In this thesis I explore how older people make use of, and interact with, their physical environment in home and near-by settings to manage cognitive situations, specifically prospective memory situations. Older adults have in past research been shown to perform better on prospective memory in real-life settings than what findings in laboratory-like settings predict. An explanation for this paradox is that older adults has a more developed skill of using the environment for prospective memory than younger adults. However, research investigating this explanation has primarily been based on self-reports. I contribute to the understanding of this skill by doing two related things. First I introduce distributed cognition, a theoretical perspective that primarily has been used within professional and socio-technical environments, to the research field of prospective memory in everyday life. Second I present a cognitive ethnography conducted during two years across eight home, and near-by, environments and old-age retired persons, for which I have used theoretical concepts from distributed cognition to analyze observations. The analysis shows rich variations in how participants use common cultural cognitive tools, invent their own cognitive tools, deliberately and incidentally shape more or less functional spaces, make use of other physical features, orient themselves toward and make sense of cognitive resources. I complement both prospective memory and distributed cognition research by describing both the intelligent shaping and use of space. Furthermore, by taking a distributed cognitive perspective I show that prospective memory processes in home environments involve properties, and the management, of a multipurpose environment. Altogether this supports the understanding of distributed cognition as a perspective on all cognition. Distributed cognition is not a reflection of particular work practices, instead it is a formulation of the general features of human cognition. Prospective memory in everyday life can be understood as an ability persons have. However, in this thesis I show that prospective memory can also be understood as a process that takes place between persons, arrangements of space, and tools.

The purpose of this research was to conduct a needs assessment for the city of Denton, Texas to learn how residents view Denton's aging-friendliness. The research design was based on the Texas Department of Aging and Disability Services' Aging Texas Well Toolkit and was funded by a two year grant from that agency. Both qualitative and quantitative methods were used to gather data on six community indicators: demographics, housing, transportation, health care (including mental health and substance abuse services), recreation, and community supports and services. Input from city residents was gathered through focus groups, followed by a survey of the broader community in the city to validate and prioritize the needs identified. The research found gaps in Denton's aging-friendliness. Denton residents feel that although there are some services for the aging in the area, other services are lacking. The top needs identified by residents were a single point of contact for, and better communication about, resources currently available, as well as a need for increased transportation options.

The thesis explores the influence of cognitive training carried out in a second language on the elderly suffering from dementia. Having described the basic anatomy of the nervous system, neurolinguistic theories as well as ageing and having dealt with cognitive aspects in relation to language learning, the thesis aims at performing an experiment that should help dementia clients to broaden their vocabulary in a second language. This is to be achieved through individual therapy- like units using worksheets created specifically for these purposes. The results indicate that cognitive training in a second language is beneficial to dementia clients and could be used more extensively. Key words ageing, dementia, language, cognitive training, neurolinguistics

Aging-related decline in immunity is believed to be the main driver behind decreased vaccine efficacy and reduced resistance to infections in older adults. Unrepaired DNA damage is known to precipitate cellular senescence, which was hypothesized to be the underlying cause of certain age-related phenotypes. Consistent with this, some hallmarks of immune aging were more prevalent in individuals exposed to whole-body irradiation (WBI), which leaves no anatomical repository of undamaged hematopoietic cells. To decisively test whether and to what extent WBI in youth will leave a mark on the immune system as it ages, we exposed young male C57BL/ 6 mice to sublethal WBI (0.5-4 Gy), mimicking human survivor exposure during nuclear catastrophe. We followed lymphocyte homeostasis thorough the lifespan, response to vaccination, and ability to resist lethal viral challenge in the old age. None of the irradiated groups showed significant differences compared with mock-irradiated (0 Gy) animals for the parameters measured. Even the mice that received the highest dose of sublethal WBI in youth (4 Gy) exhibited equilibrated lymphocyte homeostasis, robust T-and B-cell responses to live attenuated West Nile virus (WNV) vaccine and full survival following vaccination upon lethal WNV challenge. Therefore, a single dose of nonlethal WBI in youth, resulting in widespread DNA damage and repopulation stress in hematopoietic cells, leaves no significant trace of increased immune aging in a lethal vaccine challenge model.

