Abstract
Introduction
The dynamics of population ageing is increasing the demand for professional geriatric care. At the same time, ambivalent and even negative attitudes towards older people are still observed among medical students, which may affect the quality of care. The aim of this study was to identify the determinants of medical students’ perceptions of older people and to identify factors differentiating these attitudes.
Materials and methods
A cross-sectional study was conducted using an online survey, covering 203 medical students. A standardised Scale of Attitudes Towards Older Adults (SPWS) was used, comprising three subscales: Respect and Support, Rejection and Lack of Understanding, and Social Distance.
Results
The mean age of respondents was 22.51 ± 1.98 years, with women constituting the majority (73.89%). The largest group consisted of nursing students (30.54%). Frequent or very frequent contact with older adults was declared by 66.01% of respondents. Overall, students demonstrated positive attitudes, particularly on the Respect and Support subscale (M = 4.49 ± 0.61). The field of study significantly differentiated the results of the Rejection and Lack of Understanding subscales (H = 30.03; p < 0.001), with nursing students scoring higher than dental students (p < 0.001) and paramedic (p < 0.01) students. Differences according to sex were also observed, with women scoring higher than men in this dimension (Z = 3.75; p < 0.001). However, although these scores were higher than those observed among men, they remained close to the midpoint of the scale, indicating a moderate or ambivalent level of rejection and lack of understanding rather than a distinctly negative attitude.
Conclusions
Medical students mostly demonstrated positive attitudes towards older people, particularly in terms of respect and willingness to provide support. Regular contact with older people and appropriately designed gerontological education may contribute to more positive attitudes towards older adults and help counteract ageism among future healthcare professionals.
Keywords: Ageism, Students, Older people, Attitudes
Introduction
The World Health Organisation (WHO) considers the age of 60 to be the beginning of old age, while according to the United Nations (UN), this threshold is 65 years. Nowadays, due to advances in medicine and improvements in quality of life, residents of developed countries are increasingly living to the age of 70–90 years [1, 2]. Societies are ageing at an increasingly rapid pace, with projections indicating that by 2050, the population aged 60 and older will increase to around 2.1 billion [3]. The high percentage of older people and the low birth rate contribute to population ageing in societies dominated by youth-centered cultural values. Youth-centred cultural values prioritise youthfulness, productivity, physical attractiveness, independence, and innovation, while often associating old age with decline, dependency, and reduced social value. Particularly prevalent in many contemporary Western societies, these values are reinforced through media representations, labour market expectations, and consumer culture, contributing to negative perceptions of ageing and the persistence of age-related stereotypes. Such cultural narratives may foster ageism and influence healthcare students’ perceptions of older adults even before formal professional training, potentially affecting future healthcare interactions and the quality of care provided to older people. This can have a negative impact on the way older adults are perceived by society and may even lead to the phenomenon of ageism [4]. Societal attitudes towards older people vary depending on factors such as the social situation of older adults, the economic situation of the country, the immediate environment, and health status. Studies show that older people often become the targets of negative and stereotypical social judgements, which limit their participation in social and professional relationships. Given the increasing proportion of older adults in the population, attitudes towards ageing among future healthcare professionals have become an important area of research. Previous evidence indicates that age-related stereotypes may influence interactions with older patients and potentially affect the quality of care delivered. Consequently, understanding the determinants of students’ perceptions of older people may contribute to the development of educational interventions aimed at reducing ageism and improving geriatric care [5].
Although the demand for care for older adults is steadily increasing, medical students do not always exhibit a positive attitude towards working with this patient group. Previous research shows that negative attitudes towards older adults are still prevalent among students, residents and practising physicians alike [6]. These attitudes are often reflected in age-related stereotypes portraying older adults as dependent, frail, resistant to treatment, or less likely to benefit from healthcare interventions, as well as in a lower willingness to work with geriatric patients. Such perceptions are of particular concern because attitudes formed during training may influence future interactions with older patients and the quality of care delivered in clinical practice. The first longitudinal study on attitudes provided evidence that medical students’ attitudes towards older people deteriorate during medical school [7]. Researchers suggest that this trend may result from increasing exposure to frail older patients in clinical settings, combined with insufficient geriatric education and limited contact with older adults outside the context of illness and dependency [7]. In addition to educational factors, emotional responses may also play a role. Contact with frail or dependent older patients may evoke discomfort, anxiety about one’s own ageing, or concerns related to illness and mortality, which can contribute to the development of age-related stereotypes and negative perceptions of older people [8]. The relationship between intergenerational contact and attitudes towards older adults remains complex. While numerous studies have shown that frequent and meaningful contact with older people is associated with more positive perceptions of ageing and lower levels of ageism, other findings suggest that contact alone does not necessarily improve attitudes. The quality, context, and nature of these interactions appear to play a crucial role, with positive experiences fostering favourable attitudes and negative experiences potentially reinforcing existing stereotypes. For example, one Italian study involving nursing students showed that 69.7% of those exhibiting more favourable attitudes towards old age had previous experience working with older patients [8]. The challenges and perspectives related to the care of older adults are strongly conditioned by the cultural contexts and socio-economic situation of a given country. For this reason, it is necessary to conduct studies among students representing different healthcare disciplines and educational environments, as this may provide a more comprehensive understanding of factors influencing attitudes towards older adults. A better understanding of these differences may help identify areas requiring targeted educational interventions and support the development of age-inclusive healthcare education [6]. The aim of the study was to examine medical students’ attitudes towards older people and to identify factors differentiating these attitudes.
