Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991–1992, 1996, and 2001. Using data from the CSHA, we report the prevalence of urinary, fecal, and double incontinence in each wave and the cumulative incidence between waves and investigate the predictors of urinary and fecal incontinence. Urinary incontinence increased rapidly in old age, being almost twice as high in women as in men. Fecal and double incontinence were less common, but also increased rapidly with age. In women, parity showed a positive relationship with (prevalent) urinary incontinence. In men, diabetes was a risk factor for urinary and fecal incontinence. We conclude that urinary, fecal, and double incontinence increase rapidly with age and that inquiry about incontinence should be part of routine medical and nursing assessment of all elderly.

Little research can be found describing social aspects of aging with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) in Canada specifically, despite an overall increase in an aging population and increased numbers of those aging with HIV/AIDS. A systematic literature review was conducted with a selective focus on social aspects related to older adults who are living with or at risk for contracting HIV/AIDS. The primary themes that emerged in the literature are ageism and stigma, gender, mental health, and social supports. Recommendations for future research regarding prevention and education of risks for older adults and programming suitable for a wide range of audiences are presented.

The objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization’s age-friendly communities framework were relevant to understanding these findings.

As Canada’s population continues to age, social isolation among older people is a growing concern and national-level priority. Although much is known about individual-level risks and negative health outcomes associated with social isolation in later life, the impact of life course trajectories and the more collective experiences are seldom considered. Current definitions and program responses tend to rely on individualized approaches to social isolation. Here, we argue that the conversation be extended to consider the social and cultural aspects of social isolation among older people. Specifically, we suggest that definitions and approaches consider three particular dimensions: temporal factors, spatial factors, and the relationship between social isolation and exclusion. Doing so, we argue, would result in a more inclusive approach to social isolation in late life, and the development of capacity to address social isolation among a wide range of older people, particularly the needs of vulnerable or marginalized groups.

The COVID-19 pandemic and subsequent state of public emergency have significantly affected older adults in Canada and worldwide. It is imperative that the gerontological response be efficient and effective. In this statement, the board members of the Canadian Association on Gerontology/L’Association canadienne de gérontologie (CAG/ACG) and the Canadian Journal on Aging/La revue canadienne du vieillissement (CJA/RCV) acknowledge the contributions of CAG/ACG members and CJA/RCV readers. We also profile the complex ways that COVID-19 is affecting older adults, from individual to population levels, and advocate for the adoption of multidisciplinary collaborative teams to bring together different perspectives, areas of expertise, and methods of evaluation in the COVID-19 response.

This article presents two studies dealing with ageism. The objective of the first study was to adapt to French language and validate the Fraboni of Ageism Scale-Revised (FSA-R) which contains 23 items, while the objective of the second study was to test a structural model containing ageism as measured by the FSA-R and the “Big Three”: empathy, social dominance orientation, and dogmatism, controlled for by sex and age. The results of the first study (n = 323) generated a version of the FSA-R comprising 14 items, of which the psychometric properties were very satisfactory. Using structural equation modelling and bootstrap procedure, the results of the second study (n = 284) showed a direct negative and significant effect of empathy on agism. They also showed that this negative effect was mediated by dogmatism and social dominance orientation, which both exerted a positive effect on ageism.

Place of death was determined for all 58,689 seniors (age ≥ 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2%) of these individuals died in hospital, 30.5 per cent died in a long-term care facility, 9.6 per cent died at home while receiving home care, and 10.7 per cent died at home without home care. Co-morbidities were the strongest predictors of place of death (p < 0.0001). A cancer diagnosis increased the chances of death at home while receiving home care; seniors with dementia were most likely to die in LTC facilities; and those with major acute conditions were most likely to die in hospitals. Higher socio-economic status was associated with greater probability of dying at home but contributed little to the model. Appropriate planning and resource allocation may help move place of death from hospitals to nursing homes or the community, in accordance with individual preferences.

This study examined the relationships between culture and the health status of older Chinese in Canada. Data were collected through face-to-face interviews with a cross-sectional, randomly selected sample of 2,272 older Chinese between 55 and 101 years of age in seven Canadian cities. Health status was assessed by the number of chronic illnesses, by limitations in ADL and IADL, and by information on the Medical Outcome Study Short Form SF-36. Although cultural variables explained only a small proportion of variance in health status, having a stronger level of identification with traditional Chinese health beliefs was significant in predicting physical health, number of illnesses, and limitations on IADL. Other cultural variables, including religion, country of origin, and length of residence in Canada, were also significant in predicting some health variables. Interventions to improve health should focus on strategies to enhance cultural compatibility between users and the health delivery system.

