2019 Research Spotlight Series Archives - 91��ɫU Centre for Aging Research & Education (YU-CARE)

2020 Research Spotlight: Dr. Jaclyn Hurley new research study examined whether aspects of diet and nutrition risk explain variance in physical capacity and general health, after controlling for covariates, in Canadian adults with osteoarthritis (OA).

Tue, 09 Jun 2020 18:49:50 +0000

Dr. Jaclyn Hurley recently co-authored a study entitled “ Diet and Nutrition Risk Affect Mobility and General Health in Osteoarthritis: Data from the Canadian Longitudinal Study on Aging, and published in the Journals of Gerontology: Series A. It shows how aspects of diet and nutrition risk are associated with physical capacity and general health in Canadian adults with hand, hip and/or knee osteoarthritis (OA). Using baseline data from the Canadian Longitudinal Study on Aging (CLSA), this research demonstrates that nutrition risk was associated with mobility and general health, with higher nutrition risk related to poorer mobility and general health. Further, greater fiber intake was associated with better mobility. This suggests that it may be important to develop nutritional interventions for osteoarthritis (OA) to lessen impairments to health and mobility.

Dr. Hurley is a member of YU-CARE and an Assistant Professor in the School of Kinesiology and Health Science at 91��ɫ. Her area of expertise is musculoskeletal biomechanics. Her research interests include investigating mechanisms of musculoskeletal injury and developing effective exercise rehabilitation strategies for chronic musculoskeletal conditions that commonly accompany age, including osteoarthritis and rotator cuff pathologies.

Jaclyn N Chopp-Hurley, Emily G Wiebenga, Heather H Keller, Monica R Maly, Diet and Nutrition Risk Affect Mobility and General Health in Osteoarthritis: Data from the Canadian Longitudinal Study on Aging, The Journals of Gerontology: Series A, glz277,

Abstract

Background

This study examined whether aspects of diet and nutrition risk explain variance in physical capacity and general health, after controlling for covariates, in Canadian adults with osteoarthritis (OA).
Methods
This was a cross-sectional study of baseline data from the Canadian Longitudinal Study on Aging (CLSA). Data from 1,404 participants with hand, hip, and/or knee osteoarthritis (OA) were included. A series of regression analyses were conducted with independent variables of food intake (fiber and high calorie snack intake) and nutrition risk; and dependent variables of physical capacity and general health. Physical capacity was characterized through grip strength and a pooled index of four mobility tests. General health was characterized through an index of self-reported general health, mental health, and healthy aging.

Results

Higher fiber intake was related to greater mobility (p = .01). Food intake was not related to any other outcome. Nutrition risk was significantly associated with mobility (p < .001) and general health (p < .001); those with a high nutrition risk classification had poorer general health (p < .001, d = 0.65) than those at low nutrition risk. As well, those with moderate nutrition risk had poorer general health than those with low nutrition risk (p = .001, d = 0.31).

Conclusions

Nutrition risk screening for older adults with osteoarthritis (OA) provides insight into behavioral characteristics associated with reduced mobility and poorer general health. Also, those consuming greater amounts of fiber demonstrated better mobility. Thus, this research suggests that quality of diet and nutritional behaviors can impact both physical and mental aspects of health in those with osteoarthritis (OA).
To contact Dr. Hurley, please email her at: jnhurley@yorku.ca

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Health ministry slows down routine care home inspections during pandemic

Fri, 17 Apr 2020 14:56:14 +0000

Arthur White-Crummey&�Բ��;&�Բ��;•&�Բ��;&�Բ��;Regina Leader-Post

There are also 250 privately operated personal care homes with 4,600 beds in Saskatchewan. PATRICK LANDMANN / Getty Images

Saskatchewan’s health ministry has pulled back on routine inspections of private personal care homes as it looks at “virtual options,” partly due to concerns that inspectors could spread COVID-19 to vulnerable residents.But experts wonder whether a trust-based approach will be enough to protect Saskatchewan from the kind of devastating outbreaks killing Canadian seniors in other provinces.

The news comes just as Quebec steps up its own inspections amid a tragedy at a private care home west of Montreal, where 31 people died. Nearly half of Canada’s deaths from COVID-19 have occurred at seniors homes, though Saskatchewan has so far been spared a similar outbreak.

