Geriatric Medicine is a young specialty in Canada, having been formally recognized in 1981. The early years of research chiefly involved designing and describing programs of care. As the specialty matured, so too did the nature of research into the clinical problems of older adults. This article discusses research published by Canadian geriatricians since 1998, the date of a previous review. Two prominent areas of research are frailty and dementia. Several groups have studied the natural history of frailty, and designed techniques to better measure outcomes. Interventional trials are also gaining prominence, with the Systeme de services intégrés pour personnes agees en perte d'automonie (SIPA) and Mobile Geriatric Assessment Team (MGAT) being good examples. The Canadian Study of Health and Aging (CSHA) is one of the largest studies of dementia epidemiology ever conducted, and the upcoming third wave will provide new data on the outcomes of cognitive impairment not meeting criteria for dementia. Other areas of interest include pharmacoepidemiology, difficult clinical problems, advanced directives and bioethics. Canadian research in geriatrics will continue to develop, with the establishment of the Canadian Institutes of Health Research providing exciting new opportunities.

This article is an essay, based on the attempted assessment ofresearch in the social sciences on aging in Canada and in Quebec during the last 20 years. It endeavours o t understand this area as based on institutional factors, including linguistic, cultural and political divisions between English Canada and Quebec, and the role of some major forces. Canadian research on aging is profoundly based on a social democratic vision of the role of the State that establishes the basic concept of citizenship, rights, liberties, justice and equality. It consequently contributes to maintaining the protective, redistributive, regulatory andcorrection ofinequalities that the State carries out through its social and fiscal policies. In the space of 20 years, the social sciences of aging in Canada have gone from a representation of aging characterized by decline, unavoidable physical and often psychic deterioration of capacities, impoverishment, and exclusion to a much more qualified vision of aging distinguished by the search for autonomy, adaptation, and growth in which seniors do not succumb passively to their condition but rather become responsible for their own development. At the same time, researchers, as well as experts and decision makers in the area ofaging, have turned progressively from an analysis of aging centred on social problems and the programs aimed to meet these problems, which encouraged the development of the state as provider, to an analysis of the forces and resources which seniors have or could obtain to rekindle family or community solidarities with the goal of maximum promotion of the autonomy of older persons.

This paper presents a selective review of sociological gerontology in Canada, examining where it has been, where it is, and where it could go in the future in four general areas: inequality, population aging and the social construction of crisis; family relations and caregiving; work, retirement and income security; and health, health care systems, and health policy. This review suggests that the sociology of aging has not differentiated itself by the topic studied or by its applied and empirical focus, but rather in its unique perspective that reveals the importance of social structures for the personal and private experience of aging. In doing so, sociological gerontology rejects deterministic assumptions ofinevitability. The importance of relating the personal to the public and of continuing a critical examination of existing trends will continue into the future. An additional challenge will be the generation ofnew knowledge on how to transform institutions so that they better enhance the quality oflife ofseniors, including the identification of support of family structures and community environments, as well as more appropriate health and income security policies. This also includes research on effective and appropriate means of introducing new structures and implementing new policies and programs within the context of current social institutions.

The psychology of aging includes a variety of theoretical perspectives, methodological conventions, and techniques and targets of application. Psychological aging-related processes include phenomena from such disparate domains as neurological, sensory, physiological, physical health, mental health, cognition, personality and affect, social, family, interactional, and coping and adjustment. Canadian researchers actively contribute to these and other research topics and professional issues. We summarize a broad and inclusive model of the psychology of aging and highlight some of the ways in which Canadian research and training reflects and advances numerous pertinent scholarly agendas.

Illness increases with age. All else being equal, an older population has greater needs for health care. This logic has led to dire predictions of skyrocketing costs “apocalyptic demography”. Yet numerous studies have shown that aging effects are relatively small, and all else is not equal. Cost projections rest on specific assumptions about trends in age-specific morbidity and health care use that are far from self-evident. Sharply contrasting assumptions, for example, are made by Fries, who foresees a “of morbidity” and falling needs. Long-term trends in health care use in British Columbia show minimal effects of population aging, but major effects, up and down, from changes in age-specific use patterns. Why then is the demographic apocalypse story so persistent, despite numerous contrary studies? It serves identifiable economic interests.