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Canadian Geriatrics Journal: CGJ

Selina Chow, Ronald Chow, Angela Wan, Helen R Lam, Kate Taylor, Katija Bonin, Leigha Rowbottom, Henry Lam, Carlo DeAngelis, Nathan Herrmann
Background: In order to provide appropriate care for the aging population, many countries are adopting a National Dementia Strategy (NDS). On June 22, 2017, Canada announced it will become the 30th country to launch a NDS. In light of this announcement and as Canada prepares to develop its own NDS, we conducted this review to examine and compare the NDSs of the other previous 29 countries with Canadian government's policies to date. Methods: NDSs were compared according to their major priorities...
June 2018: Canadian Geriatrics Journal: CGJ
Bonnie Cheung, Camilla L Wong, Amanda Gardhouse, Christopher Frank, Laura Budd
Background: Twitter is a microblogging platform increasingly used in medicine to overcome geographic barriers and promote international connections. Tweets, the 280-character microblogs, are catalogued by hashtags (#). This study evaluates and describes the participation, content, and impact of Twitter at the 2015 Canadian Geriatrics Society (CGS) Annual Scientific Meeting, during which #CGS2015 was the official conference hashtag. Methods: Twitter transcripts of #CGS2015 were obtained from Symplur to prospectively analyze tweets for content and quantitative metrics...
June 2018: Canadian Geriatrics Journal: CGJ
Stephanie Cullen, Manuel Montero-Odasso, Louis Bherer, Quincy Almeida, Sarah Fraser, Susan Muir-Hunter, Karen Li, Teresa Liu-Ambrose, Chris A McGibbon, William McIlroy, Laura E Middleton, Yanina Sarquis-Adamson, Olivier Beauchet, Bradford J McFadyen, José A Morais, Richard Camicioli
Background: Motor and cognitive impairments are common among older adults and often co-exist, increasing their risk of dementia, falls, and fractures. Gait performance is an accepted indicator of global health and it has been proposed as a valid motor marker to detect older adults at risk of developing mobility and cognitive declines including future falls and incident dementia. Our goal was to provide a gait assessment protocol to be used for clinical and research purposes. Methods: Based on a consensus that identified common evaluations to assess motor-cognitive interactions in community-dwelling older individuals, a protocol on how to evaluate gait in older adults for the Canadian Consortium on Neurodegeneration in Aging (CCNA) was developed...
June 2018: Canadian Geriatrics Journal: CGJ
Jean-Sébastien Claveau, Nancy Presse, Marie-Jeanne Kergoat, Juan Manuel Villalpando
Background: Early assessment of cognitive symptoms is an issue in geriatrics. This study investigated the delay from the onset of cognitive symptoms to initial clinical assessment and its associations with patients' sociodemographic and clinical characteristics. Methods: This is a cross-sectional retrospective study using medical chart review of 316 patients referred for assessment to a university-affiliated memory clinic. Symptom duration was self-reported by patients/carers...
June 2018: Canadian Geriatrics Journal: CGJ
George A Heckman, Bryan B Franco, Linda Lee, Loretta Hillier, Veronique Boscart, Paul Stolee, Lauren Crutchlow, Joel A Dubin, Frank Molnar, Dallas Seitz
Background: Primary care-based memory clinics were established to meet the needs of persons with memory concerns. We aimed to identify: 1) physical examination maneuvers required to assess persons with possible dementia in specialist-supported primary care-based memory clinics, and 2) the best-suited clinicians to perform these maneuvers in this setting. Methods: We distributed in-person and online surveys of clinicians in a network of 67 primary care-based memory clinics in Ontario, Canada...
June 2018: Canadian Geriatrics Journal: CGJ
Sarah A Chau, Nathan Herrmann, Jonathan Chung, Moshe Eizenman, Krista L Lanctôt
Background: The purpose of this pilot study was to explore the potential of eye-tracking technology in monitoring symptoms and predicting outcomes in apathetic Alzheimer's disease (AD) patients treated with methylphenidate (MTP). Methods: Neuropsychological tests and eye-tracking measurements were completed at baseline and following at least four weeks of treatment with MTP (5-10 mg BID). Eye-movements were measured while patients viewed novel and social stimuli...
June 2018: Canadian Geriatrics Journal: CGJ
Ken Madden, Mark Rapoport, Colleen Maxwell
No abstract text is available yet for this article.
June 2018: Canadian Geriatrics Journal: CGJ
Megan Brenkel, Kimberley Whaley, Nathan Herrmann, Kerri Crawford, Elias Hazan, Laura Cardiff, Adrian M Owen, Kenneth Shulman
Background: With an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will. Method: This paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts...
March 2018: Canadian Geriatrics Journal: CGJ
Yu Ming, Aleksandra Zecevic
The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1...
March 2018: Canadian Geriatrics Journal: CGJ
Lesley A Charles, Chris C Frank, Tim Allen, Tatjana Lozanovska, Marcel Arcand, Sidney Feldman, Robert E Lam, Pravinsagar G Mehta, Nadia Y Mangal
Background: With Canada's senior population increasing, there is greater demand for family physicians with enhanced skills in Care of the Elderly (COE). The College of Family Physicians Canada (CFPC) has introduced Certificates of Added Competence (CACs), one being in COE. Our objective is to summarize the process used to determine the Priority Topics for the assessment of competence in COE. Methods: A modified Delphi technique was used, with online surveys and face-to-face meetings...