Ontario has the highest proportion of for-profit nursing homes in Canada. These facilities, which are known in Ontario as long-term care (LTC) homes, offer 24-hour custodial as well as nursing care to individuals who cannot live independently. Increasingly, they are also operating as members of multi-facility chains. Using longitudinal data (1996–2011) from the Residential Care Facilities Survey (n = 627), our analysis revealed discernible differences in staffing levels by profit status and chain affiliation. We found for-profit LTC homes – especially those owned by a chain organization – provided significantly fewer hours of care, after adjusting for variation in the residents’ care needs. Findings from this study offer new information on the impact of organizational structure on staffing levels in Ontario’s LTC homes and have implications for other jurisdictions where a growing presence of private, chain-affiliated operators has been observed.

Cet article examine le lien entre la famille et l'État au niveau des traitements pour les personnes âgées. L'auteur cherche à déterminer pourquoi il incombe à la famille et plus particulièrement aux femmes de veiller sur les membres âgés de la parenté. Il examine également le rôle que l'état joue en soulignant l'importance du rôle de la famille et il cite à cet effet une étude empirique importante qui porte sur les traitements offerts aux personnes âgées à Sheffield en Grande-Bretagne. Les résultats de cette étude sont utilisés pour mettre en valeur la base normative de la relation de soins. En conclusion, l'auteur examine divers autres genres de traitements et il émet des doutes concernant l'hypothèse naïve d'un conflit entre les personnes âgées et ceux qui veillent sur elles.

An experiment is reported that examines kinematic measures, reaction time and response preparation differences between young and older adults, and movement response parameters in a precueing paradigm. Ten young and ten older adults performed 5 cm or 10 cm horizontal movements to the left or right with an electronic pen on a digitizing tablet. The precue (advance information) provided information about direction, extent, or both parameters. Dependent measures of reaction time (RT), movement time (MT), peak velocity, peak acceleration, peak deceleration, and their respective time values were analysed. The results indicate that young adults were significantly different on all dependent measures. Advance precue information was advantageous for all subjects as RT was faster when advance information was provided. In addition, both groups of subjects produced higher peak velocities when provided advance information about both direction and extent. Examination of the kinematics indicate that older adults produce movement patterns which display different response characteristics such as accelerating less rapidly and displaying a prolonged deceleration phase. Finally, older adults are less efficient than young adults at scaling velocity and acceleration over time between long and short movements when spatial accuracy constraints are minimal.

Social isolation, given its established association with mortality, and risk of poor physical and/or mental health over the life course, has attracted the attention of researchers. However, such measures have been highly variable and often lack conceptual clarity. This study, which drew on a conceptual framework for classifying social isolation measures, provides a rationale for the development and validation of a composite Social Isolation Index (SII) using the Canadian Longitudinal Study on Aging (CLSA), together abbreviated as CLSA-SII. CLSA-SII was developed using standard methodology for developing other measures, including the multimorbidity resilience and successful aging indices. Associations of the CLSA-SII and four key outcome variables (life satisfaction scale, depression, perceived mental health, and perceived health) were performed using regression analyses. Associations between the CLSA-SII index and the four outcome variables resulted in statistically significant moderate associations in the expected direction, and are consistent with prior research, demonstrating good concurrent validity.

A study ofolder adults in Israel (n = 170) examined the relationship of activity level and social network characteristics to respondents' subjective well-being, controlling for background socio-demographic characteristics and extent of physical disability. Factor analysis derived three activity factors corresponding to formal, informal and solitary activity. A hierarchical regression procedure revealed that physical disability accounted for 40 per cent of the variance in the well-being measure. Extent of informal activity explained another 3 percent of the variance, but was outweighed in the final model by the addition of a social network factor – degree of network supportiveness (R2 =.48). The findings suggest that it is the social network aspect of activity that makes a difference in older persons' subjective well-being, rather than the effect of activity per se.

