Understanding the Health Impacts of Climate Change

Most scientists now agree that climate change is having far-reaching effects on human health, and will pose even greater risks in the future. Because of its large land mass, Canadians can expect a wide range of impacts which can vary from one region to another.

The extent of these effects depends on how quickly our climate changes, and on how well we adapt to the new environmental conditions and risks to health.

Learn More on:

• What is climate change?

• Why is the climate changing?

• How does climate change affect the health of Canadians?

• Who will be most affected by a changing climate?

A Portrait of Seniors in Canada: Introduction
By Martin Turcotte and Grant Schellenberg
http://www.statcan.ca/english/freepub/89-519-XIE/89-519-XIE2006001.htm

Aging of the population is probably one of the most discussed and debated subjects in Canada today. While some analysts forecast the worst in terms of costs to public services and labour market shortages, others argue that Canada is well-equipped to face this social and demographic phenomenon - and that people shouldn't worry that much about the growing percentage of seniors in the population. (For an introduction to these debates, see for example Chapell et al., 2003; Cheal et al. 2002; Gee, 2000).

Some of the chapters in A Portrait of Seniors in Canada will provide information that will feed these debates and discussions. However, the objective of this publication is not to determine whether Canadians should or should not worry about an aging society. This report is mainly about the situation of the current generation of seniors, as full-fledged members of society. Specifically, the goal of this report is to draw an up-to-date portrait of the general well-being of seniors, in absolute terms, in comparison with previous cohorts of seniors and in comparison with persons of younger ages.1

Several challenges associated with portraying the general well-being of seniors should be noted. Firstly the population of seniors, i.e. the population of individuals aged 65 and over, is a very heterogeneous population in terms of health status, cultural origins, financial situations, living arrangements, and so on. This reality necessarily imposes some simplifications and generalizations when discussing the well-being of seniors as a group. Secondly, there are no consensual definitions of concepts such as well-being and wellness; therefore, there is no consensus either on how to measure or to quantify it. What is well-being? What contributes to it? Is health more or less important to well-being than other factors like financial security or social inclusion? What about other factors? More generally, is it possible to determine, from an external point of view, that the "level" of wellness of an individual or a group of persons is greater than that of another one?

This report will not provide answers to these questions. However, it will try to put together many pieces of the puzzle, in order to provide the most complete and the most accurate portrait of seniors' well-being as possible. This introduction sets the stage by explaining the conceptual framework and the definitions chosen to guide the analysis and the organization of this book.

To be or not to be a senior?

There are ongoing debates about the definition of "senior". According to the Oxford Canadian Dictionary, a senior citizen is "an elderly person, especially a person over 65". And an elderly is, according to the same reference source, "rather old; past middle age". These definitions, not so precise but often taken for granted, can naturally be contested. Some authors argue that since life expectancy is now about 80 years and that many persons outlive that age, 65 years old cannot be considered as "old" anymore (e.g. Posner, 1995). Given that the "golden years" has a very different meaning than it had just 30 years ago, some argue that the whole concept should be redefined. For example, Denton and Spencer (2002) proposed that the population of seniors could be delimited by using a certain number of years before death, instead of using 65 years and older as the standard marker for old age. The age at which people become seniors would then be determined by life expectancy at a particular moment.

Trying to find objective definitions of "old", "senior" or "elderly" is unrealistic. The new definitions proposed by experts are not getting consensual approval at the moment. For the purpose of this report, the usual threshold of 65 years old was therefore chosen to delimit the population of seniors. While this choice has some limitations, it has many advantages. First, using the age marker of 65 is probably one of the most practical ways of defining the senior population from a methodological point of view, as well as the most commonly used procedure (Chappell et al., 2003). With the current sources of statistical data, using alternative definitions would be either very cumbersome or impossible. Secondly, from a conceptual point of view, defining seniors as individuals aged 65 and over also has the advantage that most persons recognize 65 years as the age at which individuals become senior citizens. Social institutions also recognize this as age 65 is recognized as the "normal" age of retirement and is the age at which individuals are entitled to receive full pension benefits in Canada, even if many people retire or receive full pension benefits from their former employers before that age.

Over the coming years, especially as the first Baby Boomers turn 65 years old, it is possible that a new definition of "senior" will replace the current one. What it generally means to be a senior, for seniors themselves as well as for society in general, could go through an important redefinition. However, until then we will keep, for the purpose of this report, the most common definition of senior -- seniors are all persons aged 65 and over. That being said, we will use as much as possible more specific age groups in the presentation of statistical information, i.e. 65 to 74 years old, 75 to 84 and 85 and over. The life circumstances and the situations of seniors vary significantly among these three age groups. As commonly perceived by most individuals, and as will become rather clear in this report, the characteristics of younger seniors aged 65 to 74 are in many cases dramatically different than those of persons aged 85 and over. While this publication wishes to make a general profile of seniors, it will try to account for this heterogeneity as much as possible.

