Background: Given the growing aging population, it is crucial to better understand the neurobiological underpinnings of healthy aging and how changes in structure relate to changes in function. The current study derived diffusion tensor imaging (DTI) metrics of white matter microstructure in younger and older adults to simulate the healthy aging process. Methods: The DTI metrics of fractional anisotropy (FA) and mean diffusivity (MD) as well as the cognitive domains of memory and executive function were examined in 34 healthy participants divided into older adults (17; Mean = 70.9, SD = 5.4) and younger adults (17; Mean = 28.1, SD = 2.8). Cognitive performance on the California Verbal Learning Test 2nd Edition (CVLT-II) and the trails making test (Trails-A & Trails-B) were used to evaluate memory and executive function, respectively. The differences in white matter microstructure between older and younger adults were analyzed using tract based spatial statistics (TBSS; p < 0.05, corrected for multiple comparisons) in FSL. Associations between the DTI metrics and cognition were then evaluated for each group. Results: Older adults had lower FA and higher MD in diffuse brain regions, including major tracts such as the corticospinal tract, corpus callosum and superior and inferior longitudinal fasciculi. There was a significant negative correlation between executive function and MD in the right superior and anterior corona radiata and the body of the corpus callosum of older adults. No significant relationship was detected between memory performance and DTI metrics in older adults. Furthermore, no significant relationships were detected between memory or executive function performance and FA or MD in younger adults. Conclusions: The differences in DTI metrics between groups as well as the association between MD and executive function support further examinations into the healthy aging process. Future studies should use longitudinal designs with large sample sizes to better understand changes and trajectories during healthy aging. / Graduate / 2023-08-19

The older population in Thailand is growing, and the number of older people who suffer from health problems is increasing as well. The health situation of the older population challenges healthcare providers to care for older people. Healthy aging is key to promoting the health of older people and sustaining their well-being. However, little is known about healthy aging in Thailand, especially in northeastern Thailand, or the Isan region, where the number of older people is increasing. Thus, this thesis aims to understand the factors associated with perceived health and healthy aging and how older people and their relatives in the Isan region conceptualize healthy aging. This thesis also focuses on how community nurses experience the meaning and promotion of healthy aging in this region. This thesis includes four studies. The first is a quantitative cross-sectional study with 453 participants aged 60 years or older. The second and third studies are qualitative with a phenomenographic approach that is based on lifeworld theory. Participants in the second and third studies include 17 older people and 14 relatives who are responsible for caring for older people, respectively. The fourth study is a qualitative study that involves focus group interviews with 36 community nurses who work with older people in the Isan region. The findings of the first study show a variance (24.3%) in perceived health and healthy aging based on residential area, marital status and disability status. The meaning of healthy aging, which was derived from the second, third and fourth studies, was divided into three domains: being interconnected; being able to do something good and feeling strong; and thinking beyond the capacity and functions of body and mind. The promotion of healthy aging was described as “providing health assessments”, “sharing knowledge”, and “having limited resources”. The findings of the first study revealed the key factors that will help healthcare providers promote healthy aging. The findings of the second, third and fourth studies revealed that older people, their children and grandchildren, and community nurses attach different meanings to healthy aging. The finding regarding promotion of healthy aging emphasizes that the person-centredness should be integrated in practice when promoting healthy aging. The results of this thesis will be useful to policymakers, who can apply this enhanced understanding of healthy aging to develop healthcare practices that promote healthy aging.

