Thursday 18 September 2014

Canada's demographic shift: Concordia profs work to ensure healthier & happier longevity

By: Beverly Akerman

Canada is growing much greyer. In 2011, as baby boomers began crossing that 65-year-old threshold, the Census reported almost 15 per cent of us were seniors. By 2031, one quarter of Canadians will fit that bill. Centenarians are the country’s fastest growing age group.

This demographic shift has major social, medical and financial repercussions. For instance, within a generation, the number of Canadians with dementia will more than double, to 1.1 million people, and the cost of their care will rise from today’s $1.5 billion to a projected $153 billion.

How will society deal with these huge challenges? Concordia experts are looking at these issues from multiple angles.

Investing in planning

Patrik Marier
Patrik Marier, a professor in Concordia’s department of Political Science, is also scientific director of the Centre for research and expertise in social gerontology in Montreal.

As a professor in Concordia’s Department of Political Science, Marier’s research focuses on the policy implications of our changing demo­graphics. These days, he’s analyzing the implications to pension, health care and labour policy, and working on a book about Canada’s preparations for aging populations.

“A large cohort of seniors have in­comes barely above the poverty line,” he says. “And a substantial number of baby boomers carry impressive amounts of debt into retirement.”

Gender defines another worrying pension issue, Marier adds: women tend to have more career interruptions than men and therefore are more than twice as likely to rely on the Guaranteed Income Supplement.

Yet it’s a complex issue. Governments in Canada and elsewhere are certainly aware of the potential future crunch on pensions. Marier, the holder of a Canada Research Chair in Comparative Public Policy, feels we’re not necessarily headed toward a disaster. “We must take care not to frame the issue as a crisis, a tsunami,” he says. “Public authorities should act on the challenges, but need to understand that adjustments are already taking place. For example, the data show people are already retiring later.”
As our population ages, we are looking towards overwhelming numbers of people with dementia, yet are not prepared for this. We have an obligation to provide them the best possible quality of life. 
Charles DraiminCharles Draimin, professor and chair of the department of accountancy at Concordia’s John Molson School of Business, notes that a segment of the Canadian population is no longer forced to retire.
Charles Draimin, professor and chair of the Department of Accountancy at Concordia’s John Molson School of Business, concurs. “In the early ’80s, the Quebec government changed the laws on mandatory retirement, and Ontario followed suit about eight years ago,” he says. “As a result, people are no longer forced to retire except for spe­cific, highly physical occupations like police officer or fire fighter.”

The situation varies across jurisdic­tions, Marier points out. “In general, populations in the eastern provinces are older than western ones, and federal health care transfers don’t take into ac­count there are more older people per capita in Nova Scotia than in Alberta, for example.” This makes the current health care funding formula “unfair,” he says, and describes “huge ongoing de­bates” about the effect of aging on health care costs. “A higher number of older people will most likely increase health care expenditure, but upcoming seniors are also healthier than those in previous generations.”

Louis Bherer is scientific director of Concordia’s PERFORM Centre (see the sidebar) and also serves as researcher and lab director at the Institut universitaire de gériatrie de Montréal. He agrees that 60 is the new 40 — which delays retirement age. When he started in the field as a graduate stu­dent about 15 years back, Bherer recalls that 65 was considered the start of being considered old in neurosciences re­search. “Now 75 is the geriatric cut-off.”

Nonetheless, the concern for the pop­ulation’s retirement income remains real, as a significant portion of pension­ers have relatively small incomes and one quarter of the retired population lacks any pension savings outside the public plan. As well, public pensions in Canada were designed to replace only a fraction of the median wage of a working person. Draimin points out that when German Chancellor Otto von Bismarck offered pensions to German work­ers over 65 in 1888, few people lived long enough to qualify. Yet with life ex­pectancy now nearly 86 years old, “the length of the modern retirement has effectively doubled. While still young enough to save for it, people should probably be finding out what they’d have to invest to approach 90 per cent of their pre-retirement income,” he advises.

Marier believes we need to prepare better. “People spend far more time buying a new car or fridge than on the financial decisions related to retire­ment,” he says. “People need to ask questions and they need to know what to ask. Don’t be shy.” He recommends The Naked Investor: Why Almost Everybody but You Gets Rich on Your RRSP (2007) by John Lawrence Reynolds as a resource.

Quality of life matters

Kim SawchukCommunication studies professor Kim Sawchuk helps fight the attitude by younger generations that older people don’t have a clue about digital technologies.
We live in the digital age. We also live in a time of digital ageism, an attitude that assumes younger people have a natural fluency with digital media their elders lack, and a major reason seniors are often left out of research on new digital technologies.

