In the United Kingdom (UK) and elsewhere, little is known about problematic drug use among older people (defined here as aged 50–74 years), either because few older drug users exist or because they represent a ‘hidden’ population. In this paper, we show that the average age of drug users in contact with treatment services and agency-based syringe exchange programmes (SEPs) in the counties of Cheshire and Merseyside in northwest England is rising. Between 1998 and 2004–05, the number of older male drug users in treatment increased from 80 to 310, and the number of older females rose from 46 to 117. Consequently, the median age rose from 30.8 years in 1998 to 34.9 years in 2004–05. Similarly, between 1992 and 2004, the number of older injectors accessing SEPs increased from three to 65 men and from one to nine women. The median age of SEP attenders was 27.0 years in 1992 and 34.9 years in 2004. Drug use amongst older people is associated with poor physical and psychological health and longer hospital stays. The future cost of the ageing of drug users may be considerable. Detailed research is needed to identify the characteristics and health needs of this vulnerable population.

This article explores various issues concerned with belonging and identity in the context of community change and residential location. It examines the changing nature of community attachments in later life, and their impacts on the quality of old age lives. It also notes the increased importance of environmental perspectives within gerontology, not least because environments are being transformed through the diverse social, cultural and economic changes associated with globalisation. The argument is developed that globalisation offers a new approach to thinking about community and environmental relationships in later life, and that the impact of global change at a local level has become an important dimension of sociological aspects of community change. It is argued that it is especially important to apply these perspectives to older people, given that many have resided in the same locality for long periods. At the same time, globalisation also gives rise to new types of movement in old age, and is constructing an expanding mix of spaces, communities and lifestyle settings. A key argument of the article, however, is that global processes are generating new social divisions, as between those able to choose residential locations consistent with their biographies and life histories, and those who experience rejection or marginalisation from their locality.

I am pleased to report new appointments to the editorial team and plans for expansion of the journal. Last summer Miles Lambert succeeded Jean Wilkinson as the Editorial Assistant, and to the great credit of them both, the transition caused practically no delay in the handling of the submitted papers. Then in November 2006, Mima Cattan of Leeds Metropolitan University was appointed as the journal's first Associate Editor. Mima's academic roots are in medical sociology and anthropology. I find her magnificently thoughtful and constructive, not only about the practicalities and responsibilities of an editor's trade, as with concern for the novice author when they receive an unfavourable decision letter, but also about broad epistemological issues in the production and communication of gerontological understanding. Mima's presence will be creative, stimulating and welcome support. Her appointment is to enable more papers to be published, to which I now turn.

This paper examines the status afforded old age in the Byzantine Empire. Frequently neglected in accounts of state formation or comparative history, this Christian imperial state transformed the moral ordering of the lifecourse. In contrast to both classical Greek and Roman society, old age acquired a distinct moral authority in Byzantine society. This status was not confined to a few members of the elite as in Sparta or Rome. The economic vulnerability, physical frailty and social marginality accompanying old age conferred an equal moral claim upon society that the state actively addressed. A mix of institutionalised and individual charities created a prototype ‘welfare state’ within which provision for old age played a significant part. Despite its neglect by most social historians of old age, the Byzantine Empire is of considerable historical significance in the development of the contemporary constructions of old age. Just as the Byzantine Empire helped erode the practice of slavery that had been widespread in the ancient Greek and Roman societies, so too did it help to create a prototype welfare state in which individual enterprise was tempered by a collective sense of inclusive Christian responsibility. The consideration extended by Byzantine society, to old age, to its weakness as well as to its wisdom and authority, instituted a step change from earlier classical traditions.

