It is difficult to think of any activity that does not require some degree of turning. Despite the prevalence of turning in daily activities and the challenge it poses to mobility-impaired individuals such as those with Parkinson’s disease, there is far less known about the multi-segmental control of turning than the control of standing and straight walking especially in elderly individuals and patient populations. The purpose of this thesis was to examine the coordination of body segment reorientation in healthy older adults and people with Parkinson’s disease (PD) during on-the-spot turns when standing and turns initiated when walking. The coordination of body segments was examined for small and large magnitude turns in both populations. PD participants were examined when “off” and “on” dopamine-replacement medication to determine the effects of medication on multi-segmental coordination when turning. The effect of walking velocity on the multi-segmental coordination of turning also was examined in healthy elderly participants for three different walking velocities. This research revealed differences in coordination patterns for standing versus walking turns and for healthy older adults versus persons with PD. Healthy older adults reorient their head, shoulder, and pelvis in unison, followed by mediolateral foot displacement, during standing turns. This coordination pattern was observed for both small and large turns. By contrast, turns initiated by healthy older adults while walking displayed a top-down temporal sequence similar to that reported for healthy young adults, i.e., the head turns first, followed by the shoulder and pelvis, and finally mediolateral displacement of the foot. This is a robust behavior which was not affected by the magnitude of the turn or walking velocity. PD participants (“off” and “on” medication) displayed temporal coordination patterns similar to age-matched healthy older adults for both standing and walking turns. However, PD participants (“off” and “on” medication) differed from healthy older adults with respect to the velocity and magnitude of reorientation of body segments, i.e., spatial parameters of coordination. The peak angular velocity of each body segment was significantly smaller for PD participants than the healthy older adults during both standing and walking turns; this was observed for both small and large magnitude turns. The magnitude of reorientation of each body segment was measured at the onset of mediolateral foot displacement; this measure revealed significantly smaller head and shoulder rotations for PD participants versus healthy older adults during standing turns, but not walking turns. Medication had no significant effect on the temporal or spatial parameters of body segment coordination during standing and walking turns. Medication increased the magnitude of head turn during the 90° standing turns; however, the magnitude of head turn remained smaller than that of healthy older adults. Multi-segmental coordination patterns differ for turns performed when standing (on-the-spot turn) versus when walking. The temporal parameters of these coordination patterns are not influenced by the magnitude of the turn or the velocity of walking and remain intact in Parkinson’s disease. Parkinson’s disease modifies the spatial parameters of coordination; reducing the velocity and early magnitude of reorientation of each body segment. These spatial parameters are not affected by dopaminergic medication.

Some loss in memory is considered a part of normal aging; however, there is a considerable heterogeneity in cognitive aging among older adults. Studies show that living arrangements, social interaction, social relationships and size of social network are among the predictors of memory decline for older adults. Moreover, marriage has been associated with physiological health as well as psychological and social well-being. This study has examined the relationship between the marital status and memory performance in older adults. It was hypothesized that (1) being married will be positively related to memory of older adults; (2) participants with larger supportive social network will perform better on memory tests; and (3) that quality of married life will be positively related to memory for married older adults. Results from this study did not support the hypotheses when age was controlled suggesting no relationship between marital status and memory performance.

Cognitive impairment is prevalent among older adults population. It brings restriction to older adults’ lives and bring huge burden to the society. Mind-body exercise has characteristics from both physical exercise and intellectual experience. Moreover, it has potential cognitive benefits to reduce the incidence even reverse cognitive impairment. Using meta-analysis to analyze findings form published research on mind-body exercise, this study will explore whether practicing mind-body exercise is beneficial for the management of cognitive impairment.

