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Recent political processes have rendered people with dementia an increasingly surveilled population. Surveillance is a contentious issue within dementia research, spanning technological monitoring, biomarker research and epidemiological data gathering. This paper explores surveillance in the relationships of people affected by dementia, how older relatives both with and without diagnoses are surveilled in everyday interactions, and the importance of expectations in guiding surveillance. This paper presents data from 41 in-depth interviews with people affected by dementia living in the community in the United Kingdom. Agedness was a key contributor to expectations that a person may have dementia, based on previous experiences, media accounts and wider awareness. Expectations provoked surveillance in interactions, with participants looking for signs of dementia when interacting with older relatives. Older people also enacted self-surveillance, monitoring their own behaviour. Various actions could be attributed to dementia because interpretation is malleable, partly vindicating expectations while leaving some uncertainties. Expectant surveillance transformed people's experiences because they organised their own actions, and interpreted those of others, in line with pre-existing meanings. The ability to interpret behaviours to fit expectations can bring coherence to uncertainties of ageing, cognition and dementia, but risks ascribing dementia to many older people who straddle those uncertainties. [ABSTRACT FROM AUTHOR]

An introduction to the articles within the issue of the journal on topics including need post-structuralist concerns of Deleuze and Guattari, sociological commentary on new developments in drugs and historical perspective on the development of anorexia nervosa, is presented.

Once exceptional, a long life is now an everyday expectation for many citizens of the prosperous nations. The consequence of this transformation in life expectancy however has led to a set of contradictory responses, representing threats as much as opportunities. Old age is no longer a stable coherent part of the life course; its future is fragmented by the competing narratives of the third age (opportunity) and the fourth age (threat). While there is a tendency to frame this distinction primarily through the lens of socio-demography and/or 'stages of life,' this paper proposes an alternative model. This model argues that later life is now represented through two different, though not unrelated, paradigms. The first frames the third age as a network of cultural fields dominated by rising consumerism and changing social relationships, while the second frames the fourth age as a negatively developed social imaginary of 'real old age.' The central features of this imaginary, we suggest, are frailty, abjection and the 'othering' of the self. This paper elaborates this theorising of the fourth age, briefly outlining each of these three features before considering in more detail the nature of othering and its consequences for those affected by this particular imaginary. [ABSTRACT FROM AUTHOR]

This paper examines assumptions that surround the way that aged care and assistance is conceptualised and discussed. Problems with the concept of care became apparent with the critique of care theory by the disability movement in the 1980s and continue to this day. Debates arose initially between those who sought to identify care as a gender-based duty that serves to burden those who take responsibility for it, and those who reject the concept as a form of socially constructed dependency. The paper considers the problematic sociological foundations of this critique - the failure to incorporate an understanding of the body into much sociological theory and the significance that the conceptualisation has for understanding the need for personal assistance in advanced old age. While the disability critique of care is firmly grounded in a sociological analysis, it overemphasises the social construction of social relations and ignores the visceral reality of the body. Longevity care, in contrast, needs to explicitly acknowledge that ageing is an embodied and physical process that generates a need for care. The conclusions are tested against recent Australian data and research on care needs and preferences amongst older people. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

The global economic turmoil that has unfolded since August 2007 promises to change methods for the governance of ageing in ways yet unknown. Against this background, this paper asks how the demographic shifts associated with population ageing interact with other aspects of globalisation: the financialisation of economic systems, changing patterns of migration and transformations to health provision. The emphasis is on understanding the complex interplay between these processes and their relevance for rethinking approaches to population ageing in a time of uncertain transition. Questioning the tendency to understand these fields of change as precipitating distinct crises, the paper suggests that the relative predictability of global population ageing makes it an appropriate area in which to begin a reassessment of wider policy directions. [ABSTRACT FROM AUTHOR]

