Teses / dissertações: "Older people"

1

Chan, Yin-sang. "Elderly planning in Hong Kong". [Hogn Kong] : University of Hong Kong, 1989. http://sunzi.lib.hku.hk/hkuto/record/B42574134.

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2

Saad, Paulo Murad. "Support transfers between the elderly and the family in Southeast and Northeast Brazil /". Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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3

J-Lyn, Khoo Yvonne. "Exergaming acceptance and experience in healthy older people and older people with musculoskeletal pain". Thesis, Teesside University, 2014. http://hdl.handle.net/10149/320050.

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The research reported in the thesis investigated exergaming acceptance and expe-rience in older people with special reference to technology acceptance, flowstate, chronic pain and balance control. In recent years, there has been an increasing amount of literature on the beneficial effects of exergaming on older people’s health, well-being and balance, including the use of exergaming as a method of pain con-trol. Nevertheless, when taken separately, specific studies vary in methodology and in type(s) of exergaming topics studied. Health benefits from exergaming may only be gained if older people take part in it. There is evidence in the literature to indicate that usage of a technology is preceded by user acceptance. Few studies, to date, have investigated how older people perceive and experience exergaming in relation to their perceived abilities and future intention to use it, from a technology acceptance point of view. Therefore, the purpose of this thesis was to see if (1) the exergaming technology was acceptable to healthy older people and older people with chronic pain and (2) it had any effect in the self-reported health status, pain conditions and balance in older people with chronic pain. The current thesis consists of two separate studies. In Study 1, twenty-eight healthy older people participated in six 40-minute exergaming sessions within a three-week period. In Study 2, fifty-four older people with chronic musculoskeletal pain attended a twelve 40-minute exercise intervention within a six-week period, either randomised into an exergaming group (IREXTMsystem) or standard physical exercises. A modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT) was analysed at baseline and upon completion of the intervention, including specific time points throughout the study. Self-perceived chronic pain and flow state were analysed at baseline and after exercise intervention. Rate of perceived expended physical and mental effort was recorded after every exercise session and compared between groups. Heart rate was recorded in the second study. Postural sway was assessed at the start and the end of the intervention with Centre of Pressure data being extracted via a Kistler force plate (AP SD, AP range ,ML SD, ML range and CoP velocity), where the conditions were quiet bipedal standing with eyes open and eyes closed. Evidence from both studies showed that exergaming technology was acceptable to healthy older people and older people with chronic musculoskeletal pain. Recorded high levels of flow indicated the occurrence of flow during the intervention. Perfor-mance expectancy emerged as the strongest predictor of older people’s behavioural intention to use exergaming. Previous behaviour was an important influence of future behaviour, within the context of exergaming. In Study 1, there were significant increases throughout the intervention in most of the flow state variables except challenge-skill-balance, paradox of control and transformation of time. Thematic analysis of olde rpeople’s responses relating to exergaming revealed that enjoyment was the most frequently cited theme. The significant increase of perceived physical exertion suggested that exergaming provided light-to-moderate intensity exercise for this cohort of healthy older people. In Study 2, an interesting pattern emerged over time where earlier on in the interven-tion, effort expectancy significantly predicted older people’s behavioural intention to use exergaming (instead of performance expectancy). This role was then taken over by performance expectancy midway through the intervention. This indicated that this sample of older people with chronic pain prioritised their personal ability to play the exergames, after which, they then considered the usability of the exergaming technology in choosing whether to use it in future, if it were readily made available. In addition, there was evidence of improvement in post-intervention pain intensity in the exergaming group, suggesting that exergaming may have alleviated older people’s experience of pain to some extent. Flow levels significantly increased from the start to the end of the intervention. Significant improvements over time in postural sway parameters in the control and exergaming groups suggested that short-term exercise contributed to improved balance in older people with chronic musculoskeletal pain. The indication of improved postural sway due to significant mediolateral reductions in the eyes-closed condition in the both groups suggested that older people with chronic pain could benefit from at least subtle improvements in balance after taking part in short-term exercise. Nevertheless, exergaming may have an effect on postural sway when visual sensory information is removed, as found in the experimental group that demonstrated a statistically significantly lower reduction of CoP excursion in the medio-lateral direction, than in the control group.

