Kaarin Jane Anstey

Influence of periodontal disease on risk of dementia: a systematic literature review and a meta-analysis

Publisher: Springer Science and Business Media LLC

Date: 12-06-2020

DOI: 10.1007/S10654-020-00648-X

An examination of the long-term impact of job strain on mental health and wellbeing over a 12-year period

Publisher: Springer Science and Business Media LLC

Date: 13-02-2016

DOI: 10.1007/S00127-016-1192-9

Abstract: Job strain has been implicated in a range of employee health outcomes including psychiatric health. Much of the literature is drawn from studies that utilise cross-sectional designs, whilst the long-term follow-up of participants is limited. We examine the short and long-term risks of job strain for depression and wellbeing over a 12-year period. In particular, we utilise measures of wellbeing to emphasise the importance of discriminating between indices of subjective and psychological wellbeing that complement measures of mental health. Participants (n = 2530) were aged between 40 and 44 years at baseline and were drawn from the Personality and Total Health (PATH) Through Life Project. Participants were observed once every 4 years for 12 years. A high strain job was associated with an increased risk of reporting sub-syndromal [RRR = 1.66 (95 % CI 1.23 2.25), p < 0.001], minor [RRR = 1.92 (95 % CI 1.19 3.10), p < 0.001] and major depression [RRR = 2.19 (95 % CI 1.30 3.67), p < 0.001], but strain was not a long-term risk for depression 4 years later. In contrast, strain was a risk for both cross-sectional and longitudinal wellbeing outcomes. Moving into a high strain job was a risk for developing depression [RRR = 1.81 (95 % CI 1.26 2.59), p < 0.001], but the cumulative exposure to a high strain job was not associated with poorer outcomes in adjusted models. Overall, our results emphasise the importance of current job strain, and the risk of moving into a high strain job, on adverse mental health and wellbeing outcomes. Effects were not consistent between indices of mental health, subjective or psychological wellbeing, supporting the need to dedifferentiate between wellbeing and mental health.

The Relationship Between Change in Self-Perceptions of Aging and Physical Functioning in Older Adults

Publisher: American Psychological Association (APA)

Date: 2012

DOI: 10.1037/A0027578

Abstract: Negative self-perceptions of aging (SPA) have been linked to poor physical health and functioning outcomes in late life, yet the direction of this relationship remain unclear. Using data from the Australian Longitudinal Study of Aging, we investigated the directionality of the dynamic relationship between self-perceptions of aging and physical functioning in 1,212 adults 65 years and above (mean age = 76.89, SD = 6.12) over 5 waves (up to 16 years). Bivariate Dual Change Score Models (BDCSM) revealed that the best fitting model for the data was that which allowed SPA to predict change in physical functioning over time lags of 1 year. The direction of the relationship remained after controlling for age, gender, partner status, residential care, number of medical conditions, self-rated health, and psychological well-being. Findings suggest that more positive SPA may be protective of decline in physical functioning in late life.

Effect of speed of processing training on older driver screening measures

Publisher: Frontiers Media SA

Date: 17-10-2017

DOI: 10.3389/FNAGI.2017.00338

The crash involvement of older drivers is associated with their hazard perception latencies

Publisher: Cambridge University Press (CUP)

Date: 28-05-2010

DOI: 10.1017/S135561771000055X

Abstract: Hazard perception in driving is the one of the few driving-specific skills associated with crash involvement. However, this relationship has only been examined in studies where the majority of in iduals were younger than 65. We present the first data revealing an association between hazard perception and self-reported crash involvement in drivers aged 65 and over. In a s le of 271 drivers, we found that in iduals whose mean response time to traffic hazards was slower than 6.68 s [the receiver operating characteristic (ROC) curve derived pass mark for the test] were 2.32 times [95% confidence interval (CI), 1.46, 3.22) more likely to have been involved in a self-reported crash within the previous 5 years than those with faster response times. This likelihood ratio became 2.37 (95% CI, 1.49, 3.28) when driving exposure was controlled for. As a comparison, in iduals who failed a test of useful field of view were 2.70 (95% CI, 1.44, 4.44) times more likely to crash than those who passed. The hazard perception test and the useful field of view measure accounted for separate variance in crash involvement. These findings indicate that hazard perception testing and training could be potentially useful for road safety interventions for this age group. ( JINS , 2010, 16 , 939–944.)

Patterns of Longitudinal Change in Older Adults' Self-Rated Health: The Effect of the Point of Reference

Publisher: American Psychological Association (APA)

Date: 2010

DOI: 10.1037/A0017652

Abstract: This study investigated the effect of the reference point of self-rated health (SRH) items on the trajectory of older adults' subjective health. Seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004) were used to determine change in SRH in a large s le (N = 2,081 49% men) of older adults (65+ years). Three SRH measures with different points of reference (global vs. age-comparative and self-comparative) were used. Ordinal latent growth models revealed unique patterns of change. Global ratings became more negative in a linear fashion. Self-comparative ratings initially declined however, the rate of change was found to decelerate over time. Age-comparative ratings showed a gender by age interaction, revealing that women's ratings remained relatively stable, whereas men's ratings were more likely to become more negative with age. Findings suggest that the reference point significantly influences how older adults evaluate their health over time. This has implications regarding the use of SRH items and indicates that the reference point is an important consideration in the subjective health assessment of older adults.

The role of volumetric MRI in understanding mild cognitive impairment and similar classifications

Publisher: Informa UK Limited

Date: 07-2003

DOI: 10.1080/1360786031000120732

Inability of the Mini-Mental State Exam (MMSE) and high-contrast visual acuity to identify unsafe drivers

Publisher: Elsevier BV

Date: 04-2022

DOI: 10.1016/J.AAP.2022.106595

Health literacy of older drivers and the importance of health experience for self-regulation of driving behaviour

Publisher: Elsevier BV

Date: 05-2011

DOI: 10.1016/J.AAP.2010.11.012

Abstract: This study provides much needed information on the education level of older drivers regarding the impact of health conditions and medications on personal driving safety, where they source this information, and how this knowledge influences self-regulation of driving. Random and convenience s ling secured 322 Australian drivers (63.9% males) aged 65 years and over (M = 77.35 years, SD = 7.35) who completed a telephone interview. The majority of respondents (86%) had good knowledge about health conditions (health knowledge) and driving safety, however more than 50% was classified as having poor knowledge on the effects of certain medications (medication knowledge) and driving safety. Poorer health knowledge was associated with a reduced likelihood of driving over 100 km in adjusted models. Being older and having more than one medical condition was found to increase the likelihood of self-regulation of driving. Results indicate that health knowledge was less important for predicting driving behaviour than health experience. Of great interest was that up to 85.7% of respondents reported not receiving advice about the potential impact of their medical condition and driving from their doctor. The findings indicate a need for improved dissemination of evidence-based health information and education for older drivers and their doctors.

Testing Age Differences in the Links Between Recent Financial Difficulties and Cognitive Deficits: Longitudinal Evidence From the PATH Through Life Study

Publisher: Oxford University Press (OUP)

Date: 12-2021

DOI: 10.1093/GERONB/GBAA215

Abstract: This study investigates whether the within-person associations between a recent major financial crisis and deficits in cognitive performance vary across the life course. Four waves of data from 7,442 participants (49% men) spanning 12 years and comprising 3 narrow age birth cohorts (baseline age: 20–25, 40–45, and 60–65) were drawn from a representative prospective survey from Canberra, Australia (1999–2014). Cognitive performance was assessed by the California Verbal Learning Test (CVLT) immediate recall trails, Symbol Digit Modalities Test (SDMT), Digit Span Backward (DSB), and Trail Making Test B (TMT-B). A single item from the Threatening Life Experiences Questionnaire assessed self-reported major financial crisis in the past 6 months. Multivariable-adjusted fixed-effect regression models tested the time-dependent association between financial crisis and cognition. A recent financial crisis coincided with contemporaneous declines in CVLT (mean change = −0.14, 95% confidence interval [CI] = −0.262 to −0.025), SDMT (mean change = −0.08, 95% CI = −0.147 to −0.004), and TMT-B (mean change = −0.17, 95% CI = −0.293 to −0.039) for adults in the oldest age group, and these associations were larger than in the younger age groups. In contrast, there was an overall association between financial crisis and deficits in DSB (mean change = −0.06, 95% CI = −0.105 to −0.007), with weak evidence of stronger associations in midlife relative to other age groups. These associations were independent of changes in health and socioeconomic circumstances. This study provides important new evidence that financial difficulties in later life are potent stressors associated with occasion-specific deficits in cognitive performance.

Alcohol and smoking consumption behaviours in older Australian adults: prevalence, period and socio-demographic differentials in the DYNOPTA sample

Publisher: Springer Science and Business Media LLC

Date: 10-08-2012

DOI: 10.1007/S00127-012-0558-X

Abstract: Alcohol consumption and tobacco use are key risk factors for chronic disease and health burden across the adult lifespan. We estimate the prevalence of alcohol consumption and smoking by age and time period in adults from mid to old age. Participants (n = 50,652) were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and were compared with Australian National Health Survey data. Alcohol and smoking consumption DYNOPTA data were weighted to the estimated resident population of the s ling frame for each contributing study according to age and sex distributions within major statistical regions. Comparisons in the rates of smoking and alcohol consumption between DYNOPTA and other national surveys were comparable. Males were more likely to be (RRR = 2.12) or have been smokers (RRR = 2.97), whilst females were more likely to be non-drinkers (RRR = 2.52). Period effects were also identified higher prevalence rates in consumption of alcohol (RRR = 3.21) and smoking (RRR = 1.67) for those contributing studies from the early 1990's, in comparison with those studies from the latter half of the decade, were reported. Over a decade, prevalence rates for high-risk consumption of alcohol and current smoking behaviour declined and suggest the possible impact of government health policy, with targeted-health policies, that included bans on public smoking, and a toughening of legislation against alcohol-related crime.

Cognitive, sensory and physical factors enabling driving safety in older adults

Publisher: Elsevier BV

Date: 2005

DOI: 10.1016/J.CPR.2004.07.008

Abstract: We reviewed literature on cognitive, sensory, motor and physical factors associated with safe driving and crash risk in older adults with the goal of developing a model of factors enabling safe driving behaviour. Thirteen empirical studies reporting associations between cognitive, sensory, motor and physical factors and either self-reported crashes, state crash records or on-road driving measures were identified. Measures of attention, reaction time, memory, executive function, mental status, visual function, and physical function variables were associated with driving outcome measures. Self-monitoring was also identified as a factor that may moderate observed effects by influencing driving behavior. We propose that three enabling factors (cognition, sensory function and physical function/medical conditions) predict driving ability, but that accurate self-monitoring of these enabling factors is required for safe driving behaviour.

The epidemiology is promising, but the trial evidence is weak. Why pharmacological dementia risk reduction trials haven't lived up to expectations, and where do we go from here?

Publisher: Wiley

Date: 02-11-2022

DOI: 10.1002/ALZ.12393

Abstract: There is an urgent need for interventions that can prevent or delay cognitive decline and dementia. Decades of epidemiological research have identified potential pharmacological strategies for risk factor modification to prevent these serious conditions, but clinical trials have failed to confirm the potential efficacy for such interventions. Our multidisciplinary international group reviewed seven high-potential intervention strategies in an attempt to identify potential reasons for the mismatch between the observational and trial results. In considering our findings, we offer constructive recommendations for the next steps. Overall, we observed some differences in the observational evidence base for the seven strategies, but several common methodological themes that emerged. These themes included the appropriateness of trial populations and intervention strategies, including the timing of interventions and other aspects of trials methodology. To inform the design of future clinical trials, we provide recommendations for the next steps in finding strategies for effective dementia risk reduction.

Interventions for midlife smoking cessation: A literature review

Publisher: Informa UK Limited

Date: 09-2011

DOI: 10.1111/J.1742-9544.2010.00014.X

A qualitative study of older and middle-aged adults' perception and attitudes towards dementia and dementia risk reduction

Publisher: Wiley

Date: 20-02-2015

DOI: 10.1111/JAN.12641

Abstract: To investigate perceptions of dementia and dementia risk reduction held by people without dementia. Dementia does not only affect in iduals with dementia, but also has an impact on family and friends, society and healthcare professionals. Recent research has identified modifiable risk and protective factors for dementia. However, it is unclear what knowledge people without dementia have about these risk factors and their attitudes towards addressing these risk factors to achieve dementia risk reduction are not known. Qualitative descriptive study using focus group methodology. A focus group study was conducted in February 2011 with 34 older adults aged between 52-90 years. The long-table approach was used to identify themes and categorize data on dementia knowledge, risk and attitudes. Participants correctly identified dementia risk factors as a group. Participants' responses about their perceived likelihood of developing dementia could be classified into three distinctive themes fear, rational and cynical perceptions. Both fear of developing dementia and the need to improve dementia knowledge were considered major motivators towards adopting healthier lifestyle and health behaviours. Lack of knowledge on risk factors for dementia was identified as a major barrier for behavioural and lifestyle change. These findings can be used to develop effective and personalized interventions that increase motivators and reduce barriers by tailoring interventions to in idual's dementia risk reduction literacy and motivations to change behaviours. Greater public-health promotion and education about risk and protective factors for dementia are also necessary to increase dementia health literacy and to reduce overall dementia prevalence.

Evaluating a dichotomized measure of self-reported hearing loss against gold standard audiometry: Prevalence estimates and age bias in a pooled national data set

Publisher: SAGE Publications

Date: 28-12-2012

DOI: 10.1177/0898264311425088

Abstract: Objectives: To evaluate a harmonized binary measure of self-reported hearing loss against gold standard audiometry in an older adult population. Method: Seven nationally representative population-based studies were harmonized and pooled ( n = 23,001). Self-report items were recoded into a dichotomous format. Audiometric hearing loss was defined by averaged pure-tone thresholds greater than 25-decibel hearing level in the better ear. We compared age and sex stratified prevalence rates of hearing loss estimated by self-report and audiometric measures. Results: Overall, 56% of men and 43% of women had audiometric hearing loss. There were moderate associations between self-reported and audiometric hearing loss. However, prevalence based on self-report was overestimated for adults aged below 70 years and underestimated for adults aged above 75. Discussion: Self-report of hearing loss is insensitive to age effects and does not provide a reliable basis for estimating prevalence of age-related hearing loss, although may indicate perceived hearing disability.

The interpretation of shared age-related variance among factors in cross-sectional cognitive aging studies

Publisher: S. Karger AG

Date: 2002

DOI: 10.1159/000048916

Abstract: Many cross-sectional correlational studies in cognitive aging have focused on explaining age-related variance. It has been assumed that variables sharing variance with both cognition and age may be the key explanatory variables underlying the cognitive decline in normal aging. Statistical biases intrinsic to this approach have been described by Hofer and Sliwinski and a narrow age cohort design proposed. The present paper aims at explaining how Hofer and Sliwinski’s criticisms apply to a specific type of research design in cognitive aging where the goal is to identify underlying aging processes, but does not apply to more general gerontological research. Methods to estimate bias in cross-sectional studies are required as is greater awareness of this potential bias.

Change in Health and Self-Perceptions of Aging Over 16 Years: The Role of Psychological Resources

Publisher: American Psychological Association (APA)

Date: 2012

DOI: 10.1037/A0027464

Abstract: Self-perceptions of aging (SPA) are argued to be an indicator of the ability to adapt to heath decline in late life. Our objective was to examine the influence of psychological resources in maintaining positive self-perceptions of aging in the face of declining health in older adults. Time-varying change in health (medical conditions), physical functioning (ADLs), and psychological resources (expectancy of control and self-esteem) on change in SPA were examined over 16 years (5 waves) in a large representative s le (N = 1569) of older adults (65 + years at baseline) from the Australian Longitudinal Study of Aging. Multilevel structural equation models revealed mediating effects of psychological resources at the within-person level for the relationship between decline in ADLs and SPA. At the between-person level, the relationship between medical conditions and SPA was not mediated by psychological resources, whereas ADLs and SPA were shown to be indirectly associated through self-esteem and expectancy of control. Results demonstrate that maintaining self-esteem and an expectancy of personal control can buffer the effects of declining ADLs on perceptions of aging. Findings have clinical implications regarding psychological interventions aimed at improving resilience in older adults, which may ultimately increase health outcomes and quality of life.

Older drivers' insight into their hazard perception ability

Publisher: Elsevier BV

Date: 11-2011

DOI: 10.1016/J.AAP.2011.05.035

Abstract: Even though the driving ability of older adults may decline with age, there is evidence that some in iduals attempt to compensate for these declines using strategies such as restricting their driving exposure. Such compensatory mechanisms rely on drivers' ability to evaluate their own driving performance. This paper focuses on one key aspect of driver ability that is associated with crash risk and has been found to decline with age: hazard perception. Three hundred and seven drivers, aged 65-96, completed a validated video-based hazard perception test. There was no significant relationship between hazard perception test response latencies and drivers' ratings of their hazard perception test performance, suggesting that their ability to assess their own test performance was poor. Also, age-related declines in hazard perception latency were not reflected in drivers' self-ratings. Nonetheless, ratings of test performance were associated with self-reported regulation of driving, as was self-rated driving ability. These findings are consistent with the proposal that, while self-assessments of driving ability may be used by drivers to determine the degree to which they restrict their driving, the problem is that drivershave little insight into their own driving ability. This may impact on the potential road safety benefits of self-restriction of driving because drivers may not have the information needed to optimally self-restrict. Strategies for addressing this problem are discussed.

Quantization of systems with temporally varying discretization. I. Evolving Hilbert spaces

Publisher: AIP Publishing

Date: 08-2014

DOI: 10.1063/1.4890558

Abstract: A temporally varying discretization often features in discrete gravitational systems and appears in lattice field theory models subject to a coarse graining or refining dynamics. To better understand such discretization changing dynamics in the quantum theory, an according formalism for constrained variational discrete systems is constructed. While this paper focuses on global evolution moves and, for simplicity, restricts to flat configuration spaces \\documentclass[12pt]{minimal}\\begin{document}$\\mathbb {R}^N$\\end{document}RN, a Paper II [P. A. Höhn, “Quantization of systems with temporally varying discretization. II. Local evolution moves,” J. Math. Phys., e-print arXiv:1401.7731 [gr-qc].] discusses local evolution moves. In order to link the covariant and canonical picture, the dynamics of the quantum states is generated by propagators which satisfy the canonical constraints and are constructed using the action and group averaging projectors. This projector formalism offers a systematic method for tracing and regularizing ergences in the resulting state sums. Non-trivial coarse graining evolution moves lead to non-unitary, and thus irreversible, projections of physical Hilbert spaces and Dirac observables such that these concepts become evolution move dependent on temporally varying discretizations. The formalism is illustrated in a toy model mimicking a “creation from nothing.” Subtleties arising when applying such a formalism to quantum gravity models are discussed.

Neuroimaging and APOE genotype: A systematic qualitative review

Publisher: S. Karger AG

Date: 2007

DOI: 10.1159/000109150

Abstract: Apolipoprotein E i (APOE) /i is the major genetic risk factor for late-onset Alzheimer’s disease (AD) and has also been implicated in cardiovascular disease, cognitive decline and cognitive changes in healthy ageing. The aim of this paper is to systematically review and critically assess the association between the i APOE /i genotype and structural/functional cerebral changes as evidenced by brain imaging studies. A second aim is to determine whether these observed associations between APOE and the brain reflect changes which are consistent with the progression of AD neurodegenerative changes described in Braak stages. A search of Pubmed, Psycinfo, and Web of Science databases identified 64 articles available for qualitative review. The review found that presence of the i APOE /i & #917 allele is associated with (1) hippoc al, amygdalar and entorhinal cortex atrophy, (2) increased brain atrophy, (3) increased white matter hyperintensity volumes and (4) altered cerebral blood flow and glucose metabolism patterns. It is possible that there are critical age ranges when these effects are evident and that the i APOE /i & #917 genotype might present a risk. We conclude that structural brain change is associated with the i APOE /i genotype and that it is more salient in younger ageing in iduals.

