An aging population and immigration-based population growth necessitate research, practice, and policy focusing on the mental health of older immigrants in Canada, especially, because their mental health appears to deteriorate over time. This review focuses on: What is known about the social determinants of mental health for older immigrants in Canada and what are the barriers they face in accessing mental health services? Findings reveal that: (1) the key social determinants of mental health are culture, health services and gender; (2) older immigrants use fewer mental health services than their Canadian-born counterparts due to cultural beliefs, lack of culturally and linguistically-appropriate services, financial difficulties, and ageism; and (3) regardless of the subcategories within this population, older immigrants experience mental health inequities. The research evidence provides a clear message that addressing mental health service gaps for older immigrants should be a policy and practice priority for Canada’s health care system.

To address the issue of falls, which are increasing as the population ages, an intelligent video-monitoring system is being developed. The aim of the study is to explore caregivers’ perceptions of and receptiveness to a prototype of this fall detection system. A cross-sectional mixed-method study was carried out with individual interviews of 18 caregivers. Statistical frequencies and content analysis were conducted (SPSS and N’Vivo). The results show that most participants (n = 15/18) liked the intelligent video-monitoring system and were willing to use it. They would worry less if they could be alerted if a care recipient fell, but they were concerned about privacy and cost. Participants had a positive perception of the system and expressed their wishes regarding the kind of alert and the person to contact in case of a fall.

Accessibility to buildings promotes social participation through the application of inclusive design. However, architectural frameworks for constructing accessibility ramps are based on scant scientific evidence. This article presents a statement of established standards for construction criteria for accessibility ramps and makes recommendations from the perspective of inclusive design. A literature review was performed using the databases Medline, OTseeker, PsycINFO, and CINAHL (2000 to 2013), combining keywords referring to: universal accessibility, inclusive design, accessibility ramps, biomechanics, obesity, and disabilities. Non-scientific literature was also explored (e.g. building codes). The fifty-eight articles selected were grouped under five themes: 1) ramps and users; 2) materials and climate; 3) visual reference; 4) "wayfinding"; 5) durability, aesthetics and culture. Recommendations encouraging interdisciplinary practice, pegged to inclusive design, are exhibited (e.g. tracking, tilt, contrast).

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.

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.

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.

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.

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

Computer-based, cognitive training procedures aim to increase safety by improving skills related to driving, such as speed-of-processing and the Useful Field of View. The current study assessed the effectiveness of DriveSharp in training older drivers in a naturalistic class setting. Participants (n = 24) attended 10 hours of DriveSharp classes over 5 weeks. Pre- and post-testing sessions assessed improvements on a dynamic hazard perception test, Trails A and Trails B. A control group (n = 18) completed only pre- and post-testing sessions. In-class training times were lower than expected. Participants’ improvement in the games leveled off after the first assessment and the DriveSharp group did not demonstrate a significant improvement in performance compared to the control group. Among several usability issues, the most problematic were misunderstanding task goals and the difference between training and evaluation. There are several implications for those using DriveSharp to enhance older drivers’ safety.

Older women interact with physicians more frequently than older men and younger persons, yet knowledge and understanding of their experiences with physicians is limited. The purpose of this study was to investigate older women’s perceptions of their interactions with physicians and to identify what older women want from physicians. Findings from in-depth interviews with 30 older women reveal the majority want to be actively involved in their own health care. In the patient–physician relationship, the women typically give priority to physicians’ personal attributes and behavior towards the patient. For many of the women, the age and gender of the physician also matter.

The objective of this study was to assess the relationship between the quality of mastication and dietary intake among community-dwelling older adults (67-84 years). A secondary analysis of data collected upon entry of participants in the NuAge study was effected. Perceived masticatory efficiency (n=1793) was measured using a questionnaire inspired by the Oral Health Impact Profile. Direct assessment of masticatory efficiency was carried out in a subsample (n=94), using a validated clinical test (Swallowing Threshold Test Index, 0-100%). Dietary intake was calculated from three non-consecutive 24h recalls. Mean scores indicate good perceived masticatory efficiency (Men:26.22±0.19/28;Women:25.81±0.21/28), but weak assessed efficiency (Men:60.8% [CI(57.3-64.2)]; Women:61.2% [CI(57.7-64.7)]). Multivariate regression analysis, adjusting for confounding variables (age, sex, schooling, living alone, income, smoking, chronic conditions, functional autonomy), showed that masticatory efficiency (measured or perceived) was not associated with intake of fruits/vegetables, protein, vitamin C or folic acid.