To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge-org.demo.remotlog.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
In this chapter, we review empirical and conceptual work pertaining to organic changes in the brain and shifting goals as contributors to age-related changes in affective processing. We argue for the need to integrate these two previously isolated lines of research by delineating their crucial interplay toward a comprehensive understanding of affective neuroscience in aging. We present examples of aging trajectories, impacted by organic brain and motivational change, to identify key processes of interest for future research and potent intervention targets to promote successful aging. We conclude with open basic and applied research questions embedded within our integrated conceptual framework to guide future research on affective neuroscience in aging.
Schizophrenia spectrum disorders confer an increased and earlier dementia diagnosis risk, but the relative timing and course of cognitive decline compared to individuals with affective disorders is unclear.
Methods
This retrospective study used de-identified electronic patient records to compare cognitive trajectories from the first recorded MMSE, representing the earliest cognitive concerns in relation to a possible dementia syndrome, and subsequent dementia risk between patients with a schizophrenia spectrum and primary affective disorder diagnosis. Patients had at least two MMSE scores recorded at least 6 months apart. We examined annual MMSE change from the first recorded MMSE, dementia risk, dementia subtypes, and rates of dementia assessment and treatment.
Results
Compared to affective disorders (n = 2,264; 71.1 years), schizophrenia spectrum disorders (n = 1,217; 65.0 years) showed earlier initial MMSE scores (by 6.1 years, 95% CI = 5.2–7.0), earlier dementia diagnoses (by 2.3 years, 95% CI = 0.9–3.7) but lower dementia risk (adjusted HR = 0.81; 95% CI = 0.69–0.95). Cognitive decline rates and dementia subtype diagnoses did not differ between affective and schizophrenia spectrum disorders, but it took longer for schizophrenia spectrum disorder patients to receive a dementia diagnosis (5.6 vs. 4.4 years). Anti-dementia medication was less likely to be prescribed in patients with schizophrenia versus depression.
Conclusions
Cognitive concerns in older individuals with schizophrenia spectrum disorders arise from around 63 years and are associated with earlier dementia risk versus older individuals with affective disorders. Findings emphasize the importance of targeted dementia prevention and treatment strategies in these individuals and the need to reduce the existing inequity of access to dementia services.
Approximately 25% of older adult residents who experience an acute change in health status are transferred from Long-Term Care (LTC) to Emergency Departments (ED). We explored the use of an intervention (i.e., LTC to ED) care and referral pathway, INTERACT® Change in Condition cards, and STOP AND WATCH tool, in informing decision making regarding resident transfers. We conducted 22 semi-structured interviews with Health care Providers (HCPs) involved in the LTC to ED care pathway in Western Canada. Thematic analysis of the qualitative interviews was used to evaluate the use of the pathway and tools. We identified six themes influencing decision making around resident transfers including interprofessional practice and conflict, ambiguous and clear medical cases, ageism, health care providers’ goals, family involvement in resident care, and intervention tools. The intervention may be useful in streamlining, documenting, and increasing transparency in complicated LTC resident care and transfer decisions.
La gestion socioterritoriale du vieillissement constitue un enjeu fondamental au Nouveau-Brunswick. Comme cette province ne possède pas de stratégie territoriale du vieillissement, il revient aux municipalités d’aménager leur territoire afin de favoriser le vieillissement sur place. L’objectif de cet article consiste à évaluer la perception des élus municipaux, des intervenants communautaires et des aînés en ce qui a trait à la gestion socioterritoriale du vieillissement dans quatre villes du Nouveau-Brunswick. L’approche utilisée est celle des représentations sociales des acteurs à partir d’entrevues semi-dirigées. Sur le plan théorique, notre analyse s’appuie sur le modèle de gérontologie environnementale. Bien que les résultats de nos entretiens révèlent une satisfaction généralisée des répondants concernant l’implication des élus à la gestion socioterritoriale du vieillissement, des disparités persistent notamment au chapitre de l’accessibilité par rapport à certains édifices et au manque d’infrastructures dédiées spécifiquement aux aînés. Pour pallier ces difficultés, le déploiement d’une stratégie territoriale du vieillissement multiniveau constitue une piste de solutions à envisager.
