This systematic review aims to investigate the effects of aerobic exercise on the neuroal basis of memory functions in healthy elderly individuals. The search was conducted in accordance with PRISMA and covered three electronic databases, namely PubMed, Scopus, and Web of Science, for peer-reviewed published, and original research. Six studies met the inclusion criteria and were included in the review. The studies utilized various behavioral or cognitive tasks related to memory, including the Sternberg Working Memory Task, Spatial Memory tests, and neuroimaging techniques such as magnetic resonance imaging (MRI). This systematic review suggests that aerobic exercise can improve memory in healthy elderly individuals, including spatial, working, and short- and long-term memory. As revealed by neuroimaging techniques, memory function improvement was accompanied by changes in brain structure and function in memory-processing regions. These findings provide evidence that aerobic exercise can improve the neurological basis of memory function in healthy elderly individuals. The beneficial effects of aerobic exercise on memory have significant implications for the aged population. Memory loss is a common and often debilitating issue in older adults, and the ability to recall and learn new information is crucial for maintaining independence and quality of life. Therefore, aerobic exercise is a promising intervention to improve memory function in healthy elderly individuals.

The purpose of this study was to investigate the effects of Tai Chi exercise on motor skills in older adults residing in independent living. Twenty-eight self-ambulatory older adults (age: 77 8.92; male: N = 1, female: N = 27) with no serious or restrictive health conditions, MMSE score 21, or recent surgery, completed this study. Participants engaged in one-hour biweekly Tai Chi exercise or BINGO sessions for eight weeks. Fine and gross motor skills were tested at four time-points throughout the study. Repeated measures 2x4 [2(Tai Chi exercise x BINGO) x 4(Baseline x Intraintervention x Post x Retention)] RM ANOVA was used with alpha of 0.05. Significant differences noted in fine motor function tasks (nondominant > dominant hand), and for the 6MWT, suggesting that Tai Chi exercise or BINGO may help older adults to perform activities of daily living, maintain independency, and gain a better quality of life.

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This thesis includes three manuscripts with an overarching objective to improve understanding of behavioural risk factors for falling in community-dwelling older adults. The first manuscript presented in Chapter two, presents a protocol for a scoping review. The objective of this scoping review was to highlight the current methods used to identify fall-related risk-taking behaviours in community-dwelling older adults, and to identify factors that might contribute to these behaviours. The second manuscript (Chapter three) presents the results of the scoping review written in the format for publication. The review identified older adults are generally aware of their own falls risk and engage in protective behaviours to reduce their risk of falling. Older adults engaged in risk-taking behaviours based on the potential benefits outweighing perceived risk of the behaviours. An individual’s abilities, self-perception, personal values, and the environment likely influence the perception of risk which contributes to risk-taking behaviours. The third manuscript (Chapter four) includes the analysis of clinical data from a community-based multi-component fall prevention program – the Building Balance Program. Individuals who participated in this six-week fall prevention program improved in balance ability, lower extremity muscle strength, mobility, and reduced fear of falling from baseline. Fear of falling (FoF) was the highest amongst the youngest participants despite having better physical function at the outset of the Program. This suggests that in addition to physical function, other factors, like psychological and social factors may be involved with FoF. / Thesis / Master of Health Sciences (MSc) / Falling is very common for older adults. Falling can lead to injuries and long-term side effects like fear of falling. Community-based exercise programs are a cost-effective way to help large groups of older adults reduce their risk of falling. Exercise programs can reduce older adults’ risk of falling by improving their balance and muscle strength. But exercise might not be enough to prevent falling in older adults. Falls can happen for various reasons, such as the activities or behaviours in which the individual participates. This thesis includes two studies presented in three papers aimed to better understand behavioural components which may be associated with falls. The results of this research suggest there is a psychological and social component involved with falling. The findings from this thesis highlight the importance of a holistic approach to and may help to inform the development of comprehensive interventions for fall prevention.

