Lauren Griffith

• PhD
• Professor (Assistant) at McMaster University

Background Early life adversity has long-term effects; however, the influence on changes in body size across the life course is not well understood. Objectives of this study were to define trajectories of body size across the life course and to evaluate the association between adverse childhood experiences (ACEs) and perceived life course body size...

An unintended side-effect of the COVID-19 pandemic has been changes in lifestyle factors which impact middle-aged and older adult cognition – including changes in 24-hour behaviours (i.e., physical activity, sedentary behaviour, and sleep). In a longitudinal analysis of the Canadian Longitudinal Study on Aging (CLSA) tracking cohort, we explored ag...

Objective The primary objective was to evaluate the change in the prevalence of daily or occasional tobacco smoking during the first year of the COVID-19 pandemic and to assess if socioeconomic factors were associated with changes in smoking. The secondary objective was to evaluate the association of smoking with adherence to public health measures...

Objective and ApproachThe Canadian Longitudinal Study on Aging (CLSA) is the largest national longitudinal cohort study, following ~50,000 adults across 10 provinces for at least 20 years. Health Data Research Network (HDRN) Canada is a distributed pan-Canadian network including members in all 13 provinces and territories. In February 2021, the org...

We investigated the prevalence and population attributable fraction (PAF) of 12 potentially modifiable risk factors for dementia in middle-aged and older Canadians. We conducted a cross-sectional study of 30,097 adults aged 45 to 85 with baseline data from the Canadian Longitudinal Study on Aging (2011‒2015). Risk factors and associated relative ri...

Introduction The prevalence of mild and major neurocognitive disorders (NCDs), also referred to as mild cognitive impairment and dementia, is rising globally. The prevention of NCDs is a major global public health interest. We sought to synthesize the literature on potentially modifiable risk factors for NCDs. Methods We conducted an umbrella revie...

This study aimed to develop an efficient data collection and curation process for all drugs and natural health products (NHPs) used by participants to the Canadian Longitudinal Study on Aging (CLSA). The three-step sequential process consisted of (a) mapping drug inputs collected through the CLSA to the Health Canada Drug Product Database (DPD), (b...

Decreased muscle strength and physical function often precede disability, nursing home admission, home care use, and mortality in older adults. Normative values for commonly used physical performance-based tests are not widely available for older adults but are required for clinicians and researchers to easily identify individuals with low performa...

Multimorbidity is a risk factor for patient-important outcomes including quality of life and functional decline. Multimorbidity research has focused mainly on disease counts, with less attention to patterns among chronic conditions. Network analysis has been increasingly used to examine multimorbidity clusters, but there are no guidelines for its c...

Physical activity (PA) is an important modifiable factor for noncommunicable diseases, mental health, and functional trajectories as we age. The World Health Organization highlights the need to mobilize policies targeted toward modifiable determinants of healthy aging. Therefore, understanding the current evidence for PA determinants is crucial to...

Family/friend caregivers are essential in promoting assisted living (AL) residents’ health/well-being, but their involvement was restricted during the COVID-19 pandemic. Care needs in AL are similarly complex as in nursing homes, but fewer staffing resources and services are available. Caregiver involvement and concerns with care of AL residents be...

Frailty prevalence estimates vary considerably (4.0% to 59.1% in one review). Understanding these differences and what drives frailty among individuals could lead to more focused interventions. Breaking frailty into subdomains and exploring their relationships is one approach to this. A 127-item overall Frailty Index (FI) based on data collected on...

The need for strategies to promote mobility during acute care hospital stays among older adults is increasingly recognized. Wearable technologies show great potential for this purpose. The objective of this study was to determine the most accurate wearable sensor device and location for capturing in-hospital mobility in older patients. Twenty-five...

Purpose The mapping of drug and natural health product (NHP) data to standardized terminologies is central to its analysis. This study aimed to develop an efficient data collection and curation process for all drug and NHP used by Canadian Longitudinal Study on Aging (CLSA) participants. Methods The 3-step sequential data collection and curation p...

Background and aims: Performance-based tests of mobility or physical function such as the Timed Up and Go (TUG), gait speed, chair-rise, and single-leg stance (SLS) are often administered using different protocols in aging populations, however, the reliability of their assessment protocols is not often considered. The purpose of this study was to...

