MIRA and the Labarge Centre for Mobility in Aging (LCMA) support Master’s and PhD students who are pursuing aging research across all Faculties at McMaster.
The Labarge Centre for Mobility in Aging supports research that engages and benefits older adults, their caregivers, and other stakeholders. Research supported by the LCMA may explore physical mobility and changes in abilities with age, the factors and consequences of community mobility, including transportation and social interaction and navigation, mobility within the health system, and financial mobility. MIRA supports interdisciplinary research on aging that is designed to benefit and meaningfully incorporate end users, including older adults, caregivers, health care and service providers, and other stakeholders such as policy makers, industry and the non profit sector.
Our trainees are immersed in an interdisciplinary research culture, through cross disciplinary mentorship, and research collaborations with other disciplines, and membership in the interdisciplinary MIRA Trainee Network.
Rebecca Correia: Promoting optimal aging through equitable access to “Care of the elderly” family physicians
2021 MIRA PhD Scholarship
Supervisor: Andrew Costa, Health Research Methods, Evidence, and Impact
Mentor: Lennox Arthur Sweetnam, Economics
Compared to other physician groups, family physicians deliver the highest volume of medical services to older adults. To increase family physicians’ knowledge and skills in caring for older adults, the regulatory College of Family Physicians of Canada offers a Certificate of Added Competence in ‘Care of the Elderly.’ Since 2015, more than 340 family physicians have earned this designation, but little is known about how these providers practice and their impacts within the health system. This research will examine how ‘Care of the Elderly’ family physicians influence patient- and population-level outcomes among older adults in Ontario. This work will establish a novel classification for these providers in population health databases, so that their practice patterns and the health services outcomes of their patients can be studied.
Mariia Khamina: Understanding how aging affects blood pressure through oxidative stress
2021 MIRA Master's Scholarship
Supervisor: Giuseppe Melacini Chemistry and Chemical Biology
Mentor: Jonathan Schertzer, Biochemistry & Biomedical Sciences
Reactive oxygen species are the metabolic by-products that accumulate in cells throughout life and cause age-related pathologies. To develop drugs targeting these pathological changes, it is essential to study the effect of oxidative stress at the molecular level. This research will focus on a key regulator of blood pressure - cGMP-dependent protein kinase 1 α (PKGIα) to determine how oxidation changes the structure and function of PKGIα. Under oxidative stress, PKGIα is continuously active, leading to hypotension and, ultimately, the degradation of vascular walls. This project will investigate the molecular mechanism behind PKGIα damaging behaviour under aging-induced oxidative stress.
Augustine Okoh: A transdisciplinary approach to older adults’ care in a Canadian primary healthcare setting: Exploring the possibility in an interprofessional education program
2021 Labarge Mobility Scholarship (PhD)
Supervisor: Lawrence Grierson, Family Medicine
Mentor: Ellen Badone, Religious Studies
Older adults often have multiple health concerns, spanning both physical and psychosocial domains. Team-based health-care approaches are widely recognized as the best strategy for managing the varied and complex challenges that this creates. It improves quality of life, reduces adverse events, mortality and the length of stay in the hospital and increases older adults’ satisfaction with service provision. Team-based health-care delivery has been imagined in several ways with transdisciplinary approaches conceptualized as the most effective. Transdisciplinary care encompasses shared knowledge, skills and decision-making, encouraging patient-centered care, joint assessment, role release and a unified comprehensive care framework. While transdisciplinary care for older adults has been theorized, its practical application is still evolving and remains under-researched. This doctoral research explores the transdisciplinary care approach and the necessary health profession’s education antecedents in the context of Ontario’s Family Health Teams and aims to develop knowledge that will support the optimized care of older adults.
Matthew Ruder: Assessing validity and sensitivity of remotely collected wearable sensor data in patients
2021 Labarge Mobility Scholarship (PhD)
Supervisor: Dylan Kobsar, Kinesiology
Mentor: Rong Zheng, Computing and Software Knee osteoarthritis affects more than five million Canadians, often leading to compensatory changes in walking gait. Recently, wearable inertial sensors have begun to offer a more affordable and more broadly deployable option for both researchers and clinicians to conduct gait analysis. Not only are these devices more accessible, but they offer the ability to collect data in real-world settings over longer periods of time, which provide critically important information regarding disease progression and the efficacy of different interventions, such as physical therapy or corticosteroid injections. However, most gait analysis research only utilizes these sensors within highly controlled settings, which ultimately lack real-world relevance. This project will fulfill a need to better understand not only the quality of data, but the sensitivity to changes that can be expected in remote collections as compared to in-person collections, to lead research out of the lab and into the real world.
