ORCID Profile
0000-0001-8654-2924
Current Organisation
University of Tasmania
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer International Publishing
Date: 2016
Publisher: Cambridge University Press (CUP)
Date: 05-2012
DOI: 10.1017/S1041610212000695
Abstract: Background: Subjective memory complaints are a requirement in the diagnosis of mild cognitive impairment (MCI) as they are thought to indicate a decline in objective memory performance. However, recent research suggests that the relationship between subjective memory complaint and objective memory impairment is less clear. Thus, it is possible that many people without subjective memory complaints who develop Alzheimer's disease are precluded from a diagnosis of MCI. Methods: The present study examined the relationship between subjective memory complaint assessed using the Multifactorial Memory Questionnaire (MMQ) and objective memory impairment assessed using standard neuropsychological measures in cases of amnestic MCI ( n = 48), non-amnestic MCI ( n = 27), and unimpaired healthy participants ( n = 64). Results: Correlational and regression analyses indicated that subjective memory complaints displayed a poor relationship with objective memory performance. A subsequent discriminant function analysis indicated that subjective memory complaints failed to improve the diagnostic accuracy of MCI and resulted in increased rates of false negative and false positive diagnoses. Conclusion: The results of the present study suggest that a diagnostic criterion of subjective memory complaint reduces the accuracy of MCI diagnosis, resulting in an elevated rate of false positive and false negative diagnoses. The results of this study in conjunction with recent research indicate that a criterion of subjective memory complaint should be discarded from emerging diagnostic criteria for MCI.
Publisher: Wiley
Date: 17-04-2023
DOI: 10.1002/HPJA.602
Abstract: Encouraging people to adopt life‐long habits that reduce dementia risk is necessary to manage the growing global prevalence of this condition and is, therefore, a global health priority. Current initiatives promoting risk‐reducing behaviour primarily attract participants from a limited range of backgrounds, even if widely available. This may inadvertently increase health inequities, as the people who are most likely to develop dementia are the people who are least involved in risk‐reduction initiatives. Interpersonal communication can effectively disseminate health messages to demographically erse populations and may, therefore, broaden the reach of dementia risk‐reduction information. Coding reliability thematic analysis was used to categorise reports of information sharing provided by participants from one global online dementia risk education initiative, the Preventing Dementia Massive Open Online Course, or MOOC. These reports of information sharing were provided in response to the feedback question: “If you have already applied your MOOC learning, please tell us how.” Information was reportedly shared with a wide range of people, including those from demographic groups that are under‐represented among Preventing Dementia MOOC participants. Information about specific risk factors was shared, along with general information about the course and/or dementia risk reduction. Some participants also reported that the people they shared information with were initiating risk‐reducing behaviours. Interpersonal communication has the potential to disseminate dementia risk reduction information to, and promote behaviour change among, a broad group of people at risk of dementia, thereby increasing equity in dementia risk education.
Publisher: Wiley
Date: 13-12-2021
DOI: 10.1002/HPJA.559
Abstract: Evaluated the impact of Understanding Multiple Sclerosis (MS) massive open online course, which was intended to increase understanding and awareness about MS, on self‐reported health behaviour change. Observational cohort study evaluating pre‐ (baseline) and post‐course (8‐10‐week follow‐up) survey data. The main study outcomes were self‐reported health behaviour change, change type and measurable improvement. We also collected participant characteristic data (eg, age, physical activity). We compared participants who reported health behaviour change at follow‐up to those who did not and compared those who improved with those who did not using chi square and t tests. Participant characteristics, change types and change improvement were described descriptively. A total of N = 560 course completers were included in this study. The study cohort included MS community members (eg, people with MS, health care providers) and nonmembers. Two hundred and forty‐seven (44.1%) reported behaviour change in ≥1 area at follow‐up, 160 (64.8%) reported a measurable change and, of these, 109 (68.1%) showed improvement. Participants who reported a change and those who improved had significantly lower precourse health behaviours and characteristics (eg, quality of life, diet quality). The most reported change types were knowledge, exercise hysical activity, diet and care practice. Understanding MS encourages health behaviour change among course completers, primarily through the provision of information and goal‐setting activities and discussions. An online education intervention can effectively encourage health behaviour change over an 8‐10‐week follow‐up period. Information provision, including both scientific evidence and lived experience, and goal‐setting activities and discussions are the primary mechanisms underpinning that change.