Materials and methods
Study design
The study was cross-sectional and was conducted between January and February 2025 using a diagnostic survey method and questionnaire technique. Its aim was to identify the determinants of medical students’ perceptions of older people. The choice of this research method enabled efficient data collection from students representing different healthcare disciplines within a relatively short period of time. The use of standardised measurement instruments ensured a reliable assessment of the respondents’ subjective attitudes and beliefs towards older people.
Setting and sample
The survey was conducted as an online questionnaire using Microsoft Forms among students of nursing, midwifery, physiotherapy, paramedicine, medicine, dentistry, and public health, who provided voluntary consent to participate and were informed of the anonymous nature of the study. The survey link was posted on online forums for medical students and shared through social media platforms. A total of 203 respondents meeting the inclusion criteria were enrolled in the study. The sample included both traditional undergraduate students and nursing students continuing their education after completing bridging nursing programmes. All participants were studying at Polish universities and residing in Poland at the time of the study. The study sample consisted of nursing (n = 62), medicine (n = 29), dentistry (n = 24), physiotherapy (n = 24), midwifery (n = 23), paramedicine (n = 22), and public health students (n = 19). Participation was voluntary; therefore, the gender distribution reflected the characteristics of respondents who chose to participate in the survey rather than a predetermined recruitment strategy.
Research tools
A standardised Scale of Attitudes Towards Older Adults (Polish: Skala Postaw Wobec Seniorów, SPWS), adapted by Łukasiewicz J. and Kowalski W [9]., was used to assess attitudes towards older adults across three dimensions: Respect and Support, Rejection and Lack of Understanding, and Social Distance. The SPWS questionnaire contained 60 statements rated by respondents on a six-point Likert scale, where 1 indicated “strongly disagree” and 6 indicated “strongly agree”. The instrument comprised three subscales: “Respect and Support” (α = 0.93), “Rejection and Lack of Understanding” (α = 0.86), and “Social Distance” (α = 0.70). High scores on the Respect and Support scale reflect a positive approach towards older adults, who are perceived as a source of life wisdom and experience. The Rejection and Lack of Understanding scale identifies attitudes characterised by irritation, lack of empathy, and social isolation of older adults, with higher scores indicating a negative attitude towards older people. In turn, a high score on the Social Distance scale indicates emotional detachment and the belief that older adults are excessively focused on their own material comfort [9].
An author-designed questionnaire was also used, comprising six questions on sociodemographic data such as sex, age, place of residence, field and year of study, and a question concerning the frequency of contact with older adults.
Ethical approval
The study was conducted with the approval of the Bioethics Committee of the Jagiellonian University Medical College in Krakow (No. 118.0043.1.402.2024) and in accordance with the principles of the Declaration of Helsinki and the STROBE guidelines for observational studies. All respondents were informed of the voluntary and anonymous nature of their participation in the study and about the possibility of withdrawal at any stage.
Statistical analysis
The collected data was statistically analysed using the Statistica v.13.1 PL. programme. A significance level of p < 0.05 was adopted. Quantitative variables were described using basic descriptive statistics, whereas qualitative variables were presented as frequencies (n) and percentages (%). Differences between two groups were analysed using the Mann–Whitney U test, whereas comparisons of three or more groups were performed using one-way analysis of variance (ANOVA) or its non-parametric equivalent, the Kruskal–Wallis test, with post hoc analyses. Comparisons between two groups primarily concerned gender (women vs. men), whereas analyses involving three or more groups were conducted according to field of study and frequency of contact with older adults. The choice between parametric and non-parametric tests was based on the assessment of data distribution. Variables meeting the assumptions of normality were analysed using ANOVA, whereas variables not meeting these assumptions were analysed using the Kruskal–Wallis test. Associations between variables were assessed using Spearman’s rank correlation coefficient. The frequency of contact with older adults was treated as an ordinal variable and analysed using Spearman’s rank correlation coefficient to assess its relationship with the SPWS subscale scores.
Results
A total of 203 medical students were included in the study. The respondents were predominantly women (73.89%). Participants ranged in age from 18 to 51 years; however, the majority (88.1%) were aged 25 years or younger. Older respondents were mainly nursing students continuing their education after completing bridging nursing programmes, which explains the presence of participants in the higher age categories. Nearly half of the respondents (47.29%) lived in cities with populations exceeding 100,000. The largest group consisted of nursing students (30.54%). The proportions of the remaining fields of study were markedly lower, ranging from 9% to 14% (the highest being medicine at 14.29% and the lowest public health). About one third of respondents were fifth-year students. A detailed description of the study sample is presented in (Table 1).
Table 1.
Sociodemographic characteristics of respondents
| Personal data | Categories | No | % |
|---|---|---|---|
| Age (years) | 18–20 | 35 | 17,2% |
| 21–25 | 144 | 70,9% | |
| 26–30 | 11 | 5,4% | |
| 31–40 | 7 | 3,4% | |
| 41–47 | 2 | 1,0% | |
| 48–51 | 4 | 2,0% | |
| Gender | Women | 150 | 73.89% |
| Men | 53 | 26.11% | |
| Place of residence | Village | 48 | 23.65% |
| City up to 100,000 | 59 | 29.06% | |
| City over 100,000 | 96 | 47.29% | |
| Field of study | Medicine | 29 | 14.29% |
| Dentistry | 24 | 11.82% | |
| Nursing | 62 | 30.54% | |
| Midwifery | 23 | 11.33% | |
| Physiotherapy | 24 | 11.82% | |
| Paramedicine | 22 | 10.84% | |
| Public health | 19 | 9.36% | |
| Year of study | First year | 28 | 13.79% |
| Second year | 34 | 16.75% | |
| Third year | 36 | 17.73% | |
| Fourth year | 35 | 17.24% | |
| Fifth year | 70 | 34.48% |
Over one third of the respondents (38.42%) reported frequent contact with older adults. Slightly over one quarter of the respondents reported very frequent contact with older adults (27.59%), while slightly fewer respondents reported infrequent contact (24.63%). 9.36% of respondents reported having no contact with older adults (Fig. 1).
