Older adults have historically utilized mental health services at substantially low rates. Unfortunately, though professional, policy, and other recent developments portend an increase in service use, there has been scant empirical attention devoted to the current or recent utilization of mental health treatment by the elderly, and almost nothing is known about the correlates of mental health need and service use among older adults. Accordingly, the present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18- 64) adults throughout the United States, and the extent to which various factors predict mental health need and the use and magnitude of mental health treatment. In addition, the study examined factors related to unmet need, as well as age group differences in perceived benefit from treatment. The findings reveal that older adults were three times less likely than their younger counterparts to receive any outpatient mental health treatment. Only 2.5% of older individuals utilized any outpatient mental health service in the past year, versus 7.0% of younger adults. The results indicate that the low rate of utilization by older adults may be partly a function of limited subjective mental health need. Prevalence estimates for SMI and all specific mental health syndromes, with the exception of agoraphobia, were markedly lower in the older than the younger cohort. Importantly, though mental health problems appear to be significantly undertreated in older and younger age groups, the study also reveals that those older and younger adults that make it into services typically benefit considerably from treatment. It is hoped that the knowledge yielded by the current study will promote efforts to enhance mental health care access and reduce the long neglected mental health needs of the nation’s elderly population. Several factors related to mental health need and service use were identified in the study that may assist policy, planning, and outreach efforts aimed at increasing service access.

This study aimed to realize the relationship between learning styles and use of information communication and technologies (ICTs) of older adults in Taiwan, specifically how the learning styles of the elders predict their use of ICTs. Data was collected from a sample of 313 senior adults who are above 55 years of age in the senior centers in Kaohsiung City. The instrument of the Elders¡¦ Access and Use of ICT Questionnaire was developed by the author bases on Selwyn, Gorard & Furlong¡¦s Adult Learning @ Home Questionnaire 2002 and related literature. In addition, the researcher also investigated the learning style preferences using Kolb Learning Style Inventory. The findings from the research summarized as follows: (a) most of the participants were the ¡§Accommodators¡¨, (b) in terms of access and use of ICTs, the older adults had more access to communication technologies than to information technologies , (c) receiving the videio/visual informtation is the main activity when elders used ICTs (d) and there was a significantly positive correlation between concrete experiences/ active experimentation and their frequency of ICTs use while a significantly negative correlation between abstract conceptualization/ reflective observation and frequency of ICTs use. Specifically, (e) active experience is to the most significant predictor to the older adults¡¦ ICTs use. Recommendations were also provided based on the findings of this study. It is recommended the the government should encourage elders under 64 years old to use the ICTs, viewing them as important human resources and and provide assistance to retrain their IT skills . For the elders who were above 65 years of age, they should receive more opportunities to access ICTs and develop positive attitudes towards the use of ICTs. Results from this study provided suggestions and implications to the government, institutions and organizations on ICT policy implementations to make elders become productive human resources, and to help them age productively to achieve self-realization for the purpose of life long learning.

While it is now understood that long-standing hypertension is predictive of later cognitive decline and risk for dementia, little research attention to date has focused on whether the short-term dynamics of blood pressure exert immediate influence on cognitive functioning. The present study contributes to this growing field with a conceptual replication and extension of work by Gamaldo, Weatherbee and Allaire (2008). A sample of 27 older adults (M=70.2 years) completed daily assessments of blood pressure, psychological stress and cognitive functioning for 14 consecutive days. Multilevel models conditional on demographic factors were applied to simultaneously estimate between- and within-person effects across three metrics of blood pressure (systolic, diastolic and pulse pressure) and five measures of cognitive functioning. To follow a suggestion proposed by Gamaldo et al., the model was extended to include main effect and blood pressure interaction terms for stress at both levels. In secondary analyses, within-person mediation models were applied to explore blood pressure as a mediator between stress and cognition. Results from the first model demonstrated a direct, positive association between occasion diastolic pressure and episodic memory. A cross-level interaction term revealed that processing speed was impaired on high-diastolic pressure days for those with high diastolic pressure on average. We found no evidence that occasion blood pressure mediated the association between stress and cognition. Overall, our results align with the hypothesis that age-related changes to vascular structures impair the carrying capacity of blood vessels and that occasions of increased blood pressure provide additional force to overcome these limitations, delivering larger quantities of blood and oxygen to cerebral tissue. We conclude that upward fluctuations in diastolic pressure may be cognitively beneficial for older adults; diastolic pressure is the most sensitive metric for detection of within-person associations with cognition; and episodic memory and processing speed exhibit sensitivity to occasion blood pressure levels. / Graduate

Numerous researchers have explored the benefit of creative activities for the aging population diagnosed with dementia. However, there is a lack of data available to community administrators and organizers of senior residences about how successful aging may be enhanced, in the relatively healthy older adults, through their participation in creative art-making. Activities that provide mental stimulation, facilitate expression of emotions, and that are related to overall psychological well-being can provide a foundation for healthy aging. Accordingly, the purpose of this study was to explore older adults' subjective experience of engaging in creative artwork. The conceptual framework that guided this phenomenological study was based on Lazarus's cognitive-emotional-relational theory of emotions. The focus of the research questions was on the subjective experience of 10 older adults who participated in 7 weekly art sessions offered at a senior residence. Audiotaped interviews that were held after the last art-making session, together with participants' artwork and field notes, were analyzed, coded, and then categorized into themes. Results indicated the participants learned they can be creative, and that their images became a visual inroad to meaningful expression of emotions, insight, and motivation. The results point to evident social change when community organizers and administrators of senior residences increase activities for residents, especially meaningful activities designed to facilitate expression of emotions and insight during later life. Creative image-making activities can lead to continued learning, heightened social interactions, increased mental fitness, reduced depression, and enhanced healthy aging.

