Since the late 1980s, representations of Japanese national identity and Japanese old age have been deconstructed. Images of the resilience of traditional cultural and social institutions are shown to have over-emphasized social and cultural homogeneity, elided social differentiation and inequality and minimized the significance of historical transformation. Key institutions of the postwar modernization project, including the patriarchal seniority system and household structure, are being transformed through globalization and feminization. This thesis focuses on the problem of representing individual and collective ageing in Japan in the context of modernization. Research is focussed on the contradictions, within essentialist representations of Japanese collective and individual identity, between socially constructed policy forms of old age and collective identities. Contemporary trends towards individualization and diversification of identities, and discourses on the ageing/information society, indicate cultural distance between an instrumentally rational administration and the life world of old people. Research explores the concept of embodiment through its significance in debates on postmodernization of the lifecourse in accordance with the structural shifts towards a postindustrial structure. This study examines representations of old age in broader social and cultural processes. Images of the social and cultural trajectory of the lifecourse draw attention to the embodiment of individual identities and ultimately generational cultures in contemporary social and cultural spaces. This research is the result of analyses of old age, which have been informed by postmodern theory. It in turn informs sociological theorizations of cultural representations of old age in contemporary societies.

Inspection Time (IT) is a speed measure that has been primarily investigated in the field of individual differences. However, Nettelbeck and Wilson (2004) proposed that IT could have promise as a biomarker for functional outcomes, particularly cognitive aging. The premise behind biomarker research is that chronological age is simply a proxy for the physiological and cognitive changes that occur in the body with advancing age. Biomarkers are measures that 'mark' the aging process and represent the biological age of an individual rather than the years since his/her birth. Speed of processing tasks offer promise as biomarkers because decline in speed of processing is one of the most robust findings in cognitive aging research. However, traditionally used tasks are problematic because they confound speed and accuracy and some are sensitive to cohort effects. Inspection time is a speed of processing measure that is free from these problems and is therefore a promising candidate for a biomarker. This dissertation presents the first empirical investigation of this proposition. One hundred and fifty elderly participants were assessed on IT, traditionally used biomarkers (e.g. grip strength, visual acuity), a battery of cognitive tasks (e.g. fluid ability and crystallised ability) and measures of everyday functioning (e.g. activities of daily living). These individuals were assessed on three separate occasions over a period of 18-months. For the biomarkers, initial scores, 6-month change scores and 18-month change scores were generated and used to predict final scores and 18-month change scores on the functional outcomes (cognition and everyday functioning). Results revealed that slow IT at the start of the study was associated with dependence in activities of daily living and poorer fluid ability at the end of the study. There was also evidence that slow IT at the start was associated with decline in fluid reasoning over the subsequent 18-months. Moreover, consistent with the major aims of this study, decline in IT over time was associated with more cognitive problems in daily life and poor fluid ability at the end of the study. Given that initial and change scores for IT were independent, due to the methodology used to estimate them, the two measures explained unique variance in the functional outcome measures.These findings are extremely encouraging, particularly given the relatively short time frame for this study. IT has predictive validity for everyday functioning and cognitive aging over an 18-month period, and therefore, it is concluded that IT has promise as a valid biomarker for functional age. Recommendations for further research include investigating the link between IT and mortality, examining the association between IT and a broader range of functional age measures, the replication of these findings in a different sample, and means for improving the sensitivity and specificity of the current IT estimation procedure. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