Fig. 1.
Frequency of contact between students and seniors
In the study, students achieved the highest scores in the Respect and Support attitude, with a mean of M = 4.49 (SD = 0.61), indicating a clearly positive attitude towards older adults. The Rejection and Lack of Understanding attitude was characterised by a moderate level (M = 3.38; SD = 0.84). The lowest values were observed in the area of Social Distance (M = 2.46; SD = 0.47), indicating a relatively low sense of social separation from older people. Overall, the results suggest a preponderance of positive attitudes over negative ones (Table 2).
Table 2.
Respondents' attitudes towards older adults
| Attitudes towards older adults. | Descriptive statistics | |||||
|---|---|---|---|---|---|---|
| M ± SD | Me [Q1-Q3] | Min. - Max. | Cl | SE | ||
| -95.00% | +95.00% | |||||
| Respect and Support | 4.49 ± 0.61 | 4.5 [4.07 - 5] | 2.77 - 5.6 | 4.41 | 4.58 | 0.04 |
| Rejection and Lack of Understanding | 3.38 ± 0.84 | 3.47 [2.68 - 3.89] | 1.63 - 5.74 | 3.26 | 3.50 | 0.06 |
| Social Distance | 2.46 ± 0.47 | 2.45 [2.18 - 2.73] | 1 - 4.18 | 2.40 | 2.53 | 0.03 |
Abbreviations: SD standard deviation, Min minimum, Me median, Max maximum, SE standard error
Students’ attitudes towards statements defining attitudes towards older adults were also examined using the Scale of Attitudes Towards Older Adults. The respondents primarily demonstrated strong emotional reactions towards the situations of older people, especially their loneliness and marginalisation, which was reflected in the highest rated statements (M = 5.23 to M = 5.06). High support was also expressed for attitudes of respect, care, and willingness to help older adults, as well as acknowledgement of their role as a source of wisdom and experience (M = 4.94 to M = 4.57). Moderately high scores were observed for beliefs about the possibility of learning from the older generation and their importance for younger people (M = 4.45 to M = 4.19). Some responses indicated ambivalence in attitudes and entrenched stereotypes regarding the lifestyle and attitudes of older adults (M = 4.08 to M = 3.17). The lowest mean scores were observed for statements of a prejudicial nature, downplaying the material and life situation of older adults (M = 2.93 to M = 1.63) (Table 3).
Table 3.
Level of agreement of respondents with statements regarding perceptions of older people
| Scale of Attitudes Towards Older Adults | Descriptive statistics | |||||
|---|---|---|---|---|---|---|
| M ± SD | Me [Q1-Q3] | Min. - Max. | Cl | SE | ||
| -95.00% | +95.00% | |||||
| Older people possess life wisdom shaped by their personal experiences. | 4.71 ± 0.83 | 5 [4 - 5] | 1 - 6 | 4.60 | 4.82 | 0.06 |
| Older people have enough money; they just do not know how to manage it. | 2.23 ± 0.87 | 2 [2 - 3] | 1 - 6 | 2.11 | 2.35 | 0.06 |
| I believe that young people can learn a lot from the older generation. | 4.45 ± 0.9 | 4 [4 - 5] | 1 - 6 | 4,33 | 4.58 | 0.06 |
| Older people have more opportunities to obtain money for their needs than younger people. | 2. | 2 [1 - 3] | 1 - 6 | 1.95 | 2.20 | 0.06 |
| Older adults possess life experience that can be of benefit to younger generations. | 4.57 ± 0.86 | 5 [4 - 5] | 1 - 6 | 4.45 | 4.69 | 0.06 |
| It pains me that older people are so often abandoned by their families and left without proper care. | 5.23 ± 0.92 | 5 [5 - 6] | 1 - 6 | 5.10 | 5.35 | 0.06 |
| The vast majority of older people try to support the younger generation with their experience and knowledge. | 4.04 ± 1.04 | 4 [4 - 5] | 1 - 6 | 3.90 | 4.18 | 0.07 |
| I feel envious when I think how much older people can do with so much free time. | 2.35 ± 1.06 | 2 [2 - 3] | 1 - 6 | 2.20 | 2.50 | 0.07 |
