Thesis (M.Soc.Sc.)--University of Hong Kong, 1997. / Includes bibliographical references. Also available in print.

Background Long life does not inevitably mean more healthy years; older women have an increased risk of disabilities, diseases and adverse life events. Nevertheless, many older women experience health. This may be explained by possessing resources that promote health, despite adversities. Inner strength is seen as a resource as such. In this thesis inner strength is interpreted according to a theoretical model where inner strength comprises four interrelated and interacting dimensions: connectedness, creativity, flexibility and firmness, and being rated by the Inner Strength Scale (ISS). Aim and methods The overall purpose of this thesis was to explore inner strength as a health resource among older women. In study I six focus group interviews were performed with older women (66-84 years; n = 29) and the interviews were analysed by a concept driven approach and by means of qualitative content analysis. Studies II–IV had a quantitative, cross-sectional design. A questionnaire was sent to all older women (65 years and older) living in Åland, an autonomous island community in the Baltic Sea, and 1555 (57%) women responded. The data was analysed using descriptive and inferential statistics. Results In study I, exploring how inner strength and its dimensions can be identified in narratives of older women, connectedness was interpreted as a striving to be in communion, creativity as the ability to make the best of the situation, firmness as having a spirit of determination – “it is all up to you”, and flexibility as a balancing act. The results of study II showed that strong inner strength was associated with better mental health, but not physical health. In exploring factors associated with health-related quality of life, fewer symptoms of depressive disorders was the strongest explanatory variable, and together with not feeling lonely associated with better both physical health and mental health. Better physical health was also explained by not having a diagnosed disease, being of lower age and the opportunity to engage in meaningful leisure activities. Better mental health was additionally explained by having enough money for personal needs. In study III the result showed that non-depressed women were likely to have a strong inner strength, as well as never or seldom feeling lonely, taking fewer prescribed drugs, feeling needed and having the opportunity to engage in meaningful leisure activities. In study IV poorer mental health was associated with weaker inner strength in total, and in all four dimensions of inner strength. Symptoms of depressive disorders and feeling lonely were related to lower scores in three of the dimensions (except firmness and creativity, respectively) and poorer physical health was associated with lower scores in two of the dimensions (firmness and flexibility). Some other health threats were significantly associated with only one of the dimensions (connectedness or creativity), and others were not significantly associated at all. Conclusion The results add nuance to the notion of inner strength and deepen empirical knowledge about the phenomenon. It is elucidated that the ISS can be used not only to rate inner strength but also to offer guidance as to the areas (i.e. dimensions) in which interventions may be profitable. It is further shown that inner strengths can be identified in narratives of older women. Mental ill health has shown to have overall the strongest association with weakened inner strength among community-dwelling older women. The causality can, though, not be studied due to the cross-sectional design; therefore, longitudinal studies are recommended. Notwithstanding that limitation, the findings can be used as a knowledge base in further research within this field.

published_or_final_version / Sports Science / Master / Master of Science in Sports Science

published_or_final_version / Community Medicine / Master / Master of Public Health

Older adults have been reported to show attentional preference for positive stimuli and attentional avoidance from negative stimuli. The relationship between this pattern of emotional attention and emotion regulation, however, is not well known. The present study aims to replicate the findings of age-related attentional bias for emotional stimuli and investigate the potential relationship between biased attention and emotion regulation/dysregulation in Chinese older adults. 46 older adults and 46 younger adults participated in an attention task, which measured their reaction time towards negative and neutral facial stimuli, and a questionnaire survey, which elicited self-reports of their levels of emotion regulation and dysregulation. Results showed that there was a biased attention for negative faces in older adults, but not in younger adults. There were also differences between emotion regulation/dysregulation measures in the two age groups. When associating the attentional bias score with the emotion dysregulation measures, significant correlations were found between biased attention and overall difficulty in emotion regulation and lack of emotional clarity. The data supported the age-related bias of emotional attention, and revealed potential relationship between biased attention and emotion regulation in older adults. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Several tasks examined implicit and explicit memory in matched samples of Alzheimer's (AD) and Parkinson's disease (PD) patients, and healthy elderly subjects. Lexical priming, pursuit-rotor tracking, and a fragmented pictures test, followed by explicit memory tests, were given. AD patients were impaired on all explicit tests and on lexical priming, but were intact on pursuit-rotor tracking and the procedural learning (PL) component of the fragmented pictures test. PD patients were significantly better than AD patients on all explicit memory tests, but were selectively impaired on the PL component of the fragmented pictures test. Finally, a mirror reading test was given to the PD patients and matched control subjects, with no significant differences in performance between the two groups demonstrated. Results are discussed in terms of hypothetical cognitive processes and brain circuits underlying different explicit and implicit memory domains.

