Canadian Geriatrics Journal[JOURNAL]
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200 papers
Anti-Amyloid Therapies for Alzheimer's Disease: Not the Way Forward.
Bocti C, Bergman H
Can Geriatr J · 2025 Dec · PMID 41306639 · Full text
Abstract loading — click title to view on PubMed.
Challenges Facing Canadian Long-Term Care Homes and Retirement Homes During the COVID-19 Pandemic.
Fahim C, Hassan AT, de Launay KQ … +10 more , Takaoka A, Togo E, Strifler L, Bach V, Paul N, Mrazovac A, Firman J, Gruppuso V, Boyd JM, Straus SE
Can Geriatr J · 2025 Dec · PMID 41306638 · Full text
BACKGROUND: COVID-19 exposed long-standing systemic challenges experienced by congregate settings and created a crisis for long-term care homes (LTCHs) and retirement homes (RHs). This study explored the pandemic-related...
BACKGROUND: COVID-19 exposed long-standing systemic challenges experienced by congregate settings and created a crisis for long-term care homes (LTCHs) and retirement homes (RHs). This study explored the pandemic-related challenges LTCHs and RHs faced and the strategies they used to mitigate them. METHOD: Ninety-one key informant interviews were held with LTCH and RH leadership across 47 homes (33 LTCHs, 14 RHs) in Ontario, Canada from February 2021 to July 2022. Data were analyzed following the framework method. RESULTS: Findings confirmed evidence of three main challenges. First, leaders were challenged to implement infection prevention and control (IPAC) protocols and measures. Second, leaders required supports to facilitate COVID-19 vaccine access and to promote vaccine acceptance. Finally, LTCH/RH staff experienced well-being and mental health challenges in the face of COVID-19 pressures. Despite widespread attention and efforts to support these congregate settings, challenges persisted over one year into the pandemic. CONCLUSIONS: Our findings reveal a plethora of strategies implemented by homes, with ranging reports of perceived success.
Physical, Psychological, Cognitive and Social Frailty Domains in Community-Dwelling Adults Aged 45-85: a Cross-sectional Analysis of the Canadian Longitudinal Study on Aging (CLSA).
Griffith LE, Terrera GM, van den Heuvel E … +5 more , Khattar J, Hogan DB, O'Connell M, Levasseur M, Raina P
Can Geriatr J · 2025 Dec · PMID 41306637 · Full text
BACKGROUND: Reported estimates of frailty prevalence vary considerably. At least partially attributable to differences in the conceptualization of frailty used, a better understanding of the inter-relationships among fra...
BACKGROUND: Reported estimates of frailty prevalence vary considerably. At least partially attributable to differences in the conceptualization of frailty used, a better understanding of the inter-relationships among frailty domains could clarify contributors to the noted heterogeneity. METHODS: A global frailty index (FI) created from baseline data on 30,097 Canadian Longitudinal Study on Aging comprehensive cohort participants was used to define physical, psychological, cognitive, and social domain-specific FIs. These were divided into quintiles with the highest 20% (Q5) representing the frailest participants. Logistic regression was used to estimate the associations between age group and biological sex with domain-specific FIs in unadjusted and adjusted (income, smoking status, nutritional risk, physical activity, social participation, interaction between sex and age group) models. The association between Q5 membership among the frailty domains was estimated using polychoric correlation coefficients. RESULTS: The prevalence of physical and cognitive frailty increased with age, but psychological frailty decreased, especially in males. Social frailty showed gradual increases with age in females that were only evident in the oldest age group (75-85) among men. The age-groups*sex interaction value was <.001 for social. Polychoric correlations were highest between the psychological/physical and psychological/social domains, and decreased with increasing age for all combinations. CONCLUSION: We found that domain-specific frailty prevalences differed by age group and sex with low associations among frailty domains, particularly at older ages. Understanding the evolution of these findings could be instrumental in developing tailored interventions to prevent frailty or modify its trajectory.
