Recent research demonstrates that new verbal memories are retained better if learning is followed by a brief period of wakeful rest. This effect is hypothesised to be the result of wakeful rest providing a state that is conducive for early-stage cellular consolidation (i.e. strengthening of specific memory traces) by protecting this process from interfering sensory input and associated encoding. The aims of this PhD project were to (i) examine whether the benefit of wakeful rest extends to the retention of complex spatial memories, and (ii) explore the effects of different cognitive states on memory consolidation. In order to address the first aim, three virtual reality spatial memory experiments were conducted. In young and older adults, wakeful rest not only enhanced the retention of complex spatial memories, but it also promoted the systems-level integration of spatial memories into accurate cognitive maps, a function, hitherto, assumed to be specific to sleep (Chapters 2-4). Pilot work also tentatively suggested that wakeful rest enhances the retention of complex spatial memories (i.e. a recently travelled route) in patients with amnestic Mild Cognitive Impairment (Chapter 4). In order to address the second aim, five experiments were run in young adults. The first experiment directly compared the effects of wakeful rest and sleep, two states that are positively associated with consolidation. Wakeful rest enhanced the retention of a list of known words, whereas a similar-length period of sleep enhanced the acquisition of novel linguistic constraints (Chapter 5). The final four experiments revealed that, similar to continuous external sensory input, internally generated autobiographical thinking activities (recalling the past and imagining the future) interfere with consolidation (Chapter 6). Together, the findings reported in this thesis reveal that wakeful rest promotes the strengthening (cellular consolidation) and wider integration (systems consolidation) of basic and complex declarative memories, and that this effect is contingent on a reduction in external sensory input as well as rich autobiographical thought.

Improved life expectancy is a triumph of modern medicine. However, today’s senior citizens are predicted to soon consume 75% of the available health-care resources. Identifying new strategies to promote a healthy ageing process has thus become a priority. In contribution to the research field of healthy ageing this thesis is focused on the health and gut function of older adults. Paper I explored ‘optimal functionality’; a new approach to put the older adult’s own perspectives on health in focus. According to the results a plethora of factors related to the body, the self and the external environment needs to be considered in order to create a comprehensive understanding of the health experience in old age. Paper II characterised senior orienteering athletes as a new model of healthy ageing, due to their significantly better percived health as compared to other free-living older adults; in particular they report better gut health. As the gut is important to health maintenance and immune function paper III explored inflammation and oxidative stress in senior orienteering athletes, and older adults with gut problems, generally finding low levels in both groups. Subsequently, Paper IV investigated the health status of free-living older adults in Örebro County and also reports the results from a randomised controlled trial evaluating the effect of a probiotic supplement on self-reported health and gut symptoms. Two-thirds of the included older adults reported gut problems, however, the probiotic intervention failed to show any effects. This thesis provides additional perspectives on older adults health and gut function, by concluding that 1) optimal functionality may be a useful concept to map areas of importance to the older adult’s health experience, 2) senior orienteers may be regarded as a suitable model to study healthy ageing, 3) the prevalence of gut problems among the general population of Swedish older adults is high, but was not improved by probiotic supplementation with Lactobacillus reuteri.

In the recent decades, a significant demographic shift is underway, with increasing life expectancy and falling fertility rates, causing a change in the age structure of populations. This introduces a problem for the sustainability of many modern social systems, which rely on funds from the economically active population to pay for the increased expenses of the elderly population. Over the last few decades, two scenarios that would alleviate the problem have been proposed. One is the compression of morbidity or healthy ageing, which assumes that a large part of the gains in life expectancy will be spent in good health, thus reducing the pressure on the healthcare system. The other being the concept of death-related costs hypothesis which assumes that a large portion of the older populations healthcare costs is tied to the death of the individual, which would mean that the increasing life expectancy would just shift the existing healthcare expenses to older age at the same rate as the increase in life expectancy. This thesis provides information on the situation in the Czech Republic, and whether any of these scenarios are present in the data from the last 20 years, which could be relied on to improve the healthcare system financing in the following years. The analysis of the average Czech...

