This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38.2 per cent (95% confidence interval [CI]: 29.0, 47.3; p < .001), 4.0 per cent (95% CI: –3.9, 12.0; p = .318), and 0.2 per cent (95% CI: –3.3, 3.7; p = .91). Although the study could not assess causality, findings suggest that wide-scale knowledge translation activities successfully improved vitamin D prescribing rates, although ongoing efforts are needed to target homes with low uptake.

Responses to a Life Events Schedule were obtained from 408 elderly respondents at both phases of an 18-month longitudinal investigation. Sixteen items were identified with an incidence exceeding 5% at both phases. These items were found to be structurally unrelated. Temporal stability coefficients that were statistically significant, but generally of low magnitude, were obtained for a greater proportion of the usual stressors than for the less frequently endorsed items. The reasons for stability were suggested to be multifarious. Statistically significant correlations with happiness were obtained for few stress items. The items exhibiting correlations at both phases were associated with high incidences, and the direction of the correlations varied with the direction of stress (i.e., positive or negative).

A team of health researchers of the Manitoba Centre for Health Policy at the University of Manitoba was asked to forecast the number of acute care hospital beds that will be required to meet the needs of residents of the province of Manitoba by the year 2020. Methodological considerations for this request included identification of factors expected to affect bed use in the future, and how to account for these factors. The objective of this paper is to describe these methodological considerations, how decisions were made, and steps taken in our approach to this problem. The actual projections and their implications are the subject of another contribution in this issue of the journal (Finlayson, Stewart, Tate, MacWilliam & Roos, 2005).

Medial temporal lobe (MTL)/memory and frontal lobe (FL)/executive functions indexes are used to measure changes related to cognitive aging. These indexes are based on composite scores of neuropsychological tests validated in English-speaking populations, and their use in aging research is growing in popularity. This study aimed at validating the MTL/memory and FL/executive functions indexes in French-speaking adults. Ninety-eight healthy participants (32 young and 66 older adults) were tested on eight neuropsychological tests, three associated with MTL/memory functions and five associated with FL/executive functions. Factor analysis indicated that residual scores independent of age and associated with MTL/memory functions grouped under one factor, and residual scores associated with FL/executive functions grouped under another factor. Bootstrapping analysis with 1,000 resamples confirmed stability for seven neuropsychological tests. This study provides the first validation of the MTL/memory and FL/executive functions composite scores in French-speaking adults, which may be used to assess cognitive changes in aging research.

This study explored informal caregivers’ experiences of transitioning an older adult into long-term care (LTC). Qualitative description guided our analysis of semi-structured interviews with 13 informal caregivers of older adults from three LTC homes in southern Ontario. Our findings illustrate that caregivers experience chronic worry and burden before deciding on, or requiring to apply for, LTC. A sense of lack of control was a prominent theme, especially when caregivers were applying for LTC beds. Participants perceived pushing, pressure, and punishment from the health care system and felt relieved and fortunate after they accepted a bed offer. This tumultuous experience stimulated caregivers to anticipate future transitions. It is recommended that caregivers receive preparation and targeted support to manage transition experiences. Improved communication among health professionals is essential. Penalties for declining an offer for a bed in LTC should be re-examined in relation to its negative influence on caregivers’ experiences.

The relationship between the MMSE as a measure of cognitive deficit and two procedures for assessing medical-legal competence is explored. The findings on 60 patients assessed for financial capacity by a multidisciplinary panel, and 41 published cases assessed using the HCAT for capacity to consent to treatment are analysed using logistic regression and ROC curves based on the binary outcome capable/incapable. Cognitive deficit is not a good indicator of the results for mental capacity obtained either by the multidisciplinary panel or the HCAT. The relationship between cognitive deficits and procedures for the allocation of decisional authority is unclear. Some discussion is given to account for this discrepancy.

Researchers and policy-makers interested in the needs of the frail elderly in community and institutional settings have had limited success in forming policy based on empirical evidence. The reasons for this have included a variety of organizational and political considerations (e.g., lack of effective communication mechanisms), conceptual and methodological issues (e.g., problems with reliability and validity of existing data sources) and limitations in knowledge (e.g., lack of longitudinal data across health care sectors). The Minimum Data Set (MDS) series of instruments may prove useful in dealing with these difficulties. The MDS instruments have multiple uses for different audiences (e.g., care provision, funding and quality improvement). Extensive international testing has shown the MDS to be valid and reliable, and translations are available in 11 different languages. As implementation of the MDS begins in Canada, a number of new concerns will need to be addressed (e.g., confidentiality and access to data).

