At the micro level, the clearest reported associations involved education, income, health, physical activity, and housing. Higher education and income, better self-reported health, greater physical activity, and more suitable housing were each associated with lower levels of social exclusion among the participants. These relationships emerged from the statistical analysis and do not demonstrate that changing any one of these factors would directly reduce exclusion.

The cross-sectional design cannot establish temporal order or causality, so the results are best understood as characteristics associated with lower scores in this sample of 400 older adults. The analysis also examined meso-level characteristics within the immediate community, including consumption patterns, digital connectivity, and age-friendly environments. These features were identified as correlates of social exclusion, although the reported findings did not specify a direction for their associations with exclusion scores.

The same distinction applies to several exo-level factors: satisfaction with local services, awareness of socioeconomic rights, utilization of social assistance, and active participation in community life were included among the correlates, but the abstract does not state which direction each association took. Their presence in the model nevertheless indicates that social exclusion scores varied in relation to factors extending beyond an individual’s personal characteristics. At the macro level, the absence of ageism, equitable resource access, and fewer employment barriers were associated with lower levels of exclusion.

By organizing variables across the micro, meso, exo, and macro levels, the study examined social exclusion as a multidimensional outcome embedded in interconnected personal, community, institutional, and societal conditions. The approach avoids treating age, income, health, or housing in isolation and instead considers how exclusion can be statistically related to conditions at several scales. Its scope also limits conclusions about how widely the observed associations apply beyond the surveyed population.

The authors’ overall implication is that addressing exclusion in later life may require multilevel interventions and policies directed at multiple ecological systems, rather than action confined to one setting or factor.

Subject of Research: Ecological correlates of social exclusion among adults aged 65 and over in Türkiye

Article Title: Social Exclusion Among Older Adults in Türkiye: A Cross-Sectional Assessment from an Ecological Social Work Perspective

Article References: Karakaya, C., & Çağlar, T. (2026). Social Exclusion Among Older Adults in Türkiye: A Cross-Sectional Assessment from an Ecological Social Work Perspective. Ageing International, 51(4), Article 44. https://doi.org/10.1007/s12126-026-09688-2

Image Credits: AI Generated

DOI: 10.1007/s12126-026-09688-2

Keywords: social exclusion, older adults, Türkiye, cross-sectional study, ecological systems, ageism, social assistance, digital connectivity, age-friendly environments, housing, Social, Exclusion

The theoretical foundation of the new analysis is communication accommodation theory, or CAT, the framework Giles and colleagues developed over more than fifty years and which is widely regarded as the most robust account of how people align—or fail to align—their speech with others in interpersonal and intergroup contexts. CAT holds that accommodation is a ubiquitous feature of social interaction serving two goals: keeping exchanges coherent and managing social distance. Speakers calibrate their adjustments according to motivation, ability, and expectations about what counts as situationally appropriate behavior, expectations shaped by sociohistorical context, interpersonal histories, and idiosyncratic preferences. Crucially, the theory’s sixth principle states that when accommodation is poorly calibrated—including being over-accommodative—it produces negative cognitive and affective outcomes: increased social distance, dissatisfaction, reduced mutual understanding, and a cascade of misattributions and communication failures.

Yet communicative adjustments, the authors emphasize, carry no inherent value. The same behavior—speaking more slowly, adopting an exaggerated affective tone—can be measured objectively, but its social meaning depends entirely on how interlocutors appraise it. One recipient may hear consideration; another may hear paternalism. Viladot and Giles argue that this appraisal hinges on who is speaking, to whom, in what situation, within what relationship, with what intentions attributed to the speaker, and inside what institutional and social framework. To sharpen the analysis, they distinguish conceptually between levels often homogenized in the literature: elderspeak as a discursive practice of simplified, infantilizing speech; paternalism as a relational dynamic that limits or substitutes a person’s autonomy under the justification of care; individual ageism as interpersonal stereotyping and assumptions of incompetence; and institutional ageism as structural discrimination embedded in services and policies, such as digital-only banking systems that exclude by design.

The empirical record on patronizing talk in institutional settings has consistently linked such communication to negative outcomes, including resistance to care, irritation, and reduced cooperation among older recipients. Training interventions aimed at reducing infantilizing language among younger people and healthcare professionals have demonstrated significant improvements in interaction quality and residents’ wellbeing. But much of this evidence derives from experimental and vignette-based designs with well-known methodological limitations, including social desirability and moral bias. Participants in such studies may respond not as they would actually behave but in accordance with normative judgments about what is socially appropriate—particularly when scenarios depict clearly inappropriate communication, potentially overrepresenting critical responses. These approaches, the authors contend, do not capture how overaccommodation is produced and interpreted in natural everyday interaction, nor how recipients respond in context.

Indeed, several studies indicate that certain forms of communicative adjustment associated with patronizing talk may be perceived positively under specific conditions—particularly when recipients interpret the behavior as communicatively suboptimal but well-intentioned. A qualitative study by Pierquet based on interviews with older adults found that participants identified as paternalistic those forms of communication that ignored their desires, needs, or beliefs, beyond the presence of specific linguistic features. Grammatical simplification, basic vocabulary, or exaggerated intonation may contribute to the perception of paternalism, but they are not a necessary condition for it. Potentially paternalistic behaviors may instead be read as attempts to help or facilitate interaction when benevolent intentions are attributed to them. Notably, the more effort older adults perceive in a speaker’s adaptation—even over-adaptation—of speech, the more positively they tend to evaluate it, particularly in intercultural encounters where such effort may signal respect or willingness to understand.

Here the article makes its most striking theoretical move: the first integration of system justification theory, SJT, with CAT. SJT, formulated by John Jost and Mahzarin Banaji in 1994, rests on a counterintuitive proposition: people do not only protect their self-esteem or favor their ingroup; they also tend to defend and legitimize the social system in which they live, even when that system is unequal or places them at a disadvantage. The theory distinguishes the system justification motive from ego justification, maintaining a positive self-image, and group justification, favoring one’s in-group, because it is oriented toward defending the social order itself. This motive is grounded in epistemic needs for order, coherence, and predictability; existential needs for security and reduced uncertainty; and relational needs to share a common understanding of reality with others. When individuals experience tension between perceived inequality and the need for a stable social world, cognitive dissonance emerges—and according to SJT, the response that frequently prevails is not to challenge the system but to reinterpret reality in ways that render it more coherent and acceptable.

Applied to intergenerational communication, this framework explains the gap between evaluation and acceptance that CAT alone cannot fully account for. Recipients may experience discomfort or perceive communicative practices as suboptimal while nevertheless accepting them, leaving them unchallenged, or interpreting them as appropriate within the interactional context. Assumptions circulate that it is normal to speak more slowly to older adults, that protective communication reflects respect and consideration, and that professionals are better positioned than others to determine what older patients need. Recipients may avoid confronting paternalistic communication to preserve relational harmony or avoid interactional costs. Under these conditions, certain forms of overaccommodation gradually come to be regarded as ordinary, appropriate, or expected. The authors propose a fine-grained distinction between affective evaluation, cognitive interpretation, behavioral response, and normative acceptance—showing how recipients may negatively evaluate communicative practices while simultaneously interpreting them as well-intentioned, leaving them unchallenged, or accepting them as socially legitimate.