Publisher: Wiley
Date: 15-05-2017
Publisher: SAGE Publications
Date: 12-08-2022
DOI: 10.1177/08901171211039308
Abstract: Systematically review the evaluation and impact of online health education interventions: assess approaches used, summarize main findings, and identify knowledge gaps. We searched the following databases: EMBASE, ERIC, MEDLINE, and Web of Science. Studies were included if (a) published in English between 2010-2020 in a peer-reviewed journal (b) reported an online health education intervention aimed at consumers, caregivers, and the public (c) evaluated implementation OR participant outcomes (d) included ≥ 100 participants per study arm. Two authors extracted data using a standardized form. Data synthesis was structured around the primary outcomes of the included studies. 26 studies met the inclusion criteria. We found substantial heterogeneity in study population, design, intervention, and primary outcomes, and significant methodological issues that resulted in moderate to high risk of bias. Overall, interventions that were available to all (e.g., on YouTube) consistently attained a large global reach, and knowledge was consistently improved. However, the impact on other outcomes of interest (e.g., health literacy, health behaviors) remains unclear. Evidence around the impacts of the type of online health education interventions assessed in this review is sparse. A greater understanding of who online interventions work for and what outcomes can be achieved is crucial to determine, and potentially expand, their place in health education.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.MSARD.2022.104092
Abstract: Massive open online courses (MOOCs) have grown rapidly in popularity since becoming available worldwide in 2012. There are currently > 30,000 MOOCs available from > 900 universities. However, despite their global reach, MOOCs typically have low completion rates. To evaluate reasons for non-completion among enrolees in the Understanding Multiple Sclerosis (MS) MOOC. This was a mixed methods study evaluating quantitative and qualitative data collected in an online questionnaire administered to Understanding MS enrolees who did not complete the course. The quantitative data was evaluated using frequencies, percentages, means, and standard deviations. The qualitative data was assessed using textual analysis. We recruited 397 participants (4.5% of non-completers). Both the qualitative and quantitative data suggests that the primary reasons for non-completion were time constraints and/or limitations. Some of these were exacerbated by the COVID-19 pandemic. People with MS also cited MS-related symptoms as a reason for non-completion. Suggested changes to the course reflected these results and included extending the course open period and making it self-paced. Although it was impossible to determine if study participants were representative of all non-completers due to selection bias, the results provide useful information for developing future MS educational resources. Accessibility, particularly addressing potential challenges related to MS symptoms and time constraints, should be a primary consideration when developing an educational resource for the MS community.
Publisher: SAGE Publications
Date: 02-11-2021
DOI: 10.1177/14034948211055602
Abstract: Modifiable risk factors for dementia account for 40% of cases worldwide and exert impacts on risk across the life course. To have maximal public health impact, dementia risk-reduction initiatives need to reach a large and erse audience, including people from a wide range of ages and socioeconomic backgrounds. Currently, dementia risk-reduction interventions primarily reach a narrow audience, consisting largely of highly educated older adults from high income countries. In this commentary, we review established dissemination models to identify strategies that could be used to extend and broaden the reach of dementia risk-reduction initiatives. Three potential reach-broadening strategies can be identified from these models: engaging with distinct user groups focusing on interpersonal communication and utilising dissemination agents. Engaging with distinct user groups and utilising dissemination agents show promise for broadening the reach of dementia risk-reduction initiatives, while interpersonal communication has received limited attention in this context. Further evaluation of the impact of interpersonal communication may provide avenues to take advantage of this dissemination method. Based on the reviewed models and data from current risk-reduction initiatives, we suggest that utilising all three of these strategies may most effectively broaden the reach of dementia risk-reduction initiatives. This may promote risk reduction among a larger and more erse audience, more equitably reducing the global impact of dementia.
