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Background In Cycle 7 (2022), the Canadian Health Measures Survey (CHMS) introduced the OMRON (OM) IntelliSense HEM-907XL blood pressure (BP) monitor after using the BpTRU (BT) BPM-300 BP monitor for six cycles. This study assessed differences between adult BP values measured by both devices and whether equations could be developed to compare BP measurements taken using the two devices. Data and methods In Cycle 6 (2018 to 2019) of the CHMS, BP was measured using BT and OM devices. Between-device estimates of systolic BP (SBP), diastolic BP (DBP), and hypertension prevalence were compared for 1,072 adults aged 18 to 79 years. Sex, age, body mass index (BMI), and the use of antihypertensive medication were examined in linear regression models to predict SBP and DBP values measured with OM based on those measured with BT. Results Average SBP measured with OM was 6 millimetres of mercury (mmHg) higher than average SBP measured with BT, and average DBP measured with OM was 2 mmHg lower than DBP measured with BT. Hypertension prevalence based on OM readings was 35.4%, compared with 34.0% based on BT readings. Between-device BP differences varied in magnitude by sex, age group, and BMI category. Average model-predicted estimates of BP were comparable to measured estimates, but predicted values were lower at higher levels of BP. Interpretation Switching BP monitors will substantively affect population estimates of adult SBP and DBP but may have less impact on estimates of adult hypertension prevalence. The prediction equations proposed in this study can be applied to adult BP data from cycles 1 to 6 of the CHMS for comparison with BP measurements taken in Cycle 7, with some caveats. The impact of changing to the OM monitor in Cycle 7 should be acknowledged when reporting estimates of adult BP based on the CHMS. [ABSTRACT FROM AUTHOR]

Background Canada is experiencing rapid population aging, which has a wide range of implications, including an increased need for health care services. However, very few studies have examined use of specialized health care services (e.g., visits to medical specialists, non-emergency tests, and surgeries) among older Canadians. Data and methods Data from the Canadian Health Survey on Seniors - 2019/2020 were used to examine specialized health care service use among older Canadians. Latent class analysis was calibrated using a nationally representative sample of 39,047 Canadians aged 65 years or older to identify distinct patterns of need factors related to health care service use. Multivariable logistic regression, stratified by gender, was used to examine the association of predisposing characteristics, enabling resources, and need factors with specialized health care service use. Results In 2019/2020, an estimated 2.6 million older Canadians (43.4%) visited medical specialists, 1.4 million (23.2%) got non-emergency tests, and 0.6 million (10.4%) had non-emergency surgeries. Among those, 15.6% reported experiencing difficulties accessing services. Women were less likely than men to have visited medical specialists and have received non-emergency tests. Lower education was consistently associated with lower odds of specialized health care service use. Individuals in the multimorbidity, high stress--multimorbidity--disability, and poor physical and mental health classes were more likely than those in the comparatively healthy class to use specialized health care services and to experience difficulties accessing them. Interpretation Findings of this study highlight gender differences and the importance of considering multidimensional need factors--ranging from physical health to mental health to psychosocial factors--in examining use of specialized health care services. [ABSTRACT FROM AUTHOR]

Background: Immunization against vaccine-preventable diseases such as shingles and pneumococcal disease is especially pertinent among older Canadians. However, vaccine uptake remains low. Data and methods: Data from the Canadian Health Survey on Seniors (CHSS) - 2019/2020 were used to examine receipt of shingles and pneumococcal vaccines among Canadians aged 65 and older living in the community. Multivariable logistic regression was used to identify individual predisposing, enabling and needs-related factors associated with receipt of each type of vaccination. Reasons reported for not getting vaccinated were also examined. Results: Based on the 2019/2020 CHSS, an estimated 36.3% of Canadians aged 65 and older (2.3 million people) had received the shingles vaccine, while 51.1% (3.1 million) had received the pneumococcal vaccine. Being a woman, having higher socioeconomic status, having had the flu shot and having a regular health care provider were associated with increased odds of vaccination. Being an immigrant, living outside large population centres, and belonging to South Asian or Chinese population groups were associated with lower odds of vaccination. Over one-third of unvaccinated people did not think the shingles vaccine (39.7%) or the pneumococcal vaccine (36.6%) was necessary. Other frequently reported reasons for non-vaccination were not having heard of the vaccine or the doctor not mentioning it; for the shingles vaccine, 12% cited cost as a reason. Interpretation: Understanding factors associated with uptake of vaccines and reasons for not obtaining them among older Canadians will help to inform policy and programs aimed at preventing the burden of these diseases. [ABSTRACT FROM AUTHOR]

