Aging

Researcher uses AI to understand how healthy older adults are aging at home

Christopher.Sorensen — Mon, 23 Oct 2023 16:33:13 +0000

Researcher uses AI to understand how healthy older adults are aging at home

Christopher.Sorensen Mon, 10/23/2023 - 12:33

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Charlene Chu, an assistant professor in 91�Թ�’s Lawrence S. Bloomberg Faculty of Nursing, examines the intersections of technology and older adults’ health and well-being (photo by Robert Frost Photography)

Rebecca Biason

Topic

Our Community

Aging

Artificial Intelligence

Faculty of Applied Science & Engineering

Lawrence S. Bloomberg Faculty of Nursing

Research & Innovation

University Health Network

Subheadline

“We know a lot about older adults who are ill or who have multi-morbidities, but we don’t have much insight into older adults who are aging in positive and healthy ways”

91�Թ� nursing researcher Charlene Chu wants to know how older adults age at home – and she’s using artificial intelligence to help.

An assistant professor in the Lawrence S. Bloomberg Faculty of Nursing, Chu is examining the intersections of technology and older adults’ health and well-being. Her current research uses a multi-modal AI-based sensor system called MAISON (Multimodal AI-based Sensor platform for Older iNdividuals) to help fill in knowledge gaps in the field.

MAISON uses a wearable watch as well as a variety of sensors such as sleep mats, motion detectors and chair mats to collect information on the wearers’ physiology, including heart rate, blood pressure and quality of sleep. It also detects participants’ levels of activity, including how far they can travel from home.

“We know a lot about older adults who are ill or who have multi-morbidities, but we don’t have much insight into older adults who are aging in positive and healthy ways,” Chu says. “With the rapid advancements in AI and its deployment across multiple sectors, thoughtful examination is required to determine how we can ensure older adults benefit from AI so that no one is left behind.”

Chu is the recipient of a multi-year National Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant, which supports innovation in engineering science. This will fund three interrelated projects including the design and deployment of the MAISON app interface that will help Chu and co-investigator Shehroz Khan, a scientist at the KITE Research Institute, University Health Network and an assistant professor at 91�Թ�’s Institute of Biomedical Engineering, develop a database that will provide a nuanced understanding of how healthy older adults age actively in their communities.

The database will be the first of its kind in Canada to include information on the age, sex, gender and socio-economic status of older adults and how this correlates to their ability to age at home.

The overarching goal, Chu says, is to make the database accessible to researchers from around the world, creating the potential for machine learning models to accurately predict outcomes of active aging and inform the design of new technologies – all with older adults acting as key partners in the process.

“These three projects and the app we are creating will be focused on gathering data from people who manage their own health conditions,” says Chu. “We hope to gain a holistic perspective of aging, incorporating feedback from older adults about what they think is important to include in an app that measures their lifestyle and health.”

The detailed information collected by MAISON increases the researchers ability to understand how factors like socio-economic status, geographic location, community features, age, sex and gender impact the aging process, Chu adds. This is important, she notes, because technology for older adults is often subject to bias or digital ageism – problems she has highlighted in earlier research.

“There is a difference between older adults who are 65 versus those who are 75. We cannot lump together everyone who is 55 and older when we design technology and applications for older adults, but this is what is happening now,” Chu says.

The MAISON system and app interface is currently being used to assess and monitor the activity of older adults who have been discharged from inpatient rehabilitation following hip surgery, helping to demonstrate the technical feasibility of Chu’s latest project.

“Digital ageism partially stems from a lack of data on older adults, including poor labelling and lack of access to technology,” Chu says. “With this project I’m hopeful that we will begin to overcome those barriers.”

Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 — Fri, 21 Jul 2023 18:00:11 +0000

Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 Fri, 07/21/2023 - 14:00

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(photo by Patricia Kovac/iStockphoto)

Rebecca Biason

Topic

Our Community

Canadian Institutes of Health Research

Aging

Lawrence S. Bloomberg Faculty of Nursing

Mental Health

Research & Innovation

Subheadline

New study looks at how race, ethnicity, sex, gender and age impact the experiences of unpaid caregivers across the country

A new nationwide study led by Monica Parry, a professor in the Lawrence S. Bloomberg Faculty of Nursing, will examine the intersections of race, ethnicity, sex, gender and age as they relate to the health and well-being of unpaid caregivers.

The study, which will be conducted by Parry and a team of researchers from across Canada, is funded by the Canadian Institutes of Health Research.

Monica Parry (supplied image)

Parry notes that almost one-third of Canadians provide unpaid caregiving – which can encompass personal, psychological, physical, social and financial care for someone with a long-term health condition, disability or with increased needs due to aging. In 2020, Parry conducted a six-month rapid review of the experiences of unpaid caregivers, with a particular focus on the impact of the COVID-19 pandemic.

Her study found that caregivers were reporting over 40 hours of unpaid caregiving per week – the equivalent of a full-time job. But the respondents were not necessarily reflective of the Canadian population.

“Race and ethnicity were not well reported – and yet we know that almost one in five people in Canada are born outside the country, so there is a large gap in our understanding of the health and well-being of a significant portion of the population and their caregiving experience,” Parry says.

This is significant because unpaid caregivers are often faced with increased health risks. Parry’s previous study found that unpaid caregiving was associated with high amounts of stress, anxiety and depression – which in turn can lead to the development of chronic illness such as cardiovascular disease, in addition to ongoing negative impacts on mental health.

To ensure that this current study is more reflective of Canada’s population, the research team is working closely with partners in the community – including the Pentecost International Worship Centre, the Council for Agencies Serving South Asians and the Yee Hong Centre for Geriatric Care, among others – to recruit participants.

Parry and her collaborators are also encouraging those who identify as unpaid caregivers and who are 18 or older to consider participating by completing an online survey.

The study includes an engagement advisory committee made up of unpaid caregivers who have shared their lived experiences in a series of videos to encourage participation from their peers.

“We have heard from our members of the community that until they had taken our survey, they had not recognized their own needs as caregivers and the impact of caregiving on their health,” Parry says.

“I think this illustrates just how important this study is in helping us understand what caregivers are experiencing and what they will need in the future.”

Parry adds that as a result of the pandemic, unpaid caregiving is increasing because many people simply do not want to see their family members or friends in long-term care settings, which were hit hard by COVID-19.

Caregivers are doing “heroic things” just to keep their loved ones at home, often juggling caregiving with everyday work and family responsibilities, Parry says.

“We truly want to include the voices of all unpaid caregivers and paint a full picture of what their needs are, and how caregiving impacts them.”

Study finds older cancer patients would benefit from geriatric assessment screening

Christopher.Sorensen — Fri, 06 Jan 2023 13:48:59 +0000

Study finds older cancer patients would benefit from geriatric assessment screening

Christopher.Sorensen Fri, 01/06/2023 - 08:48

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(photo by Westend61/Joseffson/Getty Images)

Topic

Lawrence S. Bloomberg Faculty of Nursing

Research & Innovation

A new study led by the 91�Թ� and its partner institutions has found that older adults – who account for more than 70 per cent of cancer diagnoses – would benefit from undergoing a geriatric assessment screening before they start chemotherapy.

The study, published in the Journal of Clinical Oncology and led by Martine Puts, an associate professor in the Lawrence S. Bloomberg Faculty of Nursing, examines whether the use of the geriatric assessment and management (GAM) model in cancer patients would show an improvement in their quality of life.

The GAM includes an assessment of an older adult’s daily living activities, their mood, cognition, whether they have or need supports at home, their risk of experiencing a fall, and their ability to report toxicity during treatment.

Martine Puts

While the study did not indicate the GAM made any significant changes to quality of life in patients, it did provide important evidence that there is work to do to help maintain functional status in older adults.