Starting this week, the Saskatchewan Health Authority (SHA) implemented new masking rules for its own facilities, . But there are also 250 privately operated personal care homes with 4,600 beds in Saskatchewan. They provide varying levels of care and are regulated under a licensing regime with routine annual inspections.

The Ministry of Health conducted six non-complaint-based inspections at those facilities over the entire month of March, when the threat of COVID-19 became palpable in the province.Brad Havervold, executive director of the ministry’s community care branch, said the low number stems in part from infection control measures.“When COVID came on stream, we’re very mindful that, when we’re putting in visitor restrictions, our staff going in there would be a visitor to that home,” said Havervold. “So we want to make sure that we’re doing that safely.”The branch is considering using video technology for inspections as a result.

“Things were evolving so quickly that we wanted to make sure that we weren’t introducing an additional risk,” said Havervold. “But it also allows us some time in that period to look at virtual options.”Havervold saidinspectors still visit facilities based on complaints to respond to pressing concerns. He was not able to say how many times that has happened over recent months, and the ministry could not provide a number within 25 hours of a request from the Leader-Post.Experts in seniors care and public health had trouble understanding the ministry’s reasons for holding back on routine inspections. Dr. Anne Huang, , said inspectors could be fitted with surgical face masks and subjected to temperature checks.

“I don’t think that’s a good reason for not having the inspectors enter these facilities,” she said.If anything, she suggested, the number of inspections should be increased.Tamara Daly, director of the Centre for Aging Research and Education at 91��ɫ in Toronto, does not believe virtual inspections would be sufficient for facilities that provide significant care to seniors.“It’s more than just looking at books,” she said. “It’s observation and conversation that is required in order to properly inspect.They need to be inspected.”There are currently four full-time and two part time inspectors on hand to do routine inspections. Daly said that does not seem like a “robust workforce,” given the number of homes in the system.

She acknowledged that there is a “balance of risk,” but argued that oversight is indispensable to ensure care homes are following the rules.The ministry has issued directives forcing personal care homes to ban visitors, screen staff, ensure two metres of social distancing and limit gatherings to 10. There are also longstanding regulations related to infection control, including around staff training and sanitation of surfaces.“If a home is not compliant with these things, it could actually, in fact, make infection more likely,” said Daly.Havervold argued that personal care home operators are “very honourable people” whose number-once concern is protecting residents. He said the ministry’s priority has been making sure they have accurate information to do precisely that.

“We’ve really ramped up our support for personal care homes,” he said. “So we’ve implemented a toll free line where personal care home operators and staff can phone in, 24 hours a day, and get a recorded message that provides the latest updates on information applicable to personal care homes.”That includes information on enhanced cleaning procedures, proper use of personal protective equipment and the clinical signs of COVID-19, according to the ministry.Care home operators appreciate that support. Colleen Nixon, manager of Gladstone Seniors Residence in 91��ɫton, said the ministry has been “really on top of it.”

She said Gladstone complied with directions, including by shutting the home down to visitors. It’s also done more. The home already had a pandemic plan in place and a stockpile of masks. Workers are wearing masks and gloves whenever they enter resident rooms, she said, and they are restricted from working at any other facilities.That goes beyond what the ministry is requiring. Continuous masking is still only under consideration for personal care homes.Huang said there is no good reason for a different approach depending on whether a home is run by the SHA or a private company. She said both should be subject to similar standards.

“I think that’s only fair to the residents or their families,” she said.Daly said there is no reason to wait to limit workers to just a single home, as British Columbia has already done for both private and public facilities.“I think that that should have been something that happened almost immediately, as soon as governments understood that COVID was a risk,” she said.“We know from SARS that health care workers can bring this from facility to facility. We already learned that lesson. We don’t want to learn that lesson again the hard way.”Huang was also concerned to hear that the ministry is not requiring personal care homes to submit specific plans for COVID-19 prevention. As part of their regular licensing renewals, homes are required to submit a plan about how they would control an influenza outbreak.