The COVID-19 pandemic highlighted significant vulnerabilities in long-term care (LTC) homes, severely impacting residents and care partners. This study investigates how care partners of older adults living in Ontario LTC homes perceived residents’ experiences during the COVID-19 pandemic, and how those perceptions shaped their own caregiving experiences. Using critical ethnography, we identified four key themes: (a) masks and miscommunication, (b) loneliness and loss, (c) from interaction to isolation, and (d) loss of the advocacy role. Supportive actions included transparent masks, increased allied health professionals, and enriching daily programs. These findings emphasize the need for policies that balance infection control with the emotional and social needs of LTC residents, addressing power imbalances, ageism, and systemic inequities.
Although residents of The Villages often say, "You name it, they have a club for it, and if they don’t, you can start one," moving to the city frequently necessitates quitting or reducing involvement in existing activities. Additionally, aging presents various challenges to participation, such as declining health and lack of companionship. Based on the ecological model of leisure constraints, this chapter explores how residents navigate these conditions, why some choose not to negotiate them, and how the vast array of activities in The Villages both supports and hinders successful negotiation.
The opening chapter sets the stage for the book. It starts with a recount of the author’s first day at The Villages and her motivation to explore the aging experience in this "city for seniors." The second part details the study that forms the book’s foundation, including the research questions, methods, and participant descriptions. The third part outlines the book’s structure, providing a brief overview of each chapter.
After outlining the history of The Villages from its origins as a trailer park in the late 1960s to its present status, this chapter examines the factors behind its success. This discussion covers the unique master planning of the community, the extensive variety of leisure activities available to residents, and the population’s relative homogeneity. By distinguishing between the place and its residents, the chapter also reviews previous research on The Villages and identifies the gaps in the existing knowledge that this book aims to fill.
The final chapter compares The Villages to other retirement communities, aging in place, and aging in community. Drawing on the study’s findings and the perceptions of interviewed individuals, it highlights how The Villages’ unique characteristics – including its size, innovation culture, bubble communication, opportunities for meaningful involvement, social networks, and communal coping – generally enhance residents’ well-being. The chapter also summarizes The Villages’ weaknesses and presents key takeaways about the societal meanings of its success.
With 115 recreation centers, 3,000 clubs, numerous activities, and media content that encourages residents to “Try something new!” The Villages actively promotes innovation in later life. Drawing on innovation theory, this chapter examines the continuity and change in residents’ leisure activities upon moving to The Villages and over time. It describes what can be termed an "innovation culture" while also noting that innovation tends to decline with age and pointing to a greater tendency towards self-preservation rather than self-reinvention innovation.
For The Villagers, "fun" is a serious matter. This chapter highlights the remarkable volunteering patterns among residents and analyzes them through the lens of the serious leisure perspective. It differentiates between volunteering in leisure and volunteering as leisure, describes the populations served by the volunteers, and examines whether the residents’ involvement in volunteering is truly optimal.
The Villages provides its residents with a wide array of formal and informal media, most of which are digital. This chapter examines the content and usage of these media, delving into the attitudes of the residents towards them. Despite frequent criticism from residents about the media’s heavy emphasis on local "happy news," this chapter suggests that such a focus fosters a sense of a "bubble," which contributes positively to their well-being.
Living in a city for older adults inevitably involves facing and coping with the frequent deaths of neighbors, friends, and acquaintances, serving as a constant reminder of one’s mortality. Through the stories of three individuals, this chapter offers a glimpse into the experiences of dying, caregiving for the dying, and grieving in The Villages. It also contrasts the pervasive presence of death with the relative invisibility of the "fourth age."
Departing from the distinctions among retirement communities, "aging in place," and the newer concept of "aging in community," this chapter presents a definition and typology of retirement communities along with a brief history of these communities in the US. It then offers a literature review on key topics: (a) transitioning into a retirement community, (b) adjusting to and aging within a retirement community, and (c) the well-being of residents in these communities.
