Dr. Paula Rochon, the inaugural Director of Research at the Weston and O’Born Centre for Mature Women’s Health at Sinai Health, is one of Canada’s leading voices in aging and women’s health. A geriatrician and health services researcher, Dr. Rochon has spent her career asking questions that highlight where women have been overlooked in health research and care – and investigating the solutions that can help them thrive through every stage of life. Dr. Rochon is also the inaugural holder of the Barry J. Goldlist Chair in Geriatric Medicine and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute.
In this conversation, Dr. Rochon shares the personal experiences and research insights that have shaped her mission to make older women more visible in science, care and policy – and to reimagine what aging can look like when equity leads the way.
Q: What sparked your interest in pursuing a career in this area of research – the intersection of how women experience health and aging?
Dr. Rochon: I was fortunate enough to watch both my grandparents and parents live long and healthy lives – my grandfather lived until he was 103 and my grandmother lived well into her nineties. Those experiences inspired me to start looking at the ways we can support older people to live healthier lives.
My interest in looking at the gaps that exist in research around mature women’s health began when I was completing my master’s in public health at Harvard. I was studying the effectiveness of treatments for arthritis and was surprised to find that data from previous trials contained hardly any data from older participants, and especially not older women. The more I looked, the more I found these kinds of gaps in the research, and the more I wanted to be able to contribute to work that builds our understanding of the different health and social needs women have as they age.
Q: What has contributed to the gaps in understanding how women experience disease and respond to care and treatment?
Dr. Rochon: Historically, women – especially older women – have been underrepresented in clinical research. Until the 1990s, women weren’t required to be included in clinical trials. This has left us with a limited base of evidence that doesn’t reflect the real-world experiences of women throughout the life course.
But another theme that comes up consistently in my work is the idea of gendered agism – a form of discrimination that is embedded in our systems and intersects to make mature women less visible in health care, policy and research. We often talk about “older adults” as a single group, but the experiences of women and men are not the same.
Older women are more likely to live alone, take on caregiving roles, and suffer from multiple chronic conditions. They are also more likely to be prescribed medications that may not be appropriate, which can lead to serious health risks. Yet, even today, when women are included in studies, researchers may not be looking at the results through the lens of how women and men experience disease and respond to treatments differently, especially older women.
Q: What are the most significant outcomes of those inequities in research?
Dr. Rochon: When older women aren’t included in research, they’re at risk of receiving care that isn’t tailored to their needs. One example of how I’ve seen this appear in my work is around the prescription of medications. In one of my early positions as a geriatrician and clinical researcher, I noticed that many of the medications I was prescribing were manufactured at a dose that was too large for older patients, who were mostly women.
This ‘overprescription’ puts patients at risk of something we’ve come to call a prescription cascade – where a patient receives a prescription, develops an adverse reaction or side effect because they’re receiving an inappropriate dose, and returns to their health practitioner for what seems to be a new health problem. At this point, they may be prescribed a new medication to deal with their new symptoms, even though those symptoms are a result of the previous medication. If this cycle continues, there can be major health consequences, including more adverse events.
Prescribing cascades are especially common among older adults, and disproportionately affect older women, who are more likely to be prescribed medications that may be potentially inappropriate. I’m proud that our research in this area has been able to advance global conversations around how to set up protocols to guide the prescription of medications, and to identify a number of the medication pathways where prescription cascades are most likely to occur.
Q: What needs to change to close these gaps in understanding women’s health and sex-based differences in aging, disease and care?
Dr. Rochon: When we’re looking at how to close some of the gaps that exist, I believe it’s crucial for researchers to report on their data with insights broken down by sex and age. When we stop looking at ‘older adults’ as a single group and seek to understand how they may respond to medications or other treatments differently, we’ll be better able to understand the unique needs of both men and women and help them age well.
Addressing these gaps requires not only better data, but a fundamental shift in how we value and include older women in research and care. That’s why I believe that the steps that Sinai Health has taken to make mature women’s health a priority and to establish a centre focused on advancing research, care and education around the different health challenges women face throughout their lives are so important. We still need to build awareness around the gaps that exist and advocate for further action to address them if we want to see improved health and social care for older women.
Q: How do you see your role as Director of Research at the Weston and O’Born Centre for Mature Women’s Health helping to lead some of these changes?
Dr. Rochon: One aspect of my role that I’m most excited about is continuing to raise awareness about the importance of including mature women in all research. There is still so much work to be done in terms of advocating for women to get the answers they deserve – answers that will help improve their health and well-being by closing the historic gaps in data.
Sinai Health’s aspiration to address the full spectrum of health challenges women face throughout their lifetime hinges on a collaborative approach to research and care. There is already incredible work happening to bring together a range of specialties to meet women’s distinct medical needs. I believe that if we continue to build on this collaborative spirit, we can expand the breadth of existing research across Sinai Health and add a focus on mature women to increase the impact of this work.
As we foster the development of research that specifically addresses the needs of mature women, we will continue to find opportunities to apply our findings to clinical practice – ultimately leading to better, more equitable care for women as they age.
At Sinai Health, our scientists and clinicians are leading research that tackles the real issues women face across every stage of life. But with women spending more of their lives in poor health with varying degrees of disability – we need to do more, faster.
Research is not just about advancing knowledge - it’s about improving lives. Every discovery brings us closer to better, more equitable care for women. Will you donate today and help women get the answers they deserve?
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