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National studies indicate that older women have a suboptimal intake of calcium, and are not consuming the recommended daily servings of dairy foods. Three focus groups of 5-10 women were conducted to examine older women’s perceptions of dairy foods. Independent living, Caucasian women aged 65 and older were recruited from retirement communities in urban and rural areas of Virginia. Discussion questions addressed preferences for dairy foods, advantages and disadvantages of dairy foods, factors that influence dairy intake, and possibilities for product improvements. Focus group discussions were audio taped, transcribed by the facilitator, then checked for accuracy by a Virginia Tech graduate student using methods described by Krueger (1988). Both persons identified major and minor themes and organized quotations thematically. Analysis was independently conducted to verify correct interpretation of quotations. Results were reported in the following three broad themes: Positive and Negative Health Perceptions, Sensory Attributes, and External Influences. The predominant negative health perception was that many dairy foods are high in fat. Many women also associated dairy foods with cholesterol, sodium, and calories. One woman in each focus group reported that she experienced lactose intolerance. Participants believed dairy foods were a good source of calcium and other nutrients and were aware of osteoporosis and its relationship with calcium. However, calcium supplement use, particularly Tums®, was prevalent, and participants felt it was important in osteoporosis prevention. Women reported their physicians encouraged them to use calcium supplements and watch intake of dairy foods due to fat content. Women also reported receiving information from media sources such as health newsletters. Women wanted the food industry to recognize older adults as an important market. Many felt that dairy food packages, particularly cottage cheese and reduced-fat ice creams, were too large for a single person and resulted in spoilage and wasted money. Women found it difficult to locate and read expiration dates, and some expressed confusion over “Use By” and “Sell By” dates. Products, such as plastic milk cartons and zip-pack cheeses, were difficult for women with arthritic hands and diminished vision to open. Women’s comments suggested that they would be receptive to products and packaging designed and marketed to meet their needs. Appropriate recommendations are made to the dairy industry for the promotion and development of such dairy foods. Nutrition education programs for this population should continue to promote the use of low fat dairy foods and should emphasize other nutrients, such as Vitamin D and phosphorus, found in dairy foods. / Master of Science

The objective of the present study was to understand how the visual and mental processes work in tandem to affect the overall information processing capability of the individual, especially the older population, in a dynamic visual task such as driving. More specifically, our aim was to understand how the different parameters related to display of visual information in an in-vehicle display system and the age of the subject affect the information processing performance. The effects of stimulus distance, target size, display time, bits of information and the age group of the subject (young versus old) on the reading performance (information processing ability) under photopic and scotopic viewing conditions were thoroughly investigated in this study. Fifty-six individuals (28 young, 28 elderly) from the Montgomery County region were tested in the study in a mixed factorial repeated measures design with age as between subjects and the other independent variables as within subjects. The dependent variable was the reading score, i.e., the number of letters correctly identified. Results obtained from this study revealed that all of the independent variables had significant effects on the reading performance of the participants, except ambient illumination. Specifically, age has an important influence on the specific values of the design parameters. Also, these parameters interact among themselves so that one can be used to compensate for the other. These results can be used for developing the most relevant and optimal in-vehicle visual displays for the older population. / Master of Science

The objective of the study was to investigate multi-modality effects (visual and auditory) on the perception of urgency in elderly individuals addressing issues of safety and comfort. Twenty individuals (10 young, 10 elderly) from Montgomery County of Virginia participated in the laboratory study. In the pre-experimental audiometric tests, as expected elderly individuals had higher hearing thresholds (dBHL) than young across all the frequencies (250, 1000, 2000 and 4000 Hz) of pure tones. The difference was more pronounced at 4000 Hz. In visual acuity tests administered, elderly individuals had a lower Snellen VA than young at both near and far distances. The participants also were administered Bausch and Lomb color test; all participants were able to differentiate red color. Method of adjustment was used to collect empirical data. Rating test was administered after every treatment to objectively assess the participants' feeling of perceived urgency associated with the auditory warning signal. All the participants rated the experimental sound as urgent. Repeated measures was conducted to remove variations due to time and treatment conditions. A mixed-factorial design was used to investigate the main and interaction effects. The age effect was found to be marginally statistically significant. Modality and trial effects were not found to be significant. The reanalysis conducted after removal of outliers resulted in marginal statistical significance for age and modality main effects. Although not significant, a trend was seen in the pulse intensity levels (dBL) across modalities in the elderly individuals. Future research should be conducted to investigate modality effects in elderly individuals in a naturalistic driving environment which would give a better insight of the effects of dual modalities. / Master of Science

