The importance of economic and social capital for health has been well-documented. However, their impact on age-related differences in health is less clear. To address this issue, this study examined the impact of several individual level indicators of economic and social capital on selected health outcomes in middle and later life. Data for the analysis were drawn from the 2008 General Social Survey (Cycle 22) conducted by Statistics Canada. Using a study sample of those aged 45 and over (n=12,135), multivariate regression analyses assessed main, mediating and moderating effects of economic and social capital measures on chronic conditions, health or activity limitations, and self-reported health. The findings indicated that individual level economic capital and structural social capital were positively associated with health status in middle and later life. In addition, the findings revealed the importance of both bonding and bridging forms of social capital in middle and later life. As well, the findings suggest that individual level structural social capital is a more upstream social determinant of health than economic capital in middle and later life as economic capital was found to mediate the social capital-health relationship, but not vice versa. Lastly, no evidence was found for an individual level interaction between economic capital and structural social capital in middle and later life. The theoretical, empirical, and policy implications of these findings are outlined. / Graduate / 2013-12-14

Title: What explains variability in blood pressure readings? Multilevel analysis of data from 8,731 older adults in 20 Ontario Communities Objectives: Despite universal healthcare and drug coverage for adults aged 65 and over in Ontario, hypertension, a treatable condition, remains uncontrolled among many older adults. Moreover, there are geographic disparities in blood pressure and hypertension within and across Canadian provinces and territories. Using baseline data collected on 8,731 older adults participating in the Cardiovascular Health Awareness Program (CHAP) in 20 randomly selected Ontario communities, we investigated associations between systolic blood pressure (SBP) and individual- and community-level characteristics, controlling for self-reported use of blood pressure medications. Method: Older adults were recruited via invitation by local family physicians, public advertising and word of mouth to attend community pharmacy sessions. During the sessions, trained older adult volunteers assisted participants to complete a cardiovascular disease risk factor questionnaire and blood pressure assessments using an automated blood pressure measuring device. The Postal Code Conversion File Plus was used to confirm residence within one of the 20 study communities. A multilevel linear regression analysis with participants nested within communities was used to determine which individual- and/or community-level characteristics were associated with measured systolic blood pressure level controlling for self-reported use of blood pressure medication. Results: 4,706 participants (53.9%) reported the use of blood pressure medication. Mean systolic blood pressure (SBP) levels varied among the 20 communities from 128.1 mmHg to 134.7 mmHg for participants not using blood pressure medication and from 131.9 mmHg to 139.0 mmHg for participants using blood pressure medication. The intraclass correlation coefficients were very small: less than 0.2% of the total variance was between communities. Among participants not using blood pressure medication, SBP was associated with the following individual- level characteristics: age, sex, body mass index , smoking, physical activity, stress, fruit/vegetable intake, and alcohol consumption and the following community-level characteristics: community size, community growth and the Rurality Index. Among participants using blood pressure medication, SBP was associated with the following individual-level characteristics: age, sex, body mass index, diabetes, fruit/vegetable intake, alcohol intake and one community-level characteristic: community size. The significance and magnitude of these associations were modified by the use of blood pressure medication. Conclusion: The majority of the variability in blood pressure occurs at the individual-level. There are specific individual- and community-level factors that explain variability in blood pressure readings among communities. These results can be used to inform health promotion strategies to decrease mean levels of blood pressure among older adults.

