An analysis of the data from the Ontario longitudinal study of aging was carried out to investigate the associations between self-reported income and perceived health status, using cross-tabulations and logistic regression models. Reported income, educational level, and smoking status were associated with perceived health status. Reported income was associated with perceived health status independently of the effects of education and smoking. The data also indicate that changes in income are related significantly to changes in perceived health status. A reduced income was associated with a worsening of health and a weak relationship was apparent between increased income and better health. The analyses further suggest that income changes precede health changes. The possible mechanisms through which an income change may lead to health changes are discussed.

The purpose of this qualitative study was to explore styles of engagement used by families with staff in long-term care facilities. Data were gathered through personal interviews with 35 family members. Five styles of engagement were identified: positive, negative, peremptory, cautious, and limited. Factors associated with these different styles were also identified. Implications for practice are discussed.

This study compared the diagnostic performance of the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) in correctly identifying depressed and nondepressed older people who are nursing home residents without cognitive disorders. At the usual cut-off scores of 10 and 11, sensitivity was 96.30 per cent for the BDI and 88.89 per cent for the GDS, while their specificity rates were 46.15 and 56.41 per cent respectively. Using Receiver Operating Characteristics (ROC) curves, the results obtained using these scales were compared with the diagnosis of psychiatric disorder according to the DSM-III-R. Contrary to the hypothesis, no difference was found between the area under the ROC for the BDI (Az = .87; SD = .04) and for the GDS (Az = .85; SD = .05). The exclusion of the somatic items, or the somatic factor, did not change the diagnostic performance of the BDI. Indices of temporal stability, concurrent validity and agreement with clinical diagnoses also confirmed the reliability and validity of these two scales for older people living in nursing homes.

Findings are presented on the psychometric properties of a short psychological hardiness measure using subjects predominantly aged over 60 years. The sample of 223 participants was administered the hardiness questionnaire and other instruments twice, with a one-year test-retest interval. First-order factor analysis yielded three factors termed challenge, control, and commitment. Second-order factor analysis revealed a single main factor of general hardiness on which all the first-order components loaded highly. Both internal consistency and test-retest forms of reliability were in the range 0.6 to 0.7. Concurrent validity was illustrated by significant correlations between hardiness and measures of happiness and adjustment.

This study examines the relationship between ethnicity and the provision of assistance to older relatives. A sample of employed Canadians (N = 2,753), a subsample of the CARNET Work and Family Survey, is used to explore how ethnicity influences the amount of assistance provided to older relatives. Findings from our study suggest that Asians, East Indians, and Southern Europeans provide higher levels ofhelp than British respondents. Final obligation affects the amount of help provided but plays a similar role within each ethnic group. However, structural factors — in particular, living arrangement and age — are stronger predictors of the level of involvement in helping older relatives than are cultural factors of filial obligation and belonging to a particular ethnic group.

A scoping review was conducted to identify patterns, effects, and interventions to address social isolation and loneliness among community-dwelling older adult populations during the COVID-19 pandemic. We also integrated (1) data from the Canadian Longitudinal Study on Aging (CLSA) and (2) a scan of Canadian grey literature on pandemic interventions. CLSA data showed estimated relative increases in loneliness ranging between 33 and 67 per cent depending on age/gender group. International studies also reported increases in levels of loneliness, as well as strong associations between loneliness and depression during the pandemic. Literature has primarily emphasized the use of technology-based interventions to reduce social isolation and loneliness. Application of socio-ecological and resilience frameworks suggests that researchers should focus on exploring the wider array of potential pandemic age-friendly interventions (e.g., outdoor activities, intergenerational programs, and other outreach approaches) and strength-based approaches (e.g., building community and system-level capacity) that may be useful for reducing social isolation and loneliness.

The global population including Canada’s is aging, which demands planning for housing that will support older adults’ quality of life. This mixed-method study is the first Canadian study to examine the impact of cohousing on older adults’ quality of life and involved 23 participants. The older adults rated their quality of life very high, especially in the environmental, physical, and psychological domains of the World Health Organization Quality of Life (WHOQOL_BREF) survey; quality of life in the social domain was rated low, which was surprising in light of the focus group data findings. Four themes of “belonging in a community”, “life in the community”, “changes associated with aging,” and “aging in place” emerged from the qualitative data to explain factors that influence older adults’ quality of life. This research provides foundational, strong evidence that seniors’ cohousing is an innovative housing solution that can support older adults’ quality of life.