The article then articulates this dissociation across three interconnected levels. At the micro level, recipients interpret language behaviors not merely in formal terms but in relation to the need to maintain a coherent, legitimate, and predictable representation of the social world; accepting overaccommodation as well-intentioned may serve functions of psychological regulation, reducing the dissonance that would arise from perceiving it as unjust or degrading, particularly when it is widely normalized. At the meso level, individual interpretations are embedded within networks of social norms that define what is considered communicatively appropriate in intergenerational contexts; from the perspective of SJT, these normative frameworks may be internalized and perceived as legitimate by the very individuals subject to them, so that their reproduction depends not only on external imposition but on processes of internal legitimation. At the macro level, overaccommodation may incorporate a broader status-regulatory function: practices such as anticipating needs, speaking on behalf of older adults, or redefining their capacities may contribute, not necessarily intentionally, to displacing older adults from positions of autonomy, authority, or social relevance. These levels operate through continuous feedback rather than linear causation, with repeated enactment of accepted communicative practices consolidating normative expectations and reproducing the age system.

Qualitative evidence supports this integrated reading. A meta-synthesis of healthcare professionals’ experiences found that patronizing communication is frequently enacted with caring intentions to facilitate care delivery, cooperation, and organizational routines, while simultaneously risking the erosion of older adults’ autonomy and personhood. Rather than describing elderspeak as a deliberate expression of ageism, professionals portray it as a communicative resource that facilitates care and organizational efficiency despite acknowledging its potential impact on residents’ dignity. The authors also note that these processes vary across structural contexts: the relationship between age and subjective wellbeing differs across countries and cohorts, and it is plausible that in contexts with higher levels of resources, autonomy, and social recognition of older adults, tolerance of overaccommodation is lower, whereas in more precarious settings such practices may be more easily legitimized and normalized.

The analysis carries implications that extend well beyond the nursing home. Age does not operate in isolation but intersects with other axes of inequality: older women tend to disappear earlier from the public sphere and are more rapidly infantilized than men, while older men may be perceived as less credible than middle-aged men, and studies show older men and women are evaluated differently when they challenge paternalistic stereotypes. The authors propose a modification to CAT’s sixth principle: when poorly calibrated overaccommodation is inferred by recipients to be motivated by compassionate or well-intended motives and is construed as normative and legitimate in the social system at hand, it may cause some communicative discomfort but can be accepted and lead to non-confrontational avoidance. Because elderspeak appears embedded in organizational cultures and everyday care routines, interventions should promote institutional reflection, person-centered communication, and organizational support for healthcare professionals if sustainable change is to be achieved. Intervening in communicative practices, recent work suggests, contributes not only to improving the quality of intergenerational interactions but also, gradually, to transforming social norms related to age. Understanding overaccommodation as a space in which evaluation and acceptance may diverge, the authors conclude, offers a key entry point for examining how age-based inequalities are subtly reproduced—and how, ultimately, they may be transformed.

Subject of Research: Psychology

Article Title: Overaccommodating language toward older adults: an interpretation based on theories of communication accommodation and system justification

Article References: Viladot, M. À., & Giles, H. (2026). Overaccommodating language toward older adults: an interpretation based on theories of communication accommodation and system justification. Frontiers in Language Sciences, 5, Article 1880735. https://doi.org/10.3389/flang.2026.1880735

Image Credits: AI Generated

DOI: 10.3389/flang.2026.1880735

Keywords: elderspeak, communication accommodation theory, system justification theory, ageism, intergenerational communication, patronizing talk, overaccommodation, aging, social norms, psycholinguistics, Overaccommodating, language

The research team, led by Theresa L. Scott alongside Melissa Kugelman and Amanda Salmon, surveyed 273 Australian residents aged between 19 and 82 years. Their goal was to untangle the psychological threads connecting pandemic stress, expectations about aging, and the quality of everyday contact between generations. What they found challenges the assumption that kindness and good intentions necessarily translate into non-ageist attitudes.

At the heart of the study lies a crucial distinction between two forms of ageism. Hostile ageism involves explicit negative beliefs—that older adults are burdensome, selfish, or dispensable. Benevolent ageism, by contrast, wears a friendlier mask: it frames older people as warm but incompetent, frail, and in need of protection. Both forms, researchers argue, can cause real harm. During the pandemic, these two faces of ageism played out publicly in starkly different ways.

Australian media coverage became a case study in benevolent ageism. Headlines urged the public to “protect the elderly, who are most at risk of death,” while the Prime Minister at the time warned young Australians not to endanger “an elder, vulnerable Australian” through their behavior. Such messaging, while well-intentioned, homogenized a diverse population into a single vulnerable category and positioned younger people as responsible guardians rather than equals. On the hostile end, commentary emerged questioning whether the lives of those in their 70s, 80s, or 90s deserved the same priority as those of younger adults—a sentiment that echoed the infamous “#BoomerRemover” hashtag circulating on social media internationally.

To measure these attitudes rigorously, the researchers adapted the Ambivalent Ageism Scale, originally developed by Cary and colleagues in 2017, tailoring items to the COVID-19 context. They paired this with the Expectations Regarding Aging survey (ERA-12), which probes beliefs about physical health, mental health, and cognitive functioning in later life. Participants also rated how frequently they experienced positive and negative contact with older adults, and reported how well they felt they were coping emotionally before and after March 2020.

The results painted a complex picture. Perhaps most strikingly, perceived changes in emotional coping showed no association with ageist beliefs whatsoever—a finding that contradicted the researchers’ initial hypothesis that pandemic-related emotional decline would fuel ageist attitudes. More positive expectations about aging, however, were linked to lower hostile ageism, though they bore no relationship to benevolent ageism. This asymmetry suggests that hostile and benevolent ageism, while conceptually related, may be driven by partly distinct psychological mechanisms.

Contact quality emerged as the most revealing variable. More frequent positive contact with older adults was associated with lower hostile ageism and more positive aging expectations—consistent with the classic contact hypothesis, which holds that meaningful intergroup interaction reduces prejudice. But here lies the paradox: positive contact was also associated with higher benevolent ageism. Meanwhile, negative contact showed the reverse pattern, correlating with greater hostile ageism and lower benevolent ageism. In other words, the kinder someone’s interactions with older adults, the more likely they were to hold paternalistic views of them as fragile and dependent.

The researchers offer several explanations for this counterintuitive finding. One possibility relates to the self-report nature of the contact measures: an individual performing an unsolicited “good deed” for an older adult might classify this as positive contact without recognizing the paternalistic assumptions embedded in the act. Another interpretation draws on prior research showing that positive intergroup contact can sometimes reinforce the societal status quo, perpetuating views of outgroup members as incompetent even as it reduces overt hostility. Studies of healthcare professionals have found a similar pattern—more contact with older patients correlated with warmer attitudes but also more benevolent stereotyping.

When participants were asked to describe older adults in two words, the results were telling. The most common benevolent descriptors were “vulnerable,” “slow,” “frail,” and “fragile,” while hostile descriptors included “stubborn,” “entitled,” “selfish,” and “ignorant.” Over one third of participants used words characteristic of either form of ageism. Statistical analysis confirmed that those who used hostile adjectives scored significantly higher on hostile ageism measures, and those using benevolent adjectives scored higher on benevolent ageism—suggesting that everyday language choices may serve as a window into underlying attitudinal structures.

Exploratory analyses comparing older participants (aged 65 and above) with younger ones revealed additional layers. Older adults held significantly more positive expectations about aging than their younger counterparts and reported more positive contact with other older adults. Crucially, the relationships between contact and ageism were significant only among younger adults, hinting that the contact hypothesis operates most powerfully across group boundaries rather than within them. The researchers caution, however, that the older adult subgroup was small, limiting statistical power for those comparisons.