March 2018: Canadian Geriatrics Journal: CGJ
Jasmine Davies, Jennifer Whitlock, Iris Gutmanis, Sheri-Lynn Kane
Background: Frailty, a common clinical syndrome in older adults associated with increased risk of poor health outcomes, has been retrospectively calculated in previous publications; however, the reliability of retrospectively assigned frailty scores has not been established. The aim of this study was to see if frailty scores, based on chart review data, agreed with clinician-determined scores based on a comprehensive geriatric assessment. Methods: Per standard practice, all patients seen by one nurse clinician (JW) from the Southwestern Ontario Regional Geriatric Program, a tertiary care-based outreach service, between August 15, 2013 and December 31, 2015 received a comprehensive geriatric assessment which included the assignment of an interview-based Clinical Frailty Scale score (CFS-I)...
March 2018: Canadian Geriatrics Journal: CGJ
Michael Gordon
No abstract text is available yet for this article.
December 2017: Canadian Geriatrics Journal: CGJ
Colin Powell
Going from physician to patient is a journey from which few of our tribe will be spared, and about which we have comparatively little formal reflection. This paper describes some of the lessons learned on such a journey from a retired Professor of Geriatric Medicine, whose course of vascular parkinsonism offers lessons both professional and personal.
December 2017: Canadian Geriatrics Journal: CGJ
John Muscedere, Perry Kim, Peter Aitken, Michael Gaucher, Robin Osborn, Barbara Farrell, Jayna Holroyd-Leduc, Laurie Mallery, Henry Siu, James Downar, Todd C Lee, Emily McDonald, Lisa Burry
Appropriate and optimal use of medication and polypharmacy are especially relevant to the care of older Canadians living with frailty, often impacting their health outcomes and quality of life. A majority (two thirds) of older adults (65 or older) are prescribed five or more drug classes and over one-quarter are prescribed 10 or more drugs. The risk of adverse drug-induced events is even greater for those aged 85 or older where 40% are estimated to take drugs from 10 or more drug classes. The Canadian Frailty Network (CFN), a pan-Canadian non-for-profit organization funded by the Government of Canada through the Networks of Centres of Excellence Program (NCE), is dedicated to improving the care of older Canadian living with frailty and, as part of its mandate, convened a meeting of stakeholders from across Canada to seek their perspectives on appropriate medication prescription...
December 2017: Canadian Geriatrics Journal: CGJ
Carla A Loftus, Lesley A Wiesenfeld
Background: Our hospital identified delirium care as a quality improvement target. Baseline characterization of our delirium care and deficits was needed to guide improvement efforts. Methods: Two inpatient units were selected: 1) A general internal medicine unit with a focus on geriatrics, and 2) a surgical unit. Retrospective chart audits were conducted for all patients over age 50 admitted during a one-month period to compare delirium care with best practice guideline (BPG) recommendations, and to determine the incidence of missed cases of delirium and negative outcomes in patients with delirium...
December 2017: Canadian Geriatrics Journal: CGJ
Anna Byszewski, Barbara Power, Linda Lee, Glara Gaeun Rhee, Bob Parson, Frank Molnar
Background: For persons with dementia (PWD), driving becomes very dangerous. Physicians in Canada are legally responsible to report unfit drivers and then must disclose that decision to their patients. That difficult discussion is fraught with challenges: physicians want to maintain a healthy relationship; patients often lack insight into their cognitive loss and have very strong emotional reactions to the loss of their driving privileges. All of which may stifle the exchange of accurate information...
December 2017: Canadian Geriatrics Journal: CGJ
Kenneth M Madden, Colleen Maxwell, Mark Rapoport
No abstract text is available yet for this article.
December 2017: Canadian Geriatrics Journal: CGJ
Ghizlane Moussaoui, Ching Yu, Vincent Laliberté, Dominique Elie, Artin A Mahdanian, Benjamin Dawson, Marilyn Segal, Karl J Looper, Rej Soham
BACKGROUND: With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection. METHODS: This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. traditional paper forms to complete self-report psychiatric symptoms...
September 2017: Canadian Geriatrics Journal: CGJ
Olga Theou, Grace H Park, Antonina Garm, Xiaowei Song, Barry Clarke, Kenneth Rockwood
BACKGROUND: The purpose of this manuscript was to evaluate the effectiveness of the Community Actions and Resources Empowering Seniors (CARES) model in measuring and mitigating frailty among community-dwelling older adults. METHODS: The CARES model is based on a goal-oriented multidisciplinary primary care plan which combines a comprehensive geriatric assessment (CGA) with health coaching. A total of 51 older adults (82 ± 7 years; 33 females) participated in the pilot phase of this initiative...
September 2017: Canadian Geriatrics Journal: CGJ
Lilian U Thorpe, Susan J Whiting, Wenbin Li, William Dust, Thomas Hadjistavropoulos, Gary Teare
BACKGROUND: Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics. METHODS: We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur...
September 2017: Canadian Geriatrics Journal: CGJ
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