- Heart disease in Canada to skyrocket
- Canadian seniors take 5 or more prescriptions on average
- Depressed Seniors in care homes
- Our Aging Drivers: Boomers facing a tough road
Heart disease in Canada to skyrocket…research completed by Becel as reported in CIEPS, JUNE 27, 2010 Newsletter
Spurred by rising obesity rates and aging baby boomers, the number of deaths from heart disease in Canada is set to dramatically outpace the rate of population growth, a noted demographer is warning.
In a report released by Becel in support of World Heart Day, David Foot, an author and professor of economics at the University of Toronto, cautions that the number of heart disease deaths will grow seven times as fast as Canada's population by the year 2031, while hospitalizations for heart disease will grow three times as fast as the population by 2051.
"This type of CVD (cardiovascular disease) mortality and hospitalization growth above population growth has three important levels of implications," says Foot in a news release. "For governments, it signals future fiscal challenges in terms of meeting the increased demand for services; at the health professional level, it indicates a significant shortfall in the number of workers available to treat the disease population; and for individuals, it sends an important message about the importance of reducing CVD risk in order to maintain a good quality of life."
The report, entitled The Shape of Things to Come: A National Report on Heart Disease and the Challenges Ahead, emphasizes a preventative strategy that targets risk factors such as obesity and saturated fats in the diet.
"One of the biggest misconceptions about heart disease is that we can't control it," says Dr. Greg Curnew, a cardiologist at McMaster University and report co-author. "Nothing could be further from the truth."
According to Foot's projections, by 2051, more than half of Canada's population will be over the age of 45, while more than 20% will be obese. Because age and obesity are two significant risk factors for heart disease, these two shifts will likely have a major impact on the rate of heart disease in the country.
"Now is the time to develop strategies that not only cope with the increased CVD needs of an aging population, but also attempt to decrease the probability of the disease occurring at all," says the report.
To that effect, the report gives numerous strategies for cutting the risk of heart disease among the general population. These include eating a heart-healthy diet, consisting of fruits, vegetables, whole grains, lean proteins and unsaturated fats; quitting smoking; keeping blood pressure and cholesterol levels in check; and making exercise a regular part of your life.
The report also calls on the government to step up preventative initiatives, including a greater emphasis on public education, improving food labels, and reducing the price of produce and other healthy foods.
The report is available at www.becel.ca/shapeofthings
Canadian seniors take 5 or more prescriptions on average As reported in CIEPS, June 27, 2010 Newsletter TOP
Most senior citizens in Canada take five prescription drugs or more, according to a new report.
The Canadian Institute of Health Information study says 67% of people over 65 take five or more types of drugs, 21% take 10 or more and 6% take 15 or more.
Public spending on prescription drugs in 2009 totaled $11.4 billion, a significant chunk of which was spent on seniors, the report says.
"With the aging of Canada's population, it is important to understand which drugs are being used most often by seniors and which account for the highest proportions of public drug program expenditure," said Jean-Marie Berthelot, CIHI's vice-president of programs. "This information helps to inform decisions about the future planning and delivery of public drug programs."
Not only are seniors taking a lot of drugs -- they're mostly taking the same drugs.
The top 10 drug classes, in terms of drug program spending, accounted for 48% of public drug spending on seniors.
Statins, which are used to treat high cholesterol, are the most commonly prescribed drug, with 40% of seniors taking them. Next on the list are ACE inhibitors, which 32% of seniors use to treat heart failure and high blood pressure.
"The prevalence of many chronic diseases increases with age, which may be contributing to the high number of drugs used by seniors," said Dr. Angela Juby, a professor of geriatric medicine at the University of Alberta.
"Therapy with multiple drugs is necessary to effectively manage chronic conditions; however, it is most important to consider the potential risks, including adverse effects and interactions between drugs or between drugs and diseases."
The study examined public drug claims for more than one million seniors in Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia and Prince Edward Island in 2008.
Depressed Seniors in care homes…results of a study completed by QMI Agency as reported in CIEPS, June 27, 2010 Newsletter TOP
A new study has found that 44% of seniors in long-term-care homes suffer from depression.
What's more, only 26% have been diagnosed, while the remaining 18% simply displayed symptoms.
"Depression can have a major impact on individuals' quality of life and also represents significant costs to society," said Nancy White, manager of home and continuing care development at the Canadian Institute for Health Information (CIHI), which conducted the study.
"As Canada's population ages, and more people could potentially move into residential care, it is important to understand how this population is affected by depression or depression symptoms in order to be able to identify the right treatment options and improve quality of life for these seniors."
The study surveyed 50,000 long-term-care residents over the age of 65 in Nova Scotia, Ontario, Manitoba, Saskatchewan and the Yukon to measure symptoms like persistent anger, tearfulness and repetitive anxiety.