The study’s practical implications are significant for anyone designing interventions to combat ageism. Simply increasing intergenerational contact—the strategy most commonly championed in the literature—may be insufficient, and could even backfire by reinforcing benevolent stereotypes if the nature and quality of interactions are not carefully considered. Programs that bring generations together must attend not just to frequency but to whether encounters position older adults as equals or as recipients of care.

The researchers acknowledge limitations: the sample was predominantly female and drawn largely from Queensland, recruitment relied on non-probability methods vulnerable to self-selection bias, and the adapted ageism scale showed questionable internal reliability for the benevolent subscale. The cross-sectional design also prevents any causal conclusions—perhaps ageist attitudes shaped contact quality rather than the reverse, or both were influenced by unmeasured factors.

Yet the broader message resonates beyond the pandemic. Ageism is a longstanding societal problem with documented consequences for mental health, physical functioning, and even life expectancy. As populations worldwide grow older, understanding how seemingly compassionate messaging can entrench stereotypes of vulnerability becomes increasingly urgent. The study suggests that the language we use to “protect” older adults may carry hidden costs—and that genuine respect, not paternalistic care, should be the goal of intergenerational relations. After all, as the researchers note, most people expect to become older adults themselves one day, making ageism an issue that ultimately affects everyone.

Subject of Research: Psychological drivers of hostile and benevolent ageism toward older adults during the COVID-19 pandemic in Australia

Article Title: Ageism toward older adults during COVID-19: associations with emotional coping and intergenerational contact

Article References: Scott, T. L., Kugelman, M., & Salmon, A. (2026). Ageism toward older adults during COVID-19: associations with emotional coping and intergenerational contact. Frontiers in Psychology, 17, Article 1949869. https://doi.org/10.3389/fpsyg.2026.1949869

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1949869

Keywords: ageism, COVID-19, older adults, benevolent ageism, hostile ageism, intergenerational contact, aging expectations, Australia, psychology, stereotypes, prejudice, pandemic

The editorial, led by Hipólito Nzwalo of the University of Algarve together with Miguel Barboza of Hospital Rafael Angel Calderon Guardia in Costa Rica and Nicola Logallo of Haukeland University Hospital in Norway, frames a persistent structural problem: most stroke trials and risk models have been built on younger, healthier cohorts. When clinicians apply those tools to patients with reduced physiological reserve, heavier comorbidity burdens, and different goals of care, accuracy degrades. In very old patients with intracerebral hemorrhage, for example, the main mortality scores retain acceptable overall discrimination but lose the ability to pinpoint which specific subgroups face the highest risk of death.

The consequences of this extrapolation are visible in everyday care. Evidence shows that older stroke survivors receive less guideline-compliant treatment than younger patients, regardless of how functionally independent they were on admission or at discharge. The editorial’s authors argue that treatment decisions should rest on biological rather than chronological age, a principle that several studies in the collection put to the test.

On the prevention side, several papers focused on risk stratification using readily available clinical data. One study examined the Weight-Adjusted Waist Index, an innovative obesity metric, as a predictor of first stroke in the elderly. Another found that combined levels of C-reactive protein and LDL cholesterol carried prognostic information, while a third investigated the glucose disposal rate, a surrogate marker of insulin resistance, in relation to stroke incidence. The appeal of these measures lies in their simplicity: they can be calculated from routine blood tests and anthropometric measurements without specialized equipment.

Two studies probed intermediate risk factors that sit upstream of stroke itself. Obesity, hypertension, triglycerides, glycosylated hemoglobin, sex, and fasting blood glucose were identified as predictors of arteriosclerosis, the arterial stiffening that underlies many cerebrovascular events. Separately, higher plasma levels of trimethylamine N-oxide, a metabolite produced by gut microbiota, were associated with a greater burden of cerebral white matter hyperintensities, the bright lesions on MRI that signal accumulating small-vessel damage. Importantly, the presence of these white matter changes was linked to early progression of stroke, particularly in older patients with anterior choroidal artery infarction, suggesting that brain imaging findings could sharpen acute risk assessment in the elderly.

Psychological factors emerged as another modifiable dimension of risk. Researchers found that an ascending trajectory of cognitive-affective symptoms, alongside unstable and persistently elevated trajectories of somatic depressive symptoms, were associated with increased stroke risk in older adults. The finding adds to growing recognition that depression and anxiety are not merely consequences of cerebrovascular disease but may actively contribute to its onset.

For prognostication after stroke has occurred, a series of studies highlighted the value of inflammatory and metabolic biomarkers calculated from standard blood counts. The neutrophil-percentage-to-albumin ratio, the triglyceride-glucose-body mass index, and the neutrophil-to-lymphocyte ratio all emerged as promising predictors of mortality in older stroke patients. In acute settings, the picture was similarly detailed: a risk model integrating cerebral circulation time and collateral status improved prediction of futile recanalization following mechanical thrombectomy, while distinct trajectories of the neutrophil-to-albumin ratio were associated with functional outcomes after endovascular treatment. The triglyceride-glucose-body mass index also predicted long-term all-cause mortality in elderly patients treated with intravenous thrombolysis, and the platelet-to-lymphocyte ratio proved an independent predictor of death in patients with severe acute ischemic stroke requiring intensive care.

Beyond biomarkers, the collection included a comprehensive review of deubiquitinases, enzymes that regulate the ubiquitin-proteasome system, a cellular machinery deeply implicated in cerebral ischemia-reperfusion injury, the cascade of damage that unfolds when blood flow is restored to oxygen-starved brain tissue. The review discusses the potential of deubiquitinase-targeted interventions as novel neuroprotective strategies, pointing toward therapies that could one day limit brain injury during reperfusion, a critical window in acute stroke care.

Several contributions directly challenged ageist assumptions by demonstrating that evidence-based interventions remain beneficial in the elderly. Extracranial vertebral artery stenting was shown to be both safe and effective in older individuals, as was intravenous thrombolysis for minor ischemic stroke. These findings carry practical weight: they support offering older patients the same reperfusion and endovascular options considered standard in younger populations, provided decisions are grounded in each patient’s biological status rather than an arbitrary age threshold.

Long-term cognitive outcomes received dedicated attention as well. One study identified three distinct post-stroke cognitive trajectories among elderly patients, characterized as high cognitive function with slow decline, low cognitive function with intermediate decline, and low cognitive function with rapid decline. Another found that the hemoglobin-to-red cell distribution width ratio, a simple calculation from a complete blood count, was associated with the risk of post-stroke cognitive impairment, offering clinicians an accessible biomarker for flagging patients at greater risk of cognitive deterioration. Taken together, the editors conclude that evidence for very old stroke patients remains weak, fragmented, and incomplete, and that tools derived from younger, less comorbid populations cannot simply be extrapolated upward. By spanning risk prediction, prognostication, acute management, and long-term outcomes, the research topic represents a concerted effort to close one of stroke medicine’s most persistent and consequential gaps.

Subject of Research: Stroke risk prediction, prognostication, and treatment in elderly and very old adults

Article Title: Editorial: Stroke research in the elderly: addressing ageism and prognostication

Article References: Nzwalo, H., Barboza, M., & Logallo, N. (2026). Editorial: Stroke research in the elderly: addressing ageism and prognostication. Frontiers in Stroke, 5, Article 1978900. https://doi.org/10.3389/fstro.2026.1978900

Image Credits: AI Generated

DOI: 10.3389/fstro.2026.1978900

Keywords: stroke, elderly, ageism, prognostication, biomarkers, intracerebral hemorrhage, thrombolysis, thrombectomy, white matter hyperintensities, cognitive decline, inflammation, insulin resistance

The study, published in the International Journal for Equity in Health, was conducted by Eva Katharina Boser, Lena Dörmann, and Niklas Ellerich-Groppe from the Division of Ethics in Medicine at the University of Oldenburg. Their research, funded by the Volkswagen Foundation as part of the FuturISE consortium on the future of intergenerational solidarity beyond the pandemic, takes a deliberately intersectional approach. Rather than treating age and gender as separate axes of analysis, the team examined how these categories interact and reinforce one another in public discourse, drawing on a tradition of intersectional feminist philosophy that has long argued that social inequities cannot be understood by looking at single categories in isolation.