Objectives This scoping review aims to understand the extent of evidence regarding preclinical mobility limitation (PCML) intervention studies that have been implemented or planned in middle-aged and older adult populations. Introduction Individuals with PCML are at a high risk of future functional loss and progression to disability. An overview o...

Purpose To assess whether there was an association between care–recipient relationship type and health-related quality of life (HRQL) of older persons living with dementia (PLWD) and their informal caregivers, and whether this association was affected by PLWD’ dementia severity. Methods This was a secondary data analysis study. PLWD (n = 1230) and...

Contexte Au Canada, environ 65 % des aînés qui subissent des blessures consultent les urgences et la grande majorité (»70 %) est retournée à domicile avec des blessures mineures pouvant potentiellement limiter leur mobilité et leur fonctionnement quotidien. L'objectif était d'estimer l'incidence cumulative du déclin fonctionnel sur une période de s...

Study objective To estimate the cumulative incidence of functional decline over 6 months following emergency department (ED) assessments of nonhospitalized injuries and to identify its main determinants. Methods We conducted a prospective multicenter cohort of older adults discharged home following assessment for injuries in 8 Canadian EDs. Partic...

Purpose The purpose of this study was to assess whether there was an association between care-recipient relationship type and the QoL of older adults and their informal caregivers, and whether this association pertained to older adults’ cognitive function. Methods This was a secondary data analysis. Older adults (n=1230) and their informal caregiv...

The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented challenge to public health, with over 233 million confirmed cases and over 4.6 million deaths globally as of September 20211. Although many studies have reported worse mental health outcomes during the early weeks of the pandemic, some sources suggest a gradual decrease in a...

Background Longitudinal studies examining the impact of changes in COVID-19 pandemic-related stressors and experiences, and coping styles on the mental health trajectory of employed individuals during the lockdown are limited. The study examined the mental health trajectories of a sample of employed adults in Hamilton, Ontario during the initial lo...

Self-reported health is a common measure predictive of morbidity and mortality among adults. Many factors are known to be associated with self-reported health including the number of chronic conditions (i.e., multimorbidity). While the association between self-reported health and morbidity and mortality has been well-established, the factors that s...

Risk prediction scores are important tools to support clinical decision-making for patients with coronavirus disease (COVID-19). The objective of this paper was to validate the 4C mortality score, originally developed in the United Kingdom, for a Canadian population, and to examine its performance over time. We conducted an external validation stud...

BACKGROUND The aim of this study was to determine the relative and absolute reliabilities of five key performance-based measures of physical function in the Canadian Longitudinal Study on Aging (CLSA). METHODS An age-stratified sub-sample of 147 participants from the CLSA who were undergoing their 3-year data collection visit participated in two r...

Existing guidelines for fall prevention in older adults recommend mobility screening for fall risk assessment; however , there is no consensus on which test to use and at what cutoff. This study aimed to determine the accuracy and optimal cutoff values of commonly used mobility tests for predicting falls in the Canadian Longitudinal Study on Aging...

Objectives The objective of this study is to describe the association of primary ovarian insufficiency (POI) and early menopause on bone mineral density (BMD) and osteoporosis in a cohort of women living in Canada. Methods Cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) was used. Female participants of the CLSA w...

Objective: To determine the mean number of chronic diseases in Canadians aged 45 to 85 years who are living in the community, and to characterize the association of multimorbidity with age, sex, and social position. Design: An analysis of data from the Canadian Longitudinal Study on Aging. The number of self-reported chronic diseases was summed,...

Existing guidelines for fall prevention in older adults recommend mobility screening for fall risk assessment; however, there is no consensus on which test to use and at what cut-off. This study aimed to determine the accuracy and optimal cut-off values of commonly used mobility tests for predicting falls in the Canadian Longitudinal Study on Aging...

The R software has become popular among researchers due to its flexibility and open-source nature. However, researchers in the fields of public health and epidemiological studies are more customary to commercial statistical softwares such as SAS, SPSS and Stata. This paper provides a comprehensive comparison on analysis of health survey data using...

Background We developed a biomarker algorithm encompassing the clinical chemistry score (CCS; which includes the combination of a random glucose concentration, an estimated glomerular filtration rate and high-sensitivity cardiac troponin; hs-cTn) with the Ortho Clinical Diagnostics hs-cTnI assay (CCS-serial) and compared it to the cutoffs derived f...

