Aging in Indigenous Communities: Perspective from Two Ancestral Communities in the Colombian Andean-Amazon Region.

The phenomenon of world aging is not foreign to indigenous communities. In the last few years, research about these communities around the world has increased, but aging in indigenous towns still has not been studied widely. The purpose of this research is to interpret the meaning of old age in two indigenous communities from the Colombian Andean-Amazon region (the Inga and Kamëntsa) to reinforce the relevance of the local sociocultural context within the configuration of the meaning of old age and to emphasize the importance of considering particular regional characteristics for the design of policies and interventions aiming to recognize and integrate indigenous populations. This is a qualitative study with an interactionism-symbolism approach. In total, six indigenous people older than 60 years from two ancestral communities from the Colombian Andean-Amazon region participated in the in-depth interviews. Data analysis was carried out in three moments: discovery, coding, and relativization of the information. The results show that old age means wisdom, "I am wise," which is supported in the cosmology and the trajectory of life, reinforces the identity and autonomy, and allows them to be agents in the dynamics of their communities from the "I do," in other words, their roles as builders of the family-society and as guards of ancestral knowledge. The loss of this knowledge and the elements that it is composed of uproot them and put them at risk of disappearing as individuals and as a collective. In conclusion, the meaning of old age in these communities is not centered on a determinate age; you are not old, you are wise, and as such, they play a central role in their communities. Moreover, wisdom is built in parallel with their cosmology and assigns them the task of safekeeping ancestral knowledge. In order to do this, they use oral tradition as a tool, words that are born in their territories, travel in a nonlinear timeline, and get strengthened by the community while also protecting it and building it. Knowing what aging means for Indigenous communities can facilitate to the development of policies and initiatives and to provide culturally appropriate and effective programs.

Medicalization of Old Age: Experiencing Healthism and Overdiagnosis in a Nordic Welfare State.

In Denmark, people are expected to take responsibility for their health, not least as their bodies age and they experience signs of physical or mental decline. Drawing on fieldwork among older Danes, I illustrate that an excessive focus on health gives rise to social and structural controversies and disparities, linking ideas of healthy behavior at the individual level with the societal framing of disease and aging. I argue that this emphasis contributes to the unwarranted diagnosis of bodily variations that naturally occur in the aging process, a phenomenon referred to as overdiagnosis, adding to a broader medicalization of old age.

Correlates of SuperAging in Two Population-Based Samples of Hispanic Older Adults.

OBJECTIVES: "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. METHODS: We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55-64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. RESULTS: Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p < .001; HRS: OR = 1.14, p = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p = .019; HRS: OR = 0.58, p = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p = .031; HRS: OR = 0.67, p = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p = .015; HRS: OR = 0.69, p = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g., chronic conditions and self-rated health) did not relate to SuperAging. DISCUSSION: Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults.

Strategies for Recruiting Older Black Men into Aging and Alzheimer's Research.

BACKGROUND: Despite their high risks for Alzheimer's disease, older Black men are minimally represented in Alzheimer's research and clinical trials. The absence of older Black men in Alzheimer's research limits our ability to characterize the changes associated with cognitive impairments in older Black men-a key health disparity concern. METHODS: Drawing on lessons we learned from years of community-based participatory research in Newark, NJ, we highlight recruitment strategies developed alongside community partners to guide our enrollment and retention efforts for Black men. RESULTS: We identified seven recruitment strategies: provide indirect health education through social programming, target older men through the younger men in their lives, go beyond Black churches, use older Black men as trained community ambassadors, enlist the women in Black men's lives, frame research participation as a legacy to leave their sons, and use past and current Black men participants as role models. CONCLUSIONS: These recruitment strategies help us address many barriers to recruiting older Black men. They can be easily implemented by researchers conducting aging and brain health research or interested in working with older Black men and under-represented populations.

Condición física, clínica y fragilidad de adultos mayores en Cali, Colombia / Physical and clinical condition and fragility of older adults in Cali, Colombia

