Dr. Kenneth Rockwood, a world leader in geriatric medicine, was named an Officer of the Order of Canada on June 27, 2024. (Provided photo)
When Dr. Kenneth Rockwood began his career as a physician and researcher, he never imagined his work would lead him to one of Canada's highest honours.
Although by his own admission "not without ambition," he was not expecting the phone call he got in April.
"Up to a few seconds before I realized why they were talking to me, I thought it was about someone else I'd helped nominate," he recalls.
The world-renowned geriatrician, researcher, and academic, is among the 83 Canadians newly appointed to the Order of Canada. Dr. Rockwood is recognized for his outstanding research, collaboration and clinical care of older adults living with frailty and dementia, his long-term campaign against ageism in healthcare, and most notably, his development of the Frailty Index and the Clinical Frailty Scale, now used in health care systems worldwide.
Dr. Rockwood was named one of 16 newly appointed Officers to the Order announced by Her Excellency the Right Honourable Mary Simon, Governor General of Canada on June 27, 2024.
Redefining frailty
Dr. Rockwood, a professor in the Department of Medicine's Division of Geriatric Medicine and the Senior Medical Director for the Frailty and Elder Care Network at Nova Scotia Health, has spent decades prioritizing patient care and enhancing patient outcomes through research and education.
The Clinical Frailty Scale (CFS) is a tool for assessing older patients' function and prognosis. Dr. Rockwood developed it in 1997 to summarize the overall level of fitness or frailty of elderly patients.
Both predictive and easy to use, the CFS summarizes the overall level of fitness or frailty of an older adult and is commonly used as a triage tool. During the pandemic, that included allocating scarce healthcare resources for COVID-19 management.
"Rationing was never an intended use," says Dr. Rockwood, "but at least it was better than a strict age-defined cutoff."
The Frailty Index (FI), also developed by Dr. Rockwood, is a key tool for assessing frailty at various levels.
"With many colleagues, especially Paul Stolee at the University of Waterloo, we tried to boil down all the changes that occur with the complex, dynamic state that is frailty," says Dr. Rockwood. "With my friend and mathematician colleague Arnold Mitnitski, the frailty index emerged as an elegant solution to that."
Used globally in routine care, the FI quantifies frailty based on the number and nature of an individual's health deficits.
"The frailty index seems, on its face, like simplicity itself: people are frail when they have more age-related health changes than do their age peers" says Dr. Rockwood. "It turns out, that properly operationalized, elaborating that simple hunch offers amazing insights into how biological aging works."
A global impact
Dr. Rockwood's prolific research career, with more than $20 million in research funding as principal investigator and over 600 peer-reviewed publications, has significantly advanced our understanding of geriatric medicine. His work has also brought considerable resources and employment to Nova Scotians and has recruited students, physicians, and scientists to collaborate in this important field.
Despite his many and varied commitments, Dr. Rockwood consistently makes time for those seeking his guidance, displaying patience and a sincere interest in their pursuits. Under his mentorship, many individuals have flourished in their academic and professional journeys.
And it is not just students. Other physicians and health-care professionals also routinely call upon him for counsel. Countries such as the United Kingdom and China often approach him to provide advice on innovation in the care of older patients, leading to improved patient care both in our province and country as well as around the world.
A lifetime of achievement
For more than 30 years, Dr. Rockwood has made exceptional contributions to health care, research, and education. He has been recognized with countless prestigious awards, including the Queen Elizabeth II Platinum Jubilee Service Medal for his work during the pandemic and the Ryman Prize, a $250,000 international award the most generous prize of its kind in the world.
And now he has received the Order of Canada, bestowed only upon those who make extraordinary contributions to the country. He is quick to underscore that it shows recognition of not only his success, but the work of all those who have committed themselves to these efforts over many decades.
"Clinical medicine is a team sport everywhere, and so is clinical science" says Dr. Rockwood. "What makes geriatrics special to me is that it truly feels like it was a job I was born to do. I am amazed at the opportunities we have here in Nova Scotia to get this right. I see it as my duty to help keep that work going, including by helping to train the next generation of leaders. For that, we seem to be on the right track, but we cannot be complacent."
Dr. Rockwood is many things, but complacent is certainly not one of them. He knows there is much work to be done.
"I fear that unless we get to grips with how to approach the complexity of frailty, and show what successful, useful, and rewarding work that is, we will lose medicare in a sea of disillusionment about how the system'seems unable to care for all these old people.' That is motivation enough to keep going as long as seems useful."
Dr. Rockwood's relentless pursuit of excellence ensures that his contributions will continue to shape the future of geriatric medicine, improving the lives of older adults and inspiring the next generation to carry forward a legacy of compassionate and innovative care.
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