Canada is undergoing a considerable demographic change. Citizens over 65 years of age are expected to increase in proportion from 13 percent in 2000 to 21 per cent in 2026^-1. The increasing proportion of older Canadians in the population has significant implications for the nation's social programs and our health care system.

Today's seniors are living longer than ever before. However, life expectancy without disability has not increased proportionately. This means that, eventually, chronic diseases such as dementia, cerebrovascular disease and congestive heart failure may develop and require treatment among the elderly, placing significant pressures on the health care system.

The first round of Canada's ten million baby-boomers will reach the age of 65^-2 over the next decade. Even though they are generally expected to be in better health than current seniors, because of different lifestyles, working conditions and developments in health care, precious little health and social data exists for this generation. It can safely be stated that these Canadians, who have developed and contributed financially to the country's safety net during their entire working lives, are likely to have different expectations and needs than today's seniors.

In order to be prepared to meet the social and health care challenges presented by the seniors of today and tomorrow, better, more cost effective treatments, delivery of care, and prevention methods as well as social and health programs and policies are required.

The response: CLSA

Improving health and preventive care requires greater knowledge of the aging process, its determinants, and their inter-relationships, acquired through careful and thorough research. In response, the CIHR-Institute of Aging has teamed up with several partners^-3 to create a framework for the most comprehensive longitudinal study in the country's history: The Canadian Longitudinal Study on Aging (CLSA).

A team of approximately 180-researchers^-4 throughout the country, lead by three principal investigators^-5, is currently developing the CLSA research protocol which will guide the study. A sum of approximately $400,000 has been granted to the team to carry out this task over 18 months. An international review board is expected to review all aspects of the protocol, including ethical considerations.

Once the research protocol is approved, CLSA will study several thousand Canadians for a period of approximately 20 years for genetic, immunologic and molecular determinants; the effects of physical exercise, nutrition and other habits; the evolution of physical, psychological and cognitive abilities; the roles of psychological determinants, social and cultural variables, and health care utilization. As well, it will study the causes and evolution of the most prominent diseases associated with aging such as cardiovascular disease, cancer, diabetes and Alzheimers.

CLSA outcomes and impacts

CLSA is being designed in a way to progressively identify and produce preventive strategies that will translate into practices, services and policies for Canadians. In other words, CLSA will help maintain better health for seniors and provide improved, more cost efficient treatment and programs that can translate into savings for taxpayers.

CLSA will produce new knowledge for:

• Policy makers: incidence and prevalence of diseases and disabilities, needs of elderly people, patterns of health care services utilization, social determinants of health, health promotion and disease prevention strategies;
• Researchers: understanding the interplay of many factors associated with healthy aging, aging processes, risk factors for diseases and disabilities;
• Clinicians: incidence and risk factors of diseases, pattern of care, drug utilisation; and
• Industry: market monitoring, gene therapy, immune therapy, data for actuarial analysis.

References

1. Statistics Canada, 2000
2. Statistics Canada, 2002
3. Framework development partners include: The Canadian Institutes of Health Research, Health Canada, Statistics Canada, the Canadian Institute for Health Information, the Canadian Association on Gerontology and private sector representatives.
4. A list is available upon request
5. Dr. Susan Kirkland of Dalhousie University, Dr. Parminder Raina of McMaster University, and Dr. Christina Wolfson of McGill University