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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Methodological and Interventional Issues and Considerations in Studies of Older Adults: Attrition, Missing Data, and Feasibility Trials. / Attrition, Missing Data, and Feasibility Trials in Older Adults.

Okpara, Chinenye January 2023 (has links)
PhD Thesis / Older adults are a rapidly growing segment of the population with unique healthcare needs. As people age, they are more likely to become susceptible to diseases and develop complex health conditions that require tailored strategies to address. These vulnerabilities could also impact different stages of the research process to generate evidence that promote healthy aging and better quality of life for this population. Attrition and missing data are some of the common methodological challenges in research with older adults. These issues could affect the quality of evidence generated if not properly addressed. There is also limited evidence to guide the development of interventions in specific populations of older adults with frailty, who have reduced function and are at higher risk for poor health outcomes. Across six chapters, this thesis addresses these methodological and interventional gaps in research with older adults. Using different research methodologies including a systematic literature survey, secondary data analysis of a cohort study, and two randomized feasibility trials, this thesis provides some important considerations for practice. In particular, we (i) evaluated the magnitude, pattern, and factors associated with attrition in the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort of older adults; (ii) performed a systematic survey of the reporting and handling of missing data in longitudinal observational studies of older adults; (iii) conducted a randomized controlled feasibility trial of the Geras virtual frailty rehabilitation program to build resilience in vulnerable older adults during the COVID-19 pandemic; and (iv) evaluated the feasibility of the FitJoints randomized controlled trial of a multimodal intervention in frail older patients with osteoarthritis awaiting hip and knee replacement. / Thesis / Doctor of Philosophy (PhD) / The number of people who are old is increasing by the day and so is the need to understand how to ensure they are aging well. Old age makes people more prone to diseases. The risks of becoming ill could make the efforts to generate knowledge that can help them thrive challenging. They could drop out of a study making it difficult to collect enough information for data analysis. For some older adults who are frail and have higher risk for diseases, there is little known about how to design programs that will enable them stay active and healthier during the COVID-19 pandemic or before they have hip or knee replacement surgery. This thesis contributes to the knowledge on how to improve the quality of research involving older adults and bridge the gap in the knowledge about how to support those who are frail among them.

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