M. Norris

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I am an Internist and a geriatrician affiliated with the University of Toronto. My field of interest includes quality improvement and patient safety for hospitalized seniors, fall prevention and dementia care. As an assistant professor of medicine with the University of Toronto my teaching interests also include medical education with a focus on support of visible minority students, Black, Indiginous and International medical graduates, postgraduate geriatric medicine and undergraduate geriatric medicine education as well as teaching quality improvement and patient safety at the postgraduate level.

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James Marrow

University of Oxford

W. Clem Karl

Boston University

David Kent

University of Cambridge

Amir Manbachi

Johns Hopkins University

Kaan Yagmurlu

University of Virginia

Giuseppe Leone

Università Cattolica del Sacro Cuore (Catholic University of the Sacred Heart)

David Vago

Vanderbilt University

Renerio Fraguas

Universidade de São Paulo

Ravi Samala

University of Michigan

Ahmed Negida

Harvard Medical School

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Papers by M. Norris

Virtual fall program assessment for frail Canadian community-dwelling older adults: Examining equitable accessibility

DIGITAL HEALTH

Objective In response to COVID-19, the fall prevention program (FPP) at Sunnybrook Health Science... more Objective In response to COVID-19, the fall prevention program (FPP) at Sunnybrook Health Sciences Centre was modified to be delivered virtually. We compared patient populations assessed for the FPP virtually versus in-person to explore equitable accessibility. Methods A retrospective chart review was performed. All patients assessed virtually from the beginning of the COVID-19 pandemic until the end of abstraction (April 25, 2022) were compared to a historic sample of patients assessed in-person beginning in January 2019. Demographics, measures of frailty, co-morbidity, and cognition were abstracted. Wilcoxon Rank Sum tests and Fisher's Exact tests were used for continuous and categorical variables, respectively. Results Thirty patients were assessed virtually and compared to 30 in-person historic controls. Median age was 80 years (interquartile range 75–85), 82% were female, 70% were university educated, the median Clinical Frailty Score was 5 out of 9, and 87% used >5 medi...

World guidelines for falls prevention and management for older adults: a global initiative

Age and Ageing

Background falls and fall-related injuries are common in older adults, have negative effects on f... more Background falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and geront...

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Retrospective analysis of VES-13 questionnaires in the Senior Women's Breast Cancer Clinic at Sunnybrook Health Sciences, Toronto, Ontario, Canada

Journal of Geriatric Oncology, 2022

PURPOSE Vulnerable Elder Survey (VES-13) is a screening tool used in assessing older vulnerable p... more PURPOSE Vulnerable Elder Survey (VES-13) is a screening tool used in assessing older vulnerable patients at risk of functional decline. We sought to evaluate how VES-13 tool would impact oncologist referral pattern to geriatricians as our primary outcome. We also sought to better understand how VES-13 scores impacted referral to additional services (allied healthcare), and modification to oncological treatment. METHODS A retrospective review of VES-13 questionnaires completed by older women (age 70 or older) with breast cancer referred to the Senior Women's Breast Cancer Clinic (SWBCC) was undertaken. Patients with a VES-13 score of three or greater, who were at significantly higher risk of functional decline, had further retrospective chart review for risk factors that would contribute to functional decline such as Eastern Cooperative Oncology Group (ECOG) score, social supports, and current living situation. The primary and secondary endpoints described above were analyzed through bivariate comparisons and multivariable logistical regression to determine if there was any statistical significance (p < 0.05). RESULTS 701 patients completed VES-13 form, of which 235 (33.5%) had a VES-13 score of three or greater. Less than 5% of oncologists documented VES-13 scores in their notes, with less than 5% of patients being referred for geriatric services. Neither VES-13 (p= 0.900) nor ECOG (p= 0.424) were associated with referral for geriatrics assessment. Referral to allied healthcare services was significantly associated with (ECOG) score (OR 2.24 [1.49-3.37], p < 0.0001), while not significantly associated with VES-13 score (OR 0.89 [0.78-1.02], p= 0.102). VES-13 (OR 1.23 [1.04-1.45], p=0.014) and ECOG (OR 2.37 [1.29-4.37), p=0.005) were both associated with modification in oncology treatment (chemotherapy or radiation). CONCLUSION Approximately one third of our population was at risk of functional decline. VES-13 scores were infrequently mentioned in oncologists notes from their clinical assessments, with very few patients being referred for geriatric assessment. By not collecting and analyzing VES-13 scores, and relying on performance status alone, there is a missed opportunity in assessing for functional decline and reducing potential complications from treatment for our patients.