Bakgrund: Sexualiteten är ett grundläggande behov för människan och är på grund av sin privata natur ett känsligt ämne. Det finns många fördomar kring äldre och sexualitet och det är inte helt socialt accepterat att äldre kan och vill ha ett rikt sexliv eftersom sexualitet i vårt samhälle är starkt förknippat med ungdom och ålderdom med asexualitet. Många äldre anser att det är sjukvårdspersonalens sak att föra sexualiteten på tal samtidigt som personalen i sin tur finner det obekvämt att diskutera sexualitet med sina patienter. Syfte: Syftet med denna uppsats är att beskriva vårdpersonalens attityder gentemot äldres sexualitet för att förstå attitydernas påverkan på omvårdnaden. Metod: Arbetet genomfördes som en litteraturstudie. Nio vetenskapliga artiklar, varav två var kvalitativa, analyserades. Samtliga artiklar fanns i Cinahl, PubMed, AgeLine och Ersta Discovery. Resultat: Analysen resulterade i fyra huvudteman; personliga faktorer, utbildning och erfarenhet, attityder som hinder för omvårdnad och attitydens relation till vårdmiljö och vårdkultur.   Diskussion: Resultatet har diskuterats mot Hendersons omvårdnadsteori och det holistiska perspektivet. Bemötandet av äldres sexualitet påverkas av personalens förförståelse, värderingar och utbildningsnivå. Det finns en diskrepans mellan teori och praktik vad gäller bemötande av äldres sexualitet. Även rådande vårdmiljö och -kultur på arbetsplatsen påverkar personalens förmåga att möta den äldres sexuella frågor och behov på ett adekvat sätt. / Background: Sexuality is a basic need for human beings and is because of its private nature a sensitive topic. There are many prejudices about older people and sexuality, and it is not entirely socially acceptable that older people can and want to have a fulfilling sex life. Sexuality in our society is strongly associated with youth, and old age with asexuality. Many older people believe that it is the staff’s duty to bring up the topic while staff find it uncomfortable to discuss sexuality with their patients. Aim: The aim of this paper is to describe nursing staff’s attitudes toward the sexuality of older adults in order to understand the impact of the attitude on nursing care. Methods: The thesis was conducted as a literature study. Nine research articles, two of which were qualitative, were analyzed. All  were found in Cinahl, PubMed, AgeLine and Ersta Discovery. Results: The analysis resulted in four main themes: personal factors, education and experience, attitudes as barriers to care and the influence of workplace culture and health care environment on attitudes. Discussions: The results were discussed in relation to Henderson's nursing theory and the holistic perspective. In dealing with sexuality staff are influenced by prior understanding, personal values ​​and education. There is a discrepancy between theory and practice with regards to the sexuality of older people. The current healthcare environment and workplace culture also affects the ability of staff to adequately meet sexual issues and needs of the older adult.

Community integration is vital for older adults with mental health issues, both as a process and as an outcome. The process of deinstitutionalization has made community integration a primary concern for these individuals. Many researchers recognize the significant lack of community resources that have been established in order to accommodate individuals with mental health issues in the community (Davidson, Hoge, Godleski, Rakfeldt, & Griffith, 1996; Pedlar, 1992). Researchers and practitioners alike, however, lack a thorough understanding of the factors that contribute to the successful and lasting community reintegration of older adults with mental health issues. The purpose of this study was to provide an in-depth analysis of the experience of community integration for older adults with mental health issues. The study was guided by the conceptual framework of phenomenology, focusing on the lived experiences of these individuals (Patton, 2002). Utilizing qualitative methods, data collection consisted of semi-structured interviews, oral member checks and the maintenance of a reflexive journal. Participants in the study were five older adults who had been diagnosed with a psychiatric disorder, had received treatment on an inpatient geriatric psychiatry unit, and had returned to their homes in the community upon discharge from the hospital. The findings suggest that being healthy and concomitantly maintaining independence played a key role in the process of community integration for these older adults. Independence, from the perspective of these individuals was quite different from the definitions of independence commonly used in North American society. The older adults in this study did not adhere to the principles of autonomy and individualism in relation to independence. Instead, they accepted a certain degree of dependence in order to prevent or avoid future disability, relapse, and readmission to hospital. A number of factors contributed to their independence, both positively and negatively, including: being healthy; social support; a smooth transition from hospital to community; maintaining feelings of self-worth; solitude; the power of knowledge; feelings of burden; and managing stress. These findings point to an emerging model of community integration that incorporates the concepts of empowerment, recovery, inclusion, and independence. The experience of independence, as described by these individuals, evoked feelings of empowerment and was strongly associated with the concept of recovery. For these older adults, being healthy, and thus, independent, meant being integrated. The findings, as well as the process of conducting this research, have lead to a number of recommendations for future research and suggestions for practitioners and policy makers involved with these older adults.

