This project will improve our understanding of how painkiller medicines work in very old and frail people which will improve the use of these medicines in pain management. This study will carefully examine pain control with two of the most commonly used pain killer medicines - paracetamol and oxycodone. By understanding all the factors that influence an older persons pain control we will be able to improve the safe and effective use of painkiller medicines in this special group of people.
We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other co ....We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other countries (in North and South America, Asia, and Europe). This study will provide the first nationally-representative information on the burden of chronic obstructive pulmonary disease (COPD) and the opportunities for health gain by improving the management of this illness. In Australia, COPD is a relatively silent and under-recognised disease but nevertheless is the third most important contributor to the burden of disease and the third leading cause of hospital admission as well as being the underlying cause of 4.2% of all deaths. The information we will collect is needed to form a basis for prevention and disease management interventions to reduce the burden of COPD, particularly among population sub-groups who are disproportionately affected, either due to greater exposure to risk factors (mainly tobacco smoking and occupation), greater susceptibility, under-recognition and under-diagnosis, or inadequate disease management. Importantly, the study will serve to raise awareness about the hazards of smoking for all Australians. By identifying target groups, prevalent exposures and management deficiencies, it will lead the way towards policy-relevant randomised controlled trials testing community-based interventions to prevent COPD and-or manage it more effectively. The information collected will help advance knowledge of the prevalence, burden and treatment of COPD that will be relevant to communities throughout the world.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
Nurses, Older People And Hospitals: Meeting New Challenges.
Funder
National Health and Medical Research Council
Funding Amount
$462,500.00
Summary
This project addresses an area of pressing international concern- how to improve health care provision in acute care hospitals to a growing group of patients, people aged 85 years and over. It is known that people 85 years and over have complex health needs. It is also known that older people typically do not do well in hospital. In fact, there is often a decline in their health following hospitalisation. The need to cope with older and often sicker patients will continue to place, substantial p ....This project addresses an area of pressing international concern- how to improve health care provision in acute care hospitals to a growing group of patients, people aged 85 years and over. It is known that people 85 years and over have complex health needs. It is also known that older people typically do not do well in hospital. In fact, there is often a decline in their health following hospitalisation. The need to cope with older and often sicker patients will continue to place, substantial pressure on the acute hospital system and those who work in it. The Registered Nurse [RN], as a part of the health care team, has a pivotal role in providing and coordinating the care that people 85 and over require while in hospital. Yet, little is known about the problems that RNs face in providing care to people 85 and over in hospital. The aim of this project is to identify the problems that impact upon RNs in the provision of care to people 85 years and over and find innovative solutions to those problems. In so doing, the final project recommendations will address ways to assist RNs to enhance the care of people 85 and over in hospital, and at the same time enhance the professional working life of RNs. These recommendations will feed into health and aged care policy development, and the educational preparation of nurses, and thus will have relevance at an individual, organisational, and policy level.Read moreRead less
Cognitive Decline In Type 2 Diabetes: Investigating The Contribution Of Neurodegeneration And Cerebrovascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$608,520.00
Summary
Dementia occurs more commonly than expected in diabetes but the reasons are unknown. There could be a build up of deposits of the toxic protein in the brain that causes Alzheimer's disease. A new technique, using Positron Emmission Tomography (PET scans), will be used to answer this question in combination with MRI scans and serial cognitive testing in patients considered to be at-risk for dementia. The study will help direct research efforts aimed at dementia prevention and treatment.
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
Are Cardiac Conditions In Older Women Managed Appropriately?
Funder
National Health and Medical Research Council
Funding Amount
$289,492.00
Summary
Cardiac conditions, including heart attach, heart failure, angina and high blood pressure are very common among older Australians. They account for large proportions of deaths, morbidity and health care costs. For most of these conditions there are highly effective treatments, however there is evidence that these are not as well used as they should be. Also, for women, diagnosis may be delayed due to perceptions that heart disease is a problem mainly among men. The project is based on the Austra ....Cardiac conditions, including heart attach, heart failure, angina and high blood pressure are very common among older Australians. They account for large proportions of deaths, morbidity and health care costs. For most of these conditions there are highly effective treatments, however there is evidence that these are not as well used as they should be. Also, for women, diagnosis may be delayed due to perceptions that heart disease is a problem mainly among men. The project is based on the Australian Longitudinal Study on Women's Health which includes more than 10,000 women, over half living in rural and remote areas. Women with cardiac conditions will be surveyed about their medical care. This information, together with data they have provided over the last 6 years (and Medicare data if the women have given their consent), will be compared with best practice guidelines established by NHMRC and the Heart Foundation. In this way the project will examine the adequacy of medical care among older women in sufficient detail to make actionable recommendations to health authorities for where improvements are needed.Read moreRead less
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.
A Supervised Exercise Programme Following Hospitalisation For Heart Failure: Does It Add To Disease Management?
Funder
National Health and Medical Research Council
Funding Amount
$730,966.00
Summary
Congestive heart failure (CHF) is a common, disabling condition. Outcomes are improved by a post-hospital disease management programme (DMP) including education, support and followup from a team of nurses, doctors and other health professionals. This study looks at whether adding a supervised exercise programme to a DMP can reduce death rates and hospital stays, and improve physical function and depression in patients with a recent hospital stay for CHF.
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