Sense of purpose in life, or the view that one’s life has direction and is guided by overarching life aims, has been found to predict better health outcomes across the adult lifespan, including better cognitive functioning and dementia risk, physical health, and improved longevity. This research is based on multi-study replications of large longitudinal datasets, as well as intensive measurement design to examine short-term (e.g., within-day, day-to-day) and long-term (years) associations between sense of purpose and markers of cognition and health. The first project used multistate survival modeling to evaluate the role of sense of purpose on transitions across cognitive states and death and was based on two large longitudinal datasets – the Rush Memory and Aging Project (MAP) and the Health and Retirement Study (HRS). More purposeful older adults were found to have lower prospective risk of developing mild cognitive impairment (and equivalent classification in HRS), later onset of impairment, and increased likelihood of improvement in cognitive functioning following MCI classification. These results were replicated across two independent longitudinal studies with disparate samples and measurement procedures. The second project examined longitudinal associations between sense of purpose in life and allostatic load in two nationally representative samples of American (HRS) and English (English Longitudinal Study of Ageing; ELSA) adults over age 50. Blood-based biomarkers of cardiovascular, metabolic, immune, and renal function, as well as anthropometric and physical markers such as lung function were used to compute overall scores representing allostatic burden. Sense of purpose in life was associated with lower overall level of allostatic load across measurement occasions in the two samples but did not predict rate of change or within-person fluctuations in allostatic burden across time. The third study investigated daily variations in sense of purpose and associations with daily cognitive performance using an ecological momentary assessment design. Multilevel models examined within- and between-person associations between end of day sense of purpose ratings and performance on five indices of cognitive functioning. Results showed no associations between daily ratings of purposefulness and performance on five cognitive tasks across a two-week period. Taken together, these findings advance existing theory and highlight important directions for the field moving forward. / Graduate / 2023-07-29

Bakgrund: Tillgänglighet till service och resurser i närmiljön har betydelse för människors hälsa och livskvalitet. Äldre människor är särskilt beroende av god tillgänglighet i närområdet då det utgör den huvudsakliga vistelsemiljön för många äldre, samtidigt som åldrandet ofta medför en försämrad rörelseförmåga. Begreppet tillgänglighet innefattar flera faktorer, exempelvis avstånd och antal faciliteter som finns inom ett visst område, hur bekvämt och obehindrat man kan ta sig till faciliteterna och i vilken utsträckning faciliteterna uppfyller invånarnas behov. God tillgänglighet till faciliteter i närmiljön som främjar äldres hälsa och höjer deras livskvalitet förbättrar möjligheterna att uppnå ett gott åldrande. Syfte: Syftet med undersökningen var att beskriva tillgängligheten i närmiljön för äldre som bor i seniorboende samt studera skillnader i tillgänglighet i olika närområden. Studien belyste särskilt tillgängligheten till grönområden, livsmedelsbutiker, sociala mötesplatser för äldre och kollektivtrafik och fokuserades speciellt på faktorer relaterade till ”de fyra hörnpelarna för ett gott åldrande”, d v s fysisk aktivitet, god kosthållning, social gemenskap och stöd samt meningsfullhet och delaktighet. Metod: I studien ingick fyra seniorboenden i Gävle kommun, två belägna i centrala Gävle och två lokaliserade i perifera stadsdelar. Tillgängligheten analyserades med hänsyn till gångavstånd och beskrevs utifrån aspekterna rumslig fördelning, gångvägens beskaffenhet samt faciliteternas individuella kvaliteter. Kartläggningen av tillgängligheten gjordes med hjälp av geografiska informationssystem och fältstudier. Resultat: Tillgängligheten var likartad i de olika närområdena beträffande den rumsliga fördelningen av faciliteter. Samtliga undersökningsområden hade god tillgänglighet till grönområden, livsmedelsbutiker, sociala mötesplatser för äldre och kollektivtrafik med hänsyn till avstånd. Analysen av gångvägars beskaffenhet och faciliteters kvaliteter visade emellertid på vissa skillnader mellan områden. Mest framträdande var hur det mest centralt belägna området skilde sig från de övriga på flera sätt. Slutsatser: Analysen av resultatet visade att närområdena stödjer de fyra hörnpelarna för ett gott åldrande, speciellt vad gäller fysisk aktivitet, social gemenskap och meningsfullhet. Hörnpelaren ”god kosthållning” hade ett sämre stöd i samtliga områden. / Background: Accessibility to services and resources in the neighborhood is important for peoples health and