Canadian Geriatrics Journal

Evaluation of a Student-Older Adult Telephone Befriending Program to Reduce Social Isolation During the COVID-19 Pandemic

Wed, 04 Mar 2026 00:00:00 +0000

Social isolation and loneliness are associated with many adverse health outcomes. The COVID-19 pandemic increased its prevalence and disproportionately affected older adults. Since telephone befriending was a potentially feasible and safe intervention during the pandemic, the McMaster Phone-a-Friend Program (PFP) was developed using this strategy to try to reduce social isolation and loneliness among older adults. Thus, this study aimed to evaluate the effectiveness and long-term feasibility of PFP. Community-dwelling older adults in Ontario, Canada were matched to trained university student volunteers, who provided social engagement and pandemic-related education through weekly telephone calls. Two main referral sources were used: 1) older adults identified by their primary care provider as at risk for social isolation; and 2) older adults referred for multi-modal frailty rehabilitation, where telephone befriending was a desired component intervention. Older adults completing ≥4 calls were contacted to participate in a telephone survey to provide program feedback. Of the 220 active participants in August 2021, 60 participated in our survey. At the time of survey completion, the mean number of calls completed was 8.3. The mean age of participants was 75.6 years and 71.7% (n=43) identified as female. Furthermore, 58.3% (n=35) of the participants agreed or strongly agreed that they felt less lonely after participating in the program and 68.3% (n=41) stated they would participate in the program after the pandemic resolves. The intergenerational PFP telephone befriending program is a safe and effective method of reducing or possibly preventing social isolation and loneliness among at-risk community-dwelling older adults.

Evaluating the Impact of an Emotion-Focused Model of Dementia Care on Patient Outcomes in Acute Care Settings

Shailesh Nadkarni, Samin Barakati, Neil Dinesh Dattani, Sudip Saha — Wed, 04 Mar 2026 00:00:00 +0000

Emotion-focused model of care delivery creates a supportive environment for persons with dementia. There is a lack of certainty regarding one such emotion-focused model’s effectiveness (Butterfly) in an acute care environment, primarily because prior research has been confined to long-term care (LTC) facilities. Studies have demonstrated reduced neuro-psychiatric symptoms (NPS) when person-centred dementia care models are deployed for persons living with dementia (PLWD). A multi-site cross-sectional design assessed NPS in PLWD using the NPI-Q scale in hospitalized patients on a Emotion-focused unit for 7–21 days. We identified 177 PLWD (88 from an acute care for elderly unit, 89 from general medicine units). The two cohorts had 40 female and 48 male patients in the ACE unit and 35 female and 54 male patients in the general medicine unit. The average age between the two groups was 83 and 84 yrs, respectively. NPI-Q symptom severity was lower on the ACE unit in comparison to the general medicine unit. Mean improvement for motor behaviours and sleep were significant. Caregiver distress scores were significantly lower for delusions, agitation, anxiety, irritability, motor behaviour and sleep. Emotion-focused care made a statistically significant change in NPS severity and caregiver distress when compared to care provided in general medicine units.

Reference Values of Quadriceps Muscle Thickness Measured by Point-of-Care Ultrasound by Sex and Age Groups in Older Adults

Wed, 04 Mar 2026 00:00:00 +0000

Sarcopenia is an age-related skeletal muscle disorder characterized by decreased muscle mass, strength, and physical function, which increases the risk of adverse outcomes in older adults. Recently, ultrasound has emerged as a practical tool for estimating muscle thickness as a proxy for muscle quantity. However, standardized protocols, reference data, and diagnostic cut-off values for ultrasound-based muscle assessment remain lacking. This study pooled participants from three cohorts in which quadriceps muscle thickness was assessed in B-mode with a linear probe using point-of-care ultrasound (POCUS). Of 391 participants, 389 were included in the final analysis. Age was categorized into five-year groups (65-69, 70-74, 75-79, 80-85, and over 85 years old). Means and standard deviations (SD) of quadriceps thickness were calculated by sex and age group. Mean age was 77 ± 7 years. Quadriceps muscle thickness followed a normal distribution with a standard deviation of 0.5 cm. Mean thickness declined with advancing age. Our pooled analysis found a mean quadriceps muscle thickness of 2.0 cm. The decline with advancing age was modest, with the lowest value observed in participants aged 85 years and older (1.8 ± 0.4). On average, muscle thickness decreased by approximately 0.1 cm per decade after age 65. These findings provide age- and sex-specific reference values for quadriceps muscle thickness measured by POCUS, and support its potential utility as a feasible tool for muscle assessment in older adults.

