Search Our Scientific Publications & Authors

Can Geriatr J 2018 Dec 30;21(4):310-319. Epub 2018 Dec 30.

Department of Pathology and Molecular Medicine, Division of Clinical Pathology, McMaster University, Hamilton, ON, Canada.

Background: Typically, long-term care home (LTCH) residents are transferred to hospital to access intravenous (IV) therapy. The aim of this study was to pilot-test an in-home IV therapy service, and to describe outcomes and key informants' perceptions of this service.

Method: This service was pilot-tested in four LTCH in the Hamilton-Niagara region, Ontario. Read More

Can Geriatr J 2018 Dec 30;21(4):307-309. Epub 2018 Dec 30.

Calgary Fall Prevention Clinic, Specialized Geriatric Services, Alberta Health Services, Edmonton, AB, Canada.

A 77-year old woman presented with a history of falls. Known health problems included biopsy-proven collagenous colitis treated with bismuth subsalicylate. On examination, in addition to impaired balance and gait, she was found to have tremors and cognitive deficits. Read More

Can Geriatr J 2018 Dec 30;21(4):303-306. Epub 2018 Dec 30.

Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada.

Background: Frailty is an established predictor of admission into long-term care (LTC) and mortality in the elderly population. Assessment of frailty among adults with intellectual and developmental disabilities (IDD) using a generic frailty marker may not be as predictive, as some lifelong disabilities associated with IDD may be interpreted as a sign of frailty. This study set out to determine if adding the Home Care-Intellectual and Developmental Disabilities Frailty Index (HC-IDD Frailty Index), developed for use in home care users with IDD, to a basic list of predictors (age, sex, rural status, and the Johns Hopkins Frailty Marker) increases the ability to predict admission to long-term care or death within one year. Read More

Can Geriatr J 2018 Dec 30;21(4):297-302. Epub 2018 Dec 30.

Trent Centre for Aging and Society, Trent University, Peterborough, ON, Canada.

Background: Older adults living with frailty represent a complex group who are increasingly accessing regional geriatric services. Goal-based care planning is the industry standard in the care of older adults, yet few studies illustrate how goal-based care planning is being conducted with this population. Understanding how frailty impacts goal-based care planning in regional geriatric services is key to improving patient care. Read More

Can Geriatr J 2018 Dec 30;21(4):292-296. Epub 2018 Dec 30.

Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.

Background: Family caregivers who provide care to seniors at no cost to the healthcare system are an integral part of the healthcare system. Caregiving, however, can cause significant emotional, physical and financial burden. We held a one-day symposium on how to best involve and support family caregivers in the healthcare system. Read More

Can Geriatr J 2018 Dec 30;21(4):290-291. Epub 2018 Dec 30.

Department of Psychiatry & Biobehavioral Science, University of California, Los Angeles, CA, USA.

Can Geriatr J 2018 Sep 30;21(3):284-289. Epub 2018 Sep 30.

Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.

Background: An exercise program involving patients, caregivers, and professionals, entitled SPecific Retraining in INTerdisciplinarity (SPRINT), has been developed to prevent functional decline during hospitalization of older patients.

Goal: Assess the feasibility of implementing SPRINT in the context of a Geriatric Assessment Unit (GAU).

Methods: GAU's health-care professionals were instructed with the SPRINT. Read More

Can Geriatr J 2018 Sep 30;21(3):274-283. Epub 2018 Sep 30.

Toronto General Hospital, University Health Network, Toronto, ON, Canada.

Background: Hip fracture (HF) is common and requires communication between patient, family, surgeons, and hospitalists. Patient and family understanding of the seriousness of HF is unclear.

Methods: We interviewed older patients (age > 65 years) hospitalized with HF at two Canadian academic hospitals, or their surrogate decision-makers (SDMs). Read More

Can Geriatr J 2018 Sep 30;21(3):269-273. Epub 2018 Sep 30.

Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada.

Background: Utilization of psychotropic medications among the elderly has garnered attention due to concerns about safety and degree of efficacy, but may be used differently across regions.

Methods: We conducted a cross-sectional study of all antipsychotic, benzodiazepine, and trazodone prescriptions dispensed to seniors ( ≥ 65 years) leveraging IQVIA (Durham, NC) GPM data in 2013. We report the units dispensed (per 100 seniors) by province. Read More

Can Geriatr J 2018 Sep 30;21(3):264-268. Epub 2018 Sep 30.

Bruyère Research Institute, University of Ottawa, Ottawa, ON.

Objective: A pilot study to determine the feasibility of recruiting patients with MCI to test for cognitive interventions.

Method: Thirty patients with amnestic MCI were to be divided into two intervention arms and one control group. Participants went to local sites and completed brain training for one hour three times per week for nine weeks. Read More

Can Geriatr J 2018 Sep 30;21(3):262-263. Epub 2018 Sep 30.

Faculty of Medicine, The University of British Columbia | Vancouver Campus, Vancouver, BC.

Can Geriatr J 2018 Sep 30;21(3):210-217. Epub 2018 Sep 30.

Department of Medicine, Division of Geriatrics, University of Toronto, Toronto, ON, Canada.

We present the top 11 articles in geriatric medicine in the past two years. The topics range from new diagnostic criteria for Lewy Body dementia, advances in biomarker diagnosis of Alzheimer's disease, a major review of dementia and risk factors, the optimal cutoff for the Montreal Cognitive Assessment, antipsychotics in delirium prevention, mobilization of inpatients, intensive blood pressure treatment and statin therapy for primary prevention in older adults, and comprehensive geriatric assessment in vascular surgery and non-small cell lung cancer. Read More

Can Geriatr J 2018 Jun 30;21(2):173-209. Epub 2018 Jun 30.

Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

Background: In order to provide appropriate care for the aging population, many countries are adopting a National Dementia Strategy (NDS). On June 22, 2017, Canada announced it will become the 30th country to launch a NDS. In light of this announcement and as Canada prepares to develop its own NDS, we conducted this review to examine and compare the NDSs of the other previous 29 countries with Canadian government's policies to date. Read More

Can Geriatr J 2018 Jun 30;21(2):166-172. Epub 2018 Jun 30.

Li Ka Shing Research Institute, University of Toronto, Toronto, ON, Canada.

Background: Twitter is a microblogging platform increasingly used in medicine to overcome geographic barriers and promote international connections. Tweets, the 280-character microblogs, are catalogued by hashtags (#). This study evaluates and describes the participation, content, and impact of Twitter at the 2015 Canadian Geriatrics Society (CGS) Annual Scientific Meeting, during which #CGS2015 was the official conference hashtag. Read More

Can Geriatr J 2018 Jun 30;21(2):157-165. Epub 2018 Jun 30.

Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada.

Background: Motor and cognitive impairments are common among older adults and often co-exist, increasing their risk of dementia, falls, and fractures. Gait performance is an accepted indicator of global health and it has been proposed as a valid motor marker to detect older adults at risk of developing mobility and cognitive declines including future falls and incident dementia. Our goal was to provide a gait assessment protocol to be used for clinical and research purposes. Read More

Can Geriatr J 2018 Jun 30;21(2):152-156. Epub 2018 Jun 30.

Département de médecine, Faculté de médecine, Université de Montréal, Montréal QC, Canada.

Background: Early assessment of cognitive symptoms is an issue in geriatrics. This study investigated the delay from the onset of cognitive symptoms to initial clinical assessment and its associations with patients' sociodemographic and clinical characteristics.

Methods: This is a cross-sectional retrospective study using medical chart review of 316 patients referred for assessment to a university-affiliated memory clinic. Read More

Can Geriatr J 2018 Jun 30;21(2):143-151. Epub 2018 Jun 30.