“We know that older adults will be more likely to accept cancer treatment if they have an understanding of how it will impact their functional status, including their ability to tolerate treatment, and whether they will be able to retain their functional status, which could impact their quality of life,” says Puts, who holds the Canada Research Chair in the Care for Frail Older Adults.

Puts notes that the assessment tool can be used in a variety of settings but is not typically used in oncology.

“The assessment can take up to two hours, and while it is useful, it is time-consuming,” Puts explains. “There is also currently a shortage of geriatric teams, which consist of nurses and geriatricians, alongside difficulties obtaining the funding needed to conduct this assessment. It is another reason that studies such as ours look to determine who the GAM benefits most, and how, so that we target when it is used.”

Puts points to previous observational studies that indicated when the assessment tool was used, up to 70 per cent of patients were found to have issues affecting their ability to receive cancer treatment, such as having an increased fall risk or undiagnosed cognitive impairment. That kind of information is useful for oncologists in determining a possible course of cancer treatment for an older adult, since certain options like specific chemotherapeutic agents can increase the risk of future falls or worsen cognition.

The study found that 25 per cent of participants fell prior to cancer treatment – and during the study, researchers recorded evidence that one in four participants experienced a further fall.

“Although we found no evidence of a change in quality of life, the fact that falls kept occurring during the study and its potential effect on outcomes means that it is clearly something that needs to be addressed,” Puts says.

The study, which took place at the height of the pandemic, also examined the impact of COVID-19 on patients in the trial. Over 60 per cent of participants were surveyed during the pandemic, with many indicating their quality of life improved during that period – an unexpected finding for Puts and her team. However, many participants were also more likely to die and interventions and resources that patients would normally be connected with following their assessment were restricted or no longer offered.

For Puts and her team, one of the most significant findings was that the use of the GAM needs to be refined so that it can target patients who would benefit from it the most. Evidence from their study points to the need to recruit and conduct the geriatric assessment on frailer patients and that these assessments should be done before a treatment plan has been finalized.

Puts and her colleagues are currently working on two separate studies to address some of these issues. One is focused on the electronic development of a rapid geriatric assessment that could be used to address the shortage of geriatric teams needed for these assessments.

The Comprehensive Health Assessment for My Plan, or CHAMP, will be tested among patients and clinicians in both oncology and non-oncology settings. Another pilot study funded by the Canadian Institutes of Health Research will examine a combination of the GAM with a virtual chair-based exercise regimen that would be used to assess functional outcomes and prevent functional decline during cancer treatment.

The research behind the GAM study received support from the Canadian Cancer Society.

With an eye to developing better supports, 91�Թ� researcher explores aging Chinese Canadians' views on elder abuse

Christopher.Sorensen — Wed, 27 Nov 2019 13:53:06 +0000

With an eye to developing better supports, 91�Թ� researcher explores aging Chinese Canadians' views on elder abuse

Christopher.Sorensen Wed, 11/27/2019 - 08:53

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Weiguo Zhang, an associate professor in the department of sociology at 91�Թ� Mississauga, embarked on a series of studies three years ago to assess how aging Chinese immigrants were faring in Canada (photo by Drew Lesiuczok)

Blake Eligh

Topic

Breaking Research

Aging

Research & Innovation

Sociology

91�Թ� Mississauga

A new 91�Թ� study highlights an important information gap that may leave some seniors in Canada vulnerable to abuse and neglect.

Weiguo Zhang, an associate professor in the department of sociology at 91�Թ� Mississauga, spent two decades studying seniors in China and three years ago embarked on a new series of studies to assess how aging Chinese immigrants were faring in Canada.

In particular, he sought to understand how Chinese-born seniors viewed abuse and neglect.

“Our knowledge of this issue is limited partly because the voices of older adults are often overlooked by policy-makers and researchers,” Zhang says, adding that voices of ethnic groups are particularly under-represented.

“It’s important to understand what shapes their definitions to develop effective strategies and interventions.”

