Reports

Are you looking for references for your research? You can find research reports from our recently completed studies. For further information and data availability at the Institute on Aging and Lifelong Health, please contact aging@uvic.ca.

Alzheimer Drug Therapy Initiatives (ADTI)

Investigators: Neena L. Chappell, B. Lynn Beattie, Ging-Yuek Robin Hsiung, Colin Dormuth, K. Malcolm Maclure 

Objective: The Alzheimer’s Drug Therapy Initiative (ADTI) was announced in October, 2007, consisting of three concurrent programs: drug coverage, education, and research. The research program consisted of four studies conducted from the University of Victoria (UVic) and one from the University of British
Columbia (UBC). 

Seniors’ Medication Study: The SMS was a prospective longitudinal observational study. It sought to understand outcomes of patients taking ChEIs with an initial indeterminate response and to assess the adequacy of the Standardized Mini-Mental State Examination (SMMSE) on the SA.

Clinical Epidemiological Study: This observational study drew on data from SA forms and provincial administrative datasets to examine response to ChEIs among those covered under the ADTI.

Utilization and Cost Study: This study drew on provincial administrative data to examine use of and costs of other health care services prior to and after the ADTI was launched as well as the effect of ChEI use on clinical outcomes and costs of health services.

Caregiver Appraisal Study: This study included face-to-face interviews, province-wide, with family caregivers to persons prescribed ChEIs, and covered for the medications under PharmaCare. It sought to better understand family caregivers’ perceptions of the effects of taking ChEI, on patients and on
themselves as caregivers as well as to compare their assessments with clinical assessments.
Researchers continue analyzing data, for academic presentations and publications. Click here for summary and publications list

Read the report here 

Baseline Study of Seniors in the Capital Regional District

Investigators: Gordon Behie, and Margaret Penning

Objective: The main purpose of the Baseline Study was to compile information on seniors (65 years and older) in the Capital Regional District. The resulting profile would provide researchers with an overview of the seniors population in the CRD. 

Sample: 1,278 older adults residing in the Capital Regional District (CRD), British Columbia.

Methods: From April to October of 1995, 1,278 face-to-face interviews were conducted with a representative sample of community-living seniors 65+ in the CRD.

Data Components: The survey dealt with a wide variety of issues including demographics, housing and living arrangements, social networks and support, health and utilization of health services, and lifestyles and quality of life.

Read the report here 

British Columbia Trajectories in Care Study (BC-TICS)

Investigator: Margaret Penning 1, Denise Cloutier1, Kim Nuernberger1, Deanne Taylor2, Taylor Hainstock1, Stuart MacDonald1, Laura Funk3, Ronald Kelly2, Francis Lau1 
1Univerisity of Victoria, Victoria, BC, Canada, 2Fraser Health Authority, Surrey, BC, Canada, 3University of Manitoba, Winnipeg, MB, Canada

Introduction: In collaboration with the Fraser Health (FH) Authority of British Columbia, an interdisciplinary research team based at the University of Victoria is studying individual and community level factors (social, psychosocial, health) to examine trajectories in long-term care (LTC) use among older adults as they transition between multiple care settings (home care, assisted living, and residential care).

Background: With older age comes increasing likelihood of multiple chronic conditions, functional decline, and changing life circumstances (e.g., widowhood), increasing the possibility of experiencing health system transitions. Few studies have specifically addressed transitions and trajectories in late life care; often focussing on single transitions (e.g. from receiving no formal care into home care or residential care). Less is known about multiple transitions over time and factors that influence such movement (e.g., age, gender, SES, marital status).

Methods: The study uses administrative data (e.g., MDS-RAI-HC and MDS-RAI-RC clinical assessment tools, hospitalization and clinical management data) representing all individuals who received publicly-funded LTC services in FH between January 1, 2008 and December 31, 2011 (N=29,565).

Results: Preliminary analyses show considerable movement within the LTC system, resulting in multiple, highly variable LTC trajectories. A complex combination of individual and community level factors influence these trajectories.

Conclusions: There is need to go beyond the correlates/determinants of specific service use (e.g., home care, residential care) in isolation to examine their role in influencing broader trajectories of care. A clearer understanding of care transitions and trajectories is critical for promoting quality of care and improving resource/ service planning.

