On January 1, 1978, a new Long Term Care Program was introduced in British Columbia. Five levels of care are offered, any one of which may be provided at home or in a facility. This paper presents data from a longitudinal study of program clients (N = 3518) in two health districts, one urban, one semi-rural. The period of interest is the first twelve months after admission. Approximately one-quarter of these clients were discharged within one year of admission—one-half of them due to death. One-third of the deaths occurred in the first two months after admission and a further one-third in the following four months. Fewer than one-third of clients changed level or placement before death. Where transfers did occur they tended to be to higher levels of care and from home to an institution. The characteristics of clients who died are examined. These data may assist care providers to identify high risk clients. As well, they have implications for future resource allocation and planning.

The effect of age on the ability of B lymphocytes and thymus cells from donors of various ages to be capable of producing an anti-idiotype-blocked, hapten-augmentable PFC was studied by adoptive cell transfer techniques. Lethally irradiated mice were reconstituted with syngeneic B lymphocytes and thymus cells from donors of various ages. Recipients were immunized with trinitrophenylated bovine gamma globulin (TNP-BGG) one or seven days after cell transfer. Splenic IgG anti-TNP plaque-forming cell (PFC) responses were assayed in the absence and presence of hapten for anti-idiotype (Id)-blocked, hapten-augmentable PFC, 14 days after immunization. It was found that the B lymphocyte population from 2 month old donors together with thymus cells from donors of various ages (2 to 19 months) were incapable of reconstituting mice to produce anti-Id-blocked, hapten-augmentable PFC. Similar results were obtained when mice were reconstituted with thymus cells from 2-month-old donors together with B cells from donors of various ages (2 to 14 months). In contrast, mice reconstituted with B cells plus thymus cells from the same 8-month or older donors produced a significantly high percentage of anti-Id-block, hapten augmentable PFC. Mice reconstituted with B cells from 8 months or older donors plus thymus cells from donors of various ages (8 to 19) months also produced a significantly high percentage of hapten-augmentable PFC. Experiments with B cells and thymus cells from 2-or 8-month old donors parked in lethally irradiated 2-or 8-months old recipients for 7 days revealed that neither lymphocytes from old donors or old recipients were capable of inducing the appearance of anti-Id-blocked, hapten-augmentable PFC in the lymphocyte population from 2-month-old donors. Thus, the results of this study indicate syner-gistic co-operation between B lymphocytes and thymus cells from old donors for the production of auto-anti-idiotypic antibody regulation with age. This production of auto-anti-Id antibody with age seems not to be an induced maturation event but perhaps an intrinsic property unique to lymphocytes from old donors.

Record running performances were compared between male and female athletes within an age range of 40–63 years and over events ranging in distance from 100 yards to the marathon. Curve fitting procedures indicated that age-performance relationships could be accurately expressed by use of an exponential model. Comparison of curve parameters revealed, a) that female performances declines more steeply with age than those of male athletes, b) decline with age was steeper for events beyond sprint distances than for sprint events for both sexes and, c) discrepancies between male and female performances did not relate significantly to event distance.

This paper describes a preliminary assessment of a departmental approach to palliative care for the dying older person. Forty patients who died in the Extended Care Wing of a teaching hospital were studied using the Palliative Care Assessment Record. Twenty-five were studied retrospectively while fifteen were followed prospectively. The results suggest that there may be subgroups of the terminally ill elderly, such as those with respiratory illnesses, requiring distinct care approaches. Suggestions are outlined regarding a more comprehensive assessment protocol to study this and related care issues.

A mental status questionnaire (MSQ) developed tor use in surveys of the non-institutionalized elderly has been validated against clinical assessment. The MSQ identities moderate and severe cognitive impairment in the elderly. However, using the suggested scoring subjects with mild impairment cannot be separated from normals.

The test is short, acceptable and reproducible and rate for false-positives and false-negatives fall well within acceptable limits for use in estimating the prevalence of dementia in the non-institutionalized elderly population.

Female retirement has received very limited attention in the research literature. In this paper, the concept of career set is employed as the basis for a framework designed to analyse the impact of women's involvement in multiple careers on their adjustment to retirement. An extensive review of existing literature leads the author to conclude that the familial careers engaged in by married, working women have a mediative effect on their transition to retirement. In order to understand female retirement it is necessary to examine the interplay of multiple careers and their relative salience to women in the labour force.

This paper describes the design and utility of a ‘Crisis Assessment Technique’ for measuring the impact of selected life events as perceived by individuals who have actually experienced them. Using the transition to retirement as an example, the utility of such a measure for assessing the relative impact of given events, is demonstrated. Analysis of data on 300 recently retired men and women in south western Ontario suggests that retirement from one's work is not as critical a life event as previous measures suggest.

Much literature supports the idea that problem-solving performance declines with aging. There are two important constraints on this generalization. The tasks that have been explored are for the most part novel ones. Literature is cited that argues that older people take longer to show improvement on such tasks. A second problem is that young control groups are more highly practiced at cognitive tasks generally. Thus age effects are confounded with skill effects. Recent work in semantically rich domains (those requiring a large knowledge base for skilled performance) show minimal effects of aging on problem-solving.