This paper sets out to explore the Australian instance of a significant international problem: Intergenerational solidarity and the willingness of younger generations to support the future care of older people. It draws on Bengston's intergenerational solidarity theory, in particular his conception of normative solidarity relative to filial obligations, to analyse data from the Australian Survey of Social Attitudes. This data demonstrates evidence of intergenerational solidarity at the policy level and a need for a continued role for government in the provision of residential care, insurance schemes, and the payment of income to full time and occasional carers. At the family level there is less support for the role of adult children in the payment of formal care or the provision of informal care. There is also a significant difference between men and women concerning the direct provision of informal care to ageing parents. Suggestions for future research are highlighted. [ABSTRACT FROM AUTHOR]

Menopause is an important health transition for women, but health-related research has largely failed to account for menopause in a meaningful way, especially when making group comparisons. Age often stands in for menopausal status; at times, it is treated as a dichotomy; however, these are clearly oversimplifications. Menopause is a process that takes place over several years, and varies in onset, length, and expression through symptoms. Defining menopause dichotomously or linking it with age obscures variability in women's experiences and overlooks patterns in physical health, mental health, and quality of life. This paper reviews research to highlight menopausal differences by age, race, and lifestyle factors in the United States. It suggests ways to incorporate a life course-based view of menopause in health research, improving our understanding of women's health outcomes on multiple dimensions. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

This essay critically examines the process of governmentality as revealed in the construction and resistance to the categorisation and classification of ‘Healthy Senior Citizenship’. This also includes an illustrative analysis of data from a national UK qualitative interview study of the input into the policy process of older adults in voluntary and community organisations. The paper demonstrates how governmentality finds its expression within the construction of healthy senior citizenship as synonymous with activity and participation within the technologies of collaboration and consultation. The conclusion reflects upon developing a critical sociology of old age in order to scrutinize conceptions of the ‘problems’ of governing an ageing population in post-welfarist or advanced liberal states. [ABSTRACT FROM AUTHOR]

The 21st century will be characterised by aged and ageing nations, making eldercare a growing concern. Most eldercare in most nations will be provided informally, primarily by female family members. Helping these people understand the dimensions of eldercare is a key to effective and cost-effective caregiving. The Person-Environment Model (Lawton and Nahemow 1973) is proposed as a theoretical framework for understanding, assessing, and optimising family-based caregiving. This paper presents findings from a qualitative study of informal rehabilitation caregiving provided to elderly stroke survivors in Thailand. Four main rehabilitation dimensions (biological, psychological, social, spiritual) are identified, as are three main caregiver needs (information, assistance, and support). We suggest that while the Person-Environment Model is useful in developed nations, it is perhaps more valuable in societies where fewer options to family-based eldercare exist, and thus where effective informal eldercare is more critical. Implications for education and training of health care providers are also discussed. [ABSTRACT FROM AUTHOR]

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Informal caregiving is increasingly common in our ageing population and entering the role of informal caregiver generally marks an important life course transition. The adjustment to such transitions is considered important for the onset of sleep problems. Therefore, this study aims to establish how becoming a daily caregiver is associated with sleep problems, if changes in caregiving status are related to changes in sleep problems and how intersections with other social roles affect this association. Based on data from waves 1, 2, 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (N=32,791), the analyses show how both current and former daily caregivers are more likely to report sleep problems than those not giving daily care. When change in sleep problems is assessed a transition to daily caregiving appears to be accompanied by increased sleep problems. Moreover, even individuals who ceased giving care experience more sleep problems than those who never gave care on a daily basis, which suggests a legacy of caregiving. No differences are found regarding employment status, but women who start giving care are more likely to experience sleep problems than their male counterparts. [ABSTRACT FROM AUTHOR]