Methodologically, the researchers built their analysis on a substantial corpus of media material. They collected articles from two major German weekly newspapers, Die Zeit and Welt am Sonntag, published between March 2020 and June 2022, a period spanning the first wave of the pandemic through its later phases. The final sample comprised 351 articles, which the team subjected to qualitative content analysis. From this material they identified two paradigmatic cases for in-depth intersectional analysis, focusing primarily on the categorical intersection of age and gender as it appeared in the newspaper coverage.

The choice of media as the object of study is significant. Newspapers such as Die Zeit and Welt am Sonntag do not merely report on public debates; they help constitute them. When a weekly publication frames the pandemic as a conflict or a contract between generations, it supplies the vocabulary through which millions of readers understand their own obligations and vulnerabilities. The Oldenburg team argues that the public renegotiation of intergenerational solidarity during the pandemic was precisely such a process of meaning-making, one in which a moral resource, the shared expectation that generations support one another, was contested, redefined, and redeployed.

What the analysis revealed is striking. The researchers observed not only a resurgence of ageism and age-related stereotypes in the media representations of intergenerational solidarity, but also a persistent entanglement of those stereotypes with gender norms. Older people were not portrayed simply as a homogeneous vulnerable group; the ways in which their vulnerability, their contributions, and their moral standing were depicted carried distinctly gendered markings. Similarly, the expectations placed on younger generations were filtered through assumptions about who owes care, who performs care, and who benefits from it.

According to the study, prevailing notions of intergenerational solidarity in the media continued to rely on gendered and age-based assumptions that shaped four dimensions of the debate: who counts as the moral actor in appeals to solidarity, what the basis of solidarity is, what contributions each generation is expected to make, and what normative goals solidarity is supposed to serve. In other words, the very architecture of the solidarity discourse was structured by stereotypes. The figure of the grandmother in need of protection, the daughter expected to provide unpaid care, the young adult asked to forgo opportunities for the sake of elders, these are not neutral archetypes, and the researchers show how they carried normative weight in the German debate.

The concept of a moral resource is central to the team’s argument. Intergenerational solidarity, they suggest, functioned during the pandemic as a reservoir of moral legitimacy that actors could draw upon to justify policies and demands. Lockdowns, contact restrictions, and vaccination priorities were all debated in the language of generational duty. Yet the study demonstrates that this resource was far from neutral in its effects. Because appeals to solidarity so often reiterated gendered ageism, the stereotypes of frail, dependent elders and self-sacrificing female caregivers, the moral currency itself risked perpetuating structural inequities even as it was being spent in the service of collective protection.

The researchers place these findings against the backdrop of intersectional feminist philosophy on structural social inequities and injustices. From this theoretical vantage point, the problem is not merely that individual articles contained biased portrayals, but that the discourse as a whole reproduced heteronormative generational divides. The study’s conclusions point to the significance of a gendered and heteronormative generational divide in appeals for intergenerational solidarity, one that embedded pertinent gender and age stereotypes into the public negotiation of pandemic ethics. This matters because stereotypes are not simply inaccurate descriptions; they distribute moral standing, expectations, and burdens unevenly across the population.

Why does this matter for future health crises? The authors argue that intergenerational solidarity remains a crucial moral resource in times of crisis, and that abandoning it is neither realistic nor desirable. Instead, they propose that approaches from intersectional feminist philosophy can help reconceptualize intergenerational solidarity as a diversity-sensitive moral resource. Such a reconceptualization would require public debates, and the media practices that shape them, to attend to the plurality of lived experiences across age, gender, and other social categories, rather than defaulting to familiar stereotypes. The German case, the study suggests, offers lessons for other countries facing similar dynamics, since the interplay of ageism and gender norms in crisis discourse is unlikely to respect national borders.

The findings also speak to a broader gap in the research literature. While a growing body of work has documented the pandemic’s impact on inequalities related to gender and other social categories, the interplay between appeals for intergenerational solidarity and these other inequalities in public debates had received limited attention before this study. By making that interplay visible through a systematic analysis of more than three hundred newspaper articles, the Oldenburg team has opened a line of inquiry with direct relevance to health equity, bioethics, and media studies. As the researchers and their colleagues in the FuturISE consortium continue to explore the future of intergenerational solidarity beyond the pandemic, their central message stands out: solidarity is indispensable, but only if it is rebuilt on foundations that do not quietly reproduce the very inequities a crisis exposes.

Subject of Research: Gendered and ageist dimensions of intergenerational solidarity in German media coverage during the COVID-19 pandemic

Article Title: Gendered forms of intergenerational solidarity in the COVID-19 pandemic: an intersectional perspective on the public renegotiation of a moral resource for future health crises in Germany

Article References: Boser, E. K., Dörmann, L., & Ellerich-Groppe, N. (2026). Gendered forms of intergenerational solidarity in the COVID-19 pandemic: an intersectional perspective on the public renegotiation of a moral resource for future health crises in Germany. International Journal for Equity in Health, 25(1), Article 244. https://doi.org/10.1186/s12939-026-03014-7

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03014-7

Keywords: intergenerational solidarity, COVID-19 pandemic, gender, ageism, intersectionality, media discourse, Germany, moral resource, health crisis, vulnerability, feminist philosophy, health equity

The research team conducted eight gender-segregated focus group discussions with 72 undergraduates aged between 18 and 25 years. Participants received information about the study and provided written informed consent, with participation voluntary and audio recording separately consented to. Transcripts were anonymised before analysis, and audio files were stored on a password-protected device under the custody of the research team. The researchers then applied reflexive thematic analysis, a qualitative method in which themes are developed through the researchers’ active interpretation of the data rather than through mechanical coding, using the theoretical lenses of intergenerational solidarity and intergenerational ambivalence to sensitise their reading of the transcripts.

Intergenerational solidarity, the framework that anchored the study, refers to the emotional, practical and normative support that flows between generations within families. The concept, formalised in classic work by Vern Bengtson and colleagues, describes how family bonds are maintained across age divides. The authors stress that in settings such as Nigeria, where formal systems of long-term care and social protection are limited, this kind of family-level solidarity carries particular weight. Yet, as they argue, solidarity is not an automatic consequence of kinship. It is negotiated within changing family, cultural and socioeconomic conditions, and it can be strengthened or strained by the circumstances in which families find themselves.

To capture the contradictions within these bonds, the researchers drew on intergenerational ambivalence, a theoretical approach developed by Kurt Lüscher and Karl Pillemer and extended by Ingrid Connidis and others. Ambivalence theory holds that family relationships routinely contain simultaneously positive and negative elements: love alongside resentment, duty alongside the desire for independence. Rather than treating such contradictions as signs of family breakdown, the framework allows researchers to ask how people manage, justify and sometimes repair the tensions embedded in their closest ties. This proved essential for interpreting what the Nigerian students actually said about their grandparents.

From the analysis, five themes emerged. The first concerned cultural images of ageing, in which older people were understood through representations of wisdom, dependence and frailty. Grandparents could be venerated as sources of knowledge and moral guidance, but the same cultural scripts also framed them as vulnerable and dependent. The second theme portrayed solidarity itself as a negotiated and potentially repairable relationship. Crucially, the researchers found that participants did not simply reject grandparental authority. Instead, they negotiated where, when and how that authority was considered legitimate, accepting guidance in some domains while contesting it in others.