Low-income older adults are at high risk for developing diet-related chronic diseases. Nutrition education programs can improve dietary and lifestyle practices, thereby decreasing the incidence of diet-related diseases. Focus groups were conducted to gain insight into the needs and preferences of low-income older adults for nutrition education. Results were made available for use in the Smart Choices Nutrition Education Program at Virginia Tech to aid in the development of nutrition education programs. Four focus groups were conducted with a total of 35 elderly (28 females; 7 males), ages 55-90+ years, recruited from Congregate Meal Program sites in four regions of Virginia. Seventeen were African American, and 18 were non-Hispanic white. Discussion questions addressed practices for purchasing and preparing foods, importance of food to health, and preferences for education methods. The Determine Your Nutritional Health Checklist of the Nutrition Screening Initiative was used to assess nutritional risk of the elderly adults. Focus group discussions were audio-taped and written transcripts were made for use in data analysis. Themes of the discussions were identified in that analysis and reported in the following broad areas: Factors that Influenced Dietary Practices of Focus Group Participants and Perceived Needs and Preferences of Focus Group Participants for Nutrition Education. All elderly believed that food was important to their health and were interested in nutrition education. The predominant theme was the influence of a health condition on dietary practices. The elderly made food choices according to dietary restrictions imposed by their health condition. The most prevalent health conditions were chronic diseases, primarily hypertension, diabetes, and hiatal hernia. The majority (32) were at nutritional risk, with a larger number at high risk (20) than at moderate risk (12). Food preferences and sensory attributes of food also were important to them when making food choices. Some reported that convenience was important because they did not want to spend time and effort to purchase and prepare foods. Some also reported experiencing food insecurity, primarily from lack of money. The majority learned about food and cooking from family members, and only a few learned about nutrition and food choices from health professionals. Most wanted information about disease-specific food choices and preparation methods, and preferred to receive this information during group discussions because sharing ideas and opinions was an effective way to learn. Only a few were interested in television programs, while many were interested in written materials. Nutrition education programs for low-income elderly should teach these adults how to choose and prepare foods that are appealing and nutritious, as well as within dietary restrictions imposed by their health conditions. Educators should convey this information to them in group settings and distribute written materials, such as pamphlets and brochures, that outline "how-to" information. / Master of Science

The present study hypothesized a positive relationship between voluntary activity participation and life satisfaction with control for social class. Inverse relationships between voluntary activity participation and major life disruptions;, and between life satisfaction and life disruptions for the aged individual were also examined. None of the null hypotheses in the study were rejected. / Master of Science

Tripping causes a significant number of falls in the elderly. These falls often result in medical costs, hospitalization, disability, decrease in quality of life, and sometimes death. Knowledge of why trips occur and the mechanics of successful recovery from a trip is critical to increasing knowledge of how to prevent falls due to trips. Two separate studies are reported in this thesis. The first study assessed if men recover from a trip equally well when stepping with their dominant or non-dominant lower limbs. An experimental model of tripping was used to determine each subject's trip recovery capability when stepping with the dominant or non-dominant lower limb. Although most subjects were able to recover better when stepping with one lower limb compared to the other, there was no recognizable trend across the subjects. Based on these results, there is insufficient data to recommend the preferential investigation of the dominant or non-dominant lower limb in future trip research. The second study investigated peak joint torques after stepping to recover from a simulated trip. The same protocol as the first study was used for simulating trips. Increasing trip severity resulted in increased ankle plantarflexor torque in young subjects and increased hip extensor torque in both young and older subjects. Older men used higher hip extensor torques and lower knee extensor torques compared to young men. Implications to falls from trips are discussed. / Master of Science

No / Falls in the elderly are a major cause of serious injury and mortality. Impaired and absent stereopsis may be a significant risk factor for falls or hip fracture, although data from epidemiological studies are not consistent. Previous laboratory based studies, however, do suggest that stereoacuity is an important factor in adaptive gait. The present study investigates how acute impairment of stereopsis, through monocular blur of differing levels, ranging from 0.50 diopter (D) to a monovision correction affected gait when negotiating a raised surface in elderly subjects. Eleven elderly subjects (73.3 3.6 years) walked up to and negotiated a raised surface under nine visual conditions, binocular vision, one eye occluded and 0.50 D, 1.00 D and monovision correction (mean 2.50 D 0.20 D) with blur and occlusion either over the dominant or non-dominant eye. Analysis focused on foot positioning and toe clearance parameters. There was no effect of ocular dominance on any parameters. Monocular blur impaired stereopsis (p 0.01), with more minor effects on high and low contrast acuity. Vertical and horizontal lead limb toe clearance both increased under all levels of monocular blur including the lowest level of 0.50 DBlur (p 0.03) and monovision correction led to toe clearance levels similar to that found with occlusion of one eye. Findings demonstrated that even small amounts of monocular blur can lead to a change in gait when negotiating a raised surface, suggesting acute monocular blur affected the ability to accurately judge the height of a step in the travel path. Further work is required to investigate if similar adaptations are used by patients with chronic monocular blur.

No / Visual impairment is an important risk factor for falls. However, relatively little is known about how visual impairment affects stair or step negotiation. The aim of the present study was to determine the effects of blurred vision on the mechanics of landing during stepping down by the elderly. Twelve elderly subjects (72.3±4.7 year) stepped down from three levels (7.2 cm, 14.4 cm and 21.6 cm). Step execution time, ankle and knee joint angular displacements at the instance of ground contact, and vertical landing stiffness and the amount of bodyweight supported by the contralateral (support) limb during the initial contact period were recorded. Measurements were repeated with vision blurred by light scattering lenses. With blurred vision, step execution time increased (P<0.05), knee flexion and ankle plantar-flexion increased (P<0.05), vertical stiffness decreased (P<0.01), and the amount of bodyweight being supported by the contralateral leg increased (P<0.05). These findings suggest that under conditions of blurred vision, subjects were more cautious and attempted to ‘feel’ their way to the floor rather than ‘drop’ on to it. This may have been an adaptation to increase the kinaesthetic information from the lower limb to make up for the unreliable or incomplete visual information. Correcting common visual problems such as uncorrected refractive errors and cataract may be an important intervention strategy in improving how the elderly negotiate stairs.