The purpose of this study was to develop a reliable and valid knowledge about aging scale. Two hundred and ninety-eight subjects (128 males, 170 females) from the University of British Columbia, Simon Fraser University, and members of the general population, ranging from 17 to 65 years of age, and having 0 to 12 years of post secondary education, participated in this study. Subjects were chosen on the basis of having gerontological, versus no gerontological training. Subjects responded to computer randomized Likert scale questionnaires consisting of the initial 60 item Proto Knowledge About Aging Scale, Palmore's Facts on Aging Quiz (FAQ), and Kogan's Old People Scale (OP). Responses to the initial Proto scale were used to construct a psychometrically appropriate 40 item scale that consisted of three factor dimensions interpreted as Psychological, Biological Change, and Social Lifestyle/Histological Change. This 40 item scale had a Chronbach's alpha of 0.839 and a construct validity value of 0.701. Analysis of Covariance results indicated that the independent variables of age, gender, and years of post secondary education, had no significant extraneous confounding influence (p≤ 0.05) on Proto scale results. However, type of training did influence Proto scale results, with those subjects having gerontological training scoring significantly higher (Duncan's Multiple Range Test p≤ 0.05) than those with no gerontological training. Investigation into Proto's scale characteristics were further analyzed in relation to the subjects in this investigation, Palmore's FAQ, and Kogan's OP scale, with discussion focussing on Proto's psychometric rigor as compared to Palmore's FAQ. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

<p> <b><u>Background</u></b></p><p> Osteoporosis affects an enormous number of people of both sexes, and osteoporosis-related fractures are costly to treat. Yet osteoporosis is poorly managed and managed differently by sex and residential setting. Therefore, this study aimed to assess the difference in medication use, adherence, and outcomes between men and women and among women, between long-term care (LTC) facility and community residents.</p><p> <b><u>Methods</u></b></p><p> Using the 2006-2008 Chronic Condition Data Warehouse 5% national random sample of Medicare beneficiaries, this retrospective study identified elderly 70 years and older with osteoporosis enrolled in Medicare Part A, B, and D stand-alone prescription drug plans from January 1, 2006 through December 31, 2008, or death. Use of bisphosphonates, calcitonin, parathyroid hormone and selective estrogen receptor modulator was tracked over the 3-year period. Treatment effectiveness was measured as hazard of fracture after treatment initiation. Modified Poisson regression was used for analyzing the effect of sex and residential status on osteoporosis medication use. Cox proportional hazard model was used for analyzing the effect of medication use and adherence on fracture risk.</p><p> <b><u>Results</u></b></p><p> The samples included 96,408 females, 8,465 males and 90,956 females, and 2,083 males and 10,262 females enrolled in Medicare Part D for aims 1, 2, 3, respectively. Utilization was lower among LTC residents (RR 0.89, 95% CI [0.87, 0.91]). Bisphosphonates were prescribed less often to LTC residents (RR 0.79, 95% CI [0.75, 0.83]) compared to among community residents. Prevalence of osteoporosis medication use in men was substantially lower than that in women (25.2% vs. 44.3% in 2006). Good adherence decreased the hazard of fracture in both sexes (HR 0.86, 95% CI [0.75, 0.99]). No difference in either treatment or adherence effect on fracture between men and women existed.</p><p> <b><u>Conclusion</u></b></p><p> Prevalence of osteoporosis medication use is low in elderly women enrolled in Part D whether community dwelling or LTC residents. Elderly men are undertreated for osteoporosis compared to elderly women. There is strong confounding by indication in the effect of osteoporosis medications on the risk of fracture; however, good adherence reduces the risk of fracture. There is no evidence for heterogeneity in treatment response among men and women.</p>