Made available in DSpace on 2016-07-27T14:20:14Z (GMT). No. of bitstreams: 1 Wadson Arantes Gama.pdf: 547234 bytes, checksum: 8909a1a2731bc04e1140c5e8bd1b49ad (MD5) Previous issue date: 2014-03-07 / The present work, based on Qualitative Epistemology, aims to understand how the subjectivity is produced in the experience of the theatre, and how it reverberates in the ageing process of the elderly subject. As a participant, this study had a lady, 91, who belongs to the theatre company Senhoras do Cerrado, from the Municipal Secretariat of Social Assistance in Goiânia municipality. For the gathering of information, there was developed a conversation with the participant about her experience in interpreting the poems and texts on theatre. Writings from different authors and the dramatic art were used as indicators capable to show the ageing of the studied lady, and at the same time the texts provided her an opening to creativity and production of new feelings and meanings about her ageing process. It was also possible to realize that the public presentations, provided by the theatre company, fortified the social role of the participant in relation to possible changes in the society s prejudiced paradigms related to old people. Across the 15 years of research in the Senhoras do Cerrado company theatre, the studied lady could produce many subjective feelings about her healthy aging. Among these, it is possible to point the autonomy, the facing of her limitations, possibilities, femininity, and finitude. It was verified that the theatre and the interpretation could be changing agents in people s reality, besides favoring their real facing of old age, without any masks . The dramatic art allows people, herein represented by the lady, to demonstrate their difficulties, illness, declines, and, above all, their self-perception as a subject in development process; people who can face their limitation and believe in their possibilities. The present work highlights the necessity of keeping the researches about interventions as this: a different way of traditional Psychology action, using the poetic and dramatic arts in the searching of a subject, without the polarization of wrong or right. / Este trabalho, com base na Epistemologia Qualitativa, objetivou compreender como a subjetividade é produzida na vivência do teatro e como ela repercute no processo de envelhecimento do sujeito. Teve como participante uma senhora de 91 anos pertencente à Cia de Teatro Senhoras do Cerrado, da Secretaria Municipal de Assistência Social da cidade de Goiânia. Para a construção das informações, trabalhou-se com a participante em um processo de conversação sobre a sua vivência da interpretação de temas e poesias no teatro. Textos de diferentes autores e a arte dramática foram os instrumentos mediadores que proporcionaram a visibilidade da qualidade de vida da pesquisada, e possibilitaram a ela uma abertura para a criatividade, a construção de novos sentidos e significados de sua vida. Percebeu-se, também, como a Cia de Teatro fortaleceu o papel social da integrante frente às possíveis mudanças de paradigmas preconceituosos da sociedade em relação à pessoa idosa por meio das apresentações públicas. A pesquisada ao longo dos 15 anos na Cia de Teatro Senhoras do Cerrado pôde desenvolver vários sentidos subjetivos de envelhecimento saudável, como a autonomia, reconhecimento de suas limitações, possibilidades, feminilidade e finitude. Constatou-se que o teatro e a interpretação podem ser agentes transformadores da realidade da pessoa favorecendo o seu enfrentamento real da velhice, sem máscaras . A arte dramática permite que a pessoa demonstre suas dificuldades, suas mazelas, seus declínios, mas, acima de tudo, se perceba como um sujeito em desenvolvimento, que pode enfrentar suas limitações e acreditar nas suas possibilidades. Essas constatações apontam a necessidade de dar continuidade a pesquisas sobre intervenções como esta, uma forma diferente de ação da Psicologia tradicional, utilizando-se da arte poética e dramática, na busca de um sujeito completo, sem polarização de saúde e doença. .

Increasing rates of overweight, obesity, and related cardiovascular diseases among older adults in the United States present unique public health challenges. Cross-cultural research has shown marked variation in health across the world’s elder populations because aging is a biological process rooted in sociocultural context. The sociocultural environment contributes to complex negotiations of food and physical activity patterns for older adults. It is well established in the literature that urban residents report low levels of physical activity and have easy access to fast food outlets, which tend to be concentrated in lower-income neighborhoods. I utilize a biocultural framework, integrating nutritional anthropology with healthy aging perspectives to recognize the role of the social determinants of health throughout the lifespan. This anthropological study integrates qualitative and quantitative methods to answer the following research question: What is the relationship between the sociocultural factors that shape diet, physical activity, and nutritional status among Alaskan elders in Anchorage? The results indicate that diet and physical activity practices in this sample do not meet national recommendations and that diet differs adversely from national reference samples. Statistical analyses indicate that the media and friends positively influenced older adults to increase their energy expenditure. Family influences increased fruit consumption, while participation in cultural and social events increased intake of fats and sweets. Cultural identity was an important factor for Alaska Native participants’ dietary selections. Social supports increased access to healthy foods and safe physical activities. This research suggests that trying to reach older adults with diverse needs through a variety of channels, including the media, social networks, and social events, can help alleviate some of the barriers to healthy diet and exercise patterns. These data indicate a need for culturally-responsive programs that maintain relationships with family members and make connections between elders with similar healthy aging goals in order to improve diet and physical activity practices.