The third theme was perhaps the most striking: gendered spiritual suspicion directed particularly towards materially vulnerable older women. The study found that ageing stereotypes among the students included suspicions that linked older women, especially those in precarious economic circumstances, to witchcraft. This finding connects the university sample to a broader and deeply troubling pattern documented across sub-Saharan Africa, where accusations of witchcraft have been linked to human rights violations against older women. The authors situate their interpretation within intersectional thinking, noting that age, gender and economic vulnerability combine to place certain older women at heightened risk of stigma and harm.

The fourth theme involved what the researchers call contested relational jurisdiction, meaning disagreements over the proper boundaries of grandparental influence. Students described friction around intimacy, appearance, religion and sociability, domains in which grandparents’ expectations clashed with young adults’ own sense of autonomy. A grandparent might be welcomed as an authority on moral or practical matters while being resisted when commenting on clothing, romantic relationships or religious practice. The fifth theme concerned the relational infrastructure of solidarity, the underlying conditions that made connection possible or difficult in the first place. Here the students pointed to migration, which separates generations geographically; parental mediation, in which parents act as bridges or barriers between grandparents and grandchildren; language, which shapes whether meaningful communication is even possible; and family conflict, which can sever or strain the ties that solidarity depends upon.

The methodological choices of the study deserve attention. Gender-segregated focus groups were used, with the fourth author moderating the male discussions and the first and second authors facilitating the female groups and taking fieldnotes for both. This design reflects an awareness that talk about family, sexuality and spiritual suspicion may unfold differently in single-gender settings. Reporting followed the COREQ checklist, a 32-item standard for qualitative research transparency, and the authors declare no external funding and no competing interests. The researchers also note that confidentiality among focus group participants could be encouraged but not guaranteed, an honest acknowledgement of the limits of group-based qualitative methods.

The findings carry implications well beyond the university campus. The World Health Organization’s global report on ageism has highlighted the social separation of old and young as a root of ageism, and cross-cultural research has documented how media portrayals and social structures reinforce negative images of older adults. This study suggests that ageism among educated young Nigerians is not a uniform attitude but a differentiated set of beliefs, some of which coexist with genuine respect and affection. For practitioners designing intergenerational programmes, the message is that solidarity cannot be assumed or simply commanded; it must be built through attention to the relational and structural conditions, such as communication, language and family conflict, that the study identifies.

The research also speaks to a larger question confronting societies across Africa and beyond: how families will care for ageing members as populations grow older, economies shift and younger generations migrate to cities and abroad. Studies from Cameroon, Senegal and Kenya have documented how changing intergenerational relations affect the health and material support of older adults, and the Nigerian findings add a crucial qualitative dimension by showing how young people themselves understand these bonds. In the end, the picture that emerges from southwest Nigeria is one of contested but resilient connection: young adults who question, negotiate and sometimes resist their grandparents’ authority, yet who continue to value the relationship enough to argue about where its legitimate boundaries lie. That ongoing negotiation, the authors suggest, is itself a form of solidarity, and understanding it may prove essential for protecting older people in societies where the family remains the primary infrastructure of care.

Subject of Research: Intergenerational solidarity and ageing stereotypes among university students in southwest Nigeria

Article Title: Contested Connections: Intergenerational Solidarity and Ageing Stereotypes Among University Students in Southwest Nigeria

Article References: Okeh, C., Akinpelu, T. O., Adewole, O. E., & Agunbiade, O. M. (2026). Contested Connections: Intergenerational Solidarity and Ageing Stereotypes Among University Students in Southwest Nigeria. Ageing International, 51(4), Article 42. https://doi.org/10.1007/s12126-026-09683-7

Image Credits: AI Generated

DOI: 10.1007/s12126-026-09683-7

Keywords: intergenerational solidarity, ageing stereotypes, grandparent-grandchild relations, intergenerational ambivalence, Nigeria, university students, ageism, witchcraft accusations, reflexive thematic analysis, family relations, gerontology, Yoruba

The core of their argument is deceptively simple: AI does not merely respond to existing challenges in long-term care, it actively reshapes them. By determining which data are collected, which risks are classified, and which outcomes are prioritized, AI systems influence how care needs are understood and addressed in the first place. Ethical risks, the authors argue, arise not only from technical performance failures but from something far subtler: the possibility that structural and relational problems in care systems are reframed as individual conditions that can be monitored and managed through technology. When loneliness, neglect, or inadequate staffing become data points on a dashboard, the underlying causes can escape scrutiny entirely.

These risks operate at several interconnected levels, the authors explain. At the individual and relational level, AI may affect autonomy, dignity, privacy, consent, and the relationships between older adults and their caregivers. AI-enabled systems can collect and process sensitive data without sufficient transparency about how that information is used, protected, or retained. Excessive reliance on AI may also weaken the human connection and reciprocity that lie at the heart of care itself. At the level of social justice, biased data, opaque systems, and weak accountability may deepen existing inequalities, particularly for older adults living with frailty, socioeconomic disadvantage, or limited AI literacy. And at the environmental level, scaling data-intensive AI carries material costs through energy consumption, water use, mineral extraction, and the expansion of data infrastructures.

Perhaps the most provocative claim concerns the cultural and epistemic level. Categories such as dependency, risk, efficiency, and quality of care, the authors stress, are not neutral descriptors. They reflect assumptions shaped by medical, administrative, commercial, and policy institutions, and those assumptions can become embedded in datasets, classification systems, platform design, and performance indicators. Decisions about what data to collect and which outcomes to optimize therefore encode particular ideas about normal aging, desirable behavior, appropriate care, and where responsibility for care should lie. The authors warn that these embedded assumptions may reinforce ageist and deficit-oriented representations of older people while marginalizing diverse experiences of aging and social relations. In this process, older adults risk being reduced to data subjects or measurable profiles, while their identities, relationships, life histories, and social belonging receive less and less attention.

To make this concrete, the authors offer a hypothetical scenario that reads like a cautionary tale for care facilities everywhere. Imagine an AI-powered chatbot introduced to reduce loneliness among residents of a long-term care home. In an underfunded facility facing chronic workforce pressures, staff may come to rely on the chatbot to monitor residents’ emotional states, flag signs of social isolation, and initiate conversations. The facility may then treat the technology as a substitute for investment in staffing, communal activities, and sustained human relationships. The system itself may rest on datasets that reflect narrow assumptions about normal social interaction, potentially misinterpreting culturally diverse forms of communication and connection. Its collection of personal data creates privacy and governance risks, while the computing infrastructure behind it carries environmental costs. Loneliness, in this scenario, has been reframed as an individual condition to be detected and technologically managed, while the organizational conditions that produced it remain untouched.

Existing regulation, the authors acknowledge, has made real progress. The European Union’s AI Act has established a risk-based approach to governing artificial intelligence, and China has been building an expanding framework for AI industry standards and technical standardization. These governance frameworks provide important safeguards. Yet compliance-oriented governance, Xu and Teerawichitchainan argue, tends to focus on the capabilities and risks of individual AI systems, framing responsibility mainly in terms of technical compliance rather than institutional responsibility for staffing, social infrastructure, and equitable care. Such approaches may leave unexamined the most important questions of all: why particular AI systems are adopted in the first place, which problems they are expected to solve, and how organizational arrangements, power relations, and sociocultural assumptions shape their use.