Orientador: Guita Grin Debert / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas / Made available in DSpace on 2018-08-26T13:00:26Z (GMT). No. of bitstreams: 1 Hora_ThiagoCesarioda_M.pdf: 928355 bytes, checksum: 6d9f1623e9ce1bde1d42103df3780ddb (MD5) Previous issue date: 2014 / Resumo: Apesar de sua escalada natural, o envelhecimento é também um processo socialmente determinado, de modo que seus limites e significados variam de acordo com a conjuntura específica em que ele se insere. Esta pesquisa trata de uma dessas conjunturas: a velhice gerida por um asilo beneficente. Primeiramente, são delimitados os aspectos históricos e discursivos responsáveis pela construção da categoria "velhinho", uma classificação essencialmente desqualificadora, estabelecida na intersecção entre velhice, dependência e beneficência, e na consolidação do asilo enquanto espaço próprio destes indivíduos. No segundo momento, através da etnografia, a intenção é mostrar como a instituição asilar perpetua esta desqualificação, através das moralidades acionadas na prática do cuidado e do voluntariado, ao passo em que, também, proporciona interações intergeracionais determinantes para as alteridades em jogo. Finalmente, a vida no asilo é abordada pela ótica dos próprios moradores, que compartilham significados específicos sobre o envelhecimento e, por meio deles, negociam cotidianamente sua posição relativa diante da instituição e dos outros internos, através de estratégias de subjetivação que têm, na afirmação da autonomia e do direito a autodeterminação, seus objetivos finais. Deste modo, proponho um debate sobre os elementos depreciativos que permeiam a imagem social das pessoas de mais idade, contribuindo assim para sua superação / Abstract: Despite its natural progress, aging is also a socially determined process, so its boundaries and meanings vary according to the specific environment in which it is inserted. This research deals with one of these situations: the aging run by a charitable nursing home. First, the historical and discursive aspects responsible for the construction of the category "velhinho" are delimited. It is an essentially disqualifying classification established at the intersection of old age, dependency, charity, and the consolidation of the nursing homes as these individuals own space. In another moment, through ethnography, the intention is to show how the nursing homes perpetuate this disqualification by the moralities triggered by care practice and volunteering, while this also provides intergenerational interactions decisive for the alterities at stake. Finally, life in the nursing homes is approached from the perspective of the residents, who share specific meanings about aging and, through them, routinely negotiate their relative position within the institution and in relation to the others residents. To accomplish their ultimate goals, they use subjectivity strategies to affirm their autonomy and self-determination. Thereby, I propose a debate about the derogatory elements that permeate the social image of older people, thus contributing to its overcoming / Mestrado / Antropologia Social / Mestre em Antropologia Social

The purpose of this inquiry was to develop substantive theory that describes the social process that influences the eating behavior of hospitalized older adults. Undernutrition or the inadequate intake of dietary nutrients necessary to maintain health, contributes to negative health outcomes such as increased morbidity and mortality in hospitalized older adults. Inadequate dietary intake is a risk factor for undernutrition. Despite the availability of vast resources within the hospital environment, hospitalized older adults have inadequate dietary intake. Undernutrition has been studied from a dietary intake perspective; however, why dietary intake remains inadequate is unknown. Inquiry of eating behavior and the social process that influences eating behavior will provide insight into why dietary intake remains inadequate. The Quality Health Outcomes Model was the conceptual framework that guided this inquiry. A qualitative, grounded theory methodology was used to investigate this phenomenon. Participants included acutely ill, hospitalized older adults and their healthcare providers. Field work included observation, interview, and document review to better understand the actions, interactions and perceptions of participants as to the process that influenced hospitalized older adult eating behavior. Datum was compared, coded, and analyzed using the constant comparative method. The Theory of Compromised Eating Behavior was developed and describes the process of compromise older adults experience related to eating behavior while hospitalized. The Theory has four stages: self-indication, joint-action, negotiation, and action. Hospitalized older adults choose to compromise their health should they eat inadequately or alternatively compromise their acculturated foodways should they eat adequately. Additionally, healthcare providers compromise their beliefs when older adult patients do not eat adequately. Older adults are at risk for negative health outcomes due to inadequate dietary intake while hospitalized. The meaning of hospital food and mealtimes differs from traditional food and mealtimes for the older adult, resulting in compromise. Intervention which enhances the meaning of food and mealtimes for the older adult during hospitalization may improve dietary intake and nutritional outcomes.