Partnering with a Chinese seniors’ association in the Greater Toronto Area, Zhang collected data from one-on-one interviews, observations and focus groups comprised of association members who immigrated to Canada after the 1990s. Participants discussed various forms of abuse that might be experienced by older Chinese immigrants, including emotional, verbal, physical and financial abuse, as well as neglect and violation of rights.

The study, published in a recent issue of Journal of Elder Abuse & Neglect, found that participants’ understanding of elder abuse diverged from Western definitions in some key areas.

“Emotional abuse was the most frequently mentioned category, with participants identifying certain words, gestures or actions seen as disrespectful in the Chinese community,” Zhang says. “Some felt the line between arguments and verbal abuse was unclear. People seldom linked yelling, ridicule, scorn and making fun of older people as abuse.”

Culture appears to play a role in these views. Study participants did not view certain behaviours as abusive, even though they might be considered so by non-Chinese-born seniors. For example, failure to respect personal autonomy is considered abusive by many in the West, but study participants felt that it was not abusive for family members to stop seniors from participating in risky behaviour – such as addictive gambling – if the consequences might negatively impact the senior’s well-being.

On the other hand, the actions of adult children who failed in their filial duty to older parents were seen as abusive or neglectful.

“Sending people to nursing homes was perceived as abuse or neglect,” says Zhang. “I found that older adults simply wanted their children to meet the socially defined obligations of caring for their parents. When they failed to do so, the children were perceived as unfilial, abusive or neglectful. This perception was particularly true when parents felt they had done a great deal for their children and were having difficulty adjusting to the new country.”

Participants also reported that they felt their status as immigrants and as dependants on adult children left them isolated and vulnerable to potential abuse. They cited language barriers, limited access to transportation and gaps in understanding Canadian culture, banking systems and laws as reasons they felt they had to be careful about their own words and actions.

“They came from China as retired doctors, professors and managers and suddenly become dependants,” Zhang says. “Except for caring for their grandchildren and contributing to household chores, they said they encountered difficulties living an independent life.”

The study also found that perceptions could change through interactions with peers and non-peers in the host society. Some of the participants reported changes in their own understanding of elder abuse.

“Discussing these issues with others made them more aware of problems,” Zhang says. “Some of them realized that abuse could be more than physical abuse or abandonment.”

The elder abuse study is the first release in a series of studies by Zhang to assess Chinese seniors in Canada.

Roomies with a twist: 91�Թ� researchers help run home-sharing project that pairs seniors with students

Christopher.Sorensen — Wed, 06 Feb 2019 17:36:44 +0000

Roomies with a twist: 91�Թ� researchers help run home-sharing project that pairs seniors with students

Christopher.Sorensen Wed, 02/06/2019 - 12:36

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Catherine Finlayson (left) and Zoe Butcher are participants in a new home-sharing program that's matching students with seniors to help them save on housing costs (photo by Naomi Harris)

Topic

Factor-Inwentash Faculty of Social Work

Housing

Undergraduate Students

On a bright December morning, first-year 91�Թ� student Zoe Butcher is quick to answer the door at a well-kept semi in Toronto’s East Danforth. She offers tea as she heads into the recently renovated kitchen where Catherine Finlayson, 61, joins her. They chat and laugh while the kettle heats up. The two live together, but they aren’t family, roommates, or your typical landlord and tenant. As participants in an intergenerational home-sharing program that launched in September, they’re something unique.

Settling in the comfortable front room where they sometimes watch Netflix together over dinner, Butcher and Finlayson joke about how boring their story will be for the researchers analyzing the results of the Toronto HomeShare Pilot Project. “Everything has just been incredibly easy,” says Butcher, 18, who was searching for a place to live with friends when she learned about the project at the 91�Թ� housing fair. “We’ve had zero problems.” Finlayson says the concept interested her right away when she heard about it on social media last summer. “I thought it would be fun to have a young person around, and I knew I could use help with the house.”