Introducción: A nivel mundial el envejecimiento de la población ha sido un tema de interés a investigar, debido a la carga de morbimortalidad y los costos en salud que ocasiona. Así, resulta relevante indagar sobre aquellos aspectos que hacen más vulnerables a los adultos mayores. Objetivo: Comparar la condición física y clínica según la fragilidad en adultos mayores de Cali, Colombia. Materiales y métodos: Estudio descriptivo transversal en adultos mayores de la ciudad de Cali, Colombia. El estudio tuvo aval ético institucional y todos los adultos mayores aceptaron participar firmando el consentimiento informado. Se usó la batería corta de desempeño físico (SPPB), y se compararon variables sociodemográficas, físicas y clínicas. y por nivel de fragilidad en vigoroso, prefrágil y frágil. Resultados: Se vincularon 470 adultos mayores con una edad promedio de 71,15±7,50 años, y en su mayoría del género femenino. Se presentaron diferencias estadísticamente significativas con un valor de p≤0,05 en la edad, estado socioeconómico, comuna, enfermedad, índice de masa corporal, actividad física, desempeño físico y riesgo de caídas; presentando mayor compromiso el grupo de fragilidad. Conclusión: El grupo de adultos mayores clasificados como frágiles presentaban menor condición física y clínica comparado con los grupos pre-frágiles y vigorosos. (AU)

Introduction: Worldwide, the aging of the population has been a topic of interest to investigate, due to the burden of morbidity and mortality and the health costs it causes. Thus, it is relevant to investigate those aspects that make older adults more vulnerable. Objective: To compare the physical and clinical condition according to frailty in older adults from Cali, Colombia. Materials and methods: Cross-sectional descriptive study in older adults from the city of Cali, Colombia. The study had institutional ethical endorsement and all the older adults agreed to participate by signing the informed consent. The short physical performance battery (SPPB) was used, and sociodemographic, physical and clinical variables and by level of frailty were compared in vigorous, pre-frail and frail. Results: Four hundred and seventy older adults with an average age of 71.15±7.50 years and mostly female were enrolled. There were statistically significant differences, P≤0.05 in age, socioeconomic status, commune, disease, body mass index, physical activity, physical performance, and risk of falls. The fragility group presented greater compromise. Conclusion: The group of older adults classified as frail had a lower physical and clinical condition compared to the pre-frail and vigorous groups. (AU)

Generativity as a Traditional Way of Life: Successful aging among Unangan Elders in the Aleutian Pribilof Islands.

Predominantly Western-based biomedical models of successful aging have been used to research, understand, and explain successful aging among diverse populations. With an increasingly heterogeneous older adult population nationwide, scholars have been exploring Indigenous understandings of successful aging. To add to the accumulation of knowledge of diverse Alaska Native populations, this study involved semi-structured qualitative interviews with 20 Unangan Elders from the Aleutian and Pribilof Islands. This community-based participatory research study explores the aging experiences and conceptualization of successful aging of these Elders from this remote and culturally distinct region of Alaska. Thematic analysis was employed to identify themes related to successful aging within this specific region, which supported our previous four themes, or characteristics, of Alaska Native successful aging: physical health, social support and emotional well-being, generativity as a traditional way of life, and community engagement and Inidgenous cultural generativity. Each of these themes or characteristics of Eldership is intertwined and together support successful aging within two remote communities in the Bering Sea. The findings of this study illuminate how Alaska Native Elders can live in geographically diverse regions of the State, yet the values and teachings they possess on successful aging possess the same cultural values and teachings. This study highlighted two new emerging constructs that influence Alaska Native Elders' successful aging based on geographical location. Findings contribute to the thematic saturation of the four main successful aging domains while outlining the importance of future research to conduct deeper investigations into the role of environment and history on Elders' perceptions and understanding of aging.

Aging, Race, and Health Disparities: Recommendations From the Research Centers Collaborative Network.

Racial disparities in adverse health outcomes with aging have been well described. Yet, much of the research focuses on racial comparisons, with relatively less attention to the identification of underlying mechanisms. To address these gaps, the Research Centers Collaborative Network held a workshop on aging, race, and health disparities to identify research priorities and inform the investigation, implementation, and dissemination of strategies to mitigate disparities in healthy aging. This article provides a summary of the key recommendations and highlights the need for research that builds a strong evidence base with both clinical and policy implications. Successful execution of these recommendations will require a concerted effort to increase participation of underrepresented groups in research through community engagement and partnerships. In addition, resources to support and promote the training and development of health disparities researchers will be critical in making health equity a shared responsibility for all major stakeholders.

Perceptions of Successful Aging among Asian Americans.

The current study explored Asian Americans' lay perceptions of successful aging and examined the differences and similarities between Asian Americans and White/Caucasian Americans. One hundred forty-five Asian American adults and 86 White/Caucasian adults were asked how they view successful aging. Open-ended responses were coded for recurring themes. The theme most often mentioned by Asian Americans was health, followed by quality of life, activities/interests, and social resources. Compared to White/Caucasian participants, Asian Americans' meaning of successful aging in the current study did not differ greatly in terms of major themes mentioned, but Asian Americans were more likely to mention certain themes, such as physical appearance and youthful look. In sum, the findings suggest that Asian Americans have a multifaceted understanding of successful aging, and reinforce the importance of cultural variations of the perceptions of successful aging.