Kim Sawchuk, a professor in the Department of Communication Studies, is working to counter digital ageism. Sawchuk holds a Concordia University Research Chair in Mobile Media Studies, a Canadian first, and directs the Mobile Media Lab, which is dedicated to interdisciplinary research in “mobili­ties,” the movement of people, objects, capital and information, locally and across the world.
From earlier work with seniors and cell phones, Sawchuk understands that seniors are extremely heterogeneous: “There are differences, for example, between someone who is 60 and not yet retired, someone recently retired and those retired 20 years or more.”

She explains that culture, language and social and kinship networks are at least as significant as age on technol­ogy use and practice, and that limits on access can be related to incomes, or simply to the realization “we have too much stuff” to manage in our lives.

“We need to understand how people decide what they want and need. We need to value those as well, those who are sceptical: every new technology is not absolutely necessary,” Sawchuk says. The Mobile Media Lab provides digi­tal learning to seniors groups based on their requirements. “We ask seniors what they want to learn and do, and then we help them access that knowledge.”

Sawchuk describes a recent flash mob at Montreal’s Place Alexis Nihon orga­nized with Ressources ethnoculturelles contre l’abus envers les aînées and the Contactivity Centre in support of World Elder Abuse Awareness Day, June 15. “It was fantastic to see the reaction of these 50 seniors dressed in purple who participated, and then put up their intervention on YouTube. They were a force taking over the public space and putting their perspective on aging, using new media, into the virtual world.”

She has other ongoing projects with many seniors’ organizations. “At Concordia, we’re being encouraged to make what we know, and the studies we’ve done, relevant to the real world. And that’s a good thing.”

Taming regret

Carsten WroschThe research by psychology professor Carsten Wrosch has shown that when seniors are trained to write about their life in a positive light, rather than focusing on regrets, they feel better about themselves.
In a society that extols persistence as a goal-seeking behaviour, for an older person, knowing when to abandon a goal can be an equally valid path to well-being. For a young person seeking a lover or a job, persistence in the face of adversity makes sense.

Yet Carsten Wrosch, a professor in Concordia’s Department of Psychology, says that for some of the intractable problems of older age, “Giving up, quitting or abandoning goals, or finding some other goal to focus on can be the most adaptive response.” Especially if the person’s circumstances can’t be altered.

Wrosch is director of the Personality, Aging and Health Lab, affiliated with the university’s interdisciplinary Centre for Research on Human Development, which unites top researchers and train­ees from six Quebec universities in the study of development over the human lifespan. A major research focus is the long-term study of aging. The Montreal Aging and Health Study has followed about 200 older adults for a decade. Last year, the study received a third Canadian Institutes of Health Research (CIHR) grant of close to $1 million.

Wrosch says research shows that re­grets — such as being unable to walk or no longer able to do the groceries — can lead to excessive rumination and even depression, and increase one’s vulnerability to disease. Wrosch has demonstrated these psychological states — and their alteration — are reflected in measurable health-relevant biological processes such as levels of cortisol (reflecting stress) and C-reactive protein (related to inflammation states). “What I’m really interested in is pre­venting this downward spiral through self-regulation, a life-management approach,” he says.

One such approach taken in his lab, pub­lished in the journal Psychology and Aging, experimented with directed writing: coach­ing seniors to write about their life regrets by “making social com­parisons, silver lining and positive reframing” — basically, making real­istic comparisons with others in the same situation, as opposed to lamenting the loss of an ideal state. Results show marked decreases in the intensity of regrets and improved outcomes, including better sleep.

“Our research is a pathway to helping older people deal with regrets over the intractable problems of aging,” he says. “The ultimate goal is to discover mecha­nisms that can contribute to helping older adults enjoy a happier and healthier life.”

Training your brain

Karen LiOne of the research projects conducted by Karen Li, a professor in Concordia’s department of psychology, found that playing computer games along with fitness training helped improve seniors’ condition.
One road to such a happier and healthier life is keeping our bodies — as well as our minds — in shape.

That’s one area being examined by Karen Li, a professor in Concordia’s Department of Psychology. Li is in­terested in executive functioning, an umbrella term for those cognitive skills harnessing mental control, organization and self-regulation. She explains execu­tive functions are closely tied with areas of the brain that shrink more rapidly as we age.

Li and her team at the Laboratory for Adult Development and Cognitive Aging test older and younger adults as they use executive functions to multitask by com­bining cognitive and motor activities. “We measure how much a person sways while balancing on one foot and com­pare that with the increased fluctuations they might exhibit while simultane­ously listening to words or doing mental arithmetic.”