Frailty of Health Care Systems.
St John PD, Hogan DB
Can Geriatr J · 2025 Dec · PMID 41306636 · Full text
Frailty is a state of vulnerability to stressors which has long been a focus of Geriatric Medicine, and is gaining acceptance in other fields. The notion of frailty considers individuals, but many similarities exist betw...
Frailty is a state of vulnerability to stressors which has long been a focus of Geriatric Medicine, and is gaining acceptance in other fields. The notion of frailty considers individuals, but many similarities exist between individuals and health care systems (HCS). We have drawn parallels between frail individuals and frail health care systems. We have adapted a commonly used measure of frailty-the "Frailty Phenotype", to measure HCS which are vulnerable to acute and chronic stresses. Finally, we note the "double jeopardy" of frail older adults within frail HCS. Ensuring that HCS remain robust and unlikely to fail should be a priority for health-care policy makers.
Interventions to Improve Cognitive Outcomes in Older Adults with Traumatic Brain Injury and Association Between Social Determinants of Health and Intervention Effectiveness: A Scoping Review.
Huang YQ, Hothi H, Weiss S … +5 more , Hoang P, McGowan J, Bier N, Straus SE, Watt JA
Can Geriatr J · 2025 Dec · PMID 41306635 · Full text
BACKGROUND: At least one million Canadians are at risk of experiencing a traumatic brain injury (TBI) in later life, which can lead to cognitive decline. We identified interventions studied to improve cognitive outcomes...
BACKGROUND: At least one million Canadians are at risk of experiencing a traumatic brain injury (TBI) in later life, which can lead to cognitive decline. We identified interventions studied to improve cognitive outcomes in older adults with TBI, and examined how social determinants of health (SDoH) may influence their effectiveness. METHODS: We followed JBI guidance and searched five electronic databases from inception until March 2023 for studies evaluating the clinical and cost effectiveness, and safety of interventions being studied to improve cognitive outcomes in older adults with TBI. We abstracted SDoH following the PROGRESS-Plus framework. RESULTS: We included 20 studies and 44,462 predominantly men/male (65%) participants with a mean age of 65.9 years; studies reported 51 cognitive outcomes. Three studies reported on race or ethnicity, eight studies reported on education, and no studies differentiated gender from sex. No studies reported on the association between SDoH and intervention effectiveness. We did not identify any economic evaluations. We classified 10 interventions into four categories: non-pharmacologic cognitive strategies (number of studies [n]=16), medications (n=1), non-invasive procedures (n=2), and invasive procedures (n=1). Invasive procedures and non-pharmacologic cognitive strategies had a statistically significant positive effect on cognitive measures in one and seven studies, respectively. Non-invasive procedures (n=2) did not have significant cognitive effects. Use of hypnotics (benzodiazepines and non-benzodiazepines) was significantly associated with a shorter time to incident dementia in one study. CONCLUSION: Non-pharmacologic cognitive strategies were the most-studied interventions for improving cognitive outcomes in older adults with TBI. Future research should better integrate a health equity lens and standardize outcome measurement.
Diagnostic Accuracy of Tools to Identify Anxiety Symptoms and Disorders in Persons with Dementia: a Systematic Review Update.
Atchison K, Wu P, Seitz D … +2 more , Watt JA, Goodarzi Z
Can Geriatr J · 2025 Dec · PMID 41306634 · Full text
Limited anxiety tools validated against a diagnostic gold standard in the context of dementia have been identified. A systematic review update was completed to identify publications since 2017 describing tools to detect...
