published_or_final_version / Medicine / Master / Master of Medical Sciences

The purpose of this study was to investigate whether biological variables could predict how older adults would respond to different types of treatment for depression. Fifty-six adults over the age of sixty-five, diagnosed with major depression (DSM III criteria) were assigned to one of four treatment conditions: group Cognitive Behavior Therapy with alprazolam or placebo medications, and minimal support therapy with alprazolam or placebo medication. Before and after treatment, REM latency and REM density were measured by polysomnograph in the sleep laboratory and the Dexamethasone Suppression Test (DST) was administered. Depression was measured by weekly by the Hamilton Depression rating Scale and the Beck Depression Inventory. Subjects presented with normal (i.e. nondepressed) values on REM latency and REM density. Thirty five percent of subjects were DST nonsuppressors, a similar percentage to that found in other studies of depressed subjects, but mean DST for the whole group was below the selected cutoff of 4 mcg/dl. The expected correlations among the biological variables and between these variables and baseline depression levels were not found. It was concluded, therefore, that depression in this group of subjects was not characterized by biological abnormalities. Multiple regression analyses of baseline variables and depression scores at mid and end of treatment and at followup indicated that initial depression levels and DST predicted later depression levels for subjects who received Cognitive Behavior Therapy, regardless of medication assignment. Low baseline DST levels were associated with good response to psychotherapy, confirming the findings of previous studies. Sleep variables were not predictive of response to treatment at any time point.

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Estudo empírico indutivo, que verifica como e percebida a velhice e a aposentadoria, e os estados subjetivos que tais fatos sugerem. Realiza entrevistas semi-estruturadas com sete professoras aposentadas. A analise revela que a velhice e uma fase critica e a aposentadoria um fato traumático. As entrevistadas sentem-se marginalizadas, ressentidas pelas perdas sofridas e falam do medo, da solidão, e da ausência de perspectivas futuras. Com esses dados elabora então, um instrumento de pesquisa que aplica a uma população de 100 indivíduos, sorteados aleatoriamente e distribuídos entre 5 faixas etárias com a idade variando entre 18 e 82 anos. Constata que entre os aposentados com mais de 59 anos, ha uma redução da auto-estima e da possibilidade de realização de ação, além da dificuldade de se reorganizarem e constituirem novos valores nesta etapa da vida. Entre aqueles com menos de 59 anos, verifica a presença de conflito, através do qual o individuo expressa suas dificuldades em relação aos aspectos investigados. Sugere a realização de outros estudos para maior investigação dos fatores que possibilitem uma velhice satisfatória e assegurem uma maior integração desses indivíduos a comunidade / This ls an empiric inductive study that checks the role now old age retirement and the subjective states that such facts suggest. The procedure started with partially structured interviews with seven retired lady teachers. The analysis has revealed that the old is a critical period and that retirement is a traumatic fact. The subjects of the interview felt alienated, expressed regret losses, and spoke experiences of fear and loneliness about a of future projects.After suc11 collected data, we built a research tool that was applied to a hundred subjects, chosen at random, and distributed among five age levels, the age varying from eighteen to eighty-two. Among the retired individuals above fifty-nine, we noticed the reduction of self-esteem and possibility of acting, and we observed their difficulty In reorganizing new values. Among the retired above fifty-nine, we noticed a conflict, through which the Individual expresses his difficulties related to the researched aspects. consequently, any clinical intervention, at a therapeutic or preventive level, cannot Ignore the confrontation of the stereotype of a quiet old age and the experienced reality, for, althougt1 we believe that the Individual may continue to develop, even at this stage of life, we noticed that the researched aspects are difficult to deal with and are noticed in a negative way by the researched population. We do hope that these results can motivate other researchers, towards th1s group of society. We should like that those aspects that can guaratee a better old age and a bigger integration of those individuals to the community could be more largely researched

Zhang, Xin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 44-49). / Abstracts in English and Chinese. / Chapter CHAPTER ONE: --- INTRODUCTION --- p.1 / What Is Poignancy? --- p.1 / Socioemotional Selectivity Theory and Poignancy --- p.3 / Influential Psychosocial Factors --- p.4 / The Present Study --- p.9 / Chapter CHAPTER TWO: --- STUDY ONE --- p.10 / Method --- p.10 / Results and Discussion --- p.15 / Chapter CHAPTER THREE: --- STUDY TWO --- p.23 / Method --- p.23 / Results and Discussion --- p.26 / Chapter CHAPTER FOUR: --- GENERAL DISCUSSION --- p.37 / Theoretical Implications for Aging and Emotion --- p.37 / Practical Implications for Psychological Well-being of Older Adults --- p.40 / Limitation and Future Directions --- p.42 / References --- p.44 / Footnote --- p.50

