Against the backdrop of demographic change and the pluralisation of living arrangements, the article focuses on repartnering after widowhood, divorce and separation in older age in Germany. While theoretically framing repartnering as a lifecourse transition, the question arises of how later-life relationships form in relation to gender- and ageing-specific as well as structural and processual dimensions. Since previous research indicates that there are gender-specific patterns when repartnering in older age which differ from repartnering in middle age, the article explicitly accounts for gendered ageing and attitudes towards ageing. Using data from the German Ageing Survey (1996–2017), longitudinal hybrid panel regressions are modelled for 3,653 respondents, 11,628 observations and 179 new relationships. I propose to understand within-effects as processual and between-effects as structural dimensions of repartnering. The results for the structural dimensions show that the likelihood of repartnering is higher for men and for individuals with more negative attitudes towards ageing. The results for the processual dimensions show how repartnering becomes less likely the older one gets and the more positive one's attitudes towards ageing become. The interaction term for gender and ageing shows that ageing has a stronger influence on the likelihood to repartner for women than for men. Additionally, the findings reveal a difference between forms of singlehood: in the short term, repartnering is less likely for divorced or separated individuals than for widowed individuals, whereas the opposite effect shows in the long term. In sensitising the lifecourse perspective with gender- and ageing-specific concepts and analytically separating processual and structural dimensions, this article demonstrates the importance of gendered ageing and of the linkage between relationship transitions. Applying hybrid panel models to lifecourse transitions in older age reveals the processual dynamic and structural embeddedness of repartnering in older age.

Several observational studies investigated risk factors for suicide attempts/completed suicides in older age with contrasting evidence from ongoing population-based research. The risk factors most associated to suicide attempts than other variables were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. There is growing evidence of a role of environmental exposures in the pathogenesis and epigenetics of suicidal behavior in older age. Little is known about the possible relationship between suicidal ideation in older age and its biopsychosocial predictors, although psychiatric disorders (among which late-life depression, LLD), play a fundamental role. LLD, distinguished as late-onset depression (LOD) and early-onset depression (EOD). Suicidal ideators accounted for 2.32% of subjects, were female, smokers and obese affected by multimorbidity. After adjusting for age, gender, education and social dysfunction, suicidal ideation was associated to LLD (EOD>LOD:OR:21.71, 95% CI:9.22-51.14). In the full random forest model, asthma was the most important contributor to suicidal ideation. Among biomarkers, interleukin (IL)-6 followed by tumor necrosis factor (TNF)-a, Apolipoprotein E e4 allele-carriers, C-reactive protein contributed most to suicidal ideation. Although EOD is a strong determinant of suicidal ideation, other non-psychiatric factors, i.e., serum inflammation biomarkers, APOE e4 allele, and multimorbidity, should be taken into account when evaluating a suicidal ideation phenotype in older age.

Wayfinding skills decay in old age, more so for wayfinding in an allocentric than an egocentric reference frame. This study investigates whether wayfinding deficits of schoolchildren mimic those of older adults. Schoolchildren were tested on two wayfinding tasks: one could only be mastered in an allocentric, and the other only in an egocentric reference frame. The results were compared with those from a previous study of young and older adults who had been tested on the same two wayfinding tasks. It was found that wayfinding performance improved somewhat from school age to young adulthood and that this improvement proceeded more or less in parallel for the allocentric and the egocentric tasks. It was further found that wayfinding performance decayed from young to older adulthood and that this decay was more dramatic for the allocentric than for the egocentric task. This pattern of findings does not support the hypothesis that the wayfinding performance of schoolchildren mimics that of older adults.

The active ageing approach supports a set of roles or activities that are supposed to be beneficial for older adults. This paper reassesses the benefits of activities for the quality of life by (a) analysing many activities at the same time to control each other, (b) using panel data to detect the effects of activities over time, and (c) performing separate analyses for four European regions to test the context-specificity of the effects. The effects of roles in later life are tested on panel data from three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) project. The results of fixed-effects regression show that only some activities – volunteering, participating in a club and physical activity – increase the quality of life, and that care-giving within the household has the opposite effect. Moreover, the beneficial effects are much weaker and less stable than the other types of regression suggest; they are beneficial only in some regions, and their effect is much weaker than the effects of age, health and economic situation. Therefore, the active ageing approach and activity theory should reflect the diverse conditions and needs of older adults to formulate more-context-sensitive and less-normative policy recommendations.

This article is based on research set up to explore temporal dimensions of loneliness amongst older people in a northern town. As the study progressed, spatial considerations and confinements emerged as a related and equally important feature. The article suggests that the ‘social sphere’ of lived reality, especially reality lived out in one confined space, is a prime candidate for what has been termed ‘de-familiarisation’. Social policy discourses focussed on ‘ageing in place’ can sometimes neglect the realities of older people’s circumstances, daily life and social contact. Central arguments put forward in the article are: that loneliness increases as spatial prospects recede; that ‘home’ can become a source of frustration and negativity rather than a source of solace and comfort; and that expanding and facilitating the social horizons of older people currently ‘confined’ to home should be prioritised within a genuinely age-friendly approach to social policy.