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4

Cruice, Madeline. "Communication and quality of life in older people with Aphasia and healthy older people /". St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16486.pdf.

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5

Charlesworth, Patricia Falcone. "Creating an evaluation tool to measure the effects of program impact on the clients of the Lehigh County Senior Citizen's Center". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2936. Abstract precedes thesis as [2] preliminary leaves. Typescript. Includes bibliographical references (leaves 60-61).

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6

Wong, Shui-wah Kitty. "An evaluation of the housing provision and its related services for the elderly in public rental housing". Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23339627.

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7

Zhang, Xuetai. "Community-based care for the frail elderly in urban China /". Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24873457.

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8

Sham, Ka-hung Joe. "The effect of group residence on the psycho-social well-being of elderly residents in public subsidized housing". Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19469998.

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9

Kung, Francis Tat-yan. "Chronic pain in older people". Connect to thesis Connect to thesis, 2001. http://adt1.lib.unimelb.edu.au/adt-root/public/adt-VU2001.0028/index.html.

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10

Conroy, Simon. "Preventing falls in older people". Thesis, University of Nottingham, 2009. http://eprints.nottingham.ac.uk/11058/.

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Falls are a major cause of injury fear of falling and death affecting 24% of older people annually. Falls have a major impact on hospital services, are an important cause of carer strain and admission to long term care. Multifactorial interventions delivered to fallers are effective in reducing falls rates by 25%. However, no UK studies have evaluated the role of screening older people living in the community and offering those at high risk a falls prevention programme. This work describes two studies – the evaluation of a postal falls risk screening tool, and a randomised controlled trial assessing the benefits of offering a falls prevention programme to those identified as being at high risk. 335 older people were recruited into the screening study, using a modified version of the Falls Risk Assessment Tool. The sensitivity was 79%, specificity 58%, positive predictive value 50% and the negative predictive value 83%. In the RCT, 364 community-dwelling older people at high risk of falls were randomised into a pragmatic, multicentre trial evaluating falls prevention programmes. 181 were allocated to the control group and 183 to the intervention. The primary outcome was the rate of falls; the adjusted IRR was 0.73 (0.51-1.03), p=0.071. There were no significant differences between the groups in terms of the proportion of fallers, recurrent fallers, medically verified falls, injurious falls, time to first fall or time to second fall. Nor were there significant differences in terms of institutionalisation, mortality, basic or extended activities of daily living, or fear of falling. Further work on testing falls prevention interventions for acceptability is required, followed by a further adequately powered RCT to determine the clinical effectiveness of a systematic screening programme and intervention. At present, there is insufficient evidence for health care commissioners to recommend screening and intervention for falls.

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11

Quinn, Helen Louise. "Microneedle technology for older people". Thesis, Queen's University Belfast, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709697.

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It is evident that the global population is ageing, with an increasing proportion of people aged over 65 years. Typically associated with a high proportion of morbidity and mortality, care of the increasing ageing population presents a challenge, with age-appropriate research required to promote and facilitate healthy ageing. In the present work, a novel drug delivery technology, designed to enhance transdermal drug delivery, was considered in the context of its potential future use in the older population. Microneedles (MNs) consist of a plurality of tiny projections in the micron scale, arranged on a base plate, for application to the skin. This thesis considers the use of MNs by the older population from a number of perspectives, encompassing possible clinical uses, the possible impact of age-related changes in the skin and the feasibility and acceptability of the technology. Transdermal delivery of three drugs, commonly prescribed for secondary prevention of cardiovascular disease, was investigated, successfully demonstrating in vitro co-delivery of the drugs, using both a dissolving and a hydrogelforming MN platform, achieving clinically relevant concentrations of each. MN arrays were successfully applied by a group of volunteers aged over 65 years, with breach of the stratum corneum confirmed using optical coherence tomography and 55.7% of the MN height observed to penetrate. Skin recovery was demonstrated to occur at a slower rate in those aged over 65 years than in a comparative group of volunteers aged 20 - 30 years, but was still predicted to regain original barrier function within 1.5 h of MN treatment. Qualitative methods were employed to collect the views and opinions of older people and community pharmacists regarding MNs, who were positive about the technology, identifying a number of benefits to MN-mediated drug delivery in older people. Concerns centred on practical issues associated with age-related functional decline, including, for example, reduced dexterity. This thesis is the first comprehensive investigation into the use of MNs by the older population, providing an initial demonstration of MN delivery of multiple drugs, for future extension to a relevant in vivo model. The ongoing involvement of end-users and healthcare practitioners is recommended to facilitate future acceptance of MN technology by the older population and design of an age-appropriate delivery platform.

