Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis

Abstract

Background. Research has found a strong link between ageism, in the form of negative stereotypes, prejudice, and discrimination toward older people, and risks to their physical and mental health. Little is known, however, about the effectiveness of strategies to reduce ageism. Objectives. To assess the relative effects of 3 intervention types designed to reduce ageism among youths and adults—education, intergenerational contact, and combined education and intergenerational contact—by conducting a systematic review and meta-analysis. Search Methods. We searched PubMed, PsycINFO, AgeLine, EBSCO, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Global Index Medicus, Database of Abstracts of Reviews of Effects (DARE), Epistemonikos, Cochrane Database of Systematic Reviews, Campbell Collaboration, PROSPERO, GreyLit, and OpenGrey. We identified additional records by hand-searching reference lists of relevant review articles as well as records included in the meta-analysis. Two independent reviewers completed the search and screening process. Selection Criteria. Eligible studies were those that (1) evaluated an intervention designed to reduce ageism, (2) examined at least 1 ageism outcome in relation to older adults, (3) used a design with a comparison group (randomized or nonrandomized), and (4) were published after 1970, when the ageism concept was developed. Data Collection and Analysis. Two independent reviewers extracted study-level data from records using a common data collection spreadsheet. They also assessed study quality by using the Cochrane Risk of Bias Tool, and used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool to assess quality of outcome evidence. Primary outcomes were attitudes toward older people and accuracy of knowledge about aging and older people. Secondary outcomes included comfort with older adults, anxiety about one’s own aging, and interest in working in the field of geriatrics or gerontology. We carried out meta-analyses with statistical mixed models. Main Results. We identified 63 eligible studies (1976–2018) with a total sample of 6124 participants. Ageism interventions demonstrated a strongly significant effect on attitudes (differences of standardized mean differences [dD] = 0.33; P < .001), knowledge (dD = 0.42; P < .001), and comfort (dD = 0.50; P < .001), but no significant effect on anxiety (dD = 0.13; P = .33) or working with older adults (dD = −0.09; P = .40). Combined interventions with education and intergenerational contact showed the largest effects on attitudes. We found stronger effects for females and for adolescent and young adult groups. Authors’ Conclusions. Interventions are associated with substantial reduction in ageism and should be part of an international strategy to improve perceptions of older people and the aging process. Additional research using more rigorous designs to examine the effects of interventions is strongly recommended. Public Health Implications. Ageism has well-established negative effects on the physical and mental health of older people. Findings suggest that relatively low-cost, feasible strategies involving education and intergenerational contact can serve as the basis of effective interventions to reduce ageism.

Too Old for Computers? The Longitudinal Relationship Between Stereotype Threat and Computer Use by Older Adults

“…Experimental evidence has shown that informing individuals about stereotype threat ( Mazerolle et al, 2016 ) and promoting either experienced or imagined intergenerational contact ( Abrams et al, 2006 , 2008 ) reduced the negative effects of stereotype threat on older adults’ cognitive performance. The latter approach may be particularly promising, as intergenerational contact can also improve stereotypes and attitudes toward older people (for reviews, see Burnes et al, 2019 ; Marques et al, 2020 ). Still, intergenerational programs focusing on technology use must be carefully designed, as they may end up reinforcing stereotypical perceptions of older adults as incompetent ( Drury et al, 2017 ).…”

Determinants of Ageism against Older Adults: A Systematic Review

“…Our review departed from a vast pool of studies, which allowed us to minimise searching bias but delayed time from searching to dissemination. We decided to not conduct an immediate update to keep our strategy consistent with the remainder of projects developed in the context of the same initiative-the Global Campaign to Combat Ageism of the WHO [22][23][24][25]. While our work is the first systematic review effort on this topic and sets bases for future endeavours within the same scope, we acknowledge it may be important to revisit this topic in a few years for an update (may further developments in the field justify).…”

“…Ultimately, we hope the findings from this systematic review may help to inform the development and expansion of intervention programs aimed at tackling ageism, including the Global Campaign to Combat Ageism that is being led by the World Health Organization (WHO) [22][23][24][25]. In addition, we also aimed to identify and discuss specific research gaps in the determinants of ageism literature where further studies may be beneficial.…”

Interdisciplinary and Collaborative Approaches Needed to Determine Impact of COVID-19 on Older Adults and Aging: CAG/ACG andCJA/RCVJoint Statement

“…Third, the use of arbitrary age cut-offs and the generalized (mis)attribution of COVID-19 risk to aging has inadvertently reinforced and intensified negative age stereotypes, prejudice, and discrimination that will need to be addressed (Ayalon et al, 2020;Brooke & Jackson, 2020;Meisner, 2020). Even before the pandemic, interventions aiming to reduce ageism were essential and thus should be developed further (Burnes et al, 2019).…”