The conceptual and methodological characteristics of ageism during COVID-19: A scoping review of empirical studies.

BACKGROUND AND OBJECTIVES: Printed and social media, as well as professional and scholarly platforms, have extensively discussed the proliferation of ageism during the COVID-19 pandemic. However, no study has systematically examined the body of knowledge on the topic. Framed around the characteristics of ageism in general, the aim of this review was to identify and characterize the conceptual and methodological underpinnings of the global, peer-reviewed, empirical literature on ageism during COVID-19. RESEARCH DESIGN AND METHODS: We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using PubMed, CINAHL, AgeLine, and PsycINFO. Quantitative and/or qualitative, English-language, peer-reviewed articles were included. Data were tabulated and synthesized. RESULTS: Thirty-six articles examining ageism during the COVID-19 pandemic met inclusion criteria. Most were quantitative (64%), and cross-sectional (81%). The level, correlates, and consequences of ageism during the pandemic were similar to the ones reported before it. Studies about ageism during COVID-19 had similar conceptualization and measurement problems to those before the pandemic. DISCUSSION AND IMPLICATIONS: Empirical studies didn't find ageism during COVID-19 to be a unique phenomenon, as suggested by the media. More theoretically sound and methodologically rigorous studies, using longitudinal designs and validated unique measures are needed to examine this unique phenomenon.

Prevalence and correlates of forgone care among adult Israeli Jews: A survey conducted during the COVID-19 outbreak.

Efforts to control the spread of the novel Coronavirus (COVID-19) pandemic include drastic measures such as isolation, social distancing, and lockdown. These restrictions are accompanied by serious adverse consequences such as forgoing of healthcare. The study aimed to assess the prevalence and correlates of forgone care for a variety of healthcare services during a two-month COVID-19 lockdown, using Andersen's Behavioral Model of Healthcare Utilization. A cross-sectional study using computerized phone interviews was conducted with 302 Israeli Jewish participants aged 40 and above. Almost half of the participants (49%) reported a delay in seeking help for at least one needed healthcare service during the COVID-19 lockdown period. Among the predisposing factors, we found that participants aged 60+, being more religious, and reporting higher levels of COVID-19 fear were more likely to report forgone care than younger, less religious and less concerned participants. Among need factors, a statistically significant association was found with a reported diagnosis of diabetes, with participants with the disease having a considerably higher likelihood of forgone care. The findings stress the importance of developing interventions aimed at mitigating the phenomenon of forgoing care while creating nonconventional ways of consuming healthcare services. In the short term, healthcare services need to adapt to the social distancing and isolation measures required to stanch the epidemic. In the long term, policymakers should consider alternative ways of delivering healthcare services to the public regularly and during crisis without losing sight of their budgetary consequences. They must recognize the possibility of having to align medical staff to the changing demand for healthcare services under conditions of health uncertainty.

Ageism towards older and younger people in the wake of the COVID-19 outbreak.

OBJECTIVES: The COVID-19 pandemic has provided a rich environment for ageist attitudes towards both older and younger people. However, publications on ageism during the outbreak have been mostly non-empirical and have concentrated on ageist beliefs directed towards older people. To overcome these limitations, we examined empirically the prevalence and the determinants of ageism towards older and younger people in the wake of COVID-19. STUDY DESIGN: A cross-sectional study using an online survey was conducted with 503 Israeli adults (51.9% male, 79.5% Jews, mean age 47 years). MAIN MEASURES: We used a structured questionnaire that measured the following: COVID-19 ageism towards older people, COVID-19 ageism towards younger people, stereotyping, the experience of discrimination, perceived fears about contracting COVID-19, subjective knowledge about COVID-19, and sociodemographic characteristics. RESULTS: Overall, participants reported a relatively low level of COVID-19 ageism towards older people but a significantly higher level of COVID-19 ageism towards younger people. Hierarchical regressions revealed that negative age stereotypes were the most important determinants of both types of ageism. Sociodemographic variables (including age and majority/minority) were significant determinants only for COVID-19 ageism towards older people. That is, older and Jewish participants reported lower levels of this type of ageism. CONCLUSIONS: Our findings demonstrate that negative age-related stereotypes have played a central role in ageist beliefs towards both older and younger people during the COVID-19 crisis. It is recommended that the public and scientific media start disseminating messages aimed at reducing rather than increasing negative stereotypes directed towards younger and older people.