The skeletal system is a dynamic organ that provides support, protection, aids in the production of all blood cells, and serves as a calcium ion reservoir. It is constantly undergoing a process called ‘remodeling’, which occurs through the actions of osteoclast and osteoblast cells. The former is responsible for breaking down bone whereas the latter secretes an organic matrix for bone synthesis. Two experiments were conducted to analyze the effects of physiological perturbations on the bone remodeling process. Specifically, the impact of aging and selective serotonin re-uptake inhibitor administration coupled with lactation on bone morphology and composition were observed. The bony skeleton is not a stagnant organ, rather it undergoes functional, mechanical, and compositional changes throughout life. Thus, we wanted to determine the consequences age had on various bone parameters and found a decrease in bone volume fraction (BV/TV), trabecular number (Tb.N), cortical thickness (C.Th), and an increase in periosteal area, endosteal area, and cortical porosity (C.Po). In regards to pregnancy, post-partum depression is a common condition. As a result, many women utilize selective serotonin re-uptake inhibitors (SSRIs) to combat the negative symptoms associated with it. Serotonin is an important hormone involved in mood regulation and the mammary-derived form has a role in lactation. It induces the production of parathyroid hormone-related protein, which is essential for regulating maternal calcium. Because the calcium source for milk production is derived from the maternal bone, we were interested in the impact peri-partum usage of SSRIs had on maternal bone mineral density. Additionally, we sought to understand the effect that circulating SSRIs had on the bone formation of pups. Analysis revealed age-related decreases in BV/TV, Tb.N, trabecular thickness (Tb.Th), C.Th and increases in trabecular spacing (Tb.Sp) and C.Po, with the effects being exacerbated in cohorts treated with a SSRI during lactation. We did not observe, however, any change in trabecular bone mineral density (Tb.BMD) or cortical bone mineral density (C.BMD) over time. In regards to the pups, we observed similar results to those of the dams in addition to a significant reduction in femur length. With the data obtained from the two projects, we hope that they bring awareness to potential consequences that physiological perturbations may have on the bone remodeling process. Both experiments have clinical correlations to humans. Further understanding the relationship between aging and bone may aid in developing methodologies to prevent age-related changes. On the other hand, analyzing the effects that SSRI usage has on maternal and child bone density may result in alternative methods to combat post-partum depression.

In 2011, a period began in which the United States demographic will change to include the largest, least prepared, and most diverse elderly population in our nation’s history. That was the year the “Baby Boomer” generation started retiring and members of this large cohort will continue to do so for approximately twenty years (Kemper, Komisar & Alecxih, 2005). Chronic health conditions and the obesity epidemic may make retirement years less healthy ones than for previous generations of older adults. Lifestyle changes in Baby Boomers as compared to previous cohorts of elders – increased divorce, fewer children, nontraditional family relationships – may result in less support for frail elders when they can no longer care for themselves, thereby increasing their vulnerability to long-term care placement (Cherlin, 2010; Ryan, Smith, Antonucci & Jackson, 2012