The proportion of dementia attributable to common modifiable lifestyle factors in Barbados,Proporção de demência atribuível a fatores comuns modificáveis do estilo de vida em Barbados

Publisher: Pan American Health Organization

Date: 2018

DOI: 10.26633/RPSP.2018.17

Systematic review of coexistent epileptic seizures and Alzheimer's disease: Incidence and prevalence

Publisher: Wiley

Date: 19-03-2021

DOI: 10.1111/JGS.17101

Abstract: Coexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics. A systematic review and meta‐analysis (PROSPERO protocol registration CRD42020150479). Population‐, community‐, hospital‐, or nursing home‐based. Thirty‐nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I 2 ) were not shown, rates were synthesized using random effect. Studies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person‐years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early‐onset AD) in one study. Meta‐analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14–19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult‐onset seizures had AD (95%CI, 7‐14). Seizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.

A Technology-Enriched Approach to Studying Microlongitudinal Aging Among Adults Aged 18 to 85 Years: Protocol for the Labs Without Walls Study (Preprint)

Publisher: JMIR Publications Inc.

Date: 06-03-2023

DOI: 10.2196/PREPRINTS.47053

Abstract: raditional longitudinal aging research involves studying the same in iduals over a long period, with measurement intervals typically several years apart. App-based studies have the potential to provide new insights into life-course aging by improving the accessibility, temporal specificity, and real-world integration of data collection. We developed a new research app for iOS named Labs Without Walls to facilitate the study of life-course aging. Combined with data collected using paired smartwatches, the app collects complex data including data from one-time surveys, daily diary surveys, repeated game-like cognitive and sensory tasks, and passive health and environmental data. he aim of this protocol is to describe the research design and methods of the Labs Without Walls study conducted between 2021 and 2023 in Australia. verall, 240 Australian adults will be recruited, stratified by age group (18-25, 26-35, 36-45, 46-55, 56-65, 66-75, and 76-85 years) and sex at birth (male and female). Recruitment procedures include emails to university and community networks, as well as paid and unpaid social media advertisements. Participants will be invited to complete the study onboarding either in person or remotely. Participants who select face-to-face onboarding (n=approximately 40) will be invited to complete traditional in-person cognitive and sensory assessments to be cross-validated against their app-based counterparts. Participants will be sent an Apple Watch and headphones for use during the study period. Participants will provide informed consent within the app and then begin an 8-week study protocol, which includes scheduled surveys, cognitive and sensory tasks, and passive data collection using the app and a paired watch. At the conclusion of the study period, participants will be invited to rate the acceptability and usability of the study app and watch. We hypothesize that participants will be able to successfully provide e-consent, input survey data through the Labs Without Walls app, and have passive data collected over 8 weeks participants will rate the app and watch as user-friendly and acceptable the app will allow for the study of daily variability in self-perceptions of age and gender and data will allow for the cross-validation of app- and laboratory-based cognitive and sensory tasks. ecruitment began in May 2021, and data collection was completed in February 2023. The publication of preliminary results is anticipated in 2023. his study will provide evidence regarding the acceptability and usability of the research app and paired watch for studying life-course aging processes on multiple timescales. The feedback obtained will be used to improve future iterations of the app, explore preliminary evidence for intrain idual variability in self-perceptions of aging and gender expression across the life span, and explore the associations between performance on app-based cognitive and sensory tests and that on similar traditional cognitive and sensory tests. ERR1-10.2196/47053

Variation in symptoms of depression and anxiety in midlife women by menopausal status

Publisher: Elsevier BV

Date: 02-2018

DOI: 10.1016/J.MATURITAS.2017.11.005

Abstract: To examine the association between menopausal status and the risk of symptoms of depression and anxiety in a community-based s le of Australian midlife women. Female participants (mean age 50.6±1.5) who were premenopausal (n=237), perimenopausal (n=249) or naturally postmenopausal (n=225) were drawn from the Personality and Total Health (PATH) Through Life Project, a longitudinal study. Symptoms of depression and anxiety were measured using the Goldberg Depression Scale and Goldberg Anxiety Scale. Generalised linear regression models with a negative binomial log link were used. Relative to premenopause and after adjusting for all relevant covariates, being perimenopausal was associated with increased risk of greater symptoms of depression (incidence rate ratio [IRR]=1.29, p=0.001), while being postmenopausal was associated with increased risk of greater symptoms of anxiety (IRR=1.15, p=0.041). Being perimenopausal or postmenopausal was associated with an increased risk of greater symptoms of depression (IRR=1.35, p=0.008 IRR=1.31, p=0.029) and anxiety (IRR=1.22, p=0.030 IRR=1.32, p=0.006) in women without a history of probable major depressive disorder or generalised anxiety disorder. Risk of symptoms did not differ with menopausal status in women with this history. Menopausal status is associated with the risk of symptoms of depression and anxiety. There is a greater likelihood of increased symptoms of depression during perimenopause and symptoms of anxiety during postmenopause. In women without a history of depression or anxiety, the perimenopause and postmenopausal stages are associated with increased risk of greater symptoms of anxiety and depression relative to premenopause.

Alzheimer's disease research progress in Australia: The Alzheimer's Association International Conference Satellite Symposium in Sydney

Publisher: Wiley

Date: 31-05-2021

DOI: 10.1002/ALZ.12380

Abstract: The Alzheimer's Association International Conference held its sixth Satellite Symposium in Sydney, Australia in 2019, highlighting the leadership of Australian researchers in advancing the understanding of and treatment developments for Alzheimer's disease (AD) and other dementias. This leadership includes the Australian Imaging, Biomarker, and Lifestyle Flagship Study of Ageing (AIBL), which has fueled the identification and development of many biomarkers and novel therapeutics. Two multimodal lifestyle intervention studies have been launched in Australia and Australian researchers have played leadership roles in other global studies in erse populations. Australian researchers have also played an instrumental role in efforts to understand mechanisms underlying vascular contributions to cognitive impairment and dementia and through the Women's Healthy Aging Project have elucidated hormonal and other factors that contribute to the increased risk of AD in women. Alleviating the behavioral and psychological symptoms of dementia has also been a strong research and clinical focus in Australia.

Association of type 2 diabetes with depression, brain atrophy, and reduced fine motor speed in a 60- to 64-year-old community sample

Publisher: Elsevier BV

Date: 12-2008

DOI: 10.1097/JGP.0B013E31818B40FC

MyCOACH (COnnected Advice for Cognitive Health): a digitally delivered multidomain intervention for cognitive decline and risk of dementia in adults with mild cognitive impairment or subjective cognit

Publisher: BMJ

Date: 10-2023

DOI: 10.1136/BMJOPEN-2023-075015

Mortality risk varies according to gender and change in depressive status in very old adults

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-2002

DOI: 10.1097/01.PSY.0000028827.64279.60

Abstract: We aimed to evaluate whether gender and different patterns of change in depressive status over 2 years were associated with different risks of mortality in the subsequent 6 years. Depression (CES-D) was assessed in 1947 participants in 1992 and a smaller proportion of the s le in 1994. The mortality risk at July 30, 2000, associated with depression and change in depression was estimated using proportional hazards models. After controlling for demographic variables, smoking, alcohol, and medical conditions, depression was associated with mortality for men but not women. In men, incident depression was associated with mortality after controlling for all other variables. Chronic depression and remitted depression were also associated with mortality, but this effect was explained by medical conditions. In women, change in depressive status was not associated with mortality. Depression confers a greater risk of mortality for men than women with incident depression in old age representing the greatest risk for men. The course of depressive illness must be considered when evaluating mortality risk.

When more is less: Associations between corpus callosum size and handedness lateralization

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.NEUROIMAGE.2010.04.016

Alcohol, hospital admissions, and falls in older adults: a longitudinal evaluation

Publisher: Cambridge University Press (CUP)

Date: 22-02-2013

DOI: 10.1017/S1041610213000173

Abstract: Background: There are limited data on the impacts of alcohol use in older adults. We aimed to evaluate self-reported hospital admissions and falls against current Australian alcohol consumption guidelines. Methods: We conducted a longitudinal analysis of data from five Australian cohort studies. The study comprised 16,785 people aged 65 years or older at baseline. Alcohol consumption was categorized using Australian guidelines in standard (10 g) drinks per day as “abstinent,” “low-risk” ( ≤2), “long-term risk” ( ≤4), or “short-term risk” ( ). Separate generalized estimating equations for men and women, controlling for key demographic, and health variables (depression, diabetes, circulatory and musculoskeletal conditions) were used to examine the relationship of alcohol consumption with hospitalization and falls against a reference category of low-risk consumption. Results: Most participants were in the low (10,369, 62%) or abstinent (5,488, 33%) categories. Among women, all alcohol groups had greater odds of admission than low-risk users among men, only the abstinent group had increased odds. For both genders, depression, diabetes, circulatory and musculoskeletal conditions all increased the odds of admission. For both genders, the unadjusted model showed that abstainers had increased odds of falling, with depression, diabetes, and for women, musculoskeletal conditions also associated with falls in the adjusted model. Conclusion: These outcomes suggest that older women in particular could benefit from targeted alcohol consumption messages or interventions. In relation to falls, other health conditions appear better targets for intervention than alcohol use.

COSMIC (Cohort Studies of Memory in an International Consortium): an international consortium to identify risk and protective factors and biomarkers of cognitive ageing and dementia in diverse ethnic and sociocultural groups.

Publisher: Springer Science and Business Media LLC

Date: 06-11-2013

DOI: 10.1186/1471-2377-13-165

Applying a cumulative deficit model of frailty to dementia: Progress and future challenges 84

Publisher: Springer Science and Business Media LLC

Date: 26-11-2014

DOI: 10.1186/S13195-014-0084-Z

Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis.

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-12-2019

DOI: 10.1212/WNL.0000000000008732

Abstract: High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data. To identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life ( years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data. Over 50,000 participants from 27 studies were included. Among those aged years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age. Our findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals. The review was registered with the international prospective register of systematic reviews (PROSPERO), registration number CRD42016045454.

Cost-Effectiveness of Dementia Prevention Interventions

Publisher: SERDI

Date: 2020

DOI: 10.14283/JPAD.2020.71

Abstract: Background: Assessment of cost-effectiveness of interventions to address modifiable risk factors associated with dementia requires estimates of long-term impacts of these interventions which are rarely directly available and must be estimated using a range of assumptions. OBJECTIVES: To test the cost-effectiveness of dementia prevention measures using a methodology which transparently addresses the many assumptions required to use data from short-term studies, and which readily incorporates sensitivity analyses. DESIGN: We explore an approach to estimating cost-effective prices which uses aggregate data including estimated lifetime costs of dementia, both financial and quality of life, and incorporates a range of assumptions regarding sustainability of short- term gains and other parameters. SETTING: The approach is addressed in the context of the theoretical reduction in a range of risk factors, and in the context of a specific small-scale trial of an internet-based intervention augmented with diet and physical activity consultations. MEASUREMENTS: The principal outcomes were prices per unit of interventions at which interventions were cost-effective or cost-saving. RESULTS: Taking a societal perspective, a notional intervention reducing a range of dementia risk-factors by 5% was cost-effective at $A460 per person with higher risk groups at $2,148 per person. The on-line program costing $825 per person was cost-effective at $1,850 per person even if program effect diminished by 75% over time. CONCLUSIONS: Interventions to address risk factors for dementia are likely to be cost-effective if appropriately designed, but confirmation of this conclusion requires longer term follow-up of trials to measure the impact and sustainability of short-term gains.

Invited Commentary: Secondhand Smoke—an Underrecognized Risk Factor for Cognitive Decline

Publisher: Oxford University Press (OUP)

Date: 12-01-2018

DOI: 10.1093/AJE/KWX378

Abstract: Pan et al. (Am J Epidemiol. 2018 (5):911-918) reported findings that exposure to secondhand smoke (SHS) was associated with cognitive decline over the course of 2 years among middle-aged and older Chinese women who never smoked, and they also reported a dose-response relationship. SHS exposure affects vulnerable people disproportionately because they have less control or choice over their living and working environment. Smoking is an established risk factor for dementia, but recent evidence reports on dementia-risk increase have not included SHS. Many epidemiologic studies collect data on smoking but not SHS exposure. SHS may be one of the most prevalent and modifiable risk factors for cognitive decline and therefore represents a major potential target for reduction of dementia risk. Given the high prevalence of smoking in China and other parts of the world, there is an urgent need to raise awareness of SHS reduction as part of global and national strategies to reduce cognitive decline and dementia and to introduce legislation that protects nonsmokers and vulnerable children and adults from SHS.

Frequency of coexistent eye diseases and cognitive impairment or dementia

Publisher: Springer Science and Business Media LLC

Date: 15-03-2023

DOI: 10.1038/S41433-023-02481-4

Abstract: We aim to quantify the co-existence of age-related macular degeneration (AMD), glaucoma, or diabetic retinopathy (DR) and cognitive impairment or dementia. MEDLINE, EMBASE, PsycINFO and CINAHL were searched (to June 2020). Observational studies reporting incidence or prevalence of AMD, glaucoma, or DR in people with cognitive impairment or dementia, and of cognitive impairment or dementia among people with AMD, glaucoma, or DR were included. Fifty-six studies (57 reports) were included but marked by heterogeneities in the diagnostic criteria or definitions of the diseases, study design, and case mix. Few studies reported on the incidence. Evidence was sparse but consistent in in iduals with mild cognitive impairment where 7.7% glaucoma prevalence was observed. Prevalence of AMD and DR among people with cognitive impairment ranged from 3.9% to 9.4% and from 11.4% to 70.1%, respectively. Prevalence of AMD and glaucoma among people with dementia ranged from 1.4 to 53% and from 0.2% to 25.9%, respectively. Prevalence of DR among people with dementia was 11%. Prevalence of cognitive impairment in people with AMD, glaucoma, and DR ranged from 8.4% to 52.4%, 12.3% to 90.2%, and 3.9% to 77.8%, respectively, and prevalence of dementia in people with AMD, glaucoma and DR ranged from 9.9% to 62.6%, 2.5% to 3.3% and was 12.5%, respectively. Frequency of comorbid eye disease and cognitive impairment or dementia varied considerably. While more population-based estimations of the co-existence are needed, interdisciplinary collaboration might be helpful in the management of these conditions to meet healthcare needs of an ageing population. PROSPERO registration: CRD42020189484.

MRI Hyperintensities and Depressive Symptoms in a Community Sample of Individuals 60–64 Years Old

Publisher: American Psychiatric Association Publishing

Date: 04-2005

DOI: 10.1176/APPI.AJP.162.4.699

Abstract: Previous studies have found associations of magnetic resonance imaging (MRI) signal hyperintensities with depression in the elderly. The present study investigates the association in a younger community s le (age 60-64 years) of depressed subjects and comparison groups for potential mediating and confounding variables. A subs le of 475 persons 60-64 years of age from a larger community survey underwent brain MRI scans. White matter hyperintensities were quantified by using an automated procedure, and basal ganglia hyperintensities were quantified by using semiquantitative visual ratings. The study also assessed depressive symptoms and use of antidepressant medication. Potential mediating or confounding variables assessed included physical disability, hypertension, stroke, diabetes, head injury, cortisol, thyroid-stimulating hormone, cognitive functioning, smoking, and alcohol use. Depressive symptoms were found to be related to total brain white matter hyperintensities but not to basal ganglia hyperintensities. However, associations disappeared when statistical adjustment was made for physical disability and smoking. Depressive symptoms are related to white matter hyperintensities in mid-adult life in a community s le. Physical disability appears to play an important role in this association.

On-Road Behavior in Older Drivers With Mild Cognitive Impairment

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.JAMDA.2020.05.046

Cancer and Cognitive Function: The PATH Through Life Project

Publisher: Oxford University Press (OUP)

Date: 04-01-2017

DOI: 10.1093/GERONA/GLW254

Abstract: A limited number of studies have shown that cancer diagnosis plays a protective role in Alzheimer's disease. However, the effect of the cancer diagnosis on general cognitive function/cognitive decline has not been previously examined. The aim of this study was to investigate the relationship between cancer diagnosis and cognitive function and mild cognitive impairment/disorders (MCI/MCD), adjusting for cancer treatments. These data were drawn from the Personality and Total Health (PATH) Through Life Study, a population-based Australian cohort study. A total of 2,547 participants (age range 60-66 years 48.4% women) who answered cancer-related questions were included in analyses. Random effects linear and logistic models were used to analyze 8-year follow-up data. Participants who were diagnosed with cancer at or prior to baseline (n = 166) had higher levels of physical conditions and depression compared with those who received cancer diagnoses during follow-ups (n = 346) and those who reported no cancer history (n = 2,035). A main effect suggested an improvement in processing speed (p < .01), working memory (p < .05), and simple reaction time (p < .05) for those who received the cancer diagnosis after baseline when compared with those without a cancer diagnosis. However, these group differences were no longer significant when adjusted for cancer treatments. Those with a cancer diagnosis at or prior to baseline reported poorer processing speed when compared with those without a cancer diagnosis, even after adjusting for the treatments. A cancer diagnosis alone did not play a protective role for cognitive function and cognitive impairment in this population of older community-living in iduals.

Cross-national gender differences in the socioeconomic factors associated with smoking in Australia, the United States of America and South Korea

Publisher: Springer Science and Business Media LLC

Date: 12-2013

DOI: 10.1007/S00038-012-0430-5

Abstract: We compared rates of smoking among those aged 45 years and older in Australia, the United States of America and South Korea, and examined cross-national gender differences in key socioeconomic differentials in smoking. We conducted weighted analyses on cross-sectional data from nationally representative surveys conducted in 2006. Current smoking was more prevalent for males than females in all countries the gender difference was largest in Korea. Being unpartnered increased the likelihood of smoking in all countries, while greater wealth reduced it. In Korea, these effects interacted with gender both indicators showed larger differentials among women than men. Lower educational attainment increased the likelihood of smoking for all groups except Korean women, among whom high school educated women were less likely to smoke than the tertiary educated. Our findings support a cultural interpretation of gender differences in smoking: in countries with low gender empowerment, gender differences in smoking are greater. With increasing orce and female tertiary education rates in nations like Korea, we highlight the need for health promotion messages targeted towards older and more educated women.

Management of Type 2 diabetes in Western Australian metropolitan general practice

Publisher: Elsevier BV

Date: 12-1994

DOI: 10.1016/0168-8227(94)90061-2

Abstract: The purpose of this study was: (1) to record GP opinions, practices and outcomes for the care of Type 2 Diabetes Mellitus (DM2), (2) compare practice facilities and process of care with a criterion of recommended competent care and (3) determine if there were any differences between vocationally registered and non-vocationally registered GPs. A random s le of 204 metropolitan doctors from 124 practices was selected and an audit performed on 467 of their patient records. GPs pursued good blood sugar control and advocated lifestyle changes before hypoglycaemic drugs. Over 80% regard uncomplicated DM2 as a condition for general practice management. However, only 15% conducted an annual diabetes check, 9% had a diabetic register, 6% a diabetic recall system and 8% used a diabetic health care checklist for monitoring their patients. The most commonly recorded processes of medical audit in the previous 12 months were: blood pressure (94%), duration of diabetes (72%), blood glucose (70%), diet (66%), body weight (56%), HBA1c (52%) and ophthalmoscopy (50%). The least commonly recorded processes of care were body mass index (5%), inspection of the feet (18%), enquiries about vaginitis or impotence (23%). The amount of exercise, alcohol and tobacco was recorded in only 34% of records. Hypoglycaemic drugs were used appropriately but the most commonly used drugs for treating hypertension in DM2 patients were thiazide diuretics and beta-blockers. Vocationally registered (VR) doctors had better records, higher process of care scores and more were willing to participate in the study than non-vocationally registered (NVR) doctors. However, there was no difference in metabolic control between patients from either group. The use of a Diabetic Health Care Checklist would improve diabetes care especially in the search for early complications and in the recording of HBA1c and other metabolic parameters. The drugs commonly used to control hypertension can have adverse effects on glucose and lipid metabolism and should be replaced with glucose and lipid neutral drugs.

