The purposes of this study were to: 1) determine absolute intrarater reliability of using the cervical range of motion device (CROM) for measuring cervical movements in older adults, and 2) determine the intrarater reliability and concurrent validity of the Candrive protocol, which uses a universal goniometer to measure rotation. Forty older adults (75.7 + 4.7 years of age) were tested in two sessions, one week apart, by two raters. Intrarater reliability scores were good for the CROM protocol (coefficient of variation (CV) values were 5.5% and 6.2 % for cervical rotation). The Candrive protocol values were higher (CV = 7.9 and 9.4%). Concordance analyses suggested that the Candrive protocol was less than good in terms of its validity, particularly when order effects were taken into consideration. In conclusion, the CROM protocol demonstrated good reliability for either group or individual analyses, whereas the Candrive protocol was less reliable and its validity marginal.

During the past decades there has been an increase in longevity. These aging trends have an enormous economic impact and present challenges to policymakers, families, and health care providers to meet the needs of aging individuals. Aging is accompanied with various physiological changes that can limit the elderly’s functional status and their independency. Some of the most noticeable changes occur within the musculoskeletal system, however cardiorespiratory changes, as well as changes in the body composition limits the elderly’s aerobic capacity and therefore increases the risk for cardiovascular and hypokinetic diseases. Moderate physical activity reduces the risk, or prolong the onset of physiological changes and various diseases. Physical activity can also enhance functional fitness amongst the elderly. Functional fitness is having the physiologic capacity to perform normal everyday activities safely and independently without undue fatigue. The aim of this study was to determine the functional fitness as well as static balance and dynamic balance status of senior citizens. Secondly, to determine the association between: physical activity, aerobic endurance and functional fitness and status amongst senior citizens. Thirdly, to determine the association between physical activity status, aerobic endurance and static– and dynamic balance amongst elderly. A once off subject availability study was performed, and 58 senior citizens (32 females and 26 males) between the ages of 65 years and 96 years participated. The physical activity index was determined with the Sharkey and Gaskill Physical activity index questionnaire. Functional fitness was measured using the Rikli and Jones Fullerton’s functional fitness test protocol. The static balance and dynamic balance was tested with the one leg balance eyes closed and functional reach test respectively. Descriptive statistics were used to describe the status of the participants. Two way summary tables were used to categorize the amount of weak test results. Partial correlations were used to determine the association between physical activity, functional fitness and static and dynamic balance. The male participants’ functional fitness status compared well with USA normal ranges, however the functional fitness test scores of the female participants were even lower than the older age group (75 to 79 years) of the USA normal ranges. The results of the frequency distribution indicated that 80.77% and 68.75% of the male and female participants respectively, tested poorly in more than four of the functional fitness tests. Neither the male nor the female participants’ static balance score were adequate, although it does not indicate a fall risk. Aerobic endurance showed to have medium (r = 0.3–0.49) to high (r 0.5) partial correlation with all functional fitness tests for the total group, as well as in the female participants. In the male participants aerobic endurance only showed high correlation (r 0.5) with lower body strength and dynamic balance and agility. Dynamic balance correlated well (r 0.5) with all functional fitness tests as well as aerobic endurance and physical activity index in the female participants, and only showed a medium correlation with agility in the male participants. This study showed alarming percentages of poor test results for both male and female senior citizens and highlights the need for physical activity interventions in old age homes. The correlations between aerobic endurance, as well as dynamic balance and functional fitness tests indicates that even simple interventions such as walking programs could enhance the functional fitness of senior citizens and thereby increase their independency. / Thesis (M.A. (Biokinetics))--North-West University, Potchefstroom Campus, 2011.

Using a basic interpretive qualitative research design, this study explores adult musicians’ reflections of participation in wind band as a health promoting activity. Five male participants between the ages of 58 and 76 participated in semi-structured interviews and provided basic demographic information. Data were analyzed thematically and findings represented evocatively. Elements of a wind ensemble were used as a metaphor to provide a rich way of presenting the data as fundamentally tied to the specific act of making music in a wind ensemble. The three main components of the metaphor and the main themes they present are: Instrumentation: Defining Roles (Purpose), Sound: Making Meaning (Physical and Emotional Well-being), and Performance: Extending Self (Challenge, Accomplishment and Connection). The current findings contribute to furthering knowledge and research in the area of music making and health, especially wind ensemble playing participation and healthy aging. Implications for both practice and future research are identified.