Bakgrund Psykisk ohälsa är ett folkhälsoproblem som förekommer bland en betydande del av den äldre befolkningen och kan felaktigt uppfattas som en naturlig del av åldrandet. Nedåtgående fysisk- och kognitiv funktion, krympande socialt nätverk och brist på sysselsättning är förändringar som kan prägla tillvaron för äldre och inverka på den psykiska hälsan. Den äldre populationen ökar kontinuerligt, en uttalad del av den äldre befolkningen lider av eller riskerar att utveckla psykisk ohälsa vilket innebär ett lidande för individen och en omfattande samhällskostnad. Syfte Syftet är att belysa faktorer som kan bidra till psykisk hälsa hos äldre personer över 65 år. Metod En icke-systematisk litteraturöversikt med 16 vetenskapliga originalartiklar. Artiklar hämtades in mellan december 2020 och mars 2021 från databaserna PubMed och CINAHL. Genom kombination av olika söktermer kunde 16 artiklar inhämtas. Samtliga artiklar kvalitetsgranskades utifrån Sophiahemmets Högskolas bedömningsinstrument varpå en integrerad dataanalys utfördes.  Resultat Resultatartiklarna ordnades i två huvudkategorier; externa faktorer och interna faktorer. Samt fyra underkategorier utifrån en induktiv ansats. En återkommande faktor som ansågs bidra till psykisk hälsa bland äldre personer var 1) fysisk aktivitet, där en gynnsam effekt syntes på den fysiska- och kognitiva funktionen samt stärkt självständighet hos individen. I flera artiklar återkom 2) social delaktighet som en faktor som bidrog till psykisk hälsa. Slutligen visade resultatet faktorerna att 3) besitta en positiv attityd samt att 4) vara anpassningsbar till förändringar som hör till åldrandet som vitala delar i ett hälsosamt åldrande.  Slutsats De fynd som gjorts genom denna litteraturöversikt visar att fysisk aktivitet, social delaktighet, att vara anpassningsbar till åldersrelaterade förändringar samt att ha en positiv attityd kan bidra till psykisk hälsa hos äldre personer. Ökad gynnsam effekt på psykisk hälsa hos äldre personer var framträdande vid kombinationen fysisk aktivitet och social delaktighet.

While evidence suggests there is indeed a relationship between arterial stiffness and changes in brain structure and function cross-sectionally, the longitudinal relationship between arterial stiffness and changes in brain structure and function is unclear. Also unclear is whether a regional effect of arterial stiffness on brain structure exists, or if the effect is homogenous across brain regions. Using a healthy cohort of the UK Biobank study (N = 1858, meanSD: 61  7 years), we investigated the longitudinal association between changes in arterial stiffness index (ASI) and brain structure (grey matter cortical thickness, whole brain grey matter volume, white matter hyperintensity volume) and function (cognitive performance in 6 tests) over 2.5  1 years. We also examined the association between baseline ASI and all structural and functional brain outcomes 8-11 years post-baseline (N = 630). Prior to post-hoc correction, we observed a significant effect of changes in ASI over 2.5  1 years on grey matter cortical thickness in 11 brain regions contributing to reductions between 0.0004-0.0024mm annually, but none of the 11 regions remained significant post-correction. Following correction there was also no effect of changes in ASI on whole brain grey matter volume (p = 0.76), white matter hyperintensity volume (p = 0.84), or cognitive performance in the domains of interest. Baseline ASI was not associated with regional grey matter cortical thickness, white matter hyperintensity volume, or cognitive function, but did have a significant negative association with whole brain grey matter volume 8.5  1.05 (p = 0.015) years later and 11  1.02 (p = 0.03) years later. Our findings suggest that taken with the effect of age, elevations in ASI may have an additive effect to accelerate changes in brain structure beyond the range that is to be expected as a part of normal aging. Our findings also suggest the relationship between ASI and reductions in whole brain grey matter volume may require long-term exposure to elevations in arterial stiffness in otherwise healthy older adults. / Thesis / Master of Science in Kinesiology / Arterial stiffening both accompanies the normal aging process and can progress due to acquired health conditions. As arteries begin to stiffen the ability to buffer high pressure blood flow is impaired and can put microvasculature at risk of damage. Microvascular damage in the brain can disrupt blood and subsequent oxygen delivery to the brain. When delivery to the brain does not meet the metabolic demand, changes in brain structure brain can occur. Changes in brain structure are associated with impaired brain function, as well as potentially accelerating the progression of neurological diseases. What remains unclear is whether arterial stiffness impacts brain structure differently across regions or all regions homogenously. The purpose of this thesis was to examine the relationship between arterial stiffness and structural and functional changes in the brain over time (objective 1: 2-5 years; objective 2: 8-11 years). Our observations suggest that the progression of arterial stiffness had an effect that was equivalent to approximately 30% of the rate of grey matter tissue loss associated with normal healthy aging (~0.25% reduction in grey matter per year). We found no effect of changes in arterial stiffness on the progression of total grey matter volume, white matter lesions or brain function. We did observe a significant negative relationship between arterial stiffness at baseline and total grey matter volume 8-11 years later. We found no relationship between baseline arterial stiffness and brain structure or function 8–11-years post-baseline. Taken with the effects of normal aging, the loss of tissue in select brain regions associated with changes in arterial stiffness may result in grey matter reductions beyond the range associated with what is considered healthy or normal aging. The association of arterial stiffness and total grey matter volume 8-11 years later suggests that changes in whole brain structure are the product of long-term exposure to arterial stiffness.