No clear associations between subjective memory concerns and subsequent change in cognitive function: the PATH through life study

Publisher: Springer Science and Business Media LLC

Date: 28-03-2022

DOI: 10.1007/S10433-022-00694-2

Abstract: The literature on subjective memory concerns (SMC) as a predictor for future cognitive decline is varied. Furthermore, recent research has pointed to additional complexity arising from variability in the experience of SMC themselves (i.e. whether they are remitting or sustained over time). We investigated the associations between SMC and objectively measured cognition in an Australian population-based cohort. Four waves (4-year intervals between waves) of data from 1236 participants (aged 62.4 ± 1.5 years, 53% male) were used. We categorized participants as experiencing SMC, when they indicated that their memory problems might interfere with their day-to-day life and/or they had seen a doctor about their memory. SMC was categorized as “no” reported SMC, “remitting”, “new-onset” or “sustained” SMC. Cognitive assessment of immediate and delayed recall, working memory, psychomotor speed, attention and processing speed were assessed using a neuropsychological battery. Eighteen percent of participants were characterised as having SMC: 6% (77) “remitting”, 6% (77) “new-onset” and 6% (69) “sustained” SMC. There was no consistent evidence for an association between SMC and subsequent decline in cognition. However, SMC was associated with poorer performance on contemporaneous tasks of attention and processing speed compared to “no” SMC. Asking about SMC may indicate a current decline in cognitive function but, in this s le at least, did not indicate an increased risk of future decline.

Mild cogitive impairment in the 60s

Publisher: Wiley

Date: 07-2011

DOI: 10.1016/J.JALZ.2011.05.1965

More highly myelinated white matter tracts are associated with faster processing speed in healthy adults

Publisher: Elsevier BV

Date: 05-2018

DOI: 10.1016/J.NEUROIMAGE.2017.12.069

Abstract: The objective of this study was to investigate whether the estimated myelin content of white matter tracts is predictive of cognitive processing speed and whether such associations are modulated by age. Associations between estimated myelin content and processing speed were assessed in 570 community-living in iduals (277 middle-age, 293 older-age). Myelin content was estimated in-vivo using the mean T1w/T2w magnetic resonance ratio, in six white matter tracts (anterior corona radiata, superior corona radiata, pontine crossing tract, anterior limb of the internal capsule, genu of the corpus callosum, and splenium of the corpus callosum). Processing speed was estimated by extracting a principal component from 5 separate tests of processing speed. It was found that estimated myelin content of the bilateral anterior limb of the internal capsule and left splenium of the corpus callosum were significant predictors of processing speed, even after controlling for socio-demographic, health and genetic variables and correcting for multiple comparisons. One SD higher in the estimated myelin content of the anterior limb of the internal capsule was associated with 2.53% faster processing speed and within the left splenium of the corpus callosum with 2.20% faster processing speed. In addition, significant differences in estimated myelin content between middle-age and older participants were found in all six white matter tracts. The present results indicate that myelin content, estimated in vivo using a neuroimaging approach in healthy older adults, is sufficiently precise to predict variability in processing speed in behavioural measures.

The association between Western and Prudent dietary patterns and fasting blood glucose levels in type 2 diabetes and normal glucose metabolism in older Australian adults

Publisher: Elsevier BV

Date: 06-2017

DOI: 10.1016/J.HELIYON.2017.E00315

International Mind, Activities and Urban Places (iMAP) study: methods of a cohort study on environmental and lifestyle influences on brain and cognitive health

Publisher: BMJ

Date: 03-2020

DOI: 10.1136/BMJOPEN-2019-036607

Abstract: Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents. Participants aged 50–79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants’ visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants’ characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures. The study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website. ACTRN12619000817145.

Prevalence of suicidal behaviours in two Australian general population surveys: Methodological considerations when comparing across studies

Publisher: Springer Science and Business Media LLC

Date: 29-03-2012

DOI: 10.1007/S00127-011-0369-5

Abstract: To investigate whether methodological differences between two Australian general population surveys have the capacity to affect the apparent prevalence rates of suicidal ideation and suicide attempts. 609 Wave 1 of the Personality and Total Health (PATH) Through Life Project participants, and 83 participants derived from the 1997 National Survey of Mental Health and Wellbeing (NSMHWB) met the criteria for inclusion (suicidal ideation/suicide attempt). Analysis involved Chi-square and binary logistic regression. Twelve-month prevalence rates for suicidal ideation and suicide attempt were 8.2%, (95% CI = 7.6-8.8) and 0.8% (95% CI = 0.6-1.0) for PATH (N = 7,485), and contrast with 2.9% (95% CI = 2.6-3.2) and 0.3% (95% CI = 0.2-0.5) for NSMHWB (N = 10,641) s les, respectively. While notable discrepancies are apparent between the prevalence statistics, both sets of statistics are within the bounds of other Australian and international studies. Parallel rate disparities for suicidal ideation are found across age-by-gender groups. Aside from differences in the basic prevalence rates, surveys have analogous age-by-gender profiles for suicidal ideation. While it is possible that s les are representative of the populations from which they are derived, 12-month prevalence rate discrepancies between PATH and NSMHWB surveys are likely to originate from demographic and survey methodology differences. Where investigations employ different methodologies, especially in relation to modes of survey administration and the assessment items utilised, a cautious approach should be taken when comparing findings.

Simulated cataract and low contrast stimuli impair cognitive performance in older adults: Implications for neuropsychological assessment and everyday function

Publisher: Informa UK Limited

Date: 24-12-2011

DOI: 10.1080/13825585.2010.501404

Abstract: To investigate how age-related declines in vision (particularly contrast sensitivity), simulated using cataract-goggles and low-contrast stimuli, influence the accuracy and speed of cognitive test performance in older adults. An additional aim was to investigate whether declines in vision differentially affect secondary more than primary memory. Using a fully within-subjects design, 50 older drivers aged 66-87 years completed two tests of cognitive performance--letter matching (perceptual speed) and symbol recall (short-term memory)--under different viewing conditions that degraded visual input (low-contrast stimuli, cataract-goggles, and low-contrast stimuli combined with cataract-goggles, compared with normal viewing). However, presentation time was also manipulated for letter matching. Visual function, as measured using standard charts, was taken into account in statistical analyses. Accuracy and speed for cognitive tasks were significantly impaired when visual input was degraded. Furthermore, cognitive performance was positively associated with contrast sensitivity. Presentation time did not influence cognitive performance, and visual gradation did not differentially influence primary and secondary memory. Age-related declines in visual function can impact on the accuracy and speed of cognitive performance, and therefore the cognitive abilities of older adults may be underestimated in neuropsychological testing. It is thus critical that visual function be assessed prior to testing, and that stimuli be adapted to older adults' sensory capabilities (e.g., by maximising stimuli contrast).

Corrigendum to Light to moderate alcohol use is associated with increased cortical gray matter in middle-aged men: A voxel-based morphometric study [Psychiatry Research: Neuroimaging 163(1) (2008) 61-69] (DOI:10.1016/j.pscychresns.2007.08.009)

Publisher: Elsevier BV

Date: 05-2009

DOI: 10.1016/J.PSCYCHRESNS.2008.12.002

Attention deficit/hyperactivity disorder symptoms and cognitive abilities in the late-life cohort of the PATH through life study

Publisher: Public Library of Science (PLoS)

Date: 28-01-2014

DOI: 10.1371/JOURNAL.PONE.0086552

Higher fasting plasma glucose is associated with striatal and hippocampal shape differences: The 2sweet project

Publisher: BMJ

Date: 05-2016

DOI: 10.1136/BMJDRC-2015-000175

How Important is Mental Activity in Old Age?

Publisher: Informa UK Limited

Date: 07-1999

DOI: 10.1080/00050069908257441

Carrier Dynamics and Saturation Effect in (113)B InAs/InP Quantum Dot Lasers

Publisher: Springer Science and Business Media LLC

Date: 03-2006

DOI: 10.1007/S11082-006-0037-2

Living alone and risk of mortality in older, community-dwelling adults

Publisher: American Medical Association (AMA)

Date: 25-02-2013

DOI: 10.1001/JAMAINTERNMED.2013.1597

Impact of simulated visual impairment on the cognitive test performance of young adults

Publisher: Wiley

Date: 08-2009

DOI: 10.1348/000712608X374723

The relationship between age-stereotypes and health locus of control across adult age-groups

Publisher: Informa UK Limited

Date: 03-11-2015

DOI: 10.1080/08870446.2014.974603

Abstract: This study integrates healthy ageing and health psychology theories to explore the mechanisms underlying the relationship between health control expectancies and age-attitudes on the process of ageing well. Specifically, the aim of this study is to investigate the relationship between age-stereotypes and health locus of control. A population-based survey of 739 adults aged 20-97 years (mean = 57.3 years, SD = 13.66 42% female) explored attitudes towards ageing and health attitudes. A path-analytical approach was used to investigate moderating effects of age and gender. Higher age-stereotype endorsement was associated with higher chance (β = 2.91, p < .001) and powerful other (β = 1.07, p = .012) health expectancies, after controlling for age, gender, education and self-rated health. Significant age and gender interactions were found to influence the relationship between age-stereotypes and internal health locus of control. Our findings suggest that the relationship between age-stereotypes and health locus of control dimensions must be considered within the context of age and gender. The findings point to the importance of targeting health promotion and interventions through addressing negative age-attitudes.

Optimal Blood Pressure Keeps Our Brains Younger

Publisher: Frontiers Media SA

Date: 05-10-2021

DOI: 10.3389/FNAGI.2021.694982

Abstract: Background : Elevated blood pressure (BP) is a major health risk factor and the leading global cause of premature death. Hypertension is also a risk factor for cognitive decline and dementia. However, when elevated blood pressure starts impacting cerebral health is less clear. We addressed this gap by estimating how a validated measure of brain health relates to changes in BP over a period of 12 years. Methods : Middle-age (44–46 years at baseline, n = 335, 52% female) and older-age (60–64 years, n = 351, 46% female) cognitively intact in iduals underwent up to four brain scans. Brain health was assessed using a machine learning approach to produce an estimate of “observed” age (BrainAGE), which can be contrasted with chronological age. Longitudinal associations between blood pressures and BrainAGE were assessed with linear mixed-effects models. Results : A progressive increase in BP was observed over the follow up (MAP = 0.8 mmHg/year, SD = 0.92 SBP = 1.41 mmHg/year, SD = 1.49 DBP = 0.61 mmHg/year, SD = 0.78). In fully adjusted models, every additional 10 mmHg increase in blood pressure (above 90 for mean, 114 for systolic, and 74 for diastolic blood pressure) was associated with a higher BrainAGE by 65.7 days for mean, and 51.1 days for systolic/diastolic blood pressure. These effects occurred across the blood pressure range and were not exclusively driven by hypertension. Conclusion : Increasing blood pressure is associated with poorer brain health. Compared to a person becoming hypertensive, somebody with an ideal BP is predicted to have a brain that appears more than 6 months younger at midlife.

Hippocampal atrophy is associated with subjective memory decline: The PATH through life study

Publisher: Elsevier BV

Date: 05-2015

DOI: 10.1016/J.JAGP.2014.07.009

Abstract: To investigate whether subjective memory decline (SMD) in cognitively healthy in iduals is associated with hippoc al atrophy. Multiple regression analyses assessing the relationship between hippoc al atrophy over 4 years and SMD at baseline and follow-up in 305 cognitively healthy in iduals aged 60-64 years free from dementia, mild cognitive impairment, and other neurological disorders. SMD at baseline was not a significant predictor of hippoc al atrophy. However, SMD at follow-up was associated with greater hippoc al atrophy. Associations were reduced but remained significant after controlling for anxiety and depression symptomatology. Hippoc al atrophy was associated with incident ersisting SMD and this association was not, or only partly, explained by anxiety and depression symptomatology. These results are consistent with a biological origin to subjective memory decline. SMD should be included in screening and neuropsychological batteries.

Clinical and Neuroimaging Correlates of Mild Cognitive Impairment in a Middle-Aged Community Sample: The Personality and Total Health through Life 60+ Study

Publisher: S. Karger AG

Date: 15-12-2005

DOI: 10.1159/000089251

Abstract: This cross-sectional study aimed at determining the clinical and structural brain magnetic resonance imaging correlates of mild cognitive impairment (MCI). The data presented here are from the first wave of the longitudinal Personality and Total Health through Life 60+ project. 2,551 community-dwelling in iduals in the age range of 60–64 years were recruited randomly through the electoral roll. They were screened using Mini-Mental State Examination and a short cognitive battery. Those who screened positive underwent detailed medical and neuropsychological assessments. Of the 224 subjects who screened positive, 117 underwent a detailed assessment. Twenty-nine subjects fulfilled the Mayo Clinic criteria for MCI. Magnetic resonance imaging scans were analyzed for 26 subjects with MCI as well as normal controls. Subjects were clinically evaluated for depressive symptoms and major and minor depression syndromes. Logistic regression analysis was performed predicting MCI from anterior and mid-ventricular brain ratios, cortical atrophy measures, hippoc al volumes, volumes of amygdala and white matter hyperintensities after adjusting for age, gender, years of education, depression and physical disability. None of the neuroanatomical substrates appeared as predictors of MCI. The only predictors were higher depression scores and fewer years of education. Structural neuroimaging may not have an added advantage in the detection of MCI in middle-aged community-dwelling subjects. It may be that this age group is too young for such brain changes to be identified.

Evaluating and using observational evidence: The contrasting views of policy makers and epidemiologists

Publisher: Frontiers Media SA

Date: 06-12-2016

DOI: 10.3389/FPUBH.2016.00267

The impact of cataract surgery on visual functioning, vision-related disability and psychological distress: A randomized controlled trial

Publisher: Wiley

Date: 14-09-2006

DOI: 10.1111/J.1442-9071.2006.01340.X

Abstract: Determine whether there are changes in visual functioning, vision-related disability, health status and mood after cataract surgery. 45 adults (mean age = 73.7 years) with bilateral cataract needing surgery for the first eye were recruited from public ophthalmology clinics. The Visual Functioning-14 survey assessed visual disability. Minimal angle of resolution tested visual acuity, and the Melbourne Edge Test examined contrast sensitivity. Demographic, psychological, health and medication use variables were examined. Participants were randomized to either an intervention or control arm. Controls were assessed on two occasions at a 3-month interval before having surgery. The intervention group was assessed 1-2 weeks before surgery and then reassessed 3 months after surgery. Visual functioning improved for those who had cataract surgery with better visual acuity in the better (P = 0.010) and worse (P = 0.028) eye compared with controls. The intervention group reported fewer difficulties with overall vision-related disability (P = 0.0001), reading (P = 0.004) and instrumental activities of daily living (P = 0.010) post-surgery compared with controls. People with improved depression scores (P = 0.048) after surgery had less difficulty with reading compared with those with unchanged or worsened depression scores. Cataract surgery did not improve health status. First eye cataract surgery is effective in improving outcomes in visual functioning and disability. Improved mood after surgery was related to less vision-related disability compared with unchanged or worse depression.

Can social dancing prevent falls in older adults? a protocol of the Dance, Aging, Cognition, Economics (DAnCE) fall prevention randomised controlled trial.

Publisher: Springer Science and Business Media LLC

Date: 15-05-2013

DOI: 10.1186/1471-2458-13-477

Considering relocation to a retirement village: Predictors from a community sample

Publisher: Wiley

Date: 17-10-2012

DOI: 10.1111/J.1741-6612.2012.00618.X

Abstract: To identify characteristics distinguishing older adults who have considered relocation to a retirement village in the future from those who have not. Community-living residents (n = 517), aged 55 to 94, randomly selected from the Australian Capital Territory completed a postal survey. Consistent with prior research, the majority of respondents had not considered relocation to a retirement village. Retired persons, those aged 55-64 years, and persons reporting sufficient financial resources, poorer physical health and poorer current neighbourhood cohesion were most likely to have considered future relocation. The identification of factors characterising older adults seeking retirement village housing in the future is important in developing an understanding of the needs and expectations of the older population, and may allow aged care providers to better target the development of services to population needs (e.g. health-care supports). Further investigation into the specific expectations of the 55-64 year cohort is required.

Self-Reported History of Chemotherapy and Cognitive Decline in Adults Aged 60 and Older: The PATH Through Life Project

Publisher: Oxford University Press (OUP)

Date: 24-12-2015

DOI: 10.1093/GERONA/GLT195

Abstract: There is a lack of data from cohort studies assessing cognitive function prior to and after chemotherapy. We evaluated the effect of self-reported cancer chemotherapy on cognitive function in a cohort assessed at baseline, 4 and 8 years. Participants were from the population-based PATH Through Life Study. Of the 2,551 participants aged 60-64 at baseline without cognitive impairment, 1,949 completed wave 3 and had data on cancer and chemotherapy and cognitive function. Linear mixed models were used to analyze the data. At wave 3, participants reporting history of chemotherapy (n = 76) had lower scores on memory, processing speed, and executive function compared with those reporting cancer without chemotherapy (n = 289) and no cancer history (n = 1508). After adjustment for depression and disability, effects remained for processing speed and memory. Chemotherapy prior to the study commencement (n = 24), but not between waves 1 and 3 (n = 81), was associated with greater decline in delayed recall (β = -.21 [95% CI -0.38, -.03], p = .02) and digits backwards β = -.05 [95% CI -0.09, -.01], p = .02) over 8 years compared with those with no cancer history (n = 1562). Women reporting chemotherapy for breast cancer after wave 1 (n = 26) had slower choice reaction time (-0.81 (95% CI -1.28, -0.34), p = .001) but did not decline faster on this measure compared with those reporting no breast cancer history (n = 818). Results suggest chemotherapy prior to old age is associated with faster decline in memory in late life but that it does not affect decline in other domains of cognitive function.

Gender Differences in Superior-memory SuperAgers and Associated Factors in an Australian Cohort

Publisher: SAGE Publications

Date: 31-01-2020

DOI: 10.1177/0733464820902943

Abstract: Background: Despite expectations of deterioration in memory function with age, some older adults demonstrate superior memory performance and have been defined as SuperAgers. Method: SuperAgers were identified in a population-based prospective cohort in Australia ( n = 1,679 49.4% female mean age = 70.6 ±1.5 years) as participants who, over a 12-year period, consistently scored at or above the median of participants 40 years younger on recall tasks. Chi-square and t tests and logistic regression models measured associations between risk factors and being a SuperAger. Results: The prevalence of SuperAgers was higher in women (8.6%) than men (5.3%). Education was associated with being a SuperAger for women (adjusted odds ratio [OR] =1.13, 95% confidence interval [CI] = [1.01, 1.26]) and men (adjusted OR = 1.22, 95% CI = [1.05, 1.40]). Other associated factors were investigative activities and alcohol consumption for women and social activities and depressive symptoms for men. Conclusion: Adults over 60 can sustain superior memory recall however, associated factors may vary between genders.

