Thesis advisor: Natalia Sarkisian / A multiplicity of scholarly publications has found salutary associations between various aspects of religion and mental health, particularly depression. However, Hispanic older adults are seldom the focus of empirical studies analyzing these relationships. I fill that gap. Theories on the effects of church attendance, private prayer, religious coping, and religiosity on depression are developed and investigated. These analyses are based on a sample of older Mexican-origin individuals (N = 1,495). Data were obtained from the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE), a longitudinal survey. Results reveal an inverse association between moderate church attendance and depression that persists despite controls for social support, financial strain, and physical and mental impairment. An inverse association between higher levels of religiosity and depression and a direct association between higher levels of religious coping and depression also persisted beyond all controls. Findings suggest that the effects of religion on depression vary and are not always salutary. Methodological and theoretical implications, limitations, and future research directions are discussed.

This study used an explorative quantitative survey method for the purpose of examining bullying among older adults in retirement homes and the consequences of bullying among this population. The study also explored the type of bullying that occurs in the community. Senior community centers were the significant domains in which to research bullying among older adults because it involved immersion of the researcher into an environment of older adults who knew one another and have witnessed or have been victims of bullying in their retirement home communities. The primary purpose of this investigation was to enhance research on bullying among older adults in retirement homes. Another purpose of this research was to address the consequences of bullying in older adults and to address mental and physical consequences of bullying addressed in previous research. Currently there is not much research done on bullying among older adults. This study found that many older adults living in retirement homes are being bullied and many of them are not speaking up and isolating themselves for the purpose of avoiding their bullies. Moreover, this study shows that staff members of the retirement communities are lacking the knowledge of the bullying problem in their community. The study suggests that future studies on bullying among older adults include qualitative research to determine if older adults understand the difference of bullying and “just being grumpy” and also explore a qualitative research regarding the perpetrator of bullying and not the victims of bullying.

In Western society competing in physically demanding sport is not considered the domain of older people. For the majority of the twentieth century older people were stereotyped as frail, socially withdrawn and dependent on health and social welfare systems. Competitive athletes on the other hand are commonly viewed as being young, strong, aggressive, physically competent and independent. Although today’s older generation are encouraged to be physically active, society does not recognise serious competition or physically intense sports as age-appropriate activities for them. If older people choose to participate in sport they are expected to be doing it to have fun, make friends and keep fit. The growing leisure phenomenon of older athletes who compete to win, achieve a personal best, break world records or push their bodies to the limit presents a challenge to these orthodoxies. The purpose of this thesis is to explain why competing in physically demanding sport is significant to some older people given the accepted view that it is not their domain. In particular, the thesis explores the multiple ways in which a group of older people negotiate conflicting discourses of both sport and ageing, as well as the contradiction between their identity as an athlete and their ageing bodies, as they talk about and experience competing in physically strenuous individual and team sports. The key themes through which this negotiation process is played out relate to friendship and fun, competition, youthfulness, and the ageing body. It is revealed that the process of competing in sport can be simultaneously empowering and problematic at both the individual and social levels. The thesis draws on insights from post-structural theories of resistance and empowerment, traditional and postmodern understandings of identity management in later life, and life-stage theories to interpret the phenomenon of older people competing in physically demanding sport. To achieve the above aims, a qualitative study exploring the experiences of a group of Masters athletes aged over 55 years who regularly compete in physically strenuous individual or team sports was undertaken. It was found that despite age-appropriate norms, competition is significant to many of the participants. Study participants embrace the ideologies and practices of competitive sport and use them to define ageing in terms of youthfulness, physical ability and personal empowerment. Simultaneously however, a denial of, or desperate resistance to, the physical ageing process accompanies this feeling of empowerment. The participants in this study were not only competing in sport, but also ‘competing for life����. It is argued that a multi-faceted and conflicting interplay of resistance and conformity, empowerment and denial, identity and the ageing body is embedded in the phenomenon of older people competing in physically demanding sport. These contradictory findings expose alternative ways of understanding sport, competition, ageing and older people in the West and raise many questions requiring further investigation. The study also points to potential applications of these findings to policy-making and provision of leisure services for older people. / PhD Doctorate

