Health Outcomes Of Older Indigenous Australians- A 5 Year Follow Up Study Of A Population At Risk
Funder
National Health and Medical Research Council
Funding Amount
$833,759.00
Summary
The health of Indigenous people is poor and a number of risk factors contribute to lower life expectancy and the development of 'aged care syndromes' such as falls, incontinence, and dementia at a younger age. The research team has described high levels of dementia in a population survey completed in 2005 on 363 older people from the Kimberley. This population will be re-surveyed to document ageing syndromes and determine factors that may improve health for this population at risk
Assessing The Health Needs Of Older Indigenous Australians Living In The Kimberley
Funder
National Health and Medical Research Council
Funding Amount
$242,000.00
Summary
This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expend ....This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expenditure; yet, little is known about the extent of these problems amongst Indigenous Australians. This study builds on a successful project conducted in the Kimberley in 2003 that was designed with the aim of developing and validating a screening instrument for the assessment of dementia amongst Indigenous people. The present project proposes to expand the scope of our previous work to include the assessment of other common conditions associated with older age, such as depression, incontinence and falls and determine use of health services and potential impediments to their access.Read moreRead less
The Effect Of Glucosamine Sulphate On Structural Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$1,250,214.00
Summary
Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommendi ....Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommending paracetamol as 'the preferred long term oral analgesic'. This recommendation is based on the increased risk of serious gastrointestinal, cardiovascular and renal diseases with long-term NSAIDs use in older people. However, NSAIDs appear to provide better pain relief for patients with more than mild joint pain. Amongst patients with OA, there is much demand for the dietary supplement glucosamine sulphate. Product marketing has led to the belief that glucosamine is able to slow the rate of joint destruction and cartilage loss and help ease joint pain with, in contrast to NSAIDs, little risk of side effects. However, the few trials conducted to date have been inconclusive. If the marketing claims are unjustified, many older people are wasting limited financial resources and due to unrealistic expectations of the benefit of glucosamine, placing a lower priority on lifestyle changes of proven effectiveness, such as regular exercise and weight loss. A total of 900 patients with knee OA will be randomly allocated to glucosamine sulphate or matching placebo capsules for two years. The main outcomes will be the rate of joint space narrowing, use of NSAIDs and physical disability. If glucosamine results in slowing disease progression or in reducing NSAIDs consumption, the widespread use of this product would effectively decrease pain, disability and NSAIDs-related illnesses amongst the increasing number of people with OA.Read moreRead less
Exercise: An Examination Of Dose-response Relationships For Women Aged 65-74 Yr.
Funder
National Health and Medical Research Council
Funding Amount
$696,249.00
Summary
The increasing number of older women in Australia presents a significant challenge to our health system. Preventative and health promotion strategies must be developed for this important group of Australian's if chronic disease and disability are to be contained and the decline in functional capacity attenuated. One potential intervention strategy is regular exercise. However, if exercise is to have multi-systems benefits, the dose of the exercise must be known. We do not know the exercise presc ....The increasing number of older women in Australia presents a significant challenge to our health system. Preventative and health promotion strategies must be developed for this important group of Australian's if chronic disease and disability are to be contained and the decline in functional capacity attenuated. One potential intervention strategy is regular exercise. However, if exercise is to have multi-systems benefits, the dose of the exercise must be known. We do not know the exercise prescription that will maximize those health benefits required for this group of Australian's. We propose to resolve this situation via two related experiments involving women aged 65-74 yr. Experiment 1 will select moderate-intensity treadmill walking for 30 min-session with the weekly exercise frequency varied from 1 to 5 session-wk for 64 sessions. Experiment 2 will also select moderate-intensity treadmill walking with the total exercise time per week (120 min-wk) and the number of weeks of training (24 wk) fixed but varying the exercise duration per session (24 to 120 min-session) and the exercise frequency per week; 5 (x 24 min) to 1 (x 120 min) session-wk. Each subject will undergo lung function tests, body fat test, fitness tests and blood tests at selected time intervals throughout each experiment. A separate fitness test will be conducted on the subjects' leg muscle to help us understand what is happening directly in the muscle. We will also conduct a tilt test to help us understand how regular exercise might lessen the likelihood of 'falls' in older individuals. We expect to determine the optimum exercise prescription to improve health and minimize injury and misadventure. It is essential that GP's who have the main responsibility for prescribing exercise for their older patients, have access to knowledge on the optimum exercise prescription to maximize the beneficial changes in health and functional capacity in females aged 65-74 yr.Read moreRead less
Testing The Effect Of Long-chain Omega-3 Polyunsaturated Fatty Acids On Cognitive Ageing In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$738,908.00
Summary
The ageing profile of our population holds challenges for society, with some of the major impact due to loss of independence and quality of life in older people, arising from decline in cognitive functioning. Evidence suggests a benefit of Omega-3 fatty acids on cognitive functioning in older people but claims that Omega-3 slows cognitive decline have not been adequately tested. This study tests the effect of Omega-3 supplementation on cognition in healthy older people, over an 18-month period.
Age-related Changes In Vision And Cognitive Performance: Are There Cognitive Benefits From Cataract Surgery?
