Edinburgh Napier University

  Background: It is an incontrovertible fact that the world has an increasing number of people who are classed as the ‘oldest old’ and sometimes referred to as the ‘fourth age’. This group of people are usually identified as those aged 85 and over. The trend is not only European, but global. However, much of the literature on ‘older people’ and ‘later life’ classifies the term old in so many different ways, which renders it a fairly useless term. Given that older people are living longer and have relatively healthier lives, it is surely time to address the needs of the oldest old and write about this distinct cohort of people with different health and social care needs from those aged 65–74 and 75–84.

Aim: The aim of this study was to explore the concept of the ‘fourth age’ or ‘oldest old’ as defined in the six top most non-medical rated journals, to examine consensus on these terms.

Materials and Methods: Researchers from Scotland, Italy and Slovenia reviewed the journals Age and Aging, Aging and Mental Health, Ageing and Society, Research on Ageing, The Gerontologist and The Journal(s) of Gerontology B. The keywords ‘fourth age’ ‘oldest old’ and ‘85 plus’ were searched on each journals’ website, with the parameters of full text only, English, peer reviewed, articles only and from January 1st 2003 - April 2015.

Results: From the initial search of the six journals, 603 articles were retrieved and entered onto an excel spreadsheet. For consistency, the researchers used the headings; author and date, country, age groups specified, methodology, sample size, key findings, reasons for acceptance/rejection in the final paper and an agree/disagree column for inter-rater reliability. Three stages of screening were undertaken which resulted in a total of 54 articles to be included in the study. Age and Aging (13), Aging and Mental Health (12), Ageing and Society (8), Research on Ageing (4), The Gerontologist (10) and The Journal(s) of Gerontology B (7).

Conclusion: The findings showed that there was little consistency in the definitions and the descriptions of old age, third age and fourth age. Many articles stated arbitrary age stratifications in the studies conducted, but few had rationales for using the age bands selected. Greater consistency is needed in research studies if health and social care services are to target the needs of those classed as ‘the oldest old’.