What is well-being and wellness? A conceptual framework

As stated above, the goal of this report is to provide a statistical portrait of seniors' well-being and wellness. However, well-being and wellness means different things to different people and societies. This report does not propose a new conceptualization of well-being, nor does it impose one particularly restrictive view of it. Instead, the analysis relies on many indicators which are commonly identified by social science researchers, health practitioners and other professionals, as well as by people in general, as having an impact on seniors' well-being.

An extensive number of these indicators or factors have been enumerated in the National Framework on Aging, which has strongly influenced the organization and the content of this publication. This analytical tool was developed by the Committee of Officials for Federal/Provincial/Territorial Ministers Responsible for Seniors, after an important series of consultations with seniors, seniors' organizations and government officials were completed across all jurisdictions in Canada. It can therefore be considered as representative of a broad range of points of view in Canada. The vision of this national framework is that "Canada, a society for all ages, promotes the well-being and contributions of older people in all aspects of life". Recognizing that wellness might mean different things to different persons, the framework identifies five core values which are said to be highly desirable outcomes for the vast majority of seniors. They are: dignity, independence, participation, fairness and security.

Many important elements are identified as favouring the realization of these core values in seniors' lives. These elements have been classified into three broad categories and are considered, in the National Framework on Aging, as the three "pillars of seniors' wellness". They are:

1. Health, wellness and security, which includes health and wellness, safety and security and income security

2. Continuous learning, work and participation in society, which includes work and retirement, age discrimination and negative stereotypes, social participation and ethnocultural diversity.

3. Supporting and caring in the community, which includes living arrangements, transportation, social isolation and loneliness, family/informal caregiving and seniors in Northern/remote Canada

Naturally, some indicators will contribute more to some individuals' well-being than to others. However for most seniors, many of these factors will have a role in their overall well-being. This publication is structured around these three pillars of well-being.

Structure of the book

Chapter 1 of this report provides contextual information about the population of seniors. How many seniors are there in Canada? How many will there be in the years ahead? What are their basic demographic characteristics? Where do they live? Although this chapter is less directly connected to the framework used for the rest of the publication, it provides valuable information about seniors as a population in Canadian society.

Chapters 2, 3 and 4 are all divided into a number of sections, but each chapter is based on one of the three pillars of seniors' wellness presented above. In Chapter 2, which is entitled Health, wellness and security, information is provided about physical and mental health, financial security and security from crime. Chapter 3, Continuous Learning, work and participation in society, is divided into three sections, and presents information on labour force participation, training, change in the educational profile of seniors and retirement. In Chapter 4, Supporting and caring in the community, a wide variety of data are presented in six chapters: living arrangements and family, social networks, social participation and engagement (including volunteering), care, political participation and values.

Chapter 5 will add other relevant information on factors which can be related to well-being, but which are less easily classifiable within the framework; these include leisure activities, computer use and religiosity. In Chapters 6 and 7, the three pillars of well-being will be used again to compare the well-being of aboriginal seniors (Chapter 6) and immigrant seniors (Chapter 7) with the senior population as a whole.

Possible data gaps in the portrait of seniors

Abstract concepts, such as values, are sometime difficult to capture with statistical data. Consequently, it is impossible to include information about all the factors of well-being and wellness identified by the National Framework on Aging. For example, it is not possible to provide direct information about seniors' level of dignity or level of independence. Direct information will mostly be provided about factors potentially contributing to the actualization of these important values for seniors, such as their capacity to age at home, involvement in significant social relationships, and so on.

It should also be noted that some aspects of seniors' lives which are not included in the National Framework on Aging but which could also contribute to the well-being of many seniors, may have been excluded from this analysis. However, all efforts have been made to present a portrait that as comprehensive and complete as possible.

As a final note to this introduction, the fact that more pages are devoted to some factors than to others is not an indicator of their relative importance to seniors' well-being. To rank the importance of various factors is far beyond the objectives of this report, and is a task that will be left to the reader. One reason why more pages are allowed to some subjects than to others is simply that data are more easily available. That said, some factors which are widely recognized as being critical determinants of well-being for most people, such as health status, do receive their fair share of coverage in the report.

Note:

• This publication is the fourth edition of A Portrait of Seniors in Canada. While its form has slightly changed from the previous edition (released in 1999), the fourth edition updates many data that were presented in it.

