Despite obstacles, many rural-dwelling older adults report that positive aspects of rural residence, such as attachment to community, social participation, and familiarity, create a sense of belonging that far outweighs the negative. By being part of a community where they are known and they know people, rural elders continue to find meaning, the key to achieving successful aging in this last stage of life. This scoping review explored factors influencing social participation and, through it, successful aging among rural-dwelling older adults. We sought to answer the question: what factors enhance or detract from the ability of rural-dwelling older adults to engage in social participation in rural communities? The scoping review resulted in 19 articles that highlight the importance of supports to enable older people to spend time with others, including their pets, engage in volunteer and community activities, and help maintain their home and care for their pets. Overall, the lack of services, including local health care facilities, was less important than the attachment to place and social capital associated with aging in place.

Objectives: Successful aging continues to be applied in a variety of contexts and is defined using a number of different constructs. Although previous reviews highlight the multidimensionality of successful aging, a few have focused exclusively on non-biomedical factors, as was done here. Methods: This scoping review searched Ovid Medline database for peer-reviewed English-language articles published between 2006 and 2015, offering a model of successful aging and involving research with older adults.
Results: Seventy-two articles were reviewed. Thirty-five articles met the inclusion criteria. Common non-biomedical constructs associated with successful aging included engagement, optimism and/or positive attitude, resilience, spirituality and/or religiosity, self-efficacy and/or self-esteem, and gerotranscendence. Discussion: Successful aging is a complex process best described using a multidimensional model. Given that the majority of elders will experience illness and/or disease during the life course, public health initiatives that promote successful aging need to employ non-biomedical constructs, facilitating the inclusion of elders living with disease and/or disability.

Although gender is often acknowledged as a determinant of health, measuring its components, other than biological sex, is uncommon. The Bem Sex Role Inventory (BSRI) quantifies self-attribution of traits, indicative of gender roles. The BSRI has been used with participants across cultures and countries, but rarely in an older population in Brazil, as we have done in this study. Our primary objective was to determine whether the BSRI-12 can be used to explore gender in an older Brazilian population. The BSRI was completed by volunteer participants, all community dwelling adults aged 65+ living in Natal, Brazil. Exploratory factor analysis was performed, followed by a varimax rotation (orthogonal solution) for iteration to examine the underlying gender roles of feminine, masculine, androgynous and undifferentiated, and to validate the BSRI in older adults in Brazil. The 278 participants, (80 men, 198 women) were 65–99 years old (average 73.6 for men, 74.7 for women). Age difference between sexes was not significant (p = 0.22). A 12 item version of the BSRI (BSRI-12) previously validated among Spanish seniors was used and showed validity with 5 BSRI-12 items (Cronbach=0.66) loading as feminine, 6 items (Cronbach=0.51) loading onto masculine roles and neither overlapping with the category of biological sex of respondent. Although the BSRI-12 appears to be a valid indicator of gender among elderly Brazilians, the gender role status identified with the BSRI-12 was not correlated with being male or female.

The objective of this study was to examine the role of social determinants of health: gender, income, education, housing, and social connections in successful aging in older adults aging with illness. Participants were 50 adults aged 65–90 years, all aging in place in their own home, and reporting at least one illness. This pilot study used non-probability sampling and employed both online and in-person interviews. The majority (82%) were aging “successfully” or “somewhat successfully” as reported on the single item successful aging scale and demonstrated by their scores on the Successful Aging Inventory (SAI). Correlations were not significant between SAI and gender, income, education, or housing. A significant negative correlation was found between SAI and community activity. However, there were significant positive correlations between SAI and religious activity and relationships. The regression model was a linear combination of participants’ community and religious activity and relationships. The majority of older adults aging with illness consider themselves to be aging successfully, but their scores are influenced by relationships with others as well as religious and community activity. Frequent community activity had a suppressor effect on successful aging.

Death of a parent in childhood can diminish both the nurturing that promotes healthy development, and household income. We consider, for the first time, whether this adverse childhood experience is associated with self-rated health decades later, among seniors and whether this lifelong effect is different for women and men. The International Mobility in Aging (IMIAS) study is a prospective cohort with survey information and biophysical measures and markers from 2000 community-dwelling 65–74 year olds in Canada, Colombia, Brazil and Albania. We assessed the independent impact of death of a parent, early hunger, and witnessing violence, while controlling for current income sufficiency and other early adversities on self-rated health using baseline (2012) IMIAS data. Regressions grouping and then separating women and men were compared. Approximately 17% of the 1991 participants had experienced early parental loss. Overall 56% rated their health as good however parental loss predicted poorer adult health, as did early hunger but not witnessing violence. Disaggregated analyses revealed that the health consequences of parental loss were significant only among men (p = 0.000 versus p = 0.210 for women) whereas early hunger predicted poor self-rated health for both (p = 0.000). Parental loss should be considered as a potent adverse childhood experience with life-long consequences for health. The gender difference in its effect, speaks to unidentified and modifiable traits that appear to be more common among women and that may build resilience to long-term harms of early parental death.

During the first wave of COVID-19, three-quarters of Canadian deaths were among those age 80 and older. We examined whether age, chronic disease load, sex, or place was the strongest predictor of such deaths. A cross-sectional analysis of administrative data from 1 January 2020 to 30 October 2020 for the population of Ontario (n = 15,023,174) was performed. Using logistic regression analysis, we determined whether place of residence (community dwelling, community dwelling with formal home care, or long-term care facility), age group, sex, or chronic disease burden was most strongly associated with the outcome of death within 60 days of a positive SARS-CoV-2 PCR test. Overall, there were 2766 deaths attributed to COVID-19. The age-related odds of dying increased from 6.1 (age 65–74) to 13.4 (age 85 or older) relative to those aged <65 years. This age effect was dwarfed by an odds ratio of 117.1 for those living in long-term care versus independently in the community, adjusted for age, sex, and chronic disease burden. The risk of death from COVID-19 aligned much more with social realities than individual risks. The disproportionate mortality arising specifically from institutional residence demands action to identify sources and ameliorate the harms of living in such facilities.