本研究以幸福感作為成功老化的指標，試圖探究高齡者本身的感恩性情及正向回憶形式對其幸福感的影響。 研究一採「個別差異」的觀點，研究者認為相較於一些隨著老化而改變的生活狀況變項（如，身體健康、日常生活功能、經濟狀況、社交活動等因素），高齡者本身的感恩性情及正向回憶形式應更能影響其自評幸福的程度。研究者主要以調查法的方式，對355名55歲以上的高齡者進行團體或個別形式的量表施測。研究結果顯示，感恩性情及正向回憶形式的確與幸福感有密切的關聯，即使在控制基本人口及生活狀況變項的影響後，感恩性情及正向回憶形式仍有助於提升個體的幸福感（其可增加的預測變異量介於6.0%~9.6%）。研究一也將幸福感的三個成分（生活滿意度、正向情緒及負向情緒）分別做為依變項，進一步探討可能的中介模式，結果發現：（1）「正向回憶形式」能完全中介感恩性情對正、負向情緒的影響，但僅能部分中介感恩性情對生活滿意度的影響。而（2）「感恩情緒」則能完全中介感恩性情對正向情緒的影響，但僅能部分中介感恩性情對生活滿意度的影響，卻完全無法中介感恩性情對負向情緒的影響。此外，正向回憶形式與感恩情緒兩中介變項各有其獨特的中介效果，無法相互取代。 研究二則採取實驗法的方式進行，用以檢視感恩情緒與幸福感的因果關係。受試者為75名參與終身學習的高齡者，研究者嘗試以不同感恩情緒的激發方式，來設計適合於高齡者的幸福感提升方案。有些高齡者被要求聚焦在現在生活中的感恩經驗（日常感恩組），有些則是寫出過去生命裡的感恩事件（人生感恩組），研究者認為當高齡者在回憶書寫這些感恩經驗時，可再經驗及品嚐感恩情緒。另有兩組高齡者則分別被要求書寫現在生活中的重要事件（日常要事組）或僅單純回答問卷、不進行其他書寫（無操弄控制組）來做為對照組。研究者對這些不同組別，分別進行分析，探討這些不同操弄對高齡者幸福感是否有提升的作用。研究結果顯示，經過七週的書寫後，相較於「無操弄控制組」，「日常感恩組」在正向情緒上有提升的現象，但在生活滿意度及負向情緒則未出現明顯差異。進一步分析顯示，幸福感中正向情緒的提升效果完全透過感恩情緒連動正向情緒而得。然而該效果頗為短暫，在研究結束後於一個月所做的追蹤調查就發現該效果已然消失。研究結果也顯示，「人生感恩組」並未能提升幸福感，其可能的原因或許是因為過去人生的感恩經驗已經太過遙遠，因此無法讓高齡者真正再次經驗到感恩情緒，所以也無法有效地提升個體的幸福感。另外，研究者也發現了一個頗為有趣的結果，就是「日常要事組」造成的影響與「日常感恩組」相似，研究者認為之所以會出現這樣的結果，主要是因為「日常要事組」的受試者其所書寫的「要事」多半為正向事件，因此提高了其幸福的感受。 綜合上述兩個研究的結果，研究者認為，感恩及正向回憶形式對高齡者是否能有較佳的幸福感確實有一定程度的影響，且若能引導高齡者多注意其日常生活中值得感恩的事情或是正向事件，將能使其感受到更多的正向情緒，也有助於幸福感的提升。換言之，即使到了老年階段，只要用對了方法，要擁有幸福快樂的銀髮生涯其實並不難！ / This research, adopting positive emotion, negative emotion, and life satisfaction as the criteria of subjective well-being, tried to examine the effects of grateful disposition and the positive type of reminiscence on successful aging. In study1, the researcher proposed that grateful disposition and the positive type of reminiscence, among other life situation variables which changed with age (e.g., health condition, functions of daily life, economic status, and social activities), could predict the well-being of the elderly. Three hundred and thirty five participants who are over the age of 55 were surveyed in groups or individually. The results were as predicted, grateful disposition and the positive type of reminiscence could predict the well-being of the elderly, even after controlling for some basic life situation variables, they still could explain 6.0% and 9.6% of variance respectively. The mediation effects were also examined and results indicated that, (1) "the positive type of reminiscence” could completely mediate the effects of grateful disposition on positive and negative emotion, but only partially mediated the effects of grateful disposition on life satisfaction; (2) “grateful emotion” completely mediated the effect of grateful disposition on positive emotion, and partially mediated the effect of grateful disposition on life satisfaction, but did not mediate the effect of grateful disposition on negative emotion. Furthermore, these two mediator variables, the positive type of reminiscence and grateful emotion, had its own specific mediating effect, and could not replace each other. In Study 2, an experiment was conducted to examine the causal relationship between grateful emotion and well-being of the elderly. Seventy five elders who actively participated in life-long education classes were recruited. They were assigned to one of four different experimental conditions and received different instructions. The first condition was called the daily gratitude condition and participants were told to write down the grateful experience from their current daily lives. The second condition was called the life gratitude condition and participants were asked to recall the grateful events from their past. Participants in the third condition were told to write down their daily important events. In the last condition, which is also the control condition, participants were asked to fill up questionnaires only. The results indicated that, after seven weeks of writing, the elderly in the daily gratitude condition had significant more positive emotion than those who in the control condition. However, the effect was quite short-lived and it disappeared one month later after the writing manipulation. The results also indicated that writing down grateful events from the past did not enhance the subjective well-being, the elderly in the condition showed neither significantly higher positive emotion nor higher life satisfaction than those who in the control condition. It might be because these events were too far away to elicit the present emotion and feeling effectively. In addition, the result also revealed an interesting finding about the daily important events group. The elderly in this condition showed same degree of positive emotion and well-being as those who in the daily gratitude condition. It might be due to the fact that the elders who were asked to write down important daily events did record more positive events than negative events. In summary, it can be concluded that, gratitude and the positive type of reminiscence did have impact on the well-being of the elderly. We can successfully promote the elders’ well-being by leading them to savor their daily grateful events. We believe, even stepping into elderhood, people are still capable of pursuing their own well-being and can live a good life, if only they choose the right way!