Ethnic Differences in Barriers and Enablers to Physical Activity Among Older Adults

Publisher: Frontiers Media SA

Date: 10-09-2021

DOI: 10.3389/FPUBH.2021.691851

Abstract: Despite its well-known health benefits, most older adults do not commit to undertaking sufficient physical activity (PA). In this study we aimed to examine the perceived benefits of and barriers and enablers to PA from the perspectives of older Caucasian and Chinese adults living in Australia. In idual and group interviews with 17 Caucasian (mean age: 72.8 years) and 47 Chinese adults (mean age: 74.0 years) were conducted and analysed using thematic analysis. Overall, participants knew about the benefits of PA on physical health but had inconsistent views on its benefits on mental and cognitive health. Older Caucasian and Chinese adults reported similar barriers (e.g., health issues, costs, bad weather and lack of time) and enablers (e.g., improving health environmental enablers such as adequate and walkable spaces and good natural environment peer support and self-motivation) to PA. In comparison, older Chinese adults reported barriers more often, and reported some unique barriers relating to language and culture issues. The findings contribute to developing targeted PA programs for older Caucasian and Chinese adults.

Neuropsychological performance and dementia in depressed patients after 25-year follow-up: A controlled study

Publisher: Cambridge University Press (CUP)

Date: 25-09-2003

DOI: 10.1017/S0033291703008195

Abstract: Background. Previous research has yielded conflicting evidence regarding the long-term cognitive outcome of depression. Some studies have found evidence for a higher incidence of subsequent cognitive impairment or dementia, while others have refuted this. Method. Depression, neuropsychological performance, functional ability and clinical variables were assessed in a s le of patients who had been hospitalized for depression 25 years previously. Results. Data were available on 71 depressed patients (10 of whom were deceased) and 50 surgical controls. No significant differences were found between depressed subjects and controls on any neuropsychological measure. Ten depressed patients but no controls were found to have dementia at follow-up (continuity corrected χ 2 =5·93, P ·01). Presence of dementia was predicted by older age at baseline. Vascular dementia was the most common type. Conclusions. We conclude that this study did not find evidence that early onset depression is a risk factor for Alzheimer's disease, but that for a small subgroup there appears to be a link with vascular dementia. Several plausible explanations for this link, such as lifestyle factors, require further investigation.

Different cognitive profiles for single compared with recurrent fallers without dementia.

Publisher: American Psychological Association (APA)

Date: 2009

DOI: 10.1037/A0015389

Abstract: Relationships between self-reported retrospective falls and cognitive measures (executive function, reaction time [RT], processing speed, working memory, visual attention) were examined in a population based s le of older adults (n = 658). Two of the choice RT tests involved inhibiting responses to either targets of a specific color or location with hand and foot responses. Potentially confounding demographic variables, medical conditions, and postural sway were controlled for in logistic regression models, excluding participants with possible cognitive impairment. A factor analysis of cognitive measures extracted factors measuring RT, accuracy and inhibition, and visual search. Single fallers did not differ from nonfallers in terms of health, sway or cognitive function, except that they performed worse on accuracy and inhibition. In contrast, recurrent fallers performed worse than nonfallers on all measures. Results suggest that occasional falls in late life may be associated with subtle age-related changes in the prefrontal cortex leading to failures of executive control, whereas recurrent falling may result from more advanced brain ageing that is associated with generalized cognitive decline.

The economics of cognitive impairment: Volunteering and cognitive function in the HILDA survey

Publisher: S. Karger AG

Date: 2016

DOI: 10.1159/000444416

Abstract: b i Background: /i /b The economic impact of older-age cognitive impairment has been estimated primarily by the direct and indirect costs associated with dementia care. Other potential costs associated with milder cognitive impairment in the community have received little attention. b i Objective: /i /b To quantify the cost of nonclinical cognitive impairment in a large population-based s le in order to more fully inform cost-effectiveness evaluations of interventions to maintain cognitive health. b i Methods: /i /b Volunteering by seniors has economic value but those with lower cognitive function may contribute fewer hours. Relations between hours volunteering and cognitive impairment were assessed using the Household, Income and Labour Dynamics in Australia (HILDA) survey data. These findings were extrapolated to the Australian population to estimate one potential cost attributable to nonclinical cognitive impairment. b i Results: /i /b In those aged ≥60 years in HILDA (n = 3,127), conservatively defined cognitive impairment was present in 3.8% of the s le. Impairment was defined by performance ≥1 standard deviation below the age- and education-adjusted mean on both the Symbol Digit Modalities Test and Backwards Digit Span test. In fully adjusted binomial regression models, impairment was associated with the probability of undertaking 1 h 9 min less volunteering a week compared to being nonimpaired (β = -1.15, 95% confidence interval -1.82 to -0.47, p = 0.001). In the population, 3.8% impairment equated to probable loss of AUD 302,307,969 per annum estimated by hours of volunteering valued by replacement cost. b i Conclusion: /i /b Nonclinical cognitive impairment in older age impacts upon on the nonmonetary economy via probable loss of volunteering contribution. Valuing loss of contribution provides additional information for cost-effectiveness evaluations of research and action directed toward maintaining older-age cognitive functioning.

Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study

Publisher: Springer Science and Business Media LLC

Date: 09-06-2010

DOI: 10.1186/1471-244X-10-41

Combining longitudinal studies showed prevalence of disease differed throughout older adulthood

Publisher: Elsevier BV

Date: 03-2012

DOI: 10.1016/J.JCLINEPI.2011.08.008

Abstract: Disease prevalence rates are often generalized across the older adult age range. By pooling self-reported health data from five Australian longitudinal studies of aging, we were able to present disease prevalence rates by 5-year age bands and sex. We also investigated the influence of education on prevalence at each age range and compared our observed prevalence rates with those from the 2001 National Health Survey (NHS) to see if existing data could be used to augment national estimates. We used data on 12,718 adults between 60 and 105 years of age from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Hypertension and arthritis were the most prevalent diseases, with approximately 30% of males and 45% of females having either condition. Nearly all diseases were most prevalent amongst older adults in their 70s and lower for in iduals in their 60s, and 80s and older. The effect of education varied by disease and older age group. Prevalence rates from DYNOPTA were generally similar to those reported by the NHS. Disease prevalence is not consistent across older adulthood. Combining longitudinal studies provided a sufficient s le to estimate precise age isions and can be used to supplement national estimates for specific populations.

Treatment of depression in the elderly

Publisher: Cambridge University Press

Date: 22-09-1994

DOI: 10.1017/CBO9780511526756.014

Weekly Alcohol Consumption, Brain Atrophy, and White Matter Hyperintensities in a Community-Based Sample Aged 60 to 64 Years

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 09-2006

DOI: 10.1097/01.PSY.0000237779.56500.AF

Abstract: The objective of this study was to determine the association between weekly alcohol consumption and brain atrophy in adults aged 60 to 64 years. Brain magnetic resonance imaging scans from 385 adults recruited through a community survey were analyzed. Automated segmentation and manual tracing methods were used to obtain brain subvolumes and automated methods were used to obtain quantification and localization of white matter hyperintensities. Visual measures of cortical atrophy were obtained as were data on health and lifestyle factors. Alcohol consumption was assessed with the Alcohol Use Disorders Identification Test. In men, weekly alcohol consumption had a positive linear association with ventricular volume and gray matter and a negative linear association with white matter. In women, weekly alcohol consumption had a nonlinear relationship with cerebrospinal fluid and white matter. Alcohol consumption was not associated with white matter hyperintensities, corpus callosum size, hippoc al or amygdala volumes in analyses adjusting for confounding variables. An association between alcohol consumption and brain atrophy is evident at the population level. In women, detrimental effects of alcohol on the brain appear to occur at lower levels of consumption. It remains possible that low levels of alcohol consumption have neuroprotective benefits but is clear that high levels of consumption are detrimental.

Co-morbidity of depression and anxiety in common age-related eye diseases: A population-based study of 662 adults

Publisher: Frontiers Media SA

Date: 2013

DOI: 10.3389/FNAGI.2013.00056

Sex differences in the causes and consequences of white matter hyperintensities

Publisher: Elsevier BV

Date: 06-2009

DOI: 10.1016/J.NEUROBIOLAGING.2007.08.023

Abstract: To examine sex differences in white matter hyperintensities (WMHs) on T2-weighted magnetic resonance imaging (MRI), reported to be more severe in older women. A random community s le of 228 men and 204 women, aged 60-64, underwent brain MRI scans. WMHs on T2-weighted FLAIR MRI scans were measured using an automated procedure. Subjects were assessed for physical health, cognitive function, vascular risk factors and Apolipoprotein E (APOE) genotyping. Women had more WMHs in both deep and periventricular regions. Hypertension, heart disease and high homocysteine were significant determinants in men and current smoking in women. Hormone replacement therapy and APOE*E4 allele did not have an association with WMHs. WMHs were related to reduced processing speed in men, and had an association with poor physical health and lowered grip strength in both sexes. WMHs are more common in women, with somewhat different putative causes and consequences than men, but >80% of the variance in their causation remains unexplained. The focus in the investigation of WMHs should move beyond the examination for cerebrovascular disease.

Cholesterol as a risk factor for dementia and cognitive decline: A systematic review of prospective studies with meta-analysis

Publisher: Elsevier BV

Date: 05-2008

DOI: 10.1097/01.JGP.0000310778.20870.AE

Optimal weights for local multi-atlas fusion using supervised learning and dynamic information (SuperDyn): Validation on hippocampus segmentation

Publisher: Elsevier BV

Date: 05-2011

DOI: 10.1016/J.NEUROIMAGE.2011.01.078

Abstract: We developed a novel method for spatially-local selection of atlas-weights in multi-atlas segmentation that combines supervised learning on a training set and dynamic information in the form of local registration accuracy estimates (SuperDyn). Supervised learning was applied using a jackknife learning approach and the methods were evaluated using leave-N-out cross-validation. We applied our segmentation method to hippoc al segmentation in 1.5T and 3T MRI from two datasets: 69 healthy middle-aged subjects (aged 44-49) and 37 healthy and cognitively-impaired elderly subjects (aged 72-84). Mean Dice overlap scores (left hippoc us, right hippoc us) of (83.3, 83.2) and (85.1, 85.3) from the respective datasets were found to be significantly higher than those obtained via equally-weighted fusion, STAPLE, and dynamic fusion. In addition to global surface distance and volume metrics, we also investigated accuracy at a spatially-local scale using a surface-based segmentation performance assessment method (SurfSPA), which generates cohort-specific maps of segmentation accuracy quantified by inward or outward displacement relative to the manual segmentations. These measurements indicated greater agreement with manual segmentation and lower variability for the proposed segmentation method, as compared to equally-weighted fusion.

Gender differences in the trajectories of late-life depressive symptomology and probable depression in the years prior to death

Publisher: Cambridge University Press (CUP)

Date: 09-07-2013

DOI: 10.1017/S1041610213001099

Abstract: Gender differences in depression are well established. Whether these differences persist into late life and in the years preceding death is less clear. There is a suggestion that there is no increased likelihood of depression in late life, but that there is an increase in depressive symptomology, particularly with proximity to death. We compared trajectories of probable depression and depressive symptomology between men and women over age and distance-to-death metrics to determine whether reports of depressive symptoms are more strongly related to age or mortality. Participants (N = 2,852) from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project had a mean age of 75 years (SD = 5.68 years) at baseline and were observed for up to 16 years prior to death. Multi-level regression models estimated change in depressive symptomology and probable depression over two time metrics, increasing age, and distance-to-death. Increases in depressive symptomology were reported over increasing age and in the years approaching death. Only male participants reported increased probable depression in the years preceding death. Models that utilized distance-to-death metrics better represented changes in late-life depression, although any changes in depression appear to be accounted for by co-varying physical health status. As death approaches, there are increases in the levels of depressive symptomology even after controlling for socio-demographic and health covariates. In line with increases in suicide rates in late life, male participants were at greater risk of reporting increases in depressive symptomology.

Dysplastic nevus: Fact and fiction.

Publisher: Elsevier BV

Date: 09-2015

DOI: 10.1016/J.JAAD.2015.04.029

Abstract: The term "dysplastic nevus" (DN) implies that this nevus exists as a distinct and defined entity of potential detriment to its host. We examine the current data, which suggest that this entity exists as histologically and possibly genetically different from common nevus, with some overlapping features. Studies show that a melanoma associated with a nevus is just as likely to arise in a common nevus as in DN. Furthermore, there is no evidence that a histologically defined DN evolves into a melanoma or that the presence of 1 or more DN on an in idual patient confers any increased melanoma risk. We suggest that the term "dysplastic nevus" be abandoned so that the focus can shift to confirmed and relevant indicators of melanoma risk, including high nevus counts and large nevus size.

Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study.

Publisher: Public Library of Science (PLoS)

Date: 21-03-2017

DOI: 10.1371/JOURNAL.PMED.1002261

The mediterranean diet is not related to cognitive change in a large prospective investigation: The PATH through life study

Publisher: Elsevier BV

Date: 07-2012

DOI: 10.1097/JGP.0B013E31823032A9

What does (low) education mean in terms of dementia risk? A systematic review and meta-analysis highlighting inconsistency in measuring and operationalising education

Publisher: Elsevier BV

Date: 12-2020

DOI: 10.1016/J.SSMPH.2020.100654

MIND not Mediterranean diet related to 12-year incidence of cognitive impairment in an Australian longitudinal cohort study

Publisher: Wiley

Date: 27-02-2019

DOI: 10.1016/J.JALZ.2018.12.011

Abstract: Associations between the Mediterranean-DASH diet Intervention for Neurological Delay (MIND) diet and incidence of cognitive impairment have not been evaluated outside the United States. We investigated MIND and Mediterranean diet relations with 12-year incidence of Alzheimer's disease/Vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) in the Personality and Total Health (PATH) Through Life cohort (n = 1220) set in Canberra, Australia: wave-1 2001-2002 wave-2 2005-2006 wave-3 2009-2010 and wave-4 2013-2014. MIND diet and two alternate Mediterranean diet scores were calculated from the baseline food frequency questionnaire responses. Higher dietary scores signified greater adherence. In adjusted logistic regression models, MIND diet (OR = 0.47, 95% CI 0.24, 0.91), but not Mediterranean diet, was associated with reduced odds of 12-year cognitive impairment. Preliminary evidence suggests that protective effects of the MIND diet are geographically generalizable. Additional prospective studies are needed in erse s les to determine the relative effects of the MIND and the Mediterranean diets against cognitive decline.

Estimates of probable dementia prevalence from population-based surveys compared with dementia prevalence estimates based on meta-analyses

Publisher: Springer Science and Business Media LLC

Date: 21-07-2010

DOI: 10.1186/1471-2377-10-62

Association of Alzheimer's genetic loci with mild behavioral impairment

Publisher: Wiley

Date: 30-10-2018

DOI: 10.1002/AJMG.B.32684

Abstract: Mild behavioral impairment (MBI) describes the emergence of later-life neuropsychiatric symptoms (NPS) as an at-risk state for incident cognitive decline and dementia, and for some as a potential manifestation of prodromal dementia. How NPS mechanistically link to the development of mild cognitive impairment and Alzheimer's disease (AD) is not fully understood, with potential mechanisms including shared risk factors related to both NPS and cognitive impairment, or AD pathology promoting NPS. This is the first exploratory study to examine whether AD genetic loci as a genetic risk score (GRS), or in idually, are a shared risk factor with MBI. Participants were 1,226 older adults (aged 72-79 738 males 763 normal cognition) from the Personality and Total Health Through Life project. MBI was approximated in accordance with Criterion 1 of the ISTAART-AA diagnostic criteria using a transformation algorithm for the neuropsychiatric inventory. A GRS was constructed from 25 AD risk loci. Binomial logistic regression adjusting for age, gender, and education examined the association between GRS and MBI. A higher GRS and APOE*ε4 were associated with increased likelihood of affective dysregulation. Nominally significant associations were observed between MS4A4A-rs4938933*C and MS4A6A-rs610932*G with a reduced likelihood of affective dysregulation ZCWPW1-rs1476679*C with a reduced likelihood of social inappropriateness and abnormal perception/thought content BIN1-rs744373*G and EPHA1-rs11767557*C with higher likelihood of abnormal perception/thought content NME8-rs2718058*G with a reduced likelihood of decreased motivation. These preliminary findings suggest a common genetic etiology between MBI and traditionally recognized cognitive problems observed in AD and improve our understanding of the pathophysiological features underlying MBI.

Age and Gender Differences Among Australian Suicide Ideators

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 02-2007

DOI: 10.1097/01.NMD.0000254746.15325.FA

Recognition, attitudes and causal beliefs regarding dementia in Italian, Greek and Chinese Australians

Publisher: S. Karger AG

Date: 2011

DOI: 10.1159/000321667

Abstract: i Background/Aim: /i To investigate recognition, attitudes and causal beliefs regarding dementia in Italian, Greek and Chinese Australians in comparison with 3rd generation Australians. Little is known about dementia literacy in these racial and ethnic minority groups. i Methods: /i A cross-sectional telephone survey was conducted of 350 Italian, 414 Greek, 437 Chinese and 500 3rd generation Australians randomly selected from the telephone directory. i Results: /i Third generation participants (85%) were more likely to recognize dementia symptoms in a vignette in comparison to Italian (61%), Greek (58%) and Chinese (72%) participants. Overall, the racial and ethnic minority groups had more negative attitudes about persons with dementia. The racial and ethnic minority groups were more likely to suggest old age and psychosocial risk factors caused dementia, whereas 3rd generation Australians were more likely to suggest brain disease. Differences between ethnic minority and 3rd generation groups remained after controlling for sociodemographic variables. There were differences between Italian, Greek and Chinese participants on markers of acculturation associated with knowledge and beliefs within each group. i Conclusions: /i Racial and ethnic minority groups have poor dementia literacy in comparison to 3rd generation Australians. There is a need for dementia education targeted to and tailored for these groups.

The International Network on Public Health and Aging (INOPA): Introducing a Life Course Perspective to the Public Health Agenda

Publisher: Springer Science and Business Media LLC

Date: 31-01-2008

DOI: 10.1007/S10823-007-9055-1

Abstract: In this paper, we present an international network of researchers from projects examining the human aging process and its consequences. It is both vital and urgent to include aging and a life course perspective on the public health agenda, particularly in low-income countries. By announcing the network in a publication, we wish not just to position the network but, more importantly, to attract the attention of other potential collaborators either at the project, institutional, decision making, or applied level.

Subjective Beliefs, Memory and Functional Health: Change and Associations over 12 Years in the Australian Longitudinal Study of Ageing

Publisher: S. Karger AG

Date: 2015

DOI: 10.1159/000369800

Abstract: b i Background: /i /b Neither subjective memory beliefs, nor remembering itself, can be isolated from the overall context in which one is aging, nor are the drivers of memory complaints well specified. Sense of control is an important self-regulatory resource that drives cognitive and physical health over the lifespan. Existing findings are equivocal concerning both the extent of stability or change in control beliefs over time as well as their contribution to changes in behavior. b i Objective: /i /b Subjective beliefs may play a role when engaging memory processes or identifying memory complaints, and it has been argued that self-regulatory potential in general may be limited by age-related changes in the domains of health and cognition. We aimed to examine trajectories of change and shed light on relationships among subjective beliefs and indicators of memory and functional health. b i Methods: /i /b Participants' data were drawn from four measurement occasions over up to a 12-year period (1992-2004) from the Australian Longitudinal Study of Ageing (ALSA), a population-based study of older adults [age 65-100 years mean age(SD) at the first and final occasion 78.2 (6.7) and 84.9 (4.9) years, respectively]. Participants completed three questionnaires assessing subjective beliefs concerning (1) memory knowledge and control, (2) health control, and (3) expectancy of control over a range of lifestyle situations. Memory comprised a recall composite. Functional health tapped mobility and disability. Latent growth curve models incorporated informative covariates (baseline age, gender, self-rated health, education, and chronic conditions). b i Results: /i /b While subjective memory control beliefs, but not subjective knowledge of memory tasks, improved over 12 years, neither was associated with level of memory performance. Knowledge of memory tasks was linked to a significant memory decline. Beliefs about memory, health, and lifestyle were interrelated. Declines in remembering and health were also coupled moreover, changes in both were coupled with change in lifestyle control beliefs. b i Conclusions: /i /b This is the first examination of in idual differences in changes in, and relationships among, psychological domains of subjective beliefs about memory, health, and lifestyle, and objective remembering and functional health in very late life. Findings point to a system of coupled changes in memory and health in late life that is related to underlying beliefs about control over lifestyle.

