Blue Mountains Cohort Study: Incidence Of Eye Disease, Hearing Loss And Other Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$813,250.00
Summary
The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examination ....The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examinations on medical history, ocular factors, vascular disease, smoking, diet, plus environmental and blood factors. The study aims to assess the impact of these sensory impairments on measures of dependence, quality of life, general health, age-related cognitive impairment, depression and on mortality. The study will be conducted in Katoomba on the cohort of residents from two postcode areas who originally attended the Blue Mountains Eye Study during the period 1992-4. Examinations will commence by May, 2002 and be completed by April, 2004. We hope to examine 2,032 of the original cohort of 3,654 people. This project will build on the data already collected by the Blue Mountains Eye Study, one of the most successful community surveys conducted in Australia. The 10-year follow-up period will provide increased statistical power and precision to assess the role of possible risk factors for eye disease already identified by the earlier baseline and 5-year studies of this population. The hearing component of the study will provide the first longitudinal data on hearing loss from a large older Australian population.Read moreRead less
Inhibition Of Bone Resorption Increases Skeletal Mechanical Strength By Thickening Trabecular Structures
Funder
National Health and Medical Research Council
Funding Amount
$175,648.00
Summary
This project will identify the basis by which a number of therapies for osteoporosis decrease the risk of bone fractures. Currently at least four classes of these compounds in current use for the treatment of osteoporosis. Some of them have been found to have a very marked beneficial effect by halving the risk of fracture. This study will determine if each of these classes of compounds have the ability to increase the mechanical strength of bone to the same level and if each of these compounds h ....This project will identify the basis by which a number of therapies for osteoporosis decrease the risk of bone fractures. Currently at least four classes of these compounds in current use for the treatment of osteoporosis. Some of them have been found to have a very marked beneficial effect by halving the risk of fracture. This study will determine if each of these classes of compounds have the ability to increase the mechanical strength of bone to the same level and if each of these compounds has the same effects on bone structure. Further the effects of stimulating bone formation by subjecting the skeletal to mechanical stress, on the efficacy of each of the therapies will be established. Conversely the effect of aging, which imposes a limitation on bone formation, will be studied.Read moreRead less
Relationship Between Nigral Injury, Dopamine Handling And Dyskinesia In Parkinsonism
Funder
National Health and Medical Research Council
Funding Amount
$65,685.00
Summary
Parkinson's Disease is a disabling condition that results from loss of nerve cells (neurones) in the part of the brain known as the substantia nigra (SN). These neurones make dopamine. Symptoms become apparent when 80% of these neurones are gone, suggesting that compensation can occur in the brain. Dopamine can be replaced with the drug L-dopa. Unfortunately this benefit is not sustained and is frequently marred by the production of unpleasant writhing wriggling movements called dyskinesia. Thes ....Parkinson's Disease is a disabling condition that results from loss of nerve cells (neurones) in the part of the brain known as the substantia nigra (SN). These neurones make dopamine. Symptoms become apparent when 80% of these neurones are gone, suggesting that compensation can occur in the brain. Dopamine can be replaced with the drug L-dopa. Unfortunately this benefit is not sustained and is frequently marred by the production of unpleasant writhing wriggling movements called dyskinesia. These movements can also complicate the treatment for schizophrenia and other neurological conditions. The way the brain compensates for loss of SN neurones and why dyskinesia occur is unknown. However we present a hypothesis that the mechanisms for compensation also produce the dyskinesia. We have shown that an injury to the SN results in a compensatory response of vigorous sprouting of the surviving dopamine neurones. This sprouting may also explain why dyskinesias occur. The aim of this study is to establish whether the degree of compensatory response corresponds with the severity of dyskinesia and how this compensatory response can be modified or regulated.Read moreRead less
Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone dens ....Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.Read moreRead less
Tai Chi For Independent Living: RCT Of Efficacy Of Tai Chi In Delaying Disability Among Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,157,574.00
Summary
This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people ....This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people. The study will recruit 670 people over 70 years of age and randomly assign them to receive either Tai Chi, or a stretching and relaxation program, for a period of 48 weeks. The groups will then be compared to determine if there is any difference in the development of disability as well as a range of functional outcomes such as strength, balance, depression, arthritic symptoms, life satisfaction, and falls. This will be the first study world-wide to test the impact of any exercise program on delaying the manifestation of disability among older people. Robust evidence that Tai Chi can in fact delay disability will have immediate and significant implications for the maintenance of independence among older people at a critical time for our ageing population. Translation of these research results to practice will decrease demand for support services for community dwelling older people, and for places in supported accommodation facilities. Older people will have improved quality of life, and government and non-government agencies will experience reduced demand for limited resources. This internationally significant study will also contribute to understanding the mechanisms by which disability develops, and create the valuable opportunity for continuing research on attrition of effect and long term adherence to exercise programs.Read moreRead less
Control Of Mastication By Periodontal Mechanoreceptors In Man
Funder
National Health and Medical Research Council
Funding Amount
$169,990.00
Summary
Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure ....Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure only about half of all patients. Improved diagnosis and treatment techniques require more precise elaboration of the neural and muscular mechanisms of chewing. Why do the chewing forces in toothless individuals, despite well fitting dentures, fall to about 20 % of the value in teethed individuals? Do jaw muscles in these subjects weaken because they get less feedback from the receptors around the teeth? How does the chewing force automatically adjust to overcome sudden or gradual changes in the characteristics of foodstuff? Although bite to bite changes in the chewing force is observed in subjects with natural teeth, no such changes occur in toothless subjects or subjects chewing with implanted bridges. How do the receptors adjust the activation of jaw muscles so that bite force is applied in the right direction and right amount at each bite? The aim of this study is to define the importance of the periodontal mechanoreceptors (tiny nerve cells that are situated between the roots of the teeth and the jaw bone that signal bite force to the brain) in the control of jaw muscles. This study will, therefore, illustrate the importance of keeping the teeth and gums healthy for the development of strong, smooth and well-controlled chewing forces, and potentially create opportunities to improve chewing (and thereby quality of life) in toothless individuals or those experiencing other difficulties in chewing.Read moreRead less
Patterns Of Care And Quality Of Life In Patients With Pancreatic Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$680,010.00
Summary
Available evidence suggests that care of patients with pancreatic cancer is variable and dependent on a variety of factors such as geographic location, socioeconomic status and hospital volume. Variability in care may influence survival and quality of life of patients. We propose to conduct a comprehensive study of the management of patients with pancreatic cancer in NSW and, in a substudy in QLD, to determine how variation in management affects patient quality of life.
Beyond Motherhood: A 27-year Follow-up Of The Mental Health Of Mid-age Women.
Funder
National Health and Medical Research Council
Funding Amount
$1,755,651.00
Summary
There have been few studies of the causes and consequences of anxiety disorders yet they are disabiling, chronic and impair life prospects particularly for women. Environmental factors hold the greatest promise to understanding their natural history and for mitigating their effects. This proposal is for a 27 year follow up of women participating in the Mater University Study of Pregnancy to understand the development of anxiety disorders and comorbid depression and substance use.
A Cognitive And Neuroimaging Study Of Exceptionally Old Individuals: Sydney Centenarian Study
Funder
National Health and Medical Research Council
Funding Amount
$857,197.00
Summary
Australia has an ageing society. Individuals over the age of 95 years are the fastest growing proportion of this population. Many of these individuals retain good cognitive function. The Sydney Centenarian Study will recruit all individuals 95 and over in 7 local government areas in Sydney to assess their brain function to determine which cognitive faculties are more or less affected, and how this relates to changes on brain scans. This will be related to neuropathology.