The deterioration of the cholinergic system in aging is hypothesized to contribute to age-related declines in attention. We investigated potential age differences in performance on the Attention Network Test (ANT) and intra-individual variability in speed (RT-IIV) on go/no-go and choice reaction time tasks in young and healthy older adults. We also asked whether short-latency afferent inhibition (SAI), a neurophysiological marker of central cholinergic activity obtained via transcranial magnetic stimulation, might be correlated with performance. Older adults were slower on the ANT and exhibited greater RT-IIV than young adults on the multiple choice RT task, but there were no age differences on the ANT network scores (alerting, orienting, and executive control). SAI was diminished in older adults, but it was not significantly correlated with performance. It may only be in cases of severe cholinergic dysfunction that relations with attention emerge. Other brain mechanisms may also be stronger predictors of functions relating to attention.

Despite Canada’s increasing population of seniors and the varying long-term care (LTC) strategies that provinces have implemented, little research has focused on understanding the extent to which publicly funded residential LTC bed supply varies across provinces, or the factors influencing this variation. Our study involved an analysis in which we examined the association of three select jurisdictional characteristics with LTC bed supply: population age demographics, provincial wealth, and provincial investments in home care. No significant cross-jurisdictional “ecology” or inter-relatedness was found between the variation in LTC bed supply and any of the examined variables. Interprovincial variation in bed supply also did not statistically influence alternate level of care days specific to LTC waits, suggesting that these days were not influenced simply by differences in LTC bed supply and that other provincial-level factors were in play.

Demographic and social trends lead to a variety of micro-level and internal structural contexts that influence caregiving in families with older members. The results of macro-level changes have received little focused attention in the aging literature, where much of the caregiving research has addressed issues within the context of traditional family structure. Yet the conventional nuclear family model is increasingly uncommon as new, pluralistic models of family life are emerging in contemporary society. The majority of elder care is provided by relatives, albeit with varying patterns of involvement and responsibility across family structures. Both conventional and pluralistic families face challenges in meeting the care needs of their oldest members, leaving some older adults at risk of having unmet needs. Additional research on family risk and resilience related to the care of older relatives is warranted, particularly with respect to pluralistic models of family life.

New Brunswick is one of the provinces most affected by the aging of the population. Moreover, aging at home in Francophone minority communities is a major challenge in rural areas. The goal of this paper is to identify the main advantages and disadvantages of aging at home and to expose organizational strategies deployed by seniors and their families in order to promote aging in place. The case study is the method of analysis that we have recommended. Our methodology is based on content analysis of 13 semi-structured interviews with seniors and their children. The results show that family and community support, resourcefulness and resiliency, the practice of leisure activities as well as the living environment are among the principal means used by older adults to promote aging at home.

In this study we investigated the impact of events from an individual’s past on the risk of death for Europeans aged 50 and older, controlling for other relevant variables. Our analysis was based on the data from retrospective biographic interviews, regular longitudinal interviews, and end-of-life interviews from the Survey of Health, Ageing and Retirement in Europe. In particular, we captured retrospectively self-reported health in childhood; periods of poverty, hunger, and poor health experienced in the past; and the history of health care, including regular dental care, blood tests, and blood pressure measurements. This information, along with age, gender, current subjective and objective health, and other socio-demographic characteristics, enables assessment of the risk of death. We applied the proportional hazard model to explain the risk of death. The survival analysis shows that events experienced in the past significantly affect risk of death for Europeans aged 50 and older, controlling for other relevant variables.

Benzodiazepines are widely prescribed for anxiety, although use of this class of medications has been associated with dependency and cognitive changes. This article describes the study in which we investigated the relationship between the class of benzodiazepine available for use and associated performance on neuropsychological tests in a community sample of 1,754 older Canadians from the Canadian Study of Health and Aging. Benzodiazepines were classified as short-, intermediate-, and long-acting. Associations were calculated between each class of benzodiazepine and eight neuropsychological measures, using multiple regression analysis and controlling for demographic variables. Results showed different effects of the co-variates across the three drug classes, and short half-life benzodiazepines were not associated with any neuropsychological measure. Intermediate half-life and long half-life benzodiazepine use were each associated with two measures. Increased focus on specific domains of cognitive function is needed to improve our understanding of how benzodiazepine use influences cognition.

Strong evidence has established the medical and health services utilization benefits of home care services for older adults. However, sparse research has been conducted on potential psychosocial benefits. Older adults (65 and over) receiving home care with their needs met are compared with persons who have unmet needs (whether they received home care or not) on three key indicators of quality of life – life satisfaction, loneliness, and perceived life stress. Data are drawn from the 2008–2009 Canadian Community Health Survey respondents who met the study criteria (n = 3,244). Regression analyses showed that older adults who had their home care needs met reported higher levels of life satisfaction, and lower levels of loneliness and perceived life stress, than those with unmet needs, net of co-variates. The results suggest that filling this home care gap would significantly raise quality of life by increasing social and environmental resilience to age in place.