Background: This study explores how a broad-range of socio-demographic factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) among older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Communit...

Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health...

Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health...

Many studies have shown that estimates of biological age (BA) can predict health-related outcomes in older adults. Often, researchers employ multiple measures belonging to a variety of biological/physiological systems, and assess the validity of BA estimates by how well they approximate chronological age (CA). However, it is not clear whether this...

Objective To examine agreement between administrative and self-reported data on the number of and constituent chronic conditions (CCs) used to measure multimorbidity. Study Design and Setting Cross-sectional self-reported survey data from four Canadian Community Health Survey waves were linked to administrative data for residents of Ontario, Canad...

Background: Type II diabetes mellitus (T2DM) affects upwards of 25% of Canadian older adults and is associated with high comorbidity and burden. Studies show that lifestyle factors and self-management are associated with improved health outcomes, but many studies lack rigour or exclude older adults, particularly those with multimorbidity. More evi...

Objective There has been a lack of consensus on which criteria are important when selecting health-related outcome measures (HROM), especially in primary health care A Delphi consensus was undertaken to identify core criteria for selecting amongst different HROM and contextual factors affecting decision-making. Study Design and Setting A Delphi su...

Background As more companies obtain regulatory approval for high-sensitivity cardiac troponin (hs-cTn) assays there is an urgent need for independent analytical and clinical evaluations. To this end, we have evaluated Ortho Clinical Diagnostics’ hs-cTnI assay and compared it to their contemporary cTnI-ES assay in emergency department (ED) patients...

Objective To compare multimorbidity prevalence using self-reported and administrative data and identify factors associated with agreement between data sources. Study Design and Setting Self-reported cross-sectional data from four Canadian Community Health Survey waves were linked to administrative data in Ontario, Canada. Multimorbidity prevalence...

Objective To describe agreement between administrative and self-report data on the number and type of chronic conditions (CCs) and determine whether associations between CC count and health service use differ by data source. Study Design and Setting We linked Canadian Community Health Survey and administrative data for a cohort of adults aged 45+...

Objectives: Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected oral health-frailty associatio...

Objective: To investigate the association between menopausal status, hormone therapy (HT) use and the presence of depressive symptoms among middle-aged women in Canada. Methods: Cross-sectional baseline data from 13,216 women aged 45 to 64 years from the Canadian Longitudinal Study on Aging (CLSA) was used. The association between menopausal sta...

Background: There is inconsistent evidence on the association between physical activity and pancreatic cancer risk and few studies have investigated early life or life-course physical activity. The objective of this study was to evaluate the association between trajectories of physical activity across the life-course and pancreatic cancer risk. M...

Background It is unknown if the relationship between multimorbidity and disability differs by combinations of chronic conditions. The objective of our study was to elucidate how joint effect of different combinations of chronic conditions impact the five year risk of functional disability at the population level. Methods Participants ≥65 years fro...

Objectives: To compare the prevalence of poor self-reported oral health (SROH) and dental service-use in a representative sample of Canadian residents, and to identify associations between SROH and psychosocial determinants of health at baseline of the Canadian Longitudinal Study on Aging. Methods: Data from baseline interviews from 2010 to 2015...

Combining data from different studies has a long tradition within the scientific community. It requires that the same information is collected from each study to be able to pool individual data. When studies have implemented different methods or used different instruments (e.g., questionnaires) for measuring the same characteristics or constructs,...

Purpose Pancreatic cancer has the highest fatality rate of all cancers. Adulthood obesity is an established risk factor for pancreatic cancer; however, life-course obesity is not well understood. The aim of this study was to evaluate the association between body mass index (BMI) trajectories throughout the life-course and pancreatic cancer risk. M...

Overweight and obesity in early life are risk factors for many adult‐onset chronic diseases. The objective of this study was to assess the validity of self‐reported recall of early life anthropometric measures. A systematic review was conducted by searching four electronic databases (PubMed, ProQuest, EMBASE, and MEDLINE). Studies were eligible if...

Large-scale studies present the opportunity to create normative comparison standards relevant to populations. Sampling weights applied to the sample data facilitate extrapolation to the population of origin, but normative scores are often developed without the use of these sampling weights because the values derived from large samples are presumed...

Background Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patterns across conditions/disciplines. These comparisons are further complicated by the impact of using different study designs, multim...

