Vol. 17 No. 33 (2026): Precarious dwelling. Everyday practices, caring relations, and meaning-making processes
Passim

Ageism in healthcare and social care settings in Europe: a scoping review

Stefano Poli
University of Genoa, Italy
Bio
Paola Giannoni
University of Genoa, Italy
Bio
Giada Moretti
University of Genoa, Italy
Bio

Published 2026-03-31

Keywords

  • Ageism,
  • Older adults,
  • Healthcare,
  • Social care,
  • Scoping review

How to Cite

Poli, S., Giannoni, P., & Moretti, G. (2026). Ageism in healthcare and social care settings in Europe: a scoping review. SocietàMutamentoPolitica, 17(33), 215–225. https://doi.org/10.36253/smp-17097

Abstract

Ageism is a widespread, complex form of discrimination negatively affecting older adults’ health, well-being, and access to healthcare and social services. In rapidly ageing societies, particularly in Europe, it has become a critical social determinant of health, shaping clinical decision-making, professional practices, organizational routines and health policies. Despite growing research on ageism, evidence remains fragmented, highlighting the need for systematic synthesis. This scoping review maps recent literature on ageism toward older adults in healthcare and social care settings. Searches were conducted in Scopus and PubMed for peer-reviewed articles published between 2021 and 2025, following the COVID-19 emergency. Fifty-five studies in European contexts were included and analysed using Template Analysis with MAXQDA. Findings show that ageism operates across four interrelated levels: internalized/self-ageism, individual/interpersonal, institutional/organizational, and structural/systemic. These levels are associated with a range of specific outcomes: internalized stereotypes, psychological distress, compromised clinical communication, ethical implications, biased service design, health and digital inequalities. While educational and organizational efforts are effective, they remain insufficient. Addressing ageism requires integrated, multilevel strategies, combining education, organizational change, policy interventions, and age-inclusive technological design.

