This study examined the longitudinal associations between self-reported residual hearing and loneliness, and whether associations differed by age and sex. Using comprehensive cohort data from the Canadian Longitudinal Study on Aging (CLSA; n = 30,097 at baseline), cross-lagged path models (CLPMs) assessed associations across three timepoints (Baseline, Follow-Up 1 [FU1], and FU2). Among females 45-64 years, we observed statistically significant bi-directional associations (hearing to loneliness β = .018, p = .027; loneliness to hearing β = .015, p = .026). For males 65+ years, associations from self-reported residual hearing to loneliness were statistically significant (β = .02, p = .038). After adjustment for cardiovascular covariates, bi-directional associations remained significant only among females aged 45-64 years. Overall, the findings provide evidence of small sub-group-specific associations between hearing and loneliness and highlight the importance of including demographic and broader health-related factors when examining hearing and psychosocial well-being in the aging population.
Abstract Background Long-term care facilities extending services to the community is an innovative and viable solution to enable the aging at home goal. The concept of Nursing Homes Without Walls was tested in four communities in New Brunswick. The overall goal was to support older adults and their caregivers to age in place. Objectives and Methods Using an explanatory sequential mixed-method design, quantitative and qualitative data were collected to measure and appreciate how NHWW would (1) allow participants to age in place; (2) provide services and/or support with which participants would be satisfied; and (3) describe the degree to which project sites became an age-friendly community. Findings Findings indicate that participants felt supported, that services and information were accessible, along with an increased level of satisfaction with social interactions, as well as feelings of security, and a high level of satisfaction with the services. Discussion This evidence-based approach was successful in supporting older adults to age in place.
Older adults in long-term care (LTC) homes experience complex nutrition-related challenges and care staff are central to supporting nutrition care, eating assistance, and positive mealtime experiences. However, nutrition care education is often inconsistently addressed in staff training. This scoping review mapped the scope, characteristics, and reported the outcome measures of nutrition care education and programs for LTC staff. This review followed JBI methodology and was reported according to PRISMA-ScR guidelines. Four databases (MEDLINE, CINAHL, Scopus, and PsycINFO) were searched from May to October 2024, with an updated search in September 2025. Grey literature and reference lists were also searched. Sixteen studies met the eligibility criteria. Programs varied in content, delivery format, duration, target staff groups, implementation supports, and outcomes. Common outcomes included staff knowledge, confidence, attitudes, eating assistance practices, mealtime environment, feasibility indicators, and selected resident nutrition outcomes. Future research should improve reporting, follow-up, outcome definitions, implementation, feasibility, and continuity.
Mindfulness-based interventions (MBIs) are increasingly recognized as relevant approaches for older adults at risk of cognitive decline. However, few studies have examined the lived experience of individuals presenting cognitive decline alongside anxiodepressive symptoms. This qualitative study aims to understand the experience of 13 adults aged 55 and older who participated in a group-based MBI. Semi-structured interviews conducted after the intervention were analyzed using an inductive approach to identify emerging themes. Findings reveal a three-phase experiential trajectory: initial surprise toward the practices, a gradual evolution of their experience at both individual and interpersonal levels, particularly through the group context, and a final sense of insight and satisfaction. The analysis highlights individual and relational processes and underscores the importance of considering multiple factors, particularly relational ones, when examining mechanisms and effects of MBIs among older adults at risk of cognitive decline.
Rural regions often have a higher proportion of older adults who take multiple medications. To provide evidence for health interventions related to medication use, this qualitative descriptive study aimed to explore the perception of older adults and caregivers living in rural settings regarding polypharmacy and deprescribing. We conducted semi-structured interviews with older adults aged 65 and older taking at least five medications daily and caregivers who look after their relatives. A general inductive thematic approach was used for analyzing the qualitative data. Findings indicate that while polypharmacy raises concerns, it is nonetheless perceived as essential. The family doctor remains a trusted figure for older adults and their caregivers when it comes to pharmacotherapy and deprescribing. Promoting a collaborative and individualized approach led by healthcare professionals may help address the challenges associated with polypharmacy and deprescribing among older adults and their caregivers.
BACKGROUND AND OBJECTIVE:We undertook a qualitative descriptive study to explore participants' perceptions of whether marital status shapes how functional social support (FSS) relates to memory. METHODS:Semi-structured interviews were conducted with 18 community-dwelling middle-aged and older people representing various marital status categories. Each interview was audio-recorded, transcribed verbatim, and thematically analyzed. FINDINGS:Participants did not perceive marital status to shape the FSS-memory relationship. Three themes emerged to explain this view: learning to cope - participants used alternatives besides a spouse to deal with memory challenges; context matters - factors such as marital satisfaction must be considered; and doing more harm than good - some spouses may provide excessive support, reducing participants' autonomy to stimulate their own cognitive processes. DISCUSSION:These themes highlight that marital relationships are complex and that contextual factors such as marital quality and support adequacy should be considered to provide a comprehensive understanding of how social and marital dynamics shape cognitive trajectories in aging populations.
