Canadian Journal on Aging-Revue Canadienne Du Vieillissement最新文献

The Connecting People and Community for Living Well initiative recognizes that communities, specifically multisector community teams, are a critical part of the provision of programs and supports for those affected by dementia. Effective collaboration and building and supporting the collective well-being of these multisector community teams is key to their success and sustainability. This research sought to understand what supports the well-being of community teams. Focus groups were conducted with multisector community teams who support those impacted by dementia from across four rural communities. The research team used thematic analysis to identify patterns emerging within and across focus groups. The findings highlighted three areas of importance: the need for a resource to support teams to measure, monitor, and describe the impact of their actions; ongoing support from a system-level team; and the development of local and/or provincial policy and infrastructure that supports sustaining collaborative community-based work.

Background: The trajectory of Mild Cognitive Impairment (MCI) to dementia within primary care is not well understood.

Objective: We investigated the 5-year trajectory of patients initially diagnosed with MCI, evaluated their risk of developing dementia considering age, sex, and Montreal Cognitive Assessment (MoCA) test scores and determined the annual conversion rate from MCI to dementia for patients assessed in a MINT (Multispecialty Interprofessional Team) memory clinic.

Methods: We conducted a longitudinal cohort study using a retrospective chart review of 751 patients assessed within a MINT memory clinic in Ontario, Canada. The conversion rate from MCI to dementia was estimated with the Kaplan-Meier method. Cox regression examined time to dementia diagnosis and the association between baseline MoCA scores and dementia risk.

Findings: The observed 5-year conversion rate from MCI to dementia was 28.0%, though with limited follow-up data. Accounting for missing data, the estimated 5-year conversion rate was 48.8% (39.5%, 59.2%) with an average annual rate of 9.8%. Each one-point increase in MoCA score at initial visit was associated with a 10% lower rate of conversion to dementia (aHR: 0.90, 95%CI: 0.85-0.96).

Discussion: Findings highlight the profile of patients assessed in MINT clinics, cognitive trajectory of those diagnosed with MCI, and the importance of primary care-based memory clinics in early detection and intervention.

Relationship-centred mealtimes can support care home residents, who are at high risk for loneliness. However, care home staff do not consistently promote relationship-centred mealtimes. This secondary analysis examined the impact of factors (selected based on the Theory of Planned Behaviour) upon care home staff interest in making mealtimes more relationship-centred. Data were from a cross-sectional, quantitative survey of 670 care home staff from North America. We used multivariable logistic regression to test hypotheses. The model was statistically significant, and explained 13 per cent of the variance in staff members' interest in making mealtimes more relationship-centred. Respondents who were more satisfied with current mealtime practices, had used collaborative change strategies in the past, and who perceived organizational support for relationship-centred care were more likely to have interest in making mealtimes more relationship-centred. These are modifiable factors to target in interventions designed to promote care home staff interest in making mealtimes more relationship-centred.

Postprandial hypotension (PPH) is defined as a postprandial decline in systolic blood pressure (SBP) of 20 mm of Hg. Some have recommended the use of acarbose (an alpha-glucosidase inhibitor) as a potential therapy for PPH based exclusively on studies of older adults with diabetes. Using a randomized placebo-controlled design, 43 older adults (23 women, 20 men, mean age 77.1 ± 0.9 years) were recruited from geriatric medicine outpatient clinics in an academic centre. Although the average decrease in SBP during the meal test was significantly attenuated in the acarbose group (standardized β  = 0.724 ± 0.286, p = 0.017), the acarbose group experienced significantly more PPH events (standardized β  = 0.593 ± 0.279, p = 0.040). Although acarbose attenuated the mean decrease in SBP during the meal test, it did not reduce the actual number of PPH events recorded in a general population of older adults.ClinicalTrials.gov ID NCT01914133.