References

  1. Allué-Sierra L., Antón-Solanas I., Rodríguez-Roca B., Anguas-Gracia A., Echániz-Serrano E., Fernández-Rodrigo M. T., … and Satústegui-Dordá P. J. (2023), «Ageism and nursing students, past or reality?: A systematic review», in Nurse Education Today, 122: 105739.
  2. Ayalon L. and Tesch-Römer C. (2018), Contemporary perspectives on ageism, Springer. https://doi.org/10.1007/978-3-319-73820-8
  3. Ayalon L., Chasteen A., Diehl M., Becca R. L., Shevaun D. N., Rothermund K., Tesch-Römer C., and Hans-Werner W. (2021), «Aging in times of the COVID-19 pandemic: Avoiding ageism and fostering intergenerational solidarity», in The Journals of Gerontology: Series B, 76(2): 49–52. https://doi.org/10.1093/geronb/gbaa051
  4. Aytulun A. and Erden Aki Ö.S. (2022), «Relationship Between Perceived Ageism, Autonomy, And Symptoms Of Depression And Anxiety During The COVID-19 Curfew In Old Age Psychiatric Patients», in Turkish Journal Of Geriatrics/Türk Geriatri Dergisi, 25(3).
  5. Başer G. and Hisar F. (2024), «Effect of interventions for health care students to develop positive attitude toward the elderly: A meta‐analysis study», in Geriatrics & Gerontology International, 24(12): 1370-1379.
  6. Bellanova M., Romaioli D. and Contarello A. (2024), «Stemming the “ageism pandemic”: A qualitative inquiry with older adults in residential care facilities during the COVID-19 outbreak», in Journal of Health Psychology, 29(4): 332-346.
  7. Bortolotti L. (2025), Epistemic Justice in Mental Healthcare: Recognising Agency and Promoting Virtues Across the Life Span, Springer Nature.
  8. Bouwmeester Stjernetun B., Gillsjö C., Odzakovic E. and Hallgren J. (2024a), «“It´ s like walking in a bubble”, nursing students´ perspectives on age suit simulation in a home environment–group interviews from reflection seminars», in BMC nursing, 23(1): 124.
  9. Bouwmeester Stjernetun B., Hallgren J. and Gillsjö C. (2024b), «Effects of an age suit simulation on nursing students’ perspectives on providing care to older persons-an education intervention study», in Educational gerontology, 50(3): 240-253.
  10. Bows H., Bromley P. and Walklate S. (2024), «Practitioner understandings of older victims of abuse and their perpetrators: not ideal enough?», in The British Journal of Criminology, 64(3): 620-637.
  11. Burnes D., Sheppard C., Henderson C. R., Jr. Wassel M., Cope R., Barber C. and Pillemer K. (2019), «Interventions to reduce ageism against older adults: A systematic review and meta-analysis», in American Journal of Public Health, 109(8): e1–e9. https://doi.org/10.2105/AJPH.2019.305123
  12. Butler R. N. (1969), «Age-ism: Another form of bigotry», in The Gerontologist, 9(4): 243–246. https://doi.org/10.1093/geront/9.4_Part_1.243
  13. Bytheway B. (1995), Ageism. Rethinking ageing, Buckingham, PA: Open University Press.
  14. Cardano M. (2020), Defending qualitative research: Design, analysis, and textualization, Routledge.
  15. Castellano-Rioja E., Botella-Navas M., López-Hernández L., Martínez-Arnau F. M. and Pérez-Ros P. (2022), «Caring for the elderly enhances positive attitudes better than knowledge in nursing students», in Medicina, 58(9): 1201.
  16. Catalao M. J., Arco H., Carrajola N. and Tavares J. (2025), «Ageism among newly graduated nurses: The influence of sociodemographic variables and gerontogeriatric nursing education», in Nurse Education in Practice, 83: 104285.
  17. Cerqueira A. F., Ramos A. L. and Palma J. (2023), «Ageism in nursing education: Students’ views of ageing», in Social Sciences, 12(3): 142.
  18. Cesari M., Canevelli M., Zhang W., Thiyagarajan J. A., Azzolino D., Cherubini A., … and Moorthy V. (2025), «Enhancing the methodology of clinical trials in older people: A scoping review with global perspective», in The Journal of nutrition, health and aging, 29(6): 100582.
  19. Chang E. S., Kannoth S., Levy S., Wang S. Y., Lee J. E. and Levy B. R. (2020), «Global reach of ageism on older persons’ health: A systematic review», in PloS ONE, 15(1): e0220857. https://doi.org/10.1371/journal.pone.0220857
  20. Chenhuichen C., O’Halloran A. M., Lang D., Kenny R. A. and Romero-Ortuno R. (2024), «The lived experience of frailty: beyond classification and towards a holistic understanding of health», in European Geriatric Medicine, 15(2): 435-444.
  21. Chrisler J. C., Barney A. and Palatino B. (2016), «Ageism can be hazardous to women’s health: Ageism, sexism, and stereotypes of aging», in Journal of Social Issues, 72(1): 86–104. https://doi.org/10.1111/josi.12156
  22. Comincioli E., Hakoköngäs E. and Masoodian M. (2022), «Identifying and addressing implicit ageism in the co-design of services for aging people», in International journal of environmental research and public health, 19(13): 7667.