A provincially funded partnership between the National Initiative for the Care of the Elderly – housed at 91�Թ� – and the City of Toronto, the project matched 12 Toronto post-secondary students with older adults willing to rent their unused space for the academic year. The students subsidize their rent with five to seven hours per week of household contributions such as errands and dog walking, while the homeowners benefit from this assistance along with rental income. Butcher pays $500 per month, while the one-bedroom apartments she had been looking at were around $1,000, and shared accommodations were $700 to $800.

A 2017 study by the Canadian Centre for Economic Analysis found there are two million empty bedrooms in the Greater Toronto and Hamilton Area alone, most of them owned by seniors. Capitalizing on this fact, the project provides quality affordable housing – a rarity in the Toronto market – for students while helping older adults age in place.

“Intergenerational home-sharing programs aren’t new,” says Raza Mirza, a senior research associate at 91�Թ�’s Factor-Inwentash Faculty of Social Work, “but to the best of our knowledge, this is the first intergenerational home-share project in Canada and potentially the world to be facilitated completely by social workers. They help mitigate risk and offer reassurance to both the students and seniors.”

Mirza and his research team at the National Initiative for the Care of the Elderly, where he is the network manager, are implementing and evaluating the project in collaboration with the city.

Based on the applicants’ lifestyles and preferences on matters such as alcohol, pets and smoking, social workers create a match and then attend an in-person meeting to evaluate whether the two individuals connect well in real life. Students undergo a vulnerable sector screening – a police background check designed for people who will be volunteering or working for potentially vulnerable populations such as older adults or children – and complete an educational module on living with older people that includes subjects such as elder abuse and how to engage with seniors. Both parties can access the social worker for support and mediation after they’re living together.

First-year 91�Թ� student Zoe Butcher helps Catherine Finlayson, 61, empty the dishwasher. Students are expected to help out around the house, doing chores and light housework in return for subsidized rent (photo by Naomi Harris)

Laura Martinez, the gerontological social worker and research officer at the National Initiative for the Care of the Elderly who matched Butcher and Finlayson, says there were only minor problems among some project participants during the four-month pilot phase. “It was just normal roommate issues like cleaning up, and they were easily resolved. But they could have escalated without intervention.”

Finlayson and Butcher are eager to talk about how well they hit it off from their first meeting. Not only were they a good match on paper – non-smokers with the same sleeping schedule, among other things – but they soon discovered other common ground, such as their love for Star Wars movies. Most striking, however, is the fact that they come from families of six kids.

The importance of family and friendships in both of their lives comes up when they try to pinpoint what makes them mesh so well. “My mom always encouraged me and my siblings to be social, and create lots of different connections,” says Butcher. She and Finlayson share a low-key warmth, along with a fondness for a good laugh. Asked what made them take the leap of living with a stranger with a 40-year age difference, they both attribute it to being “open-minded” about new experiences. “As I age, I work even harder on keeping my world growing, not shrinking,” says Finlayson.

Before Butcher moved in, Finlayson had been living alone in the house – bought in 2014 after her divorce – for more than three years. A serious knee injury around the same time limited her mobility and made home maintenance very difficult, but she says she wasn’t just looking for an extra pair of hands. “It’s nice to remain exposed to young people and their ideas. You don’t want to get too insulated as you get older.”

Yet social isolation and loneliness are not the exclusive domain of seniors, says Mirza. Students and older adults have common pressures such as housing challenges, loss of family connections and financial stress. “By bringing these two demographics together and alleviating some of their primary stressors, we’re trying to create opportunities for new connections and deeper community engagement.”

Finlayson has grown children in the city and helpful neighbours, but says it’s reassuring having someone in the house she can rely on. “I’m not very good at asking for help, so Zoe has become good at reminding me she’s willing and able to do things.” She did the fall garden cleanup, shovels snow and takes on physically demanding chores such as vacuuming.