Thesis advisor: Callista L. Roy / Purpose: The purpose of this research was to address the gap in the literature related to frail older adults' experience of participating in clinical trials. Background: Frail older adults are generally underrepresented in the population of research volunteers from which evidence-based guidelines are derived. To improve care for frail older adults, research must be expanded to specifically target this population. Most of the users of healthcare today are greater than 65 years old, use more health care services than any other age cohort and suffer from coexisting illnesses for which they take several prescribed medications. Since the number of elders is increasing within the general population, it is important to reach a more thorough understanding of frail older adults' experience. Acquiring a better understanding of their experience will give the investigator more insight into barriers of recruitment, retention, and factors affecting elders' decision to participate in research. Method: Using a qualitative descriptive approach involving semi-structured interviews, a cohort of participants age 65 and older was asked about their experience of participating in research studies. Data analysis used an interpretive paradigm involving the methods of Miles, Huberman, and Saldana (2014). Results: Participants identified the main factors influencing their decision to participate as the opinions and encouragement of family members with the strongest influence being a recommendation from their doctor. Participants were varied in the emotions evoked by their participation in the study procedures. The majority of participants stressed how important it was to them to receive feedback in the form of results of studies in which they had participated. The majority of participants stated that receiving feedback or research results was the exception. Conclusions: Data generated from this study related to the experience of frail elder participation in clinical trials will be useful in designing future clinical trials to be more inclusive of this patient population. Keywords: frail elders, research participation, clinical trials, chronic illness, qualitative, multmorbidity / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Thesis advisor: Lisa Sowle Cahill / Contrary to current transhumanist, medical, and cultural perspectives that aging is something solely to lament or even eradicate, this work explores the meaning of aging and death from the perspective of Christian theology, particularly within the schema of St. Augustine and Karl Barth. Both authors describe the complexity of aging in terms of our curse and calling as creatures aimed at participation in God through union with Christ. Locating Christology as central to our understanding of aging illuminates the ways in which the God revealed in Christ enters our humanity, sharing in our vulnerability, dependency, frailty, and even passivity. By turning to the incarnation, Christ's nature and work not only give us future hope, but transforms the daily aging experience - both active and passive waiting within our present, temporal reality for aging individuals and their surrounding communities. By maintaining union with God through contemplation and action, Christ dignifies our status as receptive and active agents. Thus, building from these two authors, I argue that aging serves as a sign and preparation for Sabbath rest by which aging persons might enact virtue through their specific vocation before God. Likewise, those persons surrounding the aging are called to enact virtues that reciprocally respond through interdependent communities that give and receive in union with Christ. Chapter One opens with preliminary questions on the meaning of death and aging while Chapter Two delineates Augustine's view on these realities as a result of the fall and original sin. However, even in Augustine's negative view of death and aging, he highlights the good in the soul/body relation and resurrected bodies. His position legitimizes grief and the human emotions, thus offering an ethics of compassion in loss. Finally, I constructively locate the positive view of aging and death is its sign and preparation for eternal Sabbath rest. Chapter Three considers Barth's analysis of death and aging as both negative and positive, evil and good through his dialectical lens. While death is a sign of judgment, finitude constitutes human identity as good in our temporal end. His ethics mirrors his anthropology in protecting life while accepting limits. He ends by describing the three stages of life including youth, middle age, and old age as composing our vocation. Each stage includes our call before God that legitimizes agency for the old as well as interdependent relationships. Chapters Four and Five explore the Christology of Augustine and Barth. Christ's divine and human natures bring together wisdom and knowledge for Augustine in Chapter Four. Aging persons grow in wisdom and knowledge through contemplation and action in union with Christ. Not only does union with Christ become the foundation for moral agency, but Christ also achieves the benefits for aging persons through his incarnation and atoning work. Christ experiences psychological anguish and forsakenness before God as the Totus Christus. Aging persons also receive the benefits of Christ's person and work that reverses the consequences of aging and death. Chapter Five claims that participation in Christ serves as the key to understanding Barth's Church Dogmatics. God's movement to humanity and our movement to God are embodied in the hypostatic union. Here we see Christ's active agency in his divine humility/obedience through the incarnation and atoning work. Christ's passive agency or human response perfectly embodies gratitude, prayer, and obedience through union with the Spirit in fulfilling his vocation in time. Moreover, in congruence with the work of W.H. Vanstone, Jesus' passive agency that receives the activity of the world legitimizes dignity and worth for those aging stages of life involving decline and dependence. Aging persons are agents who are active and passive, giving and receiving through a mixture of contemplation (prayer) and activity in union with Christ. Finally, Chapter Six synthesizes the Christology and participation present in the theologies of Augustine and Barth as the foundation for a moral virtue theory as it applies to aging persons and their surrounding communities. By emphasizing union with Christ in Augustine's virtue theory and union with Christ in Barth's morality of `vocation,' I argue moral agents are contemplative/acting persons intended for union with God. By receiving and giving in relationship with God and others, aging persons and their communities embody virtues that reciprocally benefit one another. Virtues for the aging include humility, gratitude, generosity, wisdom, prudence, memory, friendship, fortitude, and hope. Virtues for those communities surrounding aging persons entail respect, justice, mercy, and love. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Theology.