Background Prevalence of loneliness among Canadians has become an important concern because of its wider consequences on health and well-being. However, there are limited Canadian studies about loneliness disaggregated by gender and across various subgroups of older Canadians, particularly immigrant subgroups. Data and methods Data from the Canadian Health Survey on Seniors (CHSS) – 2019/2020 were used to estimate the prevalence of loneliness among older Canadians in a nationally representative sample of 38,941 Canadians aged 65 and older. The association between immigrant status and loneliness was assessed using multivariable logistic regression adjusted for demographic, socioeconomic and health characteristics. Analyses were conducted for men and women combined and separately. Results In 2019/2020, an estimated 1.1 million older Canadians (19.2%) experienced loneliness, with women having significantly higher likelihood of being lonely than men. Among men, both European and non-European immigrants were more likely to experience loneliness than the Canadian-born population. Among women, the likelihood of loneliness was higher among European immigrants than among those born in Canada. For both men and women, immigrants who migrated as adults (from ages 18 to 44) and long-term immigrants (20 years or more in Canada since immigration) were at higher risk of loneliness than the Canadianborn population. The likelihood of being lonely was higher among people living with multimorbidity or experiencing barriers to social participation. Interpretation The findings underscore the importance of considering immigrant subgroups and gender in examining loneliness among older Canadians and when developing policies and programs to address loneliness. [ABSTRACT FROM AUTHOR]

Introduction: Research has identified an association between sleep and obesity in the general population. It is also important to examine this association in a military population. Methods: Data from the 2019 Canadian Armed Forces Health Survey (CAFHS) were used to estimate the prevalence of sleep duration, sleep quality characteristics, overweight and obesity for Regular Force members. The relationship of sleep duration and sleep quality with obesity was assessed with multivariable logistic regression that controlled for sociodemographic, work and health characteristics. Results: Females were significantly more likely than males to report meeting recommended sleep duration (7 hours to less than 10 hours; 48.7% vs. 40.4%), trouble falling or staying asleep (32.3% vs. 23.5%), or that sleep was not refreshing (64.0% vs. 57.7%). Difficulty staying awake did not differ significantly between males and females (6.3% vs. 5.4%). Obesity, but not being overweight, was significantly more prevalent among those who had short (less than 6 hours) or borderline (6 hours to less than 7 hours) sleep duration, or poor sleep quality. Compared with recommended sleep duration, short sleep duration (adjusted odds ratio [AOR] 1.3; 95% confidence interval [CI]: 1.2 to 1.6) and borderline sleep duration (AOR 1.2; 95% CI: 1.1 to 1.4) were associated with obesity for males, but not females, in fully controlled models. Sleep quality indicators were not independently associated with obesity. Discussion: This study adds to the body of evidence that identifies an association between sleep duration and obesity. The results emphasize the importance of sleep as one of the components of the Canadian Armed Forces Physical Performance Strategy. [ABSTRACT FROM AUTHOR]

Background Vaping is more prevalent among younger than older Canadians. While vaping is less harmful than combustible tobacco, it is not without health risk. Data and methods Data from the 2019 Canadian Health Survey on Children and Youth were used to estimate vaping prevalence. Logistic regression models assessed the association of sociodemographic, youth, parenting and peer factors with vaping. The 2020 Canadian Community Health Survey identified adolescents who reported vaping before tobacco smoking. Data from the 2019 Canadian Tobacco and Nicotine Survey were used to examine vaping of e-liquids containing nicotine and flavours. Results Vaping rates for 15- to 17-year-olds were nearly four times (21.3%) higher than those of 12- to 14-year-olds (5.4%). Two-thirds (66.1%) of 12- to 17-year-olds who had used both tobacco and e-cigarettes reported trying e-cigarettes first. E-liquids containing nicotine were used by 89.3% of 15- to 19-year-olds who reported vaping in the past 30 days; comparable with older adults. For both younger and older adolescents, having friends who engaged in negative behaviours, having been employed, and having consumed alcohol increased the odds. For 12- to 14-year-olds, attention deficit hyperactivity disorder was a risk factor, whereas having parents who usually knew who they were with and higher relatedness scores were protective. Among older adolescents, being male, being Canadian-born, having lower grades, and using tobacco or cannabis increased the odds of vaping. Interpretation An adolescent's risk of vaping was most strongly correlated with other substance use, although other youth, parenting and peer characteristics also mattered. Because most of the data presented were collected before the COVID-19 pandemic and new vaping regulations, ongoing monitoring remains important. [ABSTRACT FROM AUTHOR]

Background Hypertension is a common condition experienced by close to one-quarter of the adult population in Canada. There is evidence that this condition or the medications used to treat it may lead to hearing health problems (defined in this study as having hearing loss, tinnitus or both conditions). Data and methods Data from the Canadian Health Measures Survey from 2012 to 2015 were used to estimate the prevalence of hypertension and hearing health problems for individuals aged 19 to 79 years (n=6,198). Data from cycles 3 (n=3,072) and 4 (n=3,126) were combined. The relationship of hypertension to hearing health problems was assessed with multivariate logistic regression. Results An estimated 40% of the adult population were free of hearing health problems, while the remaining 60% had either hearing loss (23%), tinnitus (22%) or both conditions (14%); 22% of the adult population had hypertension. Hearing health problems were significantly more prevalent among adults with hypertension (79%) than among those without hypertension (54%). Hypertension was associated with greater odds of hearing health problems in both males (adjusted odds ratio [AOR]=1.7) and females (AOR=1.6), even after accounting for age, sociodemographic, health-related and noise exposure variables. Interpretation This study adds to the body of evidence that identifies hypertension as a potentially modifiable risk factor for hearing loss and tinnitus. Males and females with hypertension had a higher risk of experiencing hearing health problems, demonstrating the importance of screening those with hypertension for hearing health. [ABSTRACT FROM AUTHOR]