Les régions rurales présentent une proportion élevée de personnes aînées utilisant plusieurs médicaments. Afin de guider les interventions en santé, cette étude descriptive qualitative visait à comprendre les perceptions de personnes aînées et de personnes proches aidantes vivant en milieu rural quant à la polypharmacie et à la déprescription. Des entrevues individuelles semi-dirigées ont été conduites auprès de personnes âgées de 65 ans et plus prenant cinq médicaments ou plus quotidiennement et de personnes proches aidantes de personnes aînées. L'analyse thématique inductive a révélé que la polypharmacie soulève des inquiétudes, mais qu'elle est perçue comme essentielle. Pour les personnes aînées et les personnes proches aidantes, le médecin demeure une figure de confiance en matière de médicaments. Une approche participative et individualisée par les professionnels de la santé permettrait d'impliquer davantage les personnes et leurs proches pour surmonter les défis liés à la polypharmacie et à la déprescription.
The AVOID Frailty framework, developed by the Canadian Frailty Network, promotes five evidence-based behaviors to reduce frailty risk in older adults: physical activity, vaccination, medication optimization, social interaction, and nutrition. Although widely adopted, its deficit-based framing may limit engagement and appeal. This commentary proposes a positively framed alternative, the THRIVE Strategy for Lifelong Wellness, which retains the core behavioral focus of AVOID while adding a sixth pillar, engaging the mind, to reflect evidence on cognitive and emotional well-being in aging. We further recommend shifting from the language of frailty prevention and healthy aging towards lifelong wellness, a more inclusive and empowering concept. Drawing on health communication theory and aging research, we argue that gain-framed messages are more motivating, less stigmatizing, and relevant across the life course. By emphasizing thriving rather than avoiding decline, the THRIVE strategy offers a holistic and potentially more effective framework for promoting sustained well-being across adulthood and later life.
BACKGROUND:Receiving a dementia diagnosis is a complex experience that can provide clarity about symptoms but often creates uncertainty. Support during and after diagnosis is essential to help individuals navigate living with dementia. This qualitative descriptive study examined experiences during and after diagnosis among people with dementia and care partners in New Brunswick, Ontario, and Quebec. METHODS:Interviews with 5 people with dementia and 15 care partners were conducted and then analysed using qualitative content analysis to identify barriers, facilitators, and contextual influences related to a positive experience. RESULTS:Barriers included limited resources, poorly coordinated care, disorganized diagnostic pathways, and stigma. Facilitators included access to information, person-centred care, support networks, recognition of personhood, and structured care navigation. The COVID-19 pandemic further shaped experiences. CONCLUSION:Findings highlight the importance of compassionate care, accessible information, and coordinated services while underscoring systemic gaps, stigma, and the impact of the pandemic.
Les interventions basées sur la pleine conscience (IBPC) sont reconnues comme des approches pertinentes auprès de personnes vieillissantes à risque de déclin cognitif. Toutefois, peu d'études ont exploré l'expérience vécue de participants présentant un déclin cognitif accompagné de symptômes anxiodépressifs. Cette étude qualitative vise à comprendre l'expérience de 13 adultes de 55 ans et plus ayant participé à une IBPC de groupe. Des entrevues semi-dirigées menées après l'intervention ont été analysées selon une approche inductive pour dégager les thèmes émergents. Les résultats révèlent une trajectoire expérientielle en trois temps : une surprise initiale face aux pratiques, une évolution progressive de leur vécu, tant individuel qu'interpersonnel, notamment grâce au groupe, puis un sentiment d'élucidation et de satisfaction à l'égard du programme. L'analyse met en lumière des processus individuels et relationnels importants, soulignant la nécessité de considérer divers facteurs dans l'étude des mécanismes et effets des IBPC auprès des personnes vieillissantes.
OBJECTIVE:This research note assessed the relationship between health status and union dissolution in middle and later life in the Canadian context. METHODS:Data were drawn from four waves (2014-2020) of the Canadian Longitudinal and International Study of Adults aged 45 and older. Logistic regression analyses examined the effects of stability and changes in self-rated health (SRH) and psychological distress on subsequent marital and cohabiting union dissolution. FINDINGS:Unlike those whose SRH declined over time, those who experienced continuing fair/poor SRH had a greater likelihood of subsequent union dissolution compared to those experiencing continuing good/very good/excellent or improved SRH. In contrast, those reporting increased psychological distress were more likely to experience union dissolution later on. DISCUSSION:Policies and interventions that limit poor physical and mental health of individuals as they age may also serve to reduce the occurrence of union dissolution and its implications.