Department of Psychiatry, Queen's University, Kingston, ON, Canada.

Background: Primary care-based memory clinics were established to meet the needs of persons with memory concerns. We aimed to identify: 1) physical examination maneuvers required to assess persons with possible dementia in specialist-supported primary care-based memory clinics, and 2) the best-suited clinicians to perform these maneuvers in this setting.

Methods: We distributed in-person and online surveys of clinicians in a network of 67 primary care-based memory clinics in Ontario, Canada. Read More

Can Geriatr J 2018 Jun 30;21(2):139-142. Epub 2018 Jun 30.

Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.

Background: The purpose of this pilot study was to explore the potential of eye-tracking technology in monitoring symptoms and predicting outcomes in apathetic Alzheimer's disease (AD) patients treated with methylphenidate (MTP).

Methods: Neuropsychological tests and eye-tracking measurements were completed at baseline and following at least four weeks of treatment with MTP (5-10 mg BID). Eye-movements were measured while patients viewed novel and social stimuli. Read More

Can Geriatr J 2018 Jun 30;21(2):138. Epub 2018 Jun 30.

Canadian Geriatrics Journal.

Can Geriatr J 2018 Mar 26;21(1):26-31. Epub 2018 Mar 26.

Department of Psychiatry, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Background: With an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will.

Method: This paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts. Read More

Can Geriatr J 2018 Mar 26;21(1):14-25. Epub 2018 Mar 26.

School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.

The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1. Read More

Can Geriatr J 2018 Mar 26;21(1):6-13. Epub 2018 Mar 26.

CFPC Working Group on the Assessment of Competence in Care of the Elderly, Mississauga, ON, Canada.

Background: With Canada's senior population increasing, there is greater demand for family physicians with enhanced skills in Care of the Elderly (COE). The College of Family Physicians Canada (CFPC) has introduced Certificates of Added Competence (CACs), one being in COE. Our objective is to summarize the process used to determine the Priority Topics for the assessment of competence in COE. Read More

Can Geriatr J 2018 Mar 26;21(1):1-5. Epub 2018 Mar 26.

Division of Geriatric Medicine, St. Joseph's Health Care London, Parkwood Institute, London, ON, Canada.

Background: Frailty, a common clinical syndrome in older adults associated with increased risk of poor health outcomes, has been retrospectively calculated in previous publications; however, the reliability of retrospectively assigned frailty scores has not been established. The aim of this study was to see if frailty scores, based on chart review data, agreed with clinician-determined scores based on a comprehensive geriatric assessment.

Methods: Per standard practice, all patients seen by one nurse clinician (JW) from the Southwestern Ontario Regional Geriatric Program, a tertiary care-based outreach service, between August 15, 2013 and December 31, 2015 received a comprehensive geriatric assessment which included the assignment of an interview-based Clinical Frailty Scale score (CFS-I). Read More

Can Geriatr J 2017 Dec 22;20(4):268-269. Epub 2017 Dec 22.

Department of Medicine, University of Toronto, Toronto, ON.

Can Geriatr J 2017 Dec 22;20(4):264-267. Epub 2017 Dec 22.

Professor of Geriatric Medicine (retired), University of Calgary, Calgary, AB.

Going from physician to patient is a journey from which few of our tribe will be spared, and about which we have comparatively little formal reflection. This paper describes some of the lessons learned on such a journey from a retired Professor of Geriatric Medicine, whose course of vascular parkinsonism offers lessons both professional and personal. Read More

Can Geriatr J 2017 Dec 22;20(4):253-263. Epub 2017 Dec 22.

Mount Sinai Hospital, Toronto, ON, Canada.