Background: Frailty is a complex syndrome that is associated with aging but not synonymous with the normal aging process. It has been associated with all-cause mortality, but less is known about frailty and mortality from specific causes. Data and methods: Data from the 2013 and 2014 Canadian Community Health Survey (CCHS) linked to the Canadian Vital Statistics - Death Database were used to estimate the prevalence of frailty among Canadians aged 65 or older. Levels of frailty were based on validated cut-points for the 30-item frailty index. The relationship of frailty to mortality risk during the period of three to five years following the CCHS interview was assessed with Cox proportional hazards models adjusted for sociodemographic factors and health behaviours. Associations between frailty and mortality from neoplasms, circulatory diseases and disease of the respiratory system were examined in separate models. Results: An estimated 1.1 million (22%) community-dwelling older adults were frail in 2013 and 2014, and another 1.6 million (32%) were considered pre-frail. Frailty was more common among females than males and among those in older age groups. The risk of mortality increased significantly with increasing levels of frailty, even after accounting for sociodemographic factors and health behaviours. This was the case for all-cause mortality, as well as for death from three major underlying causes-neoplasms, and diseases of the circulatory and respiratory systems. Interpretation: Even individuals who were classified as pre-frail had an increased risk of mortality overall and from three leading causes compared with those who were robust, demonstrating the importance of screening community-dwelling older adults for frailty. [ABSTRACT FROM AUTHOR]

Background Food insecurity has been linked to adverse mental health outcomes. This study assessed the association between household food insecurity and self-perceived mental health status and anxiety symptoms among Canadians in the early months of the COVID-19 pandemic. Data and methods The Canadian Perspectives Survey Series 2 collected cross-sectional data from May 4 to 10, 2020, on Canadians aged 15 years or older residing in the ten provinces. The brief six-item Household Food Security Survey Module was used to measure participants' households as food secure or marginally, moderately or severely food insecure within the previous 30 days. Logistic regression was used to assess associations between food security status and self-perceived fair or poor mental health and moderate or severe anxiety symptoms, adjusting for sociodemographic covariates. Results Approximately one in seven Canadians (14.6%) lived in a household that experienced some level of food insecurity. Of these individuals, 9.3% reported recently accessing free food from a community organization. About one in five Canadians self-perceived their mental health as fair or poor (22.0%), or self-reported moderate or severe anxiety symptoms (18.2%). With covariate adjustment, individuals in households with moderate food insecurity had nearly three times higher odds of reporting fair or poor mental health, and moderate or severe anxiety symptoms, compared with individuals in food-secure households. Among those with severe food insecurity, adjusted odds ratios were 4.0 (95% confidence interval [CI]: 2.0 to 7.9) for fair or poor mental health, and 7.6 (95% CI: 3.9 to 14.7) for moderate or severe anxiety symptoms. Interpretation In the early period of the COVID-19 epidemic in Canada, household food insecurity was independently associated with poorer mental health outcomes. Monitoring both food insecurity and mental health will be important as the COVID-19 pandemic continues. [ABSTRACT FROM AUTHOR]

Background: Previous research indicates that lesbian, gay and bisexual individuals have poorer mental health than their heterosexual counterparts. The concept of complete mental health, which combines the presence of positive mental health and the absence of mental disorder, has not been thoroughly examined in this population. Data and methods: Data from the 2015 Canadian Community Health Survey (CCHS) were used to estimate the number and percentage of men and women aged 15 and older who self-identify as lesbian, gay, bisexual, or heterosexual. Complete mental health was defined as the presence of flourishing mental health together with the absence of any self-reported mood disorder, anxiety disorder or suicide ideation in the previous 12 months. Multivariate logistic regression models stratified by sex were used to identify differences in complete mental health among gay, lesbian, bisexual, and heterosexual individuals. Results: In 2015, an estimated 252,000 (1.9%) Canadian men identified as gay and 145,000 (1.1%) as bisexual, while 153,000 Canadian women (1.1%) identified as lesbian and 299,000 (2.2%) as bisexual. Gay men had significantly lower unadjusted odds of complete mental health, but this association was no longer significant when controlling for sociodemographic and health factors. The likelihood of complete mental health was not significantly different for lesbians than for heterosexual women. Both bisexual men and bisexual women had significantly lower odds of complete mental health in the fully adjusted models. Interpretation: Awareness of poorer mental health outcomes, particularly for bisexual individuals, can help guide specific interventions aimed at improving the mental health and well-being of sexual minority populations. [ABSTRACT FROM AUTHOR]

