This exploratory survey aimed at determining the spatial and territorial factors used by elderly people when entering an old people's home and illustrating how these variables could be referred to two spatial and territorial appropriation processes. One hundred and two residents were asked to describe their rooms and to fill in a life satisfaction rating scale adapted by Blais, Vallerand, Pelletier and Brière (1989). The findings highlighted two distinct appropriation processes, that is to say a spatial appropriation-disappropriation process and a territorial disappropriation-reappropriation one. The respective predictors of these two processes are on the one hand the life satisfaction ratio, age and sex; and on the other hand the representation the elderly person has of his/her own autonomy as well as the evaluation of the gap between the elderly person's satisfaction with his/her past and present life.

The maximum lifespan of different animal species is genetically determined. Many biochemical and physiological systems which influence longevity have apparently evolved to regulate growth and development in a way which maximizes fitness given the ecological niche and constraints on the species. The diversity of individual genetic effects on aging makes it unlikely that either extrinsic factors such as nutrition and medicine or genetic intervention will have dramatic effects on the maximum lifespan of a species, in spite of significant qualitative effects on individuals. However, understanding the fundamental genetic determinants of senescence may be of particular importance to the treatment and or prevention of age associated problems involving tissue degeneration and/or cancer. Considerable investment in basic biological research on both aging and developmental processes is needed before this understanding can be achieved.

This article addresses three questions: Are elderly immigrants less likely than Canadian-born elderly people to reside independently? What are the effects of economic, cultural, and life course factors on residential independence among elderly immigrants? What are the effects of immigrant-specific characteristics such as duration of residence and cultural background? Descriptive results show that elderly immigrants are less likely to reside independently, but the large gap of over 15 per cent is reduced to 5 per cent once economic, cultural, life course, and other factors are considered in the multivariate analysis. Effects of economic, cultural, and life course factors are mostly as expected, as are those of immigrant-specific characteristics such as duration of residence. Although aging immigrants have more-varied living arrangements than their Canadian-born peers, these are likely to increasingly include residential independence.

A cross-sectional analysis was conducted using data from a prospective cohort study to investigate whether frailty is associated with pain intensity, disability caused by low back pain (LBP), and quality of life in an older population with acute non-specific LBP. Six hundred and two individuals with a mean age of 67.6 (standard deviation [SD] 7.0) years were included in the analysis. In relation to frailty status, 21.3 per cent of the sample were classified as robust, 59.2 per cent were classified as pre-frail, and 19.5 per cent were classified as frail. In the unadjusted analysis, pre-frail and frail groups showed significantly higher pain and disability scores than the robust group. Moreover, the same two groups exhibited lower scores in both physical and mental domains of quality of life than the robust group. After adjusting for socio-demographic and clinical variables, disability scores and the physical component of quality of life were significantly associated with frailty. In older adults with acute LBP, frailty is associated with more disability and worse scores in the physical component of quality of life.

This study investigated the relationships among several aspects of cognitive functioning and the outcome of self-medication training in hospitalized elderly patients. Data from 53 geriatric patients who received rehabilitation treatment at the SCO Hospital in Ottawa, Canada between 1992 and 1997 were collected, on an archival basis. Patients began a graduated self-medication program after undergoing a neuropsychological evaluation. Performance scores from five different aspects of cognition were regressed on the self-medication training outcome measures. Findings revealed that aspects of cognitive functioning were significantly related to the outcome of self-medication training. Thus, psychometric measures of cognition can be useful in predicting which patients are most likely to benefit from a self-medication program, or alternatively, those who would require a modified program to be able to learn. The clinical implications of these results are discussed.

Older women interact with physicians more frequently than older men and younger persons, yet knowledge and understanding of their experiences with physicians is limited. The purpose of this study was to investigate older women’s perceptions of their interactions with physicians and to identify what older women want from physicians. Findings from in-depth interviews with 30 older women reveal the majority want to be actively involved in their own health care. In the patient–physician relationship, the women typically give priority to physicians’ personal attributes and behavior towards the patient. For many of the women, the age and gender of the physician also matter.

This study examines interprovincial migration patterns of elderly and nonelderly Canadians during 1956–61 and 1971–76. The focus of the paper is on the relationships between net migration patterns and changes in the concentration of elderly persons in provincial populations. The data show that elderly and nonelderly net migration patterns are very similar; that is, provinces that attract elderly also tend to attract nonelderly while provinces that lose elderly also tend to lose nonelderly. As a consequence, the impact of elderly migration on the aging of provincial populations is offset by nonelderly migration. Nevertheless, migration patterns do contribute in two ways to the relative concentration of elderly persons in provincial populations. First, elderly net in-migration after eliminating the counterbalancing effects of nonelderly in-migration does contribute modestly to population aging in 1971–76 though not in 1956–61. Second, nonelderly net out-migration contributes to the aging of a province's population in that the out-flow of younger persons increases the relative concentration of the elderly in the remaining population.