Sentence intelligibility as a function of reverberation time and the presence or absence of a pause was measured in three age groups by means of the Kent State Speech Discrimination Test. Young, middle aged, and old subjects listened to sentences recorded with approximately zero, one or three seconds reverberation time and with half containing a meaningful pause. In a second study, a different group of participants listened to an undistorted recording of the test to provide some information on the standardization of the Kent State Speech Discrimination Test across age groups. All subjects, who were prescreened for audiological normal hearing, were tested for recognition of one key word in each sentence immediately following presentation. Reverberation of three seconds reduced intelligibility for all groups. Age differences which occurred at the longest reverberation time disappeared when a pause was inserted. However, only pauses before a key word were effective. Unmasking of reverberation was suggested as a possible factor in the pause position effect. Practical applications of results are also discussed.

Dementia has long been known to shorten life in the elderly, although some studies have suggested a weakening of this relationship in recent decades. This Ontario study involves the comparison of residents with dementia versus a matched group without dementia who were living in long-term-care institutions at the start of the follow-up period.

The 2-year death rate in the 257 cases in the matched dementia group was 40.1%, significantly higher than the 30.7% rate in the matched controls. This excess was observed in all four types of institutions, and in seven of the eight sex-age groups. Individuals with dementia who were reported to cause disturbance by noisy behaviour had a significantly higher death rate than others.

Comparison of our findings with earlier work suggests that the trend of mortality in elderly institutional residents with dementia has continued downward.

A kin selection model is offered as a feasible alternative to existing formulations of the evolutionary origins of later-life frailty. An assumption made was that reproductive patterns among early human kind were of a polygynous nature, reflecting a compromise of optimal reproductive strategies between males and females. Two general characteristics of polygyny are a delayed reproductive onset for males and an accumulation of wives by older males. The model proposes that paternal frailty occasions the demise of paternal assets to male heirs, which translates into an earlier reproductive onset for those heirs. Quantification of the model demonstrates its potentiality to account for the spread of genes for frailty through kin selection.

Women who have returned to the labour force after the departure of their children from home or the death of their husband have a lower level of social relationships at the moment of their 'retirement. Thus, they tend to increase these relationships to a higher level than the remainder of the female population, including those who had worked outside the home all their lives. On the other hand, while sociocconomic status which is defined by the characteristics of the deceased husband is bound to favour traditional relationships (with kin and children), a status defined by the characteristics of the woman herself tends to favour relationships with friends and memberships in associations.

The declining rate of population growth and the consequent aging of the Canadian population is not a new phenomenon. However, current data and population projections suggest that the rate of aging will increase over the remainder of this century and beyond. From a macroeconomic viewpoint this implies a substantial decline in the growth of the labour force and, hence, the growth potential of the Canadian economy. However, this potential is also influenced by saving (and hence capital accumulation) and productivity performance. In these cases the impacts of population aging are relatively under-researched and reflect the resolution of conflicting forces. From a public policy viewpoint the pressures on government spending from demographic sources are at an historical minimum in the early 1980s, and hence this period offers a unique opportunity to develop the policies to effect the necessary transfer of public resources from programmes oriented towards the young to those oriented towards the senior members of Canadian society.

This study uses data from the 1975 Retirement Survey to analyze the factors underlying the residential mobility of the elderly in Canada. Two theoretical perpectives are considered, one emphasizing questions of community integration as a constraint on migration and the other focusing on the economic aspects of migration. We find more support for the integration perspective, at least if home ownership and married status are used as measures of integration. While economic questions can act as push factors (difficulty of upkeep or expensive taxes), income as such can both facilitate movement and be a measure of community integration.

Three contrasting themes run through the literature on aging regarding the question of which years constitute the best period of a person's life. The themes are: 1) youth is best, 2) middle age is best, and 3) old age has its advantages. This study reports a 1979 representative and cross-sectional survey of 440 Edmontonians. Respondents were asked questions about the levels of satisfaction arising from various aspects of life as well as the amount of pressure experienced from these various life domains. The older years appear to be a period of relatively low pressure and relatively high satisfaction, although each age has advantages and disadvantages.

Community support services represent an important resource for older persons. Their significance will grow as the older population increases in size in the North American Region. It is essential for the well-being of society that an adequate array of services for older persons be developed. Community support services must be provided in sensitive and personalized ways—and must respect the dignity and integrity of older persons. Community support services promote the independence of older persons; they prevent or defer recourse to more expensive and less personally desirable forms of caring services, such as nursing homes and geriatric services. Therefore, community support services may be said to have supportive, preventive and rehabilitative functions and to play an integrative role in terms of family and community life.

At the outset it should be stated, with training in the social sciences, (in sociology) and experience as a gerontology researcher which has been exclusively university based I have a commitment to a social science research perspective. While much of what will be said may well apply to biological and medical research, that is left to those experts to determine.