Limited anxiety tools validated against a diagnostic gold standard in the context of dementia have been identified. A systematic review update was completed to identify publications since 2017 describing tools to detect anxiety in persons with dementia compared to a diagnostic gold standard. The original search strategy was replicated in MEDLINE, Embase, and PsycINFO. Pooled prevalence and diagnostic accuracy estimates were calculated based on three or more studies presenting comparable information from either the original or updated review search. No pooled estimates were calculated in the original review given limited evidence. One study evaluating the Rating Anxiety in Dementia (RAID) scale, Neuropsychiatric Inventory, and Hamilton Anxiety Rating Scale met review inclusion criteria. The pooled prevalence of generalized anxiety disorder (GAD) (n=3, 36.7%, 95% Confidence Interval (CI): 24.3-49.2%) and diagnostic accuracy outcomes for the RAID scale (≥11 cut-off) to detect GAD (n=3, sensitivity: 89%, 95% CI: 78-95%; specificity: 73%, 95% CI: 60-82%) were calculated using data from two studies identified in the original review and the newly included study from the review update. The RAID scale has the most evidence and adequate sensitivity to support its use in identifying anxiety in persons with dementia. Validated tools to detect anxiety in persons with dementia remain understudied.
Notice of Retraction: Predicting falls among older persons using machine learning [abstract].
Can Geriatr J · 2025 Dec · PMID 41306633
[This retracts the article DOI: 10.5770/cgj.27.786.].
[This retracts the article DOI: 10.5770/cgj.27.786.].
Experiences and Perspectives of Caregivers of Francophone Older Adults Accessing Community Health Services in Toronto: an Exploratory Qualitative Study.
Boyd EK, Beogo I, Liu B … +2 more , Schneider F, Norris M
Can Geriatr J · 2025 Dec · PMID 41306632 · Full text
BACKGROUND: Canada is a bilingual country; however, outside of Quebec, health-care services are predominantly offered in English. With the increasing older adult population and stretched health-care resources, Francophon...
BACKGROUND: Canada is a bilingual country; however, outside of Quebec, health-care services are predominantly offered in English. With the increasing older adult population and stretched health-care resources, Francophone older adults may face significant challenges in accessing care due to their linguistic minority status. This study explores the experiences of caregivers of Francophone older adults in the Greater Toronto Area (GTA). METHODS: Using a convenience sampling strategy, caregivers of patients who had undergone geriatric assessment at the Centre Francophone du Grand Toronto (CFGT) were recruited. Participants underwent 45-minute, semi-structured interviews and completed demographic questionnaires. Three independent reviewers conducted qualitative content analysis of the interview transcripts, using the socioecological model of health and NVivo12. RESULTS: Nine participants were primarily female (n=5), with age ranges of 40-49 (n=2), 50-59 (n=3), and 60+ (n=4). They originated from North America (n=5), Africa (n=3), and the Middle East (n=1); about half preferred English over French. Thematic analysis identified three key themes: 1) Barriers Accessing Health Care in the French Language; 2) The Need for Interpreter Support; 3) Importance of Comprehensive Francophone Community Services. CONCLUSIONS: Despite the presence of organizations (e.g., CFGT), this study reveals a significant gap in French-language services for older adults in the GTA, leading to increased challenges for their caregivers. Due to linguistic barriers, caregivers must act as interpreters to mitigate the risks associated with miscommunication and potentially worse health outcomes. Addressing these issues requires increasing bilingual health-care providers, enhancing funding for Francophone community services, and improving support systems (e.g., interpreters).
Feedback Quality in Geriatric Medicine: Analyzing Entrustable Professional Activities in a Competency-Based Curriculum.
Dolatabadi A, Nandan A, Gandell D
Can Geriatr J · 2025 Sep · PMID 40881148 · Full text
BACKGROUND: Competency-based medical education (CBME) aims to enhance the quality of medical training by providing timely, actionable feedback through entrustable professional activities (EPAs). However, variability in f...