Background: There is debate about the practice of bed sharing, which is defined as sharing a sleep surface with an infant. Most public health guidance in Canada, including the 2011 Joint Statement on Safe Sleep, advises parents against it because of an association with infant injury and death. However, proponents cite potential physical and psychological benefits, and evidence suggests that the risks associated with bed sharing are low in the absence of other risk factors. Until now, little has been known about the prevalence of and reasons for bed sharing in Canada.Data and methods: Canadian Community Health Survey data from 2015 and 2016 were used to estimate the prevalence of and reasons for bed sharing by selected characteristics among women aged 15 to 55 who had given birth in the past five years. Multivariate analysis examined factors independently associated with frequent bed sharing. Results: An estimated 33% of women reported that their infant had frequently (every day or almost every day) shared a sleep surface with someone else; 27% had bed shared occasionally (once or twice a week, a few times a month or less than once a month) and 40% had never bed shared. Breastfeeding was the most common reason for bed sharing (39%), followed by facilitating the mother's or infant's sleep (29%). In multivariate analysis, age group, marital status, province or territory of residence, region of mother's birth and breastfeeding were significantly associated with frequent bed sharing.Interpretation: The data indicate that bed sharing is relatively common and suggest that parents are doing it for practical reasons. The results of this study will provide baseline data and inform policies and programs related to safe sleep practices. [ABSTRACT FROM AUTHOR]

Background: Unmet home care needs have been linked to poor health, increased use of other health services, admission to nursing homes and reduced emotional well-being. Data and methods: Using data from the 2015/2016 Canadian Community Health Survey, this article describes home care use and unmet home care needs by type (i.e., home health care [HHC] and support services) in community-dwelling adults. Among the population with home care needs, the degree to which needs were met, partially met or unmet is presented, as well as information about the barriers to obtaining home care services and the places services were sought. Multivariate analysis was used to examine factors associated with unmet home care needs by type, while controlling for predisposing, enabling and needs-related factors. Results: In 2015/2016, just over one-third (35.4%) of people with home care needs, an estimated 433,000 people, did not have those needs met. This was more prevalent among those with support needs than those with HHC needs. Availability of services was most often cited as a barrier to obtaining home care services, particularly for those with an unmet need for HHC services. Age group, household type, long-term care insurance and health status factors were associated with perceiving an unmet home care need, with few differences by type of unmet need. Interpretation: The degree to which needs were met and the perceived barriers to obtaining home care services varied by type of unmet home care need. The results indicate proportionally higher unmet needs for home care services among adults aged 35 to 49. This suggests a possible service gap. [ABSTRACT FROM AUTHOR]

Background: Formal home care services (those typically delivered by health care providers or volunteer organizations) are different from informal home care services (given by family, friends or neighbours), and thus represent a partial picture of all home care provided. Home care has been associated with decreased mortality, improved quality of life, and reduced hospitalizations and health care costs. Data and methods: New data from the annual Canadian Community Health Survey (CCHS) 2015/2016 are used to estimate, for the first time, the number and percentage of households in which at least one person of any age received formal home care services in Canada during the previous year. A descriptive analysis of socioeconomic characteristics of households receiving formal home care is presented. Results: An estimated 6.4% of households (881,800) in Canada received formal home care services in the past year, most frequently nursing (46%) and personal/home support services (46%). Households with parents and adult children (age 25 or older), one-person households, and households with lower socioeconomic status were most likely to have received formal home care. Costs were covered by a range of sources. They were paid solely by government (52%), solely out of pocket (27%), solely by insurance (7%), at least partially by insurance and/or government (8%), and by other sources (6%). Households that received home health care services only-particularly nursing services-were more likely to have their costs entirely covered by government, while those that received support services only were more likely to pay out-of-pocket costs. Interpretation: This descriptive analysis of household use of formal home care services by socioeconomic characteristics and type of care will help inform health care policies and programs. Future person-level analysis can examine the independent factors associated with home care use. [ABSTRACT FROM AUTHOR]

This article provides new information about multiple sclerosis (MS) using the 2010/2011 Neurological Conditions Prevalence File, the 2011/2012 Survey of Neurological Conditions in Institutions in Canada, and the 2011 Survey on Living with Neurological Conditions in Canada. An estimated 93,500 Canadians living in private households and 3,800 residents of long-term care institutions had been diagnosed with MS. Prevalence estimates were 159 and 418 cases per 100,000 population for men and women, respectively; 2.6 women reported MS for every man with the condition. Among the household population, MS was generally diagnosed between the ages of 20 and 49 (82%). For the majority (68%), MS was their only neurological condition. The impact of MS included pain that prevented activities, impairments in mobility, cognition or sleep, and limitations in social functioning. Almost two-thirds (64%) stated that MS affected their lives at least moderately. [ABSTRACT FROM AUTHOR]