Cultural Competence—Lessons From an Exceptional Case of Care Delivery to My Mom

Canadian Geriatrics Journal

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Radiation Oncology Needs Related to Geriatric Oncology and Treatment of Older Adults with Cancer: A National Survey

International Journal of Radiation Oncology*Biology*Physics, 2017

To compare matching outcomes between selfreporting on Student Doctor Network (SDN) and objective ... more To compare matching outcomes between selfreporting on Student Doctor Network (SDN) and objective data from the National Resident Matching Program (NRMP). Materials/Methods: Data was collected from SDN starting in the 2010-2011 academic year to 2015-2016 academic year. A total of 193 radiation oncology (RO) applicants had reported data during the period. A total of 4 applicants (2.1%) did not match and were excluded from the analysis. Applicants were compared to the NRMP charting outcomes of 2011, 2014, and 2016. Results: US allopathic seniors comprised a majority of those reporting on SDN (95.2%). The majority of applicants (58.2%), self-reported in the later years between 2014 and 2016. Those reporting on SDN were more likely to be members of Alpha Omega Alpha (AOA) (39.

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Neurocognitive profiles in older adults with and without major depression

International Journal of Geriatric Psychiatry, 2008

Objectives To delineate the differences between older persons with and without a diagnosis of maj... more Objectives To delineate the differences between older persons with and without a diagnosis of major depression. Methods Participants were recruited from three outpatient clinics serving older patients at St Michael's Hospital. To be included in the study, participants had to speak English and have no evidence of significant sensory deficits that would interfere with neuropsychological testing. Participants were excluded if they had active delirium, active CNS disease (including dementia), active substance abuse, unstable medical disease, recent ECT treatment and a current/past diagnosis of a psychotic disorder. The diagnosis of major depression was made by qualified professionals in accordance with established guidelines. Participants were administered structured measures assessing global cognition, medical co-morbidity, subjective memory complaints, mood and detailed neurocognitive testing evaluating working memory, attention and speed of processing. Differences between depressed and non-depressed subjects with respect to these measures were analyzed using analysis of variance (ANOVA). Results Thirty-six participants were included in this study. The depressed (n ¼ 17) and non-depressed (n ¼ 19) groups were well matched in terms of age, education, medical co-morbidity and mini-mental state exam (MMSE) score. While the depressed subgroup had significantly higher subjective memory, language and cognitive complaints, there were no significant differences observed between the two subgroups on measures of memory and learning, attention and speed of information processing, fine motor dexterity and verbal fluency. Conclusion This study suggests that while significant depressive symptoms are strongly associated with increased cognitive complaints, they are not associated necessarily with objective cognitive impairment.

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Neuropsychological functioning and delusions in dementia:A pilot study

Aging & Mental Health, 2006

The present pilot study investigated the pattern of neuropsychological functioning associated wit... more The present pilot study investigated the pattern of neuropsychological functioning associated with the presence of delusions in mild-to-moderate dementia. Participants, all of whom met criteria for dementia, were divided into two groups, delusional (n ¼ 9) and non-delusional (n ¼ 9). Individuals with hallucinations were excluded. Participants completed a neuropsychological test battery. Global cognitive functioning (MMSE) and behavioral disturbance (BEHAVE-AD) were also assessed. Differences between the delusional and non-delusional group were most marked for immediate recall of stories, which was higher in the non-delusional group. Scores on semantic fluency, attention (mental control), and overall cognitive functioning (MMSE) were also lower in the delusional group. Conversely, simple attention span (Digit Span) was within normal limits in both groups. Floor effects were noted on measures of delayed recall and alternating attention. This study supports previous findings of greater neuropsychological impairment in delusional as compared to non-delusional individuals with dementia. However, some areas of cognitive functioning may be relatively preserved. Future research should examine semantic processing in persons with dementia with and without delusions.

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Review of delusions in dementia

American Journal of Alzheimer's Disease and Other Dementias, 2004

Although delusions are common symptoms in dementia and are associated with a number of adverse ou... more Although delusions are common symptoms in dementia and are associated with a number of adverse outcomes, research in this area has been limited. This article attempts to summarize the existing literature on delusions in dementia with respect to known risk factors, etiology, pathogenesis, neurocognitive findings, behavioral symptoms, and treatment. This study reviews all relevant abstracts and articles pertaining to delusions and dementia. The reviewers found that the studies were limited by confusion concerning phenomenology. However, consistent findings show that delusions are associated with certain demographic variables, neuropathologic and neurocognitive findings, adverse behavioral outcomes, and limited treatment response. The authors conclude that further longitudinal studies with better clarification of terminology are required to clarify inconsistencies and shed light on future treatment options.

