Thesis (Ph. D.)--University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "May 2006" Includes bibliographical references.

Thesis (Ph.D.). / Written for the Dept. of Epidemiology, Biostatistics and Occupational Health. Title from title page of PDF (viewed 2009/06/10). Includes bibliographical references.

The US population over the age of 65 years is growing rapidly, with elderly women outnumbering men by 50 percent. Studies show that aging is often accompanied by reduced energy intake, inadequate nutrition, and the loss of lean body mass with a subsequent increase in body fat, as well as the tendency towards inactivity. An increased level of physical activity elevates energy needs, which can lead to increased energy and nutrient intake, and has been shown to aid in the maintenance of lean body mass and the reduction of body fat. Positive health outcomes for seniors depends partly on a clearer understanding of the interrelationships between physical activity, diet, and body composition. The purpose of this study was to determine whether higher overall levels of physical activity among elderly women, were related to higher energy intake, nutrient adequacy, and less body fat, and to what extent age affected these associations. Sixty-three elderly women (aged 65-98 years) volunteers completed a three part study spanning 14 weeks. Mean level of physical activity (MLPA) and mean nutrient intakes were estimated using nine self-reported days of records, three predetermined days from each of three recording periods. MLPA was determined from self-reported hours spent in five physical activity categories (resting, very light, light, moderate, and heavy), multiplied by corresponding weighted factors of intensity (1.0, 1.5, 2.5, 5.0, 7.0, respectively). Nutrient analyses for seven vitamins (vitamin A, vitamin C, thiamin, riboflavin, niacin, vitamin B6, vitamin B12) and three minerals (calcium, iron, and zinc) were done using the Food Processor II computer software. A mean adequacy ratio (MAR) was calculated for each subject as the average percent of the RDA for intakes of all 10 nutrients. Body composition assessment included triplicate measures of: height and weight from which body mass index (BMI) was determined; waist-to-hip ratio (WHR); and an estimation of percent body fat (PBF) from the sum of four skinfolds (triceps, biceps, subscapular, suprailiac). It was determined that MLPA was not directly related to energy intake, nutrient adequacy, or the three body composition parameters. However, the correlation coefficients between MLPA and energy intake, mean adequacy ratio, and percent RDA for 8 of the 10 nutrients were positive, and the correlation coefficients between MLPA and all three body fatness measures were negative, as was expected. The small coefficient of variability of MLPA limited its discriminating power in determining associations with energy intake, nutrient adequacy, and body composition. Backward stepwise regression models were conducted to distinguish potential confounding effects of age, education, and MLPA on the variables kcal/day, kcal/kg/day, MAR, BMI, WHR, and PBF. Age was found to account for the largest portion of the variations, and was greater than the contribution of MLPA for all of these variables, except in the case of kcal/kg/day. When the subjects were divided into young-old (65-74 yr) and old-old (75-98 yr) subgroups, the younger compared to the older women were found to be more active as measured by MLPA (p=.02), explained by their engaging in more light activities of daily living (p=.04). The young-old compared to the old-old women consumed more kcalories/day (p=.01), and had a higher MAR score (p=.00). The nutrient densities of the two groups' diets were not significantly different. The younger women had slightly lower BMI, WHR, and PBF values. This study revealed age, rather than MLPA, was a better predictor of some parameters of diet adequacy and body fatness among this sample of elderly women. In addition, consistently higher levels of physical activity and greater dietary adequacy and was found among the younger compared to the older portions of this sample of senior women, suggesting that nutrition intervention programs for the elderly should encourage daily activeness as a strategy to maintain or improve dietary adequacy with advancing age. / Graduation date: 1993