Whole body vibration (WBV) is a mode of exercise by which an individual stands on a vibration platform that may be oscillating and therefore creating vertical displacement which affects gravitational forces acting upon the whole body. Manipulations of platform amplitude or frequency can affect the rate of change of the WBV (i.e. acceleration) acting upon an individual. The specific influences of frequency or amplitude, however, are unknown. The aim of the study, therefore, was two fold; (1) to identify chronic WBV effects of neuromuscular performance within a community dwelling older adult sample, and; (2) to identify WBV methods that would elicit chronic neuromuscular performance changes within such a sample. The study incorporated a randomised controlled experimental design to examine the aim. Seventy-three community dwelling older adults freely consented to the requirements of the study (mean age = 72.0 years). Neuromuscular performance was quantified with the 5-Chair Stands test, the Timed Up and Go (TUG) test and the Tinetti test. Health Related Quality of Life (HRQOL) was qualified with the SF-36 Health Survey. A six week WBV intervention significantly changed the quantifiers of neuromuscular performance in a community dwelling older adult sample. The WBV intervention significantly reduced time taken to complete the 5-Chair Stands test (p <.05) and the TUG test (p <.05). The six week WBV intervention significantly improved Tinetti test scores (p <.05). The six week WBV intervention significantly improved all components of HRQOL. For the 5-Chair Stands test, a three WBV sessions per week intervention elicited significantly larger (p <.05) neuromuscular performance gains than a two WBV sessions per week intervention in the target sample. For the TUG test, a three WBV sessions per week intervention elicited significantly larger (p <.05) neuromuscular performance gains than a zero and one WBV session per week intervention in the target sample. A significant difference (p <.05) was found between pre-test and post-test Tinetti test scores for all WBV intervention groups. There was an insignificant difference (p >.05) found within the control group of community dwelling older adults for the Tinetti test. Detraining effects were observed three weeks after the cessation of the six week WBV intervention for the three WBV sessions per week group. Neuromuscular performance reduced after the detraining period. Vibration platform dynamics (manipulated frequency and controlled amplitude) showed that gravitational forces created by the WBV were safe since no injuries were associated with the intervention and since participant compliance was 100% during the six week WBV intervention. The methods of this study showed a chronic WBV intervention to be a safe and easily administered exercise to improve neuromuscular performance and HRQOL of a community dwelling older adult sample. Specifically, WBV could be used as a safe and effective tool to improve aspects of normal daily function such as body balance and gait speed.

It is well established that there are many intrinsic and extrinsic risk factors associated with falls in older adults. Less well-known is what risk factors predict falls in more vulnerable populations, such as those with neurological conditions living in long-term care homes or receiving home care services. Furthermore, evidence comparing those with neurological conditions to those without is lacking in the literature. The primary purpose of this thesis was to determine risk factors for falls in long-term care residents and home care clients with no recent history of falls to determine if risk factors differed between individuals with dementia or Parkinson’s disease and those without any neurological conditions. Secondary data analysis was performed on a database of standardized health assessments completed for long-stay home care clients and long-term care residents in Ontario. Within each major diagnostic group, observations were stratified based on ambulatory status (ambulatory vs. non-ambulatory). Bivariate analyses followed by generalized estimating equations were used to determine statistically significant predictors of falls in each group within each care setting. The results of multivariable analyses showed that there is not a distinct set of risk factors associated with falls in home care clients and long-term care residents with dementia or Parkinson’s disease that is systematically different from risk factors associated with falls in clients and residents not diagnosed with any of the neurological conditions in this study. These results suggest that a common set of risk factors may effectively predict falls in all clients and residents with no recent falls history, regardless of certain neurological diagnoses.

With the growing number of older adults in the general population, there is also a concomitant rise in the number of older adults who require mental health services, making the measurement of psychological conditions in later life a priority. However, due to a lack of measures created for older adults, researchers and clinicians must often rely on measures created for younger populations. Three studies were designed to add to the field of evidence-based assessment and determine which anxiety measures possess strong evidence when used with older adults to warrant their use with this specific population. In the first study, I systematically reviewed the literature to identify the anxiety measures most commonly used with older adults. I reviewed each measure to examine its psychometric properties (e.g., internal consistency, test-retest reliability, inter-rater reliability, concurrent and discriminant validity) and the availability of age-appropriate norms in order to evaluate whether the instruments are appropriate for use with older adults. In the second study, I conducted a reliability generalization meta-analysis to estimate the mean reliability of each commonly used anxiety measure identified in the first study. Finally, in the third study, I examined whether the anxiety measures commonly used with an older population can be consistently and accurately categorized as evidence-based. The literature review and the reliability generalization study both revealed that most of the most commonly used measures lacked sufficient evidence to warrant their use with older adults. However, three measures (Beck Anxiety Inventory, Penn State Worry Questionnaire, and Geriatric Mental Status Examination) showed psychometric properties sufficient to justify the use of these instruments when assessing anxiety in older adults. In addition, two measures developed specifically for older adults (Worry Scale and Geriatric Anxiety Inventory) were also found to be appropriate for use with older adults. This suggests that based on their overall level of reliability and previous psychometric evidence, both researchers and clinicians assessing anxiety in a geriatric population should consider these measures as likely to be the best currently available.