<p>The general aim of this dissertation is to describe and analyse patterns of informal care and support for carers in Sweden. One specific aim is to study patterns of informal care from a broad population perspective in terms of types of care and types of carer. A typology of four different care categories based on what carers do revealed that women were much more likely than men to be involved at the ‘heavy end’ of caring, i.e. providing personal care in combination with a variety of other caring tasks. Men were more likely than women to provide some kind of practical help (Study I).</p><p>Another aim is to investigate which support services are received by which types of informal caregiver. Relatively few informal caregivers in any care category were found to be receiving any kind of support from municipalities or voluntary organizations, for example training or financial assistance (Study II).</p><p>The same study also examines which kinds of help care recipients receive in addition to that provided by informal carers. It appears that people in receipt of personal care from an informal caregiver quite often also receive help from the public care system, in this case mostly municipal services. However, the majority of those receiving personal, informal care did not receive any help from the public care system or from voluntary organizations or for-profit agencies (Study II).</p><p>The empirical material in studies I and II comprises survey data from telephone interviews with a random sample of residents in the County of Stockholm aged between 18 and 84.</p><p>In a number of countries there is a growing interest among social scientists and social policymakers in examining the types of support services that might be needed by people who provide informal care for older people and others. A further aim of the present dissertation is therefore to describe and analyse the carer support that is provided by municipalities and voluntary organizations in Sweden. The dissertation examines whether this support is aimed directly or indirectly at caregivers and discusses whether the Swedish government’s special financial investment in help for carers actually led to any changes in the support provided by municipalities and voluntary organisations. The main types of carer support offered by the municipalities were payment for care-giving, relief services and day care. The chief forms of carer support provided by the voluntary organizations were support groups, training groups, and a number of services aimed primarily at the elderly care recipients (Study III).</p><p>Patterns of change in municipal carer support could be discerned fairly soon. The Swedish government’s special allocation to municipalities and voluntary organisations appears to have led to an increase in the number of municipalities providing direct support for carers, such as training, information material and professional caregiver consultants. On the other hand, only minor changes could be discerned in the pattern of carer support services provided by the voluntary organizations. This demonstrates stability and the relatively low impact that policy initiatives seem to have on voluntary organizations as providers (Study IV).</p><p>In studies III and IV the empirical material consists of survey data from mail questionnaires sent to municipalities and voluntary organizations in the County of Stockholm.</p><p>In the fields of social planning and social work there appears to be a need to clarify the aims of support services for informal carers. Should the support be direct or indirect? Should it be used to supplement or substitute caregivers? In this process of reappraisal it will be important to take the needs of both caregivers and care recipients into account when developing existing and new forms of support. How informal caregivers and care recipients interact with the care system as a whole is undeniably a fertile field for further research.</p>

<p>The general aim was to examine the Swedish version of the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, in a population of old people with locomotor disability in Sweden. Specific aims were to examine whether the Swedish version of the PGCMAI meets the criteria of reliability and validity when assessing the life situation of Swedish old people with locomotor disability and to explore the pattern of the Swedish version of the instrument in respect of age and gender.</p><p>Home visits were made to 199 people aged 60 years and older in two counties in Sweden. They were interviewed using the Swedish version of the PGCMAI and tested with the Standardized Practical Equipment test, SPE. The data collected were tested for reliability and validity. Cronbach’s alpha varied from 0.27 to 0.86 among the eight domains of the PGCMAI, which concurred with other studies in the field. Validity was analyzed by explorative factor analysis. The eight new factors showed construct validity with a logical relation to the eight original domain distributions. There were also significant relationships between both the original domains of the PGCMAI and the SPE and the new factors of the PGCMAI and the SPE. Both the original Mobility domain index and the new factor correlated well with the ‘Balance and mobility’ factor in the SPE. The Cognitive domain index and the corresponding new factor show a high correlation with the ‘Cognitive functions’ factor in the SPE. The Swedish version of the PGCMAI and SPE presented a functional pattern among old men and women whereby women had deteriorated most with age, which is in agreement with other studies.</p><p>In conclusion the reliability and validity testing of the Swedish version of the PGCMAI has given satisfactory results when used with old people with locomotor disability. The Swedish version of the PGCMAI can be considered a valuable tool for measuring function in old people with locomotor disability.