‘Active ageing’ is a key concept in current policy and research on ageing and yet is under-analysed or interpreted largely within an economic framework. This paper explores active ageing in the broader context of older people's lives. Drawing on a series of biographical interviews with 23 people aged 60–96 years, the discussion focuses on the theme of future hopes and concerns. Exhortations for ‘active ageing’ may be challenged by a lifelong unwillingness to look forward or plan ahead. Nevertheless, the findings show that fears for a future of limited resources, decline and dependency can exist alongside not only the desire to live longer but also the positive anticipation of forthcoming events and strong inter-generational relations. ‘Living for now’ and ‘taking a day at a time’ – and by extension the accomplishment of everyday activities rather than the activity-driven goals of earlier years – are common strategies for dealing with the unpredictability of later life. In this respect, even stopping paid work and entering residential care may be actively chosen and empowering even though they are steps towards disengagement and dependency. Similarly, planning for death, such as writing (living) wills and making funeral arrangements, may be positive and proactive responses to beliefs and concerns about dying. ‘Active ageing’ therefore needs to offer choices for life to be lived at all stages whilst recognising that much of the focus for older people is on ordinary needs, deeds and relationships.

This article examines three kinds of social relationship likely to be present when people with dementia are cared for at home by relatives or friends: custodial care, an intimate relationship, and home-life. Using Goffman's three defining aspects of custodial care – routinisation, surveillance and mortification of the self – the paper examines whether these characterised the care of people with dementia at home and, if so, whether they conflicted with the intimate relationship and with home-life. The study involved sustained observations and interviews with 20 people with dementia and their carers in and around London, and qualitative analysis of the data. It was found that all three aspects of custodial care were present although not fully realised, and that they led to difficulties, many of which were associated with the concurrent pursuit of an intimate relationship and home-life. In all cases, daily life was routinised partly to help accomplish care tasks but was found monotonous, while surveillance was usual but restrictive, and prevented both the carers and those with dementia from doing things that they wished to do. Those with dementia were distressed by the denial of their former identities, such as car-driver or home-maker, and by being treated like children. Both the carers and the people with dementia had various ways of balancing custodial care, their intimate relationships and home-life, such as combining routines with other activities, evading surveillance or carrying it out by indirect means, and there were many attempts to maintain some semblance of former identities.

Although the association between falls and fear-of-falling has been established by previous studies, the temporal ordering of the two is uncertain. Moreover, the common and unique risk factors that contribute to falls and to fear-of-falling have not been investigated in either primary health-care settings or Asian societies. The aims of this study were to examine the temporal sequencing of fear-of-falling and a fall, and to identify the risk factors associated with the two. A prospective cohort study with three six-month measurement waves was conducted in primary-care settings in Hong Kong. The sample was derived from the waiting list control group of a randomised clinical trial, and 321 respondents participated in the three waves. They were evaluated with the Minimum Data Set for Home Care. It was found that falls and fear-of-falling at baseline were not independent predictors of respectively developing a fear-of-falling and becoming a faller, but that age was a common independent predictor for falls and the onset of a fear-of-falling. Individuals with a fear-of-falling were at risk of both falling and a fear-of-falling at 12 months. The good news is that no vicious cycle of falls and fear-of-falling was found, and modifiable risk factors, including IADL limitations, environmental hazards, and fear-of-falling were identified, so that effective prevention programmes for falls and for fear-of-falling can be designed.

The paper focuses on intergenerational support relations between grandparents and their grandchildren in Germany, and how they have changed from 1996 to 2002. The paper begins with a brief review of the literature on functional aspects of the grandparent-grandchild relationship, after which the research hypotheses about intergenerational support in the relationship are elaborated. Following a description of the data source, the German Ageing Survey, and its samples and measures, the evidence on the patterns of grandparents' provision and receipt of intergenerational support to and from their grandchildren are presented and compared with parent-child support patterns. The analysis also considers variations by age groups and birth cohorts and changes over time. The main empirical finding is that there was a greater likelihood of financial transfers to grandchildren in 2002 than six years earlier. Nevertheless, the grandparents' relationships with their grandchildren remained imbalanced or asymmetrical, at the older generation's expense. It was found that financial and instrumental support patterns between grandparents and grandchildren were best explained using an ‘intergenerational stake’ hypothesis rather than one of ‘intergenerational solidarity’; the latter is more consistent with parent-child support patterns.