Background: Nutritional risk has been associated with various negative health outcomes among older people. Limited longitudinal research has examined the relationship between nutritional risk and hospitalization and death in community-dwelling older people. Data and methods: Data from the 2008/2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA) linked to the Discharge Abstract Database and the Canadian Mortality Database were used to estimate the prevalence of nutritional risk among seniors and examine its relationship with acute care hospitalization and death during the 25- to 36-month period following the CCHS-HA interview. Multivariate Cox proportional hazards models were used to identify important covariates, while adjusting for demographic and socioeconomic characteristics, health status, and lifestyle factors. Results: A third (34%; 979,000) of Canadians aged 65 or older living in 9 provinces (excluding Quebec) were at nutritional risk in 2008/2009. These seniors had a higher risk of an acute care hospitalization (hazard ratio (HR) 1.2; 95% CI: 1.1 to 1.4) or death (HR 1.6; 95% CI: 1.3 to 2.0) during the follow-up period, even when potential confounders were taken into account. Seniors at nutritional risk in 2008/2009 were more likely than those not at nutritional risk to die during follow-up (9% versus 5%) and averaged shorter survival times: 498 days (95% CI: 462 to 534) compared with 538 days (95% CI: 501 to 574). Interpretation: Based on an analysis of data from a large population-based survey linked to routinely collected hospital and death data, nutritional risk is independently associated with acute care hospitalization and mortality. Results highlight the importance of monitoring seniors for nutritional risk. [ABSTRACT FROM AUTHOR]

Based on data from the 2014 Canadian Community Health Survey and the 2012 Canadian Community Health Survey-Mental Health, this study provides estimates of the prevalence of medically unexplained physical symptoms (MUPS) in the household population aged 25 or older. MUPS are examined in relation to sociodemographic characteristics, physical and mental comorbidity, health care use and unmet needs, labour force participation and productivity. In 2014, 5.5% of Canadian adults--an estimated 1.3 million - reported having chronic fatigue syndrome (1.6%), fibromyalgia (2.0%) and/or multiple chemical sensitivity (2.7%). Half (51%) of people with MUPS reported other chronic physical conditions, compared with 8% of those without MUPS. Similarly, mental comorbidities were more prevalent among those with MUPS. Higher health care use was observed among people with MUPS, but 25% of them reported unmet health care needs, compared with 11% of those without MUPS. People with MUPS were more likely than those without MUPS to be permanently unable to work or to not have a job; fewer than half (45%) were employed. Among those who were employed, 18% had missed work because of a chronic condition, compared with 5% of workers without MUPS. [ABSTRACT FROM AUTHOR]

Background: Subthreshold Generalized Anxiety Disorder (GAD) has been reported to be at least as prevalent as threshold GAD and of comparable clinical significance. It is not clear if GAD is uniquely associated with the risk of suicide, or if psychiatric comorbidity drives the association. Data and methods: Data from the 2012 Canadian Community Health Survey-Mental Health were used to estimate the prevalence of threshold and subthreshold GAD in the household population aged 15 or older. As well, the relationship between GAD and suicide ideation was studied. Multivariate logistic regression was used in a sample of 24,785 people to identify significant associations, while adjusting for the confounding effects of sociodemographic factors and other mental disorders. Results: In 2012, an estimated 722,000 Canadians aged 15 or older (2.6%) met the criteria for threshold GAD; an additional 2.3% (655,000) had subthreshold GAD. For people with threshold GAD, past 12-month suicide ideation was more prevalent among men than women (32.0% versus 21.2% respectively). In multivariate models that controlled sociodemographic factors, the odds of past 12-month suicide ideation among people with either past 12-month threshold or subthreshold GAD were significantly higher than the odds for those without GAD. When psychiatric comorbidity was also controlled, associations between threshold and subthreshold GAD and suicidal ideation were attenuated, but remained significant. Interpretation: Threshold and subthreshold GAD affect similar percentages of the Canadian household population. This study adds to the literature that has identified an independent association between threshold GAD and suicide ideation, and demonstrates that this association is also apparent for subthreshold GAD. [ABSTRACT FROM AUTHOR]

This article provides information about the prevalence and impact of epilepsy, based on the 2010 and 2011 Canadian Community Health Surveys, the 2011/2012 Survey of Neurological Conditions in Institutions in Canada, and the 2011 Survey on Living with Neurological Conditions in Canada. An estimated 139,200 Canadians had epilepsy. Among the household population, epilepsy was generally diagnosed before age 30 (75%). For the majority of these people (64%), epilepsy was their only neurological condition. People with epilepsy were more than twice as likely to have been diagnosed with a mood disorder, compared with the general population (17% versus 7%), and eight times as likely to experience incontinence (34% versus 4%). Overall, an estimated 18% reported that their life was affected quite a bit or extremely by epilepsy; 44% felt that their life was impacted a little bit or moderately; and 39% felt that their life was not impacted at all. This study examined the impact of epilepsy on interactions with others, sleep, driving, education, and employment. [ABSTRACT FROM AUTHOR]