BACKGROUND:Older refugees often navigate complex health care needs while aging in resettlement contexts. For Syrian refugees in the Greater Toronto Area and surrounding regions, barriers within the Canadian health care system may shape how care is accessed, coordinated, and supplemented through transnational practices. OBJECTIVE:This study examines how older Syrian refugees aging in the Greater Toronto Area and surrounding regions navigate health care and construct hybrid health care pathways across local and transnational contexts. METHODS:A qualitative interpretive descriptive design was used. In-depth interviews were conducted with 20 Syrian refugees aged 55-63. Data were analyzed using reflexive thematic analysis to identify patterns in participants' experiences of accessing, coordinating, and supplementing health care. FINDINGS:Participants described persistent linguistic barriers, long wait times, and limited access to culturally aligned services within the Canadian health care system. In response, they developed hybrid health care pathways that combined Canadian health care with transnational practices, including consultations with clinicians abroad, cross-border medication use, family support, traditional remedies, and digital technologies. Digital tools played a central role in bridging language and geographic gaps and supporting care coordination. While these hybrid pathways enhanced autonomy, continuity of care, and perceived control, they also introduced risks related to medication safety, fragmented care, informal decision-making, and digital inequities. DISCUSSION:The findings show that older Syrian refugees' health care navigation extends beyond formal Canadian health services and is shaped by transnational relationships, cultural knowledge, digital access, and prior health system experiences. Hybrid health care pathways can support continuity and culturally meaningful care, but they also require careful attention to safety, communication, and equity. Health systems should develop culturally responsive and digitally inclusive models that recognize transnational care practices while supporting safer integration with local care.
BACKGROUND:Immigrant and racialized Canadians constitute an increasing percentage of the older adult population. Attention is needed to the role of municipalities and their key partners in creating urban environments that are supportive of aging in place. OBJECTIVE/METHODS:We conducted a qualitative descriptive sub-study of policy partners' perceptions of age-friendly policies and initiatives as part of a larger community-based participatory project in Edmonton (Alberta, Canada). FINDINGS/DISCUSSION:Nineteen participants, including elected municipal representatives, city administrators, advisory committee volunteers and seniors-serving organization staff, took part in semi-structured interviews, which was followed with a reflexive thematic analysis of the data. Participants described high levels of awareness about inequities faced by immigrant and racialized older adults. Advocacy and policy efforts, however, were constrained by insufficient funding, lack of capacity for sustainable initiatives, unclear jurisdictional boundaries and competing priorities.
BACKGROUND:Older adults living with HIV face intersecting challenges related to aging, stigma, and healthcare navigation. Arts-based research (ABR) has the potential to support resilience and well-being in this population. OBJECTIVE:To explore how participation in ABR supports older adults living with HIV in terms of empowerment, self-expression, and social connection. METHODS:A participatory qualitative study was conducted with adults aged 50+ living with HIV. Participants engaged in creative workshops incorporating word mapping, visual arts, and storytelling. Data were collected through group discussions and analysis of art work. Reflexive thematic analysis was used to identify key themes in participants' experiences. RESULTS:Participation in ABR fostered empowerment, self-understanding, and community connection. Four themes emerged: (1) Reclaiming narratives - challenging stereotypes of HIV and aging; (2) Creative resilience - expressing emotions and promoting healing; (3) Community and connection - reducing isolation and fostering belonging; and (4) Personal and artistic growth - skill development and therapeutic engagement. Creative expression enabled participants to communicate emotions difficult to verbalize, strengthening self-esteem and social bonds. CONCLUSIONS:ABR offers a valuable approach for promoting resilience, self-expression, and collective empowerment among older adults living with HIV. Incorporating creative engagement into HIV care may enhance psychosocial well-being and community connection in this population.
BACKGROUND AND OBJECTIVE:This study examines how intensive caregivers in Nova Scotia who receive the provincial government's Caregiver Benefit interpret and experience the program, particularly in the context of its ambiguous goals. METHODS:A qualitative descriptive methodological design was used to ensure that the reporting of findings remained close to participants' own words and to emphasize the practicality of findings. Twenty family caregivers with experience receiving the Caregiver Benefit participated in a semi-structured interview. FINDINGS:Our analysis captured four themes: (a) caregiving intensity shaping perceptions of the Benefit, (b) financial relief provided by the Benefit, (c) systemic barriers to access, and (d) policy problems. DISCUSSION:To our knowledge, this is the first study to explore the firsthand accounts of caregivers' experiences with the Caregiver Benefit in Nova Scotia.