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In everyday life memory is commonly used in the completion of future intentions, such as remembering to attend a meeting or remembering to make a purchase at a particular time or place. The ability to remember to complete future intentions plays an important role in older adults maintaining independent living within the community (Cherry & LeCompte, 1999). The studies presented in this thesis evolved out of the lack of current understanding about which component processes involved in remembering future intentions are most susceptible to the effects of aging. In order to investigate these processes, a computer-based analogue of a real-life task was developed (the Virtual Street) that enabled participants to complete a series of intentions (shopping errands) during a simulated visit to a shopping centre. There were two main objectives of this thesis. The first objective was to examine whether the Virtual Street shopping task was appropriate for assessing older and younger adults ability to remember to complete delayed intentions and whether the task had better ecological and face validity than current assessment measures. The second objective was to identify the cognitive processes involved in the task that were vulnerable to the effects of aging, and whether the process of recognising the cues or the memory search of the intention content would be affected. In order to examine these cognitive processes, various factors were manipulated in ways designed to be analogous to real-world situations, which were hypothesized to be sensitive to the effects of aging. These factors include: a change in the location where an intention can be realised (Study 1), the opportunity to learn the intentions (Study 2), the familiarity of the shopping environment (Study 3), and the presence of distractions (Study 4). Overall, the results from the four studies demonstrated that older adults have difficulty remembering delayed intentions, even when the test uses naturalistic stimuli, the tasks are familiar, and they are able to move at their own pace. Furthermore, the results from Study 2 demonstrated that the memory search component but not cue detection was affected in older persons when they were given fewer trials to learn the shopping errands, possibly due to the accessibility of the cue-intention associations may be impaired in older adults. There was no age specific effect on cue detection or memory search in either an unfamiliar street environment (Study 3) or one with increased levels of irrelevant auditory and visual noise (distraction condition, Study 4). In the interruption condition of Study 4, however, cue detection but not memory search was disproportionately affected in older adults after filled interruptions, suggesting that the capacity for self-initiated reinstatement of working memory is reduced in old age. In general, the Virtual Street task was to be a practical means of examining younger and older adults ability to remember to complete delayed intentions. The Virtual Street task also provided an opportunity for behavioural observation of real-life skills and cognitive abilities, within a controlled context. It is hoped that the Virtual Street shopping task will continue to be developed into an ecologically valid measure of assessing older adults memory functioning.

The basis for sex differences in cognitive ability remains poorly defined and controversial both scientifically and politically. One of the biological hypotheses on sex differences, of particular relevance to this thesis, concerns the role of gonadal steroids, specifically testosterone (T) and oestrogen, and their relationship to individual differences in the performance of specific cognitive tasks. In addition, the role that age-related changes in these hormones play in relation to generalised and pathological cognitive ageing in males is studied. It is important to determine whether decreases in T levels that occur with ageing in males are associated with age-related decreases in cognitive performance because T levels can potentially be modified. Males have consistently been found to outperform females on measures of visuo-spatial function; performance on the Vandenberg and Kuse Mental Rotation Test (MRT) shows the largest and most robust of sex differences. Gonadal steroids have both organisational and activational effects which contribute to both withinsex variability and between-sex differences in visuo-spatial cognition. As males age, endogenous plasma T levels decline gradually yet variably between individuals. Studies in older males show improvement in visuo-spatial cognition following T supplementation; however, it remains to be resolved whether decreases in endogenous T levels with ageing are associated with poorer MRT performance. Some recent studies in older males have reported positive correlations between measures of plasma T levels and cognitive functioning, including processing speed and executive function measures. These data are inconsistent, however, and important questions remain concerning, for example: the age at which the effect is strongest; whether there are different effects at different ages; whether there is an optimal level at which T levels affect particular abilities; and which abilities show the strongest association with endogenous plasma T levels. Increased intra-individual variability in performance on Choice Reaction Time (RT) tasks has recently been shown to be a strong predictor of cognitive functioning in university students. Methodological advances in the analyses of RT distributions has allowed for the calculation of robust estimates of intra-individual RT variability. The association between these estimates and cognitive performance in middle and older aged males, however, remains to be determined. Further, the association between endogenous plasma T levels and intra-individual RT variability in aged males is unknown. The thesis addresses these issues; firstly, through cross-sectional analyses of the associations between different measures of plasma T levels, learning and memory, processing speed, and executive function performance in a large population based sample of 1046 men aged between 35 and 81 years. Secondly, further cross-sectional analyses are reported from a subsequent study in a healthy sub-sample of 96 of these men on the associations between endogenous plasma T levels, MRT performance, constituent abilities related to MRT performance, and performance on composite measures of both processing speed and executive function. In a third study, these data are re-analysed in relation to intra-individual variability in RT performance. In light of the results of these studies, the role that age-related declines in plasma T levels play in relation to generalised age-related cognitive decline in males is discussed. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1330807 / Thesis (Ph.D.) -- University of Adelaide, School of Psychology and School of Medicine, 2008