The lifespan developmental framework views aging as a time of continued personal change and development. Death is perhaps the most salient developmental challenge older persons face. The relationship of self-transcendence, spirituality, and hope to personal death perspectives was the focus of this research. A descriptive correlational approach was used to study the relationships between these variables. Interviews were conducted with forty healthy adults aged sixty-five and older. Findings revealed that self-transcendence and spirituality were significantly correlated with positive death perspectives in this sample. Findings also revealed significant relationships between age and death perspectives, gender and self-transcendence, and gender and spirituality. No significant relationships were found between hope and death perspectives and hopelessness and death perspectives.

This minithesis provides an ethnographic account of the life world of older people in the community of Belhar in the Cape Peninsula, which was historically categorised as a &lsquo / coloured&rsquo / community during the implementation of the Group Areas Act. By content analysing newspaper articles published in the early 1980s and specifically during the implementation of the Group Areas Act I found that many of the residents reported that they lived in fear of their lives, in what was once known as a &lsquo / prestige suburb&rsquo / . At the present time the community of Belhar is an intensely gang-infested area. From preliminary research done by myself at a senior citizen centre in Belhar, the high incidence of violence was a recurring theme throughout discussions with older people. In fact when I posed the question Why do you come to the centre five days a week? to a group of older people they answered without hesitation It is unsafe for an older person to be alone during the day. Answers like these to many of the questions that I posed would almost always be followed with Things were better then. It also was apparent that the older people in this community remember (or perhaps reconstruct) the past in the context of their present living situation. This became the leading theme in my study and is also the background against which I had formulated my research questions. However this study not only focused on the impact of the high incidence of violence on the community of older people but also essentially looked at elderly residents&rsquo / everyday lived experiences in Belhar. The research sample consisted of twenty elderly residents and four key informants. The latter provided mainly infrastructural data on the community. Primary data was collected by using ethnographic techniques of inquiry which included participant observation and unstructured interviews. Results revealed that older people occupy a liminal space both in the community and in their households. I also found that the elderly stroke victim is twice silenced and marginalized due to the constraints brought on by their chronic illness and their status as an older person in the community.

In later life, adverse life events, disability, health problems, inadequate social support, and personality traits hypothesized to be important risk factors for depression. Sample included 35 older (65-84) physical rehabilitation patients in a large metropolitan hospital. Statistical analysis included Pearson Product Moment correlations and multiple regression results. Perceived physical health, instrumental ADLs, life satisfaction, extraversion, and conscientiousness are inversely related to depressive symptom severity; neuroticism is positively related to depressive symptom severity. Regression models predicted depressive symptom severity, PANAS negative effect and PANAS positive affect. Neuroticism, insrumental ADLs, and age are significant predictors of depressive symptom severity; neuroticism and age are signficant predictors of PANAS negative affect, while extraversion is a significant predictor of PANAS positive affect. Personality factors, level of functioning, and age are important factors relating to mood. Limitations of this study include: small sample size with special characteristics (high level of SES); incomplete personal and family history of psychiatric problems; and lack of clinical comparison sample.

Late-life depression (LLD) is common illness, frequently associated with neuropsychological impairment. Disruption of frontal-subcortical and limbic networks may play a key role in LLD and can be examined using magnetic resonance imaging (MRI). Grey matter (GM) can be examined using T1-weighted MRI, white matter (WM) using diffusion tensor imaging (DTI), and functional connectivity using resting-state functional MRI (fMRI). To clarify the roles of GM, WM and functional connectivity in LLD, systematic reviews and meta-analyses of T1-weighted MRI, DTI and resting-state fMRI studies of depression were performed. The literature provided evidence for GM and WM abnormalities within frontal-subcortical and limbic networks, and increased functional connectivity within the default-mode network, in depression. To examine whether results gained from different techniques are complementary, multi-modal MRI was used to compare GM, WM and functional connectivity between thirty-six participants with LLD and twenty-five control participants. WM integrity was widely reduced in LLD, without significant group differences in GM or functional connectivity. To investigate whether neuropsychological deficits represent independent processes with specific neural correlates, or whether they can be explained by a core deficit, the relationships between neuropsychological and MRI measures were explored. Executive function and processing speed were found to represent core deficits that contribute to impairment in other domains; and impaired performance was correlated with reduced frontal WM integrity. Episodic memory deficits were dependent on executive function and processing speed; and associated with reduced frontal and hippocampal WM integrity. The relationships between age at onset, severity and MRI measures of GM, WM and functional connectivity were also investigated. Later onset was associated with reduced WM integrity, in line with the vascular hypothesis. Earlier onset was associated with greater duration of illness and reduced hippocampal volume, consistent with the glucocorticoid cascade hypothesis. Severity was not associated with any MRI measure. This thesis strongly supports the hypothesis that WM abnormalities in frontal-subcortical and limbic networks play a key role in LLD, with abnormalities related to neuropsychological impairment and compatible with the vascular hypothesis.