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12

Fisher, Irene Mary. "Housing services for the elderly in Hong Kong : segregation or integration? /". Hong Kong : University of Hong Kong, 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14739963.

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13

Law, Chi-chung. "An inhabitable park for the aged and kindergarten". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2595653x.

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14

Leung, Man-fuk Edward. "An analysis of policy on residential nursing care for the elderly in Hong Kong". [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13236222.

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15

Rowan, James Thomas. "Digital family portraits support for aging in place /". Available online, Georgia Institute of Technology, 2005, 2005. http://etd.gatech.edu/theses/available/etd-08242005-180131/.

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Thesis (Ph. D.)--Computing, Georgia Institute of Technology, 2006.
Elizabeth D. Mynatt, Committee Chair ; Gregory Abowd, Committee Member ; Jim Foley, Committee Member ; Mark Guzdial, Committee Member ; Wendy Rogers, Committee Member. Includes bibliographical references.

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16

Maitland, Atherton Iain. "Migration and the informal support networks of older people in Scotland /". St Andrews, 2007. http://hdl.handle.net/10023/161.

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17

Judice, Martha Arambel. "Medication assistance programs for Montana elders". Montana State University, 2004. http://etd.lib.montana.edu/etd/2004/judice/JudiceM0805.pdf.

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18

Chui, Shuk-wah Janet. "A study of the public policy on elderly care in Hong Kong". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31967498.

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19

Chan, Mee-kie Maggie. "Protein-energy malnutrition among Chinese elderly medical patients in Hong Kong". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971489.

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20

Hong, Adela Suk Yee. "A study of professional social workers' view on elderly suicide in Hong Kong". access abstract and table of contents access full-text, 2006. http://libweb.cityu.edu.hk/cgi-bin/ezdb/dissert.pl?msocsc-ss-b20327985a.pdf.

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Thesis (M.SocSc.)--City University of Hong Kong, 2006.
Title from title screen (viewed on Dec. 6, 2006) "Submitted to Department of Applied Social Studies in partial fulfillment of the requirements for the Degree of Master of Social Sciences in counselling" Includes bibliographical references.

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21

Saub, Roslan. "Oral health status and treatment needs of the institutionalised elderly population in Melbourne /". Connect to thesis, 1996. http://eprints.unimelb.edu.au/archive/00000831.

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22

Pang, Po-ling. "The construction of a model of community care for elderly people in Hong Kong". Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23234313.

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23

Tsang, Sau-hang Caroline. "Characteristics of non-attendance for re-enrollment in elderly health centres in Hong Kong : the role of socio-economic factors and self-perceived health /". Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25139204.

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24

Vecchio, Nerina. "Socioeconomic differentials among older Australians : an investigation of Gold Coast residents, 1998-1999 /". [St. Lucia, Qld. : s.n.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16652.pdf.

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25

Schuller, Kelly L. "Factors influencing older adult collaboration on health problems". Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=3402.

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Thesis (M.A.)--West Virginia University, 2004.
Title from document title page. Document formatted into pages; contains v, 121 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 56-61).

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26

Sanders, David N. Turner K. Whisnant. "An evaluation model for identifying Lewisville and San Angelo, Texas, as senior ready communities". [Denton, Tex.] : University of North Texas, 2009. http://digital.library.unt.edu/ark:/67531/metadc12195.

