Introduction: The proportion of individuals aged 65 and over is increasing and mental health services need to recognise the resources of these individuals and meet their needs. Quality of life is a widely used outcome variable in mental health policy and clinical research. Subjective factors are consistently found to be more significant than objective factors in determining quality of life. This gives clinicians areas to consider when working to improve an individual’s quality of life. The current research looks at the relationship between successful psychosocial development and quality of life in older people with mental health difficulties. A secondary aim is to consider the impact of chronic mental health difficulties on quality of life. Method: Twenty-four older people (mean age 72) who were living in the community and supported by Community Mental Health Teams opted in to the study. Questionnaires, which included the WHOQOL-Old and MEPSI, were administered by the researcher. Results: Strong and significant correlations were found between quality of life and successful psychosocial development. A regression analysis found that successful resolution of the final stage of psychosocial development was the most significant predictor of quality of life over other psychological and demographic variables. No impact of chronicity was found. Discussion: The results of the study suggest that psychosocial development is an important factor to consider when working with older people and that a sense of ego-integrity is important to an individual’s perception of quality of life.

Hand grip strength (HGS) is a new nutritional assessment parameter proposed by American Society for Parenteral and Enteral Nutrition (ASPEN) and the Academy of Nutrition and Dietetics (the Academy) for diagnosis of adult malnutrition related to acute illnesses, chronic diseases or starvation. Identification of ≥2 of the following conditions is considered to be malnourishment – weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, diminished HGS and inadequate energy intake. HGS is also a marker of sarcopenia, a condition defined by low muscle mass and low muscle strength or performance, as identified by the European Working Group on Sarcopenia in Older People. It has also been shown that lower HGS is associated with deficits in activities of daily living (ADL) and mobility. HGS is emerging as an important screening tool especially in the malnourished and aging population. This research evaluates the applicability of HGS as a nutrition screening tool in long-term care older adults. Data from a total of 129 participants age ≥60 years involved in an ongoing walking program in long-term care facilities in Saskatoon available for analysis at the time this work was undertaken. Participants were randomly assigned for an intervention period of 16 weeks to one of three study groups: 1) Usual Care Group, 2) Interpersonal Interaction Group, and 3) Walking Program Group. Activity of daily living, cognition and depression scores and hand grip strength were recorded at baseline and every eight weeks. Information on vitamin D intake status prior to study commencement was also collected. This study provides values of low grip strength similar to those defined for the risk of sarcopenia in frail older adults. Stronger baseline HGS was correlated with greater ADL independence in females (B=0.079, P=0.044). Greater ability to eat at baseline was also associated with stronger grip in females when cognition status was taken into consideration. Baseline ADL (B=-0.024) and HGS (B=1.004) were significant predictors of subsequent ADL and HGS, respectively, in males (P<0.01). Baseline HGS was associated with subsequent ADL and HGS in females, but such association was modified by other covariates. In summary, if grip strength is to be used as a nutritional screening tool in long-term care facilities, dietitians shall be cautious of other factors such as the residents’ cognitive status and age and use in conjunction with other nutrition assessment methods.

A food preference questionnaire, utilizing the Food Action Rating Scale (FACT), was developed from entrees used in congregate meal sites throughout the United States and its territories. The list of entrees was reduced to 43 choices. The FACT questionnaire was distributed to all of the participants at the Healthy Lunch Sites served by Area 6 program in East Central Indiana. There were 357 people, age 60 or older, that completed the questionnaire. Their responses were compared by age and gender. Differences in preferences of entrees were noted depending on age and gender. The five most liked entrees of the total group are Country Steak / Brown Gravy, Cubed Steak, Salmon Patties, Chicken and Noodles, and Pork Roast. The five most disliked entrees are Cheese Enchilada / mild or spicy, Turkey Divan, French Dip Sandwich, Boiled Cod, and Bean Burrito / mild or spicy. Their responses were tabulated using factor analysis. A total of eleven clusters of entrees factored together. This provided groups of entrees that received similar scores. For example, some of the groupings were turkey entrees, chopped meat and sauce, barbecued meats, fish entrees. These results can be used by menu planners to assist in writing menus. By locating an entree on one of these tables that is well liked by the group being served, the other foods listed on that particular table can be served alternately during the remainder of the menu cycle to provide a high food acceptance. / Department of Family and Consumer Sciences