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

Publisher: Public Library of Science (PLoS)

Date: 30-08-2016

DOI: 10.1371/JOURNAL.PMED.1002112

A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults

Publisher: Public Library of Science (PLoS)

Date: 08-02-2012

DOI: 10.1371/JOURNAL.PONE.0031500

A community survey demonstrated cohort differences in the lifetime prevalence of self-reported head injury

Publisher: Elsevier BV

Date: 07-2004

DOI: 10.1016/J.JCLINEPI.2003.10.015

The public's perception of the plausibility of dementia risk factors is not influenced by scientific evidence

Publisher: S. Karger AG

Date: 2007

DOI: 10.1159/000099038

Abstract: i Background/Aim: /i The public know little about risk factors for dementia. The aim of this study was to explore belief structures underlying how plausible risk factors for dementia appear to the general public. i Methods: /i Two thousand members of the Australian public were surveyed by telephone on their beliefs regarding dementia risk factors. Factor analysis was performed on 17 modifiable behaviours that were rated by participants as increasing, not changing or decreasing the risk of dementia. i Results: /i Three factors were obtained – Health and Lifestyle, Activity, and Nutrition. Items loading on the Health and Lifestyle factor were management of cardiovascular risk factors, drinking more water, reducing stress, coffee and tea, and alcohol intake. Items loading on the Activity factor were mental, physical and social activity and getting out and about more. Items loading on the Nutrition factor were eating foods high in omega-3 fatty acids, antioxidants and estrogen, using non-aluminium cookware and taking vitamin and nutritional supplements. Factors were characterised by similarity of items, rather than level of scientific evidence of an association with dementia. Factor scale scores differed according to sociodemographic characteristics. i Conclusions: /i The public do not process dementia risk factor information based on level of scientific evidence.

Cognitive performance and leukocyte telomere length in two narrow age-range cohorts: a population study

Publisher: Springer Science and Business Media LLC

Date: 16-09-2010

DOI: 10.1186/1471-2318-10-62

Association between alcohol consumption and Alzheimer’s disease: A Mendelian randomization Study

Publisher: Cold Spring Harbor Laboratory

Date: 18-09-2017

DOI: 10.1101/190165

Abstract: Observational studies have suggested that light-moderate alcohol consumptions decreases the risk of Alzheimer’s disease, but it is unclear if this association is causal. Two-s le Mendelian randomization (MR) analysis was used to examine whether alcohol consumption, alcohol dependence or Alcohol Use Disorder Identification Test (AUDIT) scores were causally associated with the risk of Late Onset Alzheimer’s disease (LOAD) or Alzheimer’s disease age of onset survival (AAOS). Additionally, γ-glutamyltransferase levels were included as a positive control. There was no evidence of a causal association between alcohol consumption, alcohol dependence or AUDIT and LOAD. Alcohol consumption was associated with an earlier AAOS and increased γ-glutamyltransferase blood concentrations. Alcohol dependence was associated with a delayed AAOS. MR found robust evidence of a causal association between alcohol consumption and an earlier AAOS, but not alcohol intake and LOAD risk. The protective effect of alcohol dependence is potentially due to survivor bias. The authors reviewed the literature using online databases (e.g. PubMed). Previous research links light-moderate alcohol consumption to a decreased risk of Alzheimer’s disease (AD), however, prior studies based on observational study designs may be biased due to unmeasured confounders influencing both alcohol consumption and AD risk. We used a two-s le Mendelian randomization (MR) approach to evaluated the causal relationship between alcohol intake and AD. MR uses genetic variants as proxies for environmental exposures to provide an estimate of the causal association between an intermediate exposure and a disease outcome. MR found evidence of a causal association between alcohol consumption and an earlier AD age of onset, suggesting that light-moderate alcohol consumption does not reduce risk of Alzheimer’s disease. Future studies should use alterative study designs and account for additional confounders when evaluating the causal relationship between alcohol consumption and AD. We evaluated causal relationships between alcohol intake and Alzheimer’s disease Alcohol consumption is causally associated with an earlier Alzheimer’s age of onset No evidence of causal assocations between alcohol intake and Alzheimer’s risk

Trends in Alzheimer's disease and dementia in the Asian-Pacific region

Publisher: Hindawi Limited

Date: 2012

DOI: 10.1155/2012/171327

Comparison of self-reported crashes, state crash records and an on-road driving assessment in a population-based sample of drivers aged 69-95 years

Publisher: Informa UK Limited

Date: 27-02-2009

DOI: 10.1080/15389580802486399

Abstract: The study evaluated associations between outcome measures used in driving research including self-reported crashes, state crash records, and an on-road driving test (ORT). A total of 750 community dwelling participants aged 69 to 95 were recruited via the electoral roll into a study on injury prevention. Of these, 509 were drivers, and data on self-reported crashes, and either state crash records, or an on-road assessment were available for 488. Crash history data were obtained from state records (five-year retrospective and twelve-month prospective), retrospective self-report (five-year) and prospective monthly injury diaries (twelve months). A subs le completed an on-road driving test. During the last five years, 22.3% reported a crash, 10.0% reported a crash in the twelve-month follow-up period, 3.2% of the s le had state crash records during the previous five years, and 0.6% had state-recorded crashes during the twelve-month follow-up period. State crash records did not agree with any other outcome measure. Those who scored 5 or less on the ORT were more likely to report a crash in the past five years (55.4% vs. 36.8% p = .009). Results did not differ when participants with probable dementia were excluded (n = 2). The results suggest that caution should be applied when using state crash records as an outcome measure in driving research and suggest that in the Australian context, retrospective self-reported crashes over five years are preferable when objective measures of driving performance are unavailable.

Effects of cerebrovascular risk factors on gray matter volume in adults aged 60-64 years: a voxel-based morphometric study.

Publisher: Elsevier BV

Date: 10-2006

DOI: 10.1016/J.PSCYCHRESNS.2006.01.009

Abstract: The effect of putative cerebrovascular risk factors on gray matter volume in a community-dwelling, non-demented 60- to 64-year-old cohort was investigated. Cranial T1-weighted MRI scans were obtained in 337 adults and voxel-based morphometric analyses were applied to detect regional gray matter volume differences related to hypertension, diabetes, smoking, and hyperlipidemia in men and women, respectively. Hypertension-related gray matter volume reduction was found in right superior, bilateral medial frontal, left superior temporal and left precentral gyri in men. No regional differences in gray matter related to hypertension were seen in women. Conversely, female but not male smokers had more gray matter volume in right fusiform gyrus and right temporal subgyral gray matter. No differences were observed in gray matter volume in association with diabetes or hyperlipidemia for men or women. Our results suggest that there are different patterns of regional effects in gray matter volume in relation to different cerebrovascular risk factors, and sex differences for the same risk factors.

Sensorimotor and Postural Control Factors Associated With Driving Safety in a Community-Dwelling Older Driver Population

Publisher: Oxford University Press (OUP)

Date: 29-10-2013

DOI: 10.1093/GERONA/GLT173

Abstract: To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this s le. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.

ADHD Symptoms and Cognitive Abilities in the Midlife Cohort of the PATH Through Life Study

Publisher: SAGE Publications

Date: 07-12-2015

DOI: 10.1177/1087054712460887

Abstract: Objective: ADHD is a lifelong condition, but it remains understudied in older adults. We examined the effects of ADHD-related inattention and hyperactivity symptoms on cognitive abilities in middle-age adults. Method: ADHD symptoms and cognitive abilities were accessed in a population-based s le ( N = 2,091). Multiple regression analyses evaluated the effect of dimensional and categorical measures of ADHD on performance in cognitive tests. Results: ADHD symptoms are negatively associated with measures of reaction time, processing speed, task-switching, mental flexibility, and an aggregate measure of cognition. Inattention and hyperactive symptoms have reciprocal effects on performance in some cognitive tasks. Significant subclinical effects are present. Conclusion: Our demonstration that cognitive effects of ADHD symptoms are present in the middle-age population provides the impetus to investigate whether these effects contribute to cognitive decline in late age and whether identification and treatment of ADHD symptoms in middle age might be effective in reducing late-age cognitive decline.

Does Resilience Predict Suicidality? A Lifespan Analysis

Publisher: Informa UK Limited

Date: 02-10-2014

DOI: 10.1080/13811118.2013.833881

Abstract: In this article, we examine the association between resilience and suicidality across the lifespan. Participants (n = 7485) from the Personality and Total Health (PATH) Through Life Project, a population s le from Canberra and Queanbeyan, Australia, were stratified into three age cohorts (20-24, 40-44, 60-64 years of age). Binary Logistic regression explored the association between resilience and suicidality. Across age cohorts, low resilience was associated with an increased risk for suicidality. However, this effect was subsequently made redundant in models that fully adjusted for other risk factors for suicidality among young and old adults. Resilience is associated with suicidality across the lifespan, but only those in midlife continued to report increased likelihood of suicidality in fully-adjusted models.

Hormone replacement therapy and cognition in an Australian representative sample aged 60-64 years

Publisher: Elsevier BV

Date: 04-2006

DOI: 10.1016/J.MATURITAS.2005.09.001

Abstract: To investigate the relationship between hormone replacement therapy (HRT) and level of cognitive performance intra-in idual variability, and interactions with statin use, progesterone therapy and type of menopause. A representative s le of 60-64 year olds was recruited from the Canberra and Queanbeyan regions in Australia. They were administered tests of verbal memory, working memory, speed of information processing, simple and complex reaction time, verbal intelligence and the Mini-Mental State Exam. Intra-in idual variation (consistency) on performance on simple and complex reaction time tasks was calculated. Women provided information on HRT use and demographic, health and lifestyle variables. Four hundred and four (35.0%) current postmenopausal HRT users, 316 (27.4%) previous HRT users and 434 (37.6%) women who had never used HRT, were included in this study. There were significant overall differences between HRT current and previous users on age, prevalence of diabetes, alcohol use, body mass index, level of anxiety and lung function. After controlling for potentially confounding health and demographic variables, there were no significant main effects detected between HRT groups on any cognitive measure. Significant interactions were detected between HRT group and statin use on intra-in idual variability on simple reaction time, and between HRT group and menopause type on intra-in idual variability on choice reaction time. All other interactions were non-significant. HRT use had no effect on level of cognitive performance. Two interactions were detected between HRT use and statin use, and type of menopause on intra-in idual variability. Given the large number of comparisons, little weight can be placed on these significant results.

Trends in disability-free life expectancy at age 50 years in Australia between 2001 and 2011 by social disadvantage

Publisher: BMJ

Date: 28-04-2021

DOI: 10.1136/JECH-2020-214906

Abstract: The aims of this study were (1) to estimate 10-year trends in disability-free life expectancy (DFLE) by area-level social disadvantage and (2) to examine how incidence, recovery and mortality transitions contributed to these trends. Data were drawn from the nationally representative Household Income and Labour Dynamics in Australia survey. Two cohorts (baseline age 50+ years) were followed up for 7 years, from 2001 to 2007 and from 2011 to 2017, respectively. Social disadvantage was indicated by the Socio-Economic Indexes for Areas (SEIFA). Two DFLEs based on a Global Activity Limitation Indicator (GALI) and difficulties with activities of daily living (ADLs) measured by the 36-Item Short Form Survey physical function subscale were estimated by cohort, sex and SEIFA tertile using multistate models. Persons residing in the low-advantage tertile had more years lived with GALI and ADL disability than those in high-advantage tertiles. Across the two cohorts, dynamic equilibrium for GALI disability was observed among men in mid-advantage and high-advantage tertiles, but expansion of GALI disability occurred in the low-advantage tertile. There was expansion of GALI disability for all women irrespective of their SEIFA tertile. Compression of ADL disability was observed for all men and for women in the high-advantage tertile. Compared to the 2001 cohort, disability incidence was lower for the 2011 cohort of men within mid-advantage and high-advantage tertiles, whereas recovery and disability-related mortality were lower for the 2011 cohort of women within the mid-advantage tertile. Overall, compression of morbidity was more common in high-advantage areas, whereas expansion of morbidity was characteristic of low-advantage areas. Trends also varied by sex and disability severity.

The Impact of Age Stereotypes on Older Adults' Hazard Perception Performance and Driving Confidence

Publisher: SAGE Publications

Date: 09-01-2016

DOI: 10.1177/0733464813517505

Abstract: This study examined the effect of age-stereotype threat on older adults’ performance on a task measuring hazard perception performance in driving. The impact of age-stereotype threat in relation to the value participants placed on driving and pre- and post-task confidence in driving ability was also investigated. Eighty-six adults aged from 65 years of age completed a questionnaire measuring demographic information, driving experience, self-rated health, driving importance, and driving confidence. Prior to undertaking a timed hazard perception task, participants were exposed to either negative or positive age stereotypes. Results showed that age-stereotype threats, while not influencing hazard perception performance, significantly reduced post-driving confidence compared with pre-driving confidence for those in the negative prime condition. This finding builds on the literature that has found that stereotype-based influences cannot simply be understood in terms of performance outcomes alone and may be relevant to factors affected by confidence such as driving cessation decisions.

Problems identifying odours predicts mild cognitive impairment in the elderly: Commentary

Publisher: BMJ

Date: 05-2008

DOI: 10.1136/EBMH.11.2.40

Our correct use of ANCOVA yields acceptable results [2]

Publisher: Cambridge University Press (CUP)

Date: 02-02-2007

DOI: 10.1017/S135561770707049X

Association between decision-making under risk conditions and on-road driving safety among older drivers.

Publisher: American Psychological Association (APA)

Date: 09-2021

DOI: 10.1037/NEU0000754

Strength in the lower limbs, visual contrast sensitivity, and simple reaction time predict cognition in older women

Publisher: American Psychological Association (APA)

Date: 1997

DOI: 10.1037/0882-7974.12.1.137

High Normal Blood Glucose Is Associated with Decreased Brain Volume and Cognitive Performance in the 60s: The PATH through Life Study

Publisher: Public Library of Science (PLoS)

Date: 04-09-2013

DOI: 10.1371/JOURNAL.PONE.0073697

The feasibility of a multidomain dementia risk reduction randomised controlled trial for people experiencing cognitive decline: the Body, Brain, Life for Cognitive Decline (BBL-CD)

Publisher: Informa UK Limited

Date: 30-03-2023

DOI: 10.1080/13607863.2023.2190083

Hormone replacement therapy, brain volumes and white matter in postmenopausal women aged 60-64 years

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 23-01-2006

DOI: 10.1097/01.WNR.0000194385.10622.8E

Abstract: Research on the structural and functional effects of hormone replacement therapy on the brain has produced inconsistent results. This paper reports on cross-sectional associations between hormone replacement therapy use and volumes of brain structures measured using magnetic resonance imaging in 213 postmenopausal women aged 60-64 years recruited from a large population study. Of these, 64 were current hormone replacement therapy users, 69 previous users and 80 had never used hormone replacement therapy. No differences were observed between groups in total grey matter, white matter, hippoc al or amygdalar volumes, severity or volume of white matter hyperintensities, or in different measures of brain atrophy. While acknowledging the limitations of a cross-sectional study, the results argue against hormone replacement therapy being protective against brain changes associated with ageing in women in their early 60s.

Volunteering benefits life satisfaction over 4 years: The moderating role of social network size

Publisher: Informa UK Limited

Date: 06-2019

DOI: 10.1111/AJPY.12217

An 8-year prospective study of the relationship between cognitive performance and falling in very old adults

Publisher: Wiley

Date: 13-06-2006

DOI: 10.1111/J.1532-5415.2006.00813.X

Abstract: To determine whether cognitive performance, as distinct from cognitive impairment, predicts falling during an 8-year follow-up in a community-based s le of very old adults and to evaluate how cognitive change is associated with falling. Prospective cohort study including three waves of data collected in 1992, 1994, and 2000. Population based, with the baseline s le drawn from the electoral roll. Inclusion criteria were completion of at least three cognitive tests at baseline and completion of the falls questionnaire at Wave 6 (N=539). Assessments of health and medical conditions, visual acuity, cognitive function, functional reach, semitandem stand, and grip strength were conducted in 1992 (baseline), 1994, and 2000. Self-report information on falls in the previous 12 months was obtained on each of these occasions. Marginal models using generalized estimating equations were used to assess the association between baseline cognitive performance and falling over 8 years, adjusting for sociodemographic, health, and sensorimotor variables. Random effects models were used to assess the relationship between change in cognitive performance and change in fall rate and fall risk over 8 years. Mini-Mental State Examination and verbal reasoning at baseline predicted rate of falling over an 8-year period. Within in iduals, declines in verbal ability, processing speed, and immediate memory were associated with increases in rates of falling and fall risk. Cognitive performance is associated with falling over 8 years in very old adults and should be assessed in clinical practice when evaluating short- and long-term fall risk.

Social networks and memory over 15 years of followup in a cohort of older Australians: Results from the Australian longitudinal study of ageing

Publisher: Hindawi Limited

Date: 2012

DOI: 10.1155/2012/856048

Abstract: The purpose was to examine the relationship between different types of social networks and memory over 15 years of followup in a large cohort of older Australians who were cognitively intact at study baseline. Our specific aims were to investigate whether social networks were associated with memory, determine if different types of social networks had different relationships with memory, and examine if changes in memory over time differed according to types of social networks. We used five waves of data from the Australian Longitudinal Study of Ageing, and followed 706 participants with an average age of 78.6 years (SD 5.7) at baseline. The relationships between five types of social networks and changes in memory were assessed. The results suggested a gradient of effect participants in the upper tertile of friends or overall social networks had better memory scores than those in the mid tertile, who in turn had better memory scores than participants in the lower tertile. There was evidence of a linear, but not quadratic, effect of time on memory, and an interaction between friends’ social networks and time was apparent. Findings are discussed with respect to mechanisms that might explain the observed relationships between social networks and memory.

Association between alcohol consumption and Alzheimer's disease: A Mendelian randomization study

Publisher: Wiley

Date: 04-01-2020

DOI: 10.1016/J.JALZ.2019.09.086

Abstract: Observational studies have suggested that light‐to‐moderate alcohol consumption decreases the risk of Alzheimer's disease, but it is unclear if this association is causal. Two‐s le Mendelian randomization (MR) analysis was used to examine whether alcohol consumption, alcohol dependence, or Alcohol Use Disorder Identification Test (AUDIT) scores were causally associated with the risk of Late‐Onset Alzheimer's disease (LOAD) or Alzheimer's disease age of onset survival (AAOS). Additionally, γ‐glutamyltransferase levels were included as a positive control. There was no evidence of a causal association between alcohol consumption, alcohol dependence, or AUDIT, and LOAD. Alcohol consumption was associated with an earlier AAOS and increased γ‐glutamyltransferase blood concentrations. Alcohol dependence was associated with a delayed AAOS. MR found robust evidence of a causal association between alcohol consumption and an earlier AAOS, but not alcohol intake and LOAD risk. The protective effect of alcohol dependence is potentially due to survivor bias.