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27

Simpson-Young, Virginia. "Meat trays, marginalisation and the mechanisms of social capital creation: An ethnographic study of a licensed social club and its older users". Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/4049.

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Alongside informal networks of friends and family, formal social groupings such as voluntary associations are valued by older people as opportunities for engagement. In Australia, one such grouping is the licensed social (or ‘registered’) club. Approximately 20 per cent of all older Australians, and 80 per cent of older residents of the state of New South Wales, actively participate in such clubs. Despite this, older people’s registered club participation has received little scholarly attention. This ethnographic study of one particular registered club aimed to discover the nature, meaning and role of club participation for its older members. Social capital existing in club-based networks emerged as a further investigative focus, and its mechanisms and outcomes were examined. Participant observation and in-depth interviewing were the main data collection methods used. Data analysis procedures included thematic analysis (based loosely on grounded theory methodology), as well as the more contextsensitive narrative analysis and key-words-in-context analysis. The study found that club participation enabled older members to maintain valued social networks, self-reliance and a sense of autonomy. Social networks were characterised by social capital of the bonding type, being largely homogeneous with respect to age, gender, (working) class and cultural background. Strong cohesive bonds were characterised by intimacy and reciprocity, and possessed norms including equality and the norm of tolerance and inclusiveness. These helped to minimise conflict and build cohesiveness, while protecting older club-goers from increasing marginalisation within the club. Peer grouping within this mainstream setting may have shielded the older club-goers from stigma associated with participation in old-age specific groups. The nature and scale of registered club participation amongst older Australians points to their unique and important role. The findings of this research indicate that – for at least this group of older men and women - club use is a major contributor to maintaining social connectedness and a sense of self as self-reliant, autonomous and capable. In the context of an ageing population, Australia’s registered clubs feature in the mosaic of resources available to older people, and their communities, for the creation of social capital.

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28

Simpson-Young, Virginia. "Meat trays, marginalisation and the mechanisms of social capital creation an ethnographic study of a licensed social club and its older users /". Faculty of Health Sciences, 2008. http://hdl.handle.net/2123/4049.

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Doctor of Philosophy(PhD)
Alongside informal networks of friends and family, formal social groupings such as voluntary associations are valued by older people as opportunities for engagement. In Australia, one such grouping is the licensed social (or ‘registered’) club. Approximately 20 per cent of all older Australians, and 80 per cent of older residents of the state of New South Wales, actively participate in such clubs. Despite this, older people’s registered club participation has received little scholarly attention. This ethnographic study of one particular registered club aimed to discover the nature, meaning and role of club participation for its older members. Social capital existing in club-based networks emerged as a further investigative focus, and its mechanisms and outcomes were examined. Participant observation and in-depth interviewing were the main data collection methods used. Data analysis procedures included thematic analysis (based loosely on grounded theory methodology), as well as the more contextsensitive narrative analysis and key-words-in-context analysis. The study found that club participation enabled older members to maintain valued social networks, self-reliance and a sense of autonomy. Social networks were characterised by social capital of the bonding type, being largely homogeneous with respect to age, gender, (working) class and cultural background. Strong cohesive bonds were characterised by intimacy and reciprocity, and possessed norms including equality and the norm of tolerance and inclusiveness. These helped to minimise conflict and build cohesiveness, while protecting older club-goers from increasing marginalisation within the club. Peer grouping within this mainstream setting may have shielded the older club-goers from stigma associated with participation in old-age specific groups. The nature and scale of registered club participation amongst older Australians points to their unique and important role. The findings of this research indicate that – for at least this group of older men and women - club use is a major contributor to maintaining social connectedness and a sense of self as self-reliant, autonomous and capable. In the context of an ageing population, Australia’s registered clubs feature in the mosaic of resources available to older people, and their communities, for the creation of social capital.

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29

Sayago, Barrantes Sergio. "Human-computer interaction with older people". Doctoral thesis, Universitat Pompeu Fabra, 2009. http://hdl.handle.net/10803/7560.