BACKGROUND: Competency-based medical education (CBME) aims to enhance the quality of medical training by providing timely, actionable feedback through entrustable professional activities (EPAs). However, variability in feedback quality remains a concern across residency programs. METHODS: We conducted a retrospective analysis of EPA feedback forms from a geriatric medicine program, comparing two distinct time periods: 2019-2020 and 2021-2022. This program averages eight residents per year with 30 full-time faculty members. The quality of feedback was assessed based on timeliness, task orientation, actionability, and polarity. RESULTS: 404 EPAs were initiated and completed in 2019-2020, with 69% (n=278) being timely, 89% (n=360) task oriented, 50% (n=203) very actionable, and 62% (n=250) corrective in polarity. 851 EPAs were initiated in 2021-2022 and 76% (n=645) were completed, with 64% (n=410) being timely, 78% (n=501) task oriented, 40% (n=259) very actionable, and 47% (n=305) corrective in polarity. Timely feedback was more likely to be task-oriented (χ(1)=11.87, <.001), actionable (χ(2)=24.40, <.001), and corrective (χ(3)=22.80, <.001) in the second timeframe. Compared to the second timeframe, EPAs completed in the first timeframe were more likely to be task oriented (χ(1)=22.08, <.001), actionable (χ(2)=25.54, <.001), and corrective in polarity (χ(3)=25.89, <.001). CONCLUSIONS: Our study revealed lower quality feedback over time since implementing CBME at a geriatric medicine subspecialty training program. The root causes of the reduction in quality were not explored but are theorized to be multifactorial. Further investigation into the reasons for the reduction in feedback quality will help direct interventions to better sustain the quality of CBME implementation.
Usefulness of Muscle Stiffness Evaluated by Ultrasonography for Detecting Muscle Change Related to Contracture in Frail Older Adults.
Nakagawa K, Kataoka H, Inoue R … +7 more , Goto K, Yamashita J, Nishi Y, Honda Y, Sakamoto J, Origuchi T, Okita M
Can Geriatr J · 2025 Sep · PMID 40881145 · Full text
BACKGROUND: Ultrasonography can be used to evaluate the echo intensity (EI) and strain ratio (SR) to identify muscle quality and stiffness, respectively. EI and SR are affected by aging, frailty, and joint angle position...
BACKGROUND: Ultrasonography can be used to evaluate the echo intensity (EI) and strain ratio (SR) to identify muscle quality and stiffness, respectively. EI and SR are affected by aging, frailty, and joint angle positions. We investigated the effects of aging and frailty on muscle EI and SR at different joint angle positions, and identified a useful measurement method to reflect muscle changes related to contractures in frail older adults. METHODS: This study had a cross-sectional design. Twenty-two healthy young adults (young group), 22 non-frail older adults (non-frail group), and 22 frail older adults (frail group) participated in this study. The range of motion (ROM) of hip abduction, EI, and SR of the adductor longus in the zero- and full-abduction positions were measured. To investigate the effects of aging and frailty, the Kruskal-Wallis test, followed by the post-hoc Steel-Dwass test, was used. In addition, to confirm whether EI and SR in each position were useful for assessing contracture, Spearman's correlation test was used. RESULTS: ROM and SR in full-abduction were significantly lower in the frail group than in the other groups and lower in the non-frail group than in the young group. The SR in full-abduction (ρ = 0.73, < .001) and in zero-abduction (ρ = 0.41, < .001) showed strong and moderate correlation with the ROM, respectively. CONCLUSIONS: SR in full-abduction is affected by both frailty and aging and is useful for evaluating muscle stiffness related to contracture in frail older adults.
"There's Huge Value in Knowing What's Going On": a Mixed Methods Study to Explore Geriatricians' Perspectives on Best Practices for Information Transfer Between Hospital-Based Geriatricians and Primary Care Physicians.
Couture S, Yang D, Lessard S … +4 more , Zaripova A, Tchervenkov J, Pavoni C, Godard-Sebillotte C
Can Geriatr J · 2025 Sep · PMID 40881142 · Full text
BACKGROUND: Geriatricians' work provides holistic recommendations to improve the health of older adults, considering medical, social, psychological, and functional domains. Their implementation most often relies on prima...