"My wife made me": motivations for body and beauty work among older Korean and Chinese migrant adults in Australia.

This article examines how older Korean and Chinese migrants living in Perth, Australia, engage in various beauty, grooming and fitness practices to negotiate "successful ageing" in transnational contexts. Drawing on semi-structured interviews with 30 men and women aged between 60 and 89, we examine what social meanings are attached to these practices, and how the transnational context of living in Australia has influenced the participants' perceptions of ageing and presentation of self in later life. Migration in later life is often considered in relation to the 'host' countries values and social practices, which can make it difficult for individuals to settle and feel a sense of belonging especially in later life. In this article, we will illustrate how gender, class, and cultural dispositions intersect and link with possibilities for defining and redefining successful ageing in migrant contexts. This study illustrates how successful ageing emerges as a malleable concept that draws on ideas of an ideal ageing body from the cultural values of the 'home' country, rather than the 'host' country. The findings illustrate how in everyday lived experience, the transnational habitus does not always necessarily result in a 'divided habitus' where the values of the 'home' country and that of the 'host' country are in conflict - even when the migration experience is relatively recent. Quite the contrary, the way the participants utilise everyday beauty, fitness and grooming practices to maintain a future-focused self in the context of 'home' country's age-appropriate body ideals to perform signifiers of 'successful migrant living' point to the positive aspects that appearance management can have on an individual in later life, particularly in migrant contexts.

Characterizing age- and sex-related differences in brain structure among middle-aged and older Hispanic/Latino adults in the study of Latinos- investigation of neurocognitive aging magnetic resonance imaging (SOL-INCA MRI).

Hispanic/Latino adults are a growing segment of the older U.S. population yet are underrepresented in brain aging research. We aimed to characterize brain aging among diverse Hispanic/Latino individuals. Hispanic/Latino individuals (unweighted n = 2273 ages 35-85 years; 56% female) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) population-based study underwent magnetic resonance imaging (MRI) as part of the SOL- Investigation of Neurocognitive Aging MRI (SOL-INCA-MRI) ancillary study (2018-2022). We performed linear regressions to calculate age associations with brain volumes for each outcome (total (global) brain, hippocampal, lateral ventricle, total white matter hyperintensity (WMH), individual cortical lobar, and total cortical gray matter) and tested modification by sex. Older age was associated with smaller gray matter volumes and larger lateral ventricle and WMH volumes. Age-related differences in global brain volumes and gray matter volumes in specific regions (i.e., the hippocampus and temporal and occipital lobes) were less pronounced among women. Our findings warrant further investigation into sex-specific mechanisms of brain aging using longitudinal studies.

Association between major discrimination and deficit accumulation in African American cancer survivors: The Detroit Research on Cancer Survivors Study.

BACKGROUND: Discrimination can adversely affect health and accelerate aging, but little is known about these relationships in cancer survivors. This study examines associations of discrimination and aging among self-identified African American survivors. METHODS: A population-based sample of 2232 survivors 20-79 years old at diagnosis were enrolled within 5 years of breast (n = 787), colorectal (n = 227), lung (n = 223), or prostate (n = 995) cancer between 2017 and 2022. Surveys were completed post-active therapy. A deficit accumulation index measured aging-related disease and function (score range, 0-1, where <0.20 is robust, 0.20 to <0.35 is pre-frail, and 0.35+ is frail; 0.06 is a large clinically meaningful difference). The discrimination scale assessed ever experiencing major discrimination and seven types of events (score, 0-7). Linear regression tested the association of discrimination and deficit accumulation, controlling for age, time from diagnosis, cancer type, stage and therapy, and sociodemographic variables. RESULTS: Survivors were an average of 62 years old (SD, 9.6), 63.2% reported ever experiencing major discrimination, with an average of 2.4 (SD, 1.7) types of discrimination events. Only 24.4% had deficit accumulation scores considered robust (mean score, 0.30 [SD, 0.13]). Among those who reported ever experiencing major discrimination, survivors with four to seven types of discrimination events (vs. 0-1) had a large, clinically meaningful increase in adjusted deficits (0.062, p < .001) and this pattern was consistent across cancer types. CONCLUSION: African American cancer survivors have high deficit accumulated index scores, and experiences of major discrimination were positively associated with these deficits. Future studies are needed to understand the intersectionality between aging, discrimination, and cancer survivorship among diverse populations.