  23. COST (2015), «Ageism. A multi national, interdisciplinary perspectictive», in EU Framework Programme Horizon 2020. European Commission, Retrieved May 22, 2015, from http://www.cost.eu/COST_Actions/isch/Actions/IS1402.
  24. Costa J. R., Quintero-Flórez A., García-Cabrera E., Romero-Barranca J. and Vilches-Arenas Á. (2025), «Ageism and the feminization of old age: A Systematic review», in Archives of Gerontology and Geriatrics, 106084.
  25. Crosignani S., Fantinati J. and Cesari M. (2021), «Frailty and geriatric medicine during the pandemic», in Frontiers in Medicine, 8: 673814.
  26. D’hondt S., Aujoulat I. and Degryse J. M. (2024), «Development and validation of a revised ambivalent ageism scale for use in the health care sector: The AAShc», in The Gerontologist, 64(4): gnad136.
  27. Draper E. J., Meiboom A. A., van Dijk N., Ket J. C., Kusurkar R. A. and Smalbrugge M. (2024), «How do ageism, death anxiety and ageing anxiety among medical students and residents affect their attitude towards medical care for older patients: a systematic review», in BMC medical education, 24(1): 199.
  28. Elvira-Zorzo M. N. and Vega Rodríguez M. T. (2025), «Changing Attitudes Towards Retirement and Ageing Through Flipped Classroom and Collaborative Learning: A Social Psychological Study with Psychology and Social Work Students», in Social Sciences, 14(9): 562.
  29. Fernandes J. B., Ramos C., Domingos J., Castro C., Simões A., Bernardes C., Fonseca J., Proença L., Grunho M., Moleirinho-Alves P., Simões S., Sousa-Catita D., Vareta D. A. and Godinho C. (2022), «Addressing Ageism—Be Active in Aging: Study Protocol», in Journal of Personalized Medicine, 12(3): 354. https://doi.org/10.3390/jpm12030354
  30. Fitzpatrick J. M., Hayes N., Naughton C. and Ezhova I. (2021), «Evaluating a specialist education programme for nurses and allied health professionals working in older people care: A qualitative analysis of motivations and impact», in Nurse Education Today, 97: 104708.
  31. Fumagalli C., Zampieri M., Presta R., Pini G., Vetere G., Argirò A., … and Cappelli F. (2025), «Prognostic Value of Malnutrition, Frailty, and Physical Performance in Transthyretin Cardiac Amyloidosis: Insights From a Prospective Multicenter Cohort Study», in Circulation: Heart Failure, e012777.
  32. Gallistl V., Richter L., Heidinger T., Schütz T., Rohner R., Hengl L. and Kolland F. (2024), «Precarious ageing in a global pandemic–older adults’ experiences of being at risk due to COVID-19», in Ageing & Society, 44(5): 991-1009.
  33. Gram E. G., Knudsen S. W., Brodersen J. B. and Jønsson A. B. R. (2023), «Women’s experiences of age‐related discontinuation from mammography screening: A qualitative interview study», in Health Expectations, 26(3): 1096-1106.
  34. Grosse A. and Kokorelias K. (2025), «Exploring ageism in medical education: A scoping review of the educational factors affecting the attitudes of medical students and junior doctors towards older inpatients», in Australasian journal on ageing, 44(1): e70016.
  35. Gümüşler Başaran A., Genç Köse B. and Kefeli Çol B. (2024), «Elderly Discrimination, Willingness to Provide Care to the Elderly and View on Aging of Students in Some Departments in the Field of Health», in Journal of Multidisciplinary Healthcare, 5035-5045.
  36. Heckemann B., Schüttengruber G., Wolf A., Großschädl F. and Holmberg C. (2022), «Attitudes towards oldest‐old adults (age≥ 80 years): A survey and international comparison between Swedish and Austrian nursing students», in Scandinavian Journal of Caring Sciences, 36(4): 1083-1093.
  37. Helaß M., Greinacher A., Müller A., Friederich H. C., Maatouk I. and Nikendei C. (2024), «The role of negative age stereotypes and sociodemographic factors in the intention to leave among German university hospital nursing staff», in INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61: 00469580241277912.
  38. Knight R. L., Chalabaev A., McNarry M. A., Mackintosh K. A. and Hudson J. (2022), «Do age stereotype‐based interventions affect health‐related outcomes in older adults? A systematic review and future directions», in British Journal of Health Psychology, 27(2): 338-373.
  39. Lampersberger L. M., Schüttengruber G., Lohrmann C. and Großschädl F. (2023), «Nurses’ perspectives on caring for and attitudes towards adults aged eighty years and older», in Scandinavian Journal of Caring Sciences, 37(2): 458-471.
  40. Langmann E. (2023), «Vulnerability, ageism, and health: is it helpful to label older adults as a vulnerable group in health care?», in Medicine, Health Care and Philosophy, 26(1): 133-142.
  41. Langmann E., Kainradl A. C., Weßel M. and Rokvity A. (2025), «Endometriosis in later life: an intersectional analysis from the perspective of epistemic injustice», in Medicine, Health Care and Philosophy, 28(1): 151-159.
  42. Levy B. R. (2017), «Age-stereotype paradox: Opportunity for social change», in The Journals of Gerontologist, 57(Suppl. 2): S118–S126. https://doi.org/10.1093/geront/gnx059