The purpose of this study was to investigate physical activity (PA) engagement among older adults (OA) following discharge from a medically supervised group exercise program and to explore the facilitators and barriers that influenced maintained PA engagement. While facilitators and barriers to PA among OA in general have been well documented, facilitators and barriers particular to maintaining PA after discharge from a supervised exercise program have not been widely explored with qualitative methods or a mixed method design. Data for this mixed method, case study approach were collected in two phases. In Phase I, questionnaires were used to investigate PA engagement as well as semi-structured qualitative interviews were completed (n = 12; Mage = 80.0 years) to explore facilitators and barriers that influenced PA engagement. In Phase II, reviews of medical charts were conducted retrospectively to gather further information on PA engagement and barriers (n = 12). All 12 individuals in Phase I remained engaged in PA activity 2 – 48 months post completion of the medically supervised exercise program. This particular group of OA identified facilitators for and barriers to maintaining PA that were personally-, socially-, and program-based, and also provided suggestions to alleviate cited barriers. Four themes identified in regards to PA engagement were: (1) Personal drive: highly aware of the need to keep moving; (2) Social connections and support: we all need people; (3) Program components matter; and, (4) Convenient, Affordable, Relevant: suggestions to improve program access. The power of multi-level, multi-sector approaches that consider the broader determinants of health was highlighted in this study. Participants identified the need for health care providers (HCP) and PA instructors to continue to communicate the benefits of PA, the importance of ongoing HCP support, and the necessity of working across sectors to reduce program related barriers to promote PA engagement among OA discharged from a medically supervised exercise program. / Graduate / melodyburgoyne@hotmail.com

4 pp. / Regular physical activity is essential for healthy aging, and most adults aged 65 years and older can safely participate in regular physical activity. This article reviews the benefits of physical activity in older adults and provides updated physical activity recommendations and tips for how to start and how to stay active for life.

Many older adults residing in long term care (LTC) homes have underlying health conditions and limited functionality. The objective of this research was to address the issues which might affect the health status and functionality of older adults (age ≥ 60y) living in LTC homes. To achieve this objective, the research was carried out as four studies. In the first study, supplement and medication use was examined, specifically exploring the impact of dementia, and to assess pill burden in older adults residing in LTC home. In the second study, menu served in this LTC was assessed for recommendations of Canada’s Food Guide servings, macro, micro nutrients, and diet quality score. This menu analysis was compared to a similar analysis conducted a decade ago to find out what changes had occurred over time. In the third study, LTC residents were assessed for blood inflammatory markers, 25-hydroxyvitamin D (25(OH)D), metabolic syndrome, physical functioning, cognition, pain, and associations between inflammation and markers of functionality. Similar analyses on healthy community dwelling older and younger adults was conducted to draw differences amongst all three groups, i.e., older frail (LTC residents), older healthy, and younger healthy (community dwelling). In the fourth study the option of adding an anti-inflammatory diet was explored to address the issues of inflammation and compromised menus in LTC. Major findings suggested that there was inappropriate overuse of supplements, yet vitamin D supplements were consumed by only one-third residents of the LTC home. The LTC menu did not meet the recommendations for Canada’s Food Guide servings except for Fruits & Vegetables. Diet quality of the LTC menu was low and indicated the need of improvement, however, the comparison of current menu to a decade old menu showed some improvements. Inflammatory markers in LTC older adults were high, and the majority of subjects had insufficient 25(OH)D. Metabolic syndrome was seen in about more than one-third of subjects. Significant correlations between C-reactive protein, cognition and activities of daily living were detected. The anti-inflammatory diet was validated from research, and strategies of incorporating it into the diets of LTC residents were addressed.

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Little is known about the impact of senior multipurpose facilities on the quality of life of African American elders. This thesis examined the context of African American elders’ participation in these facilities. Qualitative methods were used. Fifteen in-depth participant interviews, one facility program coordinator interview and eighteen weeks of participant observation were completed. The principles of grounded-theory method were used during data analysis. Findings reveal that racial experiences played an important role in participants’ sense of community. Female and male participants engaged in different types of activities. While some participants reported physical improvements, all participants recounted social and emotional benefits as a result of participation. Participation at the facility facilitated the construction of new self identities. This study increases the knowledge of African American seniors’ participation in senior multipurpose facilities. It also provides data to generate research questions for future comparative studies in predominantly black and white senior multipurpose facilities.