Sarah Schroyen

Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads.

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people’s mental and physical health in “normal” aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals’ attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients’ mental and physical health.

A Validation of the French Version of the Attitudes to Aging Questionnaire (AAQ): Factor Structure, Reliability and Validity

Introduction: The Attitudes to Aging Questionnaire (AAQ) was developed to measure attitudes toward the aging process as a personal experience from the perspective of older people. The present study aimed to validate the French version of the AAQ. Participants and methods: This study examined factor structure, acceptability, reliability and validity of the AAQ’s French version in 238 Belgian adults aged 60 years or older. In addition, participants provided information on demographics, self-perception of their mental and physical health (single items), quality of life (WHOQOL-OLD) and social desirability (DS-36). Results: Exploratory Factor Analysis produced a three-factor solution accounting for 36.9% of the variance. No floor or ceiling effects were found. The internal consistency, measured by Cronbach’s alpha coefficients for the AAQ subscales were 0.62 (Physical Change), 0.74 (Psychological Growth), and 0.75 (Psychosocial Loss). A priori expected associations were found between AAQ subscales, self-reported health and quality of life, indicating good convergent validity. The scale also showed a good ability to discriminate between people with lower and higher education levels, supporting adequate known-groups validity. Finally, we confirmed the need to control for social desirability biases when assessing self-reported attitudes toward one’s own aging. Conclusion: The data support the usefulness of the French version of the AAQ for the assessment of attitudes toward their own aging in older people.

Ageism in Belgium and Burundi: A comparative analysis

Background Recent cross-cultural comparisons between Asian and Western cultures have shown that ageism arises more from the lack of availability of social and economic resources for older adults than from the culture itself. We tested this assumption by conducting a survey among people living in a least developed country compared with those living in a developed country. Participants and methods Twenty-seven Belgians living in Belgium, 29 Burundians living in Belgium, and 32 Burundians living in Burundi were included in this study. Their attitudes toward older adults were assessed using several self-reported measures. Results Statistical analyses confirmed that older people are more negatively perceived by Burundians living in Burundi than by Burundians and Belgians living in Belgium, whose attitudes did not differ from each other. Conclusion Consistent with our hypothesis, our results suggest that the level of development of a country and more particularly the lack of government spending on older people (pension and health care systems) may contribute to their younger counterparts perceiving them more negatively.

The link between self-perceptions of aging, cancer view and physical and mental health of older people with cancer: A cross-sectional study

OBJECTIVES Older people may suffer from stigmas linked to cancer and aging. Although some studies suggested that a negative view of cancer may increase the level of depression, such an association has never been studied in the elderly population. Similarly, even though it is established that a negative self-perception of aging has deleterious consequences on mental and physical health in normal aging, the influence in pathological contexts, such as oncology, has not been studied. The main aim of this study is thus to analyze the effect of these two stigmas on the health of elderly oncology patients. MATERIALS AND METHODS 101 patients suffering from a cancer (breast, gynecological, lung or hematological) were seen as soon as possible after their diagnosis. Their self-perception of age, cancer view and health (physical and mental) was assessed. RESULTS Multiple regressions showed that patients with a more negative self-perception of aging and/or more negative cancer view reported poorer global health. We also observed that negative self-perception of aging was associated with worse physical and mental health, whereas negative cancer views were only linked to worse mental health. No interaction was observed between these two stigmas, suggesting that their action is independent. CONCLUSION Older patients with cancer face double stigmatization, due to negative self-perception of aging and cancer, and these stigmas have impacts on global and mental health. Self-perception of aging is also linked to physical health. Longitudinal studies will be necessary to analyze the direction of the association between this double stigmatization and health.

Impact de la double stigmatisation en oncogériatrie : état des lieux

Cancer is a major health problem for which age is a proved risk factor. Paradoxically, elderly suffering from cancer are often excluded from clinical trials and undertreated compared to younger patients. Also, their psychosocial needs remain unknown. An explanatory factor for these observations is the age stigma (that is to say our stereotypes about age and so, ageism), age being currently cited as the main reason for discrimination. Besides these age-related stigmas, cancerous patients face pathology-related stigmas because nowadays cancer (especially some types of cancer such as lung cancer) still conveys a lot of negative representations. These observations bring us to the notion of double stigmatization in oncogeriatry. Moreover, the aim of this review is to present ageism phenomenon on the basis of several studies that had proved negative influence of ageism on elderlys mental and physical health and on the attitude of elderlys interlocutors. Afterwards, we will broach the way by which ageism and stigmatization linked to cancer is observed in the specific context of oncogeriatry, which will allow us to identify current shortcomings.