Journal of Psychosocial Nursing and Mental Health Services

Original Article 

Factors Moderating the Influence of Intergenerational Contact on Ageism: A Systematic Review

Ameneh Yaghoobzadeh; Elham Navab, PhD; Jila Mirlashari, PhD; Alireza Nikbakht Nasrabadi, PhD; Amir Hossein Goudarzian, MSN; Kelly A. Allen, PhD; Afsaneh Pourmollamirza, MSN

Abstract

The authors conducted a systematic review of factors that moderate the influence of intergenerational contact on ageism. MEDLINE (using PubMed), EMBASE, Scopus, Web of Science, and Proquest databases were searched, using terms and keywords including intergenerational conflict, intergenerational relation, intergeneration gap, and ageism, and no date restrictions. The search yielded a total of 247 articles, of which 23 met eligibility criteria for the review. Findings revealed that the experience of ageism for older adults is widespread and highly prevalent in Western and Eastern countries. In addition, culture, age, and gender played important roles in young people's decisions to contact older adults. These factors were important moderators of intergenerational relationships and ageism. Robust, trans-disciplinary research is needed to examine factors related to intergenerational relations, particularly with older adults in clinical populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 48–55.]

Abstract

The authors conducted a systematic review of factors that moderate the influence of intergenerational contact on ageism. MEDLINE (using PubMed), EMBASE, Scopus, Web of Science, and Proquest databases were searched, using terms and keywords including intergenerational conflict, intergenerational relation, intergeneration gap, and ageism, and no date restrictions. The search yielded a total of 247 articles, of which 23 met eligibility criteria for the review. Findings revealed that the experience of ageism for older adults is widespread and highly prevalent in Western and Eastern countries. In addition, culture, age, and gender played important roles in young people's decisions to contact older adults. These factors were important moderators of intergenerational relationships and ageism. Robust, trans-disciplinary research is needed to examine factors related to intergenerational relations, particularly with older adults in clinical populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 48–55.]

Demographic aging is a new communal occurrence in developed and developing countries. Medical and technological advancements in health care, as well as the improvement of general living standards, means that individuals are living longer. It is expected that this trend will continue over the next 30 to 40 years (Drury et al., 2016). The population of older adults is estimated to rise to 2 billion by 2050 (World Health Organization, 2018). In Iran, population estimates of older adults have risen. For instance, older adults were reported to comprise approximately 5.3% of the population in 1976, whereas in 2016, this estimate rose to 9.3% (Drury et al., 2016).

Although the extension of the human lifespan is a positive consequence of technology, it also coincides with the increase of negative age-related attitudes, particularly from younger people (Drury et al., 2016). Stereotyping and prejudice toward older adults are aspects of ageism that are commonly experienced (Lytle & Levy, 2019). Prejudice is defined as a negative attitude toward a group or group members, whereas stereotypes are composed of beliefs, attitudes, and behaviors. Although the two constructs are related, they differ in important ways. Stereotype formation has a cognitive component based on mental representations about individuals or groups (Katz & Braly, 1933; Lippmann, 1922). In addition, stereotypes have an attitudinal component that is driven by the emotional response one may have toward particular social groups. This affective component is strongly related to prejudice. This is reasonable, because affect and cognition denote different components of similar underlying attitudes, and because stereotypes are, in part, rationalizations for one's prejudices. The essential motives of prejudice can be understood by the person-level variables that relate to it—indeed, our beliefs about social groups signify a vital part of our underlying political and social value orientations (Stangor, 2016).

There have been some significant attempts to focus on the social side of prejudice, predominantly by studying how individuals communicate their stereotypes and prejudices, and the effects of communication on beliefs. Perhaps most notable is the work by Crandall and Stangor (2005), showing how strongly group beliefs correlate with perceived social norms. This work suggests that, fundamentally, stereotypes and prejudices are social norms. People hold and express stereotypes and prejudices to the extent that they see them as appropriate, within their social contexts, to do so (Stangor, 2016).

Research has found that young people have perceived older adults as bad-tempered, cheerless, isolated, poor, senescent, unhealthy, unable to learn, and useless or unable to work efficaciously (Lytle & Levy, 2019). Ageism has harmful effects on older adults directly and indirectly by influencing culture at large. For instance, individuals who view aging negatively live, on average, 7.5 years less than people who have optimistic outlooks about aging (Chen et al., 2017). Moreover, research has indicated that older adults who have experienced ageism perform worse on cognitive tests, have poorer health, and live shorter lives (Abrams et al., 2006; Lytle & Levy, 2019). As such, there is a need to identify causes that lead to the development of age-related prejudice in young people to better target ageism.