Bakgrund: Forskning som behandlar sarkopeni visar att muskelförtvining påverkar funktionsförmågan under åldrandets gång och går att förebygga med olika former av styrketräning. Forskningen kring muskelförtvining gjorde således att ett intresse av träning för äldre vuxna väcktes hos oss och därav också styrketräningens potentiella effekter på livskvaliteten. Syfte: Syftet med studien är att undersöka om en ökad fysisk styrka och explosivitet bidrar till en ökad livskvalitet hos personer mellan 55 och 65 år. Metod: Detta har undersökts i en grupp på femton deltagare med inspiration från aktionsforskning. Data har insamlats med hjälp av MuscleLab, SF-36v2 och memos. Resultat: Nio deltagare uppvisade en ökning av effektutvecklingen och sex deltagare en minskning. Livskvaliteten har ökat i samtliga åtta kategorier för gruppen som helhet, vilket innebär att både den fysiska och mentala hälsan har ökat i gruppen. Slutsats: En ökad styrka och explosivitet innebar inte nödvändigtvis en ökad livskvalitet, utan vi anser snarare att förändringen i livskvalitet är beroende av en högre aktivitetsnivå i sig. Detta för att styrkan för gruppen som helhet endast ökat marginellt, men att livskvaliteten har ökat desto mer. / Background: Research on Sarcopenia shows that muscle atrophy affects the physical functioning during aging and can be prevented by various forms of strength training. Research on muscle atrophy aroused our interest in strength training for older adults and also the strength training effects on quality of life. Aim: The aim of this study is to investigate whether an increase in physical strength and explosiveness contributes to a better quality of life in people aged between 55 and 65 years. Method: This has been explored with inspiration from action research in a group of fifteen participants. Data was collected with the instruments MuscleLab, SF-36v2 and memos. Results: Nine participants showed an increase in power development and six participants showed a decrease. Quality of life has increased in all eight categories for the group as a whole, meaning that both the physical and mental health has increased in the group. Conclusion: Increased strength and explosiveness does not, in our case, necessarily mean a better quality of life, but we consider that the change in quality of life rather depends on a higher level of activity in itself. This is because the strength of the group as a whole increased only marginally, but that quality of life has increased all the more.