The percentage of the American population who are 65 years old or older is rapidly increasing, especially the proportion of women. It is becoming crucial to encourage lifestyle behaviors that will enable senior women to remain in optimal health. Following the 1990 Dietary Guidelines' recommendations to limit fat intake and consume adequate amounts of dietary fiber has been shown to positively impact longevity and health status in the elderly by decreasing risk factors for chronic diseases. An expected outcome of engaging in regular exercise is a reduction in body fat, which is also associated with a lowered incidence of several chronic illnesses. However, the literature clearly indicates that nutritional quality of the diet and involvement in regular exercise decrease with increasing age. There is evidence that, with the adoption of one health enhancing behavior, there is a greater tendency to engage in other health promoting behaviors, but little data exist on the healthseeking behaviors of older adults. The purpose of this study was to ascertain if there were identifiable differences between self-defined exercising and self-defined non-exercising elderly women with respect to their nutrient intake, food sources of dietary fat and fiber, dietary change behavior, and body composition parameters, considering their age and education and income levels. The objective was to determine whether those women who had consciously undertaken a regular exercise program would also have higher micronutrient intakes, make lower fat and higher fiber food choices, report having made more dietary changes in the direction of the 1990 Dietary Guidelines, and have leaner body compositions than those who had not undertaken such a program. Thirty-three elderly women self-reported exercisers (mean age 74.1 years) and 30 self-reported non-exercisers (mean age 71.3 years) were enrolled in a 14 week study. Exercisers were defined as those who reported having engaged in a regular program of planned exercise a minimum of 15 minutes per session, 2 times per week, for at least the last year, and non-exercisers were those who had not. They kept three, 7-day food records at 5 week intervals. Nutrient intake was estimated from 9 days of food records, 3 predetermined days from each recording period, using the Food Processor n software. Dietary intakes were analyzed for energy, macronutrients, dietary fiber, and selected micronutrients. Food sources of dietary fat and fiber were determined using a food categorization adapted from Popkin and coworkers (1989). Information concerning dietary change behavior, obtained from questionnaire responses, was compared between groups using chisquare tests. Body composition, assessed through repeat measurements during each dietary recording period, included determination of percent body fat through skinfolds, waist-to-hip-ratio and body mass index. Average 9-day nutrient intakes and anthropometric measures were compared between groups using t-tests or Mann- Whitney U tests. Both elderly women exercisers and non-exercisers had similar energy, macronutrient, and dietary fiber intakes based on 9-day means. Their total fat intakes, expressed in grams and as percentages of energy, were not significantly different. Both groups consumed a lower percentage of their daily kcalories as total fat (32%) compared with national surveys of women over 65 (36%). Exercisers consumed more total vitamin A (p=.03) and carotene (p=.00) than the non-exercising women. A great proportion of both groups did not meet 75 % of the Recommended Dietary Allowances for calcium and zinc. A larger proportion of the exercisers than the non-exercisers reported using lower fat cheese (p=.02) and green and yellow vegetables (p=.03), which partially explained their higher total vitamin A and carotene intakes. Exercisers obtained less of their total fat intake from lower fat milk (p=.02) and more of their fat intake from lower fat lunch meats (p=.04) than the non-exercisers. The categories of legumes (p=.02) and lower fiber vegetables (p=.05) supplied greater amounts of dietary fiber for the exercisers compared with the non-exercisers. When asked about dietary changes made over the past decade, a greater percentage of the exercisers than non-exercisers reported having decreased red meat intake (p=.05) and increased consumption of cereals (p=.05) and legumes (p=.00). Actual intake data showed that the legume food category contributed more dietary fiber to the diets of the exercisers than the non-exercisers (p=.02). No differences were found in body fat measures between the exercisers and non-exercisers. The lack of observed differences between the two groups reinforces what other researchers have found, that a large number of factors influence body composition, of which exercise is only one. More research is needed to distinguish the interactions of age, energy intake, and physical activity on the body fatness of elderly women, as well as the most accurate instruments for assessing body composition for this age group. Exercise participation among elderly women in this study appeared to be associated with several positive dietary behaviors. Elderly women exercisers compared to non-exercisers made food choices leading to higher total vitamin A and carotene intakes, and also reported making more changes in food consumption behaviors in the direction of current dietary recommendations. These observed outcomes provide support for designing health-promotion programs for elderly women which include both nutrition education and exercise components. / Graduation date: 1993

Thesis (M.A.)--University of Alabama at Birmingham, 2008. / Description based on contents viewed July 8, 2009; title from PDF t.p. Includes bibliographical references (p. 71-81).