Introduction: Driver perceptions may be a more important determinant of behaviour than one’s actual driving abilities. While there is evidence to support these associations, prior studies have relied on self-reports of driving behaviour. Purpose: The primary purposes of this study were to extend previous research by examining driver perceptions in relation to measures of actual driving behaviour and to compare the perceptions and behaviour of sole versus couple drivers. Methods: A convenience sample of 61 older drivers (aged 67 to 92, 59% women) were recruited as either sole drivers (only driver in the household, n=39) or couples (both currently driving and sharing a vehicle, n=22). Two in-vehicle devices (one with a GPS unit) were installed in participant vehicles for one week. Participants completed trip logs, out-of-home activity diaries, questions on usual driving habits and ratings of situational driving frequency and avoidance. Perceptions were assessed using the Driving Comfort Scales (DCS Day and Night) and Perceived Driving Abilities (PDA) Scales. Couples were also asked to rate their comfort level in their partner’s driving using modified DCSs. Tools were administered at one of two home visits (during which vehicle devices were installed and removed) and an interview conducted at the end to ascertain whether the week’s driving was typical. Results: Driving comfort scores were significantly related to multiple indicators of actual driving behaviour, including: radius from home (DCS-D, p<.05; DCS-N, p<.01), total distance overall (DCS-N, p<.001) and at night (DCS-D, p<.05; DCS-N, p<.01). Perceived abilities, meanwhile, were related to distance driven (p<.01). Although sole drivers were significantly older, they drove more often, longer distances and for greater duration than couple drivers. Overall, men had higher DCS scores and, in couples, were more likely to rate themselves higher than their spouses. Partners’ comfort levels in their spouses’ driving were related to their spouses’ self-reported situational avoidance and amount of night driving over the study week. When couples drove together, traditional roles were evident (i.e., the husband often preferred to drive and the wife let him). Multivariate analyses showed that the square-root of distance (km) was most influenced by household status, location of residence, perceived abilities, and gender (R2 = .57), while the log of the average radius was influenced by location of residence and perceived comfort in night driving (R2 = .33). Conclusions: This was the first study to examine older drivers’ perceptions in relation to actual driving behaviour and to compare the perceptions and behaviour of sole versus couple drivers. Study results supported prior associations (with self-reported driving) and extended our knowledge base by demonstrating that perceptions (both personal and those of others) are important to actual driving behaviour. The current findings also provide new insight into the importance of examining location of residence and household status.

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.