Frailty has been defined as a state of increased vulnerability to adverse outcomes. The concept of frailty has been centered around counting the number of deficits in health, which can be diseases, disabilities, or symptoms. However, there is no consensus on how it should be quantified. Frailty has been considered synonymous with functional status and comorbidity, but these may be distinct concepts requiring different management. We compared two methods of defining a frailty phenotype, a count of deficits and a weighted score of health deficits incorporating the strength of association between each deficit and mortality. The strength of association was estimated using proportional hazards coefficients. The study uses data from the third National Health and Nutrition Examination Survey. We compared the two methodologies: frailty was associated with age, gender, ethnicity, and having comorbid chronic diseases. The predictive association of frail status with the incidence of death over 12 years was significant for the weighted phenotype, with hazard ratio 3.46, 95% confidence interval (CI) (2.78, 4.30) unadjusted and hazard ratio 1.89, 95% confidence interval (CI) (1.57, 2.30) adjusted. The unweighted predictive association of frail status with the incidence of death was also significant, with a lower hazard ratio of 3.13, 95% CI (2.53, 3.87) unadjusted and hazard ratio of 1.40 95% CI (1.20, 1.65) adjusted. When examining the association of frailty and cause specific death, frailty was associated with a higher risk of death due to CHD, Stroke, CVD, and Other causes for both male and female (unadjusted). However, after adjusting for various covariates death due to CHD, CVD, and Others causes remain significant for both males and females. When comparing the definition of osteoporosis or low bone mass to the model of frailty, femoral neck T-score declined significantly with increasing levels of frailty. There was overlap and uniqueness in the definitions of frailty, functional status, and comorbidity that require further research. Understanding the causal interrelationship could help explain why these three conditions are likely to co-occur. In addition, there is an association between frailty and dietary quality based on the Mediterranean diet. This study provides a more valuable understanding of the complex concept of frailty and the role latent variables in this concept. This study also introduces a weighted score for defining a frailty phenotype that is more strongly predictive of mortality, and hence has potential to improve targeting and care of today's elderly. / A Dissertation submitted to the Department of Statistics in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2015. / April 14, 2015. / Includes bibliographical references. / Daniel McGee, Professor Co-Directing Dissertation; Elizabeth Slate, Professor Co-Directing Dissertation; Myra Hurt, University Representative; Debajyoti Sinha, Committee Member.

abstract: Hysterectomy is the second most common gynecological surgery performed in women. Half of these surgeries involve removal of the uterus alone, and half involve concomitant removal of the ovaries. While the field has retained the notion that the nonpregnant uterus is dormant, more recent findings suggest that hysterectomy is associated with cognitive detriment. Of note, the clinical literature suggests that an earlier age at hysterectomy, with or without concomitant ovarian removal, increases dementia risk, implicating age at surgery as a variable of interest. While preclinical work in a rodent model of hysterectomy has demonstrated spatial working memory impairments, the role of age at surgery has yet to be addressed. The current experiment utilized a rodent model of hysterectomy to investigate the importance of age at surgery in post- surgical cognitive outcomes and to evaluate relative protein expression related to brain activity, FosB and ∆FosB, in regions critical to spatial learning processes. Young adult and middle-aged female rats underwent sham surgery, hysterectomy, or hysterectomy with ovariectomy, and were tested on a behavioral battery that evaluated spatial working and reference memory. Following the behavioral battery, animals were sacrificed and brain tissues from the Dorsal Hippocampus and Entorhinal Cortex were processed via Western Blot for relative FosB and ∆FosB expression. Behavioral analyses demonstrated that animals receiving hysterectomy, regardless of age or ovarian status, were generally impaired in learning a complex spatial working memory task. However, rats that received hysterectomy in middle-age uniquely demonstrated persistent working memory impairment, particularly with a high working memory demand. Subsequent neurobiological analyses revealed young rats that underwent hysterectomy had reduced relative FosB expression in the Entorhinal Cortex compared to sham controls, where no significant effects were observed for rats that received surgery in middle-age. Finally, unique relationships between neurobiological and behavioral outcomes were observed largely for sham rats, suggesting that such surgical manipulations might modulate these relationships. Taken together, these findings suggest that age at surgery plays an important role in learning and memory outcomes following hysterectomy, and demonstrate the need for further research into the role of the uterus in communications between the reproductive tract and brain. / Dissertation/Thesis / Masters Thesis Psychology 2020

No description available.

Counterfeit Integrated Circuits (ICs) are previously used ICs that are resold as new. They have become a serious problem in modern electronic devices. They cause lower performance, reduced life span and even catastrophic failure of systems and platforms. To prevent counterfeiting and the associated revenue loss, there is need for non-invasive and inexpensive techniques to establish the authenticity of devices. We describe a technique to detect a counterfeit IC that does not have any special anti-counterfeiting mechanisms built-in prior to deployment. Our detection criterion is based on measuring path delays. The experiments show that a single path delay cannot directly reveal the age, as it is also greatly influenced by process variation and this could result in large error in classifying ICs as authentic or counterfeit. �Instead, we establish that the relationship between the delays of two or more paths is a great indicator for the age of device. The idea is to project ICs from different age groups onto the space of the path delays and train a trusted reference hyper-surface for each age group. Ideally, the hyper-surfaces do not overlap. In this way, an IC under test can be assigned to one hyper-surface based on the distance of its footprint with respect to these hyper-surfaces, thus predicting its age. In our simulations, we observe over 97% correct prediction of identifying an aged IC from a new IC. / Master of Science

