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The aim of the thesis was to investigate factors influencing ICT use by older-adults. A selection of psycho-social, socio-demographic and health determinants were investigated with Internet use. Data were collected through questionnaires (Studies I-III) and interviews (Study IV). Univariate and multivariate analyses were conducted, investigating Internet use as a dichotomous variable, with the aforementioned factors. The results indicated that psycho-social determinants did not affect older-adults’ Internet use (Study I). Scoring higher on the personality traits openness and extraversion did not affect whether the older adults started to use the Internet (Study II). However, well-being increased for some frail older-adults when using the tablet computer and connected to the Internet (Study IV). Some socio-demographic determinants affected Internet use. Being younger in age was a strong contributing factor in all four studies whether the older-adult would use the Internet. Higher education influenced Internet use (Study I & III), correlated with living in a rural or urban setting (Study III); yet education was not influencing whether they would start to use the Internet. Living alone was correlated with Internet use, especially if the older-adult lived in an urban setting (Study III). Functional disability and household economy did not affect Internet use. Finally, the health determinants on Internet use were quite strong. Normal cognitive functioning influenced whether older-adults would start to use the Internet (Study II). The older-adult living in an urban environment, would use the Internet if they had normal cognitive functioning (Study III). It was noted also from Study IV that the learning to use the Tablet PC and Skype took longer for older people and more repetition was needed. Being frail was a strong factor whether the older-adult would use the Internet. They would not want to learn or try to use the technology if they were too ill (Study IV). The findings show only a small increase (7.7%) in Internet use by older-adults over time. The indicators of non-use are: higher in age, lower educated, living alone or rurally, lower cognition and frailty. There are two different profiles of rural and urban Internet users. These determinants along with an understanding of the use of technology, and a good support system, are a few pillars in ICT adoption by older-adults. As ICT continues to develop as a means to provide better health care, it will be important to take into account the abovementioned indicators. In certain cases Internet use is not a given, which continues to exclude older-adults. Part of healthy aging is social participation; therefore being connected and included in the digital society is important. Alternative and not only one design solutions should be explored in health care and by organisations, so as to cater to the heterogeneity of the aging population.

Background: Physical activity (PA) is a health protective behaviour that is critical in the reduction of most major chronic diseases. It also provides the participant with psychological benefits. Despite its well-established health benefits, PA engagement is low in the adult population. Women over the age of 60 are the least physically active segment and thus an important target for behaviour change interventions. Objective: The purpose of this mixed methods feasibility study was to explore the feasibility of six-week Self-Determination Theory (SDT)-based dance and walking programs for older women. Design: This was a parallel, randomized controlled trial with three groups: dance, walking, and wait-list control. This study included the sequential collection of quantitative then qualitative data (sequential explanatory design). Setting: This study was conducted in Victoria, BC. Participants: Participants were community-dwelling, English-speaking women aged 55-70 years who were not meeting PA guidelines. Methods: Data were collected at baseline and two endpoints: post-intervention at six weeks and follow-up at 12 weeks. The primary outcomes were feasibility measures: recruitment, intervention adherence, retention, and satisfaction. Survey data included self-reported PA (Godin Leisure Time Exercise Questionnaire) and measures of behavioural regulations and psychological needs (SDT constructs) using validated tools (Behavioural Regulations in Exercise Questionnaire-2 and Psychological Need Satisfaction in Exercise Scale). Qualitative data were collected in the form of open- and close-ended program evaluation questions and during focus group interviews, both occurring at post-intervention (six weeks). Results: The feasibility measures suggest that it is feasible to recruit and retain participants and that they were generally satisfied with the programs. Thirty-five of 37 randomized participants completed the study (mean age ± SD = 62.8 ± 4.8), representing a 39% recruitment rate and 95% retention rate. Both programs were highly attended. Exploratory effect sizes for the quantitative measures were promising for conducting a larger-scale trial. Emergent themes highlighted the importance of the leadership component of the group-based PA programs. Conclusion: This study had high protocol adherence, promising effect sizes, program evaluation satisfaction, and a recreation centre took on the dance program; these factors provide a foundation for expanding this feasibility trial to a full-scale study. / Graduate / 2017-12-01