“We’ve not specifically gone out to the 250 homes and said, ‘What are you doing today?’ ” Havervold explained. “They are required to do that as part of their standard business.”Again, he said, the focus is on getting out the information.But Huang said that leaves the ministry with little information about whether the homes are really prepared. She called it “a huge gap.”“That means that we have no way of knowing if these necessary measures have been implemented, and that’s going to become a significant risk should a case develop there,” she said.“I don’t think it’s acceptable for the relevant government branch to just say … we expect them to do what they need to do, because it’s an unprecedented risk to the health of the residents.”awhite-crummey@postmedia.com

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Moving Forward: Health and Function in Later Life - Event Re-cap

Wed, 04 Dec 2019 14:00:43 +0000

Dr. Joe Baker (left) and Dr. Jaclyn Hurley (right) standing before the presentations.

Thank you to everyone who made it out on cold and rainy Monday evening to the beautiful and spacious Vaughan Civic Centre Resource Library!

The event featured fascinating presentations about muscle functioning and lifelong health by Professor Joe Baker and Assistant Professor Jaclyn Hurley from the School of Kinesiology and Health Science.

Learn more about our speakers:

Professor Baker’s research focuses on the varying influences on optimal human development and the barriers and facilitators of successful aging. Professor Baker delivered a thought-provoking presentation about how studies of older athletes help us to understand health and function in later life. To read more about his work, follow this link to his .

Professor Hurley studies strategies for chronic musculoskeletal conditions that commonly accompany age, such as osteoarthritis and rotator cuff pathologies. She presented some of her very interesting work about using research to guide the design of exercise for older adults with chronic joint pain. For more information on her studies, please check out her most recent publications on the .

Thank you to our wonderful speakers, and many more thanks to our audience for coming out! We look forward to seeing you all in the new year for our next events.

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2019 Research Spotlight: David A. Hood in the news discussing exercise and healthy aging

Sun, 25 Aug 2019 18:40:57 +0000

Dr. David Hood, Director of the Muscle Health Research Centre

In recent months, YU-CARE member David A. Hood and colleagues have presented upon the relationship between exercise and the aging process. The research produced by Dr. Hood and his colleagues at the 91��ɫ Muscle Health Research Centre is impactful along the themes of the physiology of aging and healthy aging promotion.

This spring, Dr. Hood was featured in a on the topic of relationship between exercise and illness. In this interview, Dr. Hood discusses the connection between muscle health and illness, in addition to the importance of exercise as one ages to maintain health and strength.

Along a similar topic published this year and written by David A. Hood, Jonathan M. Memme, Ashley N. Oliveira, and Matthew Triolo, exercise is explored as a therapy to reverse and enhance the impaired mitochondrial function associated with aging and chronic muscle disuse. Read the abstract of the article, titled “Maintenance of Skeletal Muscle Mitochondria in Health, Exercise, and Aging” below. You can also visit the .

Abstract

Mitochondria are critical organelles responsible for regulating the metabolic status of skeletal muscle. These organelles exhibit remarkable plasticity by adapting their volume, structure, and function in response to chronic exercise, disuse, aging, and disease. A single bout of exercise initiates signaling to provoke increases in mitochondrial biogenesis, balanced by the onset of organelle turnover carried out by the mitophagy pathway. This accelerated turnover ensures the presence of a high functioning network of mitochondria designed for optimal ATP supply, with the consequence of favoring lipid metabolism, maintaining muscle mass, and reducing apoptotic susceptibility over the longer term. Conversely, aging and disuse are associated with reductions in muscle mass that are in part attributable to dysregulation of the mitochondrial network and impaired mitochondrial function. Therefore, exercise represents a viable, nonpharmaceutical therapy with the potential to reverse and enhance the impaired mitochondrial function observed with aging and chronic muscle disuse. ()

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2019 Research Spotlight: Dr. Gary Turner presents cognitive aging in a new light

Fri, 16 Aug 2019 14:00:49 +0000

Research Summary

Dr. Gary Turner

In recent months, YU-CARE Steering Committee member from the Department of Psychology has significantly contributed to the study of the cognitive neuroscience of aging.

Dr. Turner's research uses MRI techniques to investigate how brain functioning is related to cognitive changes that occur in older adulthood. His recent studies expand beyond the commonly held assumption that cognitive aging is short-hand for cognitive decline. His research has shown that cognitive aging is also associated with cognitive gains in areas such as creative thinking as well as wisdom in solving real world problems. Dr. Turner and his students are also working to develop cognitive training programs to improve concentration and focus in later life.