Few studies have investigated how outdoor environments might disable people with dementia. The issue is rarely considered in planning and design guidelines and not at all in regulations, despite dementia being within the scope of disability discrimination legislation in the United Kingdom and other countries. This article reports a study that involved older people with mild to moderate dementias taking two walks, one in a real town centre and one in a virtual reality (VR) simulation. Adaptations were made to the VR simulation to test possible design improvements. Overall, the town centre posed relatively few problems for the 38 older people with dementia who participated, although more difficulty was evident with greater impairment. Some features of particular places were liked more than others, particularly the segregation of spaces from motor traffic. There were measurable benefits from using clear textual signs to support wayfinding and to identify objects and places in the environment. Diminished outdoor activity is likely to be experienced as a decrease in quality of life and may accelerate the progression of dementia. We conclude that older people with mild to moderate dementia should be encouraged to be active outdoors and that this can be facilitated by small environmental modifications. Some limitations of the VR technology used for the study are also reported.

Most studies of retirement migration in the United States focus at the national level, and there is comparatively little information about the retirees who cross international borders in their search for new homes. Retirement migrants are unusual in that many select destinations in less-developed countries, contrary to the general pattern of migration from poor to rich countries in search of jobs, higher incomes and a better standard of life. This study has examined the reasons for retirement migration from the United States (US) to the Lake Chapala area of the Mexican state of Jalisco. A non-random sample of 211 US retirees was surveyed using a self-completion, semi-structured questionnaire that included items about the decision to move to Mexico, the quality of life at the destination, cultural adaptation, and aspects of personal identity, financial security and health-care. Four major reasons for migrating to Mexico were identified: financial circumstances, the natural environment, a sense of community and friendship, and a better quality of life. While the migrations contradict much taken-for-granted and popular knowledge about migration patterns around the world, they have important implications for the ways of life, social relationships and welfare of the most recent cohort of older people. More in-depth multidisciplinary studies are needed to increase understanding of this evolving phenomenon.

This paper reports one component of an evaluation of the different forms, types and models of local authority social services' care-management for older people that have emerged in England since 1993. It was undertaken at a time of a growing debate about whether care-management differentiated those with simple from complex needs, and whether for the latter a multi-disciplinary approach was required. A sample representative of different approaches to care-management was selected from a national survey of local authorities to explore the associations between types of care-management and case-mix, the services received by the clients, and the use of staff time. The paper addresses the categorisation of the types of care-management and the differences associated with these. The care-management teams were distinguished by whether they used a ‘targeted approach’, had ‘specialist older people's teams’, or used other arrangements. It was found that those with a targeted approach undertook more multi-disciplinary assessments, provided more assistance to older people with mental health problems, and that their staff spent significantly less time in direct contact with users and carers. Conversely, those with specialist older people's teams had more users in receipt of occupational therapy services. Further research is required to explore the influence of these different arrangements on the wellbeing of service users and their carers.

‘University programmes for older people’ (UPOP) have recently expanded rapidly in Europe and are now well established. This study examines the functions and achievements of the programmes and the characteristics of UPOP students in Spain. The evaluation is from a general sociological perspective, and uses data from a survey of a representative sample of the students and other sources. The main socio-demographic findings are that the students are relatively young older people, have a relatively high socio-economic level, and are predominantly women and retired. It is shown that beyond the education imparted, the programmes also fulfil important social roles. A critical analysis of the programmes as social policy highlights their socially selective reach and impacts, and compares their actual and potential functions. Some alternatives are discussed. If UPOP are to maintain their identity as programmes for older people, a different approach is required to reach all elderly people, including the ‘really old’. On the other hand, if the objectives emphasise the promotion of social integration and personal development (in matters other than employment skills), there is no reason why they should be addressed exclusively to people aged 50 or more years (or any arbitrary age). Rather, they should be open to adults of all ages. If this change were made, UPOP would give less reinforcement to a particular social construction of old age.

