Understanding immunesenescence

This chapter discusses the impact of hip fracture in older age and in particular factors affecting recovery of physical function and wellbeing. It focuses particularly on a study of the impact of depression following hip fracture in older adults, and the influence of this depression on a range of outcomes including immune function, stress hormones, illness perceptions, physical function, and length of stay in health service and rehabilitation facilities. It shows that depression is common following hip fracture among older people, and is the biggest predictor of a slower recovery and poorer function in terms of immunity, wellbeing and physical ability. A pilot study associated with this research showed that illness perceptions following hip fracture did not differ between UK and Punjabi older adults, but that Punjabi speakers in India had greater levels of distress. Implications for health service policy and practice resulting from this research are discussed in this chapter, including potential intervention strategies to improve outcomes after hip fracture.

Ageing, fiction, narrative exchange and everyday life

This chapter focuses on the qualitative research undertaken through engagement with older respondents within the Fiction and Cultural Mediation of Ageing Project (FCMAP). Through consideration of FCMAP’s underlying methodologies and its data collection drawn from reflective diaries kept by University of the Third Age (U3A) Volunteer Reading Groups (VRGs), responses to a directive issued to existing diarists by the Mass Observation Archive at the University of Sussex with longitudinal analytical comparisons, and transcripts of ‘Ageing Re-imagined’ literary events and associated author interviews, FCMAP mapped the patterns of experience of and attitudinal responses to ageing. This chapter also outlines FCMAP’s development and subsequent data analysis in relation to key elements and outlines FCMAP’s collaboration with researchers from think-tank Demos and its prioritising of policy aspects of the research context, producing a policy report Coming of Age before summarising its overall findings.

Migration and nutrition

This chapter describes Project MINA, an intergenerational and transnational project using a mixed-methods approach to investigate migration, nutrition, and ageing in two generations of Bangladeshi women living in the UK or Sylhet, Bangladesh. Results indicate that varied migration histories and changing family structures play an important role in influencing nutritional status, perceived and actual health status, and future health and social care needs of ageing Bangladeshis in the UK. Future research should focus on developing culturally and linguistically tailored research tools to assess dietary intake and eating behaviours within this population, and examine the complex interplay between family dynamics, cultural norms and social influences that impact the ability of older Bangladeshi adults to eat more healthfully and engage in physical and social activities that promote healthy ageing.

Negotiating unfamiliar environments

This chapter looks at the mechanisms and strategies used by older people to navigate unfamiliar spaces as pedestrians. Based on interviews with forty-two older people collecting both quantitative and qualitative data, a street audit and interviews with planners, three principal factors helped or deterred older people in navigating an unfamiliar urban setting – the use of landmarks, the availability and usability of signage and if a public space was associated with memories. Stressful areas were identified as those where there was a perception of sensory overload and shared and unclear spaces. The implications for planners are discussed with regard to creating spaces and places that assist older people to remain active and independent.

Introduction

This chapter introduces the book by providing an overview of the New Dynamics of Ageing Programme, which comprised a total of 35 projects covering most of the major issues of ageing from a multi-disciplinary perspective. The chapter will then introduce individual chapters by summarising their subject matter and arguments. Finally, all of the projects supported by the Programme are listed together with their Principal Investigators.

Narrative representations of the self: encounters with contemporary visual art

This chapter explores how and why older people construct narrative identities in response to encounters with contemporary visual art. The respondents rejected the negative characteristics they associated with being old and articulated a more positive counter narrative associated with active and involved older people. The narratives they constructed were also inflected by meta-narratives of family, class and the history of north-east England. This work has implications for arts and cultural policy suggesting that more emphasis be placed on how artworks are consumed. It also provides a greater understanding of the value of arts engagement for older people.

Combating malnutrition in hospitals

Prevalence and risk of malnutrition amongst older people admitted to hospital remains high and a holistic approach to nutritional management is needed. An ethnographic study across 5 hospitals identified several factors contributing to undernutrition in older people in hospital, underpinned by a lack of accountability in nutritional care. The current study adopted an iterative co-design process to develop a novel prototype for nutritional care in hospitals that employed a series of smart interfaces and built a chain of accountability into patient food provision.

Towards understanding the biological drivers of cell ageing

This chapter discusses approaches to understanding cellular ageing (senescence) through molecular biology approaches. Current scientific ideas surrounding the biological and evolutionary basis of senescence are discussed in this chapter, as are recent findings that demonstrate a strong contribution of senescent cells to age-related decline in health. A new approach to generating senescent cells is described, which accelerates cell ageing in the laboratory based on understandings of premature ageing human Werner syndrome, as is a proteomics approach to probing cellular senescence. The premise that ageing is a social construct is refuted from a biological basis, and the importance of approaches to tackling cellular senescence in the human body to improve the quality of later life is strongly advocated.

Maintaining dignity and independence

Older people’s perspectives on their experiences of ageing and dependency shed light on the complex nature of dignity as a personal and social concept. In this study, participants revealed how, as they became dependent on others for support and care, their lives felt increasingly precarious and their sense of dignity was challenged. Influenced by their life-course experiences as well as by their social circumstances, their response to this challenge included both perseverance and adjustment to change. The attitudes and behaviour of others, including those of professionals, contributed in crucially important ways to maintaining their sense of identity and dignity.

Conclusion

This chapter concludes the book by first extracting the key findings from each of the preceeding chapters. This provides an easy to access summary of the main policy-orientated implications of one half of the NDA Programme (to match the similar summary in volume 1). Then the overall contribution of the NDA Programme is assessed briefly under the headings, including multi-disciplinarity, Research methods and theory building. In addition to the authors’ personal evaluation evidence is drawn from an independent one.