Thesis advisor: Elizabeth A. Kensinger / Although healthy young and older adults remember emotional information better than neutral, emotion does not confer the same benefit upon memory for those experiencing memory impairments due to Alzheimer's disease (AD). It is poorly understood at what stage of processing these deficits occur--are they due to declines in memory storage and retrieval processes, or to a decline in earlier stages of attention allocation, which then impact memory storage and retrieval? It remains an open question how attention and memory processes may interact in aging and age-related disease. The goal of this research was to examine the effects of aging on the neural mechanisms underlying selective memory for emotional information in visual scenes, and to compare memory between healthy older adults and patients with very early AD pathophysiological changes. Experiment 1 examined young and older adults' encoding-related neural activation associated with selective memory for emotional items within visual scenes and with successful memory for emotional items and the scene background. There were few regions showing significant interactions between age and memory for positive and negative scenes. In contrast, Experiment 2 showed that aging significantly affected the neural networks underlying selective emotional item memory and successful memory for emotional items and backgrounds. The results indicate that older adults require greater connectivity among prefrontal regions than young adults to encode all elements of a scene, rather than just encoding the emotional item. Experiment 3 showed that despite poorer memory overall, patients showing very early AD pathophysiological changes have relatively well preserved memory, especially for positive information. Dividing older adults' attention during encoding did not significantly alter their pattern of selective emotional item memory, suggesting that encoding of emotional items may be an easier or relatively automatic task compared to encoding of the background. In conclusion, there are significant age-related changes in the underlying neural networks, but not activation patterns, for selective memory for positive and negative scenes. Patients with early AD pathophysiological changes have impaired memory overall, however they may be able to recruit a similar neural network of prefrontal regions as healthy older adults for encoding of scenes with positive information. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Psychology.

The importance of older adults' health is increasing with extending lifespans. Despite a large amount of research conducted on older adults' health, little is known about sexual orientation differences. Although some studies have examined sexual orientation differences in health, many of them tended to focus on young and middle adulthood or paid little attention to life stage contexts. When studies do focus on older adulthood, they tend to focus solely on differences by sexual identity, and a very few studies have focused on reporting of same-sex contact (SSC) as a measure of sexual orientation. Using a population-based sample of older adults, the National Social Life, Health, and Aging Project, this dissertation focused on two major areas of comparison between SSC and non-SSC older adults that have received limited attention in past research: STDs as a sexual health outcome (Chapter 2) and alternative medicine usage as a treatment seeking behavior (Chapter 3). I argue that sexual orientation is associated with older people's health status and treatment seeking behavior. Analyses based on negative binomial regressions and propensity matching models found that older adults who report any SSC in their lifetime have higher lifetime rates of STDs and are more likely to use alternative medicine as a type of treatment seeking behavior. Primary analyses were based on negative binomial regression models, and supplemental analyses included propensity score matching models, stratified regressions, zero-inflated negative binomial regression models, sensitivity analyses, and additional tests based on alternative measures of the focal variables. These findings extend the sociological literature on sexual orientation differences in older adult health by examining outcomes of health status and treatment seeking behaviors that have previously been overlooked despite their important theoretical and policy implications. / A Dissertation submitted to the Department of Sociology in partial fulfillment of the Doctor of Philosophy. / Spring Semester 2017. / March 6, 2017. / alternative medicine, health, older adults, quantitative analysis, sexual minority, STD / Includes bibliographical references. / Koji Ueno, Professor Directing Dissertation; Neil Charness, University Representative; Miles Taylor, Committee Member; John Taylor, Committee Member.