However, researchers have discovered that a potential use has been found in those who have undergone hip or knee arthroplasty.  The British Medical Journal recently published a study that demonstrates a strong linkage between patient bisphosphonate use and the lengthening of knee or hip implants.[i]  In some cases the bone around these implants that anchors them in place can begin to degenerate and cause the implant to loosen over time.  This loosening will eventually require that the patient return for additional surgery.  While incidents of this occurring are relatively low, bisphosphonate can help to reduce those numbers even further.

The study examined a pool of 41,995 patients over a five-year span that received an artificial knee or hip.  Within this group, 1,912 patients were undergoing bisphosphonate use.  It was found that the length of time required between revision surgeries nearly doubled.  As well, the number of patients requiring revisions within this five-year window decreased to half of what it was in patients not taking bisphosphonate.

While an implant can dramatically improve a patient’s level of mobility in the long run, the surgery and recovery time does have an immediate impact on the patient’s life.  Lessening both the frequency and duration between arthroplasty revisions can significantly improve the overall value a patient receives from a total hip or knee arthroplasty.  Reducing the number of subsequent surgeries a patient needs after their initial surgery is a key factor in improving the overall patient experience.  While a full understanding of how bisphosphonate can help those in the post-operative phase is still developing, the research sheds light on the additional potential of bisphosphonate use.  More studies are still required to determine the exact outcome bisphosphonate use can have for patients, and its viability as a treatment option for those who have undergone arthroplasty.

A fall can not only lead to severe physical injuries, such as broken bones and muscular damage, it can take a serious emotional toll causing the individual to lose confidence in their mobility and sometimes even put independence into question for seniors. Some of the statistics released by the OMA on falls in Ontario include:

• A person over the age of 65 enters an Ontario emergency room every 10 minutes as the result of a fall.
• Fall-related emergency department visits most frequently involve hip fractures, open wounds to the head or face, and wrist or forearm fractures.
• More than a quarter of seniors who have fallen will require extensive rehabilitation and a further quarter will need to be transferred to long term care facilities.
• Falling is the leading cause of emergency room visits for people over the age of 65.

Remaining aware of the dangers and risks associated with falling is an important factor in preventing their occurrence. Dr. Stewart Kennedy, President of the Ontario Medical Association released a statement “We want our patients to live healthy and independent lives.  Falling can take a person from fully able and independent, to disabled and relying on others in just a split second.”

The Ontario Medical Association has posted a comprehensive resource of things to keep in mind when it comes to fall prevention categorized by: home, medicine cabinet and out on the town. Here’s a snapshot:

• Contrary to what many may think, the most common type of fall happens by tripping or slipping on level ground.
• Take care to remove loose throw rugs, cables or other tripping risks around areas of traffic.
• Make sure you have adequate lighting around doorways and easily accessible light in bedrooms and bathrooms.
• Consider the use of a non-slip mat or bath chair for your tub.
• Talk to you doctor about how any medications you may be on may affect your chances of falling.
• Staying active is an important factor in reducing your risk of falls as it helps to build muscle and bone. Even something as simple as a daily walk can play a large part in reducing your risk of a fall.

Find resource information on falls prevention at the Ontario Medical Association.

Osteoporosis is a bone degenerative disease that affects nearly two million Canadians and it leads to an increase in the likelihood of bone fractures. The risk of fractures for Canadians as a result of osteoporosis is among the highest in the world. These fractures carry with them a heavy toll on one’s quality of life including pain, decreased mobility, loss of independence and even death. Yet despite Canada’s high prevalence of this disease it often goes un-diagnosed.

While there are several risk factors associated with developing osteoporosis, there are key ways that include diet and exercise that decrease the risk. For example, physical activity plays an important role in increasing bone density and muscle mass. Being stronger and more balanced makes trips and falls that can result in fractures less likely.