This article provides information on Alzheimer's disease and other dementias, using the 2010/2011 Canadian Community Health Survey, the 2011/2012 Survey of Neurological Conditions in Institutions in Canada, and the 2011 Survey on Living with Neurological Conditions in Canada. Among Canadians aged 45 or older, an estimated 0.8% in private households and 45% in long-term residential care facilities had a diagnosis of dementia. Prevalence rose with age. The vast majority of people with dementia in private households received assistance with medical care (81%), housework and home maintenance (83%), meal preparation (88%), emotional support (90%), transportation (92%), and managing care (92%). Among those receiving assistance, 85% relied, at least in part, on family, friends or neighbours. The primary caregiver tended to be a spouse (46%) or an adult child (44%), most of whom were daughters (71%). The majority of primary caregivers lived in the same household (83%) and provided daily care (86%). [ABSTRACT FROM AUTHOR]

Background According to the activity restriction (AR) model, a potential explanation for the impact of chronic pain on mental illness is that pain contributes to depression by limiting usual activities. This study uses a measure of mental health (flourishing), rather than mental illness to examine associations between pain and activity restrictions. Data and methods Data from the 2011/2012 Canadian Community Health Survey were used to study the relationship between pain intensity, pain-related activity prevention, and flourishing mental health in people aged 18 or older. Multivariate logistic regression was used in a sample of 26,429 people with chronic pain to identify significant relationships, while adjusting for potential confounders. Results In 2011/2012, an estimated 6 million Canadians aged 18 or older (22%) reported chronic pain. They were less likely to be in flourishing mental health than were people without chronic pain (69% versus 79%). The prevalence of flourishing mental health declined as pain intensity and the number of activities prevented because of pain increased. Pain intensity and pain-related activity prevention were each independently associated with flourishing mental health, even when socio- demographic and health factors were taken into account. Pain-related activity prevention partially mediated the association between pain intensity and flourishing mental health. Interpretation The results of this study support the AR model and highlight the importance of both pain intensity and activity restriction in relation to flourishing mental health. [ABSTRACT FROM AUTHOR]

This article provides information on Parkinson's disease, using the 2010/2011 Canadian Community Health Survey, the 2011/2012 Survey of Neurological Conditions in Institutions in Canada, and the 2011 Survey of Living with Neurological Conditions in Canada. An estimated 0.2% of Canadian adults in private households (55,000), and 4.9% of those in residential institutions (12,500) had Parkinson's disease. Younger age at symptom onset was associated with a longer period to disease diagnosis. As a result of the condition, 58% reported that social interactions were negatively affected, 61% reported out-of-pocket expenses, and 56% reported receiving assistance with activities such as housework, transportation or personal care. Among those receiving assistance, 84% relied at least in part on family, friends or neighbours. The primary informal caregiver tended to be a spouse (64%), female (62%), live in the same household (72%), and provide assistance on a daily basis (76%). [ABSTRACT FROM AUTHOR]

Based on the Health Continuum Short Form administered in the 2012 Canadian Community Health Survey -- Mental Health (CCHS-MH), the percentages of Canadians aged 15 or older classified as having flourishing, moderate or languishing mental health were 76.9%, 21.6% and 1.5%, respectively. Compared with estimates for other countries, a higher percentage of Canadians were flourishing. In accordance with the complete mental health model, mental health was also assessed in combination with the presence or absence of mental illness (depression; bipolar disorder; generalized anxiety disorder; alcohol, cannabis or other drug abuse or dependence). An estimated 72.5% of Canadians (19.8 million) were classified as having complete mental health; that is they were flourishing and did not meet the criteria for any of the six past 12-month mental or substance use disorders included in the CCHS- MH. Age, marital status, socio-economic status, spirituality and physical health were associated with complete mental health. Men and women were equally likely to be in complete mental health. [ABSTRACT FROM AUTHOR]

Based on data from the 2010 and 2011 Canadian Community Health Surveys and the 2011 Survey of Living with Neurological Conditions in Canada, this article provides information about migraine among people living in private households. In 2010/2011, an estimated 8.3% of Canadians (2.7 million) reported that they had been diagnosed with migraine by a health professional. Females were more likely than males to report migraine: 11.8% versus 4.7%. Migraine prevalence was highest among people in their 30s and 40s: 17.0% for women and 6.5% for men. Compared with the national figure, the prevalence of migraine was lower in Quebec (6.8%) and higher in Manitoba (9.5%), Nova Scotia (9.1%) and Ontario (8.8%). Among people who reported a migraine diagnosis, 42% took prescription medication for their condition, and 56% incurred medication-related out-of-pocket expenses. Migraine was highly comorbid with depression and affected many aspects of daily life including education, work, sleep, and driving. [ABSTRACT FROM AUTHOR]

Background Sleep duration has been associated with overall health status, health behaviours, and mortality. Little is known about habitual longitudinal patterns of sleep in the general population. Furthermore, evidence about whether sleep duration has declined in recent years is contradictory. Data and methods The study was based on 8,673 adults aged 18 or older in 2002/2003 (cycle 5 of the National Population Health Survey) and used five self-reported biennial measurements of sleep duration spanning eight years. Multiple distinct trajectories of sleep duration were estimated using latent class growth modeling. Results Four modelled trajectories of sleep duration were identified: short (11.1% of the population); low-normal (49.4%); high-normal (37.0%); and long (2.4%). The short, low-normal and high-normal sleep trajectories each exhibited a slight linear decline in hours of sleep over the eight years of follow-up. Poor sleep was predictive of trajectory group membership and associated with a decrease in sleep duration for three of the four groups. Age and sex were also significant predictors of trajectory group membership. Interpretation Trajectory analysis is a useful descriptive tool in the investigation of sleep duration over time. [ABSTRACT FROM AUTHOR]

