Halifax physician Ken Rockwood wins international award for dementia work

A Halifax doctor has won a prestigious international award recognizing his research on people living with frailty and dementia as well as his campaign to battle ageism in the health sector.

Dr. Kenneth Rockwood a geriatrician and professor of medicine and neurology at Dalhousie University was presented with New Zealand's Ryman Prize in a virtual ceremony Tuesday night by Jacinda Ardern, the country's prime minister.

The award worth roughly $215,000 recognizes Rockwood's work helping medical systems around the world consider the overall frailty of older patients during treatment.

Ryman Prize director David King cited Rockwood's development of what's referred to as a "clinical frailty scale." The system was created at Dalhousie University in close collaboration with mathematician Arnold Mitnitski, who died earlier this year. The team translated various signs of frailty into a numerical ranking, with lower scores being less severe.

The measurement draws from factors ranging from medical test results, ability to connect socially, bladder control and visual impairment.

"It's a way to understand how fit or frail an individual is, and allows study of how the frailty mix behaves in different illnesses or different populations that gives us insight in how to improve care and prevent frailty," Rockwood said during his acceptance speech Tuesday night.

Used around the world

This system is now used in hospital networks around the globe, helping doctors including specialists who might be tightly focused on one aspect of illness to keep in mind the broader condition of the patient, Rockwood explained in an interview in Halifax.

He said the prevailing model of medicine often concentrates on specific medical problems, while the frailty approach invites doctors to recall that as a person ages, they may have "many things wrong, all at once."

Rockwood said the main reason for doctors to be conscious of frailty is it encourages them to pursue a more careful approach to the complex problems of older patients, many of whom may have cognitive issues that make diagnosis more challenging.

He says in treating one aspect of an elderly person's illness, without regard to the overall impact, "we risk inducing states that are literally worse than dying."

Rockwood also says basic steps can help address frailty, and yet they often go unaddressed in hospitals and long-term care.

"If someone is in bed, mobilize them; if they're in pain, treat that; if not sleeping, give them a restful environment. These are things we need to organize ourselves to do, and under the frailty approach, we won't be successful if we don't," he said.

The prize was also awarded in recognition of Rockwood's work debunking common myths that symptoms such as delirium and frailty were simply a result of aging and treatment options were limited.

Work 'transformed' understanding of aging

The 65-year-old physician grew up in Grand Falls, N.L., in "a house full of books," with his mother working as a teacher and his father for the railroad. "The idea was to live your life for the purpose of something good, and if it was a bit tricky, so much the better," he recalled.

Originally trained in political science and public administration, Rockwood's journey to medicine began in Saskatchewan, where he was assigned to work on a survey of the health conditions of the elderly in the province in the 1970s.

"I learned medicine can become an intellectual pursuit, rather than a repair job," he recalled.

In an emailed comment, Paul Stolee, a professor in the school of public health sciences at the University of Waterloo, said Rockwood's work has become widely known, and "has transformed vague, ageist and nihilistic conceptions of age-related illness to sophisticated understandings of frailty and complex clinical conditions that can guide both rigorous scientific measurement and humanistic, person-centred care."

Rockwood said he will donate half the prize money to Cape Breton University, Dalhousie's medical research foundation and the Queen Elizabeth II Health Foundation, and several smaller charities, for research on frailty issues. He is also planning to use some of the funds to do a lecture tour.