Read the abstracts for Dr. Turners’ recent research on cognitive aging and neuroscience below and follow the journal links for the full articles.

Abstracts and Links

Turner, G.R., Novakovic-Agopian, T., Kornblith, E., Adnan, A., Madore, M., Chen, A.J.W., & D’Esposito, M. (2019). Goal-Oriented Attention Self-Regulation (GOALS) training in older adults.

Abstract: Objectives: A common cognitive complaint of older adulthood is distractibility, or decline in ability to concentrate and maintain focus, yet few evidence-based interventions exist to address these deficits. We implemented s pilot trial of an evidence-based executive function training program, to investigate whether training in applied goal-directed attention regulation and problem solving would enhance executive control abilities in a sample of cognitively normal older adults with self-reported complaints of concentration problems.

Method: Consecutively recruited participants were placed into small groups and randomized to either Goal-Oriented Attentional Self-Regulation training (GOALS; N = 15) or a closely matched Brain Health Education program (BHE; N = 15).

Results: GOALS participants significantly improved on: neurocognitive measures of mental flexibility (p = 0.03, partial eta squared = 0.23); real-world setting functional performance measures of: task failures (p = 0.02, Cohen’s d = 0.88), task rule breaks (p = 0.02, Cohen’s d = 1.06), and execution (p = 0.04, Cohen’s d = 0.76); and in-lab functional assessment of goal-directed behaviour divergent thinking scale (p = 0.03, Cohen’s d = 0.95). All participants improved on a neurocognitive measure of planning (p = 0.01, partial eta squared = 0.031). BHE participants’ improvement over and above GOALS participants was limited to: rule adherence on the real world task (p = 0.04, Cohen’s d = 0.99), and evaluator rating (p = 0.03, Cohen’s d = 0.56), and average score (p = 0.02, Cohen’s d = 0.71) on the in-lab functional task.

Conclusion: Participation in GOALS training can enhance executive control, and lead to real-world functional improvements, for cognitively normal older adults with self-reported attention difficulties.

Spreng, R.N. & Turner, G.R. (2019). The shifting architecture of cognition and brain function in older adulthood.

Abstract: Cognitive aging is often described in the context of loss or decline. Emerging research suggests that the story is more complex, with older adults showing both losses and gains in cognitive ability. With increasing age, declines in controlled, or fluid, cognition occur in the context of gains in crystallized knowledge of oneself and the world. This inversion in cognitive capacities, from greater reliance on fluid abilities in young adulthood to increasingly crystallized or semanticized cognition in older adulthood, has profound implications for cognitive and real-world functioning in later life. The shift in cognitive architecture parallels changes in the functional network architecture of the brain. Observations of greater functional connectivity between lateral prefrontal brain regions, implicated in cognitive control, and the default network, implicated in memory and semantic processing, led us to propose the default-executive coupling hypothesis of aging. In this review we provide evidence that these changes in the functional architecture of the brain serve as a neural mechanism underlying the shifting cognitive architecture from younger to older adulthood. We incorporate findings spanning cognitive aging and cognitive neuroscience to present an integrative model of cognitive and brain aging, describing its antecedents, determinants, and implications for real-world functioning.

Adnan, A., Beaty, R., Siliva, P., Spreng, R.N., & Turner, G.R. (2019). Creative aging: functional brain networks associated with divergent thinking in older and younger adults.

Abstract: Creative thinking is associated with connectivity between the default and executive control networks in the young brain. In aging, this pattern of functional coupling has been observed across multiple tasks. We have described this as the Default-Executive Coupling Hypothesis of Aging and suggest that this connectivity pattern may also be associated with creativity in older adulthood. However, age differences in brain networks implicated in creativity have yet to be investigated. The overarching goal of the present study was to examine age-related changes to functional brain networks associated with creativity. Specifically, we explored functional connectivity patterns among default and executive control brain regions associated with creative thoughts in older and younger adults. In a cross-sectional design, young (mean age = 21 y; n = 30) and older (mean age = 70 y; n = 25) participants completed a divergent thinking task during fMRI, which was examined using region of interest functional connectivity analyses. Consistent with predictions, analyses demonstrated that default and executive networks are more functionally coupled during creative thinking for older than younger adults. Critically, despite similar performance on an in-scanner creativity task, increased network efficiency was associated with creative ability for older adults only. These findings provide novel evidence of default-executive coupling as a putative mechanism associated with creative ability in later life.