It is difficult to think of any activity that does not require some degree of turning. Despite the prevalence of turning in daily activities and the challenge it poses to mobility-impaired individuals such as those with Parkinson’s disease, there is far less known about the multi-segmental control of turning than the control of standing and straight walking especially in elderly individuals and patient populations. The purpose of this thesis was to examine the coordination of body segment reorientation in healthy older adults and people with Parkinson’s disease (PD) during on-the-spot turns when standing and turns initiated when walking. The coordination of body segments was examined for small and large magnitude turns in both populations. PD participants were examined when “off” and “on” dopamine-replacement medication to determine the effects of medication on multi-segmental coordination when turning. The effect of walking velocity on the multi-segmental coordination of turning also was examined in healthy elderly participants for three different walking velocities. This research revealed differences in coordination patterns for standing versus walking turns and for healthy older adults versus persons with PD. Healthy older adults reorient their head, shoulder, and pelvis in unison, followed by mediolateral foot displacement, during standing turns. This coordination pattern was observed for both small and large turns. By contrast, turns initiated by healthy older adults while walking displayed a top-down temporal sequence similar to that reported for healthy young adults, i.e., the head turns first, followed by the shoulder and pelvis, and finally mediolateral displacement of the foot. This is a robust behavior which was not affected by the magnitude of the turn or walking velocity. PD participants (“off” and “on” medication) displayed temporal coordination patterns similar to age-matched healthy older adults for both standing and walking turns. However, PD participants (“off” and “on” medication) differed from healthy older adults with respect to the velocity and magnitude of reorientation of body segments, i.e., spatial parameters of coordination. The peak angular velocity of each body segment was significantly smaller for PD participants than the healthy older adults during both standing and walking turns; this was observed for both small and large magnitude turns. The magnitude of reorientation of each body segment was measured at the onset of mediolateral foot displacement; this measure revealed significantly smaller head and shoulder rotations for PD participants versus healthy older adults during standing turns, but not walking turns. Medication had no significant effect on the temporal or spatial parameters of body segment coordination during standing and walking turns. Medication increased the magnitude of head turn during the 90° standing turns; however, the magnitude of head turn remained smaller than that of healthy older adults. Multi-segmental coordination patterns differ for turns performed when standing (on-the-spot turn) versus when walking. The temporal parameters of these coordination patterns are not influenced by the magnitude of the turn or the velocity of walking and remain intact in Parkinson’s disease. Parkinson’s disease modifies the spatial parameters of coordination; reducing the velocity and early magnitude of reorientation of each body segment. These spatial parameters are not affected by dopaminergic medication.

Older adults represent a growing part of the population of the United States. Due to decreased physical activity, dietary changes, and alterations in metabolic rate this population is susceptible to an increased rate of diseases. The generation entering older adulthood is one which welcomed fast food and meal replacement foods allowing them to adapt to a more sedentary lifestyle and to need programs of preventative health. The Nutrition and Life Satisfaction Survey was used to investigate gardening as a preventative health intervention for older adults. This instrument was used to compare older (age 50+) gardeners and nongardeners on their perceptions of personal life satisfaction, nutrition, health, and gardening habits. The instrument was posted online at the Aggie Horticulture website in spring 2005. Respondents differentiated themselves as gardeners or nongardeners by responding positively or negatively to the question “Do you garden?” Then, they completed the questionnaire about their quality of life andhealth status and, for gardeners, their gardening habits. Results indicated that gardeners had more desirable responses: Overall quality of life scores were higher for gardeners compared to nongardeners, and four individual quality of life statements yielded more positive answers by gardeners. Additionally, gardeners reported a higher consumption of total fruits and vegetables, including herbs, and of vegetables only including herbs. Personal reports of physical activity and of perceived health were higher among gardeners. Females were more likely than males to garden and spend a higher percentage of their budget on fruits and vegetables. Higher consumption of fruits and vegetables and higher levels of physical activity result in healthier lifestyles and, in turn, can increase quality of life.

The purpose of the study is to investigate how older adults adjust to getting older and the losses that come with aging. This study examines how E.T. Higgins's theory of self-discrepancy mediates the relationship between role loss and subjective well-being. Subjective well-being (SWB) is defined as overall life satisfaction, the presence of positive affect and the absence of negative affect. This hypothesis, grounded in both self-discrepancy and life span developmental theory, is that the level of discrepancy between the actual and ideal self mediates the relationship between role losses and mental health. This study examined three models with each investigating how self-discrepancy mediates the relationship between role loss and a different outcome variable for each model: positive affect, negative affect, and satisfaction with life. The sample consisted of adults over the age of 60 living in both community and institutional settings. Several path analyses models were run to examine the tenability of the hypotheses within the three models. This study did not support any of its hypotheses of the indirect and direct effects mediation models with the outcome variables of positive affect, negative affect and satisfaction with life scale. However, it did show support for the self-discrepancy theory. Consistent with the theory, this study showed that those reporting more self-discrepancy reported less satisfaction with life, less positive affect, and more negative affect. This study also showed levels of SWB in non-clinical samples of older adults. This study supported the idea that more self-discrepancy is related to lower levels of SWB. This is important in a clinical setting to know for treatment of older adults suggesting that clinicians help their clients work towards less self-discrepancy and in turn, greater SWB.