Background: Links between later life depression (LLD) and adverse health outcomes are well-documented, with mental ill-health in rural older adults highlighted as a priority area for health care policy. In working age adults, models of depression show that specific psychological factors (e.g. hopelessness, neuroticism, extraversion and insecure attachment) interact with life stress to increase risk of depression. In older adults, however, the direct relationship between depression and hopelessness is inconsistently replicated. In addition, there is little evidence regarding how psychological factors interact with vulnerability to depression in older adults; and whether these factors act in the same manner as they do in working age adults. Objectives: A systematic review was carried out in order to determine the strength of the depression-hopelessness relationship, and the influence of personality traits (neuroticism/ extraversion) and insecure attachment (anxious/ avoidant) on this relationship. Next, an exploratory study was carried out to determine whether there was a direct relationship between depression and hopelessness in rural older adults living in the community and, secondly, whether this relationship was indirectly influenced by specific psychological factors (e.g. neuroticism, extraversion, and attachment styles). Methods: The systematic review was carried out using several databases (Psychinfo, Science Direct, EBCOS, Cohrane Library, PROSPERO, WEBCAT and Google Scholar). Studies relating to the variables of interest, meeting inclusion and exclusion criteria, were reviewed and evaluated for methodological biases. The pilot study asked older adults (N = 58) living in a remote and rural region to complete and return a packet of self-report questionnaires (Big Factor Inventory-10, Experiences in Close Relationships, Depression, Anxiety and Stress Scale, and the Beck Hopelessness Scale). Results: The systematic review identified twenty-one studies; four examining the depression-hopelessness relationship and seventeen investigating the effects of neuroticism, extraversion and insecure attachment styles on wellbeing, depression and/ or hopelessness. Findings from the pilot showed a direct relationship between depression and hopelessness in rural community dwelling older adults, with only neuroticism indirectly influencing this relationship. Conclusions: The systematic review suggests that it is not possible, as yet, to draw robust conclusions from the existing evidence base regarding the influence of psychological variables on depression and hopelessness in older adults. The findings were particularly sensitive to methodological limitations (e.g. variability between sampling methods and small effect sizes). Despite this, studies suggest some evidence for attachment and personality influencing on the depression-hopelessness relationship. Likewise, findings from the pilot study are limited by the small sample size and cross-sectional nature of the data. Preliminary findings, however, suggest that neuroticism, and not beliefs about insecure attachment, strengthens the relationship between depression and hopelessness in non-clinical, rural older adults. These findings are consistent with research on working age adults and could, potentially, represent an emerging relationship in non-clinical older adults. Further research, however, is required as to whether the same patterns are observed in clinical populations.

The thesis addresses the topic of motivation of older adults to study at the university level. The first part deals with the topic of adult education within the context of lifelong learning, defines the concept of older adulthood, and clarifies the concept of motivation as it relates to formal education for older adults. It presents an overview of research carried out in the field of older adults as related to university studies. The second part focuses on qualitative research that answers the following questions: what motivates older adults to study at the university level; how do they describe the motivating factors and other relevant circumstances of their decision to attend university; what criteria do older adults use to assess the benefits of study; and what motivates them to persevere in their studies.

abstract: This study aimed to understand the factors that influence Chinese American older adults’ advance care planning (ACP) on end-of-life care. The Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were primarily applied to explain Chinese American older adults’ intentions toward two behaviors: 1) discussion of end-of-life care plans with family members and 2) completion of an advance directive (AD). Additionally, acculturation and family cohesion were considered to examine their impacts on the TPB and HBM. A cross-sectional survey was conducted through face-to-face interviews on a sample of 298 community-dwelling Chinese-American adults aged 55 and older living in the metropolitan Phoenix area of Arizona. Based upon random assignment, 161 participants answered questions regarding discussing end-of-life care plans with family members, while 137 participants answered questions related to the completion of an AD. Hierarchical multiple regression analysis was used to focus on the influence of TPB and HBM measures on behavioral intentions toward the two behaviors. Results indicated that both the TPB and HBM had predictive power to explain the target population’s intentions. However, the predictability of TPB and HBM measures varied across the two behaviors. Acculturation moderated the relationship between attitudes and intentions to complete an AD negatively. Family cohesion moderated the relationship between perceived benefits and intentions to discuss end-of-life care plans with family members negatively. These findings would help inform future interventions for improving the target population’s ACP awareness and engagement. / Dissertation/Thesis / Doctoral Dissertation Communication 2018