Funder
National Health and Medical Research Council
Funding Amount
$101,074.00
Summary
It is possible that some of the confusion and memory loss experienced by older people is due to perceptual errors resulting from poor vision. If this is the case, then treating visual impairment may improve everyday cognitive functioning in some older people. This study aims to find out if the improvement in vision experienced after cataract surgery leads to improvement in memory and cognitive processing among older persons. The study will follow a group of adults aged 70 and older who are about ....It is possible that some of the confusion and memory loss experienced by older people is due to perceptual errors resulting from poor vision. If this is the case, then treating visual impairment may improve everyday cognitive functioning in some older people. This study aims to find out if the improvement in vision experienced after cataract surgery leads to improvement in memory and cognitive processing among older persons. The study will follow a group of adults aged 70 and older who are about to undergo cataract surgery and test them on measures of cognitive performance before surgery, and 3 and 12 months after surgery. Another group of older adults with cataracts who have not yet had surgery and a non-cataract group will also be studied over the 12 month period. The hypothesis of the study is that the group who have had cataract surgery will show greater improvement on the measures of memory and cognitive processing over the follow-up period than the other two groups. The design of the study will allow us to determine whether improvement is due to either; a) simply being able to see the tests better, b) improvement in mood and social participation as a result of cataract surgery; c) changes in the brain that occur from increased sensory stimulation; or d) a combination of these factors.Read moreRead less
Longitudinal Brain Changes In First-episode Psychosis: A 10 Year Follow-up MRI Study
Funder
National Health and Medical Research Council
Funding Amount
$165,250.00
Summary
It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic ....It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic illness. This would be the largest follow-up study of first episode psychosis in the world, with the longest interval between the first and second brain scan. Further, for a proportion of patients we will have 3 MRI scans, at illness onset, 2-4 years post-onset, followed by a third scan at 10 years, thereby providing unique follow-up brain imaging data. Based on our own and other research, we intend to explore the relationship between progressive brain change over a ten year period and: (i) the diagnosis of the patient (schizophrenia or other disorder), (ii) the clinical and functional outcome of the patient (still chronically ill or with no further episode of psychosis), and (iii) the cognitive state of the patient (their ability to perform well on tests of memory, planning and so on). We are able to conduct this study because of the existence of an infrastructure developed to follow-up patients, with a recontact rate of 70% of those patients admitted in 1992 and 1993. In this study we seek to implement these strategies for the patients identified after 1994. The results of this study will test our ideas derived from our model of the major psychotic illnesses and may identify the structural brain changes which are associated with the development of chronic schizophrenia and other psychoses. A further novel outcome will be the inclusion of patients who have remained well and identiifying the structural correlates of a good prognosis.Read moreRead less
Prevalence And Genetic Mechanisms Of Neurological And Gynaecological Changes In Women Carrying Small FMR1 Expansions
Funder
National Health and Medical Research Council
Funding Amount
$411,895.00
Summary
Fragile X syndrome is one of the commonest genetic forms of mental retardation. The abnormal gene is passed from mothers to their sons or daughters, on their X chromosome. The gene abnormality is unstable, tending to worsen each time it is passed on. But if this gene abnormality is passed from fathers to their daughters, it does not worsen. Therefore, grandfathers of the affected children on their mother's side, as well as the mothers, may carry a mildly abnormal gene (a premutation), insufficie ....Fragile X syndrome is one of the commonest genetic forms of mental retardation. The abnormal gene is passed from mothers to their sons or daughters, on their X chromosome. The gene abnormality is unstable, tending to worsen each time it is passed on. But if this gene abnormality is passed from fathers to their daughters, it does not worsen. Therefore, grandfathers of the affected children on their mother's side, as well as the mothers, may carry a mildly abnormal gene (a premutation), insufficient to cause mental retardation. However, it has recently been discovered that these grandfathers may develop a syndrome (FXTAS) of tremor, incoordination, slowness of movements and mild dementia in their later years. Women were thought to be protected, as they carry TWO X chromosomes, one of which is normal even if the other has a premutation. But very recent reports suggest that they may also develop the FXTAS syndrome, as well as early menopause. This study aims to see how common and severe these abnormalities are in women who carry the premutation, using clinical, MRI and electronic measurements, and to relate the abnormalities to the severity of the gene malfunction and familial predisposition.Read moreRead less
The Impact Of Circadian Disturbances On Sleep Quality, Cognition And Psychiatric Symptoms In Neurodegenerative Disease
Funder
National Health and Medical Research Council
Funding Amount
$496,340.00
Summary
There is an increasing awareness that neurodegenerative diseases are associated with disturbances in sleep. Our group have recognised that patterns of sleep disturbance in these patients are also related to problems with memory and mood. The proposed study will be the first of its kind to explore whether disruptions in the circadian system represent a common mechanism underlying these comorbid disease features. Understanding this pathology will hopefully lead to the development of new therapies.
Finding The Optimum Target And Predictors Of Outcome In Deep Brain Stimulation Of Older Patients With Parkinsons Disease
Funder
National Health and Medical Research Council
Funding Amount
$428,392.00
Summary
Parkinson's disease treatment has been revolutionised by the advent of deep brain stimulator surgery. The major benefits come from improved motor function and quality of life. We aim to test the relative benefits of two different targets for brain stimulation and compare their effects on quality of life and cognition. We will also use some of Australia's expertise in brain scanning technology to look for pre-operative predictors of treatment outcomes in this group of older patients with PD.