Deaths of Despair and Population Aging in Missouri.

Recent declines in life expectancy in the US, especially for middle-aged White persons, have called attention to mortality from deaths of despair - deaths due to alcohol, drugs, and suicide. Using data from the Centers for Disease Control and the U.S. Census Bureau, this paper examined deaths of despair by race/ethnicity, age, cause of death, birth cohort, and sex in Missouri. We focused on Area Agencies on Aging as geographic units of interest to increase usefulness of our findings to public administrators. Deaths of despair began trending up for all age groups beginning in 2007-2009, with the sharpest increases occurring for Black or African American non-Hispanics beginning in 2013-2015. The most dramatic increases occurred for the population age 50-59 in St. Louis City and Area Agency on Aging regions in southern Missouri. For older adults, considerable variation in rates, trends, and cause of deaths of despair is evident across the state.

School Disengagement Predicts Accelerated Aging among Black American Youth: Mediation by Psychological Maladjustment and Moderation by Supportive Parenting.

Early experiences of school disengagement may serve as a warning sign for later young adult adjustment difficulties and eventually contribute to accelerated aging among Black American youth. At the same time, supportive parenting may play a protective role. Using longitudinal data from the Family and Community Health Study (FACHS), we examined psychological maladjustment (comprising depression, lack of self-regulation, and low self-esteem) as a mediator of the relationship between school disengagement and accelerated aging. We also examined the effect of supportive parenting in buffering the impact of school disengagement on adulthood outcomes by controlling for covariates. Hypotheses were examined in a sample of 386 (Mean age = 28.68; Females = 62.7%; Males = 37.3%) Black American youth who were followed into young adulthood. Path modeling was used to test hypothesized relationships. We found school disengagement, i.e., problems with school attendance, performance, and engagement, reported across ages 10-18, predicted psychological maladjustment, which, in turn, predicted accelerated aging at age 29. We also found a buffering effect for supportive parenting. No significant gender difference in the indirect effect or buffering effect was found. This study highlights the potential importance of greater attention to school disengagement to identify and potentially influence long-term health trajectories and adult outcomes for Black American youth.

Links Between Mortality and Socioeconomic Characteristics, Disease Burden, and Biological and Physical Functioning in the Aging Chinese Population.

OBJECTIVES: Determinants of mortality may depend on the time and place where they are examined. China provides an important context in which to study the determinants of mortality at older ages because of its unique social, economic, and epidemiological circumstances. This study uses a nationally representative sample of persons in China to determine how socioeconomic characteristics, early-life conditions, biological and physical functioning, and disease burden predict 4-year mortality after age 60. METHODS: We used data from the China Health and Retirement Longitudinal Study. We employed a series of Cox proportional hazard models based on exact survival time to predict 4-year all-cause mortality between the 2011 baseline interview and the 2015 interview. RESULTS: We found that rural residence, poor physical functioning ability, uncontrolled hypertension, diabetes, cancer, a high level of systemic inflammation, and poor kidney functioning are strong predictors of mortality among older Chinese. DISCUSSION: The results show that the objectively measured indicators of physical functioning and biomarkers are independent and strong predictors of mortality risk after accounting for several additional self-reported health measures, confirming the value of incorporating biological and performance measurements in population health surveys to help understand health changes and aging processes that lead to mortality. This study also highlights the importance of social and historical context in the study of old-age mortality.

Life Course Stressors and Functional Limitations in Later Life Among White, Black, and Hispanic Adults: Deleterious, Hardening, or Benign?

OBJECTIVES: Although striking racial and ethnic disparities in health are manifest during later life, they may be rooted in early-life exposures. Drawing from cumulative inequality theory, we investigate whether life course stressors are associated with the risk of later-life functional limitations and whether this relationship differs by race and ethnicity. METHODS: We utilize longitudinal data from the Health and Retirement Study to test whether child and adult stressors predict trajectories of the occurrence and severity of functional limitations among a diverse sample of older adults. RESULTS: Child and adult stressors are associated with greater occurrence and severity of functional limitations during later life. Mediation analyses reveal the indirect influence of child stressors via adult stressors on occurrence and severity of functional limitations; however, the indirect effects are slightly stronger for Black and Hispanic adults than their White counterparts. DISCUSSION: Child stressors, in and of themselves, do not increase functional limitations among Black and Hispanic people but are associated with greater adult stress exposure, predisposing them to more functional limitations. Results suggest that childhood stressors are associated with distinct social pathways to functional limitations among White, Black, and Hispanic older adults.