Some research suggests one effective strategy to reduce ageism is to increase contact between younger and older adults (Cadieux et al., 2019; Chen et al., 2017). Although many young adults have relatively little contact with older adults other than their grandparents, intergenerational contact can have positive results for younger and older people. For example, positive attitudes toward older adults, reduced anxiety in communicating with older adults, and improved communication between grandchildren and grandparents, are among some of the noted benefits (Chen et al., 2017). However, ageism reduction interventions are not common, have varied or questionable success as determined by empirical evaluation, and some lack a theoretical outline (Allan & Johnson, 2008; Levy, 2018; Lytle & Levy, 2019). For example, intergenerational service, even in small doses, shows promise for bridging the generational gap between college students and older adults (Andreoletti & Howard, 2018). Without explicit goals or direction, however, intergenerational service can result in negative attitudes toward older adults and others from their wider social group (Drury et al., 2017).

Several theories point to the benefits of intergenerational contact for ageism reduction, including the Positive Education about Aging and Contact Experiences (PEACE) model proposed by Levy (2018). Extended contact as described in the PEACE model is suggested to reduce anxiety about negative in-person experiences in everyday settings such as the workplace and health care (Drury et al., 2016; Levy, 2018; Lytle & Levy, 2019). In addition, the contact hypothesis (Allport et al., 1954) posits that interaction with out-group members can, under certain situations, reduce prejudice and ageism. Allport et al. (1954) suggested that positive intergroup attitudes would be developed when people from opposing groups are brought together in settings that allow both parties equality, where they can collaborate on tasks with communal aims, and where they are guided by standards and social expectations of acceptance.

Intergenerational conflict can foster negative attitudes toward older adults and can translate into harmful behaviors (Kahana et al., 2018). Although intergenerational contact can lessen ageism in young people, today's age-segregated society in many parts of the world may not deliver sufficient opportunities for positive contact between younger and older generations, despite an increasing population of older adults and increased access to communication technologies.

The advantages of positive intergenerational contact for the development of positive attitudes toward older people have been confirmed (Cadieux et al., 2019). The literature also suggests that culture plays an important role in determining and defining ageism from the perspective of younger adults in Western and Eastern societies (Kagan & Melendez-Torres, 2015; Rahmaniah & Krisnatuti, 2016). As such, it is critical to understand the mechanisms of aging, including intergenerational contact and conflict, within the context of an aging global population. Therefore, a systematic review of factors that moderate the influence of intergenerational contact on ageism was performed.

Method

Search Strategy

An extensive bibliometric search of published peer-reviewed literature was conducted using MEDLINE (through PubMed), EMBASE, Scopus, Web of Science, and Proquest using the following terms and keywords: intergenerational conflict, intergenerational relation, intergeneration gap, intergenerational contact, and ageism (with the use of OR and AND operators). There were no restrictions on date of publication.

The titles and abstracts of relevant articles were independently assessed by two of the current authors (A.Y., A.H.G.) and included in the synthesis if they met the following inclusion criteria: (1) peer-reviewed research, and (2) keywords mentioned in the title or abstract. Studies were excluded if they did not have abstracts written in English, were part of the grey literature, or did not have a full-text article available in English or Persian. Abstracts that met inclusion criteria were reviewed in detail by four reviewers (A.Y., A.H.G., A.P., E.N.). Disagreements were resolved by discussion.

Quality Assessment

The quality of the methodology was verified by two researchers independently using the STROBE checklist (for cross-sectional studies) and the COREQ checklist (for qualitative studies). STROBE examines various aspects of the methodology, including sampling methods, variable measurements, statistical analysis, confounding modifications, validity and reliability of the measures, and the objectives of the study (Von Elm et al., 2014). The minimum score for quality is 16, and studies that had a score ≥16 were included in the review. COREQ consists of 32 items, including the researcher's profile, the type of study design (e.g., sampling methods, sample size, type of interview, methodology), and the method of analyzing and reporting results (Tong et al., 2007). Studies with a score ≥23 were deemed suitable and entered into the study.

Data Collection

Data collected from eligible articles included: author names, study design, country and geographical location, sample size and type, mean age of sample, date, and main findings.

Selection Process

Figure 1 shows the selection process of articles. Literature search in the databases identified 247 articles. Authors selected articles independently based on title, abstract, and keywords according to inclusion criteria. Before the quality assessment, 119 articles were removed due to irrelevance related to the topic and keywords. A further 90 articles were omitted for various reasons, which included: inappropriate article type (e.g., letter), insufficient access to a full text, duplication, and not being related to intergenerational relations or ageism. Articles using quantitative or qualitative methodology were entered into the study.

Flowchart of article selection process.

Figure 1.

Flowchart of article selection process.