Diet also plays a key role. According to Osteoporosis Canada, people over the age 50 require 1200mg of calcium per day. Incorporating calcium rich foods into your diet such as dairy, many types of vegetables and lentils or beans is important to ensure daily requirements are being met. Another factor to consider when thinking about calcium intake is vitamin D and how it affects calcium absorption. If you are finding it hard to reach these requirements through diet alone, consider the use of supplements.

Here are some of the facts and figures that can be found on Osteoporosis Canada’s site (www.osteoporosis.ca)

• Osteoporosis fractures are more common than heart attacks, strokes and breast cancer combined.

• 1 out 3 women and 1 out of 5 men will suffer an osteoporotic fracture in their lifetime.

• 80% of fractures in people over the age of 60 are related to osteoporosis.

• Osteoporosis is the cause of 70-90% of the 30,000 annual hip fractures.

• Hip fractures related to osteoporosis result in death in up to 30% of cases.

• Less than 38% of fracture patients in Canada undergo diagnosis or adequate treatment for osteoporosis.

• The lifetime risk of hip fracture is greater (1 in 6) than the 1 in 9 lifetime risk of developing breast cancer.

Visit Osteoporosis Canada for additional information on nutrition, calcium requirements and recipes.

“I was living in agony; my joint had deteriorated to the point it was causing me horrendous pain,” said Liber. “I had reached the point where I could not deal with it anymore.”

His general practitioner acquiesced and gave him the referral to an orthopaedic surgeon in October. By the end of November he had an appointment with the specialist and surgery was scheduled for the end of January.

That year, Liber’s partial knee replacement was one of 37, 943 knee replacements performed in Canada. Luckily for Peter, he beat the median wait time for males who underwent a knee replacement, which was 173 days in 2006-2007. Today the median wait times have improved significantly to 120 days, a 15 percent reduction in just four years ago.

But the problem is not the standard pre-surgery wait times for most people suffering from chronic knee or joint degeneration, which most often caused by osteoarthritis. The problem is they simply wait too long to insist on referrals to specialists to see if they are a candidate for a partial or full joint replacement.

There are several reasons behind this says Liber, who has gone on to be part of the Canadian Orthopaedic Foundation’s peer patient counselling program, “Ortho Connect”. Most people who are candidates for the knee surgery, whether it’s minimally invasive arthroscopic surgery or a more complex full knee joint replacement, are simply scared of what will happen to them during and after surgery.

It’s one thing to have your doctor or surgeon tell you the facts, but they haven’t had the surgery themselves so they can’t really tell you what it’s like, says Liber. By being available to have phone conversations with patients scheduled for knee surgery, Liber and other peer counsellors can share their personal experience, from their point of view.

“Most people want to know if it hurts, how long it will take before they can walk, or drive or ski, “ said Liber.

For many people, the prospect of knee or hip surgery seems daunting and is a last resort option, so they end up accepting a poor quality of life steeped in joint pain for many years. Often their family doctor has warned them that joint replacements don’t last more than 10 or 15 years and if they get it “too young” they will need another surgery at some point. This makes them to delay making the decision even longer, hoping to “get by” with just one joint surgery in life. But this ensures they are living in pain, which is not a healthy choice. When they finally do have the surgery, most patients regret waiting for so long, says Liber.

Waiting too long for surgery has its consequences. There are established waiting lists for knee replacement surgery across Canada, with a goal of having surgery performed within 26 weeks of the decision to treat by the specialist and the actual start of treatment. But add up the complete wait time (e.g., the time to see a specialist and/or the time waiting to have diagnostic testing), and the total wait can be much longer. For those in severe pain, the consequences of delayed treatment can lead to abandoned activities, altered relationships, reduced or modified work, prolonged sick leave and even job loss, according to the 2009 Hip and Knee Replacement report by the Canadian Joint Replacement Registry.

Surgical wait times begin with the decision to treat by the specialist

Fortunately the advances in knee replacement surgery have allowed for smaller incisions and faster recoveries. Arthroscopy is a surgical procedure that allows the surgeon to look at the inside of a joint in your body through a viewing instrument called an arthroscope. Though some arthroscopic procedures can add short-term relief for a patient with an osteoarthritic joint disease, hip or knee athroplasty has the potential to provide person years of improved quality of life.