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L'envelliment de la població i la importància de les TIC a la societat actual han motivat la necessitat d'integrar més a les persones grans en la interacció persona-ordinador. La investigació actual es centra en factors individuals de l'envelliment i l'aproximació més generalitzada és dissenyar interfícies considerant les persones grans com a conjunt de factors. Aquesta tesi doctoral planteja un paradigma diferent: de factors a persones grans com a actors. En aquest paradigma, prestar atenció als canvis en capacitats funcionals no és l'únic que importa, cal que interacció i ús real estiguin més fortament relacionats. En aquest marc, aquesta tesi presenta els resultats d'un treball etnogràfic extens sobre el correu electrònic i la web. Mètodes quantitatius i mixtes s'han utilitzat en altres aspectes, que recolzen aquest estudi de camp. Altres capítols presenten contribucions metodològiques en avaluació en entorns reals. La tesi acaba proposant estratègies per a investigar amb persones grans com a actors socials, insistint en considerar l'experiència de vida de la gent gran i estudiar més l'ús i les interaccions en entorns reals combinant etnografia i treball més experimental.
El envejecimiento de la población y la importancia de las TIC en la sociedad actual han motivado la necesidad de integrar más a las personas mayores en la interacción persona-ordenador. La investigación actual se centra en factores individuales del envejecimiento y la aproximación más generalizada es diseñar interfaces considerando a las personas mayores como un conjunto de factores. Esta tesis doctoral plantea un paradigma diferente: de factores a personas mayores como actores. En este paradigma, prestar atención a los cambios en capacidades funcionales no es lo único que importa, sino que interacción y uso real deberían estar más fuertemente relacionados. En este marco, esta tesis presenta los resultados de un trabajo etnográfico extenso sobre el correo electrónico y la web. Métodos cuantitativos y mixtos se han utilizado en otros aspectos, que apoyan este estudio de campo. Otros capítulos presentan contribuciones metodológicas en evaluación en entornos reales. La tesis acaba proponiendo estrategias para investigar con personas mayores como actores sociales, insistiendo en considerar la experiencia de vida de la gente mayor y estudiar más el uso y las interacciones en entornos reales combinando etnografía y trabajo más experimental.
Population ageing and the role of computers in current society have created a need to strengthen HCI with older people. The current paradigm considers them as a set of factors and central to it is compensation for age-related changes in functional abilities. This dissertation proposes a different paradigm: from factors towards interaction based on older people as social actors. Within this paradigm, compensating for diminishing abilities is not the cornerstone of research. Instead, interaction and real-life use should be closely intertwined. Against this framework, the thesis presents the results of an extensive ethnographic work on e-mail and web use. Quantitative and mixed methods are employed in other aspects related to use and interaction which complement this major study. Other chapters include methodological contributions to real-life evaluation. The dissertation discusses strategies for approaching HCI with older people. Central to them is the concept of life experience and the need to turn to everyday interactions by combining classical ethnography with experimentations.

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30

Hope, Suzanne Victoria. "Hypoglycaemia in older people with diabetes". Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/21935.

