Research Institute for Aging
Research Institute for Aging


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Spotlight on the RIA’s newest researchers

Sep 14, 2023 | Researchers

We are delighted to welcome three leading researchers to our world-class research team. Dr. Sophiya Benjamin, Laura Middleton, and Tejal Patel.  Together with our existing 12 Schlegel Research Chairs and 2 Schlegel Specialists, our new researchers will tackle the biggest issues facing an aging population, specifically in medication management, mental health, and dementia prevention and well-being.

Laura Middleton | Schlegel Research Chair in Dementia and Active Living

Middleton identifies lifestyle strategies to promote the well-being and independence of those living with, or at risk for, dementia.

What inspired you to pursue research in the field of aging?

When my aunt was diagnosed with early-onset Alzheimer’s Disease at 46, it significantly affected our family, especially my cousins who were just 12, 14, and 16 at the time. Seeing her experience, along with that of our family, motivated me to identify strategies to reduce the risk of dementia. Over time and with more conversations with those living with dementia,  this evolved to focusing on improving their supports so they can live as well as possible.

What is the primary focus of your current research? 

I aim to identify strategies to reduce the risk of dementia, and improve the health and well-being of those living with dementia. I focus on physical activity, alongside other modifiable lifestyle strategies such as nutrition (in collaboration with Heather Keller), social interaction, leisure and mentally stimulating activity.

How do you ensure the active involvement of older adults and their care partners in your research process?

My research is rooted in community engagement. People living with dementia and their care partners, as well as broader community partners, are involved with the research team from the beginning stages. Their insights shape everything we do from research objectives to how we do the research, and the outcomes we strive for. 

Four years ago, I had the privilege of presenting a talk alongside Roger Marple, a person living with dementia. His quote has since been a guiding beacon for my research:

“The learning process for dementia needs to include hope for living well and practical ways to achieve this. This should be taught first.”

What real-world impact has your research had on older adults and care partners?

Many participants in our exercise trials and programs, including Minds in Motion and our local Brain and Body initiative, have experienced noticeable benefits. Their mobility improved and some started walking without walkers. They’re feeling more confident. They found a supportive community among fellow participants and group leaders. This profound impact has been local and across the province. 

We’ve also seen a shift at the community level through a recent project (the Dementia Inclusive Choices for Exercise project) that aimed to train fitness leaders and service community providers to understand dementia and meet the needs of people living with dementia in their programming. You can really see a difference in the perspective of the fitness leaders – they now champion the rights of those with dementia and proactively plan for inclusion. To date, this training has reached over 1,000 individuals globally.

Tejal Patel | Schlegel Specialist in Medication Management and Aging

Patel investigates medication-related problems in older adults, pharmacist interventions, and the role of health-care technology in medication self-management.

What inspired you to pursue research in the field of aging?

I’ve been working as a pharmacist for over 25 years, specializing in neurological conditions – including epilepsy, Parkinson’s, stroke and dementia – all of which are common among older adults. Early in my career, I was searching for literature to help me develop my practise, only to find a gap in research on the pharmacist management of these conditions.

This gap inspired me to delve into this research. There are many challenges related to medication use: polypharmacy, drug interaction and inappropriate medication use, to name a few. When you’re working with younger populations, you don’t have to think about chronic conditions, renal failure, or polypharmacy, but such factors are critical for pharmacists working with older adults.

What is the primary focus of your current research? 

The first aspect of my research focuses on medication management for older adults at home, aiming to address common medication-taking challenges. These include sensory, motivational, physical, and cognitive obstacles to managing medications at home. On average, older adults take 7-9 medications daily, often at various times through the day. Some medicines require injections, while others have specific food-related guidelines. Given this complexity, it’s understandably tough to maintain consistency. We’re working on strategies that not only assist clinicians but also empower older adults to manage their medication effectively at home.

The second dimension of my work seeks to optimize how pharmacists review medications for older adults, particularly those with dementia. Given that many older adults have multiple medical conditions, it’s easy for these reviews to become sidetracked and unfocussed. We are creating tools to ensure pharmacists can conduct more focused and effective medication reviews for this population.

Lastly, the third element of my research evaluates the impact of integrating pharmacists into interdisciplinary clinics, and exploring how this affects medication use among older adults.