The authors’ proposed remedy draws on systems thinking, a framework pioneered by researcher Donella Meadows, whose influential work on leverage points described the places where intervention can alter how an entire system behaves. Systems thinking understands complex challenges as outcomes of dynamic relationships among technical systems, organizational arrangements, professional practices, and societal values. The key insight is that changes to technical parameters, such as improving model accuracy or tightening consent procedures, may reduce particular risks but leave the system’s underlying goals and structures intact. Deeper interventions instead seek to change how problems are defined, whose knowledge carries authority, what organizations are designed to achieve, and who holds the power to redirect the system. Applied to AI-enabled long-term care, this means that the most powerful levers are not in the code but in the context surrounding it.

From this perspective, the authors identify four domains in which deep leverage points may operate. The first encompasses societal paradigms and value systems at the level of policy and public discourse, which define what counts as aging well, technological progress, and quality of care. The second concerns epistemic authority in knowledge production and technical design, determining whose knowledge is used to define care needs, relevant data, and desirable AI outputs. The third involves systemic goals and models of AI-enabled care at the organizational level, which determine whether AI strengthens relational care or primarily advances efficiency, surveillance, and risk management. The fourth addresses distributed decision-making power and user agency, asking whether affected groups can shape, contest, modify, or discontinue the AI systems that touch their lives.

Each domain suggests a corresponding intervention pathway. At the policy level, the authors argue, ethical AI governance requires challenging the assumption that care challenges are best addressed through greater prediction, automation, and individual risk management. Quality of care could instead be defined in terms of dignity, reciprocity, inclusion, sustainability, and opportunities for meaningful social connection. In knowledge production, participation should extend well beyond token consultation: older adults, family caregivers, care workers, and community members should have a meaningful role in defining the problems to be addressed, determining which data are relevant, prioritizing outcomes, and deciding whether an AI application is needed at all. At the organizational level, procurement, funding, and evaluation arrangements should reward uses of AI that strengthen relational care and support the workforce, while facilities should assess whether AI applications redirect resources away from human care, intensify surveillance, or transfer institutional responsibilities onto residents and caregivers. Finally, affected groups need practical mechanisms to question, modify, suspend, or discontinue AI applications.

The article’s ultimate message is both a warning and an invitation. AI is transforming not only how long-term care is delivered but how care needs, social problems, and desirable outcomes are understood. Governance should therefore look beyond whether individual applications are safe or compliant and examine the care contexts into which they are introduced. This demands ongoing multidisciplinary learning about how workforce conditions, organizational priorities, social relationships, and inequalities shape AI implementation, and how AI, in turn, reshapes those conditions. Given the limited evidence on long-term effects, the authors conclude, governance should remain precautionary and adaptive. Most importantly, AI should never be allowed to reframe structural and relational problems as individual conditions to be technologically managed, particularly when doing so may reproduce underinvestment, weaken care relationships, or leave inadequate social infrastructure unaddressed. The future of ethical AI in elder care, in other words, depends less on smarter machines than on wiser choices about what we ask those machines to do.

Subject of Research: Ethical and responsible governance of artificial intelligence in long-term care for older adults

Article Title: Deep leverage points for ethical and responsible AI in long-term care

Article References: Xu, W., & Teerawichitchainan, B. (2026). Deep leverage points for ethical and responsible AI in long-term care. PLOS Aging and Health, 1(3), e0000041. https://doi.org/10.1371/journal.page.0000041

Image Credits: AI Generated

DOI: 10.1371/journal.page.0000041

Keywords: artificial intelligence, long-term care, aging, AI ethics, systems thinking, leverage points, elder care, AI governance, care workforce, ageism, loneliness, health policy

The study comes at a moment when two global trends are colliding with devastating consequences. By 2030, one in six people worldwide will be over the age of 60, a proportion expected to double by 2050. At the same time, humanitarian crises driven by conflict, climate change, and disasters are increasing in both number and duration. The United Nations High Commissioner for Refugees has warned that the biological and social burdens of aging may emerge earlier in life among displaced populations, because chronic undernutrition, trauma, disease, and ageism accelerate physical decline. Yet despite this demographic reality, older people remain largely absent from the design and delivery of humanitarian programming, and older women are the most neglected of all.

To map this landscape of neglect, the research team conducted a global qualitative scoping study, interviewing 19 humanitarian practitioners drawn from 16 organizations working across Europe, the Middle East and North Africa, sub-Saharan Africa, Latin America and the Caribbean, and Asia. Half of the participating organizations operated at the local level and half internationally, spanning older persons’ organizations, disability-serving groups, and sexual and reproductive health and gender-based violence agencies. The researchers used purposive and snowball sampling, guided by a six-member advisory board of experts on older women and women with disabilities in emergencies, and followed COREQ standards for qualitative reporting. Transcripts were double-coded by two analysts, with discrepancies resolved through consensus, and interviews continued until thematic saturation was reached.

The findings paint a picture of layered, mutually reinforcing exclusion. Perhaps the most foundational problem is data: humanitarian needs assessments and monitoring systems routinely fail to disaggregate information by age, sex, and disability, and even when they do, the oldest age brackets are so thinly represented that the full picture cannot be seen. One practitioner described the situation bluntly, noting that data is often not disaggregated at all, and that even when it is, older age groups are not represented well enough to reveal what is actually happening. This statistical erasure has cascading consequences: if older women do not appear in assessments, they do not appear in budgets, program designs, or service delivery plans.

Displacement itself compounds the problem in ways that challenge standard humanitarian assumptions. Practitioners described how older women frequently remain behind during acute emergencies—a choice that is only nominally voluntary. Many feel like a burden and decline to relocate; others want to stay and protect their property, as observed extensively in Ukraine, where massive displacement over years of conflict has left large numbers of older men and women in active combat zones. The study found a striking absence of inclusive evacuation protocols and policies, meaning that those least able to flee are the most likely to be left alone without support, cut off from health services, clean water, adequate food, and safety.

Economic precarity emerged as another central theme, one that both drives and conceals abuse. Aid packages are rarely tailored to older women’s needs, and cash assistance programs often fail them in practice: mobility limitations may prevent travel to distribution points, while digitalized social protection systems create dependency on others to access benefits. That dependency opens the door to exploitation. Practitioners reported cases in which relatives collected money on behalf of older women and then withheld it—a form of financial abuse made possible by the very systems designed to deliver aid. Underlying these structural failures, practitioners identified a corrosive ageist perception that older women, especially those with disabilities, cannot contribute during displacement, leading to the systematic deprioritization of their needs.

The health and protection consequences are severe and, the study argues, deeply interconnected. Older women experience sexual violence, physical assault, denial of resources, and psychological abuse, yet are largely excluded from gender-based violence programming, which is designed primarily for women of reproductive age. Those who live alone are particularly vulnerable, and those who cannot flee are violated in place. Within homes, elder abuse and neglect by caregivers—often daughters-in-law—was reported across settings as diverse as Lebanon, Ukraine, and Indonesia, and remains underreported due to cultural sensitivity and the power families hold over the person being abused. On the health side, practitioners described missed cancer screenings, late-stage cancer diagnoses with no access to treatment or palliative care, elevated rates of HIV and sexually transmitted infections, and unmanaged incontinence, all compounded by weak referral systems and the stigma and shame that keep older women from reporting violence or seeking care.

The researchers frame these barriers through an ecological model, showing how exclusion operates at every level simultaneously. Structurally, the data gap renders older women invisible before any program can be designed. At the institutional and community levels, inaccessible services, mobility limitations, and evacuation failures constrain help-seeking. At the individual level, economic insecurity intensifies dependency on others, which simultaneously increases exposure to abuse and reduces autonomy to escape it. Assumptions that older women are asexual or no longer in need of sexual and reproductive health care silence conversations about menopause, pelvic floor disorders, and conflict-related sexual violence, embedding stigma within the very institutions meant to provide protection.