Objective: The purpose of this investigation was to examine the effect of implementation intentions on physical activity in older adults with stronger and weaker executive control resources (ECRs). Methods: One hundred and ten community dwelling older adults (Mage=74.42) were randomly assigned to receive either a physical activity implementation intention intervention, a control intervention, or no-treatment. Three ECR facets (inhibition, task-switching, working memory), baseline behaviour and baseline intentions were assessed during the initial laboratory session. During 4 weekly follow-up telephone interviews, participants reported physical activity behaviour for the previous week, and refreshed implementation intentions for each upcoming week. Results: A main effect of treatment condition on 1-month self-reported physical activity was observed, with those in the experimental group reporting significantly higher physical activity than those in the control or no-treatment conditions. In addition, a significant 2-way (intention strength by treatment condition) interaction emerged, with the experimental group showing higher intention-behaviour correspondence than the control and no-treatment groups. A marginal 2-way interaction of intention and behavioural inhibition was also detected; those with stronger behavioural inhibition had higher intention-behaviour correspondence relative to those with weaker behavioural inhibition across all three treatment conditions. Conclusions: Implementation intentions are effective in facilitating physical activity in healthy older adults. The findings also indicate that behavioural inhibition may be important for the moderation of intention-behaviour relationships in the context of physical activity, regardless of goal setting strategy.

INTRODUCTION: The fastest growing segment of the U.S. population is among individuals aged 50 and older. However, advanced age is not protective against HIV. AIM: The purpose of this study is to examine individual characteristics (gender, age, education) as well as environmental and behavioral factors (doctor visits and IDU) that may be linked with HIV status among older heterosexual African American adults. The factors associated with HIV status that were examined include education level, IDU within the last six months, non-injected drugs that were used within the last six months and the length of time since the last doctor visit. METHODS: The original study used participant-driven sampling to identify seeds in high risk zip codes within the City of Atlanta to complete questionnaire and provide biospecimens. This study focuses on the interviews and test results of participants ages 50 and older. Associations of demographic characteristics, behavioral risk factors and HIV status were analyzed using Pearson chi-square, univariatae, and multivariate tests. RESULTS: African Americans who have injected drugs within the last six months are more likely to be HIV positive than those that have not injected drugs in the last six months. DISCUSSION: Results of this study reveal that there are unique patterns of risk taking behavior among older adults. These findings can provide potential intervention opportunities that may prevent HIV transmission among this vulnerable, increasing segment of the population.

Designers and researchers have often assumed that individuals rely to some degree on individual perceptions of a product's hazard when interacting with warning systems that accompany the product. However, few investigations have been made to determine what precisely these perceptions are, and how they may differ across diverse populations (such as age). Younger and older adults were tested for perceived product hazards over a diverse group of products using a Battig and Montague (1969) style procedure. Participants were presented with a total of 78 products, and asked to list the first hazards that came to their mind (up to 7 per product) for each. Comparisons revealed age-related differences between the most commonly perceived hazards for 28 of the products, with many of the age-related differences not predicted prior to data collection. The resulting data additionally form a tool for designing warning systems and research stimuli based on the products or classes of products represented in this sample.

Automated products, especially automated decision aids, have the potential to improve the lives of older adults by supporting their daily needs. Although automation seems promising in this arena, there is evidence that humans, in general, tend to have difficulty optimizing their behavior with a decision aid, and older adults even more so. In a human-automation collaborative system, the ability to balance costs involved in relying on the automation and those involved in verifying the automation is essential for optimal performance and error minimization. Thus, this study was conducted to better understand the processes associated with balancing these costs and also to examine age differences in these processes. Cost of reliance on automation was evaluated using an object counting task. Participants were required to indicate the number of circles on a display, with support coming from a computer estimate decision aid. They were instructed to rely on the aid if they believed its answer or verify the aid by manually counting the circles on the screen if they did not believe the aid to be correct. Manipulations in this task were the cost of a wrong answer, either -5, -10, -25, or -50 points and the cost of verification, either high or low. It was expected that participants would develop a general pattern of appropriate reliance across the cost conditions, but would not change their reliance behavior enough to reach optimality. Older adults were expected to rely on the decision aid to a lesser extent than younger adults in all conditions, yet rate the automation as being more reliable. It was found that older and younger adults did not show large differences in reliance, although older adults tend to be more resistant to changing their reliance due to costs than younger adults. Both age groups significantly underutilized the computer estimate, yet overestimated its reliability. The results are important because it may be necessary to design automated devices and training programs differently for older adults than for younger adults, to direct them towards an optimal strategy of reliance.