Cultural and Ethnic Dimensions of Mealtime Practices in Long-Term and Residential Care: a Comprehensive Scoping Review

Wed, 04 Mar 2026 00:00:00 +0000

Background

As ethnically diverse populations increasingly access long-term care (LTC) and residential care facilities (RCF), mealtimes emerge as vital opportunities to preserve cultural identity, foster social connections, and support well-being. However, systemic barriers and institutional limitations often prevent culturally inclusive mealtimes, marginalizing minority populations and perpetuating inequities in mealtime delivery. This review explores the state of knowledge on cultural and ethnically diverse mealtime practices and menu options within LTC and RCF.

Methods

Using the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines, a comprehensive scoping review was conducted. Databases and grey literature sources were systematically screened, with data extracted and analyzed using a hybrid thematic analysis. Findings were organized by the socioecological model, exploring influences at intrapersonal, interpersonal, community, institutional, and societal levels.

Results

A total of 126 full-text manuscripts were reviewed and 42 were included in the final analysis. Key themes emphasized food’s role in cultural identity, and highlighted best practices in ethnic-specific facilities, which tailored menus and rituals to residents’ needs. Barriers included budget constraints, limited access to culturally specific ingredients, insufficient staff training, and standardized menus. Families often bridged these gaps, straining their resources. Promising practices included flexible meal schedules, resident-centred menu planning, staff training, and partnerships with cultural organizations. Recommendations focused on increasing funding, implementing flexible policies, and studying the long-term impacts of inclusive practices.

Conclusions

Culturally inclusive mealtime practices have the potential to transform LTC and RCF by promoting dignity, enhancing quality of life, and addressing systemic inequities. Ethnic-specific facilities provide effective models, but broader adoption of best practices is necessary for mainstream care settings.

Herpes Zoster and Frailty in Older Adults: a Systematic Review

Maria Paula B. D’Elia, Melissa K. Andrew, Henrique Pott — Wed, 04 Mar 2026 00:00:00 +0000

Background

Herpes zoster (HZ) and its complications, postherpetic neuralgia (PHN), are common in adults, particularly the frail. Frailty may affect infection outcomes and vaccine efficacy. This study evaluated the association between frailty and HZ/PHN risk, and examined vaccine uptake, immunogenicity, and efficacy in frail versus non-frail individuals.

Methods

We systematically reviewed PubMed/MEDLINE, the Cochrane Library, Embase, and grey literature for studies published from January 2015 to January 2025. Eligible studies included observational and randomized controlled trials evaluating frailty in adults aged ≥50 years and reporting HZ incidence, severity, PHN, or vaccination. Two reviewers independently selected studies, extracted data using a standardized form, and assessed quality using JBI tools. Due to heterogeneity, data were synthesized narratively.

Results

Eight studies met the inclusion criteria, with a sample size exceeding 15,000 participants. Two studies identified an association between frailty and an increased incidence of HZ, while two others indicated an elevated risk of PHN among frail individuals. One study highlighted low vaccine uptake in a frail Italian cohort. Three studies assessed the immunogenicity of the zoster vaccine, suggesting that although absolute immune responses may be diminished in frail individuals, relative responses are often maintained. A pooled analysis of recombinant zoster vaccine trials demonstrated consistently high efficacy (exceeding 90%) across all frailty levels.

Conclusions

Frailty may increase vulnerability to HZ and PHN. Routine frailty assessment may improve vaccine uptake and prevention. Further longitudinal studies using standardized frailty measures are needed to understand the causal pathways and optimize care.

What’s a “Cognitive” Intervention? The PICC-M Framework to Distinguish Cognitive Remediation, Stimulation, Training, Therapy, and Rehabilitation

Sara Pishdadian, Jacky Jin — Wed, 04 Mar 2026 00:00:00 +0000

Psychosocial interventions targeting cognition improve objective cognitive test performance, strategy use, emotional well-being, and quality of life in individuals with mild cognitive impairment and early dementia. These interventions have been labeled as cognitive training, cognitive remediation, cognitive rehabilitation, cognitive stimulation, and overlap with cognitive (psycho)therapy. The inconsistent labeling of the interventions has resulted in ambiguity of what a cognitive intervention entails and limits the translation of interventions into clinical practice. To address this, we propose a new frame-work, “PICC-M”, that classifies cognitive interventions based on five active ingredients or the mechanisms resulting in clinically significant change. These ingredients are psychotherapeutic support (P), individualized patient goals (I), cognitive exercises (C), compensatory strategies (C), and metacognitive strategies (M). We examine three intervention programs to illustrate how this framework clarifies each intervention’s active ingredients and their relation to cognitive, psychological, and functional outcomes. The PICC-M framework lays the foundation for dismantling studies to isolate and test the effectiveness of specific active ingredients and ultimately support clinical delivery of evidence-based interventions for older individuals with neurocognitive deficits.

