From a “successful aging” perspective, the subjective feeling of well-being is as important as “objective” health. Physical exercise is seen as being an effective way of staying healthy, but its link with well-being in a normal aging population remains largely unexplored. Based on two randomized surveys of the aging population, conducted in 1979 and 1994, respectively, with questionnaires including retrospective questions on activities and health, two cohorts of young-old (aged 64–74) were selected (cohort 1, born 1905–1914, N = 949; cohort 2, born 1920–1929, N = 602) and split into four groups, corresponding to their exercising trajectories (long-term exercisers LE, new exercisers NE, quitters Q, sedentary S). The link between the four trajectories and two indicators of well-being (self-rated health, self-assessed depression scale) was examined by means of regression analyses. In both cohorts, the LE group had a higher level of well-being than the Q and the S. The study also throws light on the case of the quitters (Q), who showed the lowest level of well-being. Scant research has hitherto been done on the causes and repercussions of abandoning exercise.

Information on the characteristics of seniors who use supplements is lacking. A convenience sample of community-living seniors (n = 128) was recruited from 10 sites to identify factors associated with supplement use (vitamin-mineral and/or herbal preparations). Data on nutritional variables, health history, and supplement use were collected with an interview-administered questionnaire. A Propensity to Use Supplements scale was developed and was associated with increased use of herbal supplements. At the bivariate level, few characteristics distinguished users and non-users. Multivariate modelling revealed the Propensity scale and a low Body Mass Index to be factors related to the total number of supplements used. When individual scale items were examined at the bivariate level, food supply concerns, health beliefs, and a proactive role in one's own health were associated with increased supplement use. Initial results suggest seniors' attitudes towards supplements may be an important factor contributing to their decision to use supplements. Further work is required in a more diverse, randomly selected, older Canadian population.

We evaluated an enhanced role in comprehensive geriatric assessment for community-nurse case managers. Following practicum education in geriatric assessment, two community-nurse case managers conducted assessments of frail older clients and served as a resource for their case-manager teams. Impacts on their colleagues' assessment skills were investigated in a non-randomized, controlled trial. Intervention-group case managers had higher confidence in assessing and managing the health and social concerns of older persons, greater use of standard assessment tools, and higher case-study assessment scores, than did control-group case managers. Case managers reported that interaction with the enhanced-role case managers had enhanced their skills and benefited clients; family physicians reported that improved patient outcomes had resulted from the assessment information received. Community case managers with enhanced training in geriatric assessment can have a valuable clinical and educational role. Issues include resource implications and integrating the enhanced role into home care operations.

Over the past 15 to 20 years there has been discussion and debate in the gerontological literature about the relative merits of self-report versus performance-based observational (PBO) measures of functional status. In 2001 the Aging in Manitoba Longitudinal Study had the opportunity to add a PBO measure of functional status and use it together with two self-report measures on a sub-sample of 138 participants. The PBO measure that was used was the Performance Assessment of Self-Care Skills, Version 3.1 (Home). Using ranks of the proportion of participants who were independent in nine different tasks, no significant correlations were found between the performance measure scores and either of the self-report measures. This finding suggests that using self-report data rather than performance data could lead program developers and policy makers to different conclusions about the extent of need for assistance among older adults.

Five semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.

This study was an implementation and community trial of a new falls-prevention program for seniors called Steady As You Go (SAYGO). The program, designed in the Capital Health region of Alberta, integrated the knowledge gained from successful falls-prevention research into a brief community intervention. SAYGO included a multifactorial, risk-abatement approach, as well as a cognitive-behavioural and environmental focus. The target population was relatively healthy and mobile, community-dwelling seniors. The randomized community trial was conducted in urban and rural areas in Alberta, with 660 seniors participating. Seniors who completed the program made significant reductions in eight of the nine risk factors addressed in the program. Over a 4-month follow-up period, the proportion of seniors who fell was lower in the treatment group (17%) than in the control group (23%). Among those seniors who had reported a fall in the previous year, a significantly lower proportion of those in the treatment group experienced a fall in the follow-up period (20%) as compared to those in the control group (35%).

Bathrooms are a common location for falls among older adults. Bath grab bars can assist in promoting safe bath transfers. The aim of this study was to identify predictors of bathroom safety-device use among community-living seniors. A two-stage sampling strategy was used to select, first, a random sample of non-universal apartment buildings and a matched sample of universal buildings, from among non-profit apartment buildings in two Canadian regions; and second, a random sample of participants within each building. A total of 550 seniors participated in face-to-face interviews in their apartments. Participants within each building type presented with similar profiles. A logistic regression was used to identify predictors of grab-bar use among participants who had grab bars and entered the bathtub on a regular basis (n = 478). Significant predictors, in order of odds ratios, were bathing difficulties, ease of grab-bar use, living in buildings with policies supporting universal access to grab bars, having a history of falls, and reporting few psychosocial consequences of grab-bar use. Findings of this study emphasize the importance of promoting access as a key strategy for increasing use and have important implications for policy planning and falls-prevention initiatives.

The purpose of this study was an examination of the inter-rater reliability for a psychogeriatric population of the Global Assessment of Functioning (GAF), Axis V of the DSM-IV Classification System,. One-hundred-and-eight psychogeriatric patients, admitted to an acute-care psychiatric hospital, were rated on the GAF by three clinicians: a psychiatrist, a physician, and a psychologist. The psychologist also conducted a cognitive screening assessment at the time of admission, as well as a second rating of global functioning, which was carried out at the time of transfer/discharge from the admission unit. Results indicated good inter-rater reliability, with values ranging from 0.78 to 0.86. Comparisons were also made between the admission and transfer/discharge GAF scores. Implications for improving the inter-rater reliability of the GAF are discussed.