Read the report here

Canadian Longitudinal Study on Aging

Sample: To date, more than 46,000 participants between the ages of 45 to 85 years have been recruited. 

Method: 20,000 participants provided information through telephone interview and 30,000 participants undergo physical examination and provide biospecimens

Data components: All participants provide a common set of information on demographic, social, physical, clinical, psychological, economic, and health service utilization aspects relevant to health and aging. Thirty thousand participants provides additional information through physical examination and collection of biospecimens (blood and urine samples)

Publications and Reports associated with CLSA: 

A Canadian Longitudinal Study on Aging (CLSA) dataset holds and describes variables collected from participants at each wave of data collection. The variable search tool enables researchers to locate items of interest within all available data collected from CLSA participants.

Currently, data emanating from over 20,000 tracking participants who completed the baseline 60-minute telephone interviews are available. Cognitive scoring is complete and these data will be available. 

In its first report released on memory and cognition, the Canadian Longitudinal Study on Aging (CLSA) has shown the performance of CLSA participants is similar to what has been observed in previous studies of cognition conducted in both French and English, lending support to the use of the CLSA cognitive measures in large, epidemiological studies of aging.

Find publications here.

 

Canadian Driving Research Initiative for Vehicular Safety in the Elderly (CanDrive)

Investigator: Dr. Holly Tuokko is one of the principal applicants for the Candrive study with 125 of the 928 participants in the study being assessed between 2009-2015 by Dr. Phyllis McGee at the Institute on Aging and Lifelong Health

Introduction: Established in 2002 as a result of Canadian Institute of Health Research (CIHR) NET Grant funding, Candrive is a network of diverse Canadian researchers interested in older driver issues. Research members of Candrive include occupational therapists, physiotherapists, psychologists, kinesiologists, epidemiologists, and a number of medical specialists in geriatric medicine, physical medicine and rehabilitation, rheumatology and geriatric psychiatry.

Objective : Candrive is a Canadian research program aimed at improving the safety and quality-of-life of older drivers

 

Caregivers to Adults and Children in BC

Investigator: Margaret J. Penning, Neena L. Chappell, Silvia Sorensen

Sample: 1,789 randomly sampled in BC, 1994-1995.

Methods: Participants completed a face-to-face interview which lasted approximately 1.5 hours. The sample was stratified by age and sex. A weighted formula has been calculated that takes the age and sex stratification into account. This weight factor is used on all analyses.

Data Components: (Unpaid) Caregivers, Living arrangement of care receivers; Demographics; health conditions of CR; mental conditions of CR; ADL & IADL of CR;  Types of helps CG to CR; Care Burden and coping; Demographics of CG;  physical and emotional health of CG; availability of the resources of care services - These data components are very similar with the General Society Survey Cycle 11, conducted by Statistics Canada.

Comparative Cost Analysis of Home Care and Residential Care

Investigator: Marcus J. Hollander

Sample:  The cohorts were new admission to the B.C. continuing care (home care and residential care) system in the 1987/88, 1990/91, and 1993/94.

Methods: Data were obtained on three cohorts of clients for one year prior to initial assessment and three years post-assessment  

Read the report here: Part1

Read the report here: Part 2

Ethnic Group Membership and Old Age: The Chinese Elderly in British Columbia

Investigators: Neena L. Chappell, David Chuenyan Lai, Ellen Gee, Alan Chan, Gordon Behie

Sample: Random sample of 830 Chinese seniors (65+) living in greater Vancouver and greater Victoria.

Methods: Face-to-face interviews were conducted with 830 older adults living in greater Vancouver (n=580) and greater Victoria (n=250) during the summer and fall of 1995. More were interviewed in Victoria to allow comparisons with Suzhou. A weight variable is available that reflects the correct proportions living in Vancouver and living in Victoria.

Data Components: Information was collected on demographics, physical health, well-being, use of health services, family and friends, expectations for care, social activities, involvement in the community, and the Head Tax issue.