Cognitive decline presents individual and societal challenges, underscoring the importance of identifying risk factors to inform interventions for older adults. This cross-sectional study examined how physical activity (PA), perceived stress, and social support were related to cognitive function, with mild behavioral impairment (MBI) as a mediator, among 410 Thai older adults. Structural equation model revealed that perceived stress was associated with increased MBI (p < .001), which was directly related to cognitive function (p < .05). Higher social support was associated with lower MBI (p < .05), while moderate-to-vigorous PA was related to reduced MBI (p < .001) and improved cognitive function (p < .001). MBI mediated the associations of perceived stress (indirect effect = -0.244) and moderate-to-vigorous PA (indirect effect = 0.08) with cognitive function. Perceived stress-MBI relationship was stronger in participants with chronic diseases (∆χ² = 4.236; p = 0.025). Findings support developing interventions to mitigate MBI, with input from health care professionals.

Background: Home care aims to reduce harmful effects of poor health and increase well-being.

Objective: We studied whether receiving formal or informal home care was associated with changes in satisfaction with life (SwL).

Methods: The study includes people aged 70+ who participated in the Canadian Longitudinal Study on Aging (CLSA) at baseline and three-year follow-up. Linear regression models adjusted for individual factors were used to examine the relationship between home care and changes in SwL at two time points.

Results: Receiving home care was associated with declining SwL. The association was different for formal and informal care, and to some extent, for men and women. Changes in health mainly explained the association of SwL with formal but not informal care.

Discussion: The connection between home care and declining SwL suggests that some people's needs are not met, especially by informal care, which negatively affects life satisfaction. This finding deserves more attention when planning home-based care.

The purpose of this retrospective population-based study of adults aged ≥50 years was to examine associations between older age, multimorbidity, and self-rated perceptions of health with frequent emergency department (ED) visits. Using Canadian Community Health Survey (CCHS) 2015-16 data, a multivariate logistic regression model was generated to evaluate associations between predictor variables and frequent ED use. The study sample included data for 57,138 participants across Canada, equating to approximately 13,091,592 when sampling weights applied. Frequent ED use was associated with older age, male sex, multimorbidity, and lower household income. Lower self-rated levels of health were most strongly associated with frequent ED use. Having a primary health care provider was not a significant predictor in univariate or multivariate analyses. Older adults who are frequent ED attenders are a distinct population whose characteristics need to be understood to target strategies for those who most need them to improve quality care and outcomes.

Falls account for 95 percent of hip fractures in older adults. Wearable hip protectors reduce hip fracture risk in long-term care settings, but their use is low among community-dwelling older adults. We conducted interviews to explore how hip protectors are perceived by 27 community-dwelling older adults who visited the Fraser Health Fall Prevention Mobile Clinic in British Columbia. Directed content analysis focused on perceived benefits, design preferences, and cost as a barrier to use of hip protectors. Most participants acknowledged the benefits of hip protectors in reducing the risk of hip fracture, enhancing physical activity, and reducing the fear of falling. However, most participants did not perceive they were at high enough risk to warrant the use of hip protectors. Participants also discussed how willingness to wear depended on design features, including style, pad thickness, appearance, ease of use, fit, comfort, and laundering. Participants also noted the cost, ranging from $60 to $120, as a barrier.

Notre société segmentée par l'âge offre peu de possibilités d'interactions intergénérationnelles authentiques. Cela contribue aux stéréotypes et préjugés envers les personnes de tous âges, particulièrement les adultes aînés. Pour favoriser une société plus inclusive et lutter contre l'âgisme, un changement de paradigme sociétal devient nécessaire. À partir d'une recherche basée sur la conception et l'apprentissage intergénérationnel, nous avons cherché à mieux caractériser ces apprentissages afin de développer des formations spécifiques pour les appuyer. Basé sur un questionnaire préliminaire (n=79), nous avons conçu un atelier pilote (français/anglais) avec huit adultes aînées et huit jeunes adultes au cours duquel les participants ont dû réaliser en binôme une vidéo sur TikTok. Nos résultats indiquent que l'apprentissage intergénérationnel doit se fonder sur une pédagogie active, les activités et les objectifs pédagogiques doivent être multiples pour être réalisées en binômes intergénérationnels, le format doit permettre de développer une relation de confiance et l'évaluation doit être personnelle.