Canadian baby boomers began turning 65 – traditional retirement age – in 2011. How this generation perceives and experiences retirement may differ from preceding generations. In this online, grounded-theory study, 25 baby boomers who were approaching retirement or had recently retired participated in a multi-author blog about their retirement experiences and processes. We collected additional data via subsequent focus groups and participant interviews. Participants retired in several ways, including ceasing work, adopting casual or part-time work, and adopting new types of work. Findings highlighted three phases of the retirement transition: pre-retirement, characterized by both apprehension about retirement and idealization of the perfect retirement; the initial transition, which participants compared to an extended vacation, but in which they also struggled to adjust to increased amounts of free time; and mid-transition, when participants learned to balance structure and flexibility. Findings suggest that despite retirement transition challenges, many people have positive experiences with this transition.

Primary care–based memory clinics are attracting increasing interest because they present an opportunity to improve dementia diagnosis and management. In Ontario, more than 30 primary care setting participated in a training program aimed at assisting participants to establish an independent memory clinic in their practice setting. This article outlines the key lessons learned in implementing these clinics, on the basis of a study that – used an interview methodology with memory clinic team members and – identified facilitating factors, challenges, and suggestions for sustainability. Of key importance was access to training that facilitates knowledge transfer and supports practice change, interprofessional collaboration, and ongoing infrastructure support. Suggestions for clinic implementation and ongoing capacity building were identified. Lessons learned are applicable to the implementation of other chronic-disease care models aimed at improving the primary care management of complex chronic conditions.

The monograph Changing Residence: The Geographic Mobility of Elderly Canadians (Northcott, 1988) reviewed the research that had been done up to the mid-1980s on the geographic mobility of older persons in Canada and elsewhere. The purpose of this article is to provide an update and overview of developments in the study of the geographic mobility of seniors since the mid-1980s with a particular emphasis on Canada. In this review, we first examine progress over the past 25 years in research about seniors’ geographic mobility and focus on three topics: the relocation and geographic concentration of seniors, seasonal migration (“snowbirds”), and international migration. Second, we assess the current status of research on elder migration in Canada. Finally, we identify future challenges and unanswered questions, and make suggestions for future research.

There has been considerable speculation relating the neuroanatomic changes during normal aging with corresponding neuropsychological sequelae. This paper examines the empirical support for the hypothesis that the greatest structural changes in normal aging occur in the frontal-subcortical axis, and that these produce a similar pattern of neuropsychological performance to that seen in younger individuals with subcortical damage. In this study, 14 normal elderly, 12 younger patients with HIV encephalopathy, and 14 young neurologically intact control subjects were studied with a neuropsychological test battery. The results demonstrated that the normal elderly and HIV encephalopathy patients evidenced a strong similarity in both level and pattern of neuropsychological performance despite their considerable age disparity. These results support the notion that normal aging differentially affects functions subserved by frontal-subcortical brain regions.

Access to affordable housing is a rising concern, and social housing is one approach to support low-income, older renters. A scoping review was undertaken to understand the characteristics of older tenants and social housing services to identify strategies to promote aging in place. Seven peer review databases were searched to identify relevant articles. A total of 146 articles were included. Almost all examined socio-demographic and health characteristics of older tenants, while 72 per cent examined social housing services, including eligibility policies, staffing, and access to on-site services. This review points to a high vulnerability among older tenants and highlights the importance of co-locating services on-site with a tenant-facing support staff to identify vulnerable tenants and link them to services. More research on tenancy issues (e.g., unit condition, rental management) is needed to identify new opportunities for social housing landlords to help older tenants age in place.

Participatory action research (PAR) is well suited to research that aims to address social exclusion and inclusion in older age. Illustrations of and reflections on PAR with older adults are scarce, particularly the initiation stage, which sets the stage for the cyclical participatory action that follows. In this article, we describe the initiation of a PAR project with older adults and reflect on the alignment of this process with key participatory principles and fit within typical research structures. Findings point to the tensions between developing relationships over time and time-sensitive calls for funding, how traditional conceptions of research can influence creating equitable partnerships, and the need for development of ethical and publishing guidelines that address participatory approaches. These key insights can be applied to help achieve the potential of PAR: to address issues of concern by collaboratively and equitably working with the people most affected.