The relationship between work and family is considered with an emphasis on policy solutions. Australian policy is a case example in the context of international trends. A mismatch between policy initiatives and familial and personal priorities constitutes a new social risk associated with demographic and sociocultural development. Contemporary trends, both nationally and internationally, evidence solutions to the “problem of demographic aging” by adopting a form of economic instrumentalism. This restricts legitimate age identities to those associated with work and work-related activity. When applied to family life, such a focus runs the risk of reducing policy interest in intergenerational engagement to unpaid care roles, while personal development and age-related life priorities are ignored. The need for cultural adaptation to population aging is becoming accepted in policy debate and is considered here as an effective response to the personal, social, and economic risks of population aging and associated impacts on family life.

Resident-to-resident abuse involves aggression and violence that occurs between long-term care (LTC) home residents and can have serious consequences for both aggressors and victims. To date, there has been no attempt to systematically assess the breadth of the problem in Canada. To address this gap, we undertook a scoping review to enhance understanding of resident-to-resident abuse in LTC homes. A redacted Canadian data set on resident-to-resident abuse is also reported on. Nine electronic literature databases were searched; a total of 784 abstracts were identified, but only 32 satisfied the inclusion criteria. The majority of records (75%) were retrospective case studies, qualitative studies, and reviews/commentaries. Of these, only 14 focused exclusively on resident-to-resident abuse. The redacted Canadian data set suggests resident-to-resident abuse makes up approximately one-third of reported abuse cases. Recommendations for future research, clinical practice, and policy are provided to raise awareness of this phenomenon to help decrease its incidence.

In many jurisdictions, legislation requires long-term care (LTC) facilities to have a registered nurse on duty 24 hours a day, seven days per week. Although considerable research exists on LTC nurse staffing intensity, no empirical research on this requirement exists. Our retrospective observational study in Saskatchewan compared facilities with 24/7 RN coverage to facilities with less coverage supplemented with various night-shift staffing models. Adjusted for nurse staffing intensity and other potential confounders, risk ratios associated with less-than-24/7 RN coverage supplemented with licensed practical nurse night-shift staffing were 1.17, 95% CI [0.91, 1.50] and 1.00, 95% CI [0.72, 1.39]; and with less-than-24/7 RN coverage supplemented with care aide night-shift staffing, risk ratios were 1.46, 95% CI [1.11, 1.91] and 1.11, 95% CI [0.78, 1.58], for inpatient hospital admissions and Emergency Department visits respectively. Findings suggest that acute services utilization may be negatively influenced by the absence of 24/7 RN coverage.

This study examined how intergenerational exchanges with sons and daughters predicted older parents’ likelihood of co-residing with a son prior to death in a rural area of China’s Anhui Province. Our investigation drew on theories of contingent co-residence, modernization, and social exchange, conceptualizing co-residence as having practical and symbolic importance in rural Chinese culture. The sample included 470 older parents, reported as deceased during 2001–2009, and their posthumous informants. We used logistic regression to assess intergenerational support and cohesion as predictors of co-residence with a son just prior to death. Older parents who provided instrumental support to, and received instrumental support from, sons and had better emotional relationships with sons were more likely than their counterparts to co-reside with a son at the end of life. Living with sons demonstrates filial piety for older parents at the end of life, but its realization is sensitive to intergenerational transactions.

This study examined how patients experience transitions to community from hospitals, inclusive of daily living problems and medical concerns. Analysing qualitative data from interviews with 36 individuals including 17 high-risk older adults with multiple chronic health conditions recently discharged from hospital, and 19 family members who provided the patients with ongoing care, we asked (1) What are the challenges that patients experience in transitioning home from the hospital, and (2) What are the system and policy solutions that can address the challenges these patients experience? Our findings reveal both short- and long-term challenges associated with transitions back home. Short-term challenges include preparing the dwelling for the patient and understanding the organization of care at home. Long-term challenges are associated with practical and emotional concerns. Reflecting on our findings, we suggest that patients’ social needs may be equally important to their medical needs during post-discharge recovery, and we discuss implications for policy.

The rising number of older people living with disabilities and chronic diseases has increased home care needs. Studies and reviews exploring preventive approaches have proliferated, creating a need for a synthesis of evidence. We conducted a systematic review of systematic reviews to evaluate the effectiveness of preventive home visiting approaches for older people. Of the 5,973 citations identified in over 30 scientific and grey literature databases, 10 papers met all inclusion criteria. Systematic reviews were considered if they included controlled trials comparing interventions with and without professional home care. We found that interventions often included comprehensive geriatric assessments and follow-up visits. Results indicate that multidimensional preventive home visiting programs might have the potential to reduce mortality, in particular for younger subjects, and show a potential to improve functional autonomy, but these findings should be interpreted with caution due to the diversity of the interventions analysed.