Few studies have integrated the concept of empowerment in their analysis of the interaction between formal services and informal caregivers. This study was conducted among 32 female informal caregivers living in a district served by a Montreal local community service centre (CLSC). It was designed to identify those aspects of formal services that either empowered caregivers or increased their powerlessness. Three major issues were identified: norms applicable to care giving; access to and control over resources and services; and power relationships with practitioners. Depending on their context and their perception of their role as a caregiver, caregivers reported that their recourse to services was either an empowering experience or one that increased their powerlessness.

COVID-19 has had a devasting impact on older adults in Canada, including persons living with dementia. This intrinsic case study sought to understand the perceptions of persons living with dementia regarding how COVID-19 has impacted their well-being. Ten persons living with dementia participated in in-depth qualitative interviews about their experience with COVID-19. Using thematic analysis, four themes were identified: (1) expressing current and future concerns; (2) social connections and isolation; (3) adapting to change and resilience through engagement and hope; and (4) we’re not all the same: reflecting individual experiences of the pandemic. Results highlight that while COVID-19 contributed to isolation, concerns, and frustrations, persons with dementia also demonstrated adaptation and resilience. This study reinforced that persons with dementia and their responses to challenges are unique. Therefore, interventions to support persons with dementia must also be individualized to each person’s abilities and circumstances.

This research compared older adults' use of medical assistive devices (ADs) with their use of everyday ADs as a means of managing chronic physical disability. The study also examined whether predisposing, need, and enabling factors were associated with device use in three domains of activity: personal care / in-home mobility, household activities, and community mobility. Participants were 248 adults, aged 55 years and older, with a wide range of disability levels as a result of osteoarthritis. All participants were administered an in-depth, structured questionnaire, as part of a larger study examining older adults' independence and adaptation to chronic physical illness. The results revealed that respondents actively adapted to their disabilities and used a wide range of medical and everyday devices, with everyday devices being reported more than twice as often as medical ADs and the fewest devices overall being reported for community mobility. In general, medical devices were used when subjective and objective need for ADs was considerable. Everyday devices were reported earlier in the trajectory of the disease, at mild and moderate disability levels, and were associated with a broader pattern of adaptation that included planning to avoid problems, exercise, and pacing activities.

Based on the national Canadian Study of Health and Aging, the objective of this study was to determine the importance of socio-demographic and medical factors, cognitive and functional status as predictors of the development of urinary incontinence, and to estimate five-year incidence by sex and age group. Participants from the Canadian Study of Health and Aging who underwent a clinical examination in 1992 and were continent for urine at the time were followed up and their continence status was again determined in 1997. Multivariate logistic regression models with daily incontinence and daily or less than daily incontinence as the outcomes were developed separately for male (n = 306) and female (n = 520) survivors. Predictor variables were introduced in the following chunks: socio-demographic factors; cognitive status; functional status, diabetes and stroke. Five-year cumulative incidence of daily and less than daily incontinence by sex and age group was also estimated. Results indicated that the incidence of urinary incontinence was higher in women than in men, and increased by age in both men and women. Especially among men, those in institutions were much more likely to develop urinary incontinence than those in the community. Incontinence increased dramatically with severity of dementia, less so with physical immobility. Diabetes mellitus was related to the development incontinence in men but not in women, prior stroke was related to development of incontinence in both sexes. It is concluded that urinary incontinence is common in older persons, and enquiries about its presence should be part of routine medical and nursing assessment of older persons. Those who develop incontinence commonly have dementia and are physically impaired. The extent of assessment and management should be carefully tailored to each individual patient.

Discordance between self-reports and medical records reflects patient and provider factors that have implications for management and research. This study investigated discordance and socio-demographic factors that explain concordance. A purposive sample of 402 disabled older persons was interviewed using a structured questionnaire. The highest concordances were found for diabetes, cardiovascular accident (CVA), and cancer while the lowest were evident for arthritis, and renal and gastrointestinal conditions. Significant explanatory factors included (a) age for explaining concordance in hypertension; (b) ethnicity in explaining concordance in arthritis and cancer; (c) marital status in explaining concordance in thyroid diseases; (d) education in explaining concordance in gastrointestinal conditions; and (e) functional status in explaining concordance in respiratory, gastrointestinal, and thyroid diseases. Co-morbidity increased concordance for all health conditions and decreased concordance for hypertension. Further investigation is needed to examine the reasons for the disparities between the two sources of information.