Alzheimer's Breakthrough Recorded Using Brain Stimulation Exercises

Ashby Memory Method "like taking your brain to the gym"

CALGARY, July 31 /CNW/ - The Alzheimer's Innovation Institute Inc. of Calgary unveiled an innovative brain exercise discovery at the International Conference on Alzheimer's Disease ending today in Chicago. Preliminary trials show the Ashby Memory Method improves memory in people with early and mid Alzheimer's disease by stimulating neuronal activity in several areas of the brain. Early results show the non-drug treatment could outstrip the best Alzheimer's medications on the market.

"The brain is a very complex organ and we've shown that our comprehensive brain fitness approach can return function once you've started to lose your memory," said John Ashby, the lead researcher. "It's much like taking your brain to the gym with a personal trainer." Field trials of 50 participants with early to mid Alzheimer's Disease showed an average improvement of 1.9 points over a one-year period on the 0-30 point Mini Mental State Exam (MMSE), a standard test instrument. Several participants exceeded 5 point increases. That compares to an average decline in untreated Alzheimer's patients of 3.3 points per year. The increase can equate into improved ability to dress, use the phone, converse and engage in activities halted by frustration and memory loss and results have continued for up to 1.5 years.

"With 42% of people predicted to get Alzheimer's by age 85 there was a lot of impetus to do this work," said Ashby, 53. The non-drug therapy can be administered by a caregiver or family member - especially important because 85% of people with Alzheimer's live at home. Losing your memory due to Alzheimer's disease potentially awaits 10 million American baby boomers, according to the Alzheimer's Association's 2008 Facts and Figures. Ashby believes this discovery will help turn those figures into myth.

Gayle Burrows, a Vancouver caregiver trained as a registered nurse, has seen dramatic results. One Alzheimer's participant, Timothy, improved from 16 to 26 on the MMSE. "After a year with the Ashby Memory Method he is brighter, happier and he remembers my name," said Burrows. "I can finally say there is something we can do to help. It is exciting." Ashby's mother, the late Dr. Mira Ashby, received the Order of Canada for pioneering the work of rehabilitating people with brain injuries. Ashby theorized that Alzheimer's brains could also be rehabilitated.

Alzheimer's Innovation Institute Inc. is a Calgary-based company specializing in medical technologies. www.alzinnovation.com 1-877-300-8988

Socializing with Youth Improves the Elderly's Health, Life Span
A gene associated with Alzheimer's disease may play a role
http://www.sciam.com/article.cfm?id=talk-to-teens-live-longer&print=true
By Erica Westly

“Youth is a wonderful thing,” George Bernard Shaw once said. “What a crime to waste it on children.” Humor aside, recent research suggests that youthful energy may not be “wasted” after all. Through social interactions alone, the young can pass some of their vigor on to the elderly, improving the older generation’s cognitive abilities and vascular health and even increasing their life span.

Although researchers have documented these benefits in mammals, such as rats, guinea pigs and nonhuman primates, the reason for the effect has remained unclear. Now biologist Chun-Fang Wu of the University of Iowa offers a genetic explanation in the May 27 issue of the Proceedings of the National Academy of Sciences. Wu and graduate student Hongyu Ruan found that the presence of youthful, active fruit flies doubled the life span of a group of flies with a mutation in Sod1, a gene that has been linked in humans to Alzheimer’s disease and amyotrophic lateral sclerosis (ALS), a motor-neuron disorder also known as Lou Gehrig’s disease.

Fruit flies are quite social, Wu explains; social cues govern both their reproduction and aging process. And their genes are easier to manipulate than those of their mammalian counterparts—by altering Sod1, Wu created flies that died after only about two weeks, a quarter of their normal life span. When housed with younger flies, however, the Sod1 mutants lived for about 30 days. The mutant flies also became more physically fit, according to heat-stress tests and other measures, when housed with the younger “helpers.” Clipping the younger flies’ wings significantly reduced the positive effects on the mutants’ life span, suggesting that physical activity plays a key role in the life-extending mechanism.

Physical activity is well known to benefit elderly humans, but working out in a social setting with younger people seems to be especially valuable. Sharon Arkin, a psychiatrist at the University of Arizona, runs a clinical program in which Alzheimer’s patients engage in communal exercise sessions with college students. She showed that her program stabilizes cognitive decline and improves patients’ moods. So could the Sod1 gene be playing a part in humans? Wu thinks it is possible. Besides the gene’s association with Alzheimer’s, Wu found that flies with the Sod1 mutation were more receptive to social cues than flies with other age-accelerating mutations were. Further studies are needed to determine the therapeutic potential of intergenerational socialization—but visiting the grandparents probably couldn’t hurt.