Religious Involvement and Cognitive Functioning at the Intersection of Race-Ethnicity and Gender Among Midlife and Older Adults.

OBJECTIVES: To investigate the association between religious involvement and cognitive functioning at the intersections of race-ethnicity and gender among midlife and older adults, and to determine if psychosocial factors help explain this relationship. METHOD: The sample included 14,037 adults aged 50+ from the Health and Retirement Study (HRS). We utilized measures from the HRS 2010 and 2012 Core interviews and Leave-Behind questionnaires and estimated our models using linear regression. RESULTS: Compared to individuals who frequently attended religious services, infrequent religious service attendance was related to poorer cognitive functioning. Religiosity was inversely associated with cognitive functioning at baseline, but the relationship varied by race/gender subgroup. Greater religiosity was associated with better cognitive functioning among Black women, but lower cognitive functioning among White men and women. Psychosocial factors did little to explain the inverse association between religiosity and cognitive functioning. DISCUSSION: Results suggest the association between religious involvement and cognitive functioning is varied and complex, and largely dependent on important social identities. The findings have important implications for investigating health-protective factors, like religious involvement, using an intersectional perspective.

Cultural Differences in the Intended Use of Long-Term Care Services in the United States: The Role of Family Ties.

OBJECTIVES: In the light of an increasingly diverse older population in the United States, there is an ongoing discussion on how cultural factors contribute to individual long-term care (LTC) needs and service use. This study empirically assesses whether the level of acculturation and cultural differences in the importance of the family shape foreign-born immigrants' intention to use certain LTC services. METHODS: We correlated immigrants' intention to use certain LTC services to the cultural strength of family ties that prevails in their region of origin. We used data from the National Health Interview Survey and the World Values Survey/European Values Study for analysis. Multinomial logit models were estimated and predisposing, enabling, and need factors were controlled for. Estimations were weighted to account for the sampling structure, and sensitivity analyses were conducted. RESULTS: Immigrants from cultures with stronger family ties are significantly more likely to intend the use of LTC options that include the family. Furthermore, immigrants are less likely to intend the use of exclusively family care when having lived in the United States for a longer time. DISCUSSION: We conclude that cultural differences in family ties shape immigrants' intention to use certain LTC services. If policymakers aim at increasing the provision of specific LTC services or support to family caregivers, there should be a careful evaluation of demand-side factors in an increasingly culturally diverse society.

Envelhecimento e poética de atenção às formas de vida / Aging and poetics of attention to life forms / Envejecimiento y poética de atención a las formas de vida

Este artigo discute a possibilidade de uma poética de cuidado e atenção às formas de vida em uma instituição de longa permanência para idosos. O texto ancora-se em uma etnografia que ocorreu em um abrigo para idosos, realizada por meio de observação participante, entrevistas e acompanhamento da vida cotidiana. Durante o trabalho de campo, uma das atividades centrais era um Círculo de Leitura promovido pela instituição. Ao acompanhar essas atividades, a literatura provocava os afetos e memórias dos participantes e constituiu uma forma de cuidado e produção de saúde. Nesse contexto, ler e rememorar também era produzir saúde. Procurando analisar as vivências no Círculo de Leitura, o texto indaga o que pode a literatura e quais experiências provocam. A busca é por entender como a literatura afeta os idosos.(AU)

This article discusses the potential of poetics of care in a long-term care facility for older persons. The text is anchored in an ethnography conducted in a care home using participant observation, interviews, and accompanying day-to-day life in the home. One the central activities during field work were reading circles organized by the home. It was observed that the literature triggered affects and memories among the participants and constituted a form of care and production of health. Within this context, reading and reminiscing also produce health. Analyzing the experiences of the reading circles, the text explores the potential of literature and the experiences provoked by reading, seeking to understand how it affected the residents.(AU)

El objetivo de este artículo es discutir la posibilidad de una poética de cuidado y atención a las formas de vida en una institución de larga permanencia para ancianos. El texto está anclado en una etnografía que ocurrió en un asilo para ancianos, realizada por medio de observación participante, entrevistas y acompañamiento de la vida cotidiana. Durante el trabajo de campo, una de las actividades centrales era un círculo de lectura promovido por la institución. Al acompañar esas actividades, la literatura provocaba los afectos y memorias de los participantes y se constituyó como forma de cuidado y producción de salud. En ese contexto, leer y rememorar también era producir salud. Buscando analizar las vivencias en el círculo de lectura, el texto indaga lo que puede la literatura y cuáles son las experiencias que provoca. La búsqueda es entender de qué forma la literatura afectaba a los ancianos.(AU)