Chronic knee or hip pain affects a person’s entire life. Liber’s knee was so painful that he basically stopped participating in anything that required mobility. “Chronic pain changes a person,” says Liber.

Today, five years after his partial knee replacement, Liber is leading a full and active life. His wife credits his partial knee replacement to “giving her husband back.”

Yet he knows his right knee, which has been causing him some concern, needs to be addressed. He says he will again insist his family doctor refer him to the same specialist sooner rather than later because he knows what a positive difference a working, pain-free knee is in life. He’s not going to wait this time. Feeling good is too precious to him.

Editor: Sara Rafuse, EVP & COO, The Canadian Orthopaedic Care Strategy Group
This article may be republished with permission, please contact info@mobilizecanada.com.

Invariably, it’s the last conversation that unifies the group, as a parent’s health has a direct impact on the entire family, and especially for adult daughters, who typically become the caregivers. For the tail end of the baby boomer generation, there are those whose parents are either ill now, or showing signs of a decreased ability to cope either physically or mentally and sometimes both. The conversation turns to “how to talk to parents about aging and staying healthy.”

These aren’t easy conversations to be had, but they can be positive ones. Whether the parent is in denial about their declining health or has a lifestyle that doesn’t embrace healthy, proactive aging, it’s vitally important that adult children figure out a way to cross the generation gap and talk about ways to be healthy as their parent gets older.

ACTIVE AND HEALTHY AGING EXISTS
The idea of healthier aging is not new – in fact, Canadian seniors, as a group, are healthier and living longer than generations before them. Yet their health issues, when they have them, are costly in terms of dollars and the impact they have on the entire family. In 2009, approximately 45% of provincial and territorial governments’ health care expenditures were spent on seniors, while this group accounted for only 14% of the populationi. What is also true is health spending per senior is more than four times that of non-senior adults (age 20 to 64 years).

Canadian seniors are the biggest users of national healthcare services. They are disproportionately higher users of hospital and physician services, home and continuing care services and prescription drugs. But beyond costs, the impact on families who have to become caregivers to their parents is huge. Almost a quarter of Canadian families reported assisting a senior because of the senior’s long-term health condition. It’s always better to encourage healthy aging through conversation, no matter how difficult it is, than it is to ignore the issue.

THREE TYPES OF MINDSETS
Finding the right way to approach one or both parents about their health and their lifestyle depends upon their mindset. Behavioral researchers and experts at the British Columbia Institute of Technologyii indentify the three mindsets that seniors are likely to have when it comes to their current state of health:

1. Those who don’t think there is a problem, so don’t do anything about it.
2. Those who think there is a problem, but don’t do anything about it.
3. Those who know there is a problem, and are actively doing something about it.

It’s the first category that can be most problematic. For example, the aging parent who doesn’t see that their arthritis will eventually lead to further declining mobility unless they take action, such as joining a swim therapy class, will deny they even have a problem. To them, a rehabilitative swim class is not something they would see as necessary.

In this scenario where it’s classified as not thinking, not doing, behavioral change experts suggest that you take on the role of nurturing caregiver versus stern lecturer. Have non-threatening discussions that focus on the accumulative benefits of eating healthier or joining the local community centre’s yoga for seniors class that will lead to better balance and strength. The idea is to allow them to think through how some of these benefits may apply to them. Other conversations can focus on the risks of not changing their behavior – they are unlikely to know that 40 percent of all nursing home admissions are the result of a fall. Getting educated through family physicians or sites such as MobilizeCanada its provided resources links can often lead to positive changes.

Conversation Starter:
Dad, did you know that we lose 1 to 2 percent of muscle mass every year after the age of 50? But I read a study that said people aged 65-79 who lifted weights three times a week for just three months increased their ability to walk farther distances by 38% and got stronger all over. What do you think about that?