Background Physical function limitations precede disability and are a target to prevent or delay disability in aging adults. The objective of this paper was to assess the relationship between self-report and performance-based measures of physical function with disability. Methods Baseline data (2012-2015) from the Canadian Longitudinal Study on Ag...

BACKGROUND: The Health TAPESTRY (Health Teams Advancing Patient Experience: STRengthening QualitY) intervention was designed to improve primary care teamwork and promote optimal aging. We evaluated the effectiveness of Health TAPESTRY in attaining goals of older adults (e.g., physical activity, productivity, social connection, medical status) and o...

OBJECTIVES To explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient‐important functional outcomes. DESIGN Baseline data from a population‐based cohort study. SETTING National sample of Canadians. PARTICIPANTS A tot...

Objectives The aim of this study is to identify the types of community paramedicine programs and the training for each. Methods A systematic review of MEDLINE, Embase, grey literature, and bibliographies followed a search strategy using common community paramedicine terms. All studies published in English up to January 22, 2018, were captured. Scr...

The demand for home care services is increasing, yet the literature describing the clinical characteristics of community-dwelling individuals with a history of stroke who receive home care is limited. In this retrospective, cross-sectional, population-level study, data were sourced from home care recipients aged 65+ who had a routine assessment usi...

Objective: We present descriptive information on the cognitive measures used in the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, relate this to information on these measures in the extant literature, and identify key considerations for their use in research and clinical practice. Method: The CLSA Comprehensive Cohort is compose...

This study assessed test-retest reliability and relative validity of the Short Diet Questionnaire (SDQ) and usability of an online 24 h recall among 232 participants (62 years ± 9.1; 49.6% female) from the Canadian Longitudinal Study on Aging (CLSA). Participants were asked to complete four 24 h dietary recalls (24HRs) using the Automated Self-Admi...

Background: There are multiple multimorbidity measures but little consensus on which measures are most appropriate for different circumstances. Objective: To share insights gained from discussions with experts in the fields of ageing research and multimorbidity on key factors to consider when measuring multimorbidity. Design: Descriptive study...

Background: Testing for high-sensitivity cardiac troponin (hs-cTn) may assist triage and clinical decision-making in patients presenting to the emergency department with symptoms of acute coronary syndrome; however, this could result in the misclassification of risk because of analytical variation or laboratory error. We sought to evaluate a new l...

Background The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program. Objectives...

Supplemental_File_1_Production_(June_26_2018) - Protocol for a program of research from the Aging, Community and Health Research Unit

Introduction: Frailty is a geriatric syndrome conferring a high risk of declining functional capacities. Some serum biomarkers were associated with frailty, but no study has investigated this possible association among community-dwelling seniors with minor injuries in the emergency department (ED). The aim was to determine if ED serum biomarker ass...

Purpose Previous in-depth focus groups found that postal workers employed by a crown corporation in Canada identified a lack of respect in the workplace. A lack of respect or discourteous behavior might be better understood as a phenomenon of workplace incivility. The purpose of this paper is to report a larger cross-sectional survey to determine:...

Background: The number of older people living with cancer and cardio-metabolic conditions is increasing but little is known about how specific combinations of these conditions impact mortality. Methods: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years...

Objective: The aim of this study was to verify the effect of age, education and sex on Miami Prospective Memory Test (MPMT) performance obtained at baseline of the Canadian Longitudinal Study on Aging (CLSA) by neurologically healthy French- and English-speaking subsamples of participants (N = 18,511). Method: The CLSA is a nation-wide large epi...

Objectives: To examine the relationship between hearing deterioration and several health-related outcomes among home care clients in Ontario. Design: Longitudinal analysis was completed for clients with at least two comprehensive assessments. Hearing status, based on a single item, ranged from zero (no impairment) to three (highly impaired). Hea...

Figure S1. Interaction Plots (ANCOVA).

Table S1. List of Comorbidities Included in Study

Table S2. Multiple Imputation Results (n = 159, 5 imputations). Method 1—Markov Chain Monte Carlo. Method 2—Fully Conditional Specification

Table S3. Mean Group Differences (95% CI) for Subgroup Analyses

Background: Clinicians regularly observe increased high-sensitivity cardiac troponin (hs-cTn) concentrations in patients with low estimated glomerular filtration rate (eGFR). The challenge is to differentiate acute coronary syndrome (ACS) from increased hs-cTn results across a range of eGFR. We determined the optimal hs-cTn concentrations for acut...