Editor's Note: This story was originally printed with the title "Talk to Teens, Live Longer"

Vitamin C: Cancer patients' friend or foe?
Article in New Scientist – August 2008 Issue

http://www.newscientist.com/channel/health/mg19926683.700-vitamin-c-cancers

• 06 August 2008

• Peter Aldhous

• Magazine issue 2668

COULD injecting vitamin C into the blood help to treat cancer?
That's what a study in mice suggests - and trials are already under way to test such injections in people. But the preliminary result could prompt desperate patients to take large doses of the vitamin, which some cancer specialists fear may interfere with standard cancer drugs and radiation therapy, reducing their effectiveness.

Excitement over vitamin C as a cancer treatment grew in the 1970s after the Nobel prizewinning chemist Linus Pauling suggested that it extended the lives of terminally ill patients. In 1985, however, two trials found that taking vitamin C pills orally had no effect. Now a team led by Mark Levine of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland, is investigating the effects of injecting vitamin C into the bloodstream.
First they injected mice with cells from three aggressive ...

(The complete article is 557 words long)

Obese Men, Unwitting Victims Of Aggressive Cancers
Aug 8th, 2008 | By Sindh Today | Category: Health
http://www.sindhtoday.net/health/10165.htm

Washington, Aug 8 (IANS) Testing for elevated levels of prostate-specific antigen may be biased against obese men whose PSA levels tend to be deceptively low. This bias may be creating more aggressive cancers in this population by delaying diagnosis, according to a new study led by Duke Prostate Centre and Durham Veterans Affairs (VA) Medical Center investigators.

‘We know that obese men tend to have lower PSA values than their normal-weight counterparts, possibly caused by larger blood volumes which dilute the readings,’ said Stephen Freedland, urologist at Duke and the Durham VA and lead investigator on this study. ‘Now we know some of the real implications of this — that these men are at a disadvantage in terms of prognosis compared to normal-weight men.’

‘We used patient data to examine the association between body mass index, or BMI — a measure of obesity, and the amount of disease discovered after surgery to remove the prostate, ‘ Freedland said. ‘We compared men who had their cancers detected by PSA screening to those who had an abnormal digital rectal exam, which may not confer the same bias against obese men.’ The researchers looked at a total of nearly 3,400 men in the years since 2000, when PSA screening became the gold standard test for prostate cancer.

Obese patients whose cancer was diagnosed by PSA testing had more than twice the risk of cancer recurrence after surgery than their normal-weight counterparts, Freedland said. ‘In contrast, obese men with abnormal digital rectal exams had similar outcomes as normal-weight men,’ Freedland said.

Another Duke study provides further substantiation of the concern that obese men have poorer prognoses than normal-weight men. This suggests that prostate cancer surgery is technically more challenging in obese men, making complete tumour removal harder, according to Jayakrishnan Jayachandran of Duke and lead investigator on the second study.

These findings were published online in BJU International.

Climate Change Equals Stronger Rains
Tracking El Niño with satellites reveals that a warming world means not only heavier downpours--but drier deserts
http://www.sciam.com/article.cfm?id=climate-change-equals-stronger-rains&print=true
By David Biello

As the globe continues to warm, the rainiest parts of the world are very likely to get wetter, according to a new study in Science. Desert dwellers, however, are likely to see what little rain they receive dry up, as the rain becomes even more concentrated in high-precipitation areas. Atmospheric scientists Richard Allan of the University of Reading in England and Brian Soden of the University of Miami looked at satellite records of daily rainfall stretching back to 1987 to see how warmer temperatures had affected precipitation. That's one of the key climate changes expected from rising greenhouse gas levels in the atmosphere. The researchers specifically focused on El Niño, the warming of the waters of the tropical Pacific that raises air pressure, changes winds, and recurs every few years.

The weather pattern causes floods in some areas and droughts in others while changing climate across the globe over time—and thus is a pretty good stand-in for global warming. "For the period we examined, 1987 to 2004, there was a clear relationship between warm El Niño events and increased occurrence of heavy precipitation," Soden says. Such "events will certainly become more frequent in a warmer climate."

For example, other research has shown that monsoon storms that dump six inches (150 millimeters) or more of rain on India have become more common since the 1950s. The satellite observations agree with the predictions of various computer models. The U.N. Intergovernmental Panel on Climate Change expects that such changes will wreak havoc on agriculture, human health and the natural environment.

But the Science study also reveals that the computer projections may be underestimating how severe such downpours may become. Warmer seas resulted in three times as many heavy rainstorms as the models would have predicted—and other studies have shown that such models fail to account for the rapid increase in water vapor in the atmosphere. "It is very likely that heavy rainfall will become more common and more intense in a warming world," Allan says. "It is too early to say by how much real world changes in rainfall will surpass projections from the climate models."