Long-Term Care Resident Health and Quality of Care During the COVID-19 Pandemic: A Synthesis Analysis of Canadian Institute for Health Information Data Tables.

Objective: Long-term care (LTC) homes ("nursing homes") were challenged during the first year of the COVID-19 pandemic in Canada. The objective of this study was to measure the impact of the COVID-19 pandemic on resident admission and discharge rates, resident health attributes, treatments, and quality of care.

Design: Synthesis analysis of "Quick Stats" standardized data table reports published yearly by the Canadian Institute for Health Information.

Filling Data Gaps in Access to Mental Health and Substance Use Services.

Improving access to mental health and substance use (MHSU) services continues to be an area of growing concern in Canada, amplified by the consequences of the COVID-19 pandemic. It was also identified as a priority for federal, provincial and territorial governments in the Shared Health Priorities (SHP) work (CIHI n.d.

The current and potential uses of Electronic Medical Record (EMR) data for primary health care performance measurement in the Canadian context: a qualitative analysis.

Background: Electronic Medical Records (EMRs) are a rich data source to measure and improve quality of care. As Canadian primary health care (PHC) EMRs mature, there is increasing potential use of EMR data for performance measurement. This study identifies and describes current uses of EMR data for performance measurement and considerations to further its potential in the Canadian context.

How Children and Youth with Medical Complexity Use Hospital and Emergency Department Care across Canada.

Children and youth with medical complexity are a diverse group with uncommon diagnoses, a spectrum of needs and varying access to supports. Although this population represents a small proportion of all children, their unique needs lead to substantial use of healthcare services. With its first pan-Canadian report on children and youth with medical complexity, the Canadian Institute for Health Information examined how this population uses healthcare services.

Can markers of biological age predict dependency in old age?

Recent research has shown that markers of biological age, such as leukocyte telomere length (LTL), epigenetic clocks and the frailty index (FI) are predictive of mortality and age-related diseases. However, whether these markers associate with the need for care in old age, thereby having utility in reflecting dependency, is unclear. This study was undertaken to analyze whether LTL, two epigenetic clocks-the DNA methylation age (DNAmAge) and DNAm PhenoAge-and the FI are associated with the need for regular care in up to 604 individuals (aged 48-94 years) participating in the Swedish Adoption/Twin Study of Aging.

Frailty index as a predictor of all-cause and cause-specific mortality in a Swedish population-based cohort.

Frailty is a complex manifestation of aging and associated with increased risk of mortality and poor health outcomes. However, younger individuals (under 65 years) are less-studied in this respect. Also, the relationship between frailty and cause-specific mortality in community settings is understudied.

Antipsychotic Drug Interactions and Mortality Among Nursing Home Residents With Cognitive Impairment.

Objective: Among elderly individuals with dementia, the use of antipsychotics has been associated with serious adverse events including ischemic stroke and death. Multiple medications can interact with antipsychotics and increase the risk of such adverse events. The purpose of this retrospective, longitudinal cohort study was to estimate the prevalence of potential antipsychotic drug interactions and their effect on increasing the risk of death among cognitively impaired elderly individuals treated with antipsychotics.

Genetic Influences on Functional Capacities in Aging.

Purpose: Older populations are characterized by great heterogeneity in functional capacities and understanding the factors underlying these differences has been a major area of research for some decades. Genetic differences arguably play an important role in the heterogeneity observed for many outcomes among older individuals. However, the role of genes in the variation and trajectories of functional capacities in older age is poorly understood.

Physical Restraint and Antipsychotic Medication Use Among Nursing Home Residents With Dementia.

Purpose: To explore antipsychotic (AP) medications and physical restraint use and their effects on physical function and cognition in older nursing home residents.

Methods: This retrospective cohort studied involved 532 residents with dementia from 57 nursing homes participating in the Services and Health for Elderly in Long-Term Care study. Poisson log regression models explored the effect of physical restraint and/or AP medication use on cognitive or functional decline at 6 months.

Chronic diseases and geriatric syndromes: The different weight of comorbidity.

Background: Comorbidity is a relevant health determinant in older adults. Co-occurrence of several diseases and other age-associated conditions generates new clinical phenotypes (geriatric syndromes [GS] as falls, delirium etc.).

Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

Background: Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales.

A retrospective, longitudinal study of factors associated with new antipsychotic medication use among recently admitted long-term care residents.