Many factors detrimental to healthy aging have been proposed including depression, stress, cognitive decline, and telomere shortening. Of specific interest are the genetic factors that may contribute to these factors and subsequently lead to accelerated telomere shortening and aging, namely the Bcl1, 5-HT, DRD2, and ApoE polymorphisms. We sought to: 1) further clarify the role of depression, stress tolerance, and cognitive decline in aging by examining the effect of associated polymorphisms (Bcl1, 5-HT, DRD2, and ApoE) on telomere length in two samples of older adults and 2) determine the difference in absolute telomere length between the two groups. We examined two samples of older adults: participants in a competitive, athletic event (N=220; mean age=66.8 years) and a sample of community-dwelling older adults (N=208; mean age=69.1 years). Participants completed a questionnaire with demographic information and provided a saliva sample. The Bcl1, 5-HT, DRD2, and ApoE polymorphisms were determined using PCR and Taqman assays. Telomere length was determined using qPCR analysis. The community-dwelling group had significantly shorter telomere lengths than the athletic group (t=-4.82, p< .0001). Additionally, for males in the athletic group, the L/S genotype of the 5-HT polymorphism was associated with longer telomere length. In males in the community-dwelling group, the GC genotype of the Bcl1 polymorphism was associated with shorter telomere length. In females in the athletic group, the GC and GG genotypes of the Bcl1 polymorphism were associated with shorter telomere length with the opposite being true for females in the community-dwelling group: the GC genotype of the Bcl1 polymorphism predicted longer telomere length. Exercising nearly everyday and the length of exercise were associated with telomere length in both groups. Our results indicate that competitive athletic activity in older age is associated with increased telomere length, longer periods of exercise at one time may contribute to longer telomere length, and the Bcl1 and 5-HT polymorphisms are associated with telomere length in older adults.

Preserving and improving the health and well-being of older people is a significant public health issue of the 21st century. The increased attention to the promotion of health in old age has given rise to an extensive body of literature on the subject of “healthy aging” – a discourse dedicated to understanding the multidimensional factors associated with aging and health and the application of this knowledge. Adopting a place-based, qualitative approach, this dissertation addresses key gaps in the healthy aging literature. The public life of older people aging in place was examined to understand how neighbourhoods, as important physical and social places of aging, contribute to the well-being and healthy aging of older people. This dissertation employed a critical geographical gerontology research framework and a methodology called ‘friendly visiting’ which combines ethnography, narrative and case study research and utilizes participant observation, visual methods and interview techniques. The qualitative data were analyzed using grounded theory and an adapted coding strategy that integrated the textual, visual, and auditory data. The analysis process highlighted theoretically-informed themes that characterized participant’s perceptions and experiences of their neighbourhoods. Findings reveal neighbourhoods are important places of aging that impact the well-being of older people aging in place. This dissertation provides insight into the micro-territorial functioning of neighbourhoods for older people. Embedded within these environments are key sites for informal public life called third places (e.g., parks, streets and coffee shops). Third places are important material and social places for older populations. Preparing for, journeying to, and engaging in these public sites promotes healthy aging by providing opportunities for engagement in life and facilitating social networks. Results advance healthy aging and aging and place research, contribute to gerontological and geographical methodologies, and have implications for policy and practice in areas such as health promotion and age-friendly community initiatives.