The number of people aged 60 years and over has doubled since 1980and the World Health Organization predicts that the population of over60s will reach 2 billion by the year 2050. An ageing population poses bothchallenges and opportunities for society and for individuals. Whilst theseare positive statements, increases in life spans do not directly lead to increasesin health spans. The naturally occurring ageing process can leadto reductions in functionality and, in order to address this, scholars haveargued the benefits of regularly engaging in physical activity, and especiallyresistance training. Therefore, an important challenge for modernsociety is to develop strategies that delay the onset of disease, such as interventionsthat include physical activity. This licentiate thesis investigatesolder women’s physical activity in a resistance training context and howthis affects different aspects of their health.The overall aim of the thesis is to explore healthy and physically activeolder women’s experiences of what maintains and enhances their healthafter starting resistance training.This thesis used a quantitative and a qualitative approach to investigatea group of old adult women. Data collection was structured in questionnaires(n=32) with one intervention group and one control group for thepaper I, and focus group interviews (n=14) in paper II. Paper I studied theeffects of resistance training on physically active and healthy olderwomen. Paper II relates to the women who continued to exercise after theresistance training intervention ended in order to explore their health resources.The theoretical framework used in this thesis is a movement towardshealth as explained by salutogenic theory.This thesis showed that resistance training has positive effects on psychologicalwell-being and is important because it not only benefits thosewho are physically inactive, but also those who are already physically activeand healthy.From a salutogenic perspective, physical activity provides a meaningful,comprehensible and manageable way for older women to engage in theongoing process of maintaining health.

[pt] Com o aumento da longevidade populacional, é natural que diversas áreas do saber e da atuação humana estejam voltando suas atenções ao envelhecimento, em abordagens múltiplas e mesmo antagônicas. Nesse cenário, o objetivo deste trabalho é apontar possíveis caminhos para a atividade do design em um mundo em envelhecimento. Porque o design é uma atividade interdisciplinar e seu processo se dá em parceria de campos distintos da atuação humana, o primeiro passo foi investigar o que é o envelhecimento, em revisão bibliográfica que contemplou publicações de diferentes áreas do conhecimento e se concentrou nas ciências da saúde. Teve destaque o Relatório Mundial de Envelhecimento e Saúde da Organização Mundial da Saúde, por abordar o assunto da perspectiva do corpo, do indivíduo e da sociedade. Porque o design visa transformar realidades para outras mais desejáveis, foram investigadas definições de envelhecimento bem-sucedido, ativo e saudável, tendo sido identificados os seguintes conceitos pertinentes para a atuação: funcionalidade, independência, autonomia e resiliência. Diante da infinidade de possibilidades de atuar em prol de um melhor envelhecimento, o recorte deste trabalho foi definido como as alterações funcionais relacionadas ao envelhecimento. Porque o design concretiza soluções a partir de produtos tangíveis, foi feito levantamento e reflexão de produtos projetados com a intenção de mitigar essas alterações. Considerando que o design é uma atividade que tem como foco o indivíduo, foram criados métodos qualitativos para aproximação do público idoso com o objetivo de favorecer relatos de experiências sobre o envelhecimento, sobre os conceitos identificados e sobre os sentimentos e comportamentos envolvidos na decisão de uso ou não uso de objetos de auxílio. / [en] With the increase of population longevity, several areas of knowledge and human performance are naturally turning their attention towards ageing in multiple and even antagonistic approaches. In this scenario, this thesis goal is to establish directions for the activity of design in an ageing world. Due to the interdisciplinary essence of design, the first step was to investigate what ageing is in a bibliographic review that included publications from different areas of knowledge focusing on the health sciences. The World Health Organization s World Report on Ageing and Health was highlighted for addressing the subject from the perspective of the body, the individual, and society. Because design activity aims at transforming realities for the better, definitions of successful, active, and healthy ageing were investigated. The following relevant concepts for action were then identified: functionality, independence, autonomy and resilience. Due to the endless possibilities of action towards better ageing, this research extract is defined particularly by the functional changes related to ageing. Since materializing solutions into tangible products is the bedrock of design, searching for products intended to mitigate these changes was the focus of our reflections. Considering design also as an activity which focuses on the individual, qualitative methods were created with the objective of favoring first-hand reports on the experiences of ageing, of the concepts identified, and of the feelings and behaviors involved in the decision to use or not to use assistive objects.