The study found that depression is having a serious impact on seniors and making them more likely to be aggressive, get into conflicts with family or facility staff, withdraw from activities, have trouble sleeping and experience difficult communicating.
"Moving into a care facility is usually quite stressful and often prompted by significant losses in terms of health, degree of independence and/or social supports. This can contribute to the development of a depressive disorder that may include feelings of hopelessness, self-blame and loneliness," said Dr. Marie-France Rivard, chair of the Seniors' Advisory Committee of the Mental Health Commission of Canada and professor of psychiatry at the University of Ottawa.
Those diagnosed with depression were much more likely to get the help they needed. They were twice and likely to receive a mental health evaluation and twice as likely to be prescribed anti-depressants.
The rest, however, are left out in the cold.
The CIHI recommends long-term-care facilities examine their residents' mental health using the same test used for the survey, the RAI-MDS 2.0, which measures the symptoms of depression and generates a depression rating scale.
The Copper Ridge Place in Whitehorse, Yukon has been doing this routinely since the CIHI surveyed their patients in 2007.
"Once we identify a problem we present this to the team who can work with the residents to address their needs. As a result, we have seen real success in reducing residents' depression symptoms and improving the quality of their lives," said says Cynthia Fraser, a licensed practical nurse and an MDS assessor at the facility.
Our Aging Drivers: Boomers facing a tough road TOP
Read more: Click here
Our transportation systems are geared more toward daily commuters than seniors, say researchers. How will retired drivers in the region get around?
Victoria Const. Carolin Luchuck was in a marked vehicle escorting Olympic flame torchbearers through the streets of Greater Victoria last October when an 86-year-old driver broke through the motorcade and sideswiped her.
Luchuck was in an RCMP pickup -- with its lights flashing and signs reading Police Escort: Do Not Pass. The impact of the collision broke the truck's front axle and injured the police officer.
"She didn't know she had hit me and kept driving," said Luchuck. "After being chased down, she still didn't realize she had hit someone."
It's a typical story, police say: Older drivers with cognitive impairment or dementia who mix up gas and brake pedals, drive the wrong way or become overwhelmed turning left at busy intersections, only to be confused afterward about what happened.
By 2036, the number of senior citizens in Canada will more than double from 2009.
For the first time in almost a century, these seniors will surpass the number of children age 14 and under, according to Statistics Canada.
The worry is not their age, but the medical conditions that typically accompany old age and can interfere with safe driving, said Ian Gillespie, president of the B.C. Medical Association.
The number of seniors aged 80 or older will almost triple by 2036, and the number of centenarians is projected to triple or quadruple.
Senior citizens will make up roughly 25 per cent of B.C.'s population, up from 14 per cent today.
So what's the problem? Those feisty baby boomers are expected to drive more often, and for a longer period of time, than any other generation before them.
"The reality is we are outliving our driving ability -- statistically from six to 10 years," said David Dunne, director of road safety operations for the B.C. Automobile Association Traffic Safety Foundation.
"Before, we died early and drove until we dropped. Now we're living longer but our functional abilities decline."
According to the Canadian Study on Health and Aging, 70 per cent of people age 85 and older have a cognitive impairment or dementia.
A person's crash rate, per kilometre travelled, starts to increase at the age of 65. By the time someone turns 75 or 80 years old, their crash rate equals or surpasses that of teenage drivers.
As well, drivers with cognitive impairments -- caused by a head injury, stroke or dementia, for example -- might lack the insight to take corrective action even after they have a collision caused by that impairment, Dunne said.
More elderly drivers with medical issues on the road longer means more crashes and deaths, unless something changes, said Gillespie.
"We know the number of older drivers is going to more than double by 2030 and if there is no change in current crash fatality rates the number of older-driver fatalities will increase by 300 to 400 per cent," said Gillespie, who has decades of experience in traffic safety.
Elderly people in a car crash are 3.5 times more likely than younger drivers to die or suffer protracted injuries because of their age-related fragility.
More than 480 Canadian seniors died and more than 16,000 were injured in motor vehicle collisions in 2005, according to Transport Canada.
ICBC crash statistics suggest drivers age 30 to 60 are the safest on the road.
However, after the age of 55, the prevalence of medical conditions that might cause cognitive impairment increases "and often people aren't aware of that at the time," Gillespie said.
If the brain's processing power is slowed, a driver can easily become overwhelmed at a crowded intersection where multiple decisions must be made amid several distractions.
Drivers age 70 and older were in 40 per cent of fatal collisions with other vehicles at intersections -- almost double the number involving drivers ages 35 to 54 -- according to a 2007 study by the Traffic Injury Research Foundation, an independent group that studies road safety issues.
Still, it's only after age 80 that you see a considerable increased risk for crashing, said Ward Vanlaar, the foundation's vice-president of research.