Preserving and improving the health and well-being of older people is a significant public health issue of the 21st century. The increased attention to the promotion of health in old age has given rise to an extensive body of literature on the subject of “healthy aging” – a discourse dedicated to understanding the multidimensional factors associated with aging and health and the application of this knowledge. Adopting a place-based, qualitative approach, this dissertation addresses key gaps in the healthy aging literature. The public life of older people aging in place was examined to understand how neighbourhoods, as important physical and social places of aging, contribute to the well-being and healthy aging of older people. This dissertation employed a critical geographical gerontology research framework and a methodology called ‘friendly visiting’ which combines ethnography, narrative and case study research and utilizes participant observation, visual methods and interview techniques. The qualitative data were analyzed using grounded theory and an adapted coding strategy that integrated the textual, visual, and auditory data. The analysis process highlighted theoretically-informed themes that characterized participant’s perceptions and experiences of their neighbourhoods. Findings reveal neighbourhoods are important places of aging that impact the well-being of older people aging in place. This dissertation provides insight into the micro-territorial functioning of neighbourhoods for older people. Embedded within these environments are key sites for informal public life called third places (e.g., parks, streets and coffee shops). Third places are important material and social places for older populations. Preparing for, journeying to, and engaging in these public sites promotes healthy aging by providing opportunities for engagement in life and facilitating social networks. Results advance healthy aging and aging and place research, contribute to gerontological and geographical methodologies, and have implications for policy and practice in areas such as health promotion and age-friendly community initiatives.

The progressive aging of the population corresponds with a movement in gerontology focusing on factors that promote the positive aspects of aging. The concept of healthy aging corresponds with the multifaceted nature of health but few researchers have examined this concept using a multidimensional approach. The creation of a biopsychosocial definition of healthy aging draws on previous literature to determine important components and potential predictors. The major domains of this definition include physical, cognitive, social, and psychological health. Using cross-sectional and longitudinal data from the Manitoba Study of Health and Aging (MSHA), the purpose was to develop a multidimensional construct of healthy aging based on the four components outlined above. The association between each of the components and the overall construct of healthy aging was examined. A significant interaction was found between physical and cognitive health, indicating that each dimension of health must be assessed in the context of the other. The definition was validated against mortality and institutionalization. Overall healthy aging was significantly associated with future mortality and institutionalization. In addition, healthy aging was compared with the construct of self-rated health to investigate if they are separate constructs. Results indicated that they were overlapping constructs but each variable also had an independent effect on future mortality and institutionalization. Significant demographic predictors of healthy aging at time 2 included younger age and higher education. A greater number of chronic conditions; the presence of vascular factors such as high blood pressure, stroke, heart problems, and chest pain; the presence of neurological factors such as memory problems and nerve trouble; and the presence of other conditions such as chronic pain, eye and ear trouble, and foot problems were also associated with not meeting criteria for healthy aging at time 2. Overall the findings from this study provide support for the importance of a multidimensional definition of healthy aging that is distinct from the construct of self-rated health. The findings underscore the need to assess individual characteristics, such as age, sex, and education, when attempting to predict future health outcomes. A greater understanding of the factors that are associated with healthy aging may encourage opportunities to promote healthy aging. This research may have important implications for researchers, clinicians, and policymakers as they focus on improving quality of life for our aging population.

The progressive aging of the population corresponds with a movement in gerontology focusing on factors that promote the positive aspects of aging. The concept of healthy aging corresponds with the multifaceted nature of health but few researchers have examined this concept using a multidimensional approach. The creation of a biopsychosocial definition of healthy aging draws on previous literature to determine important components and potential predictors. The major domains of this definition include physical, cognitive, social, and psychological health. Using cross-sectional and longitudinal data from the Manitoba Study of Health and Aging (MSHA), the purpose was to develop a multidimensional construct of healthy aging based on the four components outlined above. The association between each of the components and the overall construct of healthy aging was examined. A significant interaction was found between physical and cognitive health, indicating that each dimension of health must be assessed in the context of the other. The definition was validated against mortality and institutionalization. Overall healthy aging was significantly associated with future mortality and institutionalization. In addition, healthy aging was compared with the construct of self-rated health to investigate if they are separate constructs. Results indicated that they were overlapping constructs but each variable also had an independent effect on future mortality and institutionalization. Significant demographic predictors of healthy aging at time 2 included younger age and higher education. A greater number of chronic conditions; the presence of vascular factors such as high blood pressure, stroke, heart problems, and chest pain; the presence of neurological factors such as memory problems and nerve trouble; and the presence of other conditions such as chronic pain, eye and ear trouble, and foot problems were also associated with not meeting criteria for healthy aging at time 2. Overall the findings from this study provide support for the importance of a multidimensional definition of healthy aging that is distinct from the construct of self-rated health. The findings underscore the need to assess individual characteristics, such as age, sex, and education, when attempting to predict future health outcomes. A greater understanding of the factors that are associated with healthy aging may encourage opportunities to promote healthy aging. This research may have important implications for researchers, clinicians, and policymakers as they focus on improving quality of life for our aging population.