MICHELLE MEI: SECONDARY ANALYSIS OF SHARED RISK FACTORS AFFECTING OSTEOARTHRITIS, CARDIOVASCULAR DISEASE, AGING AND MOBILITY
2020 LABARGE MOBILITY SCHOLARSHIP (MASTER’S LEVEL)
Supervisor: Baraa Al-Khazraji, Department of Kinesiology Mentor: Ada Tang, School of Rehabilitation Sciences Osteoarthritis, a progressive joint disease involving breakdown of cartilage and bone, has become the most prevalent cause of physical disability in older adults. There is a greater risk of cardiovascular disease (e.g., ischemic heart disease, heart failure), stroke, and dementia with osteoarthritis. This research explores overlapping shared risk factors for the onset and/or progression of cardiovascular disease and osteoarthritis. Through machine learning approaches, Mei aims to identify potentially overlapping mechanisms between these age-associated diseases. This information will aid in managing the onset and progression of these conditions that affect mobility, independence and, subsequently, quality of life in the Canadian aging population.
Ali Ammar: Development of clinical tools to guide diagnosis and treatment of osteoporosis in older adults
2020 LABARGE MOBILITY SCHOLARSHIP (PHD LEVEL)
Supervisor: Cheryl Quenneville, Department of Mechanical Engineering Mentor: Janie Wilson, Health Sciences Osteoporosis, a disease commonly associated with age that reduces bone mass and strength, is a major contributor to hip fractures and one of the leading causes of mortality in older adults. It affects about 1.4 million Canadians including one in three women and one in twelve men over the age of 50 years old. Current tools for identifying osteoporosis (and corresponding hip fracture risk) have limited predictive capability and are poorly correlated with actual fracture risk. The development of a more accurate clinical tool to guide diagnosis and treatment of osteoporosis in older adults will facilitate independence and improve quality of life for older adults by facilitating improved diagnosis of osteoporosis, and by informing development of more accurate individualized treatment plans to prevent osteoporotic-related injuries.
Zaryan Masood: Tracking real-world changes in osteoarthritic gait patterns using wearable sensors
2020 MIRA Scholarship (Master's Level)
Supervisor: Dylan Kobsar, Department of Kinesiology
Mentor: Janie Wilson, Department of Surgery
Gait analysis is useful in understanding healthy aging, and the etiology and progression of common musculoskeletal disorders that accompany older age, such as osteoarthritis. Conventional gait analysis systems, involving motion capture cameras, are expensive and confined to laboratory settings limiting their accessibility and generalizability. Wearable inertial sensors make gait assessments more accessible and affordable, allow for assessments in real-world, out-of-lab environments, and can help alert health care providers to significant gait changes which may be related to osteoarthritis treatment or progression. This research will measure day-to-day fluctuations in the out-of-lab gait patterns of older adults with knee osteoarthritis through a dual-task perturbation measured by wearable inertial sensors.
Laura Garcia Diaz: Using technology-enabled community engagement strategies to identify community needs of people impacted by dementia
2020 MIRA Scholarship (PhD Level)
Supervisor: Lori Letts, School of Rehabilitation Science
Mentor: Paula Gardner, Department of Communication Studies & Multimedia
Dementia-friendly communities can improve the quality of life for people living with dementia and their caregivers by increasing awareness and an understanding of dementia. The objective of this research is to use technology to engage people impacted by dementia as a means to learn about their community needs to develop and implement dementia-friendly community initiatives in Hamilton and Haldimand. The initiatives promote and support aging in place for people living with dementia and will include the development and/or enhancement of existing web-based platforms to provide education and support (medical and social) to caregivers and persons with dementia living in the community.
Giulia Coletta: Improving physical activity and mobility during a pandemic via live online exercise sessions for older persons: a pilot RCT
2019 LABARGE MOBILITY SCHOLARSHIP (MASTER’S LEVEL)
Supervisor: Stuart Phillips, Department of Kinesiology
Mentor: Rebecca Ganann, School of Nursing
Declines in individual physical mobility are often a precursor to social isolation and poor physical and mental health. Reduced physical mobility and an inability to carry out daily living activities are common with aging, and are also risk factors for frailty, increased hospitalizations, and premature mortality. This research will measure whether a real-time exercise program delivered via an online virtual platform by registered kinesiologists and physiotherapists will improve older adults’ levels of physical activity and mobility.
Erynne Rowe: Modeling deviations in gait coordination and mobility in older adults
2019 LABARGE MOBILITY SCHOLARSHIP (MASTER’S LEVEL)
Supervisor: Janie Wilson, Department of Surgery Mentor: Elizabeth Hassan, Mechanical Engineering
Mobility impairments can lead to social isolation, decreased physical activity and accompanying health co-morbidities. Age-related differences in mobility are frequently accompanied by changes in gait strategies. Certain walking gait parameters may be valuable in the early assessment of cognitive decline and disease development in the aging population. Rowe’s investigation aims to define the biomechanical differences in the effect of aging on gait coordination patterns in and between males and females, and to define normative walking gait patterns in both young and older adults. Initial results have defined age and sex-related changes in gait strategies associated with healthy aging and have provided the framework to compare gait patterns in older adults with clinical conditions at both the Juravinski and St Joseph’s hospitals in Hamilton.