| Older people devote much of their free time to their family. | 4.58 ± 0.93 | 5 [4 - 5] | 1 - 6 | 4.45 | 4.71 | 0.07 |
| I think older people are generally not very supportive of the younger generation. | 3.17 ± 1.08 | 3 [2 - 4] | 1 - 6 | 3.02 | 3.32 | 0.08 |
| Older people have plenty of free time, during which they always do the same things. | 3.36 ± 1.18 | 3 [2 - 4] | 1 - 6 | 3.20 | 3.52 | 0.08 |
| Older people need as much attention from others as small children. | 3.24 ± 1.22 | 3 [2 - 4] | 1 - 6 | 3.07 | 3.41 | 0.09 |
| Older people are demanding towards younger people. | 3,31 ± 1,03 | 3 [3 - 4] | 1 - 6 | 3.16 | 3.45 | 0.07 |
| Older people are overly frugal and begrudge spending money on anything. | 2.83 ± 1.15 | 3 [2 - 3] | 1 - 6 | 2.67 | 2.99 | 0.08 |
| Older people often interfere in matters that do not concern them. | 3.51 ± 1.15 | 3 [3 - 4] | 1 - 6 | 3.35 | 3.67 | 0.08 |
| I feel obliged to give up my seat on the bus to an older person. | 5.12 ± 0.97 | 5 [5 - 6] | 2 - 6 | 4.99 | 5.26 | 0.07 |
| Older people have a lot of free time and do not know how to use it properly. | 3.21 ± 1.18 | 3 [2 - 4] | 1 - 6 | 3.05 | 3.37 | 0.08 |
| The stereotype of the grumpy old person is still valid. | 3.49 ± 1.28 | 4 [2 - 4] | 1 - 6 | 3.31 | 3.67 | 0.09 |
| Older people are often unhappy and tired of life. | 3.42 ± 1.23 | 3 [2 - 4] | 1 - 6 | 3,25 | 3.59 | 0.09 |
| Complaining is the domain of older people. | 2.85 ± 1.38 | 3 [2 - 4] | 1 - 6 | 2.66 | 3.04 | 0.10 |
| I feel that older people do not want to burden their families with their problems. | 4.19 ± 1.04 | 4 [4 - 5] | 1 - 6 | 4.04 | 4.33 | 0.07 |
| If older people were more willing to get to know others, they would be happier. | 3.78 ± 1.17 | 4 [3 - 5] | 1 - 6 | 3.62 | 3.94 | 0.08 |
| I admire older people for the neatness of their homes. | 3.91 ± 1.1 | 4 [3 - 5] | 1 - 6 | 3.76 | 4.06 | 0.08 |
| I feel sad when thinking about older people passing away. | 5.04 ± 1.03 | 5 [4 - 6] | 2 - 6 | 4.90 | 5.18 | 0.07 |
| Older people are generally surrounded by a circle of good friends and acquaintances. | 3.29 ± 0.95 | 3 [3 - 4] | 1 - 6 | 3.15 | 3.42 | 0.07 |
| Older people enjoy telling engaging stories. | 4.7 ± 0.91 | 5 [4 - 5] | 2 - 6 | 4.58 | 4.83 | 0.06 |
| I willingly make use of my grandmother’s recipes or my grandfather’s advice. | 4.94 ± 1.13 | 5 [4 - 6] | 1 - 6 | 4.78 | 5.10 | 0.08 |
| Older people are a pillar of the family and society. | 4.59 ± 1.08 | 5 [4 - 5] | 1 - 6 | 4.44 | 4.74 | 0.08 |
| Older people have a sufficiently good financial situation because they worked for it throughout their lives. | 2.29 ± 0.93 | 2 [2 - 3] | 1 - 5 | 2.16 | 2.42 | 0.07 |
| Older people are satisfied with life regardless of their past experiences. | 2.93 ± 1.07 | 3 [2 - 4] | 1 - 6 | 2.78 | 3.08 | 0.08 |
| I feel great respect for the knowledge and experience of older people. | 4.67 ± 0.86 | 5 [4 - 5] | 1 - 6 | 4.55 | 4.78 | 0.06 |
| The older generation is a huge help to the younger members of the family. | 4.32 ± 0.88 | 4 [4 - 5] | 1 - 6 | 4.19 | 4.44 | 0.06 |
| Older people have rich personalities. | 4.51 ± 0.95 | 5 [4 - 5] | 2 - 6 | 4.38 | 4.64 | 0.07 |
| Older people always evoke positive emotions in me. | 4.05 ± 1.26 | 4 [3 - 5] | 1 - 6 | 3.87 | 4.22 | 0.09 |
| Older people generally no longer make any effort towards self-development. | 3.4 ± 1.22 | 3 [2 - 4] | 1 - 6 | 3.24 | 3.57 | 0.09 |
| Older people constantly think about their impending death. | 3.53 ± 1.18 | 3 [3 - 4] | 1 - 6 | 3.37 | 3.70 | 0.08 |
| Older people are withdrawn and do many things on their own. | 3.33 ± 1.17 | 3 [2 - 4] | 1 - 6 | 3.16 | 3.49 | 0.08 |
| I am not surprised that older people are abused by others. | 1.63 ± 1.02 | 1 [1 - 2] | 1 - 6 | 1.49 | 1,77 | 0.07 |