Development of a New Method for Assessing Global Risk of Alzheimer's Disease for Use in Population Health Approaches to Prevention

Publisher: Springer Science and Business Media LLC

Date: 16-01-2013

DOI: 10.1007/S11121-012-0313-2

Cognitive health expectancies of cardiovascular risk factors for cognitive decline and dementia

Publisher: Oxford University Press (OUP)

Date: 05-08-2020

DOI: 10.1093/AGEING/AFAA111

Abstract: Cognitive health expectancy estimates the proportion of the lifespan that is lived in good cognitive health at the population level. A number of cardiovascular diseases have been identified to be risk factors for cognitive decline and dementia including diabetes, stroke, heart diseases and hypertension. The aim of this study was to examine how these cardiovascular conditions relate to cognitive health expectancy. Longitudinal data were obtained from the US Health and Retirement Study. Multistate modelling was used to estimate total life expectancy (LE), cognitive impairment free life expectancy (CIFLE) and years spent with cognitive impairment (CILE) across self-reported diabetes, hypertension, heart problems and stroke. In idual and cumulative effects of multiple cardiovascular conditions were examined. The presence of cardiovascular disease was associated with a 5- to 9-year decrease in LE and 4- to 8-year decrease in CIFLE at age 55. The outcomes varied in a hierarchical fashion by cardiovascular condition. Relative to other conditions, in iduals with stroke had the shortest LE and CIFLE. Analysis of multiple cardiovascular risk factors revealed that each additional cardiovascular condition was associated with an exponential decrease in LE and CIFLE. Having a cardiovascular condition is associated with a lower CIFLE and higher proportion of life lived with cognitive impairment. However, the outcomes vary depending on the type of cardiovascular condition. Reducing incidence of stroke and minimising exposure to multiple cardiovascular risk factors may be beneficial in helping to improve population estimates of cognitive health expectancy.

Effect of SSRI and calcium channel blockers on depression symptoms and cognitive function in elderly persons treated for hypertension: three city cohort study

Publisher: Cambridge University Press (CUP)

Date: 21-03-2018

DOI: 10.1017/S1041610217002903

Abstract: Emerging genetic, ex-vivo, and clinical trial evidence indicates that calcium channel blockers (CCB) can improve mood and cognitive function. The objective of this study was to examine the effect of selective serotonin reuptake inhibitor (SSRI) therapy augmented with CCB on depression and cognitive decline in an elderly population with hypertension. Prospective study of 296 persons treated with SSRI and antihypertensive drugs. Baseline and two year clinic assessments were used to categorize participants as users of SSRI + CCB ( n = 53) or users of SSRI + other antihypertensives ( n = 243). Clinic visits were performed up to four times in a ten-year period to assess depression and cognitive function. The s le mean age was 75.2 ± 5.47 years and 78% of participants were female. At two year follow-up there was a significant group by time interaction showing lower Center for Epidemiological Studies-Depression (CESD) scores in the SSRI + CCB group, F (1,291) = 4.13, p = 0.043, η 2 p = 0.014. Over ten-years follow-up, SSRI + CCB use was associated with improved general cognitive function (Mini-Mental State Examination: β = 0.97 95% CI 0.14 to 1.81, p = 0.023) and immediate visual memory (Boston Visual Retention Test: β = 0.69 95% CI 0.06 to 1.32, p = 0.033). The findings provide general population evidence that SSRI augmentation with CCB may improve depression and cognitive function.

CogTale: an online platform for the evaluation, synthesis, and dissemination of evidence from cognitive interventions studies

Publisher: Springer Science and Business Media LLC

Date: 24-08-2021

DOI: 10.1186/S13643-021-01787-2

Abstract: Systematic reviews and meta-analyses are critical in health-related decision-making, and are considered the gold standard in research synthesis methods. However, with new trials being regularly published and with the development of increasingly rigorous standards of data synthesis, systematic reviews often require much expertise and long periods of time to be completed. Automation of some of the steps of evidence synthesis productions is a promising improvement in the field, capable of reducing the time and costs associated with the process. This article describes the development and main characteristics of a novel online repository of cognitive intervention studies entitled Cognitive Treatments Article Library and Evaluation (CogTale). The platform is currently in a Beta Release phase, as it is still under development. However, it already contains over 70 studies, and the CogTale team is continuously coding and uploading new studies into the repository. Key features include advanced search options, the capability to generate meta-analyses, and an up-to-date display of relevant published studies.

Association of Pulmonary Function with Cognitive Performance in Early, Middle and Late Adulthood

Publisher: S. Karger AG

Date: 2004

DOI: 10.1159/000078352

Abstract: i Background: /i Pulmonary function has been associated with some measures of cognitive performance, mostly in late adulthood. This study investigated whether this association is present for a range of cognitive measures, at three stages of adulthood, and whether it remains after controlling for demographic, health and lifestyle factors. i Method: /i The relationship between forced expiratory volume at 1 s (FEV sub /sub ), a measure of pulmonary function, and cognitive test performance was examined in three cohorts aged 20–24, 40–44 and 60–64. i Results: /i After controlling for demographic variables, smoking, physical activity, and respiratory disease, significant associations between FEV sub /sub and cognitive test performance were evident in each age group for most cognitive measures. The association between FEV sub /sub and measures of speed increased with age. i Conclusion: /i FEV sub /sub has a small but reliable positive association with cognitive test performance throughout adulthood, possibly reflecting a common physiological factor.

Determinants of Retirement Timing Expectations in the United States and Australia: A Cross-National Comparison of the Effects of Health and Retirement Benefit Policies on Retirement Timing Decisions

Publisher: Informa UK Limited

Date: 07-2012

DOI: 10.1080/08959420.2012.676324

Abstract: Data from the U.S. Health and Retirement Study (N = 2,589) and the Australian Household Income and Labour Dynamics survey (N = 1,760) were used to compare the macro-level policy frameworks on in idual retirement timing expectations for pre-baby boomers (61+ years) and early baby boomers (45 to 60 years). Australian workers reported younger expected age of retirement compared to the U.S. s le. Reporting poor health was more strongly associated with younger expected retirement age in the United States than in Australia. Cohort and gender differences in the United States were found for the effect of private health insurance on younger expected age at retirement. Our results draw attention to how cross-national comparisons can inform us on the effects of policies on retirement expectations among older workers.

Within-Person Variability as a Dynamic Measure of Late-Life Development: New Methodologies and Future Directions

Publisher: S. Karger AG

Date: 2004

DOI: 10.1159/000078355

Abstract: i Background: /i Intra-in idual variability is becoming a focus of research in behavioural gerontology due to theoretical and methodological advances. i Objective: /i New directions in the study of intra-in idual variability are described and unanswered questions are proposed. i Methods: /i Papers from the special issue of i Gerontology /i on Intra-in idual Change are reviewed. i Results: /i Key findings and approaches from this set of papers are identified, including types of latent growth curve models that incorporate dynamic elements and applications to the study of late-life cognition and affect. Theoretical issues that remain unresolved are outlined. i Conclusion: /i Dynamic approaches to the measurement of change provide novel methods to answer new questions and evaluate existing theories. The focus on intra-in idual variability adds a valuable dimension to gerontological research that may refine the way we describe behaviour and measure change.

Physiologic, health and lifestyle factors associated with femoral neck bone density in older women

Publisher: Elsevier BV

Date: 04-1995

DOI: 10.1016/S8756-3282(95)80433-1

Physical activity for older Australians with mild cognitive impairment or subjective cognitive decline – A narrative review to support guideline development

Publisher: Elsevier BV

Date: 10-2020

DOI: 10.1016/J.JSAMS.2020.03.003

Pulmonary Function, Cognitive Impairment and Brain Atrophy in a Middle-Aged Community Sample

Publisher: S. Karger AG

Date: 2006

DOI: 10.1159/000091438

Abstract: i Objective: /i To determine the relationship of lung function to brain anatomical parameters and cognitive function and to examine the mediating factors for any relationships. i Methods: /i A random sub-s le of 469 persons (men = 252) aged 60–64 years from a larger community s le underwent brain magnetic resonance imaging scans and pulmonary function tests (forced vital capacity, FVC, forced expiratory volume in the first second, FEV sub /sub ). Subjects were assessed for global cognitive function, episodic memory, working memory, information processing speed, fine motor dexterity and grip strength. The magnetic resonance imaging scans were analysed for overall brain atrophy, subcortical atrophy (ventricle-to-brain ratio, VBR), hippoc al volume, and white matter hyperintensity (WMH) volume. i Results: /i FEV sub /sub had a significant negative correlation with overall brain atrophy and VBR in men. The FEV sub /sub /FVC ratio had a significant correlation with WMHs in both men and women. In regression models that controlled for sex, age, height, level of activity, smoking, chronic respiratory disease and education, FEV sub /sub and FVC were significant predictors of VBR but no other structural brain measure. Pulmonary function was also significantly related to information processing speed and fine motor dexterity. Male subjects with chronic respiratory disease had more deep WMHs. Path analyses to examine if structural measures mediated between lung function and cognition, and whether markers of inflammation and oxidative stress or cortisol mediated between lung function and brain measures were negative. i Conclusions: /i Decreased lung function is related to poorer cognitive function and increased subcortical atrophy in mid-adult life. Presence of chronic respiratory disease may be related to deep WMHs in men.

Examining the SF-36 in an older population: analysis of data and presentation of Australian adult reference scores from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project

Publisher: Springer Science and Business Media LLC

Date: 12-02-2011

DOI: 10.1007/S11136-011-9864-0

Abstract: To examine the psychometric properties of, and present reference scores for the SF-36 using data from a large community s le of older adults. Data are from the DYNOPTA project. We focus on data from five studies that included the SF-36, providing a s le of 41,338 participants aged 45-97 years. We examine the factor structure of the SF-36 and item-internal consistency. The psychometric properties of the eight scales of the SF-36 were largely consistent with previous research based on younger and/or smaller s les. However, the assumption of orthogonality between the second-order factors was not supported. In terms of age-related effects, most scales demonstrated a nonlinear effect with markedly poorer health evident for the oldest respondents. In addition, the scales measuring aspects of physical health (PH, BP, RP, GH) showed an overall linear decline in health with increasing age. There were, however, no consistent linear age-related differences in health evident for those scales most strongly associated with mental health (MH, RE, SF, VT). The results confirm the structural validity and internal consistency of the eight scales from the SF-36 with an older population and support its use to assess the health of older Australian adults.

Validation of Brief Screening Tools to Identify Impaired Driving Among Older Adults in Australia

Publisher: American Medical Association (AMA)

Date: 17-06-2020

DOI: 10.1001/JAMANETWORKOPEN.2020.8263

Construct overlap in resource theories of memory aging

Publisher: S. Karger AG

Date: 1999

DOI: 10.1159/000022119

Abstract: This article evaluates the conceptual status of working memory, processing speed, executive function and sensory function as mediational constructs to explain memory aging. The main difficulty for these mediational constructs is that they may not be independent. Mediational constructs may overlap with each other or with the dependent variable due to theoretical, substantive or methodological reasons. It is argued that sensory function has an advantage over processing speed, working memory and executive function as a mediational construct because it is non-cognitive. The problem of construct overlap is relevant to both cross-sectional and longitudinal studies. Further research is required to evaluate the relative importance of mediational constructs in theories of memory aging, general intellectual aging and dementia.

Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study.

Publisher: Public Library of Science (PLoS)

Date: 23-07-2019

DOI: 10.1371/JOURNAL.PMED.1002853

Visual memory testing in older adults with age-related visual decline: A measure of memory performance or visual functioning?

Publisher: Informa UK Limited

Date: 05-2005

DOI: 10.1080/138033990520241

Abstract: Although we know that vision is correlated with memory performance in older adults, the implications for this in terms of neuropsychological assessment have not been investigated. Relationships among age, visual acuity, and visual and verbal memory in 89 community dwelling volunteers aged 60 to 87 years were examined. Vision was tested using the Landolt C and visual and verbal memory were assessed via the Visual Reproduction (VR) and Word List (WL) subtests from the Wechsler Memory Scale, Third Edition (WMS-III Wechsler, 1997), respectively. Significant correlations were observed between vision and the VR and WL tasks. Hierarchical multiple regression analyses revealed that vision significantly increased the R2 for VR and WL after controlling for age and education. The effect of vision was not specific to visual memory. We conclude that vision is correlated with general memory function in older adults, and is not modality specific.

Age differences in psychosocial predictors of positive and negative affect: A longitudinal investigation of young, midlife, and older adults

Publisher: American Psychological Association (APA)

Date: 09-2010

DOI: 10.1037/A0019431

Abstract: Research has consistently shown that despite aging-related losses, older adults have high levels of emotional well-being relative to those in young and midlife adults. We aimed to contribute to knowledge around the factors that predict emotional well-being over the life course by examining age group differences in associations of positive and negative social exchanges and mastery beliefs with positive and negative affect in a s le of 7,472 young, midlife, and older adults assessed on 2 measurement occasions, 4 years apart. Results from structural equation models indicated lower levels of negative affect with advancing age. Mastery was consistently related to higher well-being, with the strongest associations evident for young adults. Older adults reported the most frequent positive and least frequent negative social exchanges however, associations of social relations with affect tended to be stronger among young and midlife adults relative to older adults. Results are discussed in the context of life course perspectives on goal orientations and self-regulatory processes.

Cognitive, health, and sociodemographic predictors of longitudinal decline in hearing acuity among older adults

Publisher: Oxford University Press (OUP)

Date: 13-03-2012

DOI: 10.1093/GERONA/GLS066

Abstract: We aimed to investigate predictors of change in pure-tone hearing thresholds in older adults. Data were drawn from a pooled s le from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project (N = 4,221, mean age = 73.6, range: 50-103 years). Pure-tone hearing thresholds were tested for frequencies between 0.5 and 8 kHz, on up to four occasions over a period of 11 years. Linear mixed models tested for predictors of change in hearing. Hearing loss for high-range frequencies preceded decline in low-range frequencies. Men had higher baseline hearing thresholds, but women experienced faster rates of decline in hearing for mid- to high-range frequencies. The estimated rate of change for a 75-year-old adult was 0.91 decibel hearing level (dB HL) per year for pure-tone thresholds averaged over frequencies ranging between 0.5 and 4 kHz in the better ear. Baseline age (β = 0.03, p < .01), hypertension (β = 0.15, p < .01), and probable cognitive impairment (β = 0.40, p = .01) were independent predictors of annual rate of change in hearing thresholds. Incidence of probable cognitive impairment was also associated with higher hearing thresholds. Other known correlates for prevalence of hearing impairment, including low education, noise damage, diabetes, and history of stroke were independently associated with baseline levels of hearing but were not predictive of change in hearing thresholds. Faster rates of decline in hearing are predicted by probable cognitive impairment and hypertension.

Heterogeneity in the Health and Functional Capacity of Adults Aged 85+ as Risk for Mortality

Publisher: Wiley

Date: 29-01-2019

DOI: 10.1111/JGS.15780

Abstract: To examine whether older adults aged 85+, with different health and functional capacities, cluster in different ways and to demonstrate whether in iduals within particular clusters report differential mortality risk. Retrospective cohort study. The Dynamic Analyses to Optimize Aging (DYNOPTA) project is a harmonization project of nine Australian longitudinal surveys of health and well-being in adults aged 50+ between 1991 and 2006. Participants were 685 older adults (female = 52%) living in the community and aged 85 to 103 at baseline who were followed until death or December 31, 2006, for survivors. Latent class analysis (LCA) analyzed self-reported information on physical health, mental health, and functional capacity to define homogeneous classes based on probable cognitive impairment and depression status, medical conditions, and number of activities of daily living and instrumental activities of daily living. LCA discriminated four classes reflecting two main survival patterns. Two classes reported half the median survival days differences between these classes were related to high vs moderate depression and extent of functional limitations. Two classes reported better survival differences between these classes were related to functional limitations, but both had low proportions with depression and dementia. The classes with shorter survival were associated with substantively higher rates of depression and dementia. Higher rates of baseline depression and dementia were unique characteristics of those in iduals in the clusters that reported shorter survival. However, a substantial proportion of very old adults experience good mental health with better survival outcomes. J Am Geriatr Soc 67:1036-1042, 2019.

Does parity matter in women’s risk of dementia? A COSMIC collaboration cohort study

Publisher: Springer Science and Business Media LLC

Date: 05-08-2020

DOI: 10.1186/S12916-020-01671-1

Abstract: Dementia shows sex difference in its epidemiology. Childbirth, a distinctive experience of women, is associated with the risk for various diseases. However, its association with the risk of dementia in women has rarely been studied. We harmonized and pooled baseline data from 11 population-based cohorts from 11 countries over 3 continents, including 14,792 women aged 60 years or older. We investigated the association between parity and the risk of dementia using logistic regression models that adjusted for age, educational level, hypertension, diabetes mellitus, and cohort, with additional analyses by region and dementia subtype. Across all cohorts, grand multiparous (5 or more childbirths) women had a 47% greater risk of dementia than primiparous (1 childbirth) women (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.10–1.94), while nulliparous (no childbirth) women and women with 2 to 4 childbirths showed a comparable dementia risk to primiparous women. However, there were differences associated with region and dementia subtype. Compared to women with 1 to 4 childbirths, grand multiparous women showed a higher risk of dementia in Europe (OR = 2.99, 95% CI = 1.38–6.47) and Latin America (OR = 1.49, 95% CI = 1.04–2.12), while nulliparous women showed a higher dementia risk in Asia (OR = 2.15, 95% CI = 1.33–3.47). Grand multiparity was associated with 6.9-fold higher risk of vascular dementia in Europe (OR = 6.86, 95% CI = 1.81–26.08), whereas nulliparity was associated with a higher risk of Alzheimer disease (OR = 1.91, 95% CI 1.07–3.39) and non-Alzheimer non-vascular dementia (OR = 3.47, 95% CI = 1.44–8.35) in Asia. Parity is associated with women’s risk of dementia, though this is not uniform across regions and dementia subtypes.

Level of cognitive performance as a correlate and predictor of health behaviors that protect against cognitive decline in late life: The path through life study

Publisher: Elsevier BV

Date: 11-2009

DOI: 10.1016/J.INTELL.2008.10.001

Between- and Within-Individual Effects of Visual Contrast Sensitivity on Perceptual Matching, Processing Speed, and Associative Memory in Older Adults

Publisher: S. Karger AG

Date: 2006

DOI: 10.1159/000090958

Abstract: i Background: /i Although cross-sectional studies have demonstrated associations between visual contrast sensitivity and cognitive test performance, it remains unclear whether peripheral visual or perceptual factors explain the association. i Objective: /i We aimed at determining whether reducing static contrast of the study stimuli would simulate the performance deficits on measures of processing speed and associative memory that are associated with aging. i Methods: /i We investigated the mechanism by which vision and memory are associated in a s le of 91 volunteers aged 60–87 years. In tests of perceptual matching, digit-symbol matching, and associative memory, the level of static contrast of the stimuli was manipulated, with three contrast levels. The duration of stimuli presentation was also manipulated in the associative memory task in a full-factorial experimental design. Accuracy and response latencies (for correct trials) were measured. i Results: /i Experimental results showed that within subjects, lower contrast was associated with longer latencies, indicating an effect on information processing speed. Regression analyses replicated previous findings of a moderate to strong association between visual contrast sensitivity and cognitive performance in cross-sectional studies. i Conclusion: /i These results provide support for a theory in which visual aging is associated with slower encoding of information as well as being involved at a more central level.