STEPHANIE CHAUVIN: TECHNOLOGY FOR PROMOTING EXERCISE ADHERENCE AND MOBILITY IN OLDER ADULTS
2018 LABARGE MOBILITY SCHOLARSHIP (MASTER’S LEVEL)
Supervisor: Marla Beauchamp, School of Rehabilitation Science
Mentor: Meridith Griffin, Department of Health, Aging & Society
Mobility limitations are a substantial challenge that many older adults with chronic health conditions face, which may lead to adverse outcomes such as disability, hospitalization, and death. The overarching goal of this project is to examine how technology can promote exercise adherence and mobility in older adults. The first study will explore the participant experiences of a home-based fall-prevention exercise program using DVD technology for older adults with chronic obstructive pulmonary disease. The second study aims to determine the effect of computer and mobile technology interventions versus face-to-face and/or hard copy/digital documentary-delivered interventions on exercise adherence and physical function in older adults. A systematic review and meta-analysis will be conducted to compare interventions. The results of these studies will allow for a better understanding of the role technology plays and how to best utilize technology to increase exercise adherence and mobility in older adults.
TANNER STOKES: WHOLE MILK TO AUGMENT MUSCLE PROTEIN SYNTHESIS IN OLDER WOMEN - A RANDOMIZED, CONTROLLED TRIAL
2018 LABARGE MOBILITY SCHOLARSHIP (PHD LEVEL)
Supervisor: Stuart Phillips, Department of Kinesiology
Mentor: Gregory Steinberg, Department of Medicine
Older adults experience progressive loss of muscle mass and strength accompanying the aging process, termed sarcopenia, which predisposes those affected to an increased risk of falls, fractures, diabetes, and an impaired ability to perform activities of daily living. Sarcopenia is inevitable; but research suggests that we can attenuate these losses by increasing dietary protein intake above current recommendations and encouraging physical activity. The primary aim of this study is to assess the efficacy of proteins contained in whole and skimmed milk compared to a common dairy alternative (i.e., almond beverage) on indices of mobility in older women. The team chose to look specifically at women because they live, on average, longer than men and a majority are not currently meeting basic protein requirements. Results from this study will help equip health care practitioners with a practical, easily-implementable strategy with the potential to reduce the impact of sarcopenia in the aging population.
SYDNEY VALENTINO: STAIR CLIMBING OUTCOMES IN CARDIAC REHABILITATION EXERCISE (SCORE) TRIAL
2017 LABARGE MOBILITY SCHOLARSHIP (MASTER’S LEVEL)
Supervisor: Maureen MacDonald, Department of Kinesiology
Mentor: Eva Lonn, Department of Medicine
One in twelve Canadians are living with heart disease; and, by the age of 65, it is the leading cause of death. After a cardiac event, exercise improves recovery, reduces the chance of reoccurrence, and the benefits are maintained as exercise is adhered to. The purpose of this study is to assess the changes in cardiac structure and function in individuals with coronary artery disease undergoing traditional endurance-based exercise (TRAD) in comparison to stair-climbing-based high intensity interval training (HIIT). Eligible participants are recruited from the Cardiac Health and Rehabilitation Centre at the Hamilton General Hospital to complete three cardiac testing sessions at the beginning, middle and end of the cardiac rehabilitation exercise program. As of September 2018, seven participants have successfully completed three months of cardiac rehabilitation as part of either the HIIT or TRAD groups, and an additional three participants are enrolled in the exercise program. The team believes that stair-climbing based HIIT has the potential to elicit similar physiological benefits as traditional cardiac rehabilitation, albeit with increased time efficiency and minimal equipment requirements. Recruitment, testing, and analysis is currently ongoing to understand the full benefits of this exercise modality on the cardiovascular system. Thus far, the SCORE trial has demonstrated stair climbing-based HIIT exercise is feasible within standard cardiac rehabilitation programming.
MICHAEL KALU: MOBILITY ENHANCEMENT COMPREHENSIVE CARE MODEL
2017 LABARGE MOBILITY SCHOLARSHIP (PHD LEVEL)
Supervisor: Vanina Dal Bello-Haas, School of Rehabilitation Science
Mentor: Amanda Grenier, Department of Health, Aging & Society
During the first year of study, two scoping reviews have been completed. These have been presented at two conferences and submitted for publication in peer-reviewed journals. The first scoping review was focused on understanding the role of physiotherapists (PTs) and occupational therapists (OTs) in care transitions. Of the 21 included studies, only three mentioned the role of OTs or PTs in care transitions; however, the roles were not explicitly described and there was no evidence of overt involvement of rehabilitation professionals in the care transition processes. The second scoping review was aimed at examining the association between socioeconomic status (SES) and mobility in older adults. In this review, 53 analyses (77%) reported a statistically significant association of SES (income, education, and occupation) and the mobility of older adults. This implies that older adults with higher education, higher income and who have held or hold skilled jobs have improved physical mobility.