For the second mindset, those who recognize there may be a problem but don’t do anything about it, the best way to approach this is to increase confidence in their ability to change. By acknowledging their mixed feelings about looking out for their health in new ways (from assistive mobility devices to diet change or adding mobility exercises) and having them work on realizing the pros versus the cons, you can gently move them to acceptance. The reason this works is because it makes the cost of having to change (their actions/lifestyle) less of a burden.

Conversation Starter:
Mom, you’ve been talking about how your arthritis is bothering you at night. Have you seen your doctor? I hear there are a lot of gentle exercises you can do at home that will help alleviate the pain and maybe you can sleep better. Your doctor will know about them, should we make an appointment now?

For the aging parent who knows they need to change and are making the changes, there are many important conversations to have with them to avoid relapses into their previous behavior. Making change is hard- for anyone. This action-oriented scenario requires you to provide positive feedback on changes, help them to avoid people, places or things that will increase the possibility they will relapse and to reward them for sticking to the healthy changes with lots of positive comments.

Conversation Starter:
Mom, it’s great that you joined the “healthy cooking for one” class at the community centre. I notice you are looking great these days. I am glad that you stopped eating all those processed, frozen dinners. Plus it’s nice to see you getting out to meet new people. Community centres are good places to meet new and old friends. I like how you aren’t afraid to try new things. Keep it up!

DIFFERENT FOR EVERYONE
The conversations we have with our aging parents will be unique to individual families. What is common to all is that active and healthy aging can be challenging but having open conversations early on will lead to healthier lifestyles and adjustments. The more educated that families become on how to encourage healthy aging, the better it is for parents, families and society. Make talking about active and healthy aging part of your family conversations. It’s good for everyone.

Share what you’ve found works best and what doesn’t in conversations with your parents and other family members.

Editor: Sara Rafuse, EVP & COO, The Canadian Orthopaedic Care Strategy Group
This article may be republished with permission, please contact info@mobilizecanada.com.

i Canadian Institute for Health Information, National Health Expenditure Trends, 1975 to 2011 (Ottawa, Ont.: CIHI, 2011).

ii http://www.bcit.ca/appliedresearch/mobility/seniors.shtml

As numerous studies have shown, as people age the more physically active they are, the slower the decline of mobility. In a landmark 2002 study in Amsterdam1, more than 2000 men and women aged 55-85 were tracked over a three-year period to see how their mobility was affected as they aged. It showed that people who participated in sports and had a higher level of total physical activity such as walking or household activity, and kept it up over time, had the least amount of decline in mobility. A 2006 Canadian study2 confirmed that enhanced mobility and musculoskeletal fitness is associated with improvements in overall health and potentially delays or eliminates the risk of disability and chronic disease. Mobility helps to age in a healthy way.

Why is mobility so important to slowing down the aging process? Exercise, it turns out does more for the body than just creating muscles and stronger bones which allow you to have better balance and gait; it also helps to slow down memory loss. Because aging is caused at the cellular level – our cells begin to wear out and cannot repair themselves as quickly or accurately as they could when we younger – anything that promotes healthier cell repair means healthier aging. When a person is engaging in a fitness activity, the body sends chemicals to our cells and its components, including something called telomeres, which are the “tips” at the end of our chromosomes. It is now known that as we age, these telomeres shorten and are related to memory loss. Exercise, on the other hand, delays this shortening. That vigorous nightly walk around the neighbourhood or the three-a-week swimming exercise classes at the community pool will not only keep you strong, it will also help you to remember where you left your keys or your granddaughter’s boyfriend’s name.

You Are As Young As You Feel
Many baby boomers have caught on to this fountain of youth in the form of fitness. From those who incorporate daily walks and moderate strength training into their life style to those willing to tackle intense general fitness regimes like CrossFit, they all see benefits in delayed aging. For them, “you are as young as you feel” is not just a catch phrase. It’s a reality.