Indigenous Australians are under-represented in longitudinal ageing studies

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1111/J.1753-6405.2011.00727.X

Abstract: Evidence-based policy depends on the availability of high-quality research that is relevant to the population. This study aimed to identify the available data on the health of older Indigenous Australians in population-based longitudinal studies of ageing. Evaluation of the Dynamic Analyses to Optimise Ageing Project (DYNOPTA) dataset that has pooled nine Australian longitudinal ageing studies, six of which were analysed here. Proportions of the DYNOPTA s le identified as Indigenous. Indigenous participants made up 0.7% of males and 0.5% of females in the weighted s le, compared with 0.8% of both sexes in the Australian population. Indigenous under-representation is greater at ages 45-54 than at older ages, despite overall greater participation in this age range. Within the existing Australian longitudinal ageing studies, Indigenous Australians are under-represented. This means there is a significant gap in the evidence base relating to the health of older Indigenous Australians. Research approaches specifically designed to address the health and wellbeing of older Indigenous Australians are urgently required.

Dynamic links of cognitive functioning among married couples: Longitudinal evidence from the Australian Longitudinal Study of Ageing.

Publisher: American Psychological Association (APA)

Date: 06-2009

DOI: 10.1037/A0015069

Abstract: Development does not take place in isolation close others form an important dyad for exploring interrelationships. To examine spousal interrelations in level and change of cognitive functioning in old age, the authors applied dynamic models to 11-year longitudinal data of, initially, 304 married couples from the Australian Longitudinal Study of Ageing (aged 64-98 years at Time 1 M = 76 years). Findings revealed that perceptual speed for husbands predicted subsequent perceptual speed decline for wives (time lags of 1 year). There was little evidence for the opposite unidirectional effect or a bidirectional association between husbands and wives. Potential covariates (age, education, medical conditions, functional limitations, and depressive symptoms) did not account for differential lead-lag associations. A similar, though less pronounced, pattern was found for memory, which held except when functional limitations were controlled. Findings suggest that late-life cognitive development is not solely a product of intrain idual resources and are consistent with conceptual notions that development actively influences, and is influenced by, contextual factors such as close relationships. The authors discuss possible underlying mechanisms and further steps to substantiate the findings.

Validating the role of the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI) and a genetic risk score in progression to cognitive impairment in a population-based cohort of older adults followed for 12 years

Publisher: Springer Science and Business Media LLC

Date: 04-03-2017

DOI: 10.1186/S13195-017-0240-3

Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20–76 years

Publisher: Springer Science and Business Media LLC

Date: 08-04-2021

DOI: 10.1038/S41598-021-86397-7

Abstract: Sex differences in late-life memory decline may be explained by sex differences in dementia risk factors. Episodic memory and dementia risk factors were assessed in young, middle-aged and older adults over 12 years in a population-based s le (N = 7485). For men in midlife and old age, physical, cognitive and social activities were associated with less memory decline, and financial hardship was associated with more. APOE e4 and vascular risk factors were associated with memory decline for women in midlife. Depression, cognitive and physical activity were associated with memory change in older women. Incident midlife hypertension (β = − 0.48, 95% CI − 0.87, − 0.09, p = 0.02) was associated with greater memory decline in women and incident late-life stroke accounted for greater memory decline in men (β = − 0.56, 95% CI − 1.12, − 0.01), p = 0.05). Women have fewer modifiable risk factors than men. Stroke and hypertension explained sex differences in memory decline for men and women respectively.

Stability and change in level of probable depression and depressive symptoms in a sample of middle and older-aged adults

Publisher: Cambridge University Press (CUP)

Date: 20-08-2012

DOI: 10.1017/S1041610212001470

Abstract: Background: Findings from studies investigating depression in adults in late life are mixed due to a lack of large longitudinal studies with the power necessary to yield reliable estimates of stability or change. We examined the long-term stability of probable depression and depressive symptomology over a 13-year period in the Dynamic Analyses to Optimize Ageing (DYNOPTA) project. Methods: Community-living participants ( N = 35,200) were aged 45–103 at baseline, predominantly female (79%), partnered (73%), and educated to secondary school only (61%) and followed for up to 13 years. Results: At baseline, increased age was associated with lower prevalence of probable depression and depressive symptomology. Over time, prevalence of probable depression was stable while levels of depressive symptomology reported a small decline. However, this finding was not consistent for all age groups there was evidence for increasing levels of depressive symptomology, but not probable depression, as in iduals aged. This effect was particularly notable among males aged 70 plus years. Conclusions: These results answer important questions relating to the longitudinal prevalence of probable depression and depressive symptomology in a s le of older Australians. These findings have policy implications for mental health service provision for older adults.

Being overweight is associated with hippocampal atrophy: The PATH Through Life Study

Publisher: Springer Science and Business Media LLC

Date: 04-06-2015

DOI: 10.1038/IJO.2015.106

Abstract: The prevalence of obesity has increased dramatically in the past two decades, with major implications for in idual well-being, population health and the economy. Of particular concern is the risk obesity presents for brain health and its consequences in an ageing population. These associations and their time course are not well understood, particularly after middle age. The aim of this study was to investigate whether being overweight/obese or having an increasing body weight is associated with hippoc al atrophy in early old age. Participants were 420 unimpaired (Mini-Mental State Examination >26) in iduals aged 60-64 years, living in the community and taking part in a large prospective study of ageing over an 8 year follow-up. Magnetic resonance imaging scans were collected at three assessments and the hippoc us was manually traced by expert neuroscientists. Multi-level analyses assessing the relationship between body mass index (BMI) and hippoc al atrophy over 8 years while controlling for important covariates were conducted. Analyses showed that BMI was negatively associated with left (coefficient: -10.65 mm(3) s.e. 4.81 P=0.027) and right (coefficient: -8.18 mm(3) s.e. 4.91 P=0.097) hippoc al volume at the first assessment. Over the follow-up period, those with a higher BMI experienced greater hippoc al atrophy and more so in the left (P=0.001) than in the right (P=0.058) hippoc us. The findings from this study provide important evidence indicating that being overweight or obese is associated with poorer brain health. These results are consistent with those of previous animal and human studies and further stress the importance of reducing the rate of obesity through education, population health interventions and policy.

Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction

Publisher: SAGE Publications

Date: 2019

DOI: 10.1177/2040622319880392

Abstract: Noncommunicable disease now contributes to the World Health Organization top 10 causes of death in low-, middle- and high-income countries. Particular ex les include stroke, coronary heart disease, dementia and certain cancers. Research linking clinical and lifestyle risk factors to increased risk of noncommunicable disease is now well established with ex les of confirmed risk factors, including smoking, physical inactivity, obesity and hypertension. However, despite a need to target our resources to achieve risk reduction, relatively little work has examined the overlap between the risk factors for these main noncommunicable diseases. Our high-level review draws together the evidence in this area. Using a systematic overview of reviews, we demonstrate the likely commonality of established risk factors having an impact on multiple noncommunicable disease outcomes. For ex le, systematic reviews of the evidence on physical inactivity and poor diet found each to be associated with increased risk of cancers, coronary heart disease, stroke, diabetes mellitus and dementia. We highlight the potential for targeted risk reduction to simultaneously impact multiple noncommunicable disease areas. These relationships now need to be further quantified to allow the most effective development of public health interventions in this area.

Trends in anticholinergic and opioid dispensing in older adults from 2004 to 2015: Results from the Personality and Total Health (PATH) Through Life Study

Publisher: Wiley

Date: 14-02-2021

DOI: 10.1111/AJAG.12915

Abstract: Due to potential adverse effects, guidelines recommend that anticholinergics and opioids be avoided in older adults unless necessary. This study examines the dispensing trends of these medications among older Australians. Data of 2222 PATH study (60+ cohort) participants were analysed. Medication dispensing data were obtained from the Pharmaceutical Benefits Scheme from April 2004 to March 2015. Temporal trends of prescriptions dispensed were assessed using joinpoint regression analysis. Of all dispensed prescriptions, 5.5% were for anticholinergics and opioids, and 46.2% of anticholinergics dispensed were anti‐depressants. Anticholinergic dispensing trend increased in 2004‐2015 (annual per cent change, APC = 3.4%), particularly for moderately anticholinergic medications (APC = 6.8%). Dispensing trend for opioids increased in 2004‐2011 (APC = 11.3%) and declined in 2011‐2015 (APC = −4.4%). While guidelines urge caution in prescribing these medications to older adults, dispensing increased over time in this study population.

Differential associations between sensory loss and neuropsychiatric symptoms in adults with and without a neurocognitive disorder

Publisher: Cambridge University Press (CUP)

Date: 20-07-2018

DOI: 10.1017/S1041610217001120

Abstract: To investigate the differential associations between sensory loss and neuropsychiatric symptoms among older adults with and without diagnosed neurocognitive disorder. The s le comprised 1,393 adults (52.3% men) aged between 72 and 79 years from a community-based cohort study. There were 213 cases of mild and 64 cases of major neurocognitive disorders. The main outcome was number of informant reported symptoms on the Neuropsychiatric Inventory (NPI). Sensory loss was defined by visual acuity worse the 0.3 logMAR (6/12 or 20/40) and self-reported hearing problems. Clinically relevant NPI symptoms were reported in 182 (13.1%) participants, but no in idual symptom occurred in more than 5% of the total s le. Among participants diagnosed with a major neurocognitive disorder, those with any sensory loss had over three times (95%CI: 1.72–11.78) greater rates of NPI symptoms than those with unimpaired levels of sensory functioning. There were no differences in the number of neuropsychiatric symptoms by type of sensory loss, and no additional risk associated with a dual sensory loss compared to a single sensory loss. There was no evidence of an association between sensory loss and number of neuropsychiatric symptoms among cognitively healthy adults. The extent to which this association is the result of underlying neuropathology, unmet need, or interpersonal factors is unclear. These findings have significant implications for dementia care settings, including hospitals and respite care, as patients with sensory loss are at increased risk of neuropsychiatric symptoms and may require additional psychosocial support. Interventions to manage sensory loss and reduce the impact of sensory limitations on neuropsychiatric symptoms are needed.

Corpus callosum size, reaction time speed and variability in mild cognitive disorders and in a normative sample

Publisher: Elsevier BV

Date: 2007

DOI: 10.1016/J.NEUROPSYCHOLOGIA.2006.11.020

Abstract: Intra-in idual variability in reaction time increases with age and with neurological disorders, but the neural correlates of this increased variability remain uncertain. We hypothesized that both faster mean reaction time (RT) and less intra-in idual RT variability would be associated with larger corpus callosum (CC) size in older adults, and that these associations would be stronger in adults with mild cognitive disorders. A normative s le (n=432) and a s le with mild cognitive disorders (n=57) were compared on CC area, RT mean and RT variability adjusting for age, sex, education, APOE genotype, smoking, alcohol consumption, grip strength, visual acuity, handedness and lung function. S les did not differ in CC area or intra-cranial volume. In the normative s le, simple RT (SRT) and choice RT (CRT) were negatively associated with CC area but there were minimal associations between CC area and intra-in idual RT variability. In the mild cognitive disorders s le, SRT, CRT and intra-in idual variability on the SRT task were associated with CC area. Increased RT variability explained up to 12.7 percent of the variance in CC area in the s le with mild cognitive disorders, but less than 1 percent of the variance in CC area in the normative s le. There were no associations with APOE genotype. We conclude that intra-in idual variability is associated with CC area in mild cognitive disorders, but not in normal aging. We propose that biological limits on reserve capacity must occur in mild cognitive disorders that result in stronger brain-behavior relationships being observed.

Objectively measured physical activity is associated with dorsolateral prefrontal cortex volume in older adults

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.NEUROIMAGE.2020.117150

Screening for dementia: A review of self- and informant-assessment instruments

Publisher: Cambridge University Press (CUP)

Date: 21-02-2008

DOI: 10.1017/S104161020800673X

Retirement and mental health: Analysis of the Australian national survey of mental health and well-being

Publisher: Elsevier BV

Date: 03-2006

DOI: 10.1016/J.SOCSCIMED.2005.07.013

Abstract: Nation-wide research on mental health problems amongst men and women during the transition from employment to retirement is limited. This study sought to explore the relationship between retirement and mental health across older adulthood, whilst considering age and known risk factors for mental disorders. Data were from the 1997 National Survey of Mental Health and Well-being, a cross-sectional survey of 10,641 Australian adults. The prevalence of depression and anxiety disorders was analysed in the sub-s le of men (n = 1928) and women (n = 2261) aged 45-74 years. Mental health was assessed using the Composite International Diagnostic Instrument. Additional measures were used to assess respondents' physical health, demographic and personal characteristics. The prevalence of common mental disorders diminished across increasing age groups of men and women. Women aged 55-59, 65-69, and 70-74 had significantly lower rates of mental disorders than those aged 45-49. In contrast, only men aged 65-69 and 70-74 demonstrated significantly lower prevalence compared with men aged 45-49. Amongst younger men, retirees were significantly more likely to have a common mental disorder relative to men still in the labour force however, this was not the case for retired men of, or nearing, the traditional retirement age of 65. Men and women with poor physical health were also more likely to have a diagnosable mental disorder. The findings of this study indicate that, for men, the relationship between retirement and mental health varies with age. The poorer mental health of men who retire early is not explained by usual risk factors. Given current policy changes in many countries to curtail early retirement, these findings highlight the need to consider mental health, and its influencing factors, when encouraging continued employment amongst older adults.

Intraindividual variability is a fundamental phenomenon of aging: Evidence from an 8-year longitudinal study across young, middle, and older adulthood

Publisher: American Psychological Association (APA)

Date: 2014

DOI: 10.1037/A0032650

Abstract: Moment-to-moment intrain idual variability (IIV) in cognitive speed is a sensitive behavioral indicator of the integrity of the aging brain and brain damage, but little information is known about how IIV changes from being relatively low in young adulthood to substantially higher in older adulthood. We evaluated possible age group, sex, and task differences in IIV across adulthood using a large, neurologically normal, population-based s le evaluated thrice over 8 years. Multilevel modeling controlling for education, diabetes, hypertension, and anxiety and depressive symptoms showed expected age group differences in baseline IIV across the adult lifespan. Increase in IIV was not found until older adulthood on simple tasks but was apparent even in the 40s on a more complex task. Females were more variable than males but only at baseline. IIV in cognitive speed is a fundamental behavioral characteristic associated with growing older, even among healthy adults.

Alzheimer's Environmental and Genetic Risk Scores are Differentially Associated with General Cognitive Ability and Dementia Severity

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 04-2019

DOI: 10.1097/WAD.0000000000000292

Hormone replacement therapy and cognitive performance in postmenopausal women - A review by cognitive domain

Publisher: Elsevier BV

Date: 2012

DOI: 10.1016/J.NEUBIOREV.2005.05.003

Abstract: Laboratory, animal and neuroimaging evidences suggest that hormone replacement therapy (HRT) may be beneficial to human cognition. This systematic review includes 26 studies on the association between HRT and cognition and 17 studies on HRT and risk of dementia. It was hypothesised that HRT would have a positive association with cognitive speed and verbal memory and possibly visual memory but not with executive functioning, and would be associated with a decreased risk of dementia. Evidence for HRT's neuroenhancing and neuroprotective properties was also evaluated. There was significant statistical and clinical heterogeneity among studies precluding meta-analysis. Results showed no consistent relationship between HRT and performance in any cognitive domain. Cross-sectional studies tended to report more positive results than longitudinal studies and randomised-controlled trials, particularly in the areas of verbal memory and executive functioning. HRT was associated with decreased risk of dementia in observational studies, but with increased risk in one randomised-controlled trial. Cognitive improvement or maintenance are not secondary benefits of HRT.

The epidemiology of driving in later life: Sociodemographic, health and functional characteristics, predictors of incident cessation, and driving expectations

Publisher: Elsevier BV

Date: 10-2017

DOI: 10.1016/J.AAP.2017.07.026

Abstract: To describe population-level characteristics of drivers and non-drivers in a cohort of older Australians and identify predictors of driving cessation and expectations. The s le comprised the oldest cohort of the PATH Through Life project who were assessed 4 times between 2001 and 2013. At waves 3 and 4 questions on driving were included in the study interview. Data were also collected on health, physical and cognitive function and psychosocial wellbeing. Descriptive analyses compared drivers and non-drivers on sociodemographic, health and functional variables and regression models identified predictors of cessation and driving expectations. 92.5% of the s le were current drivers. They reported better physical, mental and cognitive health than non-drivers. Drivers expected to drive for another 12.6 years, the majority drove 6+ days per week. Four percent of the s le ceased driving over the four year follow-up. Predictors of cessation were financial problems, driving expectations and driving fewer kilometres per week. Predictors of expectations were poorer self-rated health, mastery, difficulties reading maps, self-rated visual function, years of driving experience, and fewer kilometres driven per week. Driving is normative for many older Australians in their 70s. Similar factors are associated with actual cessation and expectation of driving suggesting that older adults do have a sense of their expected driving life.

Yoga-based exercise to prevent falls in community-dwelling people aged 60 years and over: study protocol for the Successful AGEing (SAGE) yoga randomised controlled trial

Publisher: BMJ

Date: 09-2020

DOI: 10.1136/BMJSEM-2020-000878

Abstract: Falls significantly reduce independence and quality of life in older age. Balance-specific exercise prevents falls in people aged 60+ years. Yoga is growing in popularity and can provide a high challenge to balance however, the effect of yoga on falls has not been evaluated. This trial aims to establish the effect on falls of a yoga exercise programme compared with a yoga relaxation programme in community-dwellers aged 60+ years. This randomised controlled trial will involve 560 community-dwelling people aged 60+ years. Participants will be randomised to either: (1) the Successful AGEing ( SAGE ) yoga exercise programme or (2) a yoga relaxation programme. Primary outcome is rate of falls in the 12 months post randomisation. Secondary outcomes include mental well-being, physical activity, health-related quality of life, balance self-confidence, physical function, pain, goal attainment and sleep quality at 12 months after randomisation. The number of falls per person-year will be analysed using negative binomial regression models to estimate between-group difference in fall rates. Generalised linear models will assess the effect of group allocation on the continuously scored secondary outcomes, adjusting for baseline scores. An economic analysis will compare the cost-effectiveness and cost-utility of the two yoga programmes. Protocol was approved by the Human Research Ethics Committee at The University of Sydney, Australia (approval 2019/604). Trial results will be disseminated via peer-reviewed articles, conference presentations, lay summaries. The protocol for this trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).

Associations between Traffic-Related Air Pollution and Cognitive Function in Australian Urban Settings: The Moderating Role of Diabetes Status

Publisher: MDPI AG

Date: 27-05-2022

DOI: 10.3390/TOXICS10060289

Abstract: Traffic-related air pollution (TRAP) is associated with lower cognitive function and diabetes in older adults, but little is known about whether diabetes status moderates the impact of TRAP on older adult cognitive function. We analysed cross-sectional data from 4141 adults who participated in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study in 2011–2012. TRAP exposure was estimated using major and minor road density within multiple residential buffers. Cognitive function was assessed with validated psychometric scales, including: California Verbal Learning Test (memory) and Symbol–Digit Modalities Test (processing speed). Diabetes status was measured using oral glucose tolerance tests. We observed positive associations of some total road density measures with memory but not processing speed. Minor road density was not associated with cognitive function, while major road density showed positive associations with memory and processing speed among larger buffers. Within a 300 m buffer, the relationship between TRAP and memory tended to be positive in controls (β = 0.005 p = 0.062), but negative in people with diabetes (β = −0.013 p = 0.026) and negatively associated with processing speed in people with diabetes only (β = −0.047 p = 0.059). Increased TRAP exposure may be positively associated with cognitive function among urban-dwelling people, but this benefit may not extend to those with diabetes.