The orofacial area stands apart from other body systems in that it possesses a unique performance anatomy whereby oral musculature inserts directly into the underlying cutaneous skin, allowing for the generation of complex three-dimensional deformations of the orofacial system. This anatomical substrate provides for the tight temporal synchrony between self-generated cutaneous somatosensation and oromotor control during functional behaviors in this region and provides the necessary feedback needed to learn and maintain skilled orofacial behaviors. The Directions into Velocity of Articulators (DIVA) model highlights the importance of the bidirectional relationship between sensation and production in the orofacial region in children learning speech. This relationship has not been as well-established in the adult orofacial system. The purpose of this observational study was to begin assessing the perception-action relationship in healthy adults and to describe how this relationship may be altered as a function of healthy aging. This study was designed to determine the correspondence between orofacial cutaneous perception using vibrotactile detection thresholds (VDT) and low-level static and dynamic force control tasks in three representative age cohorts. Correlational relationships among measures of somatosensory capacity and low-level skilled orofacial force control were determined for 60 adults (19-84 years). Significant correlational relationships were identified using non-parametric Spearman’s correlations with an alpha at 0.1 between the 5 Hz test probe and several 0.5 N low-level force control assessments in the static and slow ramp-and-hold condition. These findings indicate that as vibrotactile detection thresholds increase (labial sensation decreases), ability to maintain a low-level force endpoint decreases. Group data was analyzed using non-parametric Kruskal-Wallis tests and identified significant differences between the 5 Hz test frequency probe and various 0.5 N skilled force assessments for group variables such as age, pure tone hearing assessments, sex, speech usage and smoking history. Future studies will begin the processing of modeling this complex multivariate relationship in healthy individuals before moving to a disordered population.

A major demographic shift is projected to begin in 2011 due to the retirement of those born between 1946 and 1965, or the post-World War II baby boomer generation. Due to this trend, it is pertinent for Canadian communities to concentrate on creating ‘senior-friendly’ spaces, infrastructure and support services. One such initiative throughout British Columbia is the establishment of 18 designated Senior Community Parks (SCPs) across the province in 2008. This case-study research project, taking place in Oak Bay, British Columbia on the grounds of the Henderson Recreation Centre (HRC), examines park visitation levels, types of utilization and effectiveness of park accessibility, and infrastructure. A mixed methods approach was employed combining seven park observations, sixty-five quantitative questionnaires completed by patrons of the Henderson Recreation Centre, and 16 qualitative interviews with community-dwelling older adults between the ages of sixty-one and eighty and with six staff members of the HRC. Results indicate steady but low park visitation amounts as only 55 total people were seen during observations. Almost all persons were observed walking or jogging and only one person was seen using the equipment within the park. Quantitative data revealed under-utilization of the park and a wide discrepancy between the number persons aware of the SCP (90.8%) and those that visit more than once a month (38.5%). Qualitative interviews uncovered aspects of the park favored by participants (chip trail, park upkeep, exercise opportunities) and those that require improvement (exercise equipment, awareness). Two infrastructural shortcomings were identified; signage and equipment stations. Based on results, the ineffectiveness of the outdoor exercise equipment and awareness of the SCP need to be investigated further. / Graduate