</p> / <p>Befolkningen åldras mer och mer, både i Europa och Sverige, som en följd av längre livslängd och låga födelsetal. Det ställer krav på samhällets resurser i form av vård och omsorg för äldre. I en tid när resurserna inte ökar blir det allt viktigare att samhällets stöd fördelas efter behov.</p><p>I den här studien utvecklades och prövades den svenska versionen av the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, på personer 60 år och äldre med rörelsehinder. Instrumentet omfattar åtta huvudsakliga funktionsområden eller domäner, Activities of Daily Living, ADL, Personal Adjustment, PADI, Physical Health, PHDI, Social, SDI, Environmental, EDSI, Time Use, Mobility, MOBI and Cognitive, CDI. Varje område består av frågor som ställs till den enskilde vid en intervju. Originalversionen av instrumentet, på amerikanska, finns i tre varianter eller längder, ’short-length’, ’mid-length’ och ’full-length’. Den svenska versionen av PGCMAI är en översättning och bearbetning av ’mid-length’ varianten.</p><p>Studiens målgrupp har varit äldre med rörelsehinder. Den har genomförts i tre steg. I det första steget skickades ett frågeformulär till 3469 personer, 60 år och äldre i två geografiska områden i Jönköpings och Värmlands län, där de tillfrågades om de hade något rörelsehinder. Det andra steget innebar att de som rapporterat rörelsehinder, 566 personer, erhöll ett nytt frågeformulär där de bl.a. tillfrågades om svårigheter att förflytta sig och ADL. Det tredje steget innebar att de som besvarade det andra frågeformuläret och accepterade besök i det egna hemmet, 199 personer, intervjuades med PGCMAI och testades med det praktiska testet, Standardized Practical Equipment test, SPE.</p><p>Det första delarbetet syftade till att utreda om den svenska versionen av PGCMAI fyllde kriterierna för reliabilitet och validitet vid bedömning av livssituationen hos äldre med rörelsehinder i Sverige.</p><p>Reliabilitet testades med Cronbach’s alpha och visade högre värde för det ursprungliga PGCMAI än för den svenska versionen, med undantag av domänerna EDSI och Time Use. Jämförelse av Cronbach´s alpha mellan äldre med rörelsehinder i den egna studien (n=199) och studie från 1982 av Lawton et al (n=590) visade likheter med högst värde för ursprungsinstrumentets domäner ADL, PADI och CDI, och lägst värde för domän SDI. Den svenska versionen av PGCMAI testades på validitet med exploratorisk faktoranalys av de 40 variabler i PGCMAI som ingick i de ursprungliga domänerna. Faktoranalysen identifierade åtta faktorer som förklarade 47% av variansen. Dessa åtta faktorer visade betydande överensstämmelse med det ursprungliga instrumentets åtta domäner. Högst korrelation med de nya faktorerna visade domänerna EDSI, SDI och ADL. MOBI i originalversionen och motsvarande faktor i den nya versionen visade högst korrelation med ’Balance and mobility’ i SPE, på motsvarande sätt erhölls samband mellan CDI och ’Cognitive functions’ i SPE.</p><p>Det andra delarbetet hade syftet att undersöka mönstret i den svenska versionen av PGCMAI utifrån ålder och kön samt i jämförelse med andra studier inom området.</p><p>Materialet analyserades i två och fyra åldersgrupper och indelat i män (n=67) och kvinnor (n=132). Analysen visade att rörelsehinder ökar med ålder både för män och kvinnor. Jämförelse mellan åldersgrupperna 60-79 år, 80-99 år, visa att rörligheten försämrades med ålder enligt domänen MOBI. För kvinnor försämrades förmågan enligt domänerna ADL, Time Use, MOBI, SDI och i alla SPE faktorerna, med ålder. Slutsatsen är att PGCMAI kunde särskilja ett funktionellt mönster bland äldre män och kvinnor med rörelsehinder och en försämring med ålder. SPE visade ett motsvarande resultat.</p><p>Slutsatsen av studien är att testningen av validitet och reliabilitet på den svenska versionen av PGCMAI har givit tillfredställande resultat när det används på gruppen 60 år och äldre med rörelsehinder. PGCMAI kunde särskilja funktionella mönster hos äldre män och kvinnor och visade att kvinnor med rörelsehinder hade försämrats mest med ålder. SPE visade liknande resultat. Den svenska versionen av PGCMAI bedöms vara ett värdefullt instrument för att mäta funktionen hos äldre med rörelsehinder och kan bli ett viktigt hjälpmedel för att ge rätt insats och i rätt omfattning.</p>

Although research evidence clearly indicates support surface properties are a major factor contributing to fall risk among the elderly, investigations examining the influence of variations in surface conditions on the postural control of older adults during task performance have been limited. Thus, the primary purpose of the present studies was to determine whether the coordination and control of body kinematics exhibited by older adults during upright leaning (i.e., leaning forward through the region of stability) and gait would be different across variations in support surface properties. Secondary objectives of these studies included, examining if coordination and control measures of body kinematics differed as a function of the participants' level of postural stability and/or repeated exposure to the support surface properties. Three support surface conditions were selected for inclusion based on resistance properties to applied forces (i.e., normal and shear): rigid, high friction; compliant; and rigid, low friction. For both tasks performed, body kinematics for trials 1-3 (T1) and 10-12 (T2) from 12 completed trials on each support surface were analyzed using three-dimensional (3-D) video analyses. Results of separate univariate repeated measures analyses of variance yielded significant surface condition main effects for lower extremity coordination patterns and postural control strategies in the gait and leaning task, respectively. Additionally, a significant surface condition main effect and an interaction effect of surface condition by trial block were identified for the measure of head stability in the gait and leaning tasks, respectively. Differences in head stability and the control of lower extremity joint motions as a function of level of postural stability (i.e., group differences) were observed only during the walking task. Present findings indicate that during goal-directed behavior, the coordinated movements of the body and its segments emerge from constraints imposed by the interaction of the support surface, the task and the individual. The observed adaptations in the coordination and control of posture in response to support surface constraints evidenced in the present studies provide support for the theory of perception and the control of bodily orientation (Riccio & Stoffregen, 1988). / Graduation date: 1998

As the aging population continues to grow worldwide, age-related complications are becoming more apparent within the aging population. One of the first age-related complications to become apparent is age-associated memory impairment and it can make the elderly more dependent on caregivers early on. The N-methyl-D-aspartate (NMDA) receptor is important to learning and memory and appears to be especially vulnerable to the process of aging. The density of NMDA receptors declines with age more than any other ionotropic glutamate receptor. Both the density of NMDA receptors and the mRNA and protein expression of its subunits decline with age. In particular, the GluN2B subunit of the NMDA receptor shows the greatest age-related declines in expression across multiple brain regions, including the frontal lobe (including the prefrontal and frontal cortices), caudate nucleus and hippocampus. These declines are strongly correlated to age-related declines in spatial memory. Specifically, age-related decreases in the protein expression of the GluN2B subunit within crude synaptosomes of the frontal cortex of C57BL/6 mice show a relationship to the declines in performance in a long-term spatial memory task across age groups. However, within the population of aged mice, there was a subpopulation of aged mice in which higher expression of the GluN2B subunit within the synaptic membrane of the hippocampus was associated with poorer performance in the same task. Moreover, transgenic mice designed to express higher levels of the GluN2B subunit from birth also possess superior memory, including spatial memory, across adulthood to middle-age. Taken together, these data led to the hypothesis that increasing the expression of the GluN2B subunit within the aged brain could potentially alleviate age-related declines in memory. However, increasing its expression regionally was first examined since higher expression of the GluN2B subunit within the hippocampus has been associated with poorer memory in aged animals. Since age-related decreases in the protein expression of the GluN2B subunit within the frontal cortex show a relationship to impaired memory function, the first study was designed to determine if increasing GluN2B subunit expression in the frontal lobe would improve memory in aged mice. Mice received bilateral injections of either an adenoviral vector, containing cDNA specific for the GluN2B subunit and enhanced Green Fluorescent Protein (eGFP) (GluN2B vector); an adenoviral vector containing only the cDNA for eGFP (control vector); or vehicle into their frontal lobe. Spatial memory, cognitive flexibility and associative memory were assessed using the Morris water maze. Aged mice, with increased GluN2B subunit expression in the frontal lobe, exhibited improved long-term spatial memory, comparable to young mice, in the second day of training. Moreover, a higher concentration of the specific GluN2B antagonist, Ro 25-6981, was required to impair long-term spatial memory in aged mice with enhanced GluN2B subunit expression, as compared to aged controls. The requirement for greater antagonism in aged mice to block memory performance suggests that the number of GluN2B-containing receptors in their frontal lobe was enhanced and contributed to the improved memory. This study provides suggestive evidence that therapies that enhance GluN2B subunit expression within the aged brain could have the potential to ameliorate age-related memory loss. Since higher expression of the GluN2B subunit within the hippocampus of aged mice is associated with poorer memory, the second study was designed to determine if increasing GluN2B subunit expression in the hippocampus would improve or further impair memory in aged mice. This would help to determine if a therapy aimed at enhancing the GluN2B subunit expression or function of GluN2B-containing receptors throughout the aged brain could help ameliorate