This chapter addresses the challenge of socially "starting from scratch" when moving into a community of approximately 150,000 older adults. It suggests that most residents integrate into overlapping place-, leisure-, and faith-based communities, and experience varying levels of psychological sense of community (PSOC). The chapter also explores the few instances where no PSOC was reported and examines the multiple tensions between different groups based on age, type of residency, and political orientation.
By examining the “push” and “pull” factors influencing the decision to move to The Villages and the residents’ perceptions of the community’s rapid growth, this chapter highlights the pros and cons of living in a city for older adults. Distinguishing between veterans and newcomers, permanent residents and snowbirds, and individuals from urban versus rural backgrounds, the chapter also suggests that, overall, the community’s size fosters a collective place identity and pride.
The aim of this paper is to review several key aspects of undernutrition in later life, with a major focus on undernutrition in community-dwelling older adults. The prevalence of undernutrition in community-dwelling older adults is about 8.5%, but higher in vulnerable subgroups such as the oldest old (19.3%), those reporting poor appetite (22.4%), and those receiving home care (15.8%). Frequently reported risk factors for undernutrition in the community include poor appetite, functional limitations and previous hospitalisation. The Determinants of Malnutrition in Aged Persons (DoMAP) model provides a clear framework to structure the different direct and indirect potential determinants of undernutrition in old age. Low BMI as well as involuntary weight loss, both important phenotypic criteria of undernutrition, are associated with early mortality in older adults. Furthermore, undernutrition in community-dwelling older adults is associated with a subsequent increased risk of frailty, falls, functional decline and rehospitalisation. Qualitative studies indicate a poor undernutrition awareness among healthcare professionals working in community care as well as among older adults themselves. The Malnutrition Awareness Scale can be used to objectively measure an older persons’ undernutrition awareness. In conclusion, the prevalence of undernutrition among older adults living in the community is substantial and has several negative consequences for health and functioning. Strategies towards greater undernutrition awareness by primary care professionals as well as older adults themselves is therefore necessary.
This chapter traces the development of the character of Odette in Marcel Proust’s In Search of Lost Time. If in “Swann in Love” Odette functions as an ekphrastic projection of Swann’s desire (a Botticelli fresco), in “At Mme Swann’s” she reclaims her face, creating a “new, personal style of face.” The text describes a process of facialization as a mode of self-invention, with the help of photography. Thus reinvented, Odette is the only character in the novel who does not age, providing a narrative continuity for the arc of the novel. A reading of the concluding scene in which a gallery of aged characters appear as masks of their younger selves foregrounds Proust’s preoccupation with time and memory. The conclusion: the paradigmatic object of memory retrieval for Proust is the face.
This study aimed to identify the associations between possible sarcopenia (p-sarcopenia) and fall risk, depression, and quality of life (QOL) in middle-aged (age ≥ 45 years) and older (age ≥ 65 years) adults. In this study, we analyzed a total of 10,181 men and women aged 45–85 years from the initial survey sample of the 2006 Korean Longitudinal Study of Aging. Among middle-aged men (women) adults, fall risk and depression were 4.09 (1.34) and 2.25 (2.05) times higher in the p-sarcopenia group than in the non-possible sarcopenia (np-sarcopenia) group, respectively (p < 0.05). Middle-aged and older men and women all showed low QOL-related scores, especially middle-aged men and women in the p-sarcopenia group (p < 0.05). Therefore, adequate management of sarcopenia is necessary in both older and middle-aged adults to reduce its burden as a public health concern.
Driving enables older adults to maintain independence and community mobility. Driving plays a pivotal role in the ability to engage in activities, socialize, run errands, and access health care services; yet many people eventually stop driving. This study investigates factors that contribute to transitions from driver to non-driver (i.e., driving status) using data from the Canadian Longitudinal Study on Aging (CLSA). Among participants aged 45–85 who reported driving at baseline (n = 30,901), 1.65 percent (n = 510) had stopped driving at follow-up (three years later). Logistic regression identified predictors of this transition, including older age, female sex, lower income, urban residence, poorer self-rated health, difficulties with activities of daily living, low memory scores, and vision problems. These findings highlight the interplay of physical, cognitive, and environmental factors in driving cessation. This research advances understanding of mobility transitions in later life and informs targeted strategies to support older adults as they plan for driving retirement.