With increased age, some individuals experience cognitive declines that are more severe than what is observed in healthy cognitive aging. This decline may be related to mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Much of the current research on dementia attempts to detect subtle cognitive and memory declines before behavioral and cognitive symptoms are more apparent. Intense research interest has focused on MCI, a condition that includes impairment in some areas of cognitive functioning but is not severe enough to warrant the diagnosis of dementia. MCI may represent a transitional stage between healthy aging and AD and is considered a risk factor for AD development. The purpose of the present thesis was to examine if EEG and ERPs can be used as reliable predictors of cognitive changes in aging and MCI. Study 1 was designed to examine if there is evidence of changes in the EEG between cognitively healthy older adults and people with MCI. The purpose of this study was to examine differences in EEG activity between healthy older adults and people with MCI during early and late portions of a longer-than-normal resting-state recording. Resting state recordings typically last 1-3 minutes. It would be advantageous to run a longer testing session because this would provide more data, but such a procedure might be problematic because it might result in increased drowsiness in the latter half of testing. If this drowsiness affected those with MCI more than healthy adults, this might produce artifactual differences between groups. If increased drowsiness occurs as the duration of the recording becomes longer, an increase of low-frequency EEG activity should be observed, particularly in the delta band. Resting state EEG was recorded in 20 healthy older adults and 20 people with MCI who rested with their eyes closed. The EEG recording was divided into two three-minute halves. People with MCI exhibited a significant increase in theta power density over posterior regions of the scalp compared to healthy older adults. Power density for all frequency bands did not change over the two halves of the recording. That is, there was little evidence of drowsiness in the second half of the recording. Taken together, these findings indicate that longer resting-state EEG recording can be reliably employed without increased risk of drowsiness. Study 2 examined whether there is evidence of a dysfunction in the salience network in older adults. Previous research suggests that older adults may be less able to compute the level of salience of unattended stimulus inputs. The transient detector system is a specialized network of brain areas for detecting sudden changes in the intensity of an auditory stimulus. The output of this system, as reflected by the auditory ERP components N1 and P2, provides a measure of the level of salience of the stimulus. Twenty younger adults and healthy older adults participated in this study. A single auditory stimulus was presented rapidly, every 1.5 s, or very slowly, every 12 s, in different conditions. When the stimuli were presented rapidly, group differences were not observed for the amplitudes of N1 and P2, peaking at 100 and 180 ms, respectively. When stimuli were presented very slowly, their amplitudes were greatly enhanced for younger adults but did not increase for older adults. The failure to observe a large increase in the amplitude of N1 and P2 in older adults for very slowly presented stimuli provides strong evidence of a dysfunction of the salience network in this group. There is evidence that both the functioning of salience network and the frontoparietal network deteriorate in cognitively healthy older adults. These networks might further deteriorate in people with MCI. In study 2, when stimuli were presented slowly, the P2 was delayed and peaked at a time that is more consistent with a P3a. The P3a is elicited by a potentially highly salient, but unattended stimulus input that interrupts the functioning of the frontoparietal network, resulting in a switch of processing priorities away from current task demands and toward the processing of the stimulus input. In study 3, auditory stimuli were again presented either rapidly or very slowly to 20 healthy older adults and 20 people with MCI. The amplitude of N1 did not differ between the two groups in either the fast or slow conditions. Thus, there is little evidence that people with MCI have a deficit in computing the salience of unattended auditory stimuli. When stimuli were presented slowly, the P2/P3a was significantly smaller in people with MCI compared to healthy older adults. The attenuated P2/P3a in people with MCI may reflect a reduced frontoparietal ability to determine processing priorities. In people with MCI, priority of processing may not be switched from the ongoing cognitive task to the potentially much more relevant auditory input. In the results of studies 2 and 3, there was ambiguity regarding whether the positivity observed in the slow condition reflected P2 or P3a activity. A more definite P3a had been elicited in oddball paradigms. In the oddball paradigm, the participant is presented with a sequence of frequently presented homogenous standard stimuli. At rare and unpredictable times, a deviant is presented, the deviant representing a change in a feature of the standard. Deviants that represent a large change from the standard may elicit a P3a. Two experiments were run in which at least one of the deviants had previously been shown to elicit a large P3a in younger adults. Study 4 consisted of two experiments. In Experiment 1, the deviants represented either decreases or increases in the intensity of the standard. The deviant that represented an increase in intensity has been found to elicit a large P3a in previous studies. In Experiment 2, six different deviants were presented. The deviants included a white noise burst and environmental sounds, both of which have elicited a large P3a in previous studies. Across both experiments, the MMN/DRN and P3a did not differ between healthy older adults and people with MCI. Previous studies have indicated that the P3a is reduced in amplitude in healthy older adults compared to younger adults. The results of study 4 indicate that the P3a was not further reduced in people with MCI. This is in contrast to study 3 in which the P2/P3a was reduced in people with MCI. This could be because of the use of the oddball paradigm in study 4. Detection of the deviant would be carried out, at least in part, by the change detection system while in study 3, the presentation of a single stimulus would have been detected only by the transient detection system. Operations of the frontoparietal network controlling processing priorities can be interrupted by sufficient output from either the transient or change detector systems. This results in a switch of processing from an ongoing task to the processing of the potentially more relevant stimulus input. When this interrupt is sent from the change detection system, the operations of the frontoparietal network do not appear to deteriorate in people with MCI compared to what is observed in cognitively healthy older adults.