This paper presents findings from a national survey of quality of life (QoL) in older age. The main aim of the analyses was to examine the definitions of quality of life given by people aged 65 or more years and the underlying reasons. Open-ended questions were used to elicit their perceptions of QoL. These were followed by structured measures of self-rated QoL overall, and of domains of QoL commonly reported in the literature. The main things said by the respondents to give their lives quality were categorised into ‘themes’. These were: social relationships; social roles and activities; leisure activities enjoyed alone; health; psychological outlook and wellbeing; home and neighbourhood; financial circumstances; and independence. The reasons people gave to explain why these things were important to their QoL focused on: the freedom to do the things they wanted to do without restriction (whether in the home or socially); pleasure, enjoyment and satisfaction with life; mental harmony; social attachment and having access to companionship, intimacy, love, social contact and involvement, help; social roles; and feeling secure. This paper also presents data that demonstrates the ability of theoretically informed, structured survey indicators of QoL to predict respondents' self-rated overall QoL. Logistic regression analyses showed that most of these indicators were strong, independent predictors of self-ratings of QoL, although those that were not significant in the model did not fully incorporate lay reasons of QoL in their measurement scales. In conclusion, the indicators which were not significant in the model did not fully incorporate lay values in their measurement properties. It is also likely that those indicators that were significant could have been improved.

Much of the literature on ageing and transport has been concerned with older drivers, which underlines the importance of private transport in their everyday lives, but little has been written about how a lack of transport impacts on quality of life. A survey was commissioned by the Office for Senior Citizens of the New Zealand government, and face-to-face semi-structured interviews were conducted in 2004 with 28 couples and 43 single people (14 men and 29 women). The sample was identified through Volunteer Community Co-ordinators (VCCs) and drawn from metropolitan, urban, small-town and rural areas. The average age of the men was 84.5 years and of the women 81.4 years, and all had been without private transport for at least six months. The interviews sought the experiences and opinions of older people who were ‘coping without a car’, and asked how this affected their lifestyle and quality of life, and how they met their transport needs. The findings reveal variations by gender, health status and personal outlook, including views on independence and reciprocity. While ‘serious’ transport requirements may be provided for by alternative means, the ‘discretionary’ trips that contribute significantly to the quality of life may be lost when private transport is unavailable. The findings have implications for local and national policy and planning, extend well beyond the sphere of transport, and illuminate processes of social exclusion among older people.

This paper assesses the impact of disturbing life events over five years on the wellbeing of 340 people aged 80–84 years at baseline, by analysing data from a longitudinal survey in Switzerland. The guiding proposition was that the negative effect of life events is moderated by the event domain, i.e. health, deaths and changes in family setting and relationships, and by cognitive adaptation to one's own health state (adopting a more or less optimistic view). Multi-level regression that controlled for the effect of socio-demographic and health factors was used. Corroborating the first hypothesis, a model that differentiated the event categories, instead of their additive inclusion, gave the best fit. In support of the second hypothesis, it was shown that the positive impact of self-rated health reduced the negative effect of life events on wellbeing for survivors, but not for those who died within five years. This suggests that the former made more optimistic appraisals of their mental and physical health, while the latter adjusted their subjective health rating to their functional abilities. Survivors had better psychological resources for coping with disturbing life events, while the deceased lacked these resources, which buffered the impact of negative events. The psychological meaning of stressful events at the end of life is discussed. By encouraging optimistic self-evaluations of health, and raising awareness of the range of normal functioning of older people, health- and social-care practitioners can promote the maintenance of meaningful lives in old age.

Given its relative ethnic and socio-economic homogeneity, Sweden is an ideal nation for the study of variations in formal and informal care as a function of gender, disability and advanced age. This paper reports an analysis of the relationships between gender, disability and age and the formal care delivered to more than 1,200 people aged 75 or more years in Sweden in 1994 and 2000. In municipalities that provided above-average home-help hours per recipient, and that had high institutional placement rates, women were relatively less likely to have been receiving informal assistance alone, those with greater disability were more likely to have been receiving all forms of assistance, the oldest-old were less likely to have been receiving either informal or formal help alone, and rates of formal assistance and of no informal care were relatively low. In municipalities with high rates of institutional placement, the oldest-old were relatively more likely to have been receiving both formal and informal assistance. Sweden's system of old-age care appears broadly equitable although the quality of care could not be fully assessed. Although home and community-based service provision (HCBS) has recently decreased, variations in the volume and mix of delivered formal services reflect differences in need.