This study has presented in detail statistics and research related to the elderly and aging population and the many housing options that are currently available to this age demographic. The research has shown that Assisted Living Facilities are rapidly becoming the preferred method of Elder Care in the US, so much so that they have begun to offer nursing care which is typically offered only by nursing homes. Further exploration demonstrated that there is a lack of consistency in these facilities, and the evidence points to the need for a new model of Assisted Living that will focus more on the individual while still providing necessary care. This discovery has lead to the concept of creating an Assisted Living Development as the new model to be considered by future designers and Assisted Living planners. The creation of this model has helped to outline a new methodology for the planning and organization of Assisted Living. / Department of Architecture

The purpose of the present investigation was to gather data on the performance of nonpatient elderly subjects on the Rorschach Psychodiagnostic Test. The Comprehensive System (Exner, 1985, 1986) was used for administering, scoring, and interpreting the Rorschach because it is a research-based form with demonstrated reliability and validity and it has become the most widely used approach to the Rorschach in the past 13 years. However, the norms were based upon an adult sample, ages 18 to 64. Therefore, the present study addressed the following problems: What are the normative data for the Rorschach of a nonpatient group of elderly? How do these normative data of the elderly compare with the normative data for younger adults?Method The study used 60 men and women, ages 65 to 94, all active, nonpatient volunteers with no psychiatric history. They lived independently of any institutional supervision or care.Results Means of Rorschach variables for elderly subjects were compared with the means for a younger adult population. The elderly had significantly lower means for R, P, W, D, S, DQ+, DQ v/+, FQo, M, Ma, Mp, a (active), FC, CF, Wgt Sum C, FC'+C'F+C', FY+YF+Y, Sum Shading, (2), FD, Zd, EA, D score, ADJ D, Blends, Col-Sh B1, X+%, F+%, Pure H, ALL H Cont, DV, DR, INCOM, SUM6 SP SC, and SUM 6 SP SC.The aged subjects produced significantly higher means for the following indices: Dd, FQ-, M-, FM, C+Cn, Lambda, Z-%, S-Constell, SCZI, DEPRI, PER, and PSV.The older adults performed neither significantly higher or lower for these variables: DQo, DQv, FQ+, FQu, m, p (passive), FT+TF+T, FV+VF+V, Fr + rF, F, Zf, es, 3r+(2)/R, FABCOM, ALOG, CONTAM, AG, CONFAB, CP, and MOR.These results indicate that the elderly in this study give responses which are less embellished, complex, synthesized, and conventional and to have percepts that are of poorer quality and are more distorted than those of younger adults.The following nine percentages for the elderly group were significantly higher than for the younger adult group with whom they were compared: M - WSUM C = +1.5 to -1.5, D SCORE < 0, ADJ D SCORE < 0, Zd SCORE < -3.0, X+% < .70, F+% < .70, X-% > .15, Afr < .55, and Pure H < 2.These percentages show that the aged had no preferred problem-solving style, had more stressors than skills to cope with them, are somewhat negligent and less accurate in processing information, avoid emotion, and have less interest in the social environment. / Department of Counseling Psychology and Guidance Services

The purpose of this study was to investigate the relationship between personal factors and perceived built environmental factors and walking behaviour among middle-aged and older adults. The sample consisted of 647 people aged 45 years and above. Walking behaviour was assessed using pedometers. Decreased walking was significantly associated with increased age (r=-0.366, p<0.001). Education level (F=4.13, p=0.016) and self-rated health status (t=6.07, p<0.001) were positively associated with walking. When considering the effect of age, education level was no longer associated with walking. Better perception of general safety (F=3.105, p=0.005) and fewer safety concerns (F=7.531, p=0.001) were positively associated with walking. Age and self-rated health status jointly contributed to the walking behaviour (p<0.001), explaining 16.2% of the variance. These findings may suggest future neighbourhood interventions for age-friendly communities in Winnipeg, and help to accommodate changes through addressing perceived neighbourhood safety concerns and facilitating increased physical activity among middle-aged and older adults.