Caring Across Generations: The Urgent Need to Support Young Carers in Canada’s Aging Population

Lucas Xavier Perri, Afolasade Fakolade, Karen Okrainec, Warren Lewin — Wed, 04 Mar 2026 00:00:00 +0000

Young carers—youth aged 15 to 24 years who provide unpaid care to older adults—represent an essential yet often invisible component of Canada’s caregiving landscape. Over one million young Canadians provide unpaid care to family members, with approximately 40% caring for older adults such as grandparents. As Canada’s population ages and chronic illness prevalence rises, the number of young people assuming caregiving responsibilities continues to grow. Despite their significant contributions, young carers face unique challenges including impacts on mental health, educational attainment, and social development, often without formal recognition or support. This Perspectives article reviews the current evidence on young carers of older adults in Canada, examines their lived experiences, and identifies systemic gaps in health, education, and social systems. Unlike the United Kingdom, which has enacted legislation formally recognizing and supporting young carers, Canada lacks comprehensive policies and support structures for this population. Innovative programs are emerging, including foundational training for health professionals, online peer support communities, and cross-sector collaborations between healthcare providers, educators, and community organizations. The article recommends actionable steps including legislative recognition of young carers, improved data collection and monitoring, expanded professional training, investment in peer support programs, and implementation of family-centered care models. Primary care teams are uniquely positioned to identify young carers, recognize their contributions, and connect families with available supports. Without adequate recognition and intervention, young carers remain at risk of long-term social, academic, and mental health difficulties affecting both themselves and those for whom they care.

Prevalence and Outcomes of Frailty in Older Men—the Manitoba Follow-Up Study

Phil D. St John, Robert B. Tate — Wed, 04 Mar 2026 00:00:00 +0000

Background

The Frailty Index (FI) is a measure of frailty with recent guidance on its calculation. Objectives were: 1) To determine the prevalence of frailty and its component domains at different ages in older men; and 2) To determine if the FI, and/or its component scores predict death or long-term care (LTC) admission. Design: A cohort study. Setting: Most of the participants lived in Canada. Subjects: 3,983 men who qualified for air crew training during the Second World War. We included 1,711 men (mean age 76) free of dementia, living in the community, who had data to construct a FI in 1996.

Methods

Medical conditions have been measured from 1948. Functional status, health status, and social well-being have been measured by survey since 1996. We constructed a FI from these data and calculated the prevalence of frailty from the age of 75+. We considered three domains of frailty: medical, functional, and psychosocial. We calculated the mortality risk and the risk of LTC care admission using proportional hazards models.

Results

Frailty, dementia, and LTC use are all strongly related to age. The FI is associated with mortality and LTC admission at all ages. This effect was a spectrum of risk. The effect of functional domains was seen at all ages, while the effect of medical conditions on these outcomes declined with advancing age. Psychosocial domains were less strongly correlated with these outcomes.

Conclusions

The FI is associated with adverse outcomes, and should be considered in clinical and policy decisions.

Adverse Events in Older Adults at Risk for Dementia During Remote Physical Exercise and Cognitive Training

Wed, 04 Mar 2026 00:00:00 +0000

Background

SYNchronizing Exercises, Remedies in GaIt and Cognition @Home (SYNERGIC@Home/SYNERGIE~Chez soi) is a home-based, double-blind, randomized controlled trial. Sixty community dwelling older adults (aged 60–90 years), living in New Brunswick, Canada, who were at risk of dementia participated remotely using secure videoconferencing. Participants underwent 16 weeks (three sessions/week) of cognitive and physical interventions. This research aimed to determine the frequency, severity, and relationship of adverse events (AEs) that occurred during the physical and cognitive intervention phase of the SYNERGIC@Home study. This study addressed a critical question: Whether AEs occurring during a remote exercise and cognitive intervention for older adults at risk of dementia can be managed safely and effectively to optimize participation.

Methods

All AEs were recorded, including type, severity, and their relatedness to the intervention. Intervention modifications due to AEs were also recorded.

Results

Participant’s mean age was 69.5 years (SD=6.47), 76.7% were female, and 58.4% were living in suburban or urban communities. A total of 88 AEs affected 42 (70.0%) participants. Most AEs (71.6%) were unrelated to the intervention, and 69.3% were classified as mild, with musculoskeletal issues being the most common AE (39.8%). One unrelated serious AE was recorded. Modifications to the physical intervention were made for 31 participants, and two discontinued due to unrelated medical issues.

Conclusions

When delivered remotely, physical and cognitive interventions resulted in no serious related AEs and the few related, mostly mild AEs, were safely managed through modifications to the physical interventions.

Thank You to Our Reviewers in 2025

Wed, 04 Mar 2026 00:00:00 +0000