| Older people are a treasure trove of knowledge for the younger generation. | 4.37 ± 0.87 | 4 [4 - 5] | 1 - 6 | 4,25 | 4.49 | 0.06 |
| I feel comfortable in the company of older people. | 4.51 ± 1.05 | 4 [4 - 5] | 1 - 6 | 4.36 | 4.65 | 0.07 |
| I always associate the home of an older person with elegance and order. | 3.63 ± 1.08 | 4 [3 - 4] | 1 - 6 | 3.48 | 3.77 | 0.08 |
| I have no reluctance to help an older person with cleaning their home. | 4.54 ± 1.04 | 5 [4 - 5] | 1 - 6 | 4.40 | 4.69 | 0.07 |
| I think older people often struggle with loneliness. | 4.97 ± 0.9 | 5 [5 - 6] | 1 - 6 | 4.84 | 5.09 | 0.06 |
| I believe that older people have extensive knowledge regardless of their level of education. | 4.22 ± 1.15 | 4 [4 - 5] | 1 - 6 | 4.06 | 4.38 | 0.08 |
| I feel sad when I see an older person wearing old and worn-out clothes. | 5.06 ± 0.97 | 5 [5 - 6] | 1 - 6 | 4.92 | 5.19 | 0.07 |
| Older people place excessive emphasis on luxurious living conditions. | 2.05 ± 0.85 | 2 [2 - 2] | 1 - 6 | 1.93 | 2.17 | 0.06 |
| Older people are always happy to share what they have with others. | 4.32 ± 0.91 | 4 [4 - 5] | 1 - 6 | 4.19 | 4.45 | 0.06 |
| I like working with older people because they are more experienced. | 3.88 ± 1.04 | 4 [3 - 5] | 1 - 6 | 3.74 | 4.03 | 0.07 |
| Older people have extensive knowledge, but most of it is outdated. | 3.69 ± 0.99 | 4 [3 - 4] | 1 - 6 | 3.56 | 3.83 | 0.07 |
| A lot of unnecessary things can be found in the homes of older people. | 4.08 ± 1.07 | 4 [3 - 5] | 2 - 6 | 3.94 | 4.23 | 0.08 |
| Older people often hold a grudge against others. | 3.37 ± 1.17 | 3 [3 - 4] | 1 - 6 | 3.21 | 3.53 | 0.08 |
| Older people spend their time mainly watching television. | 3.35 ± 1.28 | 3 [2 - 4] | 1 - 6 | 3.17 | 3.53 | 0.09 |
| When I talk to older people, I think they know a lot about life. | 4.43 ± 0.93 | 4 [4 - 5] | 2 - 6 | 4.31 | 4.56 | 0.07 |
| I am always ready to stand up for an older person. | 4.6 ± 0.98 | 5 [4 - 5] | 1 - 6 | 4.47 | 4.74 | 0.07 |
| I feel very good when I go back to memories with older people. | 4.57 ± 1 | 5 [4 - 5] | 2 - 6 | 4.43 | 4.71 | 0.07 |
| Older people have a lot of free time, but most of it is taken up by medical appointments. | 3.29 ± 1.12 | 3 [2 - 4] | 1 - 6 | 3.14 | 3.45 | 0.08 |
| Older people cope better in dangerous situations than others. | 2.49 ± 1 | 2 [2 - 3] | 1 - 6 | 2.35 | 2.63 | 0.07 |
| I am annoyed by older people who are constantly looking for additional work. | 1.99 ± 0.93 | 2 [1 - 3] | 1 - 5 | 1.86 | 2.12 | 0.07 |
| Despite lower incomes, most older people are more generous than younger people. | 4.04 ± 0.9 | 4 [4 - 5] | 1 - 6 | 3.92 | 4.17 | 0.06 |
| A person of advanced age is fulfilled and happy. | 3.75 ± 1.25 | 4 [3 - 5] | 1 - 6 | 3.58 | 3.92 | 0.09 |
The field of study significantly differentiated the Rejection and Lack of Understanding attitude (p < 0.001). Post hoc tests showed that nursing students scored higher (M = 3.68) than dental students (M = 2.90) and paramedic (M = 2.97) students. For the Respect and Support attitude, the scores of students from the different fields of study ranged from 4.39 to 4.66 (p = 0.609). Values for the Social Distance attitude ranged from 2.39 to 2.51, (p = 0.87) (Table 4).
Table 4.
The relationship between the respondents’ field of study and their attitudes towards older people
| Attitude examined | Field of study | Descriptive statistics – attitudes towards older people | ANOVA / Kruskal-Wallis test | Post hoc | |||||
|---|---|---|---|---|---|---|---|---|---|
| M ± SD | Me [Q1–Q3] | Min. - Max. | Cl | SE | |||||
| -95.00% | +95.00% | ||||||||
| Respect and Support | Medicine(n = 29) | 4.44 ± 0.54 | 4.53[4.1 - 4.83] | 3.17 - 5.2 | 4.24 | 4.64 | 0.10 | F(6, 71.53) = 0,75; p = 0.609 | - |