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2019 Research Spotlight: Brad A. Meisner stimulates a dialogue about leisure and community activities and healthy aging

Tue, 06 Aug 2019 14:52:26 +0000

Research Summary

Dr. Brad A. Meisner

This year, YU-CARE Steering Committee member from the School of Kinesiology and Health Science has significantly contributed to studying the important relationships between leisure and community activities and healthy aging.

Meisner's studies, linked below, argue that the meaningful inclusion and involvement of older adults in leisure and community activities are undervalued and underused strategies to promote healthy aging, particularly in late life. His research identifies both motivators and constraints that inspire and inhibit older adult activity participation. It is important to recognize that many of these motivators and constraints are in fact beyond the control of older individuals; yet, these factors support or suppress health-related outcomes over time.

Critically, the investigation of this theme by Meisner and colleagues stimulates dialogue about age discrimination (ageism) experienced by older adults during leisure and community activities as a significant barrier, which, in turn, negatively affects healthy aging.

Read the abstracts of Meisner’s published research below or follow the journal links to access the complete articles.

Abstracts

Taking ‘Steps to Connect’ to later life: Exploring leisure program participation among older adults in rural communities (Meisner, B.A., Hutchinson, S.L., Gallant, K.A., Lauckner, H., & Stilwell, C.L., 2019), .

Abstract: “Steps to Connect is a leisure education program that facilitates participation in leisure activities to enable individuals to connect to themselves, to others around them, and to their communities. The authors’ previous program development efforts were focused on individuals with chronic conditions in rural settings, and now there is interest in adapting it for older adults. As such, the authors explored the perceptions and constraints associated with tailoring leisure activities and programs to older adults living in rural Nova Scotia, Canada. They conducted five focus groups in four rural communities, including 33 participants aged 60+ years. Thematic analysis of focus group transcripts revealed participants’ awareness of how leisure programs promote physical and mental health, social participation, as well as meaningful personal and community experiences. Participants also identified several leisure constraint themes that warrant consideration when implementing leisure programs to promote active aging among older adults living in rural communities, such as Steps to Connect.”

Perceptions of aging and experiences of ageism as constraining factors of moderate to vigorous leisure-time physical activity in later life (Massie, A.S., & Meisner, B.A., 2019), .

Abstract: “Later-life leisure-time physical activity (LTPA) is an identified way to promote active aging. Nevertheless, many active older adults experience LTPA constraints and thus may not experience the full comprehensive health benefits that result from participation. This study explored two potential LTPA constraints pertaining specifically to ‘age’: beliefs that older adults have about aging (perceptions of aging) and experiences of being treated differently because of age (ageism). One-on-one semi-structured interviews were conducted with 15 older adults (60–74 years) who engaged in an average of ≥150 minutes of moderate to vigorous LTPA per week. Data underwent thematic analysis that resulted in three themes pertaining to LTPA: (a) ‘age has nothing to do with it,’ (b) ‘but they do treat us different here,’ and (c) ‘why don’t we have an exercise class?’ Findings provide new perspectives on how aging perceptions and ageism – in both negative and positive forms – can affect LTPA engagement in later life.”

What is and isn’t working: Factors involved in sustaining community-based health and participation initiatives for people ageing with intellectual and developmental disabilities (Spassiani, N.A., Meisner, B.A., Abou Chacra, M.S., Heller, T., & Hammel, J., 2019), .