How do you ensure the active involvement of older adults and their care partners in your research process?

I engage with older adults I encounter and ask if they’re interested in helping with studies. In one of our recent studies, we invited older adults living with dementia and their care partners to participate in the design of research questions based on their views and needs. In our medication technology and adherence study, two older adults knowledge users are considered co-investigators and assist with not only study design but many other aspects of the study as well, including helping interpret data and disseminate knowledge gained. We have also invited them to present our findings alongside us at conferences.

Our approach emphasizes the active involvement of older adults, while also being flexible to be respectful of their time and contributions.

What real-world impact has your research had on older adults and care partners?

I’ve trained pharmacists to participate in Dr. Linda Lee’s MINT Memory Clinics, giving them an ability to practise within interdisciplinary clinic settings. 

One study I led showed a decreased care partner burden when we incorporated medication technology into senior living homes. This technology eliminated the need for them to constantly check on their loved ones to ensure timely and appropriate medication intake.

Dr. Sophiya Benjamin | Schlegel Chair in Mental Health and Aging

Benjamin researches the integration of geriatric specialties and digital platforms with in-person services to overcome access to care inequities and inefficiencies.

What inspired you to pursue research in the field of aging?

I have always been drawn to complexity, whether in individuals or systems. I chose psychiatry because I liked medicine but equally enjoyed humanities. While training, I worked on genetics and neuroimaging with some excellent research mentors who happened to be geriatric psychiatrists. 

Geriatric psychiatry seemed like a natural fit for me with its interplay between neuropsychiatry and the diverse impacts of aging on various physical processes, applied to balancing the risks and benefits of medical interventions while preserving the connection to the rich lived experiences of my patients.

What is the primary focus of your current research? 

With RIA’s support, we transformed GeriMedRisk from a feasibility trial into an accessible service across Ontario, exemplifying RIA’s incubation, acceleration, and mobilization model. The recent introduction of our GeriMedRisk Research and Innovation Team (GRIT) works within a learning health system framework where we continually analyze our data, apply current evidence and translate this knowledge into practice to create a safer, faster and more effective health system. 

One area of my current research is to increase non-medication interventions for sleep, given that 15 per cent of our recent referrals relate to sleep issues, a prevalent concern among older adults affecting multiple physical and mental health outcomes. Although cognitive behavioural therapy for insomnia (CBTI) is effective, its accessibility is limited in Ontario, particularly for older adults. Consequently, many receive sedative medications, which come with serious risks like falls or decreased cognitive function. We wish to make this highly effective treatment of CBTI equitably accessible to older Ontarians so that we can prevent sedative medication related harms.

How do you ensure the active involvement of older adults and their care partners in your research process?

Seeing and talking to my older adult patients keeps me grounded in problems that are worth working on. In the above example, when trying to refer patients to CBTI, I realized how hard it is to find a trained provider. Even when there are virtual psychotherapy or app-based programs available, most are not tailored to the needs of older adults. Through RIA’s engagement opportunities with older adults and care partners, I aim to create a more accessible model. I’m particularly interested in a peer support model which is well known in mental health but not common in geriatrics. 

Older adults, regardless of their previous careers, have valuable skills and lived experience which can benefit the healthcare system and society at large.  

What real-world impact has your research had on older adults and care partners?

When Dr. Ho and I created GeriMedRisk, we wanted specialized expertise in medication optimization for older adults to be widely available across Ontario. Because of this successful model, many people waiting for help from a specialist are able to get it within days rather than weeks to months. This also prevents hospitalizations and decreases the need for in-person visits. We were cited as one of the models to address the shortage in specialists in the 2019 National Dementia Strategy just a couple of years after we started. 

Other ways in which our impact has been amplified is through collaborations with specialist physicians and pharmacists. Our knowledge portal on geriatric specific drug information is used by clinicians across Canada to help prescribe safely for older adults and we have a global audience attending our monthly rounds. 

A few weeks ago, a younger colleague I am mentoring reached out to me seeking a specialized service for an older family friend. I described a new collaboration between GeriMedRisk and a local partner that could benefit this person and she said “Wow, this did not exist a few years ago. This makes the region a better place for older people to live in”. This is the type of impact I feel most proud of.


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