BACKGROUND:Older refugees are often depicted in deficit-oriented terms in policy and scholarly discourse, leading to limited recognition of their capacities, agency, and social contributions. OBJECTIVE:This study examines the sociocultural roles and contributions of older African refugees in Calgary, Canada. METHODS:Drawing on qualitative storytelling and diagramming, with 11 older African refugees serving as co-researchers, to illuminate how they support younger generations and strengthen community resilience. FINDINGS:The results demonstrate that older refugees actively contribute through cultural and linguistic transmission, moral and civic mentorship, financial guidance, and culturally grounded support. Co-researchers described themselves as heritage keepers safeguarding language, culture, and identity amid perceived cultural risks in the host society. These contributions challenge prevailing assumptions of older refugees as passive or dependent and highlight the importance of recognizing their community influences. DISCUSSION:The study underscores the need for strength-based policies and services that acknowledge older refugees' sociocultural roles in supporting intergenerational well-being and community integration.
A study using a waitlist control group pre-post design evaluated a new 13-week, peer-delivered Frailty Coach Program that was adapted from two prior self-management interventions involving persons with type 2 diabetes (2019) and other chronic conditions (2022). The intervention included teaching participants to use three Self-Management support strategies and providing education and encouragement to incorporate the Canadian Frailty Network AVOID (Activity, Vaccinate, Optimize medication, Interact, and Diet & nutrition) strategies into their lives. Results showed that over half the study participants made significant changes and had returned to lower levels of frailty as measured by the Clinical Frailty Scale. Other self-reported outcome measures that included eight subscales of the RAND 36-item Health Survey showed improved physical functioning, improved emotional well-being, and improved their impression of general health. At the end of the project, the program was approved for ongoing funding by the provincial Ministry of Health.
BACKGROUND:Approximately 30% of older adults (≥65) fall annually, yet community delivery of evidence-based fall prevention exercise remains poorly understood. This qualitative study explores fall prevention exercise service delivery from the perspective of exercise providers in Ontario. METHODS:We conducted semi-structured interviews with 20 exercise providers, guided by the Consolidated Framework for Implementation Research, and analyzed data thematically. FINDINGS:While providers valued evidence-based balance and functional training, those in large-group settings struggled with exercise tailoring and progression. Instead, many prioritized building trust, creating safe environments, and facilitating socialization. BARRIERS WERE HIGHLY CONTEXTUAL:kinesiologists lacked resources, independent providers lacked networking, and municipal/non-profit staff faced low pay and organizational competition. DISCUSSION:To enhance implementation of fall prevention exercise services, support must address unique contextual barriers while balancing clinical tailoring with participant adherence. Our insights suggest that leveraging existing community services and focusing on provider-specific supports are essential for effective implementation of fall prevention exercise services in Ontario.
BACKGROUND:Behavioral and psychological symptoms of dementia (BPSD) are common in hospitalized older people and challenge acute care delivery. OBJECTIVE:This study sought to identify available quality indicators (QIs) for BPSD, establish priorities, and explore perceived facilitators and barriers to their use. METHODS:We conducted a cross-sectional electronic survey among physicians, nurses, and administrators in Quebec acute care hospitals (January-February 2025). The survey included open-ended questions analysed using Donabedian's structure-process-outcome model. FINDINGS:Fifty-five respondents generated 677 responses, yielding 59 themes, 44 deemed priorities. Key QIs included delirium screening, restraint and antipsychotic use, length of stay, adverse events, and resource availability. Participants emphasized the need for standardized, clinically meaningful QIs. Reported barriers included staffing shortages, fragmented technological systems, and limited institutional prioritization, while facilitators included leadership commitment, interdisciplinary support, and structured training. DISCUSSION:Embedding standardized QIs into electronic health records may enhance benchmarking, guide improvement, and promote safer dementia care.
BACKGROUND:Early-onset frontotemporal dementia (EO-FTD) presents before age 65 and is frequently misdiagnosed as psychiatric or behavioural disorders, delaying care. OBJECTIVE:This scoping review synthesizes research on EO-FTD's earliest cognitive symptoms from patients, companions (family and friends), healthcare professionals, and cognitive tests to promote early detection. METHODS:A systematic search of six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Dissertations and Theses) identified 2197 studies of which 16 met inclusion criteria, encompassing 663 EO-FTD participants. FINDINGS:A total of 35 unique cognitive symptoms were identified. Memory, attention, and executive dysfunction were most frequently reported. Symptom terminology varied widely, often mirroring cognitive test phrasing, limiting clinical applicability. Many studies relied on cognitive test scores rather than detailed symptom descriptions, with patient and companion reports underrepresented. DISCUSSION:The findings underscore the need for standardized nomenclature, improved assessment tools, and greater inclusion of patient and companion perspectives to enhance EO-FTD early diagnosis and intervention strategies.