The purpose of this study was to determine if season or weather affected the objectively measured trip distances of older drivers (≥ 70 years; n = 279) at seven Canadian sites. During winter, for all trips taken, trip distance was 7 per cent shorter when controlling for site and whether the trip occurred during the day. In addition, for trips taken within city limits, trip distance was 1 per cent shorter during winter and 5 per cent longer during rain when compared to no precipitation when controlling for weather (or season respectively), time of day, and site. At night, trip distance was about 30 per cent longer when controlling for season and site (and weather), contrary to expectations. Together, these results suggest that older Canadian drivers alter their trip distances based on season, weather conditions, and time of day, although not always in the expected direction.

This paper examines use of alternative therapies to manage a chronic illness among older adults with at least one of three major conditions: arthritis, heart disease, and hypertension. Drawing from developments in the health utilization literature, a focus is placed on the illness context, predisposing factors, and several factors deemed to enable persons to use complementary medicine. The baseline data (n = 879) from the 1995–96 North Shore Self-Care Study conducted in Vancouver, Canada were used for this study. Two dependent variables were analysed using logistic regression techniques – the first is based on a comprehensive question about using alternative therapies (such as herbal remedies, acupuncture, massage therapy, etc.) to manage a chronic condition; and the second uses a more specific question pertaining to meditation or praying. The results from the first analysis show that being younger, suffering from arthritis compared to hypertension, comorbidity, taking fewer medications, lower income, reading on the chronic condition, and the interaction between reading and illness self-efficacy are associated with trying alternative therapies. The findings for the second analysis show that being female, being younger, and not married, as well as reporting a more serious condition, illness duration and the interaction between having moderate levels of mutual aid and number of confidants result in a greater likelihood of trying meditation/prayer. Implications of these results are discussed in terms of their theoretical import, and their relevance for the degree to which unconventional and conventional medicine are complementary.

Population aging is the population issue of the XXI century and many indices are used to measure its level and pace. In Science (2010), Sanderson and Scherbov suggested improvements to the measure of elderly dependency ratio. They identified several limitations to the use of chronological age as the main variable and proposed a new index, the Adult Disability Dependency Ratio, defined as the number of adults at least 20 years old with disabilities divided by the number of similarly aged adults without disabilities. They used the Sullivan prevalence-based method by multiplying derived disability rates to macro population projections. They showed results for several ECE and OECD countries; results for Canada (see online annex, available at https://www.sciencemag.org/content/329/5997/1287/suppl/DC1) were derived using coefficients of Italy. However, disability is a complex multidimensional process (see Carrière, Keefe, Légaré, Lin, & Rowe, 2007; Légaré and Décarie, 2011), and microsimulation can take into account its implied complexity. Our results for Canada, presented here, exceed those in Science to show how more-sophisticated projections of disabled older adults can improve the analysis. We used LifePaths, a Statistics Canada’s microsimulation model, to provide a perspective of the phenomena unobtainable with prevalence-based methods.

We conducted a scoping study to examine how interprofessional health care teams improve the outcomes of older adults experiencing cognitive challenges. We searched Ovid, Medline 1946, and MEDLINE In-Process and other non-indexed citations, using the concepts multi or interdisciplinary care teams, confusion or cognitive impairment, and elderly adults. Of 4,554 articles the review yielded, 34 relevant to our inquiry, using Arksey and O’Malley’s methodological framework. Twenty-nine per cent of authors reported on the processes interprofessional teams use to achieve positive outcomes for older adults. They highlighted the importance of communication, staff strategies, and education interventions in achieving outcomes with older adults and in supporting interprofessional collaboration. The review revealed knowledge gaps about the processes teams use to collaborate in caring for older adults experiencing cognitive challenges, and how to best incorporate older adults and their families’ perspectives in team decisions. More research to understand processes interprofessional teams use is needed.

Based on data from the 2002 General Social Survey, this research presents a global portrait of unmet needs for home care services among Canadians aged 65 and over. It shows that 26.8% of seniors need assistance, accounting for approximately 1,024,000 individuals. Among these, just over 180,000 (17.7%) had at least one unmet need. In nearly half the cases, elderly with unmet needs receive insufficient support for 2 activities or more. Furthermore, house cleaning, house maintenance and outdoor work are the three activities with the highest prevalence of unmet needs. Finally, the younger seniors, those who require assistance for 3 or 4 activities and those living in Quebec and British Columbia are most likely to have unmet needs.