Summary of Quality Review

Following the quality assessment (Figure 1), 39 articles were assessed via the STROBE checklist and the COREQ checklist. Among them, 16 articles were excluded because of poor quality related to sampling, design, and analysis.

Of the 23 selected studies, most articles were conducted in the United States and United Kingdom. Various samples included young adults (Andreoletti & Howard, 2018; Ayalon, 2017; Patel et al., 2018; Tam et al., 2006), children (Babcock et al., 2017; Flamion et al., 2019), older adults (Marquet et al., 2016; Portacolone & Halpern, 2016), employees (Cadieux et al., 2019; Iweins et al., 2013; Lagacé et al., 2019; Meinich & Sang, 2018; Patel et al., 2018), residents in aged care homes (Drury et al., 2017), and students (Atkins, 2018; Bousfield & Hutchison, 2010; Drury et al., 2016; Luo et al., 2013; Lytle & Levy, 2019; Smith et al., 2017; Teater & Chonody, 2017). Mean age range of samples in the included studies was 11.9 to 44.9 years. Most studies used a cross-sectional design. A summary of the studies included in the systematic review is presented in Table A (available in the online version of this article).

Summary of Entered StudiesSummary of Entered StudiesSummary of Entered StudiesSummary of Entered StudiesSummary of Entered Studies

Table A.

Summary of Entered Studies

Results

Based on the literature review conducted on the 23 selected articles, ageism is one of the most common phenomena experienced by older adults. The effect of intergenerational contact on ageism was assessed in most studies examined. Most of the cross-sectional studies concluded that increasing the quality of intergenerational relations can improve negative attitudes toward aging and older adults (Cadieux et al., 2019; Drury et al., 2016; Smith et al., 2017; Teater & Chonody, 2017). In addition, several studies found that intergenerational relations can reduce anxiety about ageism in younger adults (Bousfield & Hutchison, 2010; Drury et al., 2016). One study found that self-disclosure mediated the association between intergenerational relationships and anxiety levels (Tam et al., 2006). However, another study on students in the United Kingdom revealed that enhancing the quality of intergenerational relations had no significant impact on anxiety levels (Bousfield & Hutchison, 2010). Creating a good relationship between younger and older adults has been suggested to help young adults develop more positive perspectives about older adults and aging more generally (Smith et al., 2017). Iweins et al. (2013), who examined organizational settings, found that intergenerational relations had valuable effects for employees (i.e., more intergroup harmony within the organization) and the organization (i.e., increased positive attitudes at work). Moreover, social categorization processes and perceived procedural justice have been highlighted as relevant and important mediational mechanisms through the way social context relates to intergenerational attitudes and attitudes at work (Iweins et al., 2013).

One of the most interesting findings of the assessed articles related to the different aspects of ageism affected by intergenerational contact (i.e., beliefs=cognition, attitudes=emotions, or discrimination=behavior). Attitude was identified as the most influential component in ageism (Bousfield & Hutchison, 2010; Cadieux et al., 2019; Drury et al., 2016; Iweins et al., 2013; Luo et al., 2013; Lytle & Levy, 2019; Marquet et al., 2016; Smith et al., 2017; Tam et al., 2006; Teater & Chonody, 2017) followed by behavior (Bousfield & Hutchison, 2010). However, none of the assessed studies stated the impact of ageism on intergenerational contact. Intergenerational contact and its effect on ageism was also influenced by other factors, such as culture, age, and gender.

Culture. Some descriptive studies revealed that attitudes toward ageism were more positive in Western countries (e.g., the United States and England) compared to Eastern countries (e.g., China) (Luo et al., 2013; Smith et al., 2017).

Age. Age was considered an important factor that determined the relationship between generations and the emergence of ageism. Studies demonstrated the better the quality of contact younger people experienced with older adults, the less anxious they were about future contact, and the more positive their attitudes toward older adults became in general (Andreoletti & Howard, 2018; Bousfield & Hutchison, 2010; Drury et al., 2016).

Gender. Gender was found to be a significantly influential factor on ageism. Smith et al. (2017) and Luo et al. (2013) found that younger females had more positive attitudes toward older adults than younger males. Based on these results, a conceptual model regarding intergenerational relations and ageism, under the consideration of moderating factors, is shown in Figure 2.

Conceptual model of intergenerational relations and ageism, under consideration of moderating factors.

Figure 2.

Conceptual model of intergenerational relations and ageism, under consideration of moderating factors.

Culture as a Factor of Contact Effects and Ageism

Although most of the assessed studies examined the claim that there is a relationship between culture and the experience of ageism, the exact association is controversial. Although there are large numbers of aging people in Eastern and Western countries, the rate at which the global population is aging, the level of older adult health care, and the cultural contexts within these countries are diverse. All these factors, which are embedded in the idea of cultural differences at large, cause varying attitudes toward older adults. Therefore, it is plausible that intergenerational relations can be affected by cultural norms, which can inhibit or enhance contact between younger and older adults. These contacts, or lack thereof, can help confirm or change cultural standards.