Hospital staff members' preferences about who should be prioritized to receive the COVID-19 vaccine: People with or without Alzheimer's disease?

Background There is no doubt that people with dementia can greatly benefit from the COVID-19 vaccine, especially as they are at an increased risk of developing severe complications, including long hospitalizations and high mortality rates, as a result of being infected by the virus. However, they might need the encouragement of health professionals to become vaccinated. Professionals' preferences regarding vaccination for this group are, therefore, extremely important to increase the use of this preventive measure. Aims 1. To examine hospital staff members' preferences for COVID-19 vaccination to people with or without Alzheimer's disease (AD) while differentiating between a young and an old person with the disease. 2. To examine the factors associated with these preferences. Methods A cross-sectional survey using a structured and anonymous self-report questionnaire was conducted among a sample of 278 Israeli medical staff (nurses, physicians, and paraprofessionals) working at a general hospital. The data were collected in August 2021. Results Overall, the majority (68.4%) of participants chose the 80-year-old patient with a diagnosis of AD to be the last to receive the vaccine. The percentage of participants who preferred to give the vaccine first to the 55-year-old patient with AD was almost equal to the percentage of those who preferred giving the vaccine first to the 80-year-old patient who was cognitively intact. Religion and beliefs about susceptibility to contracting COVID-19 were significantly associated with participants' preferences. Conclusion Our results suggest that hospital staff members find it difficult to decide whether age or cognitive status should be the main factor in deciding which patient should receive the vaccine first. Therefore, there is a need to implement several policy and practical steps in hospitals to assist the medical staff in such decision-making processes.

Examining hospital staff members' preferences for allocating a ventilator to a COVID-19 patient with and without Alzheimer's disease.

The COVID 19 pandemic has led to an increase in the number of patients in need of ventilation. Limitations in the number of respirators may cause an ethical problem for the medical and nursing staff in deciding who should be connected to the available respirators.  We conducted a cross-sectional survey among a convenience sample of 278 healthcare professionals at one medical center. They were asked to rank their preference in respirator allocation to three COVID-19 patients, one 80 years old with no cognitive illness, one 50 years old with Alzheimer's disease (AD), and one 80 years old with AD. Most respondents (75%) chose the 80-year-old AD patient as last preference, but were evenly divided on how to rank the other two patients. Medical staff have difficulty deciding whether age or cognitive status should be the deciding factor ventilator allocation. Determination of a set policy would help professionals with these decisions.

Laypersons' Priority-Setting Preferences for Allocating a COVID-19 Patient to a Ventilator: Does a Diagnosis of Alzheimer's Disease Matter?

PURPOSE: The current study aimed 1) to assess laypersons' priority-setting preferences for allocating ventilators to COVID-19 patients with and without AD while differentiating between a young and an old person with the disease, and 2) to examine the factors associated with these preferences. METHODS: A cross-sectional online survey was conducted among a sample of 309 Israeli Jewish persons aged 40 and above. RESULTS: Overall, almost three quarters (71%) of the participants chose the 80-year-old patient with a diagnosis of AD to be the last to be provided with a ventilator. The preferences of the remaining quarter were divided between the 80-year-old person who was cognitively intact and the 55-year-old person with AD. Education and subjective knowledge about AD were significantly associated with participants' preferences. CONCLUSION: Our results suggest that cognitive status might not be a strong discriminating factor for laypersons' preferences for allocating ventilators during the COVID-19 pandemic.