Relocation to a personal care home is a stressful experience and may occur at a traumatic moment in life. The effects of relocation to a PCH on nutritional status are unknown, yet under-nutrition is common among PCH residents. Objectives: To explore the effect of relocating to a PCH on the nutritional status, eating habits, and nutrition attitudes of adults aged 60 years and older. Methods: Fourteen Caucasian older adults (F = 57%) with a mean age of 83 years (SD = 9.79) consented to participate. Sixty-four percent of participants experienced inter-institutional relocation. Anthropometric, biochemical, clinical and dietary information was collected at Time Points A (2-3 months following relocation) and B (6-7 months following relocation) through face-to-face interviews, medical chart reviews and communications with nursing staff. Results: At Time B, cognitive function declined (z = -2.185, p < .05) and the number of medications prescribed increased (z = -2.00, p < .05). Levels of 25-hydroxyvitamin D were insufficient among 83% of participants at both time points. Mean serum albumin was 34.4 ± 7.2 g/L at Time B and the prevalence of nutritional risk increased from 57% to 77%. Dietary intake was inadequate according to Canada’s Food Guide recommendations. Nutrition attitudes did not change. Implications & Conclusions: Six months following relocation, nutritional risk was more prevalent, with early evidence of possible protein-energy malnutrition. Nutritional inadequacies may result if dietary intakes do not improve. A collaborative approach is needed to assess environmental, psychosocial and nutritional factors that contribute to poor dietary intake and will assist in the development of an intervention program.

Relatively few studies have considered how changes in health are associated with changes in cognition in aging populations. Even fewer have investigated the similarities and differences of the health-cognition link evidenced across independent longitudinal studies of aging that differ in country and birth cohort. The main objective of the current research is to evaluate aging-related cognitive change in the context of physical health conditions and to compare patterns and synthesize results across several longitudinal studies of aging. This cross-study evaluation is based on data from three longitudinal studies of aging: 1) the OCTO-Twin Study, a longitudinal investigation of same-sex twin pairs drawn from the population-based Swedish Twin Registry (N = 702; 67% female; mean age is 83.5), 2) the Health and Retirement Study (HRS), a study of middle-aged and older adults in the U.S. (N = 21,364; 57% female; mean age is 65.8), and 3) the English Longitudinal Study of Aging (ELSA), a study of middle-aged and older adults in the U.K. (N = 11,397; 54% female; mean age is 65.3). Data were analyzed using latent growth curve (LGC) analysis to evaluate 1) the impact of diagnosed health conditions and 2) the additive impact of comorbidity on level and rate of change in distinct cognitive outcomes. Our findings indicate that particular health conditions significantly impact initial status and rate of change in cognition, but do so differently across longitudinal studies of aging. The argument is made that the inclusion of health in our predictive models is essential as we try to parse out the effects of pathological aging vs. normative age-related change in cognition. The results of this study show the importance of replication in longitudinal research and for contrasting patterns of effects across independent studies in order to build a cumulative basis for further understanding of the dynamics among aging, health, and cognition in populations that differ in cohort, culture, and country. / Graduate

Background: With the growth in elderly populations worldwide, there is a pressing need to characterize the changes in cognition and brain function across the adult lifespan. The evolution of cognitive abilities is no longer considered to reflect a universal, cumulative process of decline. Rather, significant inter- and intra-individual differences exist in cognitive trajectories, with the maintenance of functions ultimately determined by multi-dimensional biological and psychological processes. The current study examined the relationship between intra-individual variability, cognitive plasticity, and long-term cognitive function in older adults. Methods: Data were analyzed from Project Mental Inconsistency in Normals & Dementia (MIND), a 6-year longitudinal burst design study, integrating micro-weekly assessments (reaction time (RT) tasks), with macro-annual evaluations (cognitive outcome measures). Participants included 304 community-dwelling adults, ranging in age from 64 to 92 years (M = 74.02, SD = 5.95). Hierarchical multiple regression models were developed to examine long-term cognitive function, along with multilevel modeling (HLM) techniques for the analysis of specific predictors of longitudinal rates of cognitive change. Results: Baseline intraindividual variability (ISD) emerged as a robust and highly sensitive predictor, with increased variability associated with decreased long-term cognitive performance. Complex baseline cognitive plasticity (1-Back 4-Choice RT Task) uniquely predicted subsequent cognitive function for measures of processing speed, fluid reasoning, episodic memory, and crystallized verbal ability. Multilevel models revealed chronological age to be a significant predictor across cognitive domains, while intraindividual variability selectively predicted rates of change for performance on measures of episodic memory and crystallized verbal ability. Conclusion: These findings underscore the potential utility of intraindividual variability and cognitive plasticity as dynamic predictors of longitudinal change in older adults. / Graduate

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