Abstract Sheltered housing for the elderly is an intermediate type of housing, between living in ones own home and living in an institution. The aim of this study was to describe the changes in physical, cognitive and psychological abilities among the elderly living in sheltered housing during a two-year follow-up period. In this study psychological abilities were represented by depressive symptoms. The changes in the abilities of the elderly people living in sheltered housing were compared with the corresponding changes among the elderly living in their own homes. Furthermore, the associated factors and the predictors of the decline in physical and cognitive abilities, as well as the depressive symptoms were examined. The control group consisted of elderly people who were matched with those living in sheltered housing in regard to age, sex, coping with activities of daily living and depressive symptoms. The data of this study were collected among elderly people living in 20 units of sheltered housing in Finland in 1994 and 1996. 725 residents were interviewed and 340 re-interviewed after two years. Cognitive capacity was assessed with the help of the Mini-Mental Examination test (MMSE). Depressive symptoms were assessed using the shortened version of the Zung Self-rating Depression Scale (ZSDS). The results showed that the elderly living in sheltered housing were widows or widowers and lived alone more often than the home-dwelling elderly. They perceived their health as poorer, had less contacts with other people and had fewer hobbies than the elderly living at home. Nevertheless, they felt less lonely and were more satisfied with their lives than those living at home. During the two-year follow-up period the decline in the functional capacity of the elderly living in sheltered housing did not essentially differ from the corresponding change among the home-dwelling elderly. The decline in physical and psychological abilities among the elderly living in sheltered housing was similar to the decline among those living at home. Even if the decline in cognitive abilities among the elderly living in sheltered housing was more rapid than the change among the home-dwelling elderly, the difference between the groups was slight. Living in sheltered housing appeared to have neither a negative nor a positive effect on the functional capacity of the elderly. The predictors of the physical decline among the elderly living in sheltered housing were a high age, poor physical abilities at baseline, a high number of depressive symptoms, the use of medication and a low number of hobbies. The predictors of the physical decline among the home-dwelling elderly were the female sex, a high age, poor physical abilities at baseline, a high number of depressive symptoms, health perceived as poor and low social participation. The predictors of the decline in cognitive abilities among the elderly living in sheltered housing included a high age, poor cognitive abilities at baseline, poor education, dissatisfaction with life and health perceived as good. Among the home-dwelling elderly the predictors of the decline in cognitive abilities were poor cognitive abilities at baseline and a low number of hobbies. Among the elderly living in sheltered housing the predictors of depressive symptoms included a high number of depressive symptoms at baseline, poor cognitive abilities, health perceived as poor, a high number of feelings of loneliness, a low number of visits paid to other people and high education. Among the home-dwelling elderly the predictors of depressive symptoms were a high number of depressive symptoms at baseline and a high age.

The purpose of this investigation, conceived in its broadest sense, was to study the living arrangements of older persons over a specific period of time in an attempt to arrive at some generalizations about the nature and changes of these arrangements as they relate to certain sociological variables.

The purpose of this study is twofold: first, to find out to what extent and for what reasons contacts with relatives have been exhausted for long-term geriatric patients in public institutions, and second, whether there is a significant difference in family contacts for the State Hospital patient as compared to the County Hospital patient. Are the reasons for changes in the family contacts basically social-psychological, medical, or economic. Such a study of family interaction requires an investigation of (a) living arrangements, family relationships, and socio-economic background prior to the hospitalization; (b) the reasons for hospitalization and the present medical diagnosis; (c) the currents economic situation of the patients and her family; and (d) the distance of the relatives’ residence from the hospital. This study attempts to obtain objective evidence in order to find answers to the above questions and to clarify the key issue of whether long-term hospitalized geriatric patients are in fact abandoned by their families.

Dynorphin has a well-established role in feeding and gustation. Alterations in taste perception and feeding behavior are common with age. We hypothesized that proDynorphin gene expression in brain areas involved in taste and feeding declines with age. Male Sprague-Dawley rats were housed individually with ad libitum access to food and water. Brain punches of the selected regions were dissected out in groups of rats aged 4-6, 12-14 and 18-21 months. ProDynorphin mRNA (measured using a cDNA probe) decreased significantly with age in arcuate nucleus and amygdala; increased significantly with age in hippocampus; and was not significantly affected in nucleus of the solitary tract, cortex, caudate putamen or hypothalamic paraventricular nucleus. These data suggest an age-related decrease in the synthesis of dynorphin in two brain regions strongly associated with feeding behavior, and an increase in dynorphin synthesis in a brain region associated with learning and memory.

The loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using individualized per-meal protein prescriptions (1.2 g protein/kg body weight evenly distributed for all three meals) provided by a Registered Dietitian, followed by weekly diet coaching from a Nurse Practitioner (coach). Aims included: (1) An examination of the effect of diet coaching on protein intake, nutrition knowledge, muscle mass, strength, and function and (2) An understanding of how diet coaching sessions help in the process of making dietary changes. A parallel mixed methods research design allowed for a synthesis of inferences from each aim resulting in a meta-inference highlighting interdisciplinary collaboration. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18202号 / 人健博第19号 / 新制||人健||2(附属図書館) / 31060 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 荒井 秀典, 教授 十一 元三, 教授 中山 健夫 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Background Long QT syndrome (LQTS) is characterized by a prolonged QT interval on the electrocardiogram (ECG), a risk for sudden cardiac death. A simple 'rule of thumb' method states that if a patient's heart rate is between 60-100 bpm, the QT interval should not be more than half the R-R interval. The clinical accuracy of this method has not been tested in the elderly. Objectives To determine if the 'rule of thumb' to calculate QT interval prolongation, is accurate, compared to the corrected QT interval calculated using Bazett's formula. Secondary objectives include the prevalence of long QT and risk factors for QT prolongation. Methods The QT interval was calculated using Bazett's formula, and the 'rule of thumb' method, from ECG's collected from patients over 60 years old, on their first visit to a geriatric clinical service. Only data from patients with heart rates in the range 60-100 were analyzed. Medications and electrolyte levels were recorded. Results A total of 1000 ECGs were collected. 776 ECGs were included in the study. Prevalence of prolonged QT interval was 37.8% using Bazett's formula. Compared to Bazett's formula, the 'rule of thumb' method had a sensitivity of 65.2% and a specificity of 96.9%. ECG computer analysis calculated QTc was available for 42.5% of the cases and had a sensitivity of 58.1% and specificity of 95.3% compared to Bazett's formula. Of the 23.3% of patients taking medications known to prolong the QT interval only 38.6% had a prolonged QT interval. There was a significant association between QT interval prolongation and hypokalaemia. Conclusion The 'rule of thumb' method to determine QT interval prolongation, has high specificity but low sensitivity. This bedside measure is similar in accuracy to QT determination using an ECG computer analysis calculation in this population of older persons. / MT 2019

No description available.

The lived experiences of dementia in older persons have been well studied, but the unique experiences of persons between ages 35 and 65 years who are living with young-onset dementia have not been closely examined. The purpose of the research was to explore the experiences of middle-aged individuals living with young-onset dementia. Van Manen‘s (1990) approach to interpretive phenomenological inquiry was used to answer the research question. Purposive sampling was used to recruit 9 people between 42 to 61 years of age who had received a formal diagnosis of mild or early-stage dementia. Participants were prescreened for the ability to reflect on their illness and the Short Portable Mental Status Questionnaire (SPMSQ) was used to verify the participant‘s eligibility. Semi-structured, conversational interviews were used to gather the data. Consistent with van Manen‘s method of phenomenological reflection, theme analysis using the selective approach was used to grasp the essential meanings of the experience. Each participant was interviewed a minimum of two times. Six themes were extracted from 19 conversational interviews with persons living with young-onset dementia: feeling frustrated, fear of slipping away, loss of personhood, life interrupted, finding a sense of security in the familiar, and wanting one‘s voice to be heard. These themes are interpretations of the human experience of living with dementia and are not intended to be generalizations or theoretical concepts. The experiences described in this study raise awareness about young-onset dementia and help health care practitioners and society-at-large develop a better understanding of what it is like to live with the disease. The misperception that people suffering from dementia do not have insight and the underestimation of their abilities is a great source of frustration for these people. iv Study findings also suggest that middle-age people with dementia want to be involved in meaningful, productive activities. Their resounding plea is to have their personhood embraced instead of negated.

Touch screen technology is rapidly increasing, and at the same time there is a shifting, aging population. As the percentage of the population over the age of 65 increases, adults of the age group are adopting smartphones and tablets more now than ever before. Although older adults are adopting touch screen devices, they face many challenges when interacting with said devices, such as not knowing how to navigate between pages, not knowing where to click for an action to occur, and the touch screen interface is often too sensitive or the buttons are not big enough. Furthermore, the challenges of aging, specifically sensory and cognitive decline resulting from aging affect comprehension and spacial processing, which are critical when navigating through an interface. The purpose of this thesis was to better understand redundancy effect applied to females and males between the ages of 65 and 84. There were two tasks of different lengths, and for each task there were two designs. The first design included text only buttons, and the second included symbol + text buttons, the latter being the redundant interface. Quantitative results yielded no significant results for time for either task. Qualitative results included ratings for ease of navigation, general satisfaction, overall understanding, and button design preference. Preferences between text only buttons were statistically significant; for the task of online grocery shopping and booking a cruise, females prefer text only buttons and males prefer symbol + text buttons (p = 0.0068 and p = 0.0024). Although button design had no significance in completing a task, significant preference results indicate likelihood to return to a given website. Furthermore, although quantitative results were not significant, gender did influence average times per task and average ratings across categories. Further research could be conducted with larger sample sizes, other forms of redundancy, and larger tasks, however it is evident through this experiment that gender has an impact on how adults between 65 and 84 perceive and navigate through touch screen interfaces given the constraints of the symbols used, ages, and task designs. Therefore, concluding recommendations based on the qualitative data suggest that designers should create gender specific interfaces based on gender favored websites, or design based on the ability to customize the interface upon entering a website.