Extending the human life span has long been a desire of human beings. It seems the wish has been actualized. However, simply living a long life does not always seem to be a blessing. Older adults report a lower level of psychological well-being and quality of life and even have a higher rate of suicide, compared to the general population. Furthermore, as older adults are likely to experience the death of a loved one, deteriorating health, retirement, and changing relationships with others, older adults have a high risk of depression. Social work has a long history of providing social services to older adults. In particular, social work has provided older adults with a variety of services to enhance their quality of life and mental health status. Because ageism is one form of discrimination that social work has long been concerned with, this study focuses on the relationship between perceived ageism and depressive symptoms among older adults. Therefore, the purpose of this study is to examine the relationship between perceived ageism and depressive symptoms among older adults and to investigate the mechanism linking perceived ageism to late-life depression. Three primary effects were examined: the direct effect of perceived ageism on depressive symptoms in later life, the mediating effects of self-perception of aging and purpose in life on the relationship between perceived ageism and late-life depression, and the moderating effect of perceived ageism on the association between religiosity and depression among older adults. The stress process model was used to provide an overall idea to explain the three types of the effects related to the mechanism of ageism. Cooley's looking-glass self, Beck's cognitive theory of depression, and Levy's stress embodiment theory were used to explain the mediating effect of self-perception of aging, and Beck's cognitive theory of depression was applied again to clarify the mediating effect of purpose in life. The stress buffer theory and the life-span theory of control indicated the moderating effect of perceived ageism on the relationship between religiosity and depression. Secondary analysis of existing data was conducted using the Health and Retirement Study (HRS) datasets, a longitudinal panel study of the U.S. population ages 50 and over. The sample of this study was 3,991 participants, who were older adults ages 65 and over and whose answers were available for the study analyses. Descriptive and preliminary analyses were performed to roughly examine the relationships between variables. With regard to the direct effect of perceived ageism on depressive symptoms, multiple regression analyses were performed controlling for significant variables. With regard to the mediating effects of self-perception of aging and purpose in life, structural equation modeling (SEM) analyses using structural regression models were conducted. In respect to the moderating effect of perceived ageism on the relationship between religiosity and depression, SEM analyses with multiple groups were performed. Based on the results of the several different analyses, a direct relationship between perceived ageism and late-life depression was found. That is, older adults who perceive ageism are likely to have a higher level of depressive symptoms than their counterparts. This direct relationship between perceived ageism and late depressive symptoms among older adults, however, was not detected after controlling for self-perception of aging and purpose in life, indicating the full mediation effects of self-perception of aging and purpose in life. That is, older adults who perceive ageism are likely to have negative self-perception of aging, and this negative view of their own aging is likely to increase depressive symptoms. Additionally, older adults who have a negative view of their aging are likely to have a negative view of their future, and this lower purpose in life also increases depressive symptoms. The strength of the effect of religiosity on depression did not differ between the perceived ageism and the not-perceived ageism groups, indicating no moderating effect of perceived ageism on the relationship between religiosity and depression. This study contributes to the existing body of knowledge by providing the information about the relationship between perceived ageism and depression and the mechanism of this relationship. Also, this study re-examined and supported established theories in the context of perceived ageism. Additionally, the current study suggests the necessity of anti-ageism policies and social work services and describes possible ways of providing such social policies and social work services at the micro, mezzo, and macro levels. The results of this study imply that more efforts and resources are necessary to reduce ageism and its negative effect on depression among older adults, and these efforts will eventually contribute to making a more just, better society. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2015. / May 1, 2015. / Includes bibliographical references. / Bruce A. Thyer, Professor Directing Dissertation; Penny A. Ralston, University Representative; Jean C. Munn, Committee Member; Melissa Radey, Committee Member.