For Marian Marshall, 57, finding a fitness routine in her early 50s was her ticket to better health, gentler aging and increased energy. While always conscious of healthy eating, this single mother of three young adults had a high stress career that required long commutes and countless hours at a desk. As she watched seven siblings fall victim to obesity, cancer and sedentary ways, she knew that she wanted to do everything she could to promote healthy aging. Despite a reconstructed ankle from an injury 15 years ago and undergoing major surgery in 2008, she embarked on a daily walking and strength-training program at age 53.

Within weeks she began to see the benefits. Both her coordination and her balance improved. As she continued to incorporate more mobility into her lifestyle, such as taking the stairs instead of the elevator and long walks in her neighbourhood, she also found she didn’t need hormone replacement drugs any more and slept better.

“Since becoming more mobile, I can do things faster, and mentally I am more alert. I just feel happier,” says Marian. “Plus people say I look younger now than I did five years ago.”

Working Out Together Works Out
For husband and wife Chris and Tracy Hummel, finding a fitness passion in their early forties was the ticket to healthier aging, a better marriage and achieving some goals they never thought possible.

Tracy, 46, found mobility four years ago when she was diagnosed as pre-diabetic and was horrified by her obesity. “I saw photos of myself at my sister’s wedding and I couldn’t believe how big I was. I had trouble getting off the couch and getting in and out of the car,” said Tracy. “I couldn’t do anything, and I felt terrible.”

With the doctor’s grim diagnosis in hand, Tracy went to a women-only Curves fitness studio to sign up. “That was the only place that I could think of where they wouldn’t judge a fat woman walking into a gym.” Six months later, she had found enough fitness confidence and started feeling healthy enough to make a giant step in mobility – she and her husband joined a boxing class. From there, they found themselves fans of functional training methods; and they became members at their local CrossFit gym, where the intense daily workouts mimic strenuous physical challenges that involve everything from climbing 15’ ropes to rowing and lifting Olympic weights. Now, with losing 30 inches of fat off her body and gaining significant muscle, Tracy is able to participate in sporting activities with her family and do things she never thought possible and says she now feels younger and more physically capable than she did a decade ago. She has delayed the affects of aging through mobility.

Chris, 44, says he also feels younger now than he did five years ago. From a sedentary lifestyle to running half-marathons to taking on triathlons and obstacle challenge races, his priorities in life now include staying active. “I feel so much better. Before I was 30 lbs heavier, my cardio was terrible, I was not as strong and I was always stressed out. I fully expect to maintain regular fitness for the rest of my life.”

Now Is The Time
What is known is that the best time to start fitness and increase mobility is now. It doesn’t matter if you are 45, 65 or 75, the more you move the better your body feels. If you have health concerns, visit your healthcare provider and ask them for mobility guidance and about moving your body in ways that keep it healthy.

Growing old is inevitable. Feeling old, on the other hand is largely determined by your mobility. Whatever you can do to stay active is like having free refills at the fountain of youth.

Share what you are doing with MobilizeCanada to stay mobile and age in a healthy way!

Editor: Sara Rafuse, EVP & COO, The Canadian Orthopaedic Care Strategy Group
This article may be republished with permission, please contact info@mobilizecanada.com.

^ 1 Marjolein Visser, Saskia M. F. Pluijm, Vianda, S. Stel, Ruud J. Bosscher, Dorly J. H. Deeg, Physical Activity as a Determinant of Change in Mobility Performance: The Longitudinal Aging Study Amsterdam. Journal of the American Geriatrics Society. Volume 50, Issue 11, pages 1774-1781, November 2002.

2 Darren E.R. Warburton, Crystal Whitney Nicol, and Shannon S.D. Bredin, Health Benefits of Physical Activity: The Evidence. CMAJ. 174(6): 801–809. March 14, 2006.

The Conference Board of Canada has just released its annual report card on health. Although Canada gets a “B” for overall health performance, Canada currently sits in the back half of countries, ranking 10th place out of 17 countries due to weaknesses on key indicators.

The report demonstrates that this low ranking is due in large part to the “C” grade Canada received for its mortality rates of cancer, diabetes and musculoskeletal system diseases, ranking 11th place when it comes to the prevention, management and mortality of musculoskeletal diseases.