Research on dementia care continues to develop, yet little attention has been given to the dementia experience in rural, northern communities. This study explored the dementia journey through the viewpoints of health service providers, caregivers, community members, and people living with dementia. The findings highlight the complexity of dementia awareness and understanding. Sound awareness and knowledge of dementia itself, the community services available, as well as of the perspectives of individuals living with dementia and care partners specifically in rural, northern Ontario are fundamental to quality care and support of individuals with dementia. Practical service implications and the need for greater developments with respect to the awareness and understanding of dementia in rural, northern communities are discussed.

This study explored various dimensions of generational relationships between older parents and their adult children using the second wave of SHARE (Survey of Health, Ageing and Retirement in Europe), comparing it to Dykstra’s and Fokkema’s (2011) analyses of the first wave. Results were further compared to the OASIS study (Old Age and Autonomy: The Role of Service Systems and Intergenerational Solidarity). The intergenerational solidarity model served as the main conceptual framework. Analyses yielded four family relationship types present in all countries, albeit with different frequencies. Around half of the respondents in the 11 countries were identified with close ties and flow of support. Four conclusions were drawn: (1) importance of personal resources; (2) cultural differences and meanings for families; (3) highlighting within-country difference; and (4) strength of intergenerational solidarity. The importance of understanding generational relationships in the current era with higher longevity and changing family structures is emphasized and explicated.

This study examined factors affecting adherence in a 16-week tai chi program among multi-ethnic middle-aged and older adults living in a low socioeconomic environment in Toronto. Analysis was based on data collected from three tai chi program cohorts that took place from August 2009 to March 2012. The main outcome variable, adherence, was measured by the total number of sessions attended by each of the participants. Total sample size was 210 participants with a mean age of 68.1 ± 8.6. Based on the regression model, greater adherence was significantly associated with older age, greater perceived stress, higher education, and higher mental and physical scores of Short Form-36 components. Conversely, lower adherence was significantly associated with higher baseline weekly physical activity. Our findings suggest that we target less-educated individuals with poor mental and physical health to optimize adherence for future community-based tai chi programs.

Western societies currently face the aging of their populations. New challenges are experienced by health professionals who are involved in competency assessment that may necessitate a public guardianship. This assessment is complex and its consequences are significant. The Competency Assessment Tool (CAT) can be used to provide a rigorous, objective and ethical evaluation by an interdisciplinary team. The purpose of this study was to validate the CAT. To do this, a Delphi study was conducted among 33 experts from five professions (social worker, occupational therapist, physician, neuropsychologist and nurse), working in seven administrative regions of Quebec. An expert consensus on the content of the CAT was obtained in the first round of consultation. Thus, this study has validated an assessment and decision-making process (CAT) designed for health and social professionals. This decision model can guide the competency assessment of the ability of persons with cognitive impairment to take care of themselves and to manage their finances. Further studies will be necessary to support use of the CAT in practice

The primary purpose of this study was to examine age differences in processing strategies of emotionally difficult trade-off decisions. In addition, the study tested the relevant contributions of the cognitive and emotional mechanisms to age differences in processing strategies. Altogether, 40 younger adults and 40 older adults were randomly assigned to either a high or low emotionally difficult condition of a car-purchasing decision task. MouselabWEB software was used to trace participants’ processing strategies. Results showed that older adults were more likely to use attribute-based processing strategies, whereas younger adults were more likely to use alternative-based processing strategies in the high-emotion condition. In the low-emotion condition, on the other hand, both younger and older adults preferred to use alternative-based processing strategies. Furthermore, the results suggested that the cognitive measure (i.e., digit symbol coding) was not correlated with the age effects on processing strategies.

Recently, rising numbers of mid-life and older adults are starting a “living apart together” (LAT) relationship following divorce or widowhood. LAT describes an intimate relationship wherein partners maintain separate households. This study investigated the characteristics of care arrangements in older long-term LAT couples and elicited personal comments about intra-couple care. We interviewed 25 LAT partners and a comparison group of 17 remarried older adults in the Netherlands in a side study of the Netherlands Kinship Panel Study. Results showed that about half of the LAT partners intended to exchange care if needed (partnership commitment); the other half had ambiguous feelings or intentions to refuse care (independence orientation). However, for those LAT partners already confronted with illness in their current relationship, all provided care to the partner in need. The minority of LAT partners who would not exchange care reciprocally are more likely to give as opposed to receive care.