Appropriate and optimal use of medication and polypharmacy are especially relevant to the care of older Canadians living with frailty, often impacting their health outcomes and quality of life. A majority (two thirds) of older adults (65 or older) are prescribed five or more drug classes and over one-quarter are prescribed 10 or more drugs. The risk of adverse drug-induced events is even greater for those aged 85 or older where 40% are estimated to take drugs from 10 or more drug classes. Read More

Can Geriatr J 2017 Dec 22;20(4):246-252. Epub 2017 Dec 22.

Department of Psychiatry, Mount Sinai Hospital, Sinai Health System, Toronto, ON.

Background: Our hospital identified delirium care as a quality improvement target. Baseline characterization of our delirium care and deficits was needed to guide improvement efforts.

Methods: Two inpatient units were selected: 1) A general internal medicine unit with a focus on geriatrics, and 2) a surgical unit. Read More

Can Geriatr J 2017 Dec 22;20(4):241-245. Epub 2017 Dec 22.

Department of Medicine Division of Geriatrics, Faculty of Medicine, The Ottawa Hospital, Ottawa, ON.

Background: For persons with dementia (PWD), driving becomes very dangerous. Physicians in Canada are legally responsible to report unfit drivers and then must disclose that decision to their patients. That difficult discussion is fraught with challenges: physicians want to maintain a healthy relationship; patients often lack insight into their cognitive loss and have very strong emotional reactions to the loss of their driving privileges. Read More

Can Geriatr J 2017 Dec 22;20(4):240. Epub 2017 Dec 22.

Canadian Geriatrics Journal.

Can Geriatr J 2017 Sep 28;20(3):112-119. Epub 2017 Sep 28.

Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada.

Background: With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection.

Methods: This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. Read More

Can Geriatr J 2017 Sep 28;20(3):105-111. Epub 2017 Sep 28.

Department of Geriatric Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, NS.

Background: The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults.

Methods: The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative. Read More

Can Geriatr J 2017 Sep 28;20(3):97-104. Epub 2017 Sep 28.

Saskatchewan Health Quality Council, Saskatoon, SK, Canada.

Background: Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics.

Methods: We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur. Read More

Can Geriatr J 2017 Jun 30;20(2):94-96. Epub 2017 Jun 30.

Geronthorheumatological Outpatient Clinic, Mariano Lauro Hospital, Sant'Agnello, Naples, Italy.

Can Geriatr J 2017 Jun 30;20(2):85-93. Epub 2017 Jun 30.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON.

Background: It is becoming increasingly important to find ways for caregivers and service providers to collaborate. This study explored the potential for improving care and social support through shared online network use by family caregivers and service providers in home care.

Methods: This qualitative study was guided by Rogers' [NY: Free Press; 1995], and involved focus group and individual interviews of service providers (n = 31) and family caregivers (n = 4). Read More

Can Geriatr J 2017 Jun 30;20(2):75-84. Epub 2017 Jun 30.

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB.

Purpose Of The Study: The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them.

Design And Methods: A CIHR-funded, two-day conference entitled "Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes" was held. An integrated knowledge translation approach guided this planning conference. Read More

Can Geriatr J 2017 Jun 30;20(2):66-74. Epub 2017 Jun 30.

School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC.

Objectives: The objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors.

Methods: This was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Read More

Can Geriatr J 2017 Jun 30;20(2):65. Epub 2017 Jun 30.

Editorial Board, Canadian Geriatrics Journal.

Can Geriatr J 2017 Mar 31;20(1):22-37. Epub 2017 Mar 31.

Department of Critical Care Medicine, Sunnybrook Hospital, Toronto, ON, Canada; Department of Anesthesia, University of Toronto, Toronto, ON, Canada.

There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization. Read More

Can Geriatr J 2017 Mar 31;20(1):15-21. Epub 2017 Mar 31.

Conestoga College Institute of Technology & Advanced Learning, Kitchener, ON.