Persons 65 years or older are the fastest growing demographic in Canada (Government of Canada, 2011) and the need for 24-hour care and LTC support will continue to rise. An association is typically drawn between death and dying and the movement into LTC homes. Leisure can alternatively be important for promoting “living” and supporting wellness in residents. The notion of “living” in LTC shifts emphasis away from illness and death to placing value on wellness. This participatory action research (PAR) study aims to understand wellness from residents’ perspectives and the role leisure plays in their wellness. PAR stakeholders (family/care partners, staff, and residents) collaboratively discuss how to best attain, interpret, and disseminate resident perspectives on wellness and required supports. The PAR process highlights the necessity for academics and practitioners to involve residents in decisions about their care experience. Guiding questions include: (1) What does wellness mean to residents living in LTC? (2) What does a ‘well’ LTC home look like to residents? (3) What is the nature of the relationship between leisure and wellness from a resident perspective? (4) How can those involved in LTC support resident wellness? From the perspectives of residents living in LTC homes, findings inform a resident wellness model and provide insights into how wellness and “well” LTC homes can be better supported. Thus, filling a gap in the literature and shifting focus to living ‘well’ in LTC.

Fall-related injuries in adults over the age of 65 pose an important public health issue especially with an increasing number of older adults living in retirement homes and nursing homes. Safety floors have been developed as an intervention to reduce the risk of these injuries. However, their effects on balance control reactions had never been tested during certain activities of daily living in retirement home dwellers. This research investigated how balance reactions are affected by the mechanical properties of safety flooring in older adults. The safety flooring showed minimal impact on the balance reactions while retaining force attenuation properties. There were two studies as part of this thesis. The purpose of the first study was to determine whether the Nintendo Wii Balance Board (WBB) can be used as an appropriate substitution for a force plate when measuring balance reactions during common tests used to assess balance in older adults. Specifically, I characterized the technical specifications of the WBB and compared them to those of the force plate, showing that the two devices yielded similar responses during balance measures of quiet stance. The second study investigated the effect of two traditional floors and three safety flooring systems on balance control mechanisms (based on changes in underfoot centre of pressure) during sit-to-stand and quiet stance tasks in retirement home-dwellers. The results of this study provided evidence supporting the potential for safety floors to reduce fall-related injury risk without impairing balance and mobility of users. Additional research may want to assess WBB performance during dynamic tasks involving shear forces. The results from this study supports prospective clinical investigations of pilot installations of safety flooring in retirement and nursing home settings to evaluate their real life effects on fall related injuries.

The purpose of the present study is to investigate the efficacy of a reminiscence group counseling program on the life satisfaction of older adults aged 60 years and over. In the first phase of the study, 70 older adults (39 women and 31 men, M = 77 years old) residing at a retirement home in Ankara were administered the Life Satisfaction Index A (LSIA), and a demographic information sheet. In the second phase of the study, volunteering older adults were screened for a researcher-designed &ldquo / Reminiscence Group Counseling Program&rdquo / . An experimental matched-pairs design was used in the study. The group program was composed of six sessions aimed at reminiscing about pleasant memories, past accomplishments, and joyful past experiences. Session themes included place of birth, recall of childhood pastimes, holidays, life accomplishments, and favorite places. Participants in the treatment group were five older adults (three women and two men) aged 62-78 (M = 68). Following treatment, subjects in the treatment and no-treatment control groups were compared at pre- and post-test measures of life satisfaction. A focus group interview was also conducted in order to evaluate the participants&rsquo / group experience. Results of Mann-Whitney U Test and Wilcoxon Test revealed non-significant increases in the life satisfaction scores of older adults in the treatment group. The focus group interview elicited positive feedback regarding members&rsquo / group experience, such as group&rsquo / s role in facilitating interaction and friendship among participants, enhancing a more positive self-image and leading to enjoyment and pleasant feelings for them.