Most of top ranking countries such as Japan, Switzerland and Italy achieved their position mainly as a result of actions taken to improve the broader determinants of health. The main ways these countries have achieved this is through health promotion programs and policies, which are centred on healthy lifestyle choices. Choices that include such things as quitting smoking, being more active, adopting healthy eating habits and promoting safer driving.

As the population ages, chronic diseases will place an increasing burden on Canadian society. Reports and ranking systems like this are important in drawing attention to health issues that could be improved upon in Canada. These rankings are a way to point governments and policy makers in the right direction, so that steps can be taken to address these issues and improve the health of Canadians.

Source: The Conference Board of Canada

March is nutrition month in Canada. With the end of March fast approaching it is important to keep in mind that eating healthy is something to be concerned with all months of the year. Eating healthy is an integral part of maintaining or increasing mobility; a healthy balanced diet not only promotes musculoskeletal health but also helps to maintain a healthy body weight or to shed some of those extra pounds. Here are some easy tips from the Canadian Diabetes Association for eating healthy year-round that will keep you physically active.

Take some time to plan daily meals – Planning meals means you can quickly and easy work in meals around a busy weekly schedule, while being able to keep nutrition and healthy eating in mind.

Prepare a list when heading to the grocery store – Creating a list will help to ensure that you have all the necessary ingredients for preparing the meals you have planned out. Sticking to a list will also help you eliminate unhealthy impulse buys.

Consider using seasonal produce with bright colours when planning meals – A good general rule to follow when deciding what vegetables to eat is that brighter coloured vegetables are often more nutritious (i.e. red peppers or broccoli).

Start to keep healthy cooking in mind when buying kitchen tools – Items such as a basket steamer will allow you to cook vegetables without added fat and help to retain nutrients and flavours. Using non-stick cookware is a great way to fry or sauté without having to use excessive amounts of fats or oils. Pans with grooves allow fats to drip away while cooking meats.

Use more herbs in your cooking – Using savoury herbs wile cooking will help to add flavour without additional fat or salt. Think classic flavour combinations such as sage or thyme with chicken and rosemary with beef or pork.

Go meatless one night of the week – Try using beans, chickpeas or tofu to replace meat protein. There are lots of resources online to help get you inspired about great vegetarian dishes.

Think about portions – If you are feeling the urge to indulge in a treat think about serving sizes, purchasing a smaller single serving bag of chips or a mini chocolate bar will allow you to satisfy you craving without filling up on low nutrient calories.

The most popular myth is that osteoarthritis (OA), commonly known as degenerative arthritis, is a normal part of the aging process. “It doesn’t have to be a part of aging. Absolutely not.” says Dr. Frank. “It’s potentially a preventable disease and people should be doing everything in their power to avoid it if they can.”

Many people think osteoarthritis is not such a terrible thing to have, and that as you get older, you naturally succumb to it, but that’s wrong, he says. “People [without arthritis] do not want to know how bad it can be. It’s not just aches and pains, it very often can become severe, mind-numbingly painful and you don’t ever want to feel that.”

OA is arthritis (joint inflammation) and is characterized by the loss of cartilage in a joint. In hips or knees, severe OA usually means joint replacement surgery. But preventing some osteoarthritis is primarily a lifestyle choice, says Dr. Frank, former president of the Canadian Orthopaedic Association. He says that evidence suggests that a healthy diet, healthy bodyweight and an active, mobile lifestyle with ‘joint friendly exercises’ as the best bets against osteoarthritis in old age.

Obesity and OA linked

As the rate of obesity rises, so does the rate of OA. Certainly, obesity and osteoarthritis have a connection, says Dr. Frank, but he cautions that you can’t say obesity causes OA, or if you already have OA, you are inevitably headed for decreased physical mobility leading to obesity.

