We analysed a prospective cohort study to determine (1) if self-rated health (SRH) predicts mortality in older adults with and without depressive symptoms, and (2) to determine if there is an interaction between SRH and depressive symptoms on mortality. We followed 1,751 community-dwelling adults aged 65 and older over five years. Measurements included age, gender, education, the Center for Epidemiological Studies-Depression (CES-D), SRH, the Modified Mini-Mental State Examination (3MS), and the Older Americans Resource Survey (OARS). Our outcome measure was time to death. Analyses were conducted in those with, and those without, depressive symptoms. We constructed Cox regression models with an interaction term for the CES-D and SRH. The hazard ratio (HR) for mortality was 1.63 for those with depressive symptoms; it was 1.68 for those without. No significant interaction was found between depressive symptoms and SRH for mortality.

The assessments of research in social gerontology in Quebec are already numerous. The need to continue to reflect on one's work is a sign of the uncertainty amongst Quebec researchers in social gerontology. Although research activities have been multiple in the past years and research in social gerontology has a few of the characteristics of an institutionalized scientific activity, the experience of research centres in gerontology has not always been a happy one; researchers have no definite place of work and scientific publications hardly get out of Quebec. Nevertheless, numerous works should be entitled to a Canadian and international circulation, and this exposure to the international trends of research in social gerontology would in turn profit Quebec researchers. Moreover, research in social gerontology is too exclusively concentrated in the field of social psychology, while the almost ideological rejection of quantitative methods appears largely unjustified. It is imperative that social research in gerontology in Quebec be diversified, but it is also important that researchers group together around research themes and that these groups be given adequate financial assistance by the funding agencies.

Until now, family caregivers have been involved very little in the processes of assessing the quality of care delivered to a hospitalized relative. This study is the second phase of a broader research project whose aim is to develop measurement scales intended for elderly patients and their caregivers on their perceptions of the quality of services delivered in Geriatric Assessment Units. More specifically, the goal of this phase of the research is to document the criteria that caregivers use to judge the quality of these services: these criteria should constitute the content of the measurement scale that is intended for them. Four focus groups, bringing together 21 caregivers, allowed for the identification of 31 criteria of quality. These criteria have been classified according to six dimensions of quality: information, communication, attitude of staff, technical quality, continuity, and physical resources. The study highlights the dual concerns of participants: the well-being of the patient and support for caregivers. It shows that caregivers consider themselves to be clients of geriatric services.

Human diploid fibroblasts undergo a limited number of population doublings in vitro and are used widely as a model of cellular aging. Despite growing evidence that cellular aging occurs as a result of altered gene expression, little is known about the activity of transcription factors in aging cells. Here we report that the dramatic reduction in the expression of the transcription factor FOS during cellular aging appears to be due to the inability of another transcription factor, serum response factor (SRF), to bind to its cognate site termed the serum response element (SRE) that is found upstream of several genes including the human c-fos gene. In contrast, the activities of proteins binding to the RNA polymerase “core” element TATA and to the cAMP response element (CRE) were maintained in senescing human fibroblasts. We present evidence that hyperphosphorylation of SRF is responsible for the decreased binding activity seen in late passage cells, as proposed previously for the FOS protein.

The value that the elderly put on being autonomous is an intrinsic characteristic of the aging population that can have a decisive influence on their motivation to maintain or recover their autonomy. This study was designed to examine the importance that elderly people who have lost their autonomy put on the ability to perform themselves five activities of daily living: eating, washing, dressing, eliminating and moving around. It also explores the influence of age, sex, place of residence, level of physical autonomy, feeling of well-being and socio-economic status on the value put on autonomy. A non-probabilistic sample of 68 elderly subjects was interviewed and the value put on autonomy was evaluated using two instruments: Osgood, Suci and Tannenbaum's differential semantic, and Torrance's time trade-off technique. The results suggest that the subjects consider physical autonomy very important. Educational level and the degree of physical autonomy were the main factors linked to importance. However, no link with age or place of residence (institution vs. home) was found.