| Dentistry(n = 24) | 4.64 ± 0.73 | 4.75[4.15 - 5.28] | 3 - 5.53 | 4.33 | 4.94 | 0.15 | |||
| Nursing(n = 62) | 4.39 ± 0.56 | 4.32[4 - 4.87] | 2.97 - 5.57 | 4,25 | 4.53 | 0.07 | |||
| Midwifery(n = 23) | 4.47 ± 0.47 | 4.53[4.13 - 4.7] | 3.57 - 5.5 | 4.26 | 4.67 | 0.10 | |||
| Physiotherapy(n = 24) | 4.5 ± 0.62 | 4.43[4.05 - 5.07] | 2.77 - 5.47 | 4.24 | 4.76 | 0.13 | |||
| Paramedicine(n = 22) | 4.56 ± 0.78 | 4.85[4.17 - 5.1] | 2.77 - 5.6 | 4.22 | 4.90 | 0.17 | |||
| Public health (n = 19) | 4.66 ± 0.64 | 4.73[3.93 - 5.17] | 3.73 - 5.53 | 4.35 | 4.97 | 0.15 | |||
| Rejection and Lack of Understanding | Medicine(n = 29) | 3.56 ± 0.83 | 3.68[3.16 - 4.16] | 1.63 - 5.32 | 3.24 | 3.87 | 0.15 | H(6, N = 203) = 30.03; p < 0.001 | Dentistry < Nursing(p < 0.001) / Nursing > Paramedicine (p < 0.01) |
| Dentistry(n = 24) | 2.9 ± 0.8 | 2.87[2.24 - 3.39] | 1.74 - 5.11 | 2.56 | 3.24 | 0.16 | |||
| Nursing(n = 62) | 3.68 ± 0.74 | 3.76[3.32 - 4.05] | 1.74 - 5.47 | 3.49 | 3.87 | 0.09 | |||
| Midwifery(n = 23) | 3.26 ± 0.89 | 3.05[2.58 - 3.89] | 1.89 - 5.11 | 2.88 | 3.65 | 0.19 | |||
| Physiotherapy(n = 24) | 3.58 ± 0.65 | 3.71[3.21 - 3.84] | 2.21 - 5.05 | 3.31 | 3.85 | 0.13 | |||
| Paramedicine(n = 22) | 2.97 ± 0.96 | 2.74[2.16 - 3.47] | 1.95 - 5.74 | 2.55 | 3,40 | 0.20 | |||
| Publichealth(n = 19) | 3.09 ± 0.7 | 3.37[2.68 - 3.47] | 1.84 - 4.42 | 2.75 | 3.43 | 0.16 | |||
| Social Distance | Medicine(n = 29) | 2.45 ± 0.52 | 2.45[2.18 - 2.55] | 1.45 - 4.18 | 2.26 | 2,65 | 0.10 | H (6, N = 203) = 2.49;p = 0.87 | - |
| Dentistry(n = 24) | 2.42 ± 0.42 | 2.36[2.09 - 2.68] | 1.73 - 3.27 | 2.24 | 2.59 | 0.09 | |||
| Nursing(n = 62) | 2.51 ± 0.44 | 2.55[2.18 - 2.73] | 1.64 - 3.64 | 2.40 | 2.62 | 0.06 | |||
| Midwifery(n = 23) | 2.42 ± 0.47 | 2.45[2.09 - 2.64] | 1 - 3.45 | 2.22 | 2.62 | 0.10 | |||
| Physiotherapy(n = 24) | 2.39 ± 0.49 | 2.45[1.91 - 2.86] | 1.45 - 3.09 | 2.18 | 2.60 | 0.10 | |||
| Paramedicine(n = 22) | 2.51 ± 0.46 | 2.45[2.18 - 2.91] | 1.73 - 3.27 | 2.31 | 2.72 | 0.10 | |||
| Public health (n = 19) | 2.44 ± 0.54 | 2.27[2.18 - 2.55] | 1.64 - 4.09 | 2.18 | 2,70 | 0.12 | |||
Correlation analysis revealed no significant relationships between age and any of the analysed attitudes towards older people. The results indicate that age was not a differentiating factor in attitudes towards older adults. All analysed attitudes remained at a similar level regardless of the age of female and male students (Table 5; Fig. 2).
Table 5.
Correlation between the respondents’ age and their attitudes towards older people
| Characteristics | M ± SD | Spearman’s rank correlation |
|---|---|---|
| Age (years) | 22.51 ± 1.98 |
R = 0.02; t(N-2) = 0.28; p = 0.777 |
| Respect and Support | 4.49 ± 0.61 | |
| Age (years) | 22.51 ± 1.98 |
R = 0.01; t(N-2) = 0.2; p = 0.846 |
| Rejection and Lack of Understanding | 3.38 ± 0.84 | |
| Age (years) | 22.51 ± 1.98 |
R = 0; t(N-2) = 0.05; p = 0.964 |
| Social Distance | 2.46 ± 0.47 |
Fig. 2.
Attitudes towards older adults and the respondents’ age
The analysis showed that gender significantly differentiated the attitude of Rejection and Lack of Understanding, with women scoring higher (M = 3.50) than men (M = 3.04); p < 0.001. Although women scored significantly higher than men, the mean score of 3.50 remained close to the midpoint of the 6-point scale. Therefore, these findings indicate a moderate or ambivalent level of rejection and lack of understanding rather than a distinctly negative attitude towards older adults. For the other attitudes – Respect and Support and Social Distance – the values in both groups were very similar. Women and men scored comparably on both respectful attitude (M = 4.47 and M = 4.54, respectively) and Social Distance (M = 2.47 and M = 2.43); p > 0.05 (Table 6).
Table 6.