Crucially, the study does not portray older women solely as victims. Practitioners repeatedly emphasized the vital social roles older women play as caregivers, knowledge holders, and respected community figures. In some settings, an older woman helping a person with disabilities may face fewer questions and receive more community support than an external aid worker. Practitioners described using respected elders as allies to reach younger women and girls, to speak with male leaders, and to guide program design. Older people were identified as effective catalysts for spreading information, teaching skills, and driving income generation—approaches that build sustainable purpose rather than dependency. The study suggests that mixed-age programming, rather than singling out older women, may be particularly promising, and that older women should be included in project leadership, not merely consulted in focus groups.

The authors call for a fundamental reorientation of humanitarian practice: institutionalizing age- and sex-disaggregated data systems with the training and analytic capacity to capture nuanced age bands; designing universally accessible sexual and reproductive health and gender-based violence programs; conducting participatory research directly with older women rather than only about them; and partnering with local older persons’ organizations on community-based and intergenerational programming. They also raise an uncomfortable ethical question about how donor-defined metrics of success may lead age-targeted services to be judged unworthy of investment, and argue that humanitarian protection principles—non-discrimination and accessibility for all—demand renewed commitment. As the world ages and crises multiply, the study makes clear that a humanitarian system that cannot see older women cannot claim to be equitable, effective, or ethical.

Subject of Research: Health and protection needs of older women in humanitarian settings

Article Title: Overlooked health and protection needs of older women in humanitarian settings: A qualitative study of practitioners

Article References: Falb, K. L., Stevenson, M., Hiscock, D., & Lasater, M. (2026). Overlooked health and protection needs of older women in humanitarian settings: A qualitative study of practitioners. PLOS Aging and Health, 1(3), e0000044. https://doi.org/10.1371/journal.page.0000044

Image Credits: AI Generated

DOI: 10.1371/journal.page.0000044

Keywords: older women, humanitarian crises, gender-based violence, sexual and reproductive health, ageism, displacement, elder abuse, humanitarian data, economic precarity, qualitative research, aging population, incontinence

The study rests on a deceptively simple hypothesis: if ageism, the prejudice and stereotyping directed at people because of their age, fuels a desire to escape the visible markers of aging, then places where ageist attitudes are more widespread should also be places where residents show more interest in cosmetic procedures. Testing that idea at the state level required two things: a reliable measure of ambient ageism for each state, and an equally reliable gauge of how interested each state’s residents are in plastic surgery. McCann turned to large, publicly available datasets to construct both.

Interest in plastic surgery was captured in two complementary ways. The first was Google Trends search data, which reflects how often residents of each state searched for information related to plastic surgery relative to other search activity. Search behavior offers a remarkably candid window into private intentions; people who would never discuss a facelift with a neighbor may still type the query into a search engine at midnight. The second measure was the density of plastic surgeons per capita in each state, an indicator that captures the supply side of the market. Surgeons, after all, tend to establish practices where demand is strong, so a state with more plastic surgeons per resident is plausibly a state with greater appetite for their services. Encouragingly, both measures behaved similarly in the analyses, strengthening confidence that they were tapping the same underlying phenomenon.

The measure of ageism drew on the accumulated evidence of geographical psychology, a field that studies how psychological traits and attitudes cluster across regions. Previous work had already shown that implicit age bias varies meaningfully from state to state and that these variations correlate with state-level health outcomes, including the prevalence of Alzheimer’s disease among older adults. Using state-level indices of ageist attitudes, McCann computed Pearson correlations between ageism and each of the two plastic surgery interest measures. Both correlations came out positive and statistically significant: the more ageist a state, the greater its residents’ interest in plastic surgery and the higher its concentration of plastic surgeons.

Correlation alone, however, is never enough, particularly in state-level research where a handful of demographic variables can masquerade as psychological ones. Wealthier states might both hold less ageist attitudes and afford more cosmetic procedures. States with older populations might be more ageist simply because age groups are in closer proximity, or less ageist because of greater intergenerational contact. To rule out such confounds, McCann employed multiple regression and partial correlation analyses with six statistical controls: state socioeconomic status, the percentage of White residents, the percentage of urban residents, the percentage of female residents, median age, and the obesity rate. The pattern of results survived intact. Even after stripping away the variance attributable to these six characteristics, the association between ageism and plastic surgery interest remained positive and significant for both outcome measures.

The study also attended to two technical threats that can undermine regional analyses of this kind. Multicollinearity, the problem of predictor variables being so tightly intercorrelated that their individual contributions become indistinguishable, showed no evidence of distorting the regression results. Spatial autocorrelation, the tendency of neighboring geographic units to share characteristics in ways that violate the independence assumptions of ordinary statistics, was likewise assessed and not found to be a problem. These diagnostics matter because state-level findings that ignore spatial dependence can dramatically overstate the reliability of an effect. Their absence here lends the central result a solidity that many ecological studies lack.

What does the association mean? McCann offers two main interpretations, both framed carefully as speculations rather than conclusions. The first is an aggregation account: the state-level relationship may simply reflect the accumulation of individual-level relationships. If, as a substantial body of laboratory and survey research suggests, people who hold more ageist attitudes or greater aging anxiety are individually more drawn to cosmetic procedures, then states composed of more such individuals should show higher aggregate interest. This interpretation is consistent with prior findings that aging anxiety predicts favorable attitudes toward cosmetic surgery, particularly among middle-aged women, and that fear of aging and fear of death are intertwined in ways that make the pursuit of a youthful appearance psychologically meaningful.

The second interpretation is bolder: the correlation is consistent with a causal link in which ambient ageism, the ageist climate of a community, actively promotes interest in plastic surgery among its residents. Terror management theory provides one theoretical scaffold for this idea. From that perspective, awareness of mortality is buffered by cultural worldviews and symbolic immortality, and the aging body is a potent reminder of death. Anti-aging cosmetic procedures can function as an existential defense, a way of denying the body’s trajectory. A community steeped in ageist stereotypes may amplify this defense, making surgical intervention feel more necessary and more normative. Yet the study’s cross-sectional, correlational design explicitly precludes causal inference. The data were collected for a single year, 2015, and cannot establish whether ageism drives surgery interest, whether surgery-seeking communities develop more ageist climates, or whether both are downstream of some unmeasured cultural factor.

The ecological nature of the analysis also demands caution in a different way. State-level correlations cannot be automatically applied to individuals, a pitfall known since the classic work on ecological correlation in the 1950s. The finding that ageist states have more plastic surgery interest does not mean that every ageist individual wants a nose job, nor that every surgery patient is prejudiced against older people. What it does suggest is that psychological climates, the shared attitudinal atmospheres of places, are associated with consequential patterns of behavior and market activity. This aligns with a growing literature in geographical psychology showing that personality traits, implicit biases, and social attitudes are not randomly distributed across the map but cluster in stable, predictable patterns that relate to health, politics, and economics.