Neuropsychological functioning and delusions in dementia:A pilot study

by Corinne Fischer and M. Norris

Aging & Mental Health, 2006

The present pilot study investigated the pattern of neuropsychological functioning associated wit... more The present pilot study investigated the pattern of neuropsychological functioning associated with the presence of delusions in mild-to-moderate dementia. Participants, all of whom met criteria for dementia, were divided into two groups, delusional (n = 9) and non-delusional (n = 9). Individuals with hallucinations were excluded. Participants completed a neuropsychological test battery. Global cognitive functioning (MMSE) and behavioral disturbance (BEHAVE-AD) were also assessed. Differences between the delusional and non-delusional group were most marked for immediate recall of stories, which was higher in the non-delusional group. Scores on semantic fluency, attention (mental control), and overall cognitive functioning (MMSE) were also lower in the delusional group. Conversely, simple attention span (Digit Span) was within normal limits in both groups. Floor effects were noted on measures of delayed recall and alternating attention. This study supports previous findings of greater neuropsychological impairment in delusional as compared to non-delusional individuals with dementia. However, some areas of cognitive functioning may be relatively preserved. Future research should examine semantic processing in persons with dementia with and without delusions.

Review of delusions in dementia

by Corinne Fischer and M. Norris

American Journal of Alzheimer's Disease and Other Dementias, 2004

Neurocognitive profiles in older adults with and without major depression

by Sean Rourke, M. Norris, and Corinne Fischer

International Journal of Geriatric Psychiatry, 2008

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Neurocognitive profiles in older adults with and without major depression

by Corinne Fischer and M. Norris

International Journal of Geriatric Psychiatry, 2008

Download

Virtual fall program assessment for frail Canadian community-dwelling older adults: Examining equitable accessibility

DIGITAL HEALTH

World guidelines for falls prevention and management for older adults: a global initiative

Age and Ageing

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Retrospective analysis of VES-13 questionnaires in the Senior Women's Breast Cancer Clinic at Sunnybrook Health Sciences, Toronto, Ontario, Canada

Journal of Geriatric Oncology, 2022

Cultural Competence—Lessons From an Exceptional Case of Care Delivery to My Mom

Canadian Geriatrics Journal

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Radiation Oncology Needs Related to Geriatric Oncology and Treatment of Older Adults with Cancer: A National Survey

International Journal of Radiation Oncology*Biology*Physics, 2017

Download

Neurocognitive profiles in older adults with and without major depression

International Journal of Geriatric Psychiatry, 2008

Download

Neuropsychological functioning and delusions in dementia:A pilot study

Aging & Mental Health, 2006

Download

Review of delusions in dementia

American Journal of Alzheimer's Disease and Other Dementias, 2004

Neuropsychological functioning and delusions in dementia:A pilot study

by Corinne Fischer and M. Norris

Aging & Mental Health, 2006

The present pilot study investigated the pattern of neuropsychological functioning associated wit... more The present pilot study investigated the pattern of neuropsychological functioning associated with the presence of delusions in mild-to-moderate dementia. Participants, all of whom met criteria for dementia, were divided into two groups, delusional (n = 9) and non-delusional (n = 9). Individuals with hallucinations were excluded. Participants completed a neuropsychological test battery. Global cognitive functioning (MMSE) and behavioral disturbance (BEHAVE-AD) were also assessed. Differences between the delusional and non-delusional group were most marked for immediate recall of stories, which was higher in the non-delusional group. Scores on semantic fluency, attention (mental control), and overall cognitive functioning (MMSE) were also lower in the delusional group. Conversely, simple attention span (Digit Span) was within normal limits in both groups. Floor effects were noted on measures of delayed recall and alternating attention. This study supports previous findings of greater neuropsychological impairment in delusional as compared to non-delusional individuals with dementia. However, some areas of cognitive functioning may be relatively preserved. Future research should examine semantic processing in persons with dementia with and without delusions.

Review of delusions in dementia

by Corinne Fischer and M. Norris

American Journal of Alzheimer's Disease and Other Dementias, 2004

Neurocognitive profiles in older adults with and without major depression

by Sean Rourke, M. Norris, and Corinne Fischer

International Journal of Geriatric Psychiatry, 2008

Download

Neurocognitive profiles in older adults with and without major depression

by Corinne Fischer and M. Norris

International Journal of Geriatric Psychiatry, 2008

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M. Norris

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