Vers 2031, les personnes les plus âgées (85 ans et plus) pourraient composer 4 pourcent de la population totale du Canada. Ce document relève les changements constates dans le domaine de l'utilisation des soins de longue durée, des activités de la vie quotidienne (AVQ) et des activités instrumentales de la vie quotidienne (ATVQ) chez les participants les plus âgés du Aging in Manitoba Longitudinal Study, d'après trois éléments répartis sur 13 ans. Parmi les participants, 38,4 pour cent n'avaient pas eu recours aux soins de longue durée pendant la période examinée; entre 75 et 88 pour cent des participants pouvaient continuer à manger, à se déplacer dans leur maison et à se mettre au lit et à en sortir sans aide. En ce qui a trait aux activités instrumentales de la vie quotidienne, la proportion des gens qui n'avait pas besoin d'aide allait de 3 pour cent (réparations dans la maison) à 58 pour cent (se préparer une tasse de thé ou de café). Les résultats de ces analyses signalent l'hétérogénéité des aptitudes fonctionnelles des personnes très âgées et viennent enrichir la documentation portant sur cette tranche de la population.

From a “successful aging” perspective, the subjective feeling of well-being is as important as “objective” health. Physical exercise is seen as being an effective way of staying healthy, but its link with well-being in a normal aging population remains largely unexplored. Based on two randomized surveys of the aging population, conducted in 1979 and 1994, respectively, with questionnaires including retrospective questions on activities and health, two cohorts of young-old (aged 64–74) were selected (cohort 1, born 1905–1914, N = 949; cohort 2, born 1920–1929, N = 602) and split into four groups, corresponding to their exercising trajectories (long-term exercisers LE, new exercisers NE, quitters Q, sedentary S). The link between the four trajectories and two indicators of well-being (self-rated health, self-assessed depression scale) was examined by means of regression analyses. In both cohorts, the LE group had a higher level of well-being than the Q and the S. The study also throws light on the case of the quitters (Q), who showed the lowest level of well-being. Scant research has hitherto been done on the causes and repercussions of abandoning exercise.

There is great interest in identifying psychological and social variables associated with depressive symptoms in older adults. The goal of this article is to review the literature on the relationship between social support and depressive symptoms in the elderly and to identify the mechanisms involved in this relationship. The review indicates that both structural and functional dimensions of social support are inversely related to depressive symptoms in elderly persons. In addition, there is evidence supporting both the main effect model and the buffering effect model of social support. It is unclear, however, whether observation of these effects depends on the type of measure used to assess social support. A better understanding of the relationship between social support and depression requires the consideration of more precise dimensions of social support as well as the nature of the Stressors experienced by older people.

This account of nursing home care in Australia begins with a brief history of four phases of policy development from 1963 to the early 1990s. The structure of the nursing home system is then outlined; particular attention is given to data sets generated from administrative systems that are used for monitoring nursing home care. Arrangements for pre-admission assessment and assessment of resident dependency and care needs, to which reimbursement levels are related, are described next. A profile of resident characteristics and their patterns of utilization of nursing home care is presented, drawing on these assessment data. Policy issues arising in the 1990s are addressed in the conclusion; these concern the place of nursing home care in the overall balance of aged care services and the enhancement of outcomes of nursing home care in regard to quality of care and workforce training. Finally, the contribution of the continuing development of data sets for monitoring trends and outcomes to policy and program development is noted.

The experiences of elderly persons caring for elderly family members at home were examined by means of in-depth interviews with fourty-seven subjects in Montreal and seven in England. The analysis of the Montreal sample revealed that denial of fears and unwillingness to think about the future, as well as negative assessments of cared-for-person's health were more prevalent in women than in men. Women also mentioned more frequently that religious beliefs influenced their caregiving and seemed to feel more strongly the impact and burden caregiving placed on them. Experiences with old people in earlier life was associated with low burden scores; few visitors and a belief that cared-for-person was critical of them were associated with high burden scores. Suggestions for further research and recommendations for supportive services to caregivers are made.

Inappropriate prescribing to the elderly is a serious problem and is one factor contributing to adverse drug reactions in this group. It is well-known that reliance on promotional literature for prescribing information leads to less appropriate prescribing. This study surveyed ads in two major Canadian medical journals which portrayed people who appeared to be over 65 years of age. The elderly were shown in just over 7 per cent of the ads. These ads did not appear to take into account the special drug needs of the elderly. Ads featuring the elderly could lead to inappropriate prescribing because of their pictorial content, their written content or a combination of both. Further research into this area is needed, specifically directed at factors which influence prescribing to the elderly. In the meantime physicians dealing with the elderly should critically analyse the message in drug advertisements and be aware of the risks of using them for therapeutic information.