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: SAGE Publications
Date: 02-01-2017
Abstract: Cognitive reserve (CR) is a theoretical construct describing the underlying cognitive capacity of an in idual that confers differential levels of resistance to, and recovery from, brain injuries of various types. To date, estimates of an in idual's level of CR have been based on single proxy measures that are retrospective and static in nature. To develop a measure of dynamic change in CR across a lifetime, we previously identified a latent factor, derived from an exploratory factor analysis of a large s le of healthy older adults, as current CR (cCR). In the present study, we examined the longitudinal results of a s le of 272 older adults enrolled in the Tasmanian Healthy Brain Project. Using results from 12-month and 24-month reassessments, we examined the longitudinal validity of the cCR factor using confirmatory factor analyses. The results of these analyses indicate that the cCR factor structure is longitudinally stable. These results, in conjunction with recent results from our group demonstrating dynamic increases in cCR over time in older adults undertaking further education, lend weight to this cCR measure being a valid estimate of dynamic change in CR over time.
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/437013
Abstract: Previous studies of mild cognitive impairment (MCI) have been criticised for using the same battery of neuropsychological tests during classification and longitudinal followup. The key concern is that there is a potential circularity when the same tests are used to identify MCI and then subsequently monitor change in function over time. The aim of the present study was to examine the evidence of this potential circularity problem. The present study assessed the memory function of 72 MCI participants and 50 healthy controls using an alternate battery of visual and verbal episodic memory tests 9 months following initial comprehensive screening assessment and MCI classification. In iduals who were classified as multiple-domain amnestic MCI (a-MCI+) at screening show a significantly reduced performance in visual and verbal memory function at followup using a completely different battery of valid and reliable tests. Consistent with their initial classification, those identified as nonamnestic MCI (na-MCI) or control at screening demonstrated the highest performance across the memory tasks. The results of the present study indicate that persistent memory deficits remain evident in amnestic MCI subgroups using alternate memory tests, suggesting that the concerns regarding potential circularity of logic may be overstated in MCI research.
Publisher: Wiley
Date: 19-06-2014
DOI: 10.1111/ENE.12488
Abstract: Longitudinal studies of mild cognitive impairment (MCI) report that a sizeable proportion of MCI cases revert to normal levels of functioning over time. The rate of recovery from MCI indicates that existing MCI diagnostic criteria result in an unacceptably high rate of false positive diagnoses and lack adequate sensitivity and specificity. The aim of the present study was to identify a set of neuropsychological measures able to differentiate between true positive cases of MCI from those who were unimpaired at 11 months' follow-up. A discriminant function analysis identified that a combination of measures of complex sustained attention, semantic memory, working memory, episodic memory and selective attention correctly classified outcome in more than 80% of cases. The rate of false positive diagnoses (5.93%) was considerably lower than is evident in previously published MCI studies. The results of the present study indicate that the rate of false positive MCI diagnoses can be significantly reduced through the use of sensitive and specific neuropsychological measures of memory and non-memory functions.
Publisher: Informa UK Limited
Date: 28-02-2014
DOI: 10.1080/13803395.2014.890699
Abstract: Epidemiological research exploring risk factors for Alzheimer's dementia resulted in the identification of the mild cognitive impairment (MCI) profile. Subsequently, distinct subtypes of MCI have been proposed however, the validity of these as diagnostic entities remains uncertain. The aim of the present study was to examine the longitudinal neuropsychological profiles of MCI subtypes. A total of 118 adults aged 60-90 years were classified at screening as amnestic (a-MCI), nonamnestic (na-MCI), and multiple-domain amnestic (a-MCI+) and were assessed at two time points across 20 months on a comprehensive neuropsychological assessment battery. The a-MCI+ group displayed the poorest performance of all groups in terms of episodic memory, working memory, attention, and executive functioning. These findings suggest that the a-MCI+ subtype is the only variant that is recognizable via neuropsychological testing. In contrast, the differentiation between single-domain subtypes and healthy controls is difficult and may not be achievable through current neuropsychological assessment practices.