Future advances in technology may allow home-based robots to perform complex collaborative activities with individuals of different ages. Two studies were conducted to understand the expectations of and attitudes toward home-based robots by younger and older adults. One study involved questionnaires sent to 2500 younger adults (aged 18-28) and 2500 older adults (aged 65-86) in the Atlanta Metropolitan area. One hundred and eighty questionnaires were completed and returned by individuals in the targeted age groups. For the questionnaire, participants were asked to imagine a robot in their home and then to answer questions about how well characteristics matched their imagined robot. Participants' technology and robot experience, demographic information, and health information were also collected. In conjunction with the questionnaire study, twelve younger adults (aged 19-26) and twenty-four older adults in two sub-age groups (younger-older, aged 65-75, and older-older aged 77-85) were interviewed about their expectations of and attitudes toward a robot in their home. They were asked to imagine a robot in their home and answer numerous questions about the tasks their envisioned robot would perform, the appearance of the robot, and other general questions about their interaction with the robot. The results of the studies suggest that individuals have many different ideas about what a robot in the home would be like. Mostly, they want a robot to perform mundane or repetitive tasks, such as cleaning, and picture a robot as a time-saving device. However, individuals are willing to have a robot perform other types of tasks, if they see benefits of having the robot perform those tasks. The ability of the robot to perform tasks efficiently, with minimal effort on the part of the human, appears to be more important in determining acceptance of the robot than its social ability or appearance. Overall, individuals both younger and older seem to be very open to the idea of a robot in their home as long it is useful and not too difficult to use.

Background: Older adults experience health deconditioning during hospitalization. There are many facets of care impacting on older adults' health characteristics and their self confidence in managing their health. The aim of this follow-up study is to examine the long term effect of comprehensive discharge planning and nursing in-home follow-up for older adults (over 65 year old) incorporating physiotherapy exercise strategies on health characteristics. No published studies were located that had examined the impact of a comprehensive discharge program on the functional status and psychosocial among older frail adults at 12 months post-discharge. Design and methodology: Rehabilitation in Older People (RIO program) is a randomised controlled trial which evaluates the intervention of a comprehensive discharge program, exercise program incorporating nursing follow up. Participants of the RIO study were randomly allocated into usual care control group and an intervention group. The intervention group received a comprehensive training from an advanced practice gerontic nurse (APGN) and exercise strategies by physiotherapists. The APGN visited the participants in their home 48 hours post discharge, followed by telephone follow-up at 4, 8, 12 and 24 weeks. This study followed-up this cohort at 12 month via telephone interviews to evaluate their functional ability, quality of life, psychosocial characteristics and the levels of self-efficacy. The General Self-efficacy Scale (GSE) was used to measure their self-efficacy. Results: There is no difference between the demographic and health characteristics between the control and intervention group. There are significant difference in their functional ability, psychosocial health, measured by the tools mentioned above at 4 weeks (p < 0.05), 12 weeks (p < 0.05), and 24 weeks (p < 0.05), but not at 52 weeks. The possible reason could be due to lack of telephone follow up. Moreover, the levels of self-efficacy in this sample have been found to correlate with the functional ability and psychosocial at 12 months after discharge from an acute hospital.

At the intersection of adult education and social gerontology, and propelled by the ageing phenomenon, educational gerontology has a critical place in the study of older adult education. To contend with older learners' needs, professional adult educators require an enhanced preparation, and concomitance to a reinvigoration of current adult learning programs to include the constructs of educational gerontology and the geragogical imperative. Through survey and interviews, this research investigated evidence of, and the capacity for, Australian Adult Education programs and Ageing Research centres to meet this requirement. Results of this case study indicate a paucity of evidence of educational gerontology in adult education programs, coupled with significant potential for capacity development in this field through collaboration with Ageing Research initiatives. The findings suggest an expansion of current curriculum in adult education programs to include aspects of educational gerontology, professional development of Adult Education academics in the specialized area of educational gerontology, and broader adult education engagement with external stakeholders and the ageing research community as a contribution to social betterment.

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2005. / Title from first page of PDF document. Document formatted into pages; contains [1], iii, 36 p. Includes bibliographical references (p. 30-31).

Thesis (M. of Gerontological Studies)--Miami University, Dept. of Sociology and Gerontology, 2005. / Title from first page of PDF document. Document formatted into pages; contains [1], v, 60 p. Includes bibliographical references (p. 53-60).