The objective of this study was to investigate the relationship between household structure and mortality at older ages in Parma, Italy. The household is an important setting for older people's social roles and social relations and its composition has a strong association with their health. The study examines 57,830 people aged 65 or more years drawn from the population registers of Parma (Italy). Record linkage from 1989 to 2000 was carried out using their unique identification numbers. Through the linked records, it was possible to follow changes in each person's and family's history provided they remained resident in Parma. The descriptive analyses show that elderly women were more likely than men to live alone, probably on account of their higher longevity. Only 10 per cent of elderly men lived alone, as compared with 32 per cent of older women. Nonetheless, the survival curves demonstrate that up to the age of 80 years, women living alone experienced lower mortality than those living with partners. A logistic regression model based on ‘event history analysis’ was performed using the longitudinal data. The results suggest that being married provides a protective role against mortality in later life only for men. It is possible that elderly women who take care of a husband or relatives do not care for themselves (or their health), as do older women who live alone.

In the United Kingdom, as in many other developed countries, there is an established market in the provision of long-term care-homes for older people. Implicit in the market mechanism is the assumption that homes will close, but it was not until 1999–2000 that closures of care-homes received widespread public attention. This paper draws on a multi-method study that investigated home closures in England from several perspectives. The rate of home closures rose substantially between 1998 and 2000 and, although sources give different estimates, it subsequently appears to have remained at about five per cent each year. The net result has been a reduction in capacity, particularly in smaller homes. While their emphases differed, both regulators and providers broadly pointed to the same factors behind the closures: the local authorities, the majority purchasers of care-home places, were under pressure to keep fees down, and national policies that raised costs were coming into force or were anticipated, notably the National Minimum Wage and the National Care Standards. Other factors, such as problems in recruiting suitable staff, particularly those with nursing qualifications, also played a role. The government's response, driven primarily by concerns about the effect on delayed discharges from acute hospital beds, was to retreat on the Standards and to increase funding to local authorities. While this has been a helpful step, more needs to be done to prevent good homes closing and to provide incentives that will retain and promote diverse provision.

The concept of wisdom, popularly associated with the idea of old age, was neglected during the 20th century. It has recently revived as a matter of academic concern, but remains imperfectly understood. This article therefore begins to explore both the concept of wisdom and some forms we might expect wise behaviour to take. It emphasises the contemporary relevance of historical approaches through an examination of Hebrew and Greek writing on wisdom. Recent contributions from psychology develop aspects of these traditions; but studying wisdom ethnographically also substantially expands our understanding of what wisdom is. An ethnographic interview from Austria exemplifies social as well as psychological aspects of wisdom, showing that part of the meaning of wisdom resides in its effects on a social setting. Aspects of discourse in rural Ireland, when interpreted in the light of maxim-related wisdom traditions, extend this claim, showing more about how wise interventions activate wisdom in the society surrounding them. Other ethnographic cases also develop this notion of wisdom as based on social interaction, by exploring its effects. If we face the methodological challenges entailed in tracing wisdom ethnographically, we enhance our understanding of the concept itself and stress the fruitfulness of the idea of wisdom as an attainment of the lifecourse.

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

This study has examined the flow of financial transfers between generations in Sweden, measured as financial support in the form of relatively large money transactions or gifts over 12 months. Two questions are considered: is there a net downward flow in the Swedish welfare state and, if so, are there differences according to gender and social class? The questions were tested using data from two linked and nationally representative large-scale surveys. The results show that almost all inter-generational transfers are downward, from older to younger generations. Unlike earlier studies of inter-generational transfers, the analysis focuses on inequality, and the results reveal clear class and income gradients. Both giving and receiving were more common among people in the higher social strata. A gender gradient among unmarried (single) recipients was also found, whereby unmarried women more often received financial support than unmarried men. The paper concludes with a discussion of the implications of the results for social stratification and inequality. From a static or cross-sectional perspective, the results suggest that financial transfers are neutral or even equality promoting, but a dynamic or lifecourse interpretation suggests that financial transfers transmit or even reinforce class inequalities over generations.

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

This article is an initial scoping exercise for a research agenda on the international political economy of ageing. It begins with a brief review of the various critiques of the political economy perspective that have been made over the 25 years since the first article on the subject. Remarkable for its absence has been criticism of the neglect of an explicit international perspective. Then the article emphasises that it is not globalisation per se that is problematic but its dominant neo-liberal economic form. It is mainly because of this globalisation and the related growth in the power of international governmental organisations, such as The World Bank, that an international political economy of ageing is required. The bulk of the article is devoted to an outline of the eight key elements that might comprise a theoretical and empirical research agenda for social gerontology. These key elements are: global inequality in old age, development and ageing, globalism and the power of international governmental organisations, trans-national corporations, the nation state, supra-national regional structures, the United Nations, and international non-governmental organisations. In the spirit of the other articles that have celebrated the journal's 25th anniversary, this paper is intended to stimulate scientific debate.

Male ageing is in focus nowadays. The aim of this study was to investigate conceptions of the male menopause (also known as andropause) in the educational and professional literature of Finnish physicians from 1982 to 2002, and the main point of interest was how the presentation of the male menopause and its treatments have changed. Published items for analysis were retrieved from the two main Finnish medical journals and from introductory gynaecology and urology textbooks using keywords for male ageing and hormones. It was found that disagreements about the male menopause have been marked. Some authors described it as a consequence of the decline in gonad functioning that comes with increased age, and some argued that we are making a disease out of normal ageing, but its association with sexual problems has risen in prominence: libido and potency disorders have recently been identified as symptoms. The treatment provided for male menopause was androgens, about which opinions diverged, especially the effect of androgen therapy on cardiovascular diseases and osteoporosis. New forms of testosterone treatment have been eagerly adopted, but opinions varied on the appropriate duration of the therapies. By the 2000s, the male menopause was increasingly likened to the female menopause, with emphasis upon the similar symptoms. While gerontological thinking largely sees the male menopause as an aspect of ageing and a normal condition, the andrological approach regards it as a treatable disease and its rapid adoption can be seen as a reflection of both private and public concerns about increased longevity.