The ageing of the HIV population is unfolding within the context of a politicised history of medical care, medical breakthroughs changing HIV from a fatal to a chronic illness, and a long-standing treatment partnership between medical professionals and HIV patients. This article draws on in-depth interviews with those living with HIV in later life (aged 50 and over), as well as those working with them, to uncover how these various actors understand the nature and consequences of this new phenomenon, and whether their understandings and approaches vary according to the individual's connection to it. All informants described the interaction between ageing and HIV as complex and incompletely understood, and accounted for their own uncertainties about this interplay as due to a global knowledge gap produced by the novelty of ageing with HIV. In these data, working in the area of, or being personally affected by, ageing with HIV emerged as 'experiments in living,' with those variously involved in the phenomenon forced to take tentative, exploratory steps while navigating 'uncharted territory.' Yet, the poorly-understood nature of the ageing/HIV interplay was framed differently, with clinicians and scientists constructing it as a temporary gap in technical knowledge (a scientific puzzle), and non-medical stakeholders and older people living with HIV describing it as an anxiety-provoking source of chronic uncertainty permeating daily life. These differences and similarities can help us to reformulate what medical sociology has often constructed as a static 'gulf' between the clinical and the lifeworlds as, instead, gravitational pulls towards clinical and experiential dimensions of chronic illness as it unfolds in later life. [ABSTRACT FROM AUTHOR]

Qualitative research discussed shows that older people's peer-run community organisations can play an important role in promoting social engagement, which assists members to cope with the transitions and losses common to growing old. Findings revealed that perceptions of health and wellbeing appeared to be unrelated to living with various medical conditions. The study explored members' reasons for joining, their experiences in the organisation and whether what they experienced met their expectations. Companionship, mutual support, a choice of enjoyable activities, and the opportunity to contribute life-time knowledge and skills to the running of the group helped to foster feelings of wellbeing, resilience and coping. At a time when neo-liberal discourses in health policy are shifting the responsibility for 'positive ageing' on to the consumer/citizen, community-based organisations, particularly those run by older people for their peers, may have an important role to play in promoting community health, and deserve greater government support. [ABSTRACT FROM AUTHOR]

Age and ill-health have long been identified as being intrinsically intertwined, however the boundary between the discourses of ageing and chronic illness is not easy to demarcate. It is possible, however, to shed some light on the interplay between the ageing body and chronic illness by considering how differing cultures of ageing play a key role in articulating a dichotomy between seeing chronic illness as an aspect of health or of ill-health and age-related decline. Using knee pain as an example we argue that to understand how the interplay between ageing and chronic illness influences the interpretation of knee pain as 'ageing well' or as a sign of impending decline and physical dependency, then we need to employ a discursive methodological approach which explores talk as a form of action designed for its local interactional context and pays attention to what statements mean in the context in which they occur. [ABSTRACT FROM AUTHOR]

While anti-ageing medicine may be defined by efforts to control human aging, individual motivation to utilise anti-ageing medicine proves to be multifaceted. Qualitative, in-depth interviews with 15 people who have used anti-ageing medicine reveal that the turn to anti-ageing medicine may be more about disillusionment with allopathic medicine than it is about controlling bodily aging. By contextualising people's use of anti-ageing medicine within their lifelong body regimen ‘careers’, and looking closely at the first career sequence, which is characterised by a questioning of tradition – the tradition of allopathic medicine – new perspectives behind the rise of anti-ageing medicine are offered. Shared grievances with mainstream medicine tend to be situated around both the medical delivery and the medical treatment. Rather than reject the values associated with biomedicine, as is often the case with alternative health enthusiasts (Siahpush 1998), those using anti-ageing medicine seek out an ‘alternative’ biomedicine that they perceive to offer more satisfactory solutions to their problems. [ABSTRACT FROM AUTHOR]

Population ageing and increasing life expectancy are triumphs of modern times. However, advances in healthy ageing and longevity are not inevitable. Recent data suggest that future generations may not age in as good health as those who are currently over 65 years of age, particularly because of the rising prevalence of obesity. Obesity is a worldwide phenomenon associated with urbanisation and global changes to food availability, eating habits, and increasing sedentary activities. The current and future global impacts of this condition on health, health care expenditure, and human life expectancy are momentous. [ABSTRACT FROM AUTHOR]