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Diabetes prevalence is increasing in our ageing and increasingly obese society. Diabetes is a heterogeneous condition, and challenges remain in all aspects of its management - from diagnosis through to optimising treatment, to managing complications. Increasing age brings altered physiological responses to disease, treatments and complications - and there may be more wide-ranging considerations such as dietary, mobility, dependency or cognition, to name just a few. Hypoglycaemia is one of the most important potential side-effects of insulin-therapy, and elderly adults are at particular risk from its consequences. Insulin-treated patients may have long-standing Type 1 diabetes, or have Type 2 diabetes which has progressed to requiring insulin treatment, due to progressive beta cell deficiency. Even within this group of patients, there is heterogeneity, and assessment of risks can be challenging. Endogenous insulin levels can be assessed by measuring C-peptide. Recent advances in this has meant this is much more practical, enabling assessment of endogenous levels in large numbers of patients more feasible, and hence allowing important questions to be addressed. In the context of older patients, particularly interesting questions are whether patients with long-standing Type 2 diabetes can develop severe insulin deficiency, and whether absolute/severe endogenous insulin levels have an impact on treatment or complications of diabetes within insulin-treated cohorts – such as hypoglycaemia. This may thence raise the question of whether C-peptide measurement could potentially be used as an extra clinical tool for risk assessment in a patient population which can be tricky to manage at times. The aim of this thesis is thus to explore some of the issues around management of diabetes in the elderly: in particular hypoglycaemia, and use of C-peptide to more fully assess patients and consider a possible role for it in routine clinical care of some patients. Chapter 1 puts the thesis in context, firstly reviewing hypoglycaemia in the elderly in general, and then considering aspects of endogenous insulin levels and C-peptide measurement. Chapter 2 addresses the problem of recognition of hypoglycaemia in an elderly population, using primary care records and documented symptoms at consultations. Are we missing hypoglycaemia in this population? Accurate diagnosis of diabetes is crucial for getting people on the right treatment guidelines, and can be challenging. Chapter 3 uses a spot urine measure of C-peptide to test for the first time the accuracy of the UK Practical Classification Guidelines (published by the Royal College of General Practitioners and NHS Diabetes). Progressive insulin deficiency in Type 2 diabetes is the main reason people with long-standing Type 2 diabetes may eventually require insulin treatment. Chapter 4 uses the spot urine measure of C-peptide as a screening tool to assess if insulin-treated people with a clinical diagnosis of Type 2 diabetes may develop absolute insulin deficiency. Even more practical than a spot urine test to measure C-peptide, could be a random non-fasting blood measure of C-peptide, which could thus be measured when patients have their routine blood tests done in the community or outpatient appointments. Chapter 5 looks at how such a measure correlates with the gold-standard mixed meal tolerance test C-peptide measure. Severe insulin deficiency in Type 1 diabetes has been correlated with increased complications including hypoglycaemia, but the impact of endogenous insulin levels has not been assessed greatly in Type 2 diabetes. Chapter 6 reports a study looking into this possible relationship, using hypoglycaemia questionnaire responses from a large number of community-dwelling insulin-treated adults (of both diagnoses), in the context of their clinical diabetes diagnosis and their random non-fasted blood C-peptide levels. Chapter 7 assesses in more detail the rates of hypoglycaemia in a small group of insulin-treated patients with a clinical diagnosis of Type 2 diabetes, selected on the basis of their endogenous C-peptide levels. As well as subjective assessment of their hypoglycaemia experience using questionnaires, continuous glucose monitoring was used to objectively assess their rates of hypoglycaemia and glucose variability. Chapter 8 pulls all the above chapters together, summarising them in the context of other research, discussing their limitations and possible areas for future research, and their implications for now for clinical practice.

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31

Hill, Keith David. "Studies of balance in older people". Thesis, Connect to thesis, 1997. http://eprints.unimelb.edu.au/archive/00000953.

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32

McMillan, Alison. "Obstructive sleep apnoea in older people". Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/28969.

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Obstructive sleep apnoea (OSA) is common and the prevalence increases with age. When OSA leads to sleep disruption and excessive daytime sleepiness, it is referred to as obstructive sleep apnoea syndrome (OSAS). The aim of this thesis was to investigate the consequences of OSAS in older people (˃ 65 years) and the effect of continuous positive airway pressure (CPAP) therapy. CPAP is the treatment of choice in moderate to severe OSAS in middle aged people. However, there is a paucity of evidence on the therapeutic and economic benefits of CPAP in older people with OSAS. The two studies in this thesis aimed to address this by comparing outcomes in older people with OSAS before and after treatment with CPAP. The first study presented is the thesis is the PREDICT trial; a multicentre randomised controlled trial of CPAP in older people with OSAS. The trial studied the clinical efficacy of CPAP after 3 months, while determining the cost effectiveness of treatment over 12 months. The results of the trial showed that CPAP was an effective treatment for reducing excessive daytime sleepiness by -2.1 (95%CI -3.0 to -1.3); p < 0.001 points as measured by the Epworth sleepiness scale. CPAP also improved quality of life, with a statistically significant increase in the quality adjusted life years calculated with the SF-6D, equating to one week. The CPAP group also accrued marginally lower health care costs over 12 months compared to the group treated with best supportive care alone. Overall the economic benefit of CPAP was linked to the reduced healthcare usage offsetting the cost of the equipment. The second study presented in the thesis was a single centre randomised controlled trial to investigate the impact of CPAP on cognitive function and brain morphology in older people with minimally symptomatic OSAS after 6 months of treatment. In this study I tested the hypothesis that older patients with OSAS have cognitive impairment and corresponding brain changes which would be modifiable with treatment. The results of this study suggested older people with minimally symptomatic OSAS had normal cognitive function but impaired attention and executive function. CPAP treatment improved one aspect of attention, although memory and overall cognitive function were unchanged. The results of the brain MRI scans are not presented, and are in the process of being analysed. In conclusion the data presented in this thesis support the use of CPAP therapy in older people with excessive daytime sleepiness due to OSAS.