This article reports a study of older people in higher education, their socio-economic characteristics and the motivations and reported benefits of their studies. Whilst research on older learners is growing, particularly the benefits of the learning process itself, little is known about those who engage in higher education study. The findings are reported of a survey of graduates from the two UK higher education institutions that specialise in part-time study provision. The study population is distinctive in two respects: their participation in the accreditation process and that they complete with a formal qualification. It is shown that, whilst a sizable proportion of the middle-aged and older students are well-off and well educated, there is also considerable heterogeneity and that many are making up for opportunities lost earlier in life. A substantial proportion of the ‘middle-aged’ graduates still saw qualifications as a pathway to enhanced employment opportunities, whereas the older graduates placed more weight on wider benefits. The qualification was seen as an important aspect of their chosen study. Using the responses to qualitative interviews, the article explores the role of the qualification in the lives of the older graduates, and illustrates how this particular kind of study is an element of their strategies to manage the transition from work to retirement, and to make life in retirement more meaningful.

Conventional wisdom promotes gradual retirement rather than an abrupt end to the working life. This paper compares the outcomes of abrupt and gradual retirement one and three years after the transition to retirement began using data from an Australian panel study. The outcomes included changes in health, positive and negative affect, wellbeing and marital cohesion. For many outcomes there was no difference between gradual and abrupt retirements, but those who retired abruptly were more likely to rate their health as having deteriorated and more likely to report better adjustment to retirement. Control over retirement decisions was also explored; it emerged as a more important factor in retirement wellbeing than whether the transition was gradual or abrupt. The absence of interaction or additive effects between the retirement pathway and the level of control over the process confirmed this result. Thus there is no simple answer to the question in the title. Retiring gradually allows time for people to make changes to their lifestyle, but having control over the timing and manner of leaving work had a greater positive impact on psychological and social wellbeing, and this persisted three years after retirement. The findings suggest that policies and employment practices that promote employees' control of their retirement decisions will enhance wellbeing in later life and facilitate longer workforce participation.

This paper explores the intersections of age and masculinities in small information technology (IT) firms in Canada. The IT workforce, although demographically young, does not entirely comprise younger workers but is dominated by men and is ageing. Despite the infamous ‘nerd’ stereotype of IT workers and its associations with immature age and masculinity, perceptions of age and ageing in the industry have not been considered in the context of masculinities. To what extent are conceptualisations of IT work shaped by notions of age and masculinities? How do perceptions of age and masculinities correspond to occupational trajectories and responsibilities in IT work settings? To address these questions, this paper reports an analysis of qualitative semi-structured interviews with 76 employees of small IT firms in Canada. The findings indicate that the dominant frameworks for describing the nature of IT work are metaphors and analogies with sports, the military, entrepreneurial drive and craftsmanship. This paper focuses on the allusions to sport, war and ‘being driven’, and argues that the discursive ties to these masculine arenas normalise, or make ‘natural’, the affiliation of youthfulness and technical ability. The corresponding intersections between age and masculinity suggest that older workers are marginalised in small IT firms.

Several studies of frail older people have focused on the relationship between formal and informal care, while others have examined the character of inter-generational relationships. Yet knowledge of the significance of the informal-support networks of older people who receive formal care is still scarce. The aim of this paper was to explore how older Swedes who receive formal elder-care experienced their informal support networks. The findings presented emanate from a qualitative case study. The structural, interaction and functional dimensions of the support networks were the main analytical tools. In the study population, the size of the formal support network varied from one to 12 people (or categories of people), and the size of the informal support network varied from one to six people (or categories of people). The main results demonstrate the importance of informal support with reciprocal relationships, and the value of confidants and emotional support, both of which contribute to feelings of belonging, security and wellbeing. A well-functioning formal and informal support network allows individuals to maintain autonomy in old age, even when they have to depend on help from others.