The relationship between the respondents’ sex and their attitudes towards older people
| Gender | Descriptive statistics – attitudes towards older people | Mann-Whitney U test | ||||||
|---|---|---|---|---|---|---|---|---|
| M ± SD | Me [Q1–Q3] | Min. - Max. | Cl | SE | ||||
| -95.00% | +95.00% | |||||||
| Respect and Support | Women (n = 150) | 4.47 ± 0.58 | 4.48[4.07 - 4.9] | 2.77 -5.6 | 4.38 | 4.57 | 0.05 | Z = -0.82;p = 0.414 |
| Men(n = 53) | 4.54 ± 0.7 | 4.53[4.03 - 5.13] | 2.77 -5.53 | 4.35 | 4.73 | 0.10 | ||
| Rejection and Lack of Understanding | Women (n = 150) | 3.5 ± 0.76 | 3.61[3.05 - 3.89] | 1.63 -5.47 | 3.38 | 3.62 | 0.06 | Z = 3.75;p < 0.001 |
| Men(n = 53) | 3.04 ± 0.96 | 2.79[2.21 - 3.47] | 1.74 -5.74 | 2.78 | 3,30 | 0.13 | ||
| Social Distance | Women (n = 150) | 2.47 ± 0.49 | 2.45[2.09 - 2.73] | 1 -4.18 | 2.39 | 2.55 | 0.04 | Z = 0.53;p = 0.598 |
| Men(n = 53) | 2.43 ± 0.4 | 2.36[2.18 - 2.73] | 1.73 - 3.27 | 2.32 | 2.54 | 0.05 | ||
The relationship between the frequency of contact with older adults and students’ attitudes towards older people was assessed using Spearman’s rank correlation coefficient. The analysis revealed a positive and statistically significant correlation between contact frequency and the Respect and Support dimension (R = 0.29; t(N-2) = 4.32; p < 0.001). This finding indicates that more frequent contact with older adults was associated with higher levels of Respect and Support. The mean score for this attitude increased from 4.04 (SD = 0.39) among students reporting no contact with older adults to 4.68 (SD = 0.61) among those reporting very frequent contact. No significant relationships were observed between the frequency of contact with older adults and the remaining SPWS dimensions. The mean scores for the Rejection and Lack of Understanding dimension ranged from 3.29 (SD = 0.88) to 3.43 (SD = 0.87), while the mean scores for the Social Distance dimension ranged from 2.41 (SD = 0.44) to 2.58 (SD = 0.49) across the contact-frequency groups. Correlation analysis confirmed that the frequency of contact with older adults was not significantly associated with the Rejection and Lack of Understanding dimension (R = − 0.02; t(N − 2) = − 0.32; p = 0.75) or with Social Distance (R = − 0.13; t(N − 2) = − 1.81; p = 0.071).
Discussion
The aim of this study was to determine how medical students perceive older people and what factors differentiate their attitudes towards them. Differences in the intensity of attitudes depending on field of study, sex and frequency of contact with older people suggest that the perceptions of ageing among future medical professionals are complex and susceptible to the influence of educational factors and intergenerational experiences. The obtained results indicated a predominance of positive attitudes – particularly in the areas of respect and willingness to provide support – while some elements of rejection and lack of understanding persisted. The generally positive attitudes observed in the present study are consistent with previous research indicating growing awareness of the importance of geriatric care among healthcare students. This trend remained in line with observations made in the literature, which repeatedly highlighted the growing awareness of the importance of geriatrics in medical education. In their study, Castro et al., confirmed that the attitudes of nursing students became more positive with the development of clinical competence, which was explained by exposure to older patients and the development of communication skills [10]. Similarly, Jester et al., in their own study emphasised the importance of education focused on the ageing process, indicating that appropriately designed gerontological training programmes reduced stereotypes and enhanced empathy among students [11]. The findings of Cigarroa et al. were also consistent with the present results, confirming that students generally demonstrated positive attitudes towards older adults, particularly when they had previous intergenerational experiences [8]. It is noteworthy that a considerable proportion of respondents reported either infrequent contact with older adults or no contact at all. This finding may reflect contemporary social changes, including reduced opportunities for intergenerational interactions within families and local communities. Given the positive association observed between contact frequency and the Respect and Support dimension, creating opportunities for meaningful intergenerational contact during healthcare education may be particularly important. Yao et al., in turn, indicated that empathy played a moderating role: individuals with higher levels of emotional competence exhibited more favourable attitudes towards ageing [12]. Different, more nuanced attitudes can also be found in the literature. Naidoo and van Wyk demonstrated moderately positive attitudes among medical students and an insufficient level of geriatric knowledge, which may have contributed to uncertainty when working with older patients [13]. Different results were also reported by Özerdoğan et al., who pointed to both positive elements in the perception of older adults and the persistence of prejudices, particularly among students in the lower years of study [14]. These differences indicated that attitudes towards older people remained strongly influenced by educational factors, cultural factors and the intensity of clinical contacts. The importance of contextual factors was also confirmed by studies conducted in European centres.
One of the main findings of the present study was the significant difference in attitudes according to field of study. Nursing students obtained higher scores in the Rejection and Lack of Understanding dimension than dental and paramedic students. These findings suggest that educational experiences, exposure to older patients, and professional orientation may influence perceptions of older adults. Similar observations were reported by Allué-Sierra et al. [15], who noted that differences in gerontological curricula may contribute to variations in age-related attitudes among healthcare students. The influence of education was also highlighted by White et al. [16], who demonstrated that structured geriatric modules significantly improved students’ attitudes towards older adults. Shpakou et al. pointed to considerable variability in manifestations of ageism among students from five European countries, which the authors explained by differing narratives on ageing present in educational curricula [17].
The relationships presented were also addressed by recent systematic reviews. Allué-Sierra et al. concluded that, despite a gradual improvement in perceptions of ageing among nursing students, manifestations of ageism persisted in many countries, resulting from limited gerontological curricula [15]. These findings were reflected in the present study, particularly in the context of differences between fields of study, highlighting an uneven level of preparation for working with older adults. The significant impact of formal education on attitude formation was also noted in a study by White et al., which showed that structured geriatric modules significantly improved nursing students’ attitudes towards older people [16]. This indicated that appropriately designed educational interventions could effectively reduce negative attitudes and strengthen readiness to work with older people. Similar findings were made by Gholamzadeh et al. who confirmed that exposure to gerontology-related content significantly reduced manifestations of ageism [18]. Sex also differentiated attitudes towards older adults. Women achieved higher scores in the Rejection and Lack of Understanding dimension than men. However, it should be emphasised that these scores remained close to the midpoint of the scale and therefore reflect a moderate or ambivalent level of rejection rather than strongly negative attitudes. Consequently, the observed sex differences should be interpreted as relative differences within the same general range of attitudes rather than evidence of markedly negative perceptions of older adults among women. The reasons for this difference cannot be determined based on the present study and require further investigation. Previous studies have reported inconsistent findings regarding sex differences in attitudes towards ageing, suggesting that cultural, social, and psychological factors may contribute to these variations [12, 18].