  43. Lloyd‐Sherlock P., Guntupalli A. and Sempé L. (2022), «Age discrimination, the right to life, and COVID‐19 vaccination in countries with limited resources», in Journal of Social Issues, 78(4): 883-899.
  44. López-Frutos P., Pérez-Rojo G., Noriega C., Velasco C., Carretero I., Martínez-Huertas J. Á., Galarraga L. and López J. (2022), «Burnout and quality of life in professionals working in nursing homes: the moderating effect of stereotypes», in Frontiers in Psychology, 13: 772896.
  45. Mannheim I., Wouters E. J., van Boekel L. C. and van Zaalen Y. (2021), «Attitudes of health care professionals toward older adults’ abilities to use digital technology: Questionnaire study», in Journal of Medical Internet Research, 23(4): e26232.
  46. Marques S., Mariano J., Mendonça J., De Tavernier W., Hess M., Naegele L., Peixeiro F. and Martins D. (2020), «Determinants of ageism against older adults: A systematic review», in International Journal of Environmental Research and Public Health, 17(7): 2560, 1–27. https://doi.org/10.3390/ijerph17072560
  47. Martínez-Angulo P., Munoz-Mora M., Rich-Ruiz M., Ventura-Puertos P. E., Cantón-Habas V. and López-Quero S. (2023a), «“ With your age, what do you expect?”: Ageism and healthcare of older adults in Spain», in Geriatric nursing, 51: 84-94.
  48. Martínez-Angulo P., Rich-Ruiz M., Ventura-Puertos P. E. and López-Quero S. (2023b), «Integrating shared decision-making, expressing preferences and active participation of older adults in primary care nursing: a systematic review of qualitative studies and qualitative meta-synthesis», in BMJ open, 13(6): e071549.
  49. McDarby M., Ju C. H., Picchiello M. C. and Carpenter B. D. (2022), «Older adults’ perceptions and experiences of ageism during the COVID-19 pandemic», in The Journal of social issues, 10.1111/josi.12557. Advance online publication. https://doi.org/10.1111/josi.12557
  50. McDonald T. (2022), «Lethal ageism in the shadow of pandemic response tactics», in International Nursing Review, 69(2): 249-254.
  51. Mikton C., de la Fuente-Núñez V., Officer A. and Krug E. (2021), «Ageism: a social determinant of health that has come of age», in Lancet (London, England), 397(10282): 1333–1334. https://doi.org/10.1016/S0140-6736(21)00524-9
  52. Miralles O., Sanchez-Rodriguez D., Marco E., Annweiler C., Baztan A., Betancor É., … and Vall-Llosera E. (2021), «Unmet needs, health policies, and actions during the COVID-19 pandemic: a report from six European countries», in European geriatric medicine, 12(1): 193-204.
  53. Munn Z., Peters M. D., Stern C., Tufanaru C., McArthur A. and Aromataris E. (2018), «Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach», in BMC medical research methodology, 18(1): 143.
  54. Naughton-Doe R., Barke J., Manchester H., Willis P., & Wigfield A. (2024), «Ethical issues when interviewing older people about loneliness: reflections and recommendations for an effective methodological approach», in Ageing & Society, 44(7): 1681-1699.
  55. Nitschke I., Gegner U., Hopfenmüller W., Sobotta B. A. and Jockusch J. (2022), «Student perceptions of age and ageing—an evaluation of Swiss dental students receiving education in gerodontology», in International Journal of Environmental Research and Public Health, 19(12): 7480.
  56. Nitschke I., Hahnel S. and Jockusch J. (2021), «Health-related social and ethical considerations towards the utilization of dental medical services by seniors: influencing and protective factors, vulnerability, resilience and sense of coherence», in International journal of environmental research and public health, 18(4): 2048.
  57. Özdil K., Öztürk G. K., Çatıker A. and Büyüksoy G. D. B. (2021), «Views of senior nursing students on the problems of the elderly during the COVID-19 process and attitudes against ageism», in Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 14(4): 357-369.
  58. Paar E., De Lai E., Držaić M., Kummer I., Bužančić I., Ortner Hadžiabdić M., … and Fialová D. (2024), «Fall risk-increasing drugs and associated health outcomes among community-dwelling older patients: A cross-sectional study in Croatian cohort of the EuroAgeism H2020 project», in Acta pharmaceutica, 74(4): 635-653.
  59. Paoletti I. (2024), «Ageism: The Need for New Imagery for Growing Old», In Paoletti, I. (eds) Creating New Meanings For Old Age, pp. 35–62. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-97-5041-2_2
  60. Pearson G. M., Dowling S., Ben-Shlomo Y. and Henderson E. J. (2025), «Inspiring tomorrow’s geriatricians: a qualitative exploration of the facilitators and barriers to medical students choosing geriatric medicine», in Gerontology & Geriatrics Education, 1-15.
  61. Peterson J., Pearce P. F., Ferguson L. A. and Langford C. A. (2017), «Understanding scoping reviews: Definition, purpose, and process», in Journal of the American Association of Nurse Practitioners, 29(1): 12-16.