Read the report here

Home Support Services in the Capital Regional District

Investigator: M.J. Penning, and N.L. Chappell

Sample: Randomly selected sample of 567 clients in the CRD region

Methods: 567 clients and 36 proxy respondents (for those too ill or cognitively impaired to participate directly) were interviewed to determine the level of consumer satisfaction with the services being provided

Data Components:  The survey was intended to determine clients perception of the services they were receiving and to examine the role of these services in maintaining client independence, autonomy, and quality of life. The survey covered questions about themselves, their health, their informal networks, and the services they were receiving. 

Read the Client Survey report here

Independence among Older Adults with Disabilities

Investigator: Margaret J. Penning, Neena L. Chappell, Peter H. Stephenson, Lorne Rosenblood, Holly A. Tuokko

Sample: Random sample of 830 Chinese seniors (65+) living in greater Vancouver and greater Victoria.

Methods: Face-to-face interviews were conducted with 830 older adults living in greater Vancouver (n=580) and greater Victoria (n=250) during the summer and fall of 1995. More were interviewed in Victoria to allow comparisons with Suzhou. A weight variable is available that reflects the correct proportions living in Vancouver and living in Victoria.

Data Components: Information was collected on demographics, physical health, well-being, use of health services, family and friends, expectations for care, social activities, involvement in the community, and the Head Tax issue.

Read the report here

Intermediate Care Facility

Sample: 510 residents in 77 long-term care facilities throughout British Columbia (excluding the far north).

Methods: All British Columbia facilities with at least 10 beds and that cared for persons with dementia (N=262) were surveyed between September 1995 and January 1996.

Data Components: Data on institutional care quality (pre-admission and admission procedures, non-use of physical and chemical restraints, staff training and education, physical environment, and flexibility of care) were collected during this first phase. During the second phase (1996-1998), data on resident outcomes (effect, mortality, cognitive function, agitated behaviors, physical dependency, expressive language skills, and social skills) were collected from residents, staff, and family first at admission and again in 12 months.

Respite from the Caregiver's Point of View

Investigators: Neena L. Chappell, and Elizabeth Dow

Sample: Fourteen caregivers, focus group, and a random selection of 243 caregivers on southern Vancouver Island (Capital Regional District minus the Gulf Islands).

Methods: In-depth qualitative interviews were conducted with 14 caregivers and a focus group of 5 women caregivers. All focused on what having a break means to them. A preliminary typology of meanings was derived. Face-to-face interviews were then conducted with 243 randomly-selected caregivers in the Capital Regional District (minus the Gulf Islands).

Data Components: The interview covered the areas of demographics, social network characteristics, care recipient characteristics, employment, and burden. The representative sample of 243 caregivers was also asked what having a break means to them.

Seniors Drug Focus Project

Investigator: Malcolm Maclure 

Sample: A province-wide representative telephone survey 1,699 seniors (65+) in 1996.

Methods: Construction of the questionnaire was based on the results of a series of 17 focus groups with seniors and clinicians and interviews with senior Pharmacare policy makers.

Data Components: Medications and health history; expectation of prescriptions and generic substitution; knowledge and perceptions about reference based pricing; general policy questions; and demographics.

Read the report here

Technology Supports for Community—Dwelling Older Adults with Dementia and Family Caregivers

Prinicipal Investigator: Debra Sheets1, Cheryl Beach2, Andrew S. Mitz3, Sandra R. Hundza1, Stuart MacDonald1, Carl Asche1, Brent Gali1, Julie Gorenko 1 
1University of Victoria, Victoria, BC, Canada, 2Canadian Institute for Health Information, Victoria, BC, Canada, 3National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA

Introduction: Over 2.7 million Canadians are family caregivers; they are “the backbone of home care” and provide more than three-quarters of the care needed by older adults (CIHI, 2010). Caregiving is a demanding role and the demands increase over time. Recent technologies have great potential to reduce caregiver burden, including reduced homecare support hours needed. 

Purpose: This project explores family caregiver needs and priorities and investigates preferences for technologies that can safely support caregiving functions. 

Method: Structured interviews, 1 hour in length, were conducted with 8 family caregivers, a convenience sample, caring for older adults with dementia who were receiving homecare. Questions focused on gathering detailed information on caregiving needs, attitudes towards technologies, and preferences for support. Descriptive analyses were run as well as thematic coding for qualitative data.  