This paper discusses the informal and formal provision of help and support to older people from a comparative welfare state perspective, with particular reference to the relationships between inter-generational family help and welfare state support. While the ‘substitution’ hypothesis states that the generous provision of welfare state services in support of older people ‘crowds out’ family help, the ‘encouragement’ hypothesis predicts a stimulation of family help, and the ‘mixed responsibility’ hypothesis predicts a combination of family and formal help and support. The paper reports findings from the Old Age and Autonomy: The Role of Service Systems and Inter-generational Family Solidarity (OASIS) research project. This created a unique age-stratified sample of 6,106 people aged 25–102 years from the urban populations of Norway, England, Germany, Spain and Israel. The analyses show that the total quantity of help received by older people is greater in welfare states with a strong infrastructure of formal services. Moreover, when measures of the social structure, support preferences and familial opportunity structures were controlled, no evidence of a substantial ‘crowding out’ of family help was found. The results support the hypothesis of ‘mixed responsibility’, and suggest that in societies with well-developed service infrastructures, help from families and welfare state services act accumulatively, but that in familistic welfare regimes, similar combinations do not occur.

Our purpose in this paper is to explore and deepen the understanding of older women's relations to bodily appearance by looking at two different conditions of existence. Recent research has touched on the experiences of older women in societies with youthful norms of beauty, but the diversity of older women's experiences has been little explored, and there has been little dialogue between theoretical writing and empirical research on the topic. It was therefore decided to conduct an empirical study of older women's relations to bodily appearance, applying Pierre Bourdieu's sociological theory and particularly the concept of habitus to the body. Qualitative, semi-structured interviews were conducted with 51 francophone women aged 65 to 75 years from working-class and affluent neighbourhoods of Montréal (Québec, Canada). The findings showed clearly that, despite the social differentiation associated with variations in economic and cultural capital, older women's relations to bodily appearance converged as they aged. Two previously unidentified and overlapping processes of attitudinal change were recognised: (1) differentiation by social class, and (2) convergence with increasing age. In conclusion, we discuss the embodiment of women's social and biological conditions of existence in the context of personal ageing. The notion of age-habitus is introduced to explain how older women maintain their social value in the context of omnipresent youthful ideals of beauty for western women.

The use of age as a criterion for the allocation of medical resources has been extensively debated internationally. This paper describes a study of the significance of age for the quality of life (QoL) of older and younger people with end-stage renal failure (ESRF) and in receipt of renal replacement therapy (RRT). The study has two components: a structured literature review to characterise the QoL and health-status measurement instruments that have been developed for use with all or specifically older RRT patients; and a longitudinal survey of the QoL domains nominated by older RRT patients by their age and duration of treatment. The literature review found that no validated QoL instrument had been developed specifically for use with older RRT patients. Moreover, there was little correspondence between the QoL domains used in the instruments described in the published literature and those mentioned by the survey participants. Older and younger patients nominated different domains, and their nominations changed with the duration of treatment. No significant differences in QoL scores were found between older and younger patients, but the scores improved significantly between 6–12 and 18–24 months of treatment. The findings suggest that using older age as a criterion for refusing full access to healthcare resources in ESRF is a simplistic and potentially erroneous strategy.

For the older individual, leisure activities are a resource that helps to maintain health and engagement with life. This article investigates change over 10 years in the level of participation of older people in leisure activities in Sweden, and the factors associated with these changes. The data are from nationally representative samples of the Swedish population aged 77 or more years in 1992 and 2002. The level of participation was higher at the later date, and among four major groups of activities, social and cultural activities increased the most, while physical and intellectual activities increased only among women. Ordered logistic regressions enable variations in the level of participation by age, gender, level of education, disability and fatigue to be described. Participation in most kinds of activities, including the overall level, was more common at the younger ages (the late seventies and early eighties) and among those with full mobility and more education. Since average health was worse in 2002 than in 1992, it cannot explain the higher level of participation. Other possible explanations, such as cohort differences, improved accessibility, and changing gender roles, and the implications for health promotion programmes are discussed.

This article presents an analysis of the factors that were associated with preferences for ‘early retirement’ or ‘late exit’ from paid work in Sweden. It draws upon special questions that were added to the country's Labour Force Survey of 2001 and were put to a sample of more than 1,000 people aged 55–64 years who were (self-) employed. Separate models of the factors influencing women's and men's preferred retirement age were calibrated, using variables that described current working conditions, whether the respondents perceived themselves as being appreciated as employees, and their attitudes to work and to private or home life. Among the findings, a positive attitude towards work motivated both women and men to stay in work beyond the normal retirement age, while positive attitudes towards private life promoted an early exit. Poor working conditions generated negative attitudes towards work (and vice versa). The strengths of various push and pull factors were gender-specific: for women, a trying job tended to push them out of the labour market; for men, a socially-rewarding job tended to keep them in the labour force. The more that men worked mainly for pecuniary reasons, the stronger their wish for an early exit. Men who felt that they were unappreciated at work preferred early retirement: in some of these cases, the ‘push’ factor was related to ageism. As people approach retirement age, many appear to reconceptualise more positively their life outside the work place.