BACKGROUND: Geriatricians' work provides holistic recommendations to improve the health of older adults, considering medical, social, psychological, and functional domains. Their implementation most often relies on primary care physicians. Extant evidence suggests benefit from systematized information transfer between hospital-based specialists and primary care physicians. Yet, direct communication between hospitals and primary care physicians is rare. We aimed to describe the information transfer practice of hospital-based geriatricians in Quebec, Canada. METHODS: We sent a survey to all (146) geriatricians and Geriatric Medicine residents of Quebec on their current practice and opinions on information transfer and obtained 64 responses. We then performed 20-minute semi-structured interviews with 13 participants to further explore knowledge on information transfer, barriers and facilitators, risks and benefits, and recommendations to improve transmission. RESULTS: While geriatricians believe that their recommendations should be transmitted to primary care physicians and that the absence of a systematic information transfer procedure has a negative impact on quality of care, only 1.6% report having such a procedure in place in their practice. They think that the absence of information transfer procedures disrupts the communications of key diagnoses and medication changes, and leads to duplicated interventions. Harnessing technology to facilitate information transfer is viewed as a solution. CONCLUSION: Information transfer between hospital-based geriatricians and primary care physicians in Quebec is rare. The absence of a systematic information transfer procedure is seen by geriatricians as a hindrance to the provision of safe, high-quality care to older adults.
Application of Lean Principles to the Comprehensive Geriatric Assessment to Reduce Cycle Time.
Park J, Lipinski E, Fisher P … +1 more , Sidhu A
Can Geriatr J · 2025 Sep · PMID 40881149 · Full text
BACKGROUND: Prolonged cycle times for new geriatric medicine assessments at the Centre for Healthy Aging have reduced the capacity to see patients. Using a time series design, the aim of the project was to decrease the a...
BACKGROUND: Prolonged cycle times for new geriatric medicine assessments at the Centre for Healthy Aging have reduced the capacity to see patients. Using a time series design, the aim of the project was to decrease the average cycle time for new patients during one geriatrician's clinic from 114 to 90 minutes by May 1, 2024. METHODS: Lean methodology was used for diagnostics by creating a value stream map of the workflow. This informed change ideas to improve efficiency by implementing a shared note within the electronic health record for information sharing and an assessment guide for targeted cognitive testing. The primary outcome measure was total cycle time. Balancing measures were patient clinic experience scores and counseling time. Process measures included caregiver interview time, pre-clinic intake completion rate, assessment guide use rate, and nursing assessment time. RESULTS: Total cycle time decreased 19% from 114 minutes (19 patients) to 93 minutes (33 patients). Pre-clinic intake assessment completion rate increased from 60 to 80% and caregiver interview time decreased from 45 to 33 minutes. There was 100% uptake of the assessment guide, and nursing assessment time decreased from 43 to 31 minutes. Counseling time remained stable, and the average clinic experience scores did not decline from the baseline. CONCLUSIONS: This is the first study examining potential methods to improve efficiency of the comprehensive geriatric assessment by using value stream mapping. Spread of change ideas across the centre will be examined next with the goal of increasing capacity using available resources.
Depiction of a Novel Patient Navigator Program to Support Delayed Discharges Among Older Adults Admitted to Acute Care.
Liu G, Knoepfli A, DasGupta T … +5 more , Ziegler N, Elliot E, English M, Hitzig SL, Guilcher SJT
Can Geriatr J · 2025 Sep · PMID 40881147 · Full text
BACKGROUND: A novel Patient Navigator Program (PNP) was introduced at a Canadian hospital's Reactivation Care Centre (RCC) to support transitions by helping older adults navigate the complexities of delayed discharge sta...