Background: Evidence-informed care to support seniors is based on strong knowledge and skills of nursing assistants (NAs). Currently, there are insufficient NAs in the workforce, and new graduates are not always attracted to nursing home (NH) sectors because of limited exposure and lack of confidence. Innovative collaborative approaches are required to prepare NAs to care for seniors. Read More

Can Geriatr J 2017 Mar 31;20(1):10-14. Epub 2017 Mar 31.

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Background: Caring for older patients can be challenging in the Emergency Department (ED). A > 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium. Read More

Can Geriatr J 2017 Mar 31;20(1):2-9. Epub 2017 Mar 31.

Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada; Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada; Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, ON, Canada, Canada; Centre for Research on Safe Driving, Lakehead University, Thunder Bay, ON, Canada.

Objectives: Describe the characteristics and determine the annual cumulative incidence of traumatic brain injury (TBI) in older adults receiving home care in Ontario from 2003 to 2013.

Methods: A retrospective cohort study of longitudinal data from the Ontario Association of Community Care Access Centers (N = 554,313). TBI, demographic variables, depression, neurological conditions, and recent falls were measured from the Resident Assessment Instrument-Home Care. Read More

Can Geriatr J 2016 Dec 23;19(4):202-203. Epub 2016 Dec 23.

Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, AB, Canada.

Can Geriatr J 2016 Dec 23;19(4):195-201. Epub 2016 Dec 23.

Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

Background: Evidence indicates that care experiences for complex HF patients could be improved by simple organizational and process changes, rather than complex clinical mechanisms. This survey identifies care gaps and recommends simple changes.

Methods: The study utilized both quantitative and qualitative methods at The Ottawa Hospital, Geriatric Medical Unit during a three-month period. Read More

Can Geriatr J 2016 Dec 23;19(4):189-194. Epub 2016 Dec 23.

Department of Psychiatry/Langley Porter Psychiatric Institute, Psychosomatic Medicine Division, UCSF Weill Institute for Neurosciences, University of California San Francisco Medical Center, San Francisco, CA, USA.

Background: Homeless adults frequently use emergency departments (EDs), yet previous studies investigating ED utilization by the older segment received little attention. This study sought to characterize older homeless adults who utilized local urban EDs.

Methods: ED encounters at three hospitals in Hamilton (Ont. Read More

Can Geriatr J 2016 Dec 23;19(4):182-188. Epub 2016 Dec 23.

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.

Background: The Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies.

Methods: The Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine team meeting. Postgraduate trainees were recruited from July 2010-November 2013. Read More

Can Geriatr J 2016 Dec 23;19(4):164-181. Epub 2016 Dec 23.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

Background: Primary care-based memory clinics (PCMCs) have been established in several jurisdictions to improve the care for persons with Alzheimer's disease and related dementias. We sought to identify key quality indicators (QIs), quality improvement mechanisms, and potential barriers and facilitators to the establishment of a quality assurance framework for PCMCs.

Methods: We employed a Delphi approach to obtain consensus from PCMC clinicians and specialist physicians on QIs and quality improvement mechanisms. Read More

Can Geriatr J 2016 Dec 23;19(4):163. Epub 2016 Dec 23.

Can Geriatr J 2016 Sep 30;19(3):127-128. Epub 2016 Sep 30.

Geri-PARTY Research Group, Jewish General Hospital, Montréal, PQ;; Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON.

Can Geriatr J 2016 Sep 30;19(3):113-126. Epub 2016 Sep 30.

Department of Geriatric Medicine, Jewish General Hospital, McGill University, Montreal, PQ.

Introduction: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Read More

Can Geriatr J 2016 Sep 30;19(3):103-112. Epub 2016 Sep 30.

Department of Public Health Sciences, Queen's University, Kingston, ON.

Background: Individuals with intellectual and developmental disabilities (IDD) are both living longer than in previous generations and experiencing premature aging. Improved understanding of frailty in this aging population may inform community supports and avoid negative outcomes.

Methods: The objective of this study was to review the literature on frailty and IDD and determine areas for future research and application. Read More