“That’s another myth. That being obese by itself causes the joint deterioration. Indeed, some of the damage is done by the chronic excess weight loads the joints are subjected to, but that’s not the whole story,” says Dr. Frank. “There are many complex causes of obesity; all obesity is not the same and it’s not a simple relationship; it could be a food addiction or a metabolic problem like diabetes. You need to medically investigate the problem of a person’s obesity.”

Dr. Frank, like most orthopaedic surgeons, counsels his patients, the majority who are overweight or obese, to lose weight before any knee joint replacement surgery takes place in order to ensure a better outcome.

The problem is that many people are without a support system to help them lose the weight and keep it off, he says. People suffering from OA, often fall into a self-perpetuating cycle of immobility, convinced that their pain stops them from getting exercise that will help them to achieve a better quality of life and a healthy body weight. “That’s another big myth. That people with arthritis are unable to live an active lifestyle,” says Dr. Frank.

People with lower extremity OA shouldn’t be running or taking up other joint-pounding exercises, but there are plenty of other ways to stay active like biking or deep water exercising, he says. “There are lots of things you can do to get up and move and ways to help you do it, including braces, orthotics and other non-surgical interventions.”

Women Affected More

In Canada, osteoarthritis, which is one of the 100 different forms of arthritis, is having huge impact on the health of Canadians and the healthcare system. Those who are obese are two-and-a-half to three times more likely to develop knee OA and twice as likely to develop hip OA, compared to those with a normal body mass index, according to a major Canadian report released in 2010 by the Public Health Agency of Canada and other arthritis experts*.

Of the 4.2 million Canadians over the age of 18 with some form of arthritis, 63 percent were overweight or obese. Nearly two thirds of those with arthritis were women. Arthritis was the second and third most common chronic condition reported by women and men, respectively.

Don’t Wait for Treatment

Another misconception is that while you do have to have severe joint disease to be a candidate, you do not need to be totally disabled before seeking treatment for joint replacement. Evidence suggests that women seem to be especially reluctant to seek surgical treatment for OA damaged joints, says Dr. Frank. There are a lot of factors for this including “a combination of trust, not being taken as seriously, living alone after widowhood, living in rural parts of the country without easy access to medical care and just sucking it [pain] up,” he says. But as the large baby boomer demographic ages, surgeons are seeing more and more patients requiring new knee and hip joints. In 2005-2006, 59,200 joint replacements for arthritis were performed in Canada with nearly all of these (57,300) were hip or knee replacements. New maximum “wait time guarantees” for joint replacement surgery is speeding up the process, but at the same time the continual influx of new patients is stressing the Canadian healthcare system.

It’s not just the patients and the healthcare system suffering, the economy is taking a crippling hit because of arthritis. In 2000, the Canadian economy lost 6.4 billion dollars through arthritis related costs. On average, over a quarter of men and women with arthritis between 25 and 44 years of age were not in the labour force because of their arthritis, according to the most current statistics.

Finally, Dr. Frank dispels the myth is that cortisone shots are bad. “Cortisone can buy you some time if it is used judiciously,” he acknowledges. He believes that cortisone, in appropriate doses, can allow some people to lead an active lifestyle without substantial pain, which is a definite improvement over immobility and crippling pain.

The truth behind osteoarthritis is undeniable; if you don’t have it, do everything you can to not get it and if you do have it, do everything to stay mobile and not get injured.

Share with us what you are doing to keep moving!

*2010 Life With Arthritis In Canada: A Personal And Public Health Challenge Editorial Board: Public Health Agency of Canada, Arthritis Consumer Experts, Arthritis Community Research & Evaluation Unit, Canadian Arthritis Patients Alliance, Canadian Arthritis Network, Canadian Institute for Health Information, Statistics Canada and The Arthritis Society

Editor: Sara Rafuse, EVP & COO, The Canadian Orthopaedic Care Strategy Group
This article may be republished with permission, please contact info@mobilizecanada.com.

Does your city have non-slip sidewalks wide enough for wheelchairs? How about specialized transportation for disabled people? Or pedestrian crossings with longer crossing times?

In other words…do you live in an age-friendly city?