The statistics cry out for seniors to take more responsibility in planning for their possible driving retirement, Gillespie said.
"I think it's important doctors and patients [and their families] have a dialogue early on regarding how they would prepare for the possibilities of not driving because that can happen suddenly and unexpectedly -- from a visual problem to a stroke," Gillespie said.
There are 3.1 million licensed drivers in B.C., of which 300,000 are 70 years of age and older. Almost 70,000 of those drivers 70 years of age and older are on Vancouver Island, and 28,000 are in the capital region.
Just as planning for job retirement is the norm, governments, health-care authorities, charities and community groups should also plan for these drivers to retire, say doctors.
We are such a car-obsessed and car-dependent society that the thought of not being able to drive is too traumatic for some people to even contemplate and so they delay making a plan for driving retirement, said Dunne.
"People have said they would prefer to get a diagnosis of cancer than to be told they couldn't drive anymore," Dunne said.
"How crazy is that? The perception of some people is 'cancer can be beaten, but if I can't drive anymore, and there's no alternative, you might as well kill me now.' "
Some drivers, typically men, become depressed if they are prohibited from driving, said Gillespie.
"It's a crisis because they haven't planned for it," Dunne said. "We shouldn't be that dependent on a single transportation mode."
Following Const. Luchuck's crash on Oct. 30, 2009, she was convinced that all elderly drivers of a certain age should be required to take a road test. She maintains it's the best way to care for seniors and protect them from the fright and guilt --and possible injury or death -- that can result from car crashes.
A road test is the gold standard to determine whether or not a person is fit to drive or not, say some doctors and researchers.
In Canada, there is no standard approach to testing seniors for driving fitness.
In Saskatchewan, Manitoba, Prince Edward Island, Nova Scotia and New Brunswick there is no age at which an older driver must be re-tested or submit to a medical exam for driving.
In the Yukon, the age requirement for a medical exam starts at age 70 and in Alberta, Quebec, Nunavut, Northwest Territories, and Newfoundland and Labrador, it starts at age 75.
In Ontario and B.C., an 80-year-old driver must submit to a medical fitness exam.
In Europe, age-based requirements vary by country.
In Belgium, France, Germany and Austria, older drivers are effectively licensed for life. In other countries -- including Netherlands, Sweden, the United Kingdom -- older drivers are required to have a medical exam at a certain age to prove their continued fitness to drive. In Finland, that testing starts at 45 years old.
In the United States it's just as random. In Alabama, Delaware, Kentucky, Massachusetts, Vermont and West Virginia there's no age at which driver's must get a medical exam and/or road test, whereas in Illinois, Nevada and New Hampshire there is.
Age requirements are controversial and vulnerable to being called prejudiced. "There's not a lot of research to suggest there is such a thing as a particular age before which you are safe to drive, and beyond which you are not safe any longer," said Vanlaar. "It really depends on the individual condition of that person."
Research shows rigid age-based restrictions do not take into consideration that the aging process is individual, and there can be large differences in driving skills of people the same age. Some 85-year-old people, for example, are in better shape than those who are age 40.
On average about 3,100 people either have their licence cancelled or voluntarily surrender it each year, according to the B.C. Office of the Superintendent of Motor Vehicles.
Of the approximately 120,000 people assessed by the superintendent of motor vehicles in B.C. annually, only about 5,000 are requested to take a re-examination.
Last year, of those required to take a road test, more than half, 57 per cent, passed.
Those who don't pass are thrust into the world of alternate transportation -- a system that isn't adequate to meet the needs of today's baby boomers, said Holly Tuokko, director of the University of Victoria's Centre on Aging.
Expect baby boomers to demand a better system to help them keep their licence and better alternatives if they retire from driving, she said.
"With baby boomers, it won't be a matter of someone saying to them: 'You're this age and you're off the road and that's it,' " Tuokko said.
The UVic researcher said elderly drivers will take more medical and mental fitness classes and they will enroll in more driver refresher courses -- whatever they need to do to stay behind the wheel.
And when baby boomers decide to turn in their licences, expect them to demand more innovative transportation alternatives, Tuokko said.
"I think we will see the baby boomers take charge of these sorts of things and they'll make sure all those options are available."
Unlike the typical aging process, dementia affects your ability to know your own limitations. You might be at risk if you:
- are unaware of driving errors
- have close calls
- drive too slowly
- are unaware of other vehicles
- miss traffic signs
- get lost or confused
- confuse the brake and
- Or if other drivers often honk
SOURCE: ALLEN R. DOBBS, PRESIDENT OF DRIVEABLE ASSESSMENT CENTRES,
PROFESSOR EMERITUS, PSYCHOLOGY AND NEUROSCIENCES, UNIVERSITY OF ALBERTA
Read more: Click here