Tai chi (TC) has been shown to positively influence health-related fitness (HRF) of elderly participants by affording them a means to increase musculoskeletal strength. The objective of this study was to examine TC intervention effects on HRF and whether ethnic groups not culturally related to TC experienced a barrier to participation in a community-based program for low-income older adults. Seventy-eight older mixed-ethnicity adults (age 55 and older) who were not culturally affiliated with TC were recruited for this study. HRF measures were taken before and after a 16-week TC program that offered seven sessions per week. Significant improvements were found in upper and lower musculoskeletal fitness and partial curl-ups, with TC being embraced by the participants. These results suggest that TC can be effective for improving HRF and that non-TC culturally related ethnic groups did not experience a barrier to participation in an older low-socioeconomic population sample.

Much literature supports the idea that problem-solving performance declines with aging. There are two important constraints on this generalization. The tasks that have been explored are for the most part novel ones. Literature is cited that argues that older people take longer to show improvement on such tasks. A second problem is that young control groups are more highly practiced at cognitive tasks generally. Thus age effects are confounded with skill effects. Recent work in semantically rich domains (those requiring a large knowledge base for skilled performance) show minimal effects of aging on problem-solving.

Canada’s Aging Population by Susan McDaniel was the inaugural book in the Butterworths series on aging in the 1980s. It opened a “growth industry” in research on aging. Much more is known now about the processes, both individual and collective, that are part of aging. More reliable projections of future population can now be made. That said, myths and misunderstandings – particularly about the policy implications of population aging – persist. It seems that the same fears and anxieties occur again and again. The disconnect remains between our growing knowledge about population aging and media or policy responses.

Previous studies suggest that intergroup contact has a positive effect on older workers’ perception of ageism and satisfaction. This study aims at assessing such relationships amongst Canadian younger workers. Precisely, in light of the intergroup contact theory (ICT), it was first hypothesized that a positive perception of intergenerational workplace climate (IWC) and knowledge sharing practices (KSP) increase younger workers’ awareness of ageist behaviors targeting older peers. Second, it was hypothesized that such awareness has a positive effect on young workers’ level of satisfaction. Relying on a cross-sectional design composed of 612 participants, path analysis was conducted. Findings suggest that whereas KSP increases younger workers’ awareness of ageist behaviors towards older workers, this is not the case for IWC. On the other hand, both IWC and KSP have a direct and positive impact on younger workers’ level of satisfaction. Theoretical and practical implications of findings are discussed.

We know little about the retirement plans of adults with chronic diseases. This research recruited Canadian workers 50–67 years of age from a national panel of 80,000 individuals (arthritis, n = 631; diabetes, n = 286; both arthritis and diabetes, n = 111; no chronic disabling conditions, n = 538). A cross-sectional survey asked participants about their expected age of retirement, future work plans, whether they were retiring sooner than planned, and bridged retirement. Chi-square analyses, analyses of variance, and regression analyses examined expectations and factors associated with them. Despite health difficulties, workers with arthritis and diabetes had retirement plans similar to those of healthy controls and consistent with normative expectations of working to a traditional retirement age. However, more respondents with arthritis or diabetes reported bridged retirement than healthy controls. Contrary to predictions, health factors accounted for less of the variance in retirement expectations than other factors. These findings point to the complexity surrounding retirement expectations and highlight person–job fit rather than disease factors alone.

Background: There is little empirical research into lay definitions of frailty. Objectives: (1) To explore the definitions of frailty among older men, and (2) to explore if these definitions match commonly used clinical definitions of frailty. Methods: Analysis of open-ended questions to survey data from a prospective cohort study of older airmen. The definitions of frailty were elicited, and grouped according to themes. Results: 147 men responded (mean age: 93). There was considerable heterogeneity in older men’s’ definitions of frailty, and no theme of frailty was predominant. The most common theme was impairment in activities of daily living. Older men’s’ definition of frailty was not consistent with any commonly used medical theory of frailty. Conclusions: Most older men think frailty is important, but their definitions are not consistent. Frailty may be a heterogeneous experience, which different people experience differently.

Elder abuse is a serious public health concern requiring immediate intervention; however, the under-reporting of elder abuse by victims to formal and informal networks remains a major obstacle. This scoping review aims to identify barriers to help seeking that older adults experiencing abuse confront. The goal is to inform public policies and practices in the Canadian context and identify research gaps in the extant literature. Seven scholarly databases were searched from which 12 articles met the inclusion criteria and were extracted for analysis. The findings from this scoping review revealed three levels at which barriers exist: individual focused, abuser/family focused, and community/culture focused barriers. The results suggest that there are several complex obstacles that older adults face when contemplating disclosure of abuse. Future research into help seeking in the Canadian context should more readily incorporate the voices of elder abuse victim-survivors to develop effective assessment strategies and responsive service provisions.