ARCHIVED - Research About - Aging

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The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 13,000 health researchers and trainees across Canada. Through CIHR, the Government of Canada invested approximately $120.4 million in 2008-09 in aging-related research.

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The Facts

• The proportion of senior citizens is projected to boom, reaching 23% to 25% in 2031 and 25% to 30% in 2056. In 2005, it was 13%. Seniors will outnumber children around 2015, a first in Canada's history.
• By 2031, 9 million Canadians will be 65 and older – this means all baby boomers will have become seniors by this time.
• Today's Canadian seniors have mixed attitudes about the state of their health. In all, 57% rate their health as fair/poor, compared to 24% who rate it as good and 15% as very/good excellent.
• Gender makes a difference in whether Canadian seniors live alone or not. Older women most often live alone (43%) while it is the least common living arrangement among elderly men (16%).
• In 2007, about 2.7 million Canadians aged 45 and over, or about 20% of the age group, provided some form of unpaid care to people 65 or older who had long-term health problems. Between 2002 and 2007, the number of people providing care to seniors increased by more than 670,000.

Sources: Statistics Canada

Finding Solutions

Guiding people with dementia through life's tasks

Dementia erodes a person's ability to do simple daily tasks such as using the toilet and washing hands. The need for constant supervision can cause tension, restrict privacy and diminish dignity. In response to this growing problem, the University of Toronto's Dr. Alex Mihailidis has developed several prototypes that use robotics, mechanical engineering, artificial intelligence, voice recognition and computer programming to guide people with dementia through their daily activities. His "talking bathroom" uses an overhead camera to monitor people's movements as they stand at a sink to wash their hands. When the person hesitates, the camera feeds a message to a computer that offers verbal prompts such as "turn on the tap." Similarly, a personal emergency response system uses a ceiling-mounted camera to track a person's movements in a room. Should the person fall, the system triggers a set of computerized responses – such as asking the person if he or she needs help. CIHR-funded Dr. Mihailidis is adapting the prototypes for in-home use.

Exercise boosts brain power as we age

Is your brain getting out of shape? Dr. Marc Poulin of the University of Calgary suggests a strong correlation exists between a fit body and a well-functioning mind. In a study published in Neurobiology of Aging in December 2008, Dr. Poulin's research team tracked 42 women aged 50 to 90, comparing those who took part in regular aerobic activity with a sedentary group. Those who exercised regularly had better blood pressure and better blood flow to the brain. They also scored higher on tests for cognition and perception. He is now leading a five-year CIHR study of the effects of regular exercise on preventing age-related cognitive decline.

This is your brain, falling down

Almost one-third of people over 65 fall at least once every year – which can lead to fractured bones, hospitalization and a diminished quality of life. Research suggests that difficulties in concentrating, planning and strategizing are linked to an increased risk of falling. Drs. Todd Handy and Teresa Liu-Ambrose of the University of British Columbia have shown that seniors who tend to fall demonstrate different neural patterns while performing tasks that require "executive function" such as starting and stopping actions, changing behaviour as required, and planning future behaviour. As part of an ongoing CIHR-supported study, the two researchers are trying to identify cognitive impairments associated with recurrent falling to devise better fall-prevention strategies.

Groundbreaking Canadian study aims to unravel the mysteries of aging

It's one of the most comprehensive studies of its kind ever undertaken, and it could unlock some of the greatest mysteries about how and why we age the way we do. The $30-million federally funded Canadian Longitudinal Study on Aging (CLSA) will follow 50,000 Canadians, aged 45-85 years, over the next two decades. In addition to starting at mid-life, the CLSA is the first study of its kind to examine social and economical retirement factors, as well as clinical and biological measures. "Some people age in a healthy fashion despite many physical health challenges, while others who are in good physical health age less optimally. What explains this phenomenon? The study will answer questions that are relevant to decision-makers to improve the health of Canadians," says Dr. Parminder Raina, the study's lead principal investigator and a McMaster University researcher.

The Researchers

Dr. Kenneth Rockwood – The Patient Listener

Dr. Kenneth Rockwood has heard all of the negative names: bed-blockers, train wrecks, even gomers, an abbreviation for 'get out of my emergency room'.

But while some frustrated hospital staff resort to name calling with their frail, elderly, often demented patients, what could reduce the frustration and improve treatment he says isn't talking, but listening.

"I've been doing Alzheimer's clinical trials for about 20 years," says Dr. Rockwood, director of Dalhousie University's Geriatric Medicine Research Unit. "I'm convinced that we don't know as much about Alzheimer's disease as we think we do because we haven't listened carefully enough to these patients and their caregivers."

Listening to patients is the starting-point for a number of CIHR-supported initiatives he's involved with, all focused on improving knowledge sharing among geriatrics researchers, clinicians, caregivers and patients.

Can listening to patients really improve scientific insight? Dr. Rockwood points to the history of our understanding of Alzheimer's. In the early 1990s, neurologists discovered the initial physical evidence of the disease in the hippocampus, the part of the brain responsible for episodic memory.

Thus candidate drugs for treating Alzheimer's were evaluated based on their effect on episodic memory. However, family members often reported that patients 'got better' — even though their memories didn't necessarily improve. What researchers realized, more than a decade later, is that some of these drugs improved frontal lobe function, an area critical to judgment. Improved frontal lobe function in turn compensated for aspects of memory loss.

"This insight was there to be had in 1991, if we'd listened more carefully to what caregivers said," says Dr. Rockwood, whose upcoming book is entitled The Joy of Geriatrics. "We want to develop a rigorous, systematized way to listen to people and to hear what they say. Then we can take these facts and turn them into scientifically plausible hypotheses that we can test."

It's research that builds on the success of his goal attainment scaling technique. In this approach, clinical effectiveness is based on patients' feedback before and during treatment. His research will form part of the new CIHR-funded Canadian Dementia Knowledge Translation Network, co-led by Dr. Rockwood and involving more than a hundred Canadian clinicians and researchers.

The network will close the listening circle by taking lessons learned and broadly sharing these new research insights.

"What we're trying to do is to stir up a knowledge-translation culture," says Dr. Rockwood. "We want to inspire new Alzheimer's researchers to learn how to take the information they gain, and not just be happy to publish a paper, but to find some way to get useful information out to people with dementia and their caregivers."

For More Information

CIHR's Institute of Aging (CIHR-IA) has identified five themes as urgent research priorities for Canada: cognitive impairment in aging, mobility and functional autonomy, healthy aging, health services for an aging population, and the biological processes of aging itself. As the stories above demonstrate, the impact of early investments and strategic development in these research domains is now evident. To learn more about these priorities and other CIHR-IA activities, please visit the Institute's website.

For more information, go to ARCHIVED - Your Health Research Dollars at Work.