BACKGROUND: A novel Patient Navigator Program (PNP) was introduced at a Canadian hospital's Reactivation Care Centre (RCC) to support transitions by helping older adults navigate the complexities of delayed discharge stays by improving their transition from hospital to home. The PNP was comprised of a community agency patient navigator who was embedded into the RCC setting to support transitions in care, and who followed patients up to 90 days post-hospital discharge. The purpose of this study was to describe the PNP, which included detailing the needs of patients (i.e., socio-demographics, case-mix, delayed discharge), the scope of service provision (i.e., referral process, follow-up duration), and patient outcomes (i.e., post-discharge location). METHODS: A cohort observational design was used to collect data on the PNP mainly via the patient navigator's clinical tracking sheet, and secondly via the hospital's administrative system. Data analysis included the use of frequencies and descriptive statistics. RESULTS: Between November 2021 and October 2022, 100 patients were referred to the PNP, with 70 patients (39% male; 61% female; median age of 81 years) being admitted to the patient navigator's caseload. The patient navigator provided follow-up care for a median of 58 days, and supported 76% of the patients (n=53) to return to their next point of care (e.g., homes or to a supportive housing setting). CONCLUSION: The PNP led to a high proportion of patients being discharged back to the community. This study provides insights to providers and decision-makers interested in implementing PNP care models in a hospital in partnership with a community agency.
Qualitative Interview with Older Adults and Caregivers on their Perspectives with Self-Management and Remote Vital Sign Monitoring.
Chan CSY, Park S, Yakubu T … +2 more , Jafari N, Ho K
Can Geriatr J · 2025 Sep · PMID 40881146 · Full text
BACKGROUND: Research underscores the role of self-management capabilities as a strategy for enhancing the well-being of older adults by mitigating potential health risks and functional decline. Self-management tools like...
BACKGROUND: Research underscores the role of self-management capabilities as a strategy for enhancing the well-being of older adults by mitigating potential health risks and functional decline. Self-management tools like remote vital sign monitoring serve as critical indicators for detecting adverse health outcomes. Thus, the study aims to understand prior experiences of older adults and caregivers in self-management, along with soliciting their perspective on the technical advantages and barriers of using technology in medicine, citing their experience with remote vital sign monitoring as an example. METHODS: Through semi-structured qualitative interviews, 32 participants were interviewed virtually about their personal experience with prior remote vital sign monitoring. Eligibility included older adults and/or caregivers of older adults. Participants who were unable to read or understand English were excluded, unless sufficient support was provided to navigate the study procedures. RESULTS: The full interview transcriptions were captured under the following five major themes: health-care experience, personal perception of technology in medicine, impact of remote vital sign monitoring, contactless monitoring system considerations, and acceptance and collaboration in remote vital sign measurement. CONCLUSION: Based on participants' prior experience using remote vital sign monitoring, compatibility, data security and privacy, and patient education were identified as important considerations when developing monitoring systems for older adults and caregivers.
A Description of QT-Interval Prolonging Drug Interactions with Fluoroquinolones in Older Women with Uncomplicated Urinary Tract Infections.
Trenaman SC, von Maltzahn M, Stewart SA … +3 more , Tamim H, Sketris I, Black E
Can Geriatr J · 2025 Sep · PMID 40881144 · Full text
BACKGROUND: Fluoroquinolone (FQ) antibiotics are associated with QT-interval prolongation and Torsades de Pointes (TdP). Female sex, older age, and other QT-interval prolonging medications further increase risk for TdP....