their quality of life. Elderly people are especially dependent on good access in the neighborhood because it is the principal residence environment for many elderly. The concept of accessibility includes several factors such as distance and number of facilities that exist in a given area, how comfortable it is to reach the facilities and how the facilities provide for the residents needs. Good accessibility to facilities in the neighborhood which promote health of the elderly and increases their quality of life improves the chances of healthy ageing. Purpose: The purpose of this study was to describe the accessibility in the neighborhood for elderly living in senior housing. The research focused on accessibility to green open spaces, supermarkets, social venues and public transportation. Method: The study included four senior housings, two in urban areas and two in suburban areas. The accessibility was analyzed with regard to walking distance and was described based on spatial aspects of accessibility, how comfortable it was to reach the facilities and how the facilities provided for the elderly persons needs. The accessibility was analysed by geographical information systems and field studies. Result: The accessibility to the facilities was similar in the neighborhood areas concerning the spatial distribution of facilities. All neighborhoods had good accessibility to green open spaces, supermarkets, social venues and public transportation regarding distance. The analysis of the other aspects of accessibility, however, showed some differences between areas in terms of the areas “walkability” and the quality of facilities. The most remarkable finding was how the most centrally located area differed from the others in several ways. Conclusion: The analysis of results showed that the neighborhoods had the potential to support healthy ageing, especially with regard to physical activity, social support and participation.

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Made available in DSpace on 2016-08-03T16:34:22Z (GMT). No. of bitstreams: 1 SUELI FERREIRA.pdf: 1241623 bytes, checksum: 58d91dd3c7df52e31f9ab9e69bd20dcb (MD5) Previous issue date: 2012-03-28 / This study was intended to identify and describe a possible relationship between social support and quality of life in elderly participants in a continuing education program, which is promoted by a public agency in partnership with a University, located in one of the cities of the ABC region in São Paulo. The sample consisted of 106 individuals of both genders ranging in age from 60 years on, who effectively participate in the program. For data collection, the sample was divided into two subgroups, where the first group consisted of 54 seniors who have been attending the program for less than one year, and the other group consisted of 52 seniors who have been attending the program for more than one year, with the objective of identifying a possible existence of different perceptions between the groups, of the variables analyzed, depending on the time of participation in the program, which was not confirmed, as the results pointed to a homogeneity between the groups, both in the socioeconomic aspects and the perceptions of social support and quality of life, regardless of the time of participation in the program. This study used the exploratory descriptive method of comparative and quantitative character. The Scale of Perceived Social Support (SPSS) was used for data collection, which assesses the perception of social support in their emotional and practical dimensions; the instrument for evaluating the quality of life: WHOQOL Old & Bref; and a questionnaire with socioeconomic data that helped to characterize the profile of the sample and the statistical analysis of results. The results indicated that the sample studied is characterized by having a distinctive socioeconomic profile, with regard to higher education and monthly income, compared to the national average that presents a more vulnerable profile of the elderly Brazilian, with low education and income. The results of the evaluations of social support and quality of life perceptions have demonstrated that these seniors feel satisfied with their moment in life; and perceive the emotional support, feeling themselves as the object of affection in their social network. Regarding the perception of practical support, the results showed that the elderlies have a relative perception, pointing to uncertainties and doubts about receiving such support from their social network. Given this result, the perception of doubt and uncertainty in receiving practical support, and the distinctive socioeconomic characteristic of the sample, we can assume that these elderly people have these perceptions, by feeling themselves or by being in fact providers and not dependent on their social network. An inverse and negative correlation between the levels of social support and the quality of life facets was evident, suggesting that the social support construct may be perceived by