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33

Smeeth, Liam. "Screening older people for impaired vision". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://researchonline.lshtm.ac.uk/682306/.

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A systematic review of trials about screening older people for visual impairment found no evidence that screening improved vision. We undertook a new trial nested within a larger cluster randomised trial of multidimensional screening for people aged 75 years and over. 106 general practices were randomised to: targeted screening in which only a small proportion of participants with a range of health problems were offered visual acuity screening, and universal screening in which all participants were offered visual acuity screening. People identified with impaired vision were referred to the eye services. Around 220 participants were randomly sampled from ten practices in each group and visual outcomes measured at three to five years. The response rate to the baseline assessments was 76.1 Over one third of eligible participants died before having an outcome assessment. Of those alive, 67.8% in the targeted screening group and 57.9% in the universal group completed an outcome assessment. At outcome 37.0% (307/829) in the universal group had visual acuity of less than 6/18 in either eye compared with 34.7% (339/978) in the targeted group (odds ratio 1.11,95% confidence interval 0.76 to 1.62, P=0.58). The 25 item National Eye Institute Visual Function Questionnaire composite score was 86.03 in the universal group and 85.62 in the targeted group (difference 0.41,95% confidence interval - 1.68 to 2.50, P=0.69). Although visual impairment was common, few people benefited from subsequent intervention. Possible explanations for the lack of effect include: chance; under-detection of uncorrected refractive error and that only around half the recommendations for referral to an ophthalmologist resulted in referral.

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Haardt, David A. M. "Labour market dynamics among older people". Thesis, University of Essex, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442511.

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Three substantive chapters examine labour market dynamics among older people. Chapter 2 analyses older men and women's labour market transitions using the British Household Panel Survey (BHPS). I find large peaks in exit rates out of employment at ages 60 and 65 occurring in the exact birthday month, suggesting strong incentive effects of pension schemes. Discrete-time hazard regression analysis shows that health and potential income out of work are the most important determinants of these transitions, with effects that are larger than found in previous studies for British and US men. When modelling unobserved heterogeneity, the estimated probability of being a mover between work and non-work is twice as high for women as for men. Chapter 3 analyses how spouses in older couples react to shocks to their partner's labour income using BHPS data. After a separation, wives reduce their labour supply while husbands tend to increase theirs. If a wife becomes unemployed, it does not affect her husband's labour supply while wives whose husband becomes unemployed reduce their labour supply, too. A decline in husband's health causes the wife to reduce her labour supply while husbands tend to increase theirs when facing a decline in wife's health. Partner's death does not have statistically significant labour supply effects. Chapter 4 analyses the relationship between cognitive functioning and employment among older men and women using data from the English Longitudinal Study of Ageing. Regression analysis shows that the change in cognitive functioning over time does not have any statistically significant effects on the probability to exit or enter employment, or on working hours. These results are not sensitive to the definition of work. My findings differ from earlier research on younger age groups in Germany and the USA where some effects of cognitive functioning on labour force participation were found.

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Peachey, Karen M. "Pharmacoepidaemiology of medication use by the community-based elderly /". [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18250.pdf.

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Lou, Kong-sang. "User empowerment in the users' councils of Caritas neighbourhood elderly centres and district elderly community centres /". View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36784254.