Publisher: Informa UK Limited
Date: 10-2016
DOI: 10.1111/AP.12178
Publisher: Wiley
Date: 26-12-2014
DOI: 10.1111/ENE.12333
Abstract: Previous research examining mild cognitive impairment (MCI) has highlighted the heterogeneity of outcome in MCI sufferers. MCI is associated with greater risk of progression to dementia however, a substantial proportion of those identified with MCI have alternative outcomes including recovery to unimpaired status. This heterogeneity may in part reflect insufficient sensitivity and specificity in identifying subclinical memory impairment. The present study examined learning in a s le of 109 adults aged 61-91 years with persistent amnestic MCI, persistent non-amnestic MCI, recovered MCI and healthy controls. At the final assessment point, learning for words recalled across each trial of the Rey Auditory Verbal Learning Test was examined for each group. It was found that persistent amnestic MCI participants displayed significantly lower learning compared with recovered MCI and healthy control groups. The results of this study indicated that poor learning across trials may be a defining feature of persistent amnestic MCI. Further research is required to establish the predictive utility of within trial list learning performance to identify in iduals with persistent and progressive variants of MCI.
Publisher: Wiley
Date: 08-01-2022
DOI: 10.1002/GPS.5672
Abstract: Dementia is a stigmatised condition and dementia‐related stigma is associated with low self‐esteem, poor psychological wellbeing, social isolation and poor quality of life in people living with dementia and their families. There is, however, a lack of valid measures that accurately quantify dementia‐related stigma in the general public. This study reports the initial psychometric evaluation of a new tool designed to measure dementia‐related public stigma amongst community dwelling adults. A s le of 3250 in iduals aged 18 and over completed an online survey on their beliefs and feelings regarding dementia and people living with dementia, and their behavioural intentions towards people living with dementia. Exploratory factor analysis (EFA) using Maximum Likelihood with oblique rotation was performed to extract factors. Confirmatory factor analysis (CFA) was used to confirm the factor structure using goodness‐of‐fit index (GFI), the comparative fit index (CFI), and the root mean square error of approximation (RMSEA) to evaluate the model fit. Internal consistency was measured for the final scale version. EFA resulted in a 16‐item, 5‐factor model (Fear and discomfort, Negative perceptions, Positive perceptions, Burden, and Exclusion) that explained 50.43% of the total variance. The CFA‐estimated model demonstrated a good fit all fit indices were larger than 0.95 (GFI = 0.967, CFI = 0.959) and smaller than 0.05 (RMSEA = 0.048). The final scale showed moderate to high reliability scores ranging from α = 0.738 to 0.805. The Dementia Public Stigma Scale is a tool with reliability, and some demonstrated validity. This scale can be used to measure the public stigma of dementia amongst adults and may be used in the development and evaluation of interventions aimed at dementia‐related stigma reduction.
Publisher: Wiley
Date: 16-02-2014
DOI: 10.1111/PSYG.12042
Abstract: Research suggests that working memory and attention deficits may be present in mild cognitive impairment (MCI). However, the functional status of these domains within revised MCI subtypes remains unclear, particularly because previous studies have examined these cognitive domains with the same tests that were used to classify MCI subtypes. The aim of this study was to examine working memory and attention function in MCI subtypes on a battery of neuropsychological tests that were distinct from those used to classify MCI subtypes A total of 122 adults aged 60-90 years were classified at baseline as amnestic MCI, non-amnestic MCI, and multi-domain amnestic (a-MCI+). The attentional and working memory capacity of participants was examined using a battery of tests distinct from those used to classify MCI at screening. The a-MCI+ group demonstrated the poorest performance on all working memory tasks and specific sub-processes of attention. The non-amnestic MCI group had lowered performance on visual span and complex sustained attention only. There was no evidence of either attentional or working memory impairment in the amnestic MCI participants. When MCI cohorts are assessed on measures distinct from those used at classification, a-MCI+ subjects had the most compromised working memory and attention function. These results support previous findings that suggest a-MCI+ more closely resembles early stage Alzheimer's disease and those with a-MCI+ may be at increased rate of future cognitive decline compared to those with other MCI subtypes.
No related grants have been discovered for Shannon Klekociuk.