Thesis (M.S.)--University of Missouri--Columbia, 2004. / "May 2004." Typescript. Includes bibliographical references (leaves 27-30). Also available on the Internet.

Thesis (M.S.), Kinesiology and Health Studies--University of Central Oklahoma, 2010. / Includes bibliographical references (leaves 44-48).

Falls in the elderly Canadian population pose a serious health problem; they are the leading cause of accidental death in persons aged 65 and older. The most common serious injuries associated with falling are hip fractures; more than 19,000 Canadians sustain a hip fracture yearly as a result of a fall. A review of the literature reveals that most of the studies on falling have been conducted in institutional settings. Community-based studies have identified the risk factors associated with falling to assist in case-finding and fall prevention. However, qualitative studies of falling for elderly community-dwelling individuals are non-existent. The purpose of this study is to describe the meaning of falling for elderly community-dwelling individuals. The phenomenological approach to qualitative methodology was used for this study. This approach seeks to describe human experience as it is lived. Individuals 65 years of age or older were contacted through a Long Term Care Unit. Eight women became informants, participating in repeated interviews guided by open-ended questions. From the content analysis of the data, three major categories of data that were common to the participants were identified and developed. The three categories represent levels of perception in relation to falling, which together represent the entire meaning of falling. At the first level, participants interpreted the various aspects of their falls. The second level describes the reactions to falling. The third level describes how participants coped with falling in the context of coping with aging. These findings revealed that falling was viewed as a symbol of aging and therefore, the emotional reaction to falling occurred in the context of growing old. Furthermore, it was found that coping with falling occurred in the broader context of coping with aging. The implications for nursing practise, education, and research were identified in light of the research findings. / Applied Science, Faculty of / Nursing, School of / Graduate

The establishment of intermediate care facilities in British Columbia, as well as the establishment of similar facilities throughout the rest of Canada, was and still is a well-intentioned approach to meet the long term care needs of the elderly. The practices and procedures adopted by long term care facilities, however, tend to inhibit the personal autonomy of residents (Thomasma, 1985). Specifically, a facility's practices and procedures tend to inhibit residents' latitude of choice regarding daily living activities. Residents' latitude of choice may also be lessened when nurses implement well-intentioned helping interventions based on their own motivations and goals, rather than those of elderly residents. Latitude of choice measures the extent to which an individual's perceived degree of choice includes activities of importance to him/her. At present, there is limited research addressing both resident and staff perceptions regarding the autonomy (freedom of choice) of residents, particularly in relation to their daily activities. Accordingly, this study's purpose was to determine the institutionalized elderly residents' and their caregivers' perceptions of residents' latitude of choice regarding activities of daily living. From determining these specific staff and resident perceptions, significant differences were isolated. This study was conducted in two intermediate care facilities located in a large city within the province of B.C. The data collection instruments in this study included selected questions from Hulicka et al.'s (1975) revised Importance, Locus and Range of Activities Checklist, as well as a demographic data sheet developed by the researcher. Forty-five intermediate care 1 residents and forty-five nurses (Registered Nurses, Licensed Practical Nurses and Nurses' Aides) completed the study questionnaire and the demographic data sheet. The researcher studied the residents' and staff's responses to the Importance, Locus and Range of Activities Checklist by using non-parametric techniques for statistical analysis. The researcher used these techniques to determine the existence and location of differences in perceptions among the residents and staff. Significant differences exist in residents' and staff's perceptions when each group's importance ratings are combined with choice ratings. Isolation of the above importance and choice components for individual analyses indicate that the residents and staff had significantly different response patterns regarding a) the importance residents attach to daily living activities and b) the degree of choice residents associate with daily living activities. The above findings indicated that residents' latitude of choice may not be realized to a greater extent if the staff do not attach a degree of importance to a particular activity(ies) similar to that attached by the residents. Residents' latitude of choice may not be recognized to a greater extent if staff do not perceive that residents associate "some" or "no choice" with an activity of particular importance to them. / Applied Science, Faculty of / Nursing, School of / Graduate

published_or_final_version / Social Work / Master / Master of Social Work