Age as a Factor of Contact Effects and Ageism

Benefits of intergenerational contact in reducing ageism have been demonstrated in many of the articles in the current study (Bousfield & Hutchison, 2010; Cadieux et al., 2019; Drury et al., 2016; Tam et al., 2006; Teater & Chonody, 2017). In general, the prosocial behavioral intentions of younger adults toward older adults increase after positive contact with older adults (Bousfield & Hutchison, 2010). However, one study conducted on residential aged care homes reported no association between positive or negative contact and ageism (Drury et al., 2017). These findings can be explained using different theoretical orientations. For example, the intergroup threat theory proposes that individuals within an intergroup (e.g., young adults) respond in adversarial ways toward outgroups (e.g., older adults), predominantly when outgroups are perceived as potentially harmful (Stephan & Stephan, 2017). The theory recognizes two major sources of threat, which enhance intergroup hostility and conflict: realistic and symbolic threats. Realistic threats include threats to the group's power, resources, and welfare, whereas symbolic threats include threats to one's world view, belief system, and values (Ayalon, 2017). The extended contact theory emphasizes contact that is not necessarily in-person but is characterized by friendship and social identity (Wright et al., 1997). This theory suggests that the understanding that one's friends from the same group (e.g., other young adults) have friends from a different group (e.g., older adults) offers many of the same benefits of having in-person intergenerational friendships, such as more positive attitudes toward older adults (Wright et al., 1997). From the perspective of terror management theory, ageism is the consequence of younger people's fear of death that is provoked by the presence of older people (Solomon et al., 1991). Based on this theory, younger adults are a source of worry for older adults, who may see younger adults as representative of the future, physical decline, death, and loss of self-worth. Terror management theory rests on the notion that human beings must control their knowledge of the inevitability of death (Cameron, 2015). Finally, the contact hypothesis states that contact with outgroup members can, under certain conditions, lessen prejudice (Allport et al., 1954). These theories help explain what can facilitate or hamper the relationship between different generations (i.e., young and old), therefore explaining how ageism can be strengthened or quelled.

The impact of age on intergenerational contact and ageism has been studied in the workplace. Although some younger employees appreciate the diversity that intergenerational workplaces bring, others believe it causes conflict due to inconsistent attitudes toward work (Ayalon & Tesch-Römer, 2018). Moreover, younger workers show positive and negative perceptions of older workers. Positive perceptions of older workers include their increased knowledge and experience, reliability, high satisfaction, successful aging, and better social skills. Negative perceptions of older workers relate to older adults being resistant to change, slower at using technology, and lacking the drive to progress. To make work settings that are favorable to the well-being of employees of all age groups, organizations should emphasize programs to reduce intergenerational conflict. This could be attained by team-building meetings that offer a chance for individuals to better understand intergenerational differences (Lagacé et al., 2019; Patel et al., 2018).

Gender as a Factor of Contact Effects and Ageism

The current study found gender differences in the attitudes of younger adults toward aging and older people. For example, Smith et al. (2017) claimed that male individuals had more negative perceptions about older adults, such as “they give unwelcome advice,” in comparison with female individuals. The authors argued that this difference is due, in part, to the differences in personal and/or professional experiences, and the more caring nature of females (Smith et al., 2017). Moreover, Luo et al. (2013) indicated that although female students are more likely to hold more positive attitudes than male students across countries, American female students hold more positive attitudes than Chinese female students (Luo et al., 2013). Moreover, the impact of contact with grandparents on children's and adolescents' views of older adults indicated that girls' perceptions of older adults were slightly but meaningfully more positive than boys.

Discussion

Integrated findings from the 23 studies included in the current review provide a foundation to examine the impact of intergenerational relationships on ageism.

The Relevance of Culture, Age, and Gender for Ageism

Culture was one of the factors identified in the current review that could have an important role in determining the relationship between ageism and intergenerational relationships. Ageism is embedded in and reinforced by society and culture (Teater & Chonody, 2017). American culture emphasizes individual happiness, personal interests, self-determination, and individuality. Despite a growing older population, American culture is argued to be progressively youth-oriented and appears to have more negative attitudes toward older adults. In contrast, Eastern cultures, such as China, are collectivist-oriented and emphasize respect and care for older people, applying oneself to family responsibilities, interdependence, and self-denial. Similarly, strong family bonds are also emphasized in Iranian culture. Iranian individuals are committed to keeping close relationships with their family and providing care for older family members. In addition, older adults are appreciated and respected because of their seniority (Navab et al., 2012; Navab et al., 2013). Therefore, it is often expected that people from Eastern cultures tend to have more positive attitudes toward older people, in contrast to those from Western cultures (Cuddy et al., 2005; Wang & Mallinckrodt, 2006). However, some researchers propose that due to economic advancement, urbanization, and the rise of consumerism, Eastern cultures could be more ageist than their Western counterparts (Luo et al., 2013; Yun & Lachman, 2006).