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Ma, Xiaoguang. "The association between socioeconomic status and health-related quality of life among older people in Hong Kong". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B39634589.

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Wong, Kai-shu. "A study of the housing problems of the elderly single persons in Hong Kong : the role of government in providing a better quality housing /". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2012580X.

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O'Reilly, Evelyn Marie. "Issues in talk about aging in the United States /". Access Digital Full Text version, 1991. http://pocketknowledge.tc.columbia.edu/home.php/bybib/10262003.

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Thesis (Ed.D.) -- Teachers College, Columbia University, 1991.
Typescript; issued also on microfilm. Sponsor: Herve' Varenne. Dissertation Committee: Paul Byers. Includes bibliographical references: (leaf 148-154).

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Tse, Yin-loi Susanna. "The housing demand for senior citizens of middle income group in Hong Kong". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21029143.

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Hunter, Cecily Elizabeth. "Doctoring old age : a social history of geriatric medicine in Victoria /". Connect to thesis, 2003. http://eprints.unimelb.edu.au/archive/00000123.

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Lowry, Deborah Sue Wilson. "Relative expectations in rural China later-life distinction, duty, dreams, and discontent /". Diss., Connect to online resource - MSU authorized users, 2008.

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Lin, Jou-Chia. "The nutritional effects of the Elderly Nutrition Program: Title III-C for the Menomonie congregate-site meal program participants". Online version, 1999. http://www.uwstout.edu/lib/thesis/1999/1999lin.pdf.

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Kao, Hsueh-fen. "Caregiver burden and institutionalization of the elderly in Taiwanese families /". Digital version accessible at:, 1999. http://wwwlib.umi.com/cr/utexas/main.

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Shreve-Neiger, Andrea K. "The relations between spirituality, religiosity and reasons for living in older adults". Morgantown, W. Va. : [West Virginia University Libraries], 2002. http://etd.wvu.edu/templates/showETD.cfm?recnum=2283.

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Ham, Thomas Arlan. "Preaching to older adults". Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.

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Kiss, Vincent. "Facilitating access for older adults in residential care to computers and the internet". Australasian Digital Theses Program, 2008. http://hdl.handle.net/1959.3/39614.

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Thesis (PhD) - Swinburne University of Technology, 2008.
Submitted for the degree of Doctor of Philosophy, Swinburne University of Technology - 2008. Typescript. Includes bibliographical references (p. 194-228).

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Iwarsson, Susanne. "Functional capacity and physical environmental demand exploration of factors influencing everyday activity and health in the elderly population /". Lund : Dept. of Community Health Sciences, Lund University, 1997. http://books.google.com/books?id=GVZrAAAAMAAJ.

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Kiraly, Zoltan. "Pastoral care of older adults". Theological Research Exchange Network (TREN), 2002. http://www.tren.com.

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Fleming, Alfred Andrew. "Older Men Working it Out A strong face of ageing and disability". Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/852.

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This hermeneutical study interprets and describes the phenomena of ageing and living with disability. The lived experiences of 14 older men and the horizon of this researcher developed an understanding of what it is like for men to grow old and, for some, to live with the effects of a major disability. The study is grounded in the philosophical hermeneutics of Gadamer and framed in the context of embodiment, masculinity, and narrative. I conducted multiple in-depth interviews with older men aged from 67 to 83 years of age. Seven of the participants had experienced a stroke and I was able to explore the phenomenon of disability with them. Through thematic and narrative analyses of the textual data interpretations were developed that identified common meanings and understandings of the phenomena of ageing and disability. These themes and narratives reveal that the men's understandings are at odds with conventional negative views of ageing and disability. These older men are 'alive and kicking', they voice counternarratives to the dominant construction of ageing as decline and weakness, and have succeeded in remaking the lifeworld after stroke. Overall I have come to understand an overarching meaning of older men 'working it out' as illustrative of a strong face of ageing and disability. Older men seek out opportunities to participate actively in community life and, despite the challenges of ageing and disability, lead significant and meaningful lives. These findings challenge and extend our limited understandings of men's experiences of ageing and living with disability. This interpretation offers gendered directions for policy development, clinical practice, and future research.

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