The incidence of falls is common in older adults and becomes more frequent with advancing age. Falls and injuries associated with falls are among the most debilitating and traumatic medical problems encountered by the elderly. There is evidence that indicates there may be a cause and effect relationship between specific gait parameters and falling. If a simple gait test can predict fallers, it could become a valuable tool for identifying individuals at high risk of falling. The purposes of this study were 1) to determine whether performance on the Functional Ambulation Profile (FAP) could accurately predict fallers and non-fallers in a prospective manner and 2) to identify gait parameters within the FAP that would best classify fallers. My hypothesis for this study include 1) the Functional Ambulation Profile (FAP) will accurately predict subjects as fallers and non-fallers and 2) of the five variables that comprise the FAP walking velocity, right and left step length:leg length ratio, step width will be the most powerful predictors of fall status. Two hundred twenty six subjects were evaluated using the GAITRite electronic walkway. Falls surveillance was conducted for 8 months after each participant's specific GAITRite testing date. Average height, weight and BMI were 161.9 �� 8.7 cm, 68.1 �� 16.7 kg, and 25.9 �� 4.1 kg/m��, respectively. Men and women were analyzed separately using analysis of variance, logistic regression and relative operating characteristic curves. There was no difference between fallers and non-fallers for any of the FAP variables for both the men and women. Regression results indicated the overall model for FAP to predict fallers was not statistically significant for either men or women, (p=0.706 and p=0.543, respectively). In addition, none of the five variables that make up the FAP was significant enough to be included in a stepwise logistic model, thus we were unable to develop an alternative model for predicting fallers based on gait variables. A secondary analysis found that the FAP was unable to distinguish multiple fallers (3 or more) from occasional and non-fallers in this same study population. The results of this study indicate that the FAP does not predict falls in independently living men and women over the age of 70. Further, none of the five gait variables that compose the FAP was a significant independent predictor of falls in this same population. Based on the results of this study we conclude that the FAP alone is not sufficient to predict risk of falling among older adults. Because of the complexity of all the physical, psychological and environmental elements that can lead to falling, tests based on only spatial and temporal gait characteristics do not appear to be good fall predictors for independent older adults. / Graduation date: 2003

This dissertation examines processes and practices that make certain social categories real in people’s lives. One of these categories is old age and old people. In contemporary societies that are inundated by images of youth, old age is under attack. Old age does not fit into the contemporary framework of idealised lifestyle and images of perfect people. Thus, the main question addressed in this dissertation concerns spaces of ageing, which are societal arenas in which people are expected and/or allowed to become old. This study investigates discourses of old age within the context of welfare. It describes actions, statements and attitudes related to old age within the context of the welfare state. This study is based on multiple data that include 121 opinion weekly news magazines articles, social policy observations, and two case studies of a non-governmental and a user-organisation. The method of analysis comprises two approaches to discourse: discourse analysis and analysis of discourses. The study adopts a perspective that highlights the contextual, emotional and unstable character of welfare states that undergo constant processes of change. It notes the process of people production based on instilling in them norms and principles that should govern their lives. The findings of the study illustrate the lack of spaces of ageing in the welfare state context. People are expected not to grow old, and old age remains a misunderstood phenomenon. Therefore, spaces of (non)ageing are invoked to elaborate on these processes. Spaces of (non)ageing  occur in various societal domains and show what is required to avoid becoming old. Spaces of (non)ageing frame the idea of old age as something terrifying and, in many cases, immoral. The findings of this study are discussed in relation to the processes and practices of inequality (re)production. The complexity and multiperspectivity of understanding such phenomena are taken into consideration. The study invites a perspective of ‘us’ from which to examine social inequalities, and ‘we’ who think and feel at the same time.   This dissertation is written from a perspective of knowledge, which is always plural, changing and fluid. Therefore, the results are discussed in terms of the production of some knowledges about the researched phenomenon but not as an exhaustive study. The final sections of the dissertation are devoted to a cross-study discussion of new ways of interpreting and describing the research material presented in four sub-studies. This discussion does not aim at obtaining better or more correct results; instead, it aims at presenting a different aspect of these results. It acknowledges different spatial and temporal locations and the ways in which these locations affect the production of knowledge.