Objetivo: verificar associação independente entre subnutrição e óbito em idosos brasileiros domiciliados. Métodos: pesquisa epidemiológica, observacional, longitudinal, retrospectiva e analítica, baseada no Estudo SABE: Saúde, Bem-estar e Envelhecimento, realizado nos anos 2000 e 2006, no município de São Paulo. Foram estudados 1170 idosos ( 60 anos), de ambos os sexos, residentes habituais em domicílios particulares da área urbana do município de São Paulo. As variáveis analisadas foram: óbito, subnutrição, sexo, renda, força muscular reduzida, fratura de quadril, hábito de fumar, câncer, depressão, diabete melito, doença coronariana, doença pulmonar crônica, doença vascular cerebral e hipertensão, sendo a maioria relatada pelos idosos ou por seus proxis, com exceção do óbito (averiguado pelo Sistema de Informações sobre Mortalidade de São Paulo), da subnutrição (Miniavaliação Nutricional®), da depressão (Escala de depressão geriátrica) e da força muscular reduzida (força de preensão manual). Realizou-se, segundo grupos etários (60-74 anos e 75 anos), análise multivariada hierarquizada por regressão logística, baseada em modelo teórico proposto, selecionando as variáveis cujo p foi < 0,05. Resultados: constataram-se 332 óbitos, com maior proporção no grupo 75 anos (41,8%) que 60-74 anos (18,3%) (p < 0,001). A subnutrição foi identificada em 2,4% dos idosos e, assim como para óbito, verificou-se maior proporção no grupo 75 anos (2,5% e 2,4%, respectivamente). Em idosos de 60-74 anos, 6,7% daqueles que morreram eram subnutridos e, no grupo etário 75 anos, 3,9%. Tanto em idosos de 60-64 anos (OR = 6,17; IC = 5,89-6,47), como 75 anos (OR = 2,82; IC = 2,57- 3,10), a subnutrição foi fator de risco independente para óbito (p < 0,05). Exceto fratura de quadril e doença vascular cerebral, em ambos grupos etários, e hipertensão, em idosos de 60-74 anos, todas as outras variáveis também explicaram o óbito, porém, com menor efeito. Conclusão: a subnutrição representou fator de risco 6 independente e mais fortemente associado ao óbito em idosos brasileiros domiciliados dentre as variáveis consideradas, com efeito mais pronunciado no grupo de 60-74 anos. / Objective: to verify the independent association between undernutrition and death in older Brazilian adults community-dwelling setting. Methods: epidemiological, observational, longitudinal, retrospective and analytical study based in Health, Wellbeing and Aging survey realized in the years 2000 and 2006. This study included 1170 older adults ( 60 years) both gender that living in private households in São Paulo urban area. The variables analyzed were: death, undernutrition, sex, income, low muscle strength, hip fracture, smoker, cancer, depression, diabetes, coronary heart disease, chronic lung disease, cerebral vascular disease and hypertension being the majority self reported by older adults, except death (investigated in the Mortality Information System of the São Paulo city), undernutrition (Mini-nutritional Assessment®), depression (Geriatric Depression Scale) and muscle strength (handgrip). Hierarchical multivariate analysis by logistic regression was performed according to age groups (60-74 years and 75 years) based on a proposed theoretical model. The p-values < 0.05 were considered significant. Results: were identified 332 death being the highest proportion in the age group 75 years (41.8%) that 60-74 years (18.3%) (p < 0.001). Undernutrition was identified in 2.4% of older adults and as well as for death, there was a higher proportion in the group 75 years (2.6 and 2.4, respectively). In the older adults from 60-74 years, 6.7% died and were undernutrition and the older adults 75 years, 3.9%. Undernutrition was independent risk factor for death (p<0.05) both in the age group 60-74 years (OR = 6.17; CI = 5.89-6.47) and in the age group 75 years (OR = 2.82; CI = 2.57-3.10). Except hip fracture and cerebral vascular disease in both age groups and hypertension in age group from 60-74 years, the other variables also explained the death in older adults, however, the effect of these variables was lower. Conclusion: undernutrition represented the independent and the most strongly risk factor to death in older 8 Brazilian adults in the community-dwelling setting among the variables considered in this study with effect more pronounced in older adults from 60-74 years.

Older adults are increasingly using social networking sites such as Facebook to maintain social relationships. A growing body of literature indicates that frequent communication with family members and close friends influences successful ageing. Consequently, the purpose of this study is to establish the nature of the relationship between the impact of Facebook communication and successful ageing on older adults living in the rural municipality of Hagfors. This study defines an older adult as a person aged 55 years and above. Self-reported life-satisfaction, social engagement and social trust are used as indicators of successful ageing. Predictions about Facebook communication and successful ageing are tested by theories of socio-emotional selectivity and social capital. This is based on 15 semi-structured interviews conducted with older adults living in the municipality of Hagfors. The results indicate that having small social connections and frequently exchanging privately composed communication with family members and close friends promotes successful ageing. Facebook is found to be a potential source of social capital.