Canadian health regions are required to set priorities and allocate resources within a limited funding envelope. Program budgeting and marginal analysis (PBMA) was piloted in continuing care in Claresholm, Alberta, with the aim of improving overall benefit from available resources. A marginal-analysis expert panel was used to assess options for continuing-care delivery. Inputs into the decision-making process included evidence from the literature, regional and provincial reports, program budgeting information, and local knowledge. Recommendations included implementing adult, day-and-night support programs and converting long-term beds to convalescent beds. Changes were funded through allocating provincial Broda funding and altering nursing assistant and physiotherapy activity. PBMA was demonstrated to be an effective framework in aiding decision makers with redesigning services in Claresholm. This case study is one of several which indicate PBMA to be a valuable aid to priority setting in health care service provision.

The results of examining all hospitalizations of the elderly consequent to injury in one Canadian province indicate that 66.3% were for accidental falls and 21.3% were for “other accidents” and for adverse effects of therapeutic regimens. Nursing home residents were significantly more likely to be hospitalized for falls than community dwellers but very elderly institutionalized females, who comprise 40% of the nursing home population, used significantly fewer days than their community peers.

This study aimed to develop an efficient data collection and curation process for all drugs and natural health products (NHPs) used by participants to the Canadian Longitudinal Study on Aging (CLSA). The three-step sequential process consisted of (a) mapping drug inputs collected through the CLSA to the Health Canada Drug Product Database (DPD), (b) algorithm recoding of unmapped drug and NHP inputs, and (c) manual recoding of unmapped drug and NHP inputs. Among the 30,097 CLSA comprehensive cohort participants, 26,000 (86.4%) were using a drug or an NHP with a mean of 5.3 (SD 3.8) inputs per participant user for a total of 137,366 inputs. Of those inputs, 70,177 (51.1%) were mapped to the Health Canada DPD, 20,729 (15.1%) were recoded by algorithms, and 44,108 (32.1%) were manually recoded. The Direct algorithm correctly classified 99.4 per cent of drug inputs and 99.5 per cent of NHP inputs. We developed an efficient three-step process for drug and NHP data collection and curation for use in a longitudinal cohort.

Cette étude visait à identifier les facilitateurs, les obstacles et la faisabilité d’implanter un Accompagnement-citoyen personnalisé d’intégration communautaire (APIC) pour des aînés en perte d’autonomie et vivant dans la communauté. L’APIC est un suivi hebdomadaire de trois heures réalisé par un accompagnateur non professionnel formé et supervisé qui vise à optimiser la réalisation d’activités sociales et de loisirs de personnes ayant des incapacités. Une recherche-action a permis de réaliser des entretiens semi-dirigés auprès de 16 participants de la communauté. Les principaux facilitateurs de l’implantation sont l’adaptabilité de l’APIC et son appui scientifique, la reconnaissance d’un besoin, l’expertise et la collaboration. La présence de leaders ouverts à la nouveauté et d’individus offrant du soutien est favorable. Le financement de l’implantation, associé à un contexte économique défavorable, est un obstacle. La majorité des participants perçoivent qu’il serait faisable d’implanter l’APIC en l’intégrant à des structures bénévoles déjà existantes. Ces connaissances permettront d’optimiser l’implantation de l’APIC ou d’interventions similaires dans la communauté.

Most older adults prefer to age in place, which for many will require home and community care (HCC) support. Unfortunately, HCC capacity is insufficient to meet demand due in part to low wages, particularly for personal support workers (PSWs) who provide the majority of paid care. Using Ontario as a case study, this paper estimates the cost and capacity impacts of implementing wage parity between PSWs employed in HCC and institutional long-term care (ILTC). Specifically, we consider the cost of increased HCC PSW wages versus expected savings from avoiding unnecessary ILTC placement for those accommodated by HCC capacity growth. The expected increase in HCC PSW retention would create HCC capacity for approximately 160,000 people, reduce annual health system costs by approximately $7 billion, and provide an 88 per cent return on investment. Updating wage structures to reduce turnover and enable HCC capacity growth is a cost-efficient option for expanding health system capacity.

