December 11, 2018 from 1-2pm EST. The Centre for Studies in Aging & Health is pleased to feature PhD Candidate Atul Jaiswal for this free Research & Innovation in Aging Forum webinar introducing the condition of dual sensory loss or deafblindness. The characteristics, epidemioogy and impact of dual sensory loss on life will be explored. The unique participation experiences of three categories of individuals in this population will be discussed. Register here.

November 29, 2018 from 11am - 2:30pm at Providence Care Hospital, Kingston. Caregivers ae invited to share their stories and experiences.  Caregivers of frail seniors (65+) who require assistance with walking, managing medications, managing pain, getting to and from the bathroom; socialization; managing nutrition; and/or help with remembering, are asked to participate to help create educational materials to support caregivers across Ontario.  A free lunch will be provided. Parking passes will be available for people parking at PCH. Transportation and respite support is available by contacting Sarah Gibbens at 905-376-8206 or emailing sgibbens@rgpo.ca. To register click here.

We Can't Address What We Don't Measure Consistently. Building Consensus on Frailty in Canada

This report is authored by Dr. Samir Sinha, Allan McKee, Ivy Wong, Julie Dunning, Michael Nicin, and Dr. John Muscedere. It shows that frailty is a common condition more prevalent in older populations, which increases an individual’s risk of falls, emergency department visits, hospitalization, institutionalization, and death. The problem, the authors argue, is that frailty is not being measured consistently in Canada, which makes it difficult for health providers and governments to address.
 
The report urges the research and health care communities to come to consensus on a common definition of frailty, and argues that clinicians need to consider social factors, such as poverty, housing and loneliness, which can contribute to how well individuals cope with frailty. 56 pages. Last reviewed September, 2018.

Highlights of this issue include a reading list on "Osteoporosis & the Older Adult,” updates from the Alzheimer Society of Ontario, Baycrest, Brainxchange, Bruyere Research Institute, Centre for Studies in Aging and Health, Institute for Life Course & Aging, National Institute on Ageing, Ontario Age-Friendly Communities Outreach Program,Ontario Neurotrauma Foundation, Ontario Osteoporosis Strategy and Regional Geriatric Program of Toronto and Schlegel-UW Research Institute for Aging.

Information about funding opportunities from AGE-WELL, Alzheimer’s Drug Discover Foundation, Ontario Brain Institute and Weston Brain Institute are included.  A number of upcoming events and educational opportunities are listed. Sign up to receive Linkages directly here.

Home Adaptation Checklist

This checklist identifies environmental adaptations for seniors that could help prevent accidents and enhance independent living at home. Guidelines on how to hire a reputable contractor are included.

Fri. Dec. 7, 2018 from 8am - 3pm at Baycrest Health Sciences, Toronto.  Baycrest's annual clinical update conference is jointly presented with the Centre for Aging and Brain Health Innovation.  The program will also be available via videoconferencing and webcasting.  See the pdf for the conference program and registration information.  Register here.

Bone Mineral Density Test Requisition Form: Ontario

Currently, in Ontario, and in most other provinces, there is great variation in the way BMD (Bone Mineral Density) test referrals are made. BMD testing measures bone mass, indicating whether someone has osteoporosis or is at risk, and plays an important role in the reduction of morbidity and mortality related to fractures. It is therefore important to standardize BMD requisitions, to ensure appropriate ndividuals get tested for osteoporosis risk.

The Recommended Use Requisition (RUR) for referral for Bone Mineral Density (BMD) testing, a tool developed through the Ontario Osteoporosis Strategy by a team of researchers at Women’s College Hospital, has potential to influence the development and implementation of a standardized requisition for BMD testing.

The RUR has the potential to make the following impacts:

  • Increase BMD testing in those at high risk
  • Decrease BMD testing in those at low risk
  • Increase the accuracy of BMD reports by ensuring that clinical risk factors that modify fracture assessment are included at the time of BMD reporting/fracture risk assessment, by the reading physician.

These impacts will improve the overall quality of osteoporosis and fracture care in Ontario as information gained from a BMD test can guide clinicians and patients in understanding the risk of having an osteoporosis-related fracture, and inform decisions aimed at mitigating these risks.

This RUR has been validated by the Ontario BMD Working Group (a multidisciplinary team of family physicians, radiologists, internists, and scientists) and in relation to the current clinical guidelines for BMD testing, the OHIP Fee Schedule, and recommendations from Choosing Wisely Canada. In recognition of the importance of this initiative, Choosing Wisely Canada has recently partnered with the Ontario Osteoporosis Strategy on the initiative

The RUR form is currently available in PDF format and a version for the PS Suite EMR is under development. The PDF can be downloaded at: www.osteostrategy.on.ca

Safer Prescribing in Elderly Patients

This article takes a case study approach to introduce pharmacokinetic changes with aging, pharmacodynamic drug changes associated with aging, the impact of multiple medications,  considerations for UTI and risk of falls, 7 pages. Last reviewed October 2018.

Better Prescribing in the Elderly

This article  presents the importance of potentially inappropriate medications (PIMs) in the elderly. Guidance on deprescribing is provided. 7 pages. Last reviewed October 2018.

Problem-Based Deprescribing: A Practical Patient-Centred Approach to Promoting the use of Existing Deprescribing Resources in Frontline Care

This article discusses recent  resources available to support better prescribing for older adults. Case studies are utilized to illustrate how to operationalize problem-based deprescribing. 14 pages. Last reviewed October 2018.

Pages