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' Theory of Diffusion of Innovations [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

Can Geriatr J 2016 Sep 30;19(3):97-102. Epub 2016 Sep 30.

Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB.

Background: A common scenario that may pose challenges to primary care providers is when an older patient has been discharged from hospital. The aim of this pilot project is to examine the experiences of patients' admission to hospital through to discharge back home, using analysis of patient narratives to inform the strengths and weaknesses of the process.

Methods: For this qualitative study, we interviewed eight subjects from the Sheldon M. Read More

Can Geriatr J 2016 Sep 30;19(3):83-96. Epub 2016 Sep 30.

Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton.

Background: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted.

Methods: A mixed methods approach was used. Read More

Can Geriatr J 2016 Jun 29;19(2):74-82. Epub 2016 Jun 29.

Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;

Can Geriatr J 2016 Jun 29;19(2):66-73. Epub 2016 Jun 29.

Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;

Two new sets of criteria for Alzheimer's disease (AD) are now in play, including one set released in 2014, and a proposal for a "new lexicon" for how to describe the disease spectrum. A 2012 Canadian consensus conference said that to then, none of the new criteria or terminology would change primary care practice; that is still likely to be so. For dementia consultants, however, the new criteria pose challenges and offer opportunities. Read More

Can Geriatr J 2016 Jun 29;19(2):50-7. Epub 2016 Jun 29.

Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB.

Background: The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives. Read More

Can Geriatr J 2016 Jun 29;19(2):40-9. Epub 2016 Jun 29.

Department of Family Medicine and Dentistry, University of Alberta, Edmonton, Alberta.

Background: Warfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care.

Methods: This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. Read More

Can Geriatr J 2016 Jun 29;19(2):34-9. Epub 2016 Jun 29.

Department of Medicine, Internal Medicine, London Health Sciences Centre, The University of Western Ontario, London, ON;; Department of Medicine, Division of Geriatric Medicine, The University of Western Ontario, London, ON;; Gait and Brain Lab, Lawson Health Research Institute, Parkwood Hospital, London, ON;

Background: Frailty is characterized by increased vulnerability to external stressors. When frail older adults are admitted to hospital, they are at increased risk of adverse events including falls, delirium, and disability. The Clinical Frailty Scale (CFS) is a practical and efficient tool for assessing frailty; however, its ability to predict outcomes has not been well studied within the acute medical service. Read More

Can Geriatr J 2016 Jun 29;19(2):33. Epub 2016 Jun 29.

Canadian Geriatrics Journal.

Can Geriatr J 2016 Jun 29;19(2):1-8. Epub 2016 Jun 29.

Geriatric Education and Research in Aging Sciences (GERAS) Centre, St Peter's Hospital, Hamilton, ON; Department of Medicine, McMaster University, Hamilton, ON;; Hamilton Health Sciences-St Peter's Hospital, Hamilton, ON;; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON;

Background: Engaging with art can be valuable for persons living with dementia. 'Artful Moments' was a collaborative project undertaken by the Art Gallery of Hamilton and the Behavioural Health Program at Hamilton Health Sciences that sought to develop and implement a program of arts-based activities for persons in the middle-to-late stages of dementia who exhibit behavioural symptoms and for their accompanying care partners.

Methods: This pilot study employed a qualitative descriptive design. Read More

Can Geriatr J 2016 Mar 31;19(1):15-8. Epub 2016 Mar 31.

The Research Institute of the McGill University Health Centre, Montreal, QC;; Department of Neurology & Neurosurgery, McGill University Health Centre, Montreal, QC.

Background: The Montreal Cognitive Assessment (MoCA) is a screening tool for mild cognitive impairment (MCI) in elderly individuals. We hypothesized that measurement error when using the new alternate MoCA versions to monitor change over time could be related to the use of items that are not of comparable difficulty to their corresponding originals of similar content. The objective of this study was to compare the difficulty of the alternate MoCA items to the original ones. Read More

Can Geriatr J 2016 Mar 31;19(1):9-14. Epub 2016 Mar 31.

Geriatric Medicine Research Unit, Halifax, NS;; Division of Geriatric Medicine, Dalhousie University, Halifax, NS.

Background: Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge. Read More

Can Geriatr J 2016 Mar 31;19(1):2-8. Epub 2016 Mar 31.

Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON;; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON;

Background: This study was designed to determine a clinically significant point drop in function to define functional decline and the required sensitivity for a clinical decision tool to identify elderly patients at high risk of functional decline following a minor injury.

Methods: After a rigorous development process, a survey questionnaire was administered to a random sample of 178 geriatricians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique. Read More

Can Geriatr J 2016 Mar 31;19(1). Epub 2016 Mar 31.

Canadian Geriatrics Journal.

Can Geriatr J 2015 Dec 23;18(4):231-45. Epub 2015 Dec 23.

Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, AB;; Brenda Stafford Foundation Chair in Geriatric Medicine, Faculty of Medicine, University of Calgary, Calgary, AB;; Departments of Medicine, Clinical Neurosciences and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB;; Alberta Seniors Health Strategic Clinical Network, Alberta Health Services, Calgary, AB.

Background: Observational studies have suggested that various nutrients, dietary supplements, and vitamins may delay the onset of age-associated cognitive decline and dementia. We systematically reviewed recent randomized controlled trials investigating the effect of nutritional interventions on cognitive performance in older non-demented adults.

Methods: We searched MEDLINE, CINAHL, Embase, and the Cochrane Library for articles published between 2003 and 2013. Read More

Can Geriatr J 2015 Dec 23;18(4):225-30. Epub 2015 Dec 23.

School of Medicine, Division of Geriatric Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON.

Background And Purpose: To foster interest in geriatric care, the Queen's Geriatrics Interest Group (QGIG) collaborated with the Division of Geriatric Medicine to arrange a Geriatrics Pre-Clerkship Observership Program.

Methods: Forty-two pre-clerkship medical students participated in the program between October 2013 and May 2014. Participants were paired with a resident and/or attending physician for a four-hour weekend observership on an inpatient geriatric rehabilitation unit. Read More

Can Geriatr J 2015 Dec 23;18(4):217-24. Epub 2015 Dec 23.

Department of Psychiatry, Dalhousie University, Halifax, NS;

Background: The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors' risks of mental disorders, including dementia.

Methods: A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors' mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Read More

Can Geriatr J 2015 Dec 23;18(4):212-6. Epub 2015 Dec 23.

Department of Medicine, Dalhousie University, Halifax, NS;; Center for Health Care of the Elderly, QEII Health Sciences Centre, Capital District Health Authority, Halifax, NS;

Background And Purpose: Delirium is common after hip fracture. Previous work has shown that a simple delirium risk factor tool, the Delirium Elderly At Risk instrument (DEAR), has a high inter-rater reliability in this population. Little research has looked at the ability of risk factor screening tools to identify patients at high risk of pre-operative delirium. Read More

Can Geriatr J 2015 Dec 23;18(4):211. Epub 2015 Dec 23.

Can Geriatr J 2015 Sep 30;18(3):159-67. Epub 2015 Sep 30.

Faculty of Medicine and Dentistry, Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB.

Background: The annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop.

Methods: Discussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors. Read More

Can Geriatr J 2015 Sep 30;18(3):152-8. Epub 2015 Sep 30.

Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada;

Background: Indigenous peoples in Canada have higher prevalence of modifiable risk factors for Alzheimer's disease (AD). The relative importance of these risk factors on AD risk management is poorly understood.

Methods: Relative risks from literature and prevalence of risk factors from Statistics Canada or the First Nations Regional Health Survey were used to determine projected population attributable risk (PAR) associated with modifiable risk factors for AD (low education and vascular risk factors) among on- and off-reserve Indigenous and non-Indigenous people in Canada using the Levin formula. Read More

Can Geriatr J 2015 Sep 30;18(3):144-51. Epub 2015 Sep 30.

Department of Medicine, Division of Geriatric Medicine, QEII Health Sciences Centre, Dalhousie University, Halifax, NS, Canada.

Background: Even subtle impairments on cognitive test scores can be associated with future cognitive decline and dementia. We assayed the relationships between test score impairment and adverse outcomes.

Methods: Secondary analyses were performed on data from non-institutionalized participants, 50+ years of age (N = 30,038), from 12 countries taking part in the Survey of Health, Ageing and Retirement in Europe (SHARE) longitudinal study on aging. Read More

Can Geriatr J 2015 Sep 30;18(3):136-43. Epub 2015 Sep 30.