the elderlies in the sample as a diminishing factor of biopsychosocial functionality or of behavioral competence. / Este estudo objetivou identificar e descrever uma possível relação entre suporte social e qualidade de vida, em pessoas idosas participantes de um programa de educação permanente, o qual é promovido por órgão público em parceria com uma universidade, instalada em um dos municípios que integram a região do ABC Paulista, em São Paulo. A amostra consistiu de 106 idosos, com idade a partir de 60 anos, de ambos os sexos, e que efetivamente participam do referido programa. Para a coleta de dados, a amostra foi dividida em dois subgrupos, onde o primeiro grupo constou de 54 idosos que freqüentam o programa há menos de 1 ano, e o outro grupo foi formado por 52 idosos que freqüentam o programa há mais de 1 ano, com isso objetivamos identificar uma possível existência de diferentes percepções entre os grupos, das variáveis estudadas, em função do tempo de participação no programa, o que não foi confirmado, com os resultados apontando para uma homogeneidade entre os grupos, tanto nos aspectos socioeconômicos quanto nas percepções de suporte social e qualidade de vida, independente do tempo de participação no programa. Este estudo utilizou método descritivo exploratório, de caráter quantitativo e comparativo. Para a coleta de dados foram utilizadas a Escala de Percepção de Suporte Social (EPSS), que avalia percepção de suporte social em suas dimensões emocional e prático; o instrumento de avaliação da qualidade de vida: WHOQOL Bref e Old, e um questionário com dados socioeconômicos que auxiliaram na caracterização do perfil da amostra e na análise estatística dos resultados. Os resultados apontaram que a amostra pesquisada caracteriza-se por possuir um perfil socioeconômico diferenciado, no que se refere a uma maior escolaridade e rendimento mensal, quando comparado a media nacional que mostra o perfil do idoso brasileiro mais vulnerável, com baixa escolaridade e rendimento. Os resultados das avaliações das percepções de suporte social e da qualidade de vida demonstraram tratar-se de idosos que se sentem satisfeitos com seu momento de vida; que percebem apoio emocional, sentindo-se objeto de afeto em sua rede social. Com relação a percepção de suporte prático, os resultados demonstraram que os idosos possuem uma percepção relativa, apontando dúvidas e incertezas quanto ao recebimento deste tipo de apoio de sua rede social. Diante deste resultado, percepção de dúvidas e incertezas em receber suporte prático, e a característica socioeconômica diferenciada da amostra, podemos supor que esses idosos possuem estas percepções, por se sentirem ou por serem de fato provedores e não dependentes da sua rede social. Não foi evidenciada correlação entre as variáveis suporte social e qualidade de vida, sugerindo que o construto suporte social talvez seja percebido pelos idosos da amostra como fator de diminuição da funcionalidade biopsicossocial ou da competência comportamental; ou ainda, pode-se supor que diante dos sentimentos de satisfação com a vida atual, a amostra de idosos volta-se menos aos aspectos protetores do suporte social.

Ageing is accompanied by a progressive decline in skeletal muscle mass and strength which may lead to impaired ability to perform activities of daily living in older adults. Although the exact cause of the gradual decline in muscle mass is unknown, identifying efficient strategies aiming to prevent age-related loss of muscle mass and strength is important in order to promote healthy ageing. The overall aim of this thesis was to explore the effects of resistance training alone or combined with a healthy diet on skeletal muscle mass and function of healthy recreationally active older women and to determine mechanisms by which elevated systemic inflammation may contribute to the age-related decline of muscle mass in older adults. The combination of resistance training and a healthy diet induced gains in leg lean mass as well as greater gains in dynamic explosive force than resistance training alone in healthy recreationally active older women. The observed gains in leg lean mass were accompanied by increases in the size of type IIA muscle fibres together with down-regulation in gene expression of a pro-inflammatory factor (IL-1β) and upregulation in gene expression of a regulator of cellular growth (mTOR) in skeletal muscle of older women. Additionally, reduced muscle protein synthesis and size of muscle cells may mediate the detrimental effects of elevated circulating markers of inflammation on muscle mass in older adults. In conclusion, the present thesis depicts mechanistic links between elevated systemic marker of inflammation and muscle mass and provides new information on the effects of combined resistance training and healthy diet on muscle mass and strength in a group of healthy recreationally active older women. This knowledge is instrumental for development of strategies aiming to prevent age-related loss of muscle mass and function.