age-associated memory loss. Mice were injected bilaterally with either the GluN2B vector, a control vector or vehicle into the hippocampus. Spatial memory, cognitive flexibility and associative memory were assessed using the Morris water maze. Aged mice, with increased GluN2B subunit expression in the hippocampus, exhibited improved long-term spatial memory, comparable to young mice, early in training. However, there was a trend for impaired memory later in the long-term spatial memory trials. Still, these data suggest that enhancing GluN2B subunit expression in the aged hippocampus could be more beneficial to memory than harmful. In addition, the results of this study suggest that enhancing GluN2B subunit expression in different brain regions may improve memory at different phases of learning. Therefore, therapies that enhance GluN2B subunit expression throughout the aged brain could help ameliorate age-related memory loss. The first two studies demonstrated that enhancing the expression of the GluN2B subunit within either the frontal lobe or hippocampus of the aged brain has the potential to reduce age-related memory declines. However, the increase was not global nor specific to the synapse. Therefore, a third study was developed with the intent of garnering a more global increase in GluN2B subunit expression that was localized to the synapse. Cyclin dependent kinase 5 (Cdk5) enhances endocytosis of the GluN2B subunit-containing NMDA receptors from the synapse. Previous research has shown that inhibiting Cdk5 increases the number of GluN2B subunits at the synapse and within the whole cell and improves memory in young mice. This study was designed to determine if using antisense phosphorodiamidate morpholino oligomers (Morpholinos) to decrease the expression of Cdk5 protein within the brain would improve memory in aged mice. Morpholinos were conjugated to a cell penetrating peptide, which enhances cellular uptake, and delivered bilaterally to the lateral ventricles of both young and aged mice via acute stereotaxic injection. Treatments consisted of equivalent volumes and concentrations of either vehicle, control Morpholino or a Morpholino targeting the mRNA of Cdk5 (Cdk5 Morpholino). Memory was evaluated in the Morris water maze and using a novel object recognition task. Aged mice treated with the Cdk5 Morpholino exhibited improved early acquisition and spatial bias in the long-term spatial memory trials, as well as improved performance overall, compared to control Morpholino-treated aged animals. However, aged mice treated with the Cdk5 Morpholino performed similarly to vehicle-treated aged animals. The presence of the peptide-conjugated Morpholinos within the brain may have worsened performance in the Morris water maze task since control Morpholino-treated animals performed significantly worse than vehicle-treated animals. In concurrence, there was significantly greater gliosis in peptide-conjugated Morpholino-treated animals over vehicle-treated brains, suggesting it was neurotoxic. In contrast, young mice treated with the Cdk5 Morpholino showed impaired early acquisition and spatial bias but a trend for improved later learning in the long-term spatial memory task compared to control Morpholino-treated animals. Treatment with the Cdk5 Morpholino had no significant effect on cognitive flexibility, associative memory or novel object recognition for young or aged animals. Immunohistochemistry revealed increased GluN2B subunit expression within cells with characteristics of neurons and astroglia in regions of the frontal lobe, caudate nucleus and hippocampus of aged mice who received the Cdk5 Morpholino compared to control treatments. However, the increased GluN2B subunit expression appeared to be greater within the hippocampus. These results suggest that inhibiting the translation of Cdk5 using Morpholinos increased GluN2B subunit expression in both young and aged mice and may have contributed to the improved long-term spatial memory observed in aged mice, despite the Morpholino being administered at a presumably toxic concentration. An additional group of mice was used to determine a non-neurotoxic dosage of the peptide conjugated Morpholino. However, future studies are needed to determine the efficacy of the Cdk5 Morpholino at this dosage. Taken together, the studies presented here suggest that increasing expression of the GluN2B subunit within the aged brain does improve age-associated memory declines. In addition, cell penetrating peptide- conjugated Morpholinos show promise as tools for genetic manipulation within the brain and Cdk5 could prove to be a novel target for enhancing GluN2B subunit expression within the aged brain. Though future studies are needed, the studies presented here do suggest that therapies that enhance GluN2B subunit expression within the aged brain have the potential to help ameliorate memory loss. However, since enhanced GluN2B subunit expression itself can increase the potential for excitotoxicity, an optimal dose of such a therapeutic would need to be determined. / Graduation date: 2013

Thesis (M. Soc. Sc.)--University of Hong Kong, 2006.

Thesis (M.A.)--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. Title from title screen of research.pdf file viewed on (February 20, 2007) Includes bibliographical references.