Background Urinary incontinence (UI), a prevalent condition among seniors, can have substantial impacts on quality of life. Data and methods Data from the 2008/2009 Canadian Community Health Survey-Healthy Aging were used to examine the prevalence of UI, as well as the relationship between UI and loneliness in a sample of 16,369 people aged 65 or older. Multivariate logistic regression was used to identify significant relationships, while adjusting for potential confounders. Results In 2008/2009, an estimated 512,000 seniors reported that they experienced UI. Women were more likely than men to have this complaint (14% versus 9%), as were older seniors. Those with UI were significantly more likely to be lonely than were those without the condition (OR=1.8, 95% CI: 1.5 to 2.0). This association persisted when socio-demographic, social and functional health factors were taken into account (OR=1.5, 95% CI: 1.3 to 1.7). Interpretation This study highlights the prevalence of UI among Canadian seniors and its correlation with loneliness, which, itself, is associated with negative health outcomes. Further research is needed to establish exactly how UI has an impact on seniors' feelings of loneliness. [ABSTRACT FROM AUTHOR]

Background Social participation has been associated with health and well-being in older adults. Data and methods Data from the 2008/2009 Canadian Community Health Survey (CCHS)-Healthy Aging were used to examine the relationship between frequent social participation and self-perceived health, loneliness and life dissatisfaction in a sample of 16,369 people aged 65 or older. Multivariate logistic regression was used to identify significant relationships, while adjusting for potential confounders. The mediating role of social support and the prevalence of reported barriers to greater social participation were also examined. Results An estimated 80% of seniors were frequent participants in at least one social activity. As the number of different types of frequent social activities increased, so did the strength of associations between social participation and positive self-perceived health, loneliness, and life dissatisfaction. The associations generally remained significant, but were attenuated by individual social support dimensions. The desire to be more involved in social activities was reported by 21% of senior men and 27% of senior women. Interpretation Social participation is an important correlate of health and well-being in older adults. It may be that social support gained through social contacts is as important in these associations as the number of activities in which one participates frequently. [ABSTRACT FROM AUTHOR]

With data from the 2009 Canadian Community Health Survey--Healthy Aging Cognition Module, five cognitive functioning categories based on normative values that adjust for age, sex and education were created. The two lowest categories were combined to identify seniors (65 or older) without Alzheimer's disease or dementia living in private households, who had low scores on four cognitive tasks: first recall, second recall, semantic fluency, and processing speed. Low income, not living with a spouse or partner, and diabetes were associated with low scores on each task. Heart disease, impairment in instrumental and daily activities, receiving home care, social participation, loneliness, and self-perceived general and mental health were also associated with low cognitive performance, although the associations differed by cognitive task. [ABSTRACT FROM AUTHOR]

Background The objective of this study was to validate categories of cognitive functioning using data from the 2009 Canadian Community Health Survey (CCHS)--Healthy Aging Cognition Module. Data and methods Four measures of cognitive functioning--immediate and delayed recall (memory), and animal-naming and the Mental Alternation Test (executive functioning)-were coded into five categories for the Canadian household population aged 45 or older. The scores for each measure were standardized to t-scores that controlled for age, sex and education. Respondents were classified into five cognitive functioning categories. Cross-tabulations, stratum-specific likelihood ratios and multinomial logit regression were used to assess associations between levels of cognitive functioning and various health outcomes: self-reported general and mental health status, memory and problem-solving ability, activities of daily living, life satisfaction, loneliness, depression, and chronic conditions. Results Results supported the use of five levels of cognitive functioning for all four outcomes on the CCHS-Healthy Aging sample overall and by age group (45 to 64, 65 or older) and language group (English, French). Interpretation These categories can be used in future work on cognitive functioning based on the CCHS--Healthy Aging. [ABSTRACT FROM AUTHOR]

Early results (January to April) from the 2010 Canadian Community Health Survey show that an estimated 41% of Canadians (excluding those in the territories) aged 12 or older had been vaccinated for H1N1 by April 2010. The percentages were higher in the Atlantic provinces, Quebec and Saskatchewan than in Canada overall. Relatively high percentages of females and people aged 45 or older were vaccinated; the percentage of immigrants who had done so was relatively low. Being in a priority group (health-care worker, having children younger than 5 in the household, or having a chronic condition that could increase the risk for complications from H1N1) increased the likelihood of vaccination. A history of seasonal flu vaccination and having a regular doctor were also associated with H1N1 vaccination. Nearly three-quarters of those who had not been vaccinated reported that they did not think it was necessary. [ABSTRACT FROM AUTHOR]