BACKGROUND: Fluoroquinolone (FQ) antibiotics are associated with QT-interval prolongation and Torsades de Pointes (TdP). Female sex, older age, and other QT-interval prolonging medications further increase risk for TdP. Our aim was to describe QT-interval prolonging drug interactions when FQs were dispensed to women who resided in long-term care (LTC) for uncomplicated urinary tract infections (UTIs). METHODS: This retrospective cohort study used administrative health data from the Nova Scotia Seniors' Pharmacare program from January 2005 through March 2020. The cohort included women residing in LTC dispensed a FQ antibiotic within five days of a diagnostic code for an uncomplicated UTI in physician billing data. Additional drug dispensations were collected 30 and 90 days after the FQ to identify drug interactions that resulted in potentially increased QT-interval prolongation risk. Drug interactions were described. A Mann-Kendall trend test assessed the change in the frequency of FQ-drug interactions over the study period. RESULTS: Annual dispensation of FQs ranged from 12-28% of antibiotic dispensations for presumed uncomplicated UTI. The proportion of FQ dispensations associated with a QT-interval prolonging drug interaction increased over time (=.00007). Within 30 days of the FQ dispensation, the most common drug interactions identified were: furosemide (n=702, 20.3% of FQ-drug interactions), citalopram (n=566, 16.4% of FQ-drug interactions), and trazodone (n=461, 13.3% of FQ-drug interactions). CONCLUSIONS: An increasing proportion of women dispensed a FQ for uncomplicated UTI experienced a potential QT-interval prolonging drug interaction over the study period. When prescribing FQs to older women, addressing potentially modifiable risk factors for TdP, and monitoring closely, is warranted.
Electronic Documentation of Goals of Care Designation Discussions Among Alberta-based Geriatric Patients.
Aronyk SE, Higgins K, Charles L … +1 more , Tian PGJ
Can Geriatr J · 2025 Sep · PMID 40881143 · Full text
BACKGROUND: Goals of Care Designations are important medical orders that are used to determine the appropriate level of medical intervention for individuals in the event of life limiting illness. Canada has an aging popu...
BACKGROUND: Goals of Care Designations are important medical orders that are used to determine the appropriate level of medical intervention for individuals in the event of life limiting illness. Canada has an aging population and individuals are living with higher levels of chronic illness and comorbidity. As patient autonomy increases, it has become increasingly important to have accurate and up-to-date documentation of a patient's medical wishes for life sustaining care. METHODS: This was a retrospective chart review of 400 randomly selected patients 65 years of age and over, seen at the University of Alberta Hospital outpatient clinic for Comprehensive Geriatric Assessment from July 1, 2022 to June 30, 2023. We extracted the frequency of Goals of Care Designation (GCD) documentation determined by historical data available within selected patient charts, the setting of each discussion, and the specialty of each provider completing Goals of Care documentation. RESULTS: Only 49.3% (197/400) of patients had any documented GCD entered on their electronic medical record (EMR). Of the 356 completed GCD forms, 267 (75%) were completed in an inpatient setting; the majority of GCD forms were completed by a specialist in Internal Medicine (39.89%, n=142) or Family Medicine (37.64%, n=134). CONCLUSIONS: Our study revealed that less than half of patients had any GCD documentation in the provincial EMR. As accurate Goals of Care documentation is vital to patient care and autonomy, every opportunity should be taken by health-care professionals to complete this essential documentation.
Care Partner Perspectives on Driving Cessation in Dementia in the Province of Saskatchewan, Canada.
Sommer D, Stasiulis E, Rapoport MJ … +2 more , Kelm P, Naglie G
Can Geriatr J · 2025 Sep · PMID 40881141 · Full text
Driving cessation is an expected eventuality in dementia care that has significant consequences for people with dementia (PWD) and care partners (CPs) alike. In collaboration with the Alzheimer Society of Saskatchewan, w...
Driving cessation is an expected eventuality in dementia care that has significant consequences for people with dementia (PWD) and care partners (CPs) alike. In collaboration with the Alzheimer Society of Saskatchewan, we explored CPs' experiences of the driving cessation process. Using an online survey including closed- and open-ended questions, we collected data from 44 CPs of current drivers and from 207 CPs of former drivers. Our quantitative and qualitative analyses identified three key findings. First, although CPs want and expect regulatory bodies and medical practitioners to be involved in the driving cessation process, their involvement is often less than anticipated. Second, driving cessation poses unique challenges to CPs in rural areas given the centrality of driving in smaller communities and limited transportation options to access services. Finally, CPs of former drivers found several positive benefits from the driving cessation process that were unanticipated. In conclusion, these three areas represent opportunities for education, support, and resources for PWD, CPs, and professionals through the driving cessation process.