Department of Conservative Dentistry and Endodontics, Gov't. Dental College & Research Institute VIMS, Bellary, Karnataka, India.

Background: The population of older people, as well as the number of dependent older people, is steadily increasing; those unable to live independently at home are being cared for in a range of settings. Practical training for nurses and auxiliary care staff has frequently been recommended as a way of improving oral health care for functionally dependent elderly. The aim was improve oral hygiene in institutionalized elderly in Bangalore city by educating their caregivers. Read More

Can Geriatr J 2015 Sep 30;18(3):135. Epub 2015 Sep 30.

Can Geriatr J 2015 Jun 30;18(2):134. Epub 2015 Jun 30.

Department of Medicine, Dalhousie University, Saint John, NB, Department of Medicine, Memorial University, St. John's, NL, and Horizon Health Network, Saint John, NB;

[This corrects the article on p. 63 in vol. 17, PMID: 24883164. Read More

Can Geriatr J 2015 Jun 30;18(2):105-7. Epub 2015 Jun 30.

Geriatric Medicine Research, Dalhousie University, Halifax, and Centre for Health Care of the Elderly, QEII Health Sciences Centre, Capital District Health Authority, Halifax, NS.

Working in health care can sometimes be exhilarating. At other times it is exhausting, especially if there is interpersonal conflict amongst health-care providers about the best course of action. This can occur in relation to the care of frail older adults. Read More

Can Geriatr J 2015 Jun 30;18(2):73-104. Epub 2015 Jun 30.

Schlegel-UW Research Institute for Aging and School of Public Health and Health Systems, University of Waterloo, Waterloo, ON.

Background: Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the 'feasibility' of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Read More

Can Geriatr J 2015 Jun 30;18(2):65-72. Epub 2015 Jun 30.

Department of Kinesiology, University of Waterloo, Waterloo; ; Canadian Partnership for Stroke Recovery (Sunnybrook Site);

Background: Exercise is a promising strategy to prevent dementia, but no clinically supervised exercise program is widely available to people with mild cognitive impairment (MCI). The objective was to survey health professionals to assess the feasibility of using cardiac rehabilitation exercise programs for MCI populations.

Methods: We distributed surveys to: 1) health professionals working in cardiac rehabilitation exercise programs (36/72 responded); and 2) physicians who treat MCI (22/32 responded). Read More

Can Geriatr J 2015 Jun 30;18(2):57-64. Epub 2015 Jun 30.

Department of Family Medicine, McMaster University, Hamilton, ON.

Background: Dementia diagnosis and management is increasing in importance in the training of future family physicians. This study evaluated the impact of a dementia education program for family medicine residents (FMR) on residents' knowledge, attitudes, and confidence with respect to dementia assessment and management. A three-part questionnaire was developed and validated for these purposes. Read More

Can Geriatr J 2015 Jun 30;18(2):51-6. Epub 2015 Jun 30.

Department Of Public Health Dentistry, K.V.G Dental College & Hospital Sullia, D.K, Karnataka, India;

Background/introduction: For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral hygiene status would need urgent care.

Objective: To assess the oral hygiene status of institutionalized dependent elderly in Bangalore City, India.

Methods: A cross-sectional study of 322 dependent elderly patients was conducted at seven elderly homes of Bangalore City, India. Read More

Can Geriatr J 2015 Jun 30;18(2):43-50. Epub 2015 Jun 30.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Cognitive impairment and depression frequently co-occur in late life. There remains a need to better characterize psychosocial risk factors of cognitive decline in older adults with depression. We hypothesized that certain psychosocial factors would be associated with higher risk of cognitive decline in individuals with late-life depression. Read More

Can Geriatr J 2015 Jun 30;18(2):42. Epub 2015 Jun 30.

Canadian Geriatrics Journal.

Can Geriatr J 2015 Mar 31;18(1):37-41. Epub 2015 Mar 31.

Department of Family Medicine, University of British Columbia, Vancouver, BC.

Ageing is a common subject in arts and literature as it is a universal experience. The use of the humanities in medical education may have a positive effect on trainees' attitude to caring for seniors and on geriatrics as a career choice. This paper summarizes the role of humanities in medical education and provides some examples and thoughts on how humanities curriculum can be used in geriatric teaching. Read More