An estimated 36,000 home support workers assist older Canadians annually with daily activities, such as bathing, dressing, grooming, and light housework, yet home support workers’ day-to-day experiences are not well understood. Mahmood and Martin-Matthews (2008) have developed a model that locates the home support worker, elderly client, and family member at the intersection of the public and private spheres framed by their social, spatial, temporal, and organizational features. This study, funded by the Canadian Institutes of Health Research, examines and refines that model through an analysis of in-depth interviews with home support workers in British Columbia. Home support workers identify key issues in service delivery and discuss a range of creative solutions to complete their daily tasks efficiently, effectively, and respectfully. The study’s findings inform our understanding of home support workers’ job experiences; they also highlight those qualities that characterize exceptional workers in navigating the various domains of home support.

The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.

This article identifies home care practitioners' perceptions of the responsibilities, difficulties, and needs for support of caregivers. It is based on a study undertaken in Quebec with 55 practitioners and 10 administrators from 10 CLSCs located in rural, urban, and metropolitan areas. The study had a qualitative, multiple-case design and used logs recording all contact with caregivers in the space of a week, followed by semi-structured interviews. Analysis reveals that practitioners tend to perceive the work of caregivers as mainly instrumental and clinical, ignoring the family relations that tie them to their relative. Although aware of the difficulties facing caregivers and the negative impacts of caregiving, a majority of practitioners have high expectations of caregiver participation in treatment plans, albeit as quasi-nurse's aides. Our analysis offers an explanation for this apparent contradiction by examining practitioners' values with regard to family responsibility for care.

This study examined the relationship between attachment styles and subjective well-being in late adulthood. Seventy-six elderly adults (mean age = 67.9 years) completed the Relationship Questionnaire (a measure of attachment styles), the MUNSH (a measure of subjective well-being) and ratings of perceived health and marital status. Results indicated that both health and attachment style produced significant main effects, but no interaction, on well-being. Specifically, healthy individuals were happier than unhealthy ones; participants with secure and dismissive attachment styles were significantly happier than those classified as fearful. The distribution of attachment style classification across secure, preoccupied, fearful, and dismissive styles showed differences compared to previous research with younger adults.

This article presents a study that directly replicated the recently developed Balanced Time Perspective Scale (BTPS; J.D. Webster, 2011) and included middle-aged and older adults. Participants included 90 younger, 69 middle-aged, and 69 older adults who completed the BTPS and a measure of life satisfaction and happiness. A factor analysis replicated original findings with separate subscales for a past orientation and a future orientation obtaining simple structure (alphas = .94 and .95 respectively). A balanced time perspective predicted higher scores on both measures of well-being replicating the original J.D. Webster (2011) findings. A chi-square analysis indicated, as predicted, that the percentage of younger adults tended to be higher in the future-focused category, and the percentage of older adults tended to be higher in the past-focused category. Implications of a balanced time perspective on mental health over the life course are discussed.

The rising cost of health care and changing demographic profiles have resulted in the relocation and redistribution of funding and services between rural and urban areas. Most econometric analyses of Canada’s health service use include broad controls by province and rural/urban status, but relatively little econometric work has focused on geographical variation in health service use. Using the Canadian Community Health Survey 2.1, we examined determinants of various measures of health services use by Canadians aged 55 or older across a range of urban and rural areas of residence. Our regression analysis showed that older residents in rural areas made fewer visits to a general practitioner, to a specialist, and to a dentist relative to urban residents. All else being equal, there are no significant differences in hospital nights or in unmet healthcare needs. These differences are significant after controlling for demographic characteristics, socioeconomic status, private health insurance, and health status.

ESA study data were paired with Quebec medical and pharmaceutical services records to document potentially inappropriate benzodiazepines (Bzs) prescriptions among community-dwelling adults aged 65 and older. Results indicate that 32 per cent of respondents took a mean daily dose of 6.1 mg of equivalent diazepam for, on average, 205 days per year. Almost half (48%) of Bzs users received a potentially inappropriate benzodiazepine prescription at least once during the year preceding the survey. About 23 per cent received at least one concomitant prescription of a Bz and another drug that could result in serious interaction. In addition, individuals aged 75 and older were more likely to receive Bzs for a longer period of time than those aged 65–74. Number of pharmacies used was associated with inappropriate Bzs prescriptions. Our results argue in favour of a more integrated health services system, including a regular review of older adults’ drug regimens.