Results: Caregivers of older adults with dementia report high levels of caregiver burden. Participants were interested in technologies to support caregiving but were unaware of many existing technologies. Caregiver preferences point to the need for technologies that are easy to use, function automatically, and provide simple, informative alerts. 

Implications:  Implementing technologies widely requires understanding caregiver attitudes and priorities. Read more

Read the summary report here.

 

Too Little, Too Late: How we fail vulnerable Canadians as they die and what to do about it

Priniple Investigator: Kelli I. Stajduhar

Background: For most Canadians, good palliative care is still not a given, despite its many proven benefits that add up to a longer, more comfortable time before death. Access to the services involved, from medical to social to psychological, is uneven across the country and is not universally funded. This is especially true for those people facing poverty, and homelessness and unstable housing.

Methods: Researchers from the Equitable Access to Care Study spent more than 300 hours with 25 homeless or barely housed people in Victoria over a two-year period or until they died. They attended trips to medical appointments, made observations of interactions between health and social care workers, and conducted almost 150 interviews with others who were either friends, partners, chosen family of study participants, or service providers.

Read the report here.

Victoria Longitudinal Study

Principal Investigator: The VLS was founded in the late 1980s by three main co-investigators, Drs. Roger A. Dixon, Christopher Hertzog, and David F. Hultsch. The three friends would meet regularly in Victoria and elsewhere to design, plan, execute, and report new VLS research. Since about 1994-95, Dr. Dixon has been the principal investigator of the VLS. The research and scientific headquarters of the VLS moved with Dr. Dixon to the University of Alberta in the early 2000s, where it remains to this day. The satellite data collection lab is on the campus of UVictoria. Dr. Stuart MacDonald is the Co-Investigator at UVictoria.

Objective: Much information is available concerning how older adults compare to younger adults on a variety of cognitive, biomedical, biological, clinical, neuropsychological, lifestyle, personality, social, physiological, and health indicators. However, relatively little is known about whether and how the processes represented by these indicators actually change across adulthood. The Victoria Longitudinal Study was designed in part to examine the profiles, patterns, and predictors (modifiers) of aging-related brain and cognitive changes. We examine these characteristics often over multiple longitudinal waves covering a 40-year band of aging.

Design: The VLS was begun in the late 1980s, with the initial goal of examining profiles and predictors of cognitive changes in relatively healthy, community-dwelling middle-aged and older adults. The ambitious research design called for a series of three large samples of adults (initially ranging in age from 55 to 85 years) to be repeatedly interviewed and tested over a long period of time. The initial blueprint called for the three VLS samples to begin in the 1980s, 1990s, and 2000s and to be followed for 6-8 waves of measurement. In addition, recent large and targeted comparison groups (e.g. young, middle-aged, Alzheimer's) are also recruited and monitored by the VLS.

Click here for publications

Voluntary Action by Seniors in Canada

Investigator: Michael J. Prince, and Neena L. Chappell

Sample: 70,000 Canadians 15 years of age and older

Methods: For screening questionnaire, 85% of the respondents were interviewed in a 30 minutes telephone interview and other 15% were interviewed face-to-face. For the follow-up, respondents were asked to complete the questionnaire and return it in an enclosed post-paid envelope. The initial screening questionnaire determined whether individuals had been involved in formal and/or informal volunteering from November 1986 to October 1987. A follow-up questionnaire gathered more detailed information on formal volunteering, that is, volunteer activity performed in or through an organization.  

Data Components: Data covered information on age, educational level, income, health, gender, and other variables such as religion, ethnicity, labor force status, place of residence and marital status.   

Read the report here

Volunteer Drivers in the Greater Victoria Area

Investigators: Holly Tuokko, and Vincenza Gruppuso

Sample: Volunteers from the James Bay Community Project, Saanich Volunteer Services Society, and Capital City Volunteers

Method: Volunteers were interviewed in person or by telephone regarding their experiences as volunteer drivers as well as their perceptions of the positive and negative aspects of this involvement to understand the facilitators and barriers to engaging in this activity.

Data Components: The project questions were designed to describe the characteristics and qualities of volunteer drivers (who drive seniors to medical appointments)

Read the report here