It is also worth highlighting the role of empathy as a key factor in shaping attitudes towards older adults. Gholamzadeh et al. and Yao et al. showed that students with higher empathy presented more positive attitudes [12, 18]. In turn, research by Bamakan et al. indicated that geriatric simulations – such as so-called “aging suits” – effectively improved understanding of the functional difficulties of older people and enhanced empathy among students. These results remained in line with the recommendations of the WHO, which identified such tools as an effective method to counter ageism [19]. The results of a study by Hernández-Pizarro et al. indicate that moderate stereotypes of old age still exist among medical students, which may hinder the formation of more mature attitudes towards older adults [20]. In contrast, Vives-Cases et al. showed that the willingness to work with older adults resulted primarily from positive clinical experiences, support from teaching staff and a high self-assessment of care competencies [21].
A comparison of our findings with the extensive literature indicates that students’ attitudes towards older people were complex, shaped by knowledge, clinical experience, the quality of intergenerational contacts, and psychosocial factors. Although positive attitudes predominated, there were also ambivalent elements, requiring further educational interventions. These results highlight the need to strengthen the gerontology component in medical study programmes, invest in simulation education, and provide students with opportunities for regular, positive contact with older people. In summary, the results of the study confirm the presence of positive attitudes towards older people among medical students, but they also reveal areas that require further educational work – especially in terms of reducing negative stereotypes and strengthening preparedness for working with older adults.
Conclusions
The study demonstrated that medical students generally showed positive attitudes towards older adults, especially in the areas of respect and willingness to provide support, which indicated the dominance of the pro-senior component. At the same time, there were noticeable differences in the attitude of “Rejection and Lack of Understanding” between the different fields of study, which highlights the need to adapt gerontological education to the specific nature of the profession and the degree of contact with older patients. In the study group, gender proved to be a factor differentiating attitudes, with women demonstrating higher levels of rejection and lack of understanding than men. The reasons for this difference cannot be determined based on the present data and should be explored in future studies. The lack of a significant relationship between students’ age and their attitudes suggests that environmental factors, contact experiences, and educational elements may be more important than the age of the participants themselves. Furthermore, the results confirmed that more frequent contact with older adults was associated with higher levels of Respect and Support, highlighting the importance of intergenerational interaction in shaping positive attitudes towards older people.
Limitations of the study
The study was cross-sectional, which did not allow cause-and-effect relationships to be established. The small sample size may have affected the stability of the results and increased the risk of random error. The use of self-report questionnaires was associated with the risk of social desirability bias, and the analysis did not account for qualitative aspects of contact with older adults, which may have influenced the formation of attitudes. Furthermore, the predominance of women in the study sample may have affected the overall results, as women demonstrated higher scores on the Rejection and Lack of Understanding dimension. Consequently, the aggregate results may partly reflect the sex structure of the sample, and caution should be exercised when generalizing the findings to populations with different sex distributions. Despite these limitations, the inclusion of multiple fields of study and the use of a standardised research instrument made it possible to obtain a valuable picture of students’ attitudes towards older people and increased the reliability of the data obtained.
Practical implications
The study results indicate the need for further strengthening of gerontological education, particularly in fields of study in which contact with older adults is especially intensive. It also seems important to introduce educational interventions that promote positive attitudes towards older adults and support students in developing communication and geriatric care competencies. Increasing the number of positive intergenerational interactions, community projects and volunteering, can further foster pro-senior attitudes. Further research should include multi-centre analyses and the use of mixed methods, which would allow for a more comprehensive capture of students’ experiences in their contact with older adults. It is also worth evaluating the effectiveness of simulation tools, such as the “geriatric experience simulator”, recommended by the WHO as a method for enhancing understanding of the needs of older adults.
Acknowledgments
Clinical trial registration
Not applicable.
Authors’ contributions
SK and IS conceived and designed the study, performed the data analysis, interpreted the results, and wrote the main text of the manuscript.GM was responsible for data collection and data acquisition.KD, DB, and AK contributed to the literature review and assisted in drafting and revising the manuscript.IML supervised the study, contributed to the interpretation of the findings, and critically revised the manuscript for important intellectual content.All authors reviewed and approved the final version of the manuscript.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Data availability
The datasets generated and/or analyzed during the current study (in Polish) are not publicly available due to ethical restrictions and the need to protect participant confidentiality but are available from the corresponding author on reasonable request.
Declarations
Ethics approval and consent to participate
The study was conducted in accordance with the Declaration of Helsinki and approved by the Bioethics Committee of the Jagiellonian University Medical College in Krakow (No. 118.0043.1.402.2024).
Informed consent was obtained from all participants prior to their participation in the study.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Citations
- Cigarroa I, Alonso J, Vallejos MG, Parra-Rizo MA, Basoalto D, Robles-Tapia D. Attitudes toward older adults: a descriptive cross-sectional study in chilean. Int J Environ Res Public Health. 2025;22(9):1450. 10.3390/ijerph22091450. [et al]. [DOI] [PMC free article] [PubMed]
Data Availability Statement
The datasets generated and/or analyzed during the current study (in Polish) are not publicly available due to ethical restrictions and the need to protect participant confidentiality but are available from the corresponding author on reasonable request.