According to results from the 2007/2008 Canadian Community Health Survey, about 1 in 10 Canadians aged 12 to 44-9% of males and 12% of females, an estimated 1.5 million people-experienced chronic pain. The prevalence of chronic pain increased with age and was significantly higher among people in households where the level of educational attainment was low and among the Aboriginal population. The most common pain-related chronic conditions at ages 12 to 44 were back problems and migraine headaches. Chronic pain prevented at least a few activities in the majority of sufferers. It was associated with activity limitations and needing help with everyday tasks, and had work-related implications. Individuals with chronic pain were frequent users of health care services, and were less likely than people without chronic pain to respond positively on measures of well-being, including mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

Background This article assesses the association between self-rated mental health and selected World Mental Health-Composite International Diagnostic Interview (WMH-CIDI)-measured disorders, self-reported diagnoses of mental disorders, and psychological distress in the Canadian population. Data and methods Data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being. Weighted frequencies and cross-tabulations were used to estimate the prevalence of each mental morbidity measure and self-rated mental health by selected characteristics. Mean self-rated mental health scores were calculated for each mental morbidity measure. The association between self-rated mental health and each mental morbidity measure was analysed with logistic regression models. Results In 2002, an estimated 1.7 million Canadians aged 15 or older (7%) rated their mental health as fair or poor. Respondents classified with mental morbidity consistently reported lower mean self-rated mental health (SRMH) and had significantly higher odds of reporting fair/poor mental health than did those not classified with mental morbidity. Gradients in mean SRMH scores and odds of reporting fair/poor mental health by recency of WMH-CIDI-measured mental disorders were apparent. A sizeable percentage of respondents classified as having a mental morbidity did not perceive their mental health as fair/poor. Interpretation Although self-rated mental health is not a substitute for specific mental health measures it is potentially useful for monitoring general mental health. [ABSTRACT FROM AUTHOR]

Background Diabetes prevalence is associated with low socioeconomic status (SES), but less is known about the relationship between SES and diabetes incidence. Data and methods Data from eight cycles of the National Population Health Survey (1994/1995 through 2008/2009) are used. A sample of 5,547 women and 6,786 men aged 18 or older who did not have diabetes in 1994/1995 was followed to determine if household income and educational attainment were associated with increased risk of diagnosis of or death from diabetes by 2008/2009. Three proportional hazards models were applied for income and for education--for men, for women and for both sexes combined. Independent variables were measured at baseline (1994/1995). Diabetes diagnosis was assessed by self-report of diagnosis by a health professional. Diabetes death was based on ICD-10 codes E10-E14. Results Among people aged 18 or older in 1994/1995 who were free of diabetes, 7.2% of men and 6.3% of women had developed or died from the disease by 2008/2009. Lower-income women were more likely to develop type 2 diabetes than were those in high-income households. This association was attenuated, but not eliminated, by ethno-cultural background and obesity/overweight. Associations with lower educational attainment in unadjusted models were almost completely mediated by demographic and behavioural variables. Interpretation Social gradients in diabetes incidence cannot be explained entirely by demographic and behavioural variables. [ABSTRACT FROM AUTHOR]

Objective: A population-based sample of 4,948 men and women aged 40 or older who did not have heart disease in 1994/1995 were followed to 2006/ 2007 to determine if depression was associated with increased risk of heart disease diagnosis or death. Data sources: Data from seven cycles of the National Population Health Survey (NPHS), 1994/1995 through 2006/2007, were used for longitudinal analysis. Prevalence estimates of heart disease and depression in the population aged 40 years or older were based on the 2002 Canadian Community Health Survey 1.2: Mental Health and Well-being. Analytical techniques: The association between depression and heart disease was analyzed with separate proportional hazards models for men and women, adjusting for socio-demographic characteristics and heart disease risk factors. Main results: Among people aged 40 or older and free of heart disease in 1994/1995, 19% of men and 15% of women had developed or died from heart disease by 2006/2007. The risk of heart disease was significantly higher for women who had depression, but not for men. When heart disease events occurring within two years of baseline were removed, depression was not significantly associated with heart disease risk among women or men. [ABSTRACT FROM AUTHOR]

Objectives This article estimates the prevalence of depression among employed Canadians aged 25 to 64, and examines its association with work impairment, as measured by reduced work activity, mental health/general disability days, and work absence. Data sources Data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being and the longitudinal household component of the National Population Health Survey (1994/1995 to 2002/2003). Analytical techniques Cross-tabulations were used to estimate and determine factors associated with the prevalence of depression among the employed population. Multiple logistic regression was used to examine associations between depression and work impairment while controlling for other variables. Longitudinal data for 1994/1995 to 2002/2003 were used to examine the temporal sequence of depression and work impairment. Main results In 2002, almost 4% of employed people aged 25 to 64 had had an episode of depression in the previous year. Cross-sectional analysis indicates that these workers had high odds of reducing work activity because of a long-term health condition, having at least one mental health disability day in the past two weeks, and being absent from work in the past week. Longitudinally, depression was associated with reduced work activity and disability days two years later. [ABSTRACT FROM AUTHOR]