Although the aging process begins at birth, concerns about old age can be a source of fear in younger people as they may associate old age with loss and loneliness, fading beauty and health, and eventually, death. Intergroup attitudes can be enhanced when individuals from opposing groups are integrated within contexts that let both parties hold equal status, in which they collaborate and together generate norms of acceptance (Allport et al., 1954). In other words, intergenerational contact is an effective mechanism for reducing ageism (Babcock et al., 2017). Intergenerational educational programs hold promise for offering opportunities for younger people and older adults to cooperate on tasks and share responsibilities. Such programs may also inspire cross-generational attachment and provide better support systems for both groups. Many examples of such programs are evident in schools and universities; however, more opportunities for voluntary intergenerational engagement are needed for the general population (Atkins, 2018; Babcock et al., 2017; Christian et al., 2014). Encouraging greater partnerships between the general community and nursing homes may increase contact with older adults and prevent negative stereotypes that older people are sick, weak, and helpless (Christian et al., 2014; Patel et al., 2018).

Gender was another factor found to facilitate contact with older adults. Most articles in the current review reported that females were more likely to have positive relationships with older adults than males. One explanation for this finding is that females have more realistic views on aging and thus have greater empathy toward older adults (Flamion et al., 2019). Regardless of gender, one of the most significant burdens for older adults is social isolation and loneliness. Social isolation can have negative emotional and physical consequences, as noted by the high rate of suicide among older adults. Social isolation also deprives older adults of the emotional care and social support provided by normal social relationships among younger people (Henry, 2019).

Limitations

Most studies examined in the current review lack descriptive statistics of participant demographic characteristics; however, many participants were students with a mean age of 25 years. Future research must incorporate older adults into their samples to examine intergenerational differences and perspectives on ageism. This systematic review also identified a gap in the literature concerned with interdisciplinary perspectives and clinical populations. This gap could be addressed in future research.

Implications

It is important for health care providers, such as psychiatric nurses and psychologists, to understand the physiological and psychological factors that support well-being in older age groups. Promoting realistic attitudes toward older adults and reducing ageism in society will enable older people to live more satisfied lives. Facilitating conversations about negative perceptions is an important step toward promoting the psychological health of older adults (Ayalon & Tesch-Römer, 2018). Therefore, improved education and training of key stakeholders at all levels of geriatric health care are vital to reducing age-related bias. These stakeholders include hospital administrators, physicians, nurses, psychologists, personal caregivers, and associated health professionals (Hagestad & Uhlenberg, 2005). Findings of the current review also have implications for society-wide interventions related to targeting negative attitudes toward older adults through promoting opportunities for intergenerational contact.

Conclusion

The current systematic review shows that the experience of ageism among older adults is widespread and highly prevalent in Western and Eastern countries. Based on our review, culture, age, and gender are important factors when considering the impact of intergenerational relationships on ageism toward older adults. Robust research, especially qualitative research, is needed to focus on factors related to intergenerational relationships.