As the Indigenous population in Canada ages, there is a need to recognize the role of place and culture in supporting health and resilience over the life course. This article draws on the findings of a Photovoice project about Southern Inuit experiences of transitions into aging and dementia in NunatuKavut, Labrador. Here, culture and the natural environment are prominent in descriptions of health promotion and care trajectories. These factors may contribute to healthy aging, protect against cognitive decline, and support the maintenance of identity for people living with dementia. However, significant pressures on ways of living embedded in the land are also evident. Such forces are impacting Southern Inuit older adults’ ability to age and be cared for “in place”. The findings of this research reflect a need to consider ways to support Southern Inuit older adults to age in place, which might include reflecting on culturally grounded understandings of personhood, and policy and programming which promote engagement with the nature and culture.

PubMed lists over 6,000 references (700 reviews) on unintentional falls in older adults. This article traces key methodological milestones in the application of epidemiologic methods since the earliest publications in the late 1940s. Within the context of advances in case definition, sampling, measurement, research design, and statistical analysis, the article reviews estimates of frequency of occurrence, risk factor associations, morbidity and mortality consequences, demonstration of the multiple risk factor theory of falls using fall prevention interventions, and the challenges of fall risk prediction models. Methodological explanations are provided for observed heterogeneities, and the case is presented for moving beyond undifferentiated lists of risk factors by focusing on balance and gait as the factors through which the mechanistic effects of distal risk factors can be understood. Moreover, the case is made to advance our statistical analyses by looking at interactions among intrinsic risk factors and between intrinsic, extrinsic, and environmental factors.

This study uses qualitative methods to explore subjective perceptions of independence and dependence for older adults with chronic musculoskeletal conditions. Twenty-seven in-depth interviews were conducted with community-dwelling older adults with osteoarthritis and/or osteoporosis in the greater Metropolitan Toronto area. Respondents shared similar overall perceptions of independence and dependence, but self-definitions as independent were related to domains of difficulty, coping skills used, assistive devices, and nature of the helping relationship. Three categories of respondents based on domains of difficulty (Community Mobility, Household Activities, and Personal Care) are used to illustrate how respondents negotiate their self-identities as independent in light of the other three factors.

This study examined a population-based profile of older adults with acquired brain injury, and their functional outcomes, in in-patient rehabilitation. Older adults aged 65 and older admitted to in-patient rehabilitation from acute care with traumatic brain injury (TBI) (n = 1214) or non-traumatic brain injury (nTBI) (n = 1,530) from 2003/04 to 2009/10 in Ontario were identified. Demographic and clinical characteristics and the total function score from the FIM(TM) Instrument were examined. The Discharge Abstract Database and National Rehabilitation Reporting System were used. Results indicated that older adults with TBI had significantly higher total function scores than those with nTBI at admission and at discharge (p < .001). However, both groups made significant (p < .001) and similar gains (p > .05) in total function scores. We conclude that older adults with TBI and nTBI make similar in-patient rehabilitation gains. Lower initial functional ability of nTBI patients on admission and patients’ different clinical profiles have implications for clinical care and resources.

Health promotion and participatory research present challenges and opportunities for extending the benefits of science to populations who have not fully benefited from innovations available through self-care and mutual aid. This paper illustrates some of the strengths, weaknesses, issues and problems in applying the approaches of health promotion and participatory research with First Nations populations for purposes of arthritis self-management. We suggest ways in which these experiences apply to the elderly. Preliminary results from our First Nations Arthritis Self-Management study illustrate participatory research and promising outcomes. The adaptability of these health promotion strategies in the First Nations community can be generalized to the elderly in the general population based on their common experience with arthritis and the advantages of participatory planning with distinguishable demographic groups who share a common identity.

This paper examines access to bathtub grab bars in privately and publicly owned apartment buildings and explores the profile of seniors who have access to bathtub grab bars. Results indicate that bathtub grab bars were significantly more prevalent in apartments that were publicly owned (91.3%) as compared to privately owned (37.8%) (p < 0.05). Results of a logistic regression for participants residing in non-universal-access buildings indicated that seniors were more likely to have grab bars in their bathtubs if they were older, were in poor health, had had a fall in the previous year, or used a mobility aid. Among those who did not have bathtub grab bars, 33 per cent reported fear of falling while bathing, 20 per cent reported difficulty bathing, and 23 per cent were found to have impaired balance. Findings are discussed in light of policy implications for universal access to grab bars, with apartment buildings being a logical place to start.