The value of comparing health outcomes in cohort studies: An example of self-rated health in seven studies including 79 653 participants

Publisher: Wiley

Date: 22-11-2007

DOI: 10.1111/J.1741-6612.2007.00261.X

The global financial crisis and psychological health in a sample of Australian older adults: A longitudinal study

Publisher: Elsevier BV

Date: 10-2011

DOI: 10.1016/J.SOCSCIMED.2011.06.063

Abstract: Economic stress and uncertainty is argued to increase older adults' vulnerability to physical health decline and mental distress. Nevertheless, there is a paucity of research that examines the relationship between a large historical economic event, such as the recent global financial crisis (GFC), and health outcomes for older adults. This study provides a unique opportunity to compare self-reported health status and psychological functioning (number of depression and anxiety symptoms) in 1973 older Australian adults (mean age of 66.58 years (SD = 1.5)) prior to the GFC (2005-2006), with their status four years later during the GFC period (2009-2010). Latent difference score models revealed a significant difference in depression and anxiety symptoms over the two measurement occasions, indicating poorer psychological functioning for those who reported an impact as a result of the economic slowdown. These effects were not explained by demographic or socio-economic factors. Interaction effects showed that those participants who were surveyed within the acute salience period of the GFC (April to September 2009) were significantly less likely to report poorer psychological health over time compared to those who were surveyed after September 2009. This interesting timing effect is discussed in terms of potential time-lags in the negative effects of economic stress on health outcomes, as well as the possible protective effects of social norms that may be created by a large scale economic crisis.

Trajectory of blood pressure, body mass index, cholesterol and incident dementia: Systematic review

Publisher: Royal College of Psychiatrists

Date: 08-2020

DOI: 10.1192/BJP.2019.156

Abstract: The global ageing population and the long prodromal period for the development of cognitive decline and dementia brings a need to understand the antecedents of both successful and impaired cognitive ageing. It is increasingly apparent that the trajectory of risk-factor change, as well as the level of the risk factor, may be associated with an increased or decreased risk of cognitive decline or dementia. Our aim was to summarise the published evidence and to generate hypotheses related to risk-factor trajectories and risk of incident cognitive decline or dementia. We collated data from longitudinal observational studies relating to trajectory of blood pressure, obesity and cholesterol and later cognitive decline or dementia using standard systematic review methodology. The databases MEDLINE, Embase and PsycINFO were searched from inception to 26 April 2018. Thirteen articles were retained for inclusion. Analytical methods varied. Our summary of the current evidence base suggests that first body mass index and then blood pressure rises and then falls more steeply in those who go on to develop dementia. The evidence for cholesterol was less consistent. Based on our review we present the hypothesis that weight falls around 10 years and blood pressure around 5 years before diagnosis. Confirmatory work is required. However, characterisation of risk according to combinations and patterns of risk factors may ultimately be integrated into the assessments used to identify those at risk of receiving a diagnosis of cognitive decline or dementia in late life.

Dietary mineral intake and risk of mild cognitive impairment: The PATH through life project

Publisher: Frontiers Media SA

Date: 2014

DOI: 10.3389/FNAGI.2014.00004

The brain reserve hypothesis, brain atrophy and aging

Publisher: S. Karger AG

Date: 20-10-2007

DOI: 10.1159/000096482

Abstract: i Background: /i Researchers have used the concept of brain reserve to explain the dissociation between pathological brain damage and cognitive and functional performance. A variety of brain reserve hypotheses exist, and different empirical strategies have been employed to investigate these variants. i Objective: /i The study investigates (i) the relationship between measures of brain burden (atrophy, white matter hyperintensities (WMH)) and measures of reserve (education, creativity, and intelligence) (ii) the relationship between cognitive decline and reserve (iii) whether measures of reserve mediate the effect of atrophy on estimated cognitive change, and (iv) the association between brain risk factors, education and atrophy. i Methods: /i A cross-sectional study of a s le of 446 in iduals 60–64 years of age who underwent MRI scans as part of a large epidemiological study. Measures were taken of education, intelligence, creativity, cognitive speed, brain volume, WMH, estimated cognitive decline from earlier in life and brain atrophy. i Results: /i No association was found between estimated cognitive decline and brain burden (atrophy, WMH). Risk factors for brain insult were not associated with greater brain atrophy in the less well educated. Neither education, nor any other measure including intelligence or creativity, provided a buffer for cognitive decline in in iduals with high levels of brain atrophy. i Conclusion: /i Little support was found for the brain reserve hypothesis.

Cohort profile: The PATH through life project

Publisher: Oxford University Press (OUP)

Date: 24-02-2012

DOI: 10.1093/IJE/DYR025

Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: the COSMIC consortium

Publisher: Cold Spring Harbor Laboratory

Date: 31-08-2023

DOI: 10.1101/2023.08.30.23294876

Mental health and the timing of Men's retirement

Publisher: Springer Science and Business Media LLC

Date: 13-04-2006

DOI: 10.1007/S00127-006-0064-0

Abstract: Analysis of the Psychiatric Morbidity Survey of Great Britain showed that the prevalence of common mental disorders was lower amongst men at or above Britain's state pension age of 65, relative to younger men. Retirees below this age had consistently higher rates of mental disorders than working men. In contrast, the low prevalence of mental disorders amongst retirees aged 65 and older was similar to that of their working peers. The aim of this analysis was to investigate this pattern of results in a national s le of Australian men, and the mediating role of socio-demographic factors. Data were from the Household, Income and Labour Dynamics (HILDA) in Australia survey (2003). The analyses included men aged 45-74 years who were active in the labour force (n = 1309), or retired (n = 635). Mental health was assessed using the mental health scale from the Short-Form 36 Health Questionnaire. Retirees were more likely to have mental health problems than their working peers, however this difference was progressively smaller across age groups. For retirees above, though not below, the age of 55 this difference was explained by poorer physical functioning. When age at retirement was considered it was found that early retirees who were now at or approaching the conventional retirement age did not display the substantially elevated rates of mental health problems seen in their younger counterparts. Further, men who had retired at age 60 or older did not display an initially elevated rate of mental health problems. The association between retirement and mental health varies across older adulthood. Retired British and Australian men below the conventional retirement age of 65 are more likely to have mental health problems relative to their working peers, and retirees above this age. However, poor mental health appears to be linked to being retired below this age rather than an enduring characteristic of those who retire early.

A Multidomain Approach for Predicting Older Driver Safety Under In-Traffic Road Conditions

Publisher: Wiley

Date: 18-04-2008

DOI: 10.1111/J.1532-5415.2008.01709.X

Abstract: To identify a battery of tests that predicts safe and unsafe performance on an on-road assessment of driving. Prospective cohort study. University laboratory assessment and an on-road driving test. Two hundred seventy community-living adults aged 70 to 88 recruited through the electoral roll. Performance on a battery of multidisciplinary tests and on a standardized measure of on-road driving performance. A combination of three tests from the vision, cognitive, and motor domains, including motion sensitivity, color choice reaction time, postural sway on a compliant foam rubber surface, and a self-reported measure of driving exposure, was able to classify participants into safe and unsafe driver groups with sensitivity of 91% and specificity of 70%. In a s le of licensed older drivers, a short battery of tests and a self-reported measure of driving exposure were able to accurately predict driving safety.

Self-reported cognitive decline on the informant questionnaire on cognitive decline in the elderly is associated with dementia, instrumental activities of daily living and depression but not longitudinal cognitive change

Publisher: S. Karger AG

Date: 2013

DOI: 10.1159/000345439

Abstract: A subjective history of cognitive decline is integral to dementia screening, yet there are few data on the accuracy of retrospective self-reports. We prospectively examined the longitudinal predictors of self-reported decline, including rate of cognitive change, clinical diagnosis, depressive symptoms and personality. We used a large (n = 2,551) community-dwelling s le of older adults (60-64 years at baseline) and tracked their cognitive functioning over 3 waves across a period of 8 years. In idual rates of change in multiple domains of cognition, incident dementia and mild cognitive disorders, apolipoprotein E (APOE) ε4 genotype, level of education, depressive symptoms and personality were examined as predictors of wave 3 retrospective self-reported decline as measured by the Informant Questionnaire on Cognitive Decline in the Elderly. The rate of cognitive decline did not predict subjective decline. Significant predictors of self-reported decline included dementia diagnosis, problems with instrumental activities of daily living, depression and neuroticism at the time of self-report, as well as the presence of an APOE ε4 allele. In this relatively young cohort, retrospective self-report of cognitive decline does not reflect objective deterioration in cognition over the time period in question, but it may identify in iduals in the initial stages of dementia and those with elevated psychological and genotypic risk factors for the development of dementia.

An Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled Tr

Publisher: JMIR Publications Inc.

Date: 17-04-2020

DOI: 10.2196/PREPRINTS.19431

Abstract: here is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. his study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m sup /sup or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation (2) a single clinician–led group, Lifestyle Modification Program (LMP) and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). aseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means −3.86, 95% CI −6.81 to −0.90, i P /i =.01 week 18: difference in means −4.05, 95% CI −6.81 to −1.28, i P /i & .001 week 36: difference in means −4.99, 95% CI −8.04 to −1.94, i P /i & .001 and week 62: difference in means −4.62, 95% CI −7.62 to −1.62, i P /i & .001). web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small s le size, and replication on a larger s le with longer follow-up will strengthen the results. ustralian clinical trials registration number (ACTRN): 12616000868482 anzctr.org.au/ACTRN12616000868482.aspx.

Cognitive Deficits Are Associated with Frontal and Temporal Lobe White Matter Lesions in Middle-Aged Adults Living in the Community

Publisher: Public Library of Science (PLoS)

Date: 21-10-2010

DOI: 10.1371/JOURNAL.PONE.0013567

Subjective memory complaints and incident dementia in a high risk older adult hypertensive population

Publisher: Oxford University Press (OUP)

Date: 07-01-2019

DOI: 10.1093/AGEING/AFY193

Abstract: there is a growing body of evidence demonstrating an association between subjective memory complaints (SMC) and an increased risk of incident cognitive decline or dementia. To date this has not been examined in hypertensive older adults, a prevalent and growing population group at high risk of cognitive decline. using data from participants in the Hypertension in the Very Elderly Trial cohort the association between baseline SMC and incident cognitive decline and dementia was examined using Cox proportional hazard regression. Cognitive function was assessed using the Mini-Mental State Exam and diagnoses of dementia were made using standard diagnostic criteria. SMC was assessed by the question 'do you feel that you have more problems with memory than most?' Analyses were rerun to examine the associations by level of baseline cognitive function, to evaluate the role of SMC by dementia type and by sex. baseline SMC were associated with an increased risk of developing any dementia (hazard ratio (HR)1.63 (95% confidence intervals (CI): 1.18:2.25)), Alzheimer's disease (HR1.59 (95% CI: 1.08:2.34)) and vascular dementia (HR2.05 (95% CI: 1.19:3.54)). Similar patterns were seen across all levels of baseline MMSE but were strongest in those with scores of 25-27. There were no clear differences by sex. a positive report of SMC assessed by a single question in an older adult with hypertension raises the possibility of increased risk of incident dementia. As such its use may be a useful addition to the repertoire of the general practitioner and geriatrician when assessing older adults.

Older drivers in australia: Trends in driving status and cognitive and visual impairment

Publisher: Wiley

Date: 10-2009

DOI: 10.1111/J.1532-5415.2009.02439.X

Abstract: To investigate self-reported driving status within three Australian states associations between demographic, health, and functional factors and driving status and the extent to which remaining a driver in spite of cognitive and visual impairments varies as a function of sex. Secondary data analysis of a pooled data set. Australian communities. Adults aged 65 to 103 (N=5,206) from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. DYNOPTA is a unique data set created through the harmonization and pooling of data across nine separate Australian longitudinal studies of aging conducted between 1990 and 2007 (N=50,652). Driving status, demographic characteristics, Mini-Mental State Examination score, visual acuity, physical activity, and occupation. Men and participants with higher-level occupations had greater odds of driving. Older age, more medical conditions, and poorer vision increased the odds of not driving. Persons who were orced, widowed, or never married were at a greater risk than married adults of not driving. Descriptive analyses revealed a large proportion of men with probable visual or cognitive impairments who reported driving. Subsequent comparative analyses between the DYNOPTA s le and other published U.S. and Canadian data revealed lower proportions of current drivers among Australian women and those at older ages, although there were consistently lower proportions of drivers within Australia and Canada than in the United States. The rate of men with probable dementia or visual impairments who reported driving is of particular concern. Research and policy need to focus on evidence-based assessment of older drivers and development of appropriate interventions and programs to maintain the mobility and independence of older adults.

The utility of estimating population-level trajectories of terminal wellbeing decline within a growth mixture modelling framework

Publisher: Springer Science and Business Media LLC

Date: 10-08-2015

DOI: 10.1007/S00127-014-0948-3

Abstract: Mortality-related decline has been identified across multiple domains of human functioning, including mental health and wellbeing. The current study utilised a growth mixture modelling framework to establish whether a single population-level trajectory best describes mortality-related changes in both wellbeing and mental health, or whether subpopulations report quite different mortality-related changes. Participants were older-aged (M = 69.59 years SD = 8.08 years) deceased females (N = 1,862) from the dynamic analyses to optimise ageing (DYNOPTA) project. Growth mixture models analysed participants' responses on measures of mental health and wellbeing for up to 16 years from death. Multi-level models confirmed overall terminal decline and terminal drop in both mental health and wellbeing. However, modelling data from the same participants within a latent class growth mixture framework indicated that most participants reported stability in mental health (90.3 %) and wellbeing (89.0 %) in the years preceding death. Whilst confirming other population-level analyses which support terminal decline and drop hypotheses in both mental health and wellbeing, we subsequently identified that most of this effect is driven by a small, but significant minority of the population. Instead, most in iduals report stable levels of mental health and wellbeing in the years preceding death.

A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms

Publisher: Elsevier BV

Date: 11-2004

DOI: 10.1016/J.JCLINEPI.2003.11.011

Abstract: This study determined whether self-reported Traumatic Brain Injury (TBI), identified in a community s le and occurring up to 60 years previously, is associated with current psychiatric symptoms, suicidality, and psychologic well-being. Three age cohorts (20-24, 40-44, 60-64) were randomly s led from the cities of Canberra and Queanbeyan, Australia, yielding a total of 7,485 participants. The s les were administered scales measuring anxiety, depression, suicidality, positive and negative affect, personality traits, and physical health status. Of the total s le, 5.7% reported history of TBI involving loss of consciousness for at least 15 min, occurring an average of 22 years previously. History of TBI was associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation. History of TBI is a risk factor for psychiatric morbidity. The effect is greatest in young adults, and occurs up to several decades subsequent to the occurrence of TBI.

Higher normal Fasting plasma glucose is associated with hippocampal atrophy the path study

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 03-09-2012

DOI: 10.1212/WNL.0B013E31826846DE

Higher fasting plasma glucose is associated with smaller striatal volume and poorer fine motor skills in a longitudinal cohort

Publisher: Elsevier BV

Date: 08-2018

DOI: 10.1016/J.PSCYCHRESNS.2018.06.002

Abstract: Previous studies have demonstrated associations between higher blood glucose and brain atrophy and functional deficits, however, little is known about the association between blood glucose, striatal volume and striatal function despite sensori-motor deficits being reported in diabetes. This study investigated the relationship between blood glucose levels, striatal volume and fine motor skills in a longitudinal cohort of cognitively healthy in iduals living in the community with normal or impaired fasting glucose or type 2 diabetes. Participants were 271 cognitively healthy in iduals (mean age 63 years at inclusion) with normal fasting glucose levels (<5.6 mmol/L) (n=173), impaired fasting glucose (5.6-6.9 mmol/L) (n=57), or with type 2 diabetes (≥7.0 mmol/L) (n=41). Fasting glucose, Purdue Pegboard scores as measurement of fine motor skills, and brain scans were collected at wave 1, 2 and 4, over a total follow-up of twelve years. Striatal volumes were measured using FreeSurfer after controlling for age, sex and intracranial volume. Results showed that type 2 diabetes was associated with smaller right putamen volume and lower Purdue Pegboard scores after controlling for age, sex and intracranial volume. These findings add to the evidence suggesting that higher blood glucose levels, especially type 2 diabetes, may impair brain structure and function.

Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-2021

DOI: 10.1161/HYPERTENSIONAHA.121.17797

Abstract: Research links high blood pressure variability (BPV) with stroke and cerebrovascular disease, however, its association with cognition remains unclear. Moreover, it remains uncertain which BP-derived parameter (ie, variability or mean) holds more significance in understanding vascular contributions to cognitive impairment. We searched PubMed, Embase, PsycINFO, and Scopus and performed a meta-analysis of studies that quantified the association between resting BPV with dementia or cognitive impairment in adults. Two authors independently reviewed all titles, abstracts, and full-texts and extracted data, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Study quality was assessed using the (modified) Newcastle-Ottawa Scale. A multilevel meta-analysis was used, which included effect sizes for both BPV and mean BP, with a combined end point of dementia or cognitive impairment as primary outcome. In the primary analysis, 54 effect sizes were extracted from 20 studies, with a total analytical s le of n=7 899 697. Higher systolic BPV (odds ratio [OR], 1.25 [95% CI, 1.16–1.35]), mean systolic pressure (OR, 1.12 [95% CI, 1.02–1.29]), diastolic BPV (OR, 1.20 [95% CI, 1.12–1.29]), and mean diastolic pressure (OR, 1.16 [95% CI, 1.04–1.29]) were associated with dementia and cognitive impairment. A direct comparison showed that mean BP effect sizes were less strong than BPV effect sizes (OR, 0.92 [95% CI, 0.87–0.97], P .01), indicating that the relative contribution of BPV exceeded that of mean BP. Methodological and statistical heterogeneity was high. Secondary analyses were less consistent as to whether BPV and mean BP were differentially associated with dementia subtypes and cognitive domains. Future studies are required to investigate BPV as a target for dementia prevention.

Relationships between cognitive function and frontal grey matter volumes and thickness in middle aged and early old-aged adults: The PATH Through Life Study

Publisher: Elsevier BV

Date: 04-2011

DOI: 10.1016/J.NEUROIMAGE.2011.01.015

Abstract: The study examined the relationship of lateral frontal cortical volume and thickness with cognitive function in two s les of healthy middle aged (MA, 44-48 years old) and early old-age (OA, 64-68 years old) adults. T1-weighted magnetic resonance imaging scans were acquired in 400 MA and 397 OA adults from respective random community s les. Cortical volumes and thickness were measured with a surface-based segmentation procedure (surfer.nmr.mgh.harvard.edu). Volumes of lateral frontal grey matter were found to be significantly lower for OA than MA. Structure-function relationships were investigated using path analyses. In OA, smaller lateral frontal volumes were associated with better episodic memory (EM) (p<0.012, B=-0.117), and Symbol-Digit Modalities Test (SDM) (p<0.031, B=-0.118) performance. Smaller frontal cortical thickness was also associated with better EM (p<0.01) and SDM (p<0.01) performance in OA. However, in MA greater cortical thickness was associated with better EM and (p<0.01) and reaction time (RT) (p<0.01). OA cohort showed significant positive correlations between Total Brain Volume and SDM, Digit-Backwards span and RT. Possible explanations and implications of the relationships in the context of cognitive aging in healthy adults, and limitations of cross-sectional research are discussed.

Post-Starburst Galaxies: Why Aren’t They Forming Stars?

Publisher: AIP

Date: 