The practical implications are hard to ignore. The American Society of Plastic Surgeons reports millions of cosmetic procedures performed annually, and international surveys confirm that aesthetic surgery is a vast and growing global industry. If ageist climates contribute to that demand, then the stakes of ageism extend beyond the well-documented harms to older adults themselves, including worse health outcomes and increased mortality risk documented in prior research. Ageism, this study implies, may also be written onto younger bodies in the form of Botox, fillers, and facelifts, as people internalize the message that aging is something to be fought. The author notes that this is the first study to empirically demonstrate the association between ambient ageism in a geographic area and residents’ interest in plastic surgery, and the data are openly available for other researchers to scrutinize and extend. Future work with longitudinal designs, individual-level data, and measures that track both attitudes and procedures over time will be needed to determine whether the arrow of influence points from prejudice to the operating table, from the operating table back to prejudice, or in both directions at once. For now, the study stands as a striking reminder that our attitudes toward aging may be inscribed not only in policy and healthcare but in the very geography of the beauty industry.

Subject of Research: The association between state-level ageism and interest in plastic surgery across the contiguous United States

Article Title: U.S. state levels of ageism and interest in plastic surgery

Article References: McCann, S. J. H. (2026). U.S. state levels of ageism and interest in plastic surgery. Current Psychology, 45(18), Article 1521. https://doi.org/10.1007/s12144-026-10025-8

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10025-8

Keywords: ageism, plastic surgery, cosmetic surgery, aging anxiety, geographical psychology, Google Trends, age stereotypes, U.S. states, Current Psychology, state-level analysis, terror management theory, ecological correlation

The scale of the underlying problem is global. A 2023 national survey in the United States found that 60 percent of Black adults and 42 percent of Asian adults reported preparing themselves for potentially unfair treatment before medical visits—psychological armor that patients should never need. Nurses, as the largest group of health professionals in continuous contact with patients, sit at the exact point where such inequities are either challenged or reproduced. Yet most research on the topic has relied on surveys measuring prevalence, leaving the how and why of discriminatory behavior largely unexplored, particularly outside Western healthcare systems with their distinct power dynamics and resource constraints.

The Iranian context sharpens the stakes. The country’s hospitals operate under severe economic sanctions, a depreciating currency, and chronic shortages of supplies, with nurse-to-patient ratios in public general wards often reaching 1:10 to 1:15—far beyond international standards. Extreme workloads, burnout, and the emigration of experienced staff create conditions in which rapid prioritization decisions are made constantly, and in which, the study suggests, discriminatory practices can take root whether or not anyone intends them. Against this backdrop, the research team conducted a secondary qualitative analysis of interviews originally collected between June 2023 and May 2024 in public and private hospitals across Tehran, using conventional inductive content analysis to let categories emerge from the data rather than imposing a pre-existing framework.

The participants—seven women and six men with a mean age of 34.7 years and roughly a decade of clinical experience each—worked in settings ranging from emergency departments and intensive care to surgery, psychiatry, and neonatal units. Saturation was confirmed after eleven interviews, with two additional interviews verifying that no new codes emerged. Rigor was reinforced through member checking with four participants, independent peer review of the coding, an external audit by a qualitative expert, and maximum variation sampling across departments, hospital types, and experience levels. The analysis yielded three overarching categories—patient-related, organizational, and nurse-related factors—comprising ten subcategories in total.

The patient-related findings are the most socially charged. Nurses consistently described how socioeconomic status shaped care: wealthy patients, celebrities, and government officials received faster medications, quicker physician visits, and the best rooms in the ward. One participant put it bluntly, saying such patients are prioritized in almost everything. At the opposite pole, prisoners, people with substance use disorders, homeless patients, and those lacking social support were described as receiving care delivered merely to fulfill a duty—fewer visits, less communication, a lower overall level of attention. Age and gender added further layers: young patients, especially young women, were monitored more carefully and given more explanation, while older adults, despite closer basic monitoring, sometimes saw aggressive treatment quietly scaled back on the assumption that they were old and had underlying diseases anyway.

Clinical condition itself became a vector of inequity. Nurses admitted that end-stage patients—those near death with little hope of recovery—could trigger emotional distancing, with care sliding into a minimal, task-focused routine. One nurse described care for such patients as provided just to keep them alive, not to make them comfortable. Stigmatized infectious diseases acted independently: when HIV or hepatitis appeared in a chart, some colleagues unconsciously kept their distance, delaying even routine tasks in ways that went well beyond standard universal precautions. Patient behavior mattered too—aggressive or demanding patients received less time and attention, while proactive family members who constantly followed up extracted more care for their relatives, a dynamic nurses themselves acknowledged was unfair.

Perhaps the study’s most striking contribution is its demonstration that much discrimination is organizational rather than personal. Nurses in private hospitals reported direct calls from managers flagging socially influential or ‘VIP’ patients as important to the hospital’s reputation and brand, instructing staff to provide everything without delay even when the patient’s clinical condition was no different from anyone else’s. Informal referrals from senior physicians and administrators—conveyed through a single phone call saying a patient is an acquaintance—were enough to reorder care priorities across an entire ward, and nurses who ignored such recommendations risked warnings, lost support, or damaged performance evaluations. In these situations, the researchers argue, nurses function less as agents of discrimination than as enforcers of institutional directives, a dynamic closely aligned with the concept of moral distress: knowing the ethically right action but being constrained from taking it.

Structural scarcity compounded everything. Facing staff shortages, insufficient equipment, and limited beds, nurses described triaging not by who deserved care more but by which patient they could manage faster. Complex, high-risk, or time-consuming patients drifted to the bottom of the list—not out of intent, participants stressed, but because systemic pressure made them the path of least resistance. Compounding this, the study found a striking educational void: nurses reported receiving in-service training on CPR, infection control, and new equipment, but never on how to treat all patients equally. Ethics instruction stayed abstract, with no real clinical examples, so discriminatory habits were absorbed unconsciously from ward culture and senior colleagues, normalized as an unavoidable byproduct of an overburdened system.

The nurse-related factors add a final, human dimension. Tips, gifts, and implicit promises from patients or families fostered a sense of reciprocal obligation, producing faster care and closer follow-up even when nurses knew it was professionally improper. Personal connections and fear of reputational damage when a patient was introduced by someone important created further sensitivity. Emotional responses cut both ways: one nurse described doing everything possible for a child whose condition resembled her own child’s, while another admitted following up less on terminal cancer patients because whatever she did would not make a difference. A third realized, after the fact, that a patient who reminded her of her deceased father had received extra time and attention at the implicit expense of others.

The authors’ conclusion is a call to shift the frame from individual blame to systemic design. Because discriminatory care is embedded in power relations, managerial logics, structural constraints, and educational gaps—not merely personal belief—sustainable change requires transparent triage protocols based on clinical urgency, anonymous reporting systems, ethics rounds where moral distress can be discussed without reprisal, and curricula that teach implicit bias and social determinants of health through case-based learning rather than abstract principle. Simple practices such as self-auditing time spent per patient could help nurses detect unconscious prioritization patterns. As one of the first in-depth qualitative investigations of this phenomenon in the Middle East, the study offers a multi-level framework that is directly actionable for resource-constrained health systems everywhere—and a sobering reminder that fairness at the bedside depends on fixing the system around it, not just the hearts within it.

Subject of Research: Factors contributing to discriminatory nursing care in Iranian hospitals

Article Title: Factors Contributing to Discriminatory Nursing Care: A Qualitative Study From Nurses' Experiences

Article References: Karimian, A., Sadooghiasl, A., Khoobi, M., Mohammadi, E., & Kazemnejad, A. (2026). Factors Contributing to Discriminatory Nursing Care: A Qualitative Study From Nurses' Experiences. Nursing Open, 13(10), Article e70890. https://doi.org/10.1002/nop2.70890

Image Credits: AI Generated

DOI: 10.1002/nop2.70890

Keywords: nursing, healthcare discrimination, qualitative research, Iran, health equity, moral distress, implicit bias, hospital management, ageism, stigma, nursing ethics, workload