Finlayson (left) says she enjoys having Butcher keep her on top of the latest technology and popular culture trends (photo by Naomi Harris)

Mirza and his research team are now taking what they’ve learned from the pilot phase and using it to improve and expand the project. The major criticism from participants was that it took too long to apply and get matched, so the team is developing a tech platform to streamline the process. The feedback from participants on the actual home-sharing experience was overwhelmingly positive, prompting Mirza to apply for a grant to replicate the project at five other Canadian universities. The pilot project included students from 91�Թ�, Ryerson University and York University.

“The results show that this project was not about needy older adults renting their rooms out of necessity, nor were students just looking for a cheap space,” says Mirza. “We found a true sense of reciprocity, where both parties contributed to each other’s lives.”

Next year Butcher plans to find an apartment with friends so she can try out a more typical student lifestyle, while Finlayson says she would take another student every year from now on “in a heartbeat.” She adds, “It’s just been such a rewarding experience all around. I’d encourage anybody to do it.”

This story originally appeared in 91�Թ� Magazine

91�Թ� researcher looks into why dementia and depression hit women hardest

ullahnor — Mon, 13 Mar 2017 16:33:50 +0000

91�Թ� researcher looks into why dementia and depression hit women hardest

ullahnor Mon, 03/13/2017 - 12:33

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Gillian Einstein’s work is breaking new ground in how researchers think about biological and social factors and the ways they relate to health (photo courtesy of Gillian Einstein)

Jovana Jankovic

Author legacy

Jovana Jankovic

Topic

Global Lens

Women's Health

Faculty of Arts & Science

Dalla Lana School of Public Health

Health

Aging

Subheadline

Gillian Einstein is the holder of the inaugural Wilfred and Joyce Posluns chair in women’s brain health and aging

Why is the incidence of depression, stroke, dementia and Alzheimer's significantly higher in women than men?

Women’s health – and women’s brain health, in particular – is something “distinct in itself”, says 91�Թ� researcher Gillian Einstein, the holder of the inaugural Wilfred and Joyce Posluns chair in women’s brain health and aging.

Yet the majority of research into women’s health has so far focused mainly on reproductive health, rather than on other systems like the nervous, musculoskeletal, cardiovascular and immune systems and the ways in which they’re influenced by hormones like estrogen.

Einstein is an associate professor of psychology in the Faculty of Arts & Science and the Dalla Lana School of Public Health. With the support of the Posluns chair – $1 million over five years – Einstein is keen to look into a number of key mysteries surrounding women’s brain health.

“Women are subjected to different life conditions than men,” she says. “A big mystery is why more women have Alzheimer’s disease than men.”

Einstein says with women living longer that could explain the discrepancy. But it could also be that women are subjected to “different life conditions than men.”

There have not been many studies trying to understand if gendered life experiences – like having one's ovaries removed – might affect the prevalence of Alzheimer’s disease, she says. Reports indicate that those who have their ovaries removed have a higher incidence of dementia.

“One of the things that the Posluns Chair will allow us to do,” says Einstein, “is to study the trajectory of brain changes from having one’s ovaries removed to, say, 13 years later. When do the brain changes start? Are they getting worse over time? Which brain regions are most affected?”

The significance of the Posluns chair being awarded to a researcher from 91�Թ� is not lost on Einstein. She points to the calibre of research and the culture of teamwork here.

“My research program wouldn’t be possible without the kind of collaboration of excellent scientists that exists here. There isn’t any project in my lab that doesn’t have at least three or four people who are collaborating on it.”

In addition to pursuing her own research, Einstein is passionate about encouraging students who are interested in studying sex, gender and brain health.

“One of the goals of the chair is to provide graduate students in psychology and neuroscience who are studying the brain and cognition extra financial support if they’re interested in adding sex differences to their studies or adding females or women to their research,” says Einstein. Having more researchers thinking about sex differences and gender and how to incorporate these considerations into their studies would enhance the rigour and relevance of brain and cognition research.

”There are a lot of expectations about the way that women are supposed to be, and sometimes we only research those things,” says Einstein. “Women bear children so we focus enormous energy and time on reproductive health. This chair allows us to study some surprising things that might not be expected.”