Fall risk among older adult is a worldwide public health problem. As the older adult population is continuing to increase, addressing this issue is critical. Several fall risk assessment tools have been designed to help predict various risk factors. Among these assessment tools is the Hendrich II Fall Risk Model (HIIFRM). This tool uses evidence-based risk factors including mental status, sex, functional status, and whether the patient is taking antileptics and/or benzodiazepines. The purpose of this paper is to validate the HFRM, explore additional variables that increase the likelihood of falling including both past falls and the number of prescription medications a patient is taking. Our findings validate the HFRM; with each additional point on the HFRM score, holding all other explanatory variables constant, the odds of having multiple previous fall-related admissions increased by 38.3% (P < 0.001). The strongest predictor of future falls was previous falls. With confounders held constant, each additional previous fall predicted a 3.9-fold increase in the odds of experiencing a future fall (p < 0.001; 95% CI of OR: 3.131 to 4.961). When looking at prescription medications, for each additional increase in prescription medications, we observe a 11.8% increase in the number of falls experienced during the tracking period (p<0.001; 95% CI of IRR: 1.084 to 1.170). Although a validated tool, our research indicates additional variables that could further enhance its effectiveness.

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Healthy individuals can adjust their movements when changes arise to the body or the environment. Advanced age is associated with central and peripheral changes that may negatively impact one’s ability to adapt motor performance, such us upper-limb (UL) reaching movements. In this thesis, we conducted four studies to address the impact of aging on coordination and adaptation of goal-directed reaches. In the first experiment, we examined compensatory arm–trunk coordination in older adults during trunk-assisted reaching, using two motor tasks : 1) the Stationary Hand Task (SHT) in which older and young participants were asked to maintain a fixed hand position while flexing forward at the trunk, and 2) the Reaching Hand Task (RHT) in which participants were instructed to reach to a within-arm’s reach target while simultaneously flexing forward at the trunk (Raptis et al., 2007; Sibindi et al., 2013). We found that in SHT, young and older participants were able to maintain a stable hand position and compensate for trunk movement by appropriate angular rotations at the elbow and shoulder joints. As well, in the RHT, both groups made similar small overshoot errors. However, older participants performance was significantly more variable compared to young adults. These results suggest that older adult preserve their ability to coordinate arm and trunk movements efficiently during reaching but are not as consistent as young adults. In the second experiment, we sought to determine the ability of older adults to adjust shoulder and elbow coordination in response to changing task demands. Thus, we asked young and older adults to perform the RHT of Raptis et al. (2007) from the first experiment. A detailed comparison of UL kinematics during reaches in the presence and absence of trunk motion (i.e., free- vs. blocked-trunk trials) was performed and compared between young and older adults. We found that participants in both age group were able to coordinate motion at the elbow and shoulder joints in accordance with motion at the trunk. However, the extent of changes at the UL joints was smaller and more variable in older adults compared to young ones, especially when trunk motion was involved. These results imply that older adults can coordinate their UL movements based on task requirements, but with less consistent performance compared to young adults. In the third experiment, we investigated the preservation of intermanual transfer and retention of implicit visuomotor adaptation in older adults. We had young and older participants train to reach with visual feedback rotated 30° counter-clockwise relative to their actual hand motion. Furthermore, we examined whether providing augmented somatosensory feedback regarding movement endpoint would enhance visuomotor adaptation. We found that older adults demonstrated a comparable magnitude of implicit adaptation, transfer, and retention of visuomotor adaptation as observed in young adults, regardless of the presence of augmented somatosensory feedback. These results indicate that intermanual transfer and retention do not differ significantly between young and older adults when adaptation is driven implicitly, regardless the availability of augmented somatosensory feedback. In the fourth experiment, we looked to determine age-related differences in the engagement of offline and online control processes during implicit visuomotor adaptation. A detailed analysis of reaching performance was conducted and between young and older adults, during and after visuomotor adaptation. We found that when rotation was introduced, participants in both age took longer time to complete their movements, reached with a lower peak velocity and spent more time homing in on the target compared to reaches with aligned cursor feedback. Additionally, older adults had more curved paths with rotated cursor feedback compared to their reaches with aligned cursor feedback. Moreover, these changes in reaching performance continued following adaptation for both groups. These results suggest that young and older adults engage more in online control processes during implicit visuomotor adaptation. Together, these studies show that older adults: 1) maintain the ability to use compensatory arm-trunk coordination to maintain reaching accuracy, 2) preserve the ability to adjust the coordination between UL joints to meet task demands, 3) maintain the ability to adjust reaches to meet changes in the reaching environment, as well as transfer and retain the newly acquired movement, and 4) preserve the ability to modify the control processes underlying these adapted movements to meet the demands of the reaching environment. In conclusion, the flexibility to coordinate and adapt upper limb reaching performance to meet changes in task demands is maintained across lifespan.