Background: Use of antipsychotic (AP) medications is high and often inappropriate among institutionalized populations. Little is known about the correlates of new AP drug use following admission to long-term care (LTC) settings. This study investigated the frequency and correlates of new AP drug use among newly admitted LTC residents.

Comparing the characteristics of people living with and without HIV in long-term care and home care in Ontario, Canada.

Population aging and successful drug therapy in human immunodeficiency virus (HIV) management mean that more people are living longer with HIV. As these individuals age, they become more at risk of developing other chronic health conditions which will have many implications for disease management and choice of care setting. As people living with HIV turn to home care and long-term care (LTC) settings for care, understanding the particular needs of this population is becoming increasingly important.

Use of antipsychotic drugs among residents with dementia in European long-term care facilities: results from the SHELTER study.

Background: Behavioral and psychological symptoms of dementia (BPSD) are common reasons for use of antipsychotic drugs among older individuals with dementia. These drugs are not approved for such use and both the Food and Drug Administration and European Medicines Agency have issued warnings to limit such use.

Objectives: This study aimed to describe patterns of antipsychotic drug use in a sample of nursing home residents with dementia in 7 European countries and Israel.

Prevalence and correlates of cardiovascular medication use among nursing home residents with ischemic heart disease: results from the SHELTER study.

Objectives: Despite being the highest group of users of many medications, older individuals remain underrepresented in clinical trials. This leaves a gap in evidence to guide management of many conditions, such as ischemic heart disease (IHD), in this population. This study aimed to describe factors associated with IHD medication use among nursing home residents in 7 European countries and Israel to depict challenges facing disease management in this population.

The Value of Admission Clinical Data for Diagnosing Heart Failure in Long-term Care.

Background: Heart failure (HF) is common in long-term care (LTC). Diagnostic uncertainty is important barrier to optimal HF management, stemming from inadequate health information transfer upon LTC admission. We determine the utility of admission clinical information to confirm a HF diagnosis in new LTC residents.

Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study.

Background: The interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions.

Adverse events associated with hospitalization or detected through the RAI-HC assessment among Canadian home care clients.

Background: The occurrence of adverse events (AEs) in care settings is a patient safety concern that has significant consequences across healthcare systems. Patient safety problems have been well documented in acute care settings; however, similar data for clients in home care (HC) settings in Canada are limited. The purpose of this Canadian study was to investigate AEs in HC, specifically those associated with hospitalization or detected through the Resident Assessment Instrument for Home Care (RAI-HC).

Heart failure--related mortality and hospitalization in the year following admission to a long-term care facility: the geriatric outcomes and longitudinal decline in heart failure (GOLD-HF) study.

Background: Heart failure (HF) is common in long-term care facilities (LTCs). This study compared mortality and hospitalization rates and examined predictors of these outcomes among new LTC residents with and without HF.

Methods And Results: This prospective cohort study followed 546 newly admitted residents from 42 LTCs for up to 1 year.

Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study.

Background: Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes.

Polypharmacy and mortality among nursing home residents with advanced cognitive impairment: results from the SHELTER study.

Introduction: Older adults with advanced cognitive impairment have a limited life expectancy and the use of multiple drugs is of questionable benefit in this population. The aim of the present study was to assess if, in a sample of nursing home (NH) residents with advanced cognitive impairment, the effect of polypharmacy on mortality differs depending on estimated life expectancy.

Methods: Data were from the Services and Health for Elderly in Long TERm care (SHELTER) project, a study collecting information on residents admitted to 57 NHs in 8 European countries.

Caregiver status affects medication adherence among older home care clients with heart failure.

Background And Aims: For older individuals living in the community with chronic diseases such as heart failure (HF), caregivers may play an important role in medication adherence. This role may be increasingly important as cognition declines. This study aimed to 1) examine the role of caregivers in medication adherence in a complex population of older home care clients with mild cognitive impairment (MCI) and 2) examine the effect of caregiver stress on medication non-adherence.

Clinical, demographic and functional characteristics associated with pharmacotherapy for heart failure in older home care clients: a retrospective, population-level, cross-sectional study.

Background: Use of combination pharmacotherapy, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) and β-adrenoceptor antagonists (β-blockers) in the management of heart failure (HF) can reduce mortality, prevent functional decline and reduce health service use. However, these first-line therapies are underused in older populations. This article describes the use and predictors of use of first-line HF therapies in a population-based cohort of older home care clients in Ontario, Canada.