There are many examples of sex and gender bias in scientific studies. For example, males and females have both estrogens and androgens and both mediate important biological mechanisms, but there’s a lack of study about testosterone in women or estrogen in men, she says.

“We have actually gendered those hormones as ‘male’ or ‘female’ and then we study them in the sex we think they belong in,” explains Einstein.

The Wilfred and Joyce Posluns chair is an initiative of the late Wilfred Posluns' Family Foundation and the Women's Brain Health Initiative. It is supported through a partnership between the foundation, the Canadian Institutes of Health Research, the Alzheimer Society of Canada and the Ontario Brain Institute.

Sex matters less and less when it comes to mortality rates, says 91�Թ� researcher

ullahnor — Mon, 14 Nov 2016 21:54:05 +0000

Sex matters less and less when it comes to mortality rates, says 91�Թ� researcher

ullahnor Mon, 11/14/2016 - 16:54

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91�Թ� Assistant Professor of Public Health Laura Rosella leads study that finds high-income men are living longer than low-income women (photo by Colin Payson)

Nicole Bodnar

Author legacy

Nicole Bodnar

Topic

Dalla Lana School of Public Health

Health

Subheadline

High-income men are living longer than low-income women

New trends show that low-income women have a shorter life expectancy than high-income men in Canada, according to 91�Թ� researchers who conducted one of the first and largest Canadian studies to examine gender-based mortality differences.

“This study is important because it looks like male and female mortality rates are actually going to converge,” said Laura Rosella, the study’s lead author, and an assistant professor at the Dalla Lana School of Public Health and Canada Research Chair in Population Health Analytics.

Read the Globe and Mail story about the study

Historically, male mortality has always been higher than their female counterparts across all ages and causes and it was thought to have a biological basis, but this study finds the gap is closing, which has implications for health care and social systems. It also illustrates the persistent social inequalities between men and women, and challenges some of the clinical thinking that women always live longer.

“The converging mortality rates for men and women suggest that it’s a social phenomenon – we’re seeing the delayed effects of women taking up risky behaviours like drinking, smoking, and poor eating habits – and for the first time, some men are living longer than some women,” said Rosella, who is also an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES) and scientist at Public Health Ontario.

“It also may be that since women tend to assume the caregiver role, they bear more of the family responsibilities while sacrificing their own needs. For example, the kids will eat before them or they’ll take others to the doctor before going themselves,” said Rosella, noting that the social inequities facing women worsen over time.

Published today in BMJ Open, the study, “The narrowing mortality gap between men and women over two decades: A registry based study in Ontario, Canada,” analyzed data from 1.7 million deaths in the Ontario Registrar’s General Death file from 1992 to 2012. The research team calculated absolute mortality – the rate which men and women are currently at compared to the mortality rate where they started – and relative mortality or the per cent change based on where people start from. Then, they measured sex differences for all-cause and cause-specific mortality, looking specifically at the following causes of death: circulatory, cancers, respiratory and injuries.

They found that men and women are living longer overall, but from the year 2000 onwards, men experienced more gains in all categories. Mortality rates of high income males were lower than those seen among low-income females. Relative mortality declines were greater among males than females for cancer, respiratory and injury-related deaths, and the largest absolute mortality gains were seen among men over the age of 85.

This phenomenon is observed globally as well. There is an even bigger disparity in the United States, and it’s less pronounced in Europe, where social systems are more robust. Canada, even with its universal health care, falls in the middle.

The overall mortality gains underscore the positive impact of improved medical interventions, but the findings suggest that men are benefitting more than women. One potential reason, explains Rosella, is that physicians may not perceive women’s risk to be as high as men’s for heart disease or other chronic diseases that are the top killers in Canada.

“We should be paying attention to these demographic shifts as it affects all aspects of our health system, from clinical care delivery to preventive and wellness services,” said Rosella.

“There are going to be a lot more older men – 80 years and up – than society has seen before, and these men tend to rely more on their spouse for support so we’ll need to adjust social supports for older men to provide alternative caregiver support.”