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.
[Learn about three Dalhousie alumni also appointed this summer at the bottom of this article]
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.
The following Dalhousie alumni were also named along with Dr. Rockwood:
Members
Sylvia Hamilton
Alum Sylvia Hamilton (LLD’01, MA’00) is a filmmaker and poet who dedicates herself to recalling and reclaiming forgotten lives, especially the lives of Black people in Nova Scotia. Her award-winning films have premiered at festivals in Canada and abroad and are taught in schools and universities across the country. Her groundbreaking body of work has helped to enrich and reframe conceptions of Canadian history.
Hamilton’s connection with Dalhousie began as a community member, serving on the advisory board for Dalhousie’s Transition Year Program and supporting the law school’s Indigenous Blacks & Mi’kmaq Initiative. She earned a Master’s of Education at Dal in 2000. “[Dalhousie is] an institution that has really tried to open its doors to so many people from this province, the country, around the world,” said Hamilton in 2018.
Recently, The University of King’s College, where she is an Inglis Professor, established The Sylvia D. Hamilton Award. It is valued at $2,020 annually, reflecting the year she retired from King’s. It’s open to African Canadian students, with a preference given to those entering the journalism program.
Zoe Lucas
For more than 50 years, educator and advocate Zoe Lucas (LLD’08) has explored and shared her observations and insights regarding the unique natural and cultural values of Sable Island, dedicating her life to biological research and environmental monitoring.
A NSCAD art student on her first visit to Sable Island in 1971, Lucas soon landed a job there with a seal research program in Dalhousie’s psychology department. By the mid-1980s, she moved permanently to Sable, located 160 kms off the province’s southeast coast.
Lucas continues to study the horses, seals and other wildlife of Sable Island in their unique windswept habitat. Her work has appeared in many scientific journals. She is a founding member and president of the Sable Island Institute, and her contributions have encouraged research and conservation that will help preserve the island’s rich legacy for future generations.
Dalhousie awarded Lucas an honorary degree in 2008.
Officer
Vaira Vike-Freiberga
Vaira Vike-Freiberga (LLD’07), O.C., has enriched Canada-Latvia relations and reflected Canadian values abroad.
As a child, Vike-Freiberga was forced to flee her home due to the Soviet occupation of Latvia at the end of World War II. She became an acclaimed academic in psychology in Canada (and remains a professor emerita in psychology at l’Université de Montréal) before returning to her homeland where she became President of Latvia. During her presidency, she oversaw many political and economic reforms, helping the country enter into NATO and the European Union, and regain stability during its post-Soviet period. She remains committed to protecting democracy and human rights, and to promoting women leaders worldwide.
Dalhousie awarded Vike-Freiberga an honorary degree in 2007. Throughout her convocation address, Dr. Vike-Frieberga’s message revolved around respect for human rights, democracy and freedom, and the power of the human spirit. “Canada’s high quality of life, democracy, and justice exist because great minds had a vision of what their country should look like,” she said.