions: This paper illustrates considerable variations of disability and its relationship with age. It supports the hypothesis that less developed social policies and more pronounced socioeconomic inequalities are related to higher levels of disability and an earlier onset of disability. [ABSTRACT FROM AUTHOR]

Policy PointsCountries have adopted different strategies to support aging populations, which are broadly reflected in social, economic, and contextual environments. Referred to as "societal adaptation to aging," these factors affect countries' capacity to support older adults.Results from our study show that countries with more robust societal adaptation to aging had lower depression prevalence. Reductions in depression prevalence occurred among every investigated sociodemographic group and were most pronounced among the old‐old.Findings suggest that societal factors have an underacknowledged role in shaping depression risk. Policies that improve societal approaches to aging may reduce depression prevalence among older adults. Context: Countries have adopted various formal and informal approaches to support older adults, which are broadly reflected in different policies, programs, and social environments. These contextual environments, broadly referred to as "societal adaptation to aging," may affect population health. Methods: We used a new theory‐based measure that captured societal adaptation to aging, the Aging Society Index (ASI), which we linked with harmonized individual‐level data from 89,111 older adults from 20 countries. Using multi‐levels models that accounted for differences in the population composition across countries, we estimated the association between country‐level ASI scores and depression prevalence. We also tested if associations were stronger among the old‐old and among sociodemographic groups that experience more disadvantage (i.e., women, those with lower educational attainment, unmarried adults). Findings: We found that countries with higher ASI scores, indicating more comprehensive approaches to supporting older adults, had lower depression prevalence. We found especially strong reductions in depression prevalence among the oldest adults in our sample. However, we did not find stronger reductions among sociodemographic groups who may experience more disadvantage. Conclusions: Country‐level strategies to support older adults may affect depression prevalence. Such strategies may become increasingly important as adults grow older. These results offer promising evidence that improvements in societal adaptation to aging—such as through adoption of more comprehensive policies and programs targeting older adults—may be one avenue to improve population mental health. Future research could investigate observed associations using longitudinal and quasi‐experimental study designs, offering additional information regarding a potential causal relationship. [ABSTRACT FROM AUTHOR]

Brought to fame by a 1994 World Bank report, the idea of pension pillarization has become part of the orthodoxy of pension reform. Yet scholars have neglected both the national origins and the pre-1994 diffusion of the ‘three-pillar doctrine’. This article presents a critical history of the transnational diffusion process that led to the adoption of this concept at the World Bank. My analysis retrieves the Swiss roots of the doctrine during the late 1960s, as well as its gradual adoption and mainstreaming during the 1970s and early 1980s by a transnational epistemic community of life insurers and pension consultants. By 1990, the doctrine was widely used without reference to its national origins: a Swiss trademark had become a generic reform idea that framed controversies on the future shape of old-age provision. [ABSTRACT FROM PUBLISHER]

This study explores whether the plans of older workers on the cusp of retirement are in line with the active ageing agenda set by policy makers in Europe. The study was carried out in Italy, England, and the United States of America (USA). A total of 133 older workers who planned to retire within the next 10-12 months were interviewed (55 in England, 40 in Italy and 38 in the USA) between May 2014 and early 2015 using common semi-structured questions. Active Ageing Index dimensions were used to gauge the orientation of older people towards their retirement. The results of the study suggest that, with some differences, retirement plans of interviewees were substantially consistent with the active ageing perspective. However, some challenges were highlighted, including the need for governments to do more to promote genuine freedom of choice in relation to leaving the labour market, and to provide greater support for informal family carers. Findings also pointed to the need to measure active ageing in connection with individual wellbeing, e.g. by including indicators of leisure activities and by considering the re-weighting of employment and informal care dimensions. Companies could also provide more support during the retirement transition, with opportunities for maintained social connection with former colleagues, and help in making and fulfilling retirement plans. [ABSTRACT FROM AUTHOR]

In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy. [ABSTRACT FROM AUTHOR]

In 2011, the earliest segment of the baby boom generation turned 65 years of age. This event marks the beginning of a new phase of growth of the older adult population in the United States and is in line with what is referred to worldwide as “population aging.” By 2030, older adults will comprise 20% of the U.S. population. With the impending increase in the older adult population, the United States is unprepared to handle the accompanying social and economic impact of growing rates of age-related diseases such as diabetes, hypertension, and cardiovascular disease. These diseases have nutritional determinants and, as such, they signify the need for effective preventive nutrition initiatives to address population aging in the United States. Comparatively, the European Union (EU) is projected to reach an older adult population of 24% by 2030. In this special article we evaluate nutrition initiatives for older adults in the United States and also examine nutrition initiatives in the European Union in search of an ideal model. However, we found that available data for EU initiatives targeted at population aging were limited. We conclude by offering the proposal of a physician-based model that establishes the primary care physician as the initiator of nutrition screening, education, referrals, and follow-up for the older adult population in the United States as a long-term goal. Apropos of the immediate future, we consider barriers that underscore the establishment of a physician-based model and suggest objectives that are attainable. Although the data are limited for the European Union, this model may serve to guide management of chronic diseases with a nutritional component in economies similar to the United States worldwide. [ABSTRACT FROM PUBLISHER]

Recently, a number of new forecasts have been published pointing out the considerable demographic crisis in the NASA workforce. Although a few years ago there were signs that the problem of an ageing workforce in United States would be less severe than in Europe, we cannot ignore the effects of new developments in the European space sector. Indeed, a number of mergers and a slightly regressive space turnover took place in Europe, and the effects of this on the workforce population have not been re-evaluated. For this study, a questionnaire was developed to investigate this effect, with a major emphasis on the future requirements of the European space sector's future workforce, in particular the desired hard and soft skills, and the current prevalence of those skills. This questionnaire was distributed amongst human resources departments of space organizations in Europe with help of the European Association for International Space Year (EURISY) network. Preliminary data on planned recruitment and present demographic distribution were collected, and these are presented herein. [ABSTRACT FROM AUTHOR]

Sir Edmund Leach argues that doctors in the modern world, fortified by the traditional concept that the life of the sick person must at all costs be preserved, are to some extent guilty of the false antitheses current today between youth and age. Moreover youth means health, age illness and senility. Until this imbalance is corrected society will be in danger of `a kind of civil war between the generations'. Society must be taught again that mortality cannot be avoided or conquered by medical science, and at the same time that `health' is not enshrined in the young alone. [ABSTRACT FROM PUBLISHER]