Abstract: “As people with intellectual and developmental disabilities (I/DD) age, it is important that I/DD agencies are prepared to support healthy ageing in homes and in communities. This study explored supports and barriers to sustaining community‐based health and participation initiatives (CBHPI) for people ageing with I/DD living in group homes managed by agencies. The study utilized interviews and photovoice with 70 participants—35 individuals with I/DD and 35 management/direct support agency staff. Data were analysed through content analysis and triangulation of data where five themes emerged: Agency values and policies related to healthy ageing; resources and staff competencies; communication between management and staff; community/university partnerships; and peer relations. Findings show that I/DD agencies and people with I/DD value CBHPI, but they find them difficult to sustain due to limited resources and lack of training specific to ageing with I/DD. Conducting system‐level research within I/DD agencies to include first‐person accounts of people with I/DD, staff and management provides insight on how to effectively support the needs of people with I/DD to improve their health and community participation as they age.”

Mindful aging: The association between trait mindfulness and expectations regarding aging among middle-aged and older adults (Fiocco, A.J. & Meisner, B.A., 2019), .

Abstract: “Objectives: Positive Expectations Regarding Aging serve as a protective factor of healthy aging; however, negative stereotypes regarding aging continue to dominate popular aging discourse. It is proposed that trait mindfulness (TM) is associated with aging expectations through the cultivation of openness, curiosity, and non-judgment to one’s thoughts, emotions, and sensations, whether they are positive or negative.

Methods: Associations between the Five Facet Mindfulness Questionnaire and the Expectations Regarding Aging Survey (ERA-38) were examined among 201 participants aged 55+ years.

Results: Analyses revealed that higher levels of TM was significantly associated with positive aging expectations, controlling for retirement and socioeconomic status (Rchange2= 14.0%, F(5,192) = 7.17, p < .001).

Conclusion: The development of TM, notably the facet of non-judgment, may be used to promote positive aging expectations to help support healthy aging.”

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2019 Research Spotlight: Dr. Mary Fox awarded CIHR grants for aging and health services studies

Mon, 22 Jul 2019 13:00:42 +0000

Exciting and important new research is coming!

This spring, YU-CARE Steering Committee member Dr. Mary Fox was awarded funding from two Canadian Institutes of Health Research grants to evaluate and improve health care services in Canadian rural communities.

In March, Dr. Fox was awarded funding for a three-year project aimed to improve hospital-to-home transitional care for persons with dementia in rural Ontario and Nova Scotia. In a field where there is minimal research focusing on functioning and transitional care, this project will impact strategies to enhance the delivery of care and help recover independent functioning of older people with dementia returning home from a hospital stay.

Dr. Mary Fox

In a wholesome approach, the study will involve older people with dementia, their families, and health care providers in an evaluation of the ability of practical care strategies to meet their needs. Conclusions will be used to modify and integrate more effective care strategies in transitional care in rural communities. Read the for further details.

In May, Dr. Fox was also awarded a one-year . Her research will investigate how best to support health-care providers in implementing the service Warning Signs Intervention in rural Ontario communities.

The Warning Signs Intervention is a health service designed to support patients in detecting and responding to the warning signs of deteriorating health. This program has been successful in building knowledge and confidence amongst patients who manage their health at home, however implementation of the service in rural communities, where patients and families often live far from healthcare services, has yet to be supported.

The study, undertaken in collaboration with key stakeholders in rural Ontario and national researchers, will involve a survey and focus groups wherein health-care providers can discuss measures to successfully implement the service. The team will then systematically design an implementation plan to introduce the intervention to rural Ontario communities, creating room for the measurement of the implementation plan’s effectiveness in the future. Read the for more information.

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2019 Research Spotlight: Dr. Tamara Daly

Thu, 11 Jul 2019 12:45:59 +0000

YU-CARE Director Tamara Daly has recently co-authored a study in Social Politics: International Studies in Gender, State & Society. The article, titled Borrowed Time and Solidarity: The Multi-Scalar Politics of Time and Gendered Care Work explores the impact of the larger policy context of care work on the ability of care workers to provide quality care.

Abstract

Exploring long-term residential care (Ontario, Canada), we argue that within the context of late neoliberalism, care time is political, contested, and multi-scalar. Multi-scalar time captures the way that time commodifies, disciplines, and delimits workers’ experience of care, and fractures human relations and solidarities. Drawing on data from nonprofit nursing homes in Canada, the article explores how the larger policy context of care work shapes and hinders workers’ abilities to spend time caring and building relationships with residents, how workers negotiate care provision in austere environments, and how workers use borrowed time to de-commodify care and find spaces for solidarity.

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