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Summary of Entered Studies

AuthorsCountryStudy parametersStudy designMain findings
Sample (number of respondents)Geographical locationMean age (SD)
Lagacé et al. (2019)CanadaWorkers (415)Francophone private and public sector Companies in Quebec54.18 (5.38)Cross-sectionalThe results suggest that a healthy intergenerational workplace climate exerts a significant and positive impact on perceived ageism in the workplace; in turn and as predicted, ageism significantly lowers feelings of satisfaction at work. Moreover, the importance of a healthy intergenerational workplace climate is demonstrated through a direct link with older workers' level of satisfaction. Theoretical and practical implications are discussed.
Burnes et al. (2019)Canada---Systematic reviewAgeism interventions demonstrated a strongly significant effect on attitudes (differences of standardized mean differences [dD] = 0.33; P < .001), knowledge (dD = 0.42; P < .001), and comfort (dD = 0.50; P < .001), but no significant effect on anxiety (dD = 0.13; P = .33) or working with older adults (dD = −0.09; P = .40). Combined interventions with education and intergenerational contact showed the largest effects on attitudes. We found stronger effects for females and for adolescent and young adult groups.
Flamion et al. (2019)BelgiumChildren and adolescents (1151)schools in the cities of Brussels, Charleroi, Huy, and Namur11.5 (2.7)Cross-sectionalFour factors were found to affect these views: gender (girls had slightly more positive views than boys), age (ageism was lowest in 10- to 12 year-old, reminiscent of other forms of stereotypes and cognitive developmental theories), grandparents' health, and most importantly, quality of contact with grandparents (very good and good contacts correlated with more favorable feelings toward the elderly, especially in children with frequent contacts).
Andreoletti & Howard (2018)USAYoung adults (50) and older adults (21)Central Connecticut State UniversityYoung adults: 21.62 (2.30); older adults: 86.4 (8.6)Quasi experimentalResults showed a significant reduction in ageism on the Fraboni Scale of Ageism for young adults. Qualitative data for young adults suggested two themes. First, many young adults expressed disconfirmation of their negative stereotypes. The second theme that emerged was how much younger and older adults actually have in common. As one young adult noted, “Participating in the WISE program changed the way I view older adults by highlighting similarities between generations.” Descriptive data suggested an increase in generativity on the Loyola Generativity Scale for older adults. that all participants gained a greater appreciation for one another and recognized how much they had in common. The most common themes in qualitative data for older adults were “good feeling” the program gave them about younger adults. Bringing the generations togetherwas another themes that emerge from the data of older adults.
Meinich & Sang (2018)UKEmployees (20)Norwegian technical industry-QualitativeThrough the lens of ageism, the findings reveal that generational stereotypes are strongly held by respondents, and may affect how members of the generations interact in the workplace. Further, the data demonstrate that both age and generation are socially constructed, and age discrimination is perceived by both older and younger workers.
Cadieux et al. (2018)CanadaWorkers (302)Mechanical Turk24.4 (3.14)Cross-sectionalIt was founded that positive contact with one older adult reduced incompetence stereotypes both directly and through an increase in Inclusion of outgroups in the self, and both the increase in Inclusion of outgroups in the self and the decrease in incompetence stereotypes predicted better attitudes towards older adults. Incompetence stereotypes were a stronger predictor of age-related attitudes than warmth stereotypes.
Patel et al. (2018)EnglandEmployers (35)multigenerational workplace in England-QualitativeThis study found that whilst some younger employees valued working with older colleagues as they believe that their differing characteristics are complementary, others felt that it leads to intergenerational conflict due to contrasting approaches towards work. Positive perceptions of older workers included their increased knowledge and experience, reliability and better social skills; however, ageism was also prevalent, such as the perception of older workers as resistant to change, slower at using technology and lacking the drive to progress. This study also provided evidence for the socioemotional selectivity and social identity theories
Babcock et al. (2018)USA5th-grade students (23)Rural Midwestern classroom-Quantitative and QualitativeResults indicated that when measured implicitly, but not explicitly, children reveal negative biases against older adults. However, with the exception of a self-assessment of their knowledge of and contact with older family members, there were no significant differences before and after the IG program.
Atkins et al. (2018)USAStudents (31)20.74 (2.14)Quantitative and QualitativeStudent reactions to this assignment were overwhelmingly positive and insightful. While a number of students expressed initial concern about these interactions, they unanimously reported them to be positive experiences. Students also indicated that it was a learning experience for them, and sometimes for the older adults as well, and several made note of stereotypes or ageist ideas that they had held. Students completed the Fraboni Scale of Ageism after completing these assignments, and scores were significantly below neutral. While pretest, and additional post-test, measures would make the results of this study stronger, the students' reports indicate that they perceived positive change within themselves, which suggests that this was an effective means of promoting positive attitudes about older adults.
Ayalon (2017)IsraelEuropeans over the age of 15 (56170)29 European countries44.9 (18.4)Cross-sectionalA three-profile solution indicated that the perception of older and younger adults as threats to society often co-occurs. Socio-demographic characteristics at the individual-level and the Gini coefficient (e.g., an inequality indicator) at the country-level had differential associations with the profiles identified.
Lytle & Levy (2017)USAundergraduate participants (354)Stony Brook University19.69 (1.90)Quasi experimentalIn Study 1, 354 undergraduates in all 3 experimental conditions (vs. control participants) reported less negative attitudes toward older adults (delayed post-test) and greater aging knowledge (immediate and delayed post-tests), when controlling for pre-study attitudes. In Study 2, 505 national community participants (ages 18–59) in all experimental conditions (vs. control participants) reported less negative attitudes toward older adults (immediate post-test) and greater aging knowledge (immediate and delayed post-tests).
Drury et al. (2017)Englandresidential eldercare homes (56)South East England40.41 (12.25)Cross-sectionalResults showed that neither positive nor negative contact generalized blatant ageism. However, the effect of negative, but not positive, contact on the denial of humanness to care home residents (CHRs) generalized to subtle ageism towards older adults. This evidence has practical implications for management of care workers' (CWs) work experiences and theoretical implications, suggesting that negative contact with a subgroup generalizes the attribution of humanness to superordinate groups.
Teater & Chonody (2017)EnglandStudents (69)urban location in the southwest England11.9 (0.4)Cross-sectionalThe results indicate that positive more than negative stereotypes were acknowledged, and more positive stereotyping was positively correlated with more positive attitudes towards older adults. Contact with older adults and age that one considers “old” were significant in predicting attitudes towards older people. The results suggest that time matters, both in terms of contact with an older adult and time to reach “old age”, in shaping youths' attitudes and stereotypes. Intergenerational and educational programs that seek to address aging myths and increase contact between youth and older adults are discussed as ways to improve attitudes amongst youth transitioning from middle childhood into adolescence.