Long-term poverty, precarious employment, low pay, the increased pension age and real-term reductions in welfare benefits, including bereavement allowances, have brought into focus the financial vulnerability of many older women aged 55 years and older in the United Kingdom. In this article, survey data were analysed alongside evidence from observations of debt support meetings and interviews with older women who were receiving debt advice from a support charity. The findings suggest that older women were more likely to have financial problems than older men, particularly those women who were living on low incomes and who were separated or divorced. Following the breakdown of a relationship, many older women were at increased risk of more debt and bankruptcy, particularly those aged between 55 and 64 years and those in routine and semi-routine occupations. Many women had kept their financial problems hidden due to fear and shame whilst bringing up their children and some had been subject to coercive control and economic abuse by their former husbands or partners. It is important that any pension reforms, changes to minimum wage rates, and new divorce and domestic abuse legislation and welfare policies take account of the circumstances of separated, divorced and widowed older women. More financial support and advice needs to be provided to older women facing financial difficulties.

This article challenges the dominance of age homophily in the literature on friendship. Using findings from a recent study on intergenerational friendship, we put forward a new conceptualization of a homophily of doing-and-being in friendships between adults who are of different generations. This research took a qualitative approach using constructivist grounded theory methodology. Homophily of doing-and-being has three components: being “friends in action” (pursuing interests and leisure activities, or simply spending time together), being “not only old” (sharing identities beyond age), and sharing attitudes and approaches to friendship and life. Additionally, “differences” were an important element of interest between the intergenerational friends. Our discovery of the centrality of doing-and-being, and the relative insignificance of age homophily, constitute a novel way of looking at friendship, and a new way of conceptualizing how and why (older) adults make and maintain friendships.

Sports participation contributes to maintaining health and wellbeing in old age, hence a deeper understanding of its various determinants is necessary. Previous research has primarily focused on either the effects of individual resources or age-specific attitudes to sports participation. However, a deeper understanding of the inter-relationships between these variables is required to develop effective policies to promote sports participation in ageing societies. To address the hypothesised inter-relationships, we consider both individual resources as well as age-specific attitudes and behaviours in order to integrate them simultaneously in our analysis. Furthermore, the analysis will be differentiated according to the three social status groups. The sample contains 1,560 retired persons, aged 65 years and older, based on the fifth wave (2014) of the German Ageing Survey. Multiple Poisson regression models were estimated to test our hypotheses. After adjusting for demographic variables, greater individual resources are associated with more regular sports participation. The findings also reveal that positive age perception and healthy behaviours are related to sports participation. Slight mediation effects between the different variables can be observed. Furthermore, the effect structures vary across different social status groups. The findings show that both individual resources and age-specific behaviours and attitudes are independent determinants of sports participation in older age. Our results confirm slight inter-relationships between socio-economic resources and age-specific attitudes.

In this comparative study focusing on the population aged 50 and over in three European countries, we investigate the association between household debt and depressive symptoms, and possible country differences in this association, using data from Waves 1, 2, 4, 5 and 6 of the Surveys of Health, Ageing and Retirement in Europe (SHARE) for Belgium, France and Germany. Multi-level regression models with random intercepts for individuals were used to analyse the association between household debt status and number of depressive symptoms (EURO-D score). Country differences in the household debt–depression nexus were tested using country interaction models. After controlling for other measures of socio-economic position and physical health, low or substantial financial debt was associated with a higher number of depressive symptoms in all countries. Housing debt was strongly linked to depressive symptoms for women while the association was weaker for men. The only country difference was that for both sexes substantial financial debt (more than €5,000) was strongly associated with depressive symptoms in Belgium and Germany, but the association was weak or non-significant in France. Associations between financial debt and depression were also evident in analyses of within-individual changes in depressive symptoms for a longitudinal sub-group, and in analyses using a dichotomised, rather than a continuous, measure of depression. The findings indicate that measures of household indebtedness should be taken into consideration in investigations of social inequalities in depression and suggest a need for mental health services targeted at indebted older people.

The psycho-social contexts of older lesbian, gay and bisexual (LGB) individuals suggest that they may face unique strengths and barriers in accessing social support. The present review aimed to explore what is known about this by providing a synthesis of this area of research and a methodological critique. The Applied Social Sciences Index (ASSIA), Psychinfo and Medline databases were searched and 22 relevant articles were identified. Key findings were extracted and quality was assessed using a standardised rating scale. The findings indicated that although many older LGB people report similar-sized support networks to older heterosexuals, more support came from friends and less from biological family members. Many reported not receiving enough support; it is possible that differences in care-giving between friends and family and anticipated social support difficulties due to previous LGB-stigma experiences partially account for this. Current recruitment strategies may mean that more-connected older LGB people are over-represented in research. There is a lack of research with the ‘old-old’ population, bisexual people, those with significant health needs, those outside the United States of America and those with additional characteristics associated with discrimination. Practical and research implications are discussed and it is suggested that friendship–carer dyads may need support to have more explicit discussions about care-giving roles due to a lack of societal templates for these kinds of relationships.