  62. Pham M. T., Rajić A., Greig J. D., Sargeant J. M., Papadopoulos A. and McEwen S. A. (2014), «A scoping review of scoping reviews: advancing the approach and enhancing the consistency», in Research synthesis methods, 5(4): 371-385.
  63. Piaton S., Adam S., Roger-Leroi V. and Vallet G. T. (2024), «Implicit ageism in dental students: general representations of ageing health and specific representations of the mouth», in Educational Gerontology, 50(7): 659-670.
  64. Piaton S., Roger-Leroi V., Vallet G. (2023), «Specific form of ageism in dental care: Convergent validity of the Ageism Scale for Dental Students and its implications for education», in European Journal of Dental Education, 27(2): 368-373.
  65. Pinho M. and Araújo A. (2022), «How to fairly allocate scarce medical resources? Controversial preferences of healthcare professionals with different personal characteristics», in Health Economics, Policy and Law, 17(4): 398-415.
  66. Poli S. (2020), «Invecchiamento e Coronavirus: la costruzione sociale del rischio e la marginalizzazione degli anziani oltre il lockdown», in SocietàMutamentoPolitica, 11(21): 271-280. https://doi.org/10.13128/smp-11967
  67. Pons E. G., Pinazo-Clapés C., Galan A. S., Pinazo-Hernandis S. and Esquiva I. C. (2025), «Ageism and suicide: A structural equation modeling analysis and evaluation of a high-fidelity simulation-based intervention for future healthcare professionals», in Geriatric Nursing, 66: 103674.
  68. Previtali F., Allen L. D. and Varlamova M. (2020), «Not only virus spread: The diffusion of ageism during the outbreak of COVID-19», in Journal of Aging & Social Policy, 32(4-5): 506–514. https://doi.org/10.1080/08959420.2020.1772002
  69. Rodriguez-Rodriguez V., Rojo-Perez F., Perez de Arenaza Escribano C., Molina-Martínez M. Á., Fernandez-Mayoralas G., Sánchez-González D., Rojo-Abuin J., Rodríguez-Blázquez C., João Forjaz M. and Martin Garcia S. (2022), «The impact of COVID-19 on nursing homes: study design and population description», in International journal of environmental research and public health, 19(24): 16629.
  70. Schüttengruber G., Stolz E., Lohrmann C., Kriebernegg U., Halfens R. and Großschädl F. (2022), «Attitudes towards older adults (80 years and older): a measurement with the ageing semantic differential‐a cross‐sectional study of Austrian students», in International journal of older people nursing, 17(3): e12430.
  71. Settels J. and Leist A. K. (2022), «The role of country-level availability and generosity of healthcare services, and old-age ageism for missed healthcare during the COVID-19 pandemic control measures in Europe», in Journal of aging and health, 34(6-8): 1016-1036.
  72. Snellman F. (2016), «Whose ageism? The reinvigoration and definitions of an elusive concept», in Nordic Psychology, https://doi.org/10.1080/19012276.2015.1125301.
  73. Springer F., Matsuoka A., Obama K., Mehnert-Theuerkauf A., Uchitomi Y. and Fujimori M. (2025), «Quality of life in older patients with cancer and related unmet needs: a scoping review», in Acta Oncologica, 64: 42602.
  74. Stypińska J. and Franke A. (2023), «AI revolution in healthcare and medicine and the (re-) emergence of inequalities and disadvantages for ageing population», in Frontiers in Sociology, 7: 1038854.
  75. Teaster P. B. and Giwa A. O. (2023), «Ageism as a source of global mental health inequity», in AMA Journal of Ethics, 25(10): 765-770.
  76. Trevisan C., Pedone C., Maggi S., Noale M., Di Bari M., Sojic A., … and Epicovid Working Group (2021), «Accessibility to SARS-CoV-2 swab test during the COVID-19 pandemic: Did age make the difference?», in Health policy, 125(12): 1580-1586.
  77. Tricco A. C., Lillie E., Zarin W., O’Brien K. K., Colquhoun H., Levac D., Moher D., Peters M. D. J., Horsley T., Weeks L., Hempel S., Akl E. A., Chang C., McGowan J., Stewart L., Hartling L., Aldcroft A., Wilson M. G., Garritty C., … and Straus S. E. (2018), «PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation», in Annals of Internal Medicine, 169(7): 467–473. https://doi.org/10.7326/M18-0850.
  78. United Nations (2024), World population prospects 2024: Highlights, Department of Economic and Social Affairs.
  79. Uwitonze J. P., Duminy L. and Blankart C. R. (2024), «Identifying health inequities faced by older adults with rare diseases: A systematic literature review and proposal for an ethical spectrum and resource allocation framework», in Health Policy, 149: 105176.
  80. Van Kolfschooten H. (2023), «The AI cycle of health inequity and digital ageism: mitigating biases through the EU regulatory framework on medical devices», in Journal of Law and the Biosciences, 10(2): lsad031.
  81. WHO (2021), Global report on ageism, World Health Organization.
  82. WHO (2025), Ageing and health, World Health Organization.