The general aim was to examine the Swedish version of the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, in a population of old people with locomotor disability in Sweden. Specific aims were to examine whether the Swedish version of the PGCMAI meets the criteria of reliability and validity when assessing the life situation of Swedish old people with locomotor disability and to explore the pattern of the Swedish version of the instrument in respect of age and gender. Home visits were made to 199 people aged 60 years and older in two counties in Sweden. They were interviewed using the Swedish version of the PGCMAI and tested with the Standardized Practical Equipment test, SPE. The data collected were tested for reliability and validity. Cronbach’s alpha varied from 0.27 to 0.86 among the eight domains of the PGCMAI, which concurred with other studies in the field. Validity was analyzed by explorative factor analysis. The eight new factors showed construct validity with a logical relation to the eight original domain distributions. There were also significant relationships between both the original domains of the PGCMAI and the SPE and the new factors of the PGCMAI and the SPE. Both the original Mobility domain index and the new factor correlated well with the ‘Balance and mobility’ factor in the SPE. The Cognitive domain index and the corresponding new factor show a high correlation with the ‘Cognitive functions’ factor in the SPE. The Swedish version of the PGCMAI and SPE presented a functional pattern among old men and women whereby women had deteriorated most with age, which is in agreement with other studies. In conclusion the reliability and validity testing of the Swedish version of the PGCMAI has given satisfactory results when used with old people with locomotor disability. The Swedish version of the PGCMAI can be considered a valuable tool for measuring function in old people with locomotor disability. / Befolkningen åldras mer och mer, både i Europa och Sverige, som en följd av längre livslängd och låga födelsetal. Det ställer krav på samhällets resurser i form av vård och omsorg för äldre. I en tid när resurserna inte ökar blir det allt viktigare att samhällets stöd fördelas efter behov. I den här studien utvecklades och prövades den svenska versionen av the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, på personer 60 år och äldre med rörelsehinder. Instrumentet omfattar åtta huvudsakliga funktionsområden eller domäner, Activities of Daily Living, ADL, Personal Adjustment, PADI, Physical Health, PHDI, Social, SDI, Environmental, EDSI, Time Use, Mobility, MOBI and Cognitive, CDI. Varje område består av frågor som ställs till den enskilde vid en intervju. Originalversionen av instrumentet, på amerikanska, finns i tre varianter eller längder, ’short-length’, ’mid-length’ och ’full-length’. Den svenska versionen av PGCMAI är en översättning och bearbetning av ’mid-length’ varianten. Studiens målgrupp har varit äldre med rörelsehinder. Den har genomförts i tre steg. I det första steget skickades ett frågeformulär till 3469 personer, 60 år och äldre i två geografiska områden i Jönköpings och Värmlands län, där de tillfrågades om de hade något rörelsehinder. Det andra steget innebar att de som rapporterat rörelsehinder, 566 personer, erhöll ett nytt frågeformulär där de bl.a. tillfrågades om svårigheter att förflytta sig och ADL. Det tredje steget innebar att de som besvarade det andra frågeformuläret och accepterade besök i det egna hemmet, 199 personer, intervjuades med PGCMAI och testades med det praktiska testet, Standardized Practical Equipment test, SPE. Det första delarbetet syftade till att utreda om den svenska versionen av PGCMAI fyllde kriterierna för reliabilitet och validitet vid bedömning av livssituationen hos äldre med rörelsehinder i Sverige. Reliabilitet testades med Cronbach’s alpha och visade högre värde för det ursprungliga PGCMAI än för den svenska versionen, med undantag av domänerna EDSI och Time Use. Jämförelse av Cronbach´s alpha mellan äldre med rörelsehinder i den egna studien (n=199) och studie från 1982 av Lawton et al (n=590) visade likheter med högst värde för ursprungsinstrumentets domäner ADL, PADI och CDI, och lägst värde för domän SDI. Den svenska versionen av PGCMAI testades på validitet med exploratorisk faktoranalys av de 40 variabler i PGCMAI som ingick i de ursprungliga domänerna. Faktoranalysen identifierade åtta faktorer som förklarade 47% av variansen. Dessa åtta faktorer visade betydande överensstämmelse med det ursprungliga instrumentets åtta domäner. Högst korrelation med de nya faktorerna visade domänerna EDSI, SDI och ADL. MOBI i originalversionen och motsvarande faktor i den nya versionen visade högst korrelation med ’Balance and mobility’ i SPE, på motsvarande sätt erhölls samband mellan CDI och ’Cognitive functions’ i SPE. Det andra delarbetet hade syftet att undersöka mönstret i den svenska versionen av PGCMAI utifrån ålder och kön samt i jämförelse med andra studier inom området. Materialet analyserades