As cognitive tasks increase in diffi­culty, older adults show a greater drop in performance than younger adults. “That suggests that in older age, what used to be an automatic physical task — balancing — requires more attention and cognitive resources. Avoiding a loss of balance has practical implications for healthy, independent living,” she says.

So how to strengthen these cognitive functions? “A growing number of studies show that aerobic fit­ness training, even with a mod­est physical improvement, can lead to improved executive functioning,” she says. “Social engagement is also an important source of mental stimulation.”

Li’s work has also established that brain training with computer games can be a useful add-on to more conven­tional forms of physical therapy/fitness training. Together with Louis Bherer and other Concordia researchers at the PERFORM Centre, Li’s latest projects involve older adults with (and without) mild hearing impairment. In popula­tion studies of age-related conditions, hearing loss is associated with increased falling. Li hopes that brain-gym in com­bination with aerobic fitness training will better elucidate this link and, ulti­mately, be used to decrease falling.

She’s also keen on an ongoing proj­ect, funded through CIHR, involving the Toronto Rehabilitation Institute. Healthy young and older adults and older adults with hearing loss walk on a treadmill in a virtual reality simula­tion of crossing a six-lane street. As the subjects are challenged with listening tasks, their walking is measured using motion-capture technology. The goal is to simulate a real-life multitasking situation in a safe environment to un­derstand how hearing loss and mobility decline are linked.

Music to their ears

Laurel YoungMusic therapy assistant professor Laurel Young recently received awards from Wilfrid Laurier University and Temple University in Philadelphia for outstanding contributions to the field.

Laurel Young, an assistant profes­sor of music therapy in Concordia’s Department of Creative Arts Therapies, may have one solution. Young is an ac­credited music therapist with clinical experience in geriatrics and dementia, palliative care and other areas of physi­cal and mental health.

Prior to her music therapy training, as a university student Young had the op­portunity to play music in the locked dementia units of a long-term care fa­cility. “I could also awaken those who were very withdrawn,” she says. “I knew I needed to understand more and that’s why I decided to pursue training as a music therapist.”

Young’s initial interest in research came out of an internship where she worked with dementia patients at Toronto’s Baycrest Centre for Geriatric Care. While there, she investigated the use of music to stimulate object recogni­tion. It was clear that music stimulated memory and interpersonal connection. “The science is just starting to catch up with the anecdotal experiences that music therapists have been talking about for years,” she says.

She expanded her bio-psycho-so­cial health perspectives into the area of singing and health, yet her passion for working with seniors remained. “With almost all dementias, the music func­tions of the brain remain intact. Most individuals retain a sensitivity to music, and have the ability to participate in a wide variety of music experiences,” she says. “Research has also shown that both these attributes may be enhanced, even as other capacities deteriorate.”

Creative arts therapies won’t cure de­mentia, Young says, but by decreasing agitation, stimulating cognition and fa­cilitating meaningful interactions with others, they can significantly improve quality of life for many patients.

She describes a case where the hus­band was institutionalized and hadn’t spoken for many years. The wife usually visited daily, sharing in much of his care. Young would see this couple in a small music therapy group. Singing gentle songs on guitar and touching the man’s hands, she was often able to rouse him from his languor.

When Young discovered that the couple’s song was Let Me Call You Sweetheart, the results were revelatory. She would sing “Let me call you sweet­heart,” and the husband would finish the line with “I’m in love with you,” and then look at his wife. Here was a wom­an, Young explains, who for years didn’t know if her husband was aware of her presence or anything she did to help him. When the husband acknowledged his wife in that setting, it was moving and meaningful for them both.

“Music is a distinct domain of func­tioning in the brain that seems to serve a variety of purposes, but we are still discovering its full potential,” Young maintains. “My theory is that if the music functions of the brain are so important, shouldn’t we be trying to maintain these functions to the fullest possible extent?” She believes using creative arts therapies in this way is “not just fun and enjoyable, but clinically indicated.”

As our population ages, we are looking towards overwhelming numbers of people with dementia, yet are not physically, financially, or psychologically prepared for this, Young warns. We have an obligation to provide them the best possible quality of life.

In future, she hopes, “We may be able to understand how music works when other forms of communication have failed, to discover a way to capitalize on this in creative, functional, and mean­ingful ways. These people will be us — if we live long enough. How will you want to be treated?”

–Beverly Akerman is a Montreal writer.

Adapted from the original, published here.