This cross-sectional study investigated staff’s attitudes towards the use of mobile telepresence robots in long-term care (LTC) homes in western Canada. We drew on a Health Technology Assessment Core Model 3.0 to design a survey examining attitudes towards nine domains of mobile telepresence robots. Staff, including nurses, care staff, and managers, from two LTC homes were invited to participate. Statistical analysis of survey data from 181 participants revealed that overall, participants showed positive attitudes towards features and characteristics, self-efficacy on technology use, organizational aspects, clinical effectiveness, and residents and social aspects; neutral attitudes towards residents’ ability to use technology, and costs; and negative attitudes towards safety and privacy. Participants who disclosed their demographic backgrounds tended to exhibit more positive attitudes than participants who did not. Content analysis of textual data identified specific concerns and benefits of using the robots. We discuss options for implementing mobile telepresence robots in LTC.

Avec l’augmentation de la longévité, plusieurs personnes ayant une déficience intellectuelle (DI) vieillissent au domicile familial avec leurs parents. Cette recherche porte sur l’expérience de 17 pères d’adultes ayant une DI. Ces pères ont répondu à un questionnaire incluant des questions ouvertes et fermées en entrevue individuelle afin de décrire leurs motivations pour cohabiter avec leur fils ou leur fille ayant une DI, les bénéfices et contraintes de cette cohabitation, les services résidentiels futurs envisagés et la planification de « l’après-parents ». Les résultats indiquent que les pères ont choisi cette cohabitation. Ils éprouvent de l’anxiété, ignorant qui assumera le soutien auprès de l’adulte avec une DI lorsqu’ils ne pourront plus le faire. Leur planification de l’après-parents correspond à des démarches légales et à des conversations avec la fratrie ou la famille élargie. La discussion souligne la complexité de la situation où entrent en jeu les émotions des parents, leur attachement à l’adulte ayant une DI et les expériences antérieures avec les services résidentiels, sociaux ou de réadaptation.

This study aims to assess changes in long-term care (LTC) residents’ quality of life (QoL) before and during the COVID-19 pandemic. A pre-test post-test study of 49 QoL measures, across four dimensions from the interRAI self-reported QoL survey, was conducted. Secondary data from 2019 (n = 116) and 2020 (n = 128) were analysed to assess the change in QoL. A significant decline in 12 measures was observed, indicating a change in QoL of LTC residents during the pandemic. Social life was the dimension mostly affected with residents reporting less opportunities to spend time with like-minded residents, explore new skills and interests, participate in meaningful religious activities, and have enjoyable things to do in the evenings. Several measures of personal control, staff responsiveness and care, and safety also demonstrated a significant change. The results can inform future strategies for pandemic and outbreak preparedness. Balancing the safety of residents with attention to their QoL should be a priority moving forward.

In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents’ health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.

Older adults have an increased risk of complications or death from influenza. Despite the benefits of vaccination for older adults, vaccination coverage among older adults ages 65 years and over is still below Canada’s national target of 80 per cent. As health–care-seeking behaviours are influenced by several factors, including life satisfaction, we investigated the relationship between life satisfaction and influenza vaccination among older adults. A sample (n = 22,424) from the 2015–2016 Canadian Community Health Survey data was analysed using descriptive and multinomial logistic regression analyses. Higher life satisfaction was associated with a more recent influenza vaccination history. Vaccination differed by gender, age, and self-reported health status, as women, much older adults, and those with the poorest health status were more likely to be vaccinated. The study suggests an association between life satisfaction and influenza vaccination. More research into the factors that impact influenza vaccination in older adults is needed to increase vaccination coverage in the older adult population.

While the majority of seniors live outside of institutions, many live in seniors apartment buildings rather than in single family dwellings. MacPherson (1983) suggested that not maintaining an independent living style may have some negative consequences for seniors. The question asked was whether differences in lifestyle arising from the nature of the residence were associated with measures of psychomotor performance. Some 36 seniors, average age approximately 68 yrs., all in good health, completed 800 responses on a discrete pursuit tracking task which emphasized response speed and accuracy. Significant differences in performance were noted for both RT and speed of movement. Overall, seniors living independently, either in urban or rural areas, responded faster than seniors living in seniors apartment buildings. The data do not imply a causal relationship, however, they do suggest that psychomotor variables are relevant factors to consider in regard to differing living styles.