Last Veterans-a Short History.
Frank C
Can Geriatr J · 2025 Jun · PMID 40873972 · Full text
Abstract loading — click title to view on PubMed.
Biological Sex and the Association Between Grip Strength and Cardiovascular Disease: a Scoping Review.
Mendo CW, Ciarciello A, Vary-O'Neal A … +3 more , Clairoux N, Sylvestre MP, Keezer MR
Can Geriatr J · 2025 Jun · PMID 40463645 · Full text
BACKGROUND: This scoping review examines how biological sex has been considered in studies investigating the association between grip strength and cardiovascular outcomes and risk factors. METHODS: We used the Askey and...
BACKGROUND: This scoping review examines how biological sex has been considered in studies investigating the association between grip strength and cardiovascular outcomes and risk factors. METHODS: We used the Askey and O'Malley framework, reported as per the PRISMA extension for scoping reviews. A search was conducted in four electronic bibliographic databases to identify relevant peer-reviewed studies published after 2001. RESULTS: Of the 39 included studies, 82.0% (n = 32) used biological sex as a confounder variable in the association of interest. Two studies used interaction terms between biological sex and grip strength and found no statistically significant interactions. Five studies used sex-stratified analyses alone. Three of these studies found that the cardiovascular risk due to low grip strength is higher in males than in females. Two other studies used both interaction terms between biological sex and grip strength and sex-stratification analyses and found no statistically significant differences. Sociocultural gender was not considered in any of the identified studies. CONCLUSION: We found that biological sex was often considered as a confounder variable in the association between grip strength and cardiovascular outcomes, as well as cardiovascular risk factors. On the other hand, two studies reported the presence of effect modification by sex rather than confounding, that these associations were stronger in males versus females. Five other studies did not identify evidence of interaction nor effect modification. Future research is needed to clarify the nature of these associations and understand any potential biological mechanisms.
Validity and Utility of the CanMEDS "Resident as Teacher Multisource Feedback" Assessment Tool for Resident-led Structured Teaching.
Lee JCL, Huang YQ, Wong CL
Can Geriatr J · 2025 Jun · PMID 40463644 · Full text
We evaluated the validity of using the CanMEDS Resident as Teacher Multisource Feedback (RaTMSF) assessment tool to gather learner feedback from structured resident-led teaching within the University of Toronto's postgra...
We evaluated the validity of using the CanMEDS Resident as Teacher Multisource Feedback (RaTMSF) assessment tool to gather learner feedback from structured resident-led teaching within the University of Toronto's postgraduate geriatric medicine residency program. The RaTMSF consists of 10 rated items and narrative comments. Completed RaTMSF evaluations from resident teachers were analyzed by descriptive statistics for internal consistency and inter-rater reliability, and narrative comments were reviewed for thematic content. Resident teachers were surveyed on the acceptability of the tool to develop teaching competencies. A total of 132 evaluations were collected prospectively from 11 residents from April 2021 to April 2022, and retrospectively from seven graduates from 2016 to 2019. The overall performance rating, 4.75 (SD 0.47), was very positive for all resident teachers. The RaTMSF demonstrated high internal consistency with Cronbach's alpha of 0.97, 95% CI 0.89-0.99 between all 10 items, and good inter-rater reliability with Fleiss kappa of 0.73 (95% CI 0.13-0.80). The most common themes of narrative comments also captured in the rated items were organization to teach (n=53) and openness to questions (n=36). Written comments regarding delivery style (n=52) and audience interactivity (n=44) were not captured on the rated items. While most resident teachers surveyed found the RaTMSF acceptable to use, we suggest opportunities to improve the RaTMSF by restructuring focus onto written feedback and revising rated items to better reflect themes found in narrative comments. The RaTMSF can be a valuable feedback tool to help residents gather high-quality feedback on their teaching skills.
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