[pt] A compreensão do funcionamento cognitivo no envelhecimento torna-se fundamental na atualidade diante do crescimento desta população. A presente dissertação, elaborada a partir de dois artigos, teve como objetivo investigar o perfil cognitivo, funcional e sintomas de depressão em idosos residentes na comunidade. O protocolo neuropsicológico utilizado em ambos os estudos foi composto por instrumentos de rastreio validados para a população brasileira. O estudo foi realizado com 298 idosos inseridos nas atividades oferecidas pelas Casas de Convivência da Prefeitura do Rio de Janeiro. O primeiro estudo investigou o perfil cognitivo e funcional destes idosos e identificou um padrão de normalidade na amostra, apesar de um desempenho abaixo do esperado no Teste do Desenho do Relógio. Entretanto, 20,9 por cento dos idosos apresentaram sintomas leves de depressão. Desta forma, o segundo artigo avaliou estes idosos com sintomas de depressão, comparando-os com um grupo controle pareado por idade e escolaridade. Os resultados evidenciaram que os sintomas depressivos interferiram nas atividades instrumentais de vida diária, na memória episódica anterógrada e na fluência verbal. Os estudos apontaram a importância da investigação neuropsicológica em idosos para uma maior compreensão da senescência, bem como os fatores que interferem neste processo e que representam um risco potencial para uma evolução para transtornos cognitivos leves ou estágios pré-clínicos de quadros demenciais. / [en] Understanding how the aging process affects cognitive functioning is crucial nowadays, given the growth of the elderly population in the world. This dissertation, comprised of two research papers, aimed to investigate the cognitive and functional profile, as well as symptoms of depression, in community-dwelling elderly adults. The neuropsychological protocol used in both studies consisted of screening tools validated for the Brazilian population. The studies were conducted with 298 elderly adults who participate in the activities offered by the government in the city of Rio de Janeiro. The first study investigated the cognitive and functional profile of these subjects and identified a pattern of normality in the sample, despite a below average performance in the Clock Drawing Test. However, 20,9 percent of the elderly had symptoms of mild depression. Thus, the second study specifically assessed these subjects, comparing them to a control group matched for age and education. The results showed that depressive symptoms significantly interfered with instrumental activities of daily living, anterograde episodic memory, and verbal fluency. The studies pointed out the importance of neuropsychological research of elderly adults for a greater understanding of senescence, as well as factors that interfere with this process and represent a potential risk for progression to mild cognitive impairment or preclinical stages of dementia.

Healthy Ageing Programme is a concept which should have a significant influence on every resident in the countries where population median age has been quickly increasing. This topic of healthy ageing is the key issue of the given Master´s Diploma Thesis. At the present, our country is involved not only in several smaller-scale regional programmes focused on lives of seniors but also in the events of European importance. If we want to provide our seniors with a quality life in all aspects, it is necessary to encourage promoting Healthy Ageing Programme. The wide scope of activity is thus open, especially for nurses. The first objective develops the approach of seniors in the selected health-care facilities to healthy ageing. The second objective introduces the approach of a client before retirement age to the healthy ageing principles. Finally, the third objective specifies the role of general practice nurses in their support of clients before retirement age in their healthy ageing. Research questions included the following issues: the approach of a client at the age before retirement to the healthy ageing principles and the role of a general practice nurse and her support of the abovementioned clients. The given research also develops one hypothesis regarding the fact that personal objectives will change depending on barriers.Both qualitative and quantitative research was used in the given Diploma Thesis. An in-depth interview was conducted during the survey. Additional information was obtained on the basis of an opinion poll. Two research groups were used for the interview: the first one consisted of 11 respondents from the general practitioner´s outpation departments, the second research group consisted of 6 nurses working for the aforementioned departments. The total number of 150 respondents from the designated health-care facilities was selected for the survey during which they were answering the research questions. As a result, a large number of useful information was obtained. The clients' approach can be divided into several groups: leisure activities, education, workload, prevention and medical examinations, regimen, community nursing care, healthy ageing. The key roles of a nurse should take into consideration the following aspects: healthy ageing from the nurse´s point of view, prevention and geriatric nurse at the outpatient department, community nursing care, health support of the patients provided by a nurse. Information obtained from the interviews were interconnected and often corresponded with each other. Research questions are also followed by the given results. A nurse has a significant role in the area of education, provision of necessary information to the clients, promotion of prevention programmes informing the clients about the solution to their problems. The motivation of clients before retirement age is also crucial because it is at this age when people can influence their life, its length and quality. The survey also observes the general perception of people of an old age and changes in their point of view with age. The information collected from this survey may be also used in different studies in order to improve both quality of nursing care and motivation of the clients before their retirement.