i två och fyra åldersgrupper och indelat i män (n=67) och kvinnor (n=132). Analysen visade att rörelsehinder ökar med ålder både för män och kvinnor. Jämförelse mellan åldersgrupperna 60-79 år, 80-99 år, visa att rörligheten försämrades med ålder enligt domänen MOBI. För kvinnor försämrades förmågan enligt domänerna ADL, Time Use, MOBI, SDI och i alla SPE faktorerna, med ålder. Slutsatsen är att PGCMAI kunde särskilja ett funktionellt mönster bland äldre män och kvinnor med rörelsehinder och en försämring med ålder. SPE visade ett motsvarande resultat. Slutsatsen av studien är att testningen av validitet och reliabilitet på den svenska versionen av PGCMAI har givit tillfredställande resultat när det används på gruppen 60 år och äldre med rörelsehinder. PGCMAI kunde särskilja funktionella mönster hos äldre män och kvinnor och visade att kvinnor med rörelsehinder hade försämrats mest med ålder. SPE visade liknande resultat. Den svenska versionen av PGCMAI bedöms vara ett värdefullt instrument för att mäta funktionen hos äldre med rörelsehinder och kan bli ett viktigt hjälpmedel för att ge rätt insats och i rätt omfattning.

The general aim of this dissertation is to describe and analyse patterns of informal care and support for carers in Sweden. One specific aim is to study patterns of informal care from a broad population perspective in terms of types of care and types of carer. A typology of four different care categories based on what carers do revealed that women were much more likely than men to be involved at the ‘heavy end’ of caring, i.e. providing personal care in combination with a variety of other caring tasks. Men were more likely than women to provide some kind of practical help (Study I). Another aim is to investigate which support services are received by which types of informal caregiver. Relatively few informal caregivers in any care category were found to be receiving any kind of support from municipalities or voluntary organizations, for example training or financial assistance (Study II). The same study also examines which kinds of help care recipients receive in addition to that provided by informal carers. It appears that people in receipt of personal care from an informal caregiver quite often also receive help from the public care system, in this case mostly municipal services. However, the majority of those receiving personal, informal care did not receive any help from the public care system or from voluntary organizations or for-profit agencies (Study II). The empirical material in studies I and II comprises survey data from telephone interviews with a random sample of residents in the County of Stockholm aged between 18 and 84. In a number of countries there is a growing interest among social scientists and social policymakers in examining the types of support services that might be needed by people who provide informal care for older people and others. A further aim of the present dissertation is therefore to describe and analyse the carer support that is provided by municipalities and voluntary organizations in Sweden. The dissertation examines whether this support is aimed directly or indirectly at caregivers and discusses whether the Swedish government’s special financial investment in help for carers actually led to any changes in the support provided by municipalities and voluntary organisations. The main types of carer support offered by the municipalities were payment for care-giving, relief services and day care. The chief forms of carer support provided by the voluntary organizations were support groups, training groups, and a number of services aimed primarily at the elderly care recipients (Study III). Patterns of change in municipal carer support could be discerned fairly soon. The Swedish government’s special allocation to municipalities and voluntary organisations appears to have led to an increase in the number of municipalities providing direct support for carers, such as training, information material and professional caregiver consultants. On the other hand, only minor changes could be discerned in the pattern of carer support services provided by the voluntary organizations. This demonstrates stability and the relatively low impact that policy initiatives seem to have on voluntary organizations as providers (Study IV). In studies III and IV the empirical material consists of survey data from mail questionnaires sent to municipalities and voluntary organizations in the County of Stockholm. In the fields of social planning and social work there appears to be a need to clarify the aims of support services for informal carers. Should the support be direct or indirect? Should it be used to supplement or substitute caregivers? In this process of reappraisal it will be important to take the needs of both caregivers and care recipients into account when developing existing and new forms of support. How informal caregivers and care recipients interact with the care system as a whole is undeniably a fertile field for further research.