Objectives: To compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities. Design: Multisite, single-blind, parallel, pragmatic, randomiz...

Background There is interest in utilizing different cut-offs per sex for high-sensitivity cardiac troponin I (hs-cTnI) but less so for high-sensitivity cardiac troponin T (hs-cTnT) for patient management in the acute setting. Our objective was to assess if differences in hs-cTn concentrations exist between males and females for an acute cardiac out...

Objective: This study sought to compare obstetrical outcomes for women with a cephalic presentation at birth resulting from successful external cephalic version (ECV) compared to those resulting from spontaneous cephalic version (SCV). Methods: Secondary analysis was performed on Early External Cephalic Version Trial data. A total of 931 study p...

Objective: We detail a new approach to the creation of normative data for neuropsychological tests. The traditional approach to normative data creation is to make demographic adjustments based on observations of correlations between single neuropsychological tests and selected demographic variables. We argue, however, that this does not describe t...

Background Frailty is a way to appreciate the variable vulnerability to declining health status of people as they age. No consensus for measuring frailty has been established. This study aimed to adapt a Frailty Index (FI) to the Canadian Longitudinal Study on Aging (CLSA) and evaluate its applicability in both younger and older adults. Methods An...

This study describes the striking similarities seen across three studies examining health service use and associated costs among community-living older adults with comorbidity and one of dementia, diabetes, or stroke, using linked administrative databases from Ontario, Canada. We identified 376,434 persons with diabetes, 95,399 with dementia, and 2...

The Canadian Longitudinal Study on Aging is following 50,000 men and women aged 45–85, every three years for at least 20 years. Of the total, 20,000 (Tracking participants) are randomly selected within age/sex strata in each province, and 30,000 (Comprehensive participants) are randomly selected within age/sex strata from within 25–50 km of 11 site...

While much is known about the effect of individual chronic conditions (CCs) on people’s ability to undertake their everyday activities, less is known about effect of having multiple CCs. We will present data from over 20,000 Canadian men and women on population patterns of self-reported CCs and how different combinations of CCs impact disability an...

Poster presented at the Canadian Association for Health Services and Policy Research annual meeting

Aims: Diabetes puts many individuals at risk for developing diabetic retinopathy (DR). Non-mydriatic (NM) retinal photography without pharmacological pupil dilation can be used to detect DR, however, its value in a general clinical setting has not been established. The objective of this review is to evaluate the validity of NM retinal photos, as c...

Introduction: Frailty is associated with functional decline and physiological impairments in seniors with minor injuries. Serum biomarkers have also been suggested as potential markers of these impairments in clinical studies. However, no study has addressed the usefulness of serum biomarkers among pre-frail seniors consulting emergency departments...

Introduction: While evidence suggests that beginning an external cephalic version (ECV) before term (34(0/7) to 36(6/7) ) compared to after term may be associated with an increase in late preterm birth (34(0/7) to 36(6/7) weeks), it remains unknown what might account for this risk. The objective of the present study is to further investigate the a...

Background: there is no standardised test for assessing mobility in the Emergency Department (ED). Objective: we wished to evaluate the relationship between the Timed Up and Go (TUG) and frailty, functional decline and falls in community dwelling elders that present to the ED following minor trauma. Methods: this was a secondary analysis of a...

Background. Validity of pain recall is questioned in research.Objective.To evaluate the reliability of pain intensity recall for seniors in an emergency department (ED).Methods.This study was part of a prospective multicenter project for seniors (≥65 years old) treated in an ED for minor traumatic injury. Pain intensity (0-10 numerical rating scale...

Background: Frailty is a geriatric syndrome conferring a high risk of declining functional capacities. Some serum biomarkers are associated with frailty, but no study has specifically investigated the possible association between frailty and serum biomarkers in independent community-dwelling seniors who consulted the emergency department (ED) follo...

Background Both physical frailty and cognitive impairment predict death, but the joint effect of these two factors is uncertain. The objectives are to determine if the Mini-mental state examination (MMSE) and the Frailty Index (FI) predict death over a five-year interval after accounting for the effect of the other; and if there is an interaction i...