Although Middle East respiratory syndrome coronavirus (MERS-CoV) has a recorded 5 years of circulation in 27 countries worldwide, there is no international study to assess whether there is variation in mortality by region. Neither has there been a comprehensive study detailing how the disease characteristics of MERS-CoV influence mortality in patients presenting symptoms. This study aimed to assess how region, patient and disease characteristics influence 14- and 45-day mortality in MERS patients. The author utilised publically available data on MERS-CoV. The study included 883 MERS patients reported between 5 January 2015 and 10 March 2017. Data on patient and disease characteristics were collected. The mean age at MERS-CoV diagnosis was 54.3 years: 69.1% were male, and 86.7% of the cases were reported from Saudi Arabia. About 40% of MERS patients studied were over the age of 60. The study estimated 14- and 45-day survival rates after initial onset of symptoms: 83.67% and 65.9%, respectively. Saudi Arabian MERS patients exhibited 4.1 and 5.0 times higher 14-day (adjusted hazard risk (aHR) = 4.1; 95% confidence interval (CI) 1.012–16.921) and 45-day (aHR = 5.0; 95% CI 1.856–13.581) mortality risk compared with MERS patients in the Republic of Korea or other countries. Similarly, Middle Eastern MERS patients showed 5.3 and 4.1 times higher 14-day (aHR = 5.3; 95% CI 1.070–25.902) and 45-day (aHR = 4.1; 95% CI 1.288–113.076) mortality risk compared with MERS patients in the Republic of Korea or other countries. The results demonstrated a link between mortality and geography, disease and patient factors such as regions, symptoms, source of infections, underlying medical conditions, modes of transmission, non-healthcare workers and those of older age. Educational programmes, access to healthcare and early diagnosis could be implemented as modifiable factors to reduce the higher mortality rates in MERS patients.

The current paper seeks to explore whether there are differences in leisure patterns among men and women aged 50 and above, and whether the characteristics of one's country of residence influence these patterns. Data were obtained from the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE 2004/5), as well as from the database of the Organisation for Economic Co-operation and Development. The research population comprised 7,769 men and 9,337 women aged 50 and above from 11 European countries. Three clustered-robust logistic regression models examined the likelihood of participating in one or more of three leisure activities: going to sport or social clubs, participating in a course or educational class, and volunteering. Three Blinder–Oaxaca decompositions were used to examine gender gaps in participation in each activity. At the micro level, the results showed that men were more active than women and that men were also less influenced by the observed characteristics. In addition, retirement only increased the likelihood of participating in sport club activities for men. At the macro level, the country's expenditure on culture and recreation was found to contribute significantly to women's participation in leisure activities, especially those in which most of the participants are men. In addition, macro variables as a whole were found to reduce the contribution of the observed micro characteristics. The main conclusion of the study is that the macro factors, especially the country's expenditure on culture and recreation as a percentage of the Gross Domestic Product, contribute substantially to reducing the gender gap in participation in leisure activities in older age.

Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory (d=0.82 to 1.18), attention set-shifting (d=−0.61 to −0.69), and physical quality of life measures (d=0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory (d=0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma. (JINS, 2014, 20, 1–9)

The aim of this review is to summarise the evidence linking vitamin D to bone health outcomes in older adults. A plethora of scientific evidence globally suggests that large proportions of people have vitamin D deficiency and are not meeting recommended intakes. Older adults are at particular risk of the consequences of vitamin D deficiency owing to a combination of physiological and behavioural factors. Epidemiological studies show that low vitamin D status is associated with a variety of negative skeletal consequences in older adults including osteomalacia, reduced bone mineral density, impaired Ca absorption and secondary hyperparathyroidism. There seems to be inconsistent evidence for a protective role of vitamin D supplementation alone on bone mass. However, it is generally accepted that vitamin D (17·5 μg/d) in combination with Ca (1200 mg/d) reduces bone loss among older white subjects. Evidence for a benefit of vitamin D supplementation alone on reducing fracture risk is varied. According to a recent Agency for Healthcare Research and Quality review in the USA the evidence base shows mixed results for a beneficial effect of vitamin D on decreasing overall fracture risk. Limitations such as poor compliance with treatment, incomplete assessment of vitamin D status and large drop-out rates however, have been highlighted within some studies. In conclusion, it is generally accepted that vitamin D in combination with Ca reduces the risk of non-vertebral fractures particularly those in institutional care. The lack of data on vitamin D and bone health outcomes in certain population groups such as diverse racial groups warrants attention.