It isn’t a rhetorical question. And the examples aren’t just made up. They’re part of a written Checklist of Essential Features of Age-friendly Cities, developed by the World Health Organization. You can view the entire list here. The WHO says the list “is to be used by individuals and groups interested in making their city more age-friendly,” and notes that strong public involvement and advocacy are crucial. “For the checklist to be effective, older people must be involved as full partners. In assessing a city’s strengths and deficiencies, older people will describe how the checklist of features matches their own experience of the city’s positive characteristics and barriers. They should play a role in suggesting changes and in implementing and monitoring improvements.”

Not surprisingly, a high percentage of the items on the checklist speak to the issues of mobility and accessibility. Some examples:

• Pavements are non-slip, are wide enough for wheelchairs and have dropped curbs to road level
• Pedestrian crossings are sufficient in number and safe for people with different levels and types of disability, with non-slip markings, visual and audio cues and adequate crossing times
• Buildings are well-signed outside and inside, with sufficient seating and toilets, accessible elevators, ramps, railings and stairs, and non-slip floors
• Specialized transportation is available for disabled people
• Priority parking and drop-off spots for people with special needs are available and respected
• Home modification options and supplies are available and affordable, and providers understand the needs of older people
• Sufficient and affordable housing for frail and disabled older people, with appropriate services, are provided locally
• Venues for events and activities are conveniently located, accessible, well-lit and easily reached by public transport
• Events are held at times convenient for older people
• An adequate range of health and community support services is offered for promoting, maintaining and restoring health
• Health and community service facilities are safely constructed and fully accessible

Experts agree that the aging of the population – and with it, the increase in the incidence of mobility and accessibility challenges – will put much more pressure on local governments to create a more age-friendly environment. In a 2011 article on the subject, the Globe & Mail quoted John Lewis, an urban planner at the University of Waterloo: “The reality is that we will have a very large group of people that have very particular needs that will be pressing upon municipal planners and municipal politicians, not only for social services but also for physical infrastructure.”

Just how large is that group?

Take as one example Canada’s largest metropolis, the Greater Toronto Area (GTA). According to Ontario government estimates, in 2012 the number of people aged 65 and up in the GTA will be approximately 820,000. Over the next 15 years, the population of this age group is projected to increase by 76%, reaching 1.4 million people in 2027. At that point, it will be larger than every other age group. Add to that 1 million people aged 45-54 and another 1 million people aged 55-64. Result: 3.4 million people (or over half the adult population) over the age of 45, and with a higher probability of coping with mobility issues of their own or worrying about those issues on behalf of their elderly parents. No wonder city planners are starting to take note. Canadian cities such as Saanich, B.C., Calgary, Mississauga and Halifax have all started to address this topic.

But some see the topic as more than a social issue. For Henry O’Keefe, who chairs the Niagara Region’s Age-friendly Management Committee, there are solid business reasons, as well. Quoted in that same Globe & Mail article, he noted, “Many seniors control the wealth of this country. By attracting them to an area, you’re creating an economic advantage.”

Whatever the motive is, it’s clear that the drive for age-friendly cities is gaining momentum – and it provides a very fertile ground for activism by those who are concerned about mobility issues. “Canadian cities are in the property and public space business. They establish zoning regulations and define standards for public spaces within their boundaries,” said Mark Towhey, Director of Policy and Strategic Planning for Toronto Mayor Rob Ford. “Municipal politics is incredibly open, transparent and accessible – far more so than other levels of government in Canada. It’s probably the best place to start looking for political support to make changes to public policy about the shape and form of public space.”

If you care about mobility issues, and want to be active and mobile in your city, talk with your local councilor to highlight what’s important to you on features of the age-friendly checklist. Small victories can matter when it comes to staying active while you age. The Mobilize Canada campaign intends to increase its focus on the age-friendly city topic and keep the spotlight on mobility at the local level alongside of other interests.

Editor: Sara Rafuse, EVP & COO, The Canadian Orthopaedic Care Strategy Group

This article may be republished with permission, please contact info@mobilizecanada.com.