Smith et al. (2017)USAcollege students (641)public university in Florida-Cross-sectionalApproximately 37% of participating college students interacted with older adults one or more times per week, 38.3% had resided with an older adult in their lifetime and 78.2% had volunteered/worked with an older adult. Participants who were female (P = 0.035), African American (P =0.033), those with more frequent interaction with older adults (P= 0.001) and those with experience living with an older adult (P = 0.028) reported significantly lower negative ageist attitudes. Findings suggest that increased exposure to and interactions with older adults can reduce ageist views among college students.
Drury et al. (2016)EnglandStudents (70), psychology students (110), Amazon's Mechanical Turk online tool (95)London university21.16 (2.12), 21.21 (2.12), 24.52 (3.29) [Respectively]Cross-sectionalIn Study 1 (N = 70), extended contact was associated with more positive attitudes towards older adults even when controlling for direct intergenerational contact (contact frequency and contact quality). In Study 2 (N = 110), the positive effects of direct and extended contact on young people's age-related attitudes were mediated by reductions in intergroup anxiety and ageing anxiety. The mediational effects of intergroup anxiety were replicated in Study 3 (N = 95) and ingroup norms additionally emerged as a mediator of the positive effects of extended contact on young people's attitudes towards older adults.
Portacolone & Halpern (2016)USAolder adults (47)San Francisco-QualitativeFindings illuminate the dynamics that favor age-segregation. Senior housing might be cheaper, safer, and offer more socializing opportunities than conventional housing. Yet, tenants of senior housing may also experience isolation, crime, and distress. Findings suggest that rather than individual preference, cultural, political, and economic factors inform the individual decision to relocate into age-segregated settings. Findings also call for an increased awareness on the ethical implications of societies increasingly segregated by age.
Marquet et al. (2016)BelgiumAdults: Belgians living in Belgium (27), Burundians living in Belgium (29), Burundians living in Burundi (32)University of LiègeBE/BE= 36.04 (7.69), BE/BU= 37.07 (9.77), BU/BU= 33.22 (7.59)Cross-sectionalStatistical analyses confirmed that older people are more negatively perceived by Burundians living in Burundi than by Burundians and Belgians living in Belgium, whose attitudes did not differ from each other. In conclusion results suggest that the level of development of a country and more particularly the lack of government spending on older people (pension and health care systems) may contribute to their younger counterparts perceiving them more negatively.
Christian et al. (2014)UK---ReviewWhile contact interventions are not a panacea, they do constitute a main plank in efforts to redress ageism. We, therefore, examine the types of interventions that are effective, the processes underlying their enhanced impact, and clarifying when and how intergenerational contact can predict more positive attitudes towards the elderly.
Luo et al. (2013)USA and ChinaUSA students (332), China students (980)Public university at the Pacific Northwest (USA), public university in southwestern province of SichuanUSA= 21.7 (2.64), China= 22.0 (1.99)Quantitative and Qualitative methodsThis study revealed that Chinese students actually hold more negative attitudes toward aging and older people compared to their American peers. It was also found that females tend to hold more positive attitudes than male students across both cultures, though American female students hold more positive attitudes than Chinese female students. Chinese students' interactions with seniors are often limited to their grandparents whereas American students tend to reach out to non-grandparent seniors in larger communities. Chinese students' more negative attitudes toward aging and older people may be a result of a combination of educational, social, and economic factors—a higher level of age segregation (geographically, socially, and intellectually) and a lack of gerontological curriculum in Chinese educational system, the caregiving burden faced by the one-child generation compounded with lack of governmental support for caregiving, as well as the rising youth-oriented consumerist culture.
Iweins et al. (2013)BelgiumStudy 1: 496 French-speaking Belgian employees Study2: 534 French-speaking Belgian employeesStudy 1: financial companies Study 2: Belgian hospitalStudy 1: 37.74 Study 2 37.08:Cross-sectionalThe results show that high-quality intergenerational contact and the fostering of an organizational multi-age perspective are favorable both for the employees (more intergroup harmony within the organization) and the organization (more positive attitudes at work). Moreover, social categorization processes and perceived procedural justice have been highlighted as relevant and important mediational mechanisms through the way social context relates to intergenerational attitudes and attitudes at work. Finally, findings complement the literature on ageism by measuring this bias with a proper consideration of its cognitive, affective, and behavioral components, according to the tripartite model of attitudes. Hopefully, the message emanating from our data will provide all parties involved in organizations with effective strategies for allowing further promotion of diversity and tolerance in the workplace.
Hutchison et al. (2010)United KingdomStudents (61)London Metropolitan University21.38 (2.14)Cross-sectionalRegression analyses confirmed that frequent positive intergenerational contact predicted more positive outcome expectancies, less intergroup anxiety, and more willingness to engage in future contact with elderly people. Meditation analyses confirmed that outcome expectancies mediated the influence of contact on intergenerational anxiety, and intergenerational anxiety, in turn, mediated the influence of both contact and outcome expectancies on willingness to engage in future contact with elderly people.
Bousfield & Hutchison (2010)United Kingdom55 studentsLondon university20.4 yearsCross-sectionalResults showed Contact quality was positively associated with attitudes and behavioral intentions towards elderly people, and was negatively associated with intergroup anxiety. Intergroup anxiety was, in turn, negatively associated with attitudes and behavioral intentions towards the elderly. There was no association between contact quality and aging anxiety, or between aging anxiety and attitudes or behavioral intentions. The present research demonstrated that positive contact with elderly people is associated with greater intentions among the young to engage in prosocial behavior towards the elderly in general. Given the strong association between behavioral intentions and actual behavior (e.g., Sutton, 1998), this finding has real implications for predicting young persons' actual behavior towards the elderly. This study examined two different types of anxiety as potential mediators between intergenerational contact and young persons' attitudes and behavioral intentions towards the elderly and result shows Greater anxiety about coming into contact with the elderly—i.e., intergroup anxiety—was associated with less positive previous contact with older people and was also associated with more negative attitudes towards the elderly. Thus, the better the quality of contact young people experienced with elderly individuals, the less anxious they were about future contact, and the more positive their attitudes towards elderly people in general. No such mediating role was found for aging anxiety, which was unrelated to contact (quantity or quality) or to attitudes or behavioral intentions towards elderly people.
Tam et al. (2006)United Kingdom77 native English speakers at a British university (27 males, 50 femalesBritish University20.1 yearsCross-sectionalThis study investigated contact and ageism on both the implicit and the explicit level and examined three hypotheses:

The quantity and quality of contact with older people are associated with more self-disclosure with grandparents and more positive explicit attitudes toward older people based on the results both quantity and quality of contact were related to self-disclosure However, only quality of contact was related to explicit attitudes quantity of contact was, on the other hand, unrelated to explicit attitudes.

The quantity of contact with older people is associated with more positive implicit associations for older people the results confirmed this hypotheses and quantity of contact was associated with more positive implicit associations.

self-disclosure mediates the relationship between contact and both anxiety and empathy with grandparents; and anxiety and empathy mediate the effects of self-disclosure on ageist attitudes that result showed Self-disclosure, in turn, had a negative effect on anxiety with grandparents, as well as a positive effect on empathy with grandparents, and both anxiety and empathy predicted explicit attitudes toward the elderly.

Authors

Ms. Yaghoobzadeh is PhD Candidate in Nursing, Community Health and Geriatric Nursing Department, Dr. Navab is Associate Professor, Critical Care and Geriatric Nursing Department, Dr. Mirlashari is Associate Professor, Dr. Nasrabadi is Professor and Dean, and Ms. Pourmollamirza is Master's Student in Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Mr. Goudarzian is MSc of Nursing, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran; and Dr. Allen is Senior Lecturer in the Faculty of Education, Monash University, Melbourne, Australia. Dr. Mirlashari is also Postdoctoral Fellow, Women's Health Research Institute, Department of OBGYN, University of British Columbia, Vancouver, Canada.

The authors have disclosed no potential conflicts of interest, financial or otherwise. This work was supported by Tehran University of Medical Sciences (IR.TUMS.FNM.REC.1397.135).

The authors acknowledge the assistance of Professor Clemens Tesch-Roemer and his precious feedback and suggestions.

Address correspondence to Elham Navab, PhD, Associate Professor, Critical Care and Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tohid Square, Tehran, Iran, 1419733171; email: e-navab@sina.tums.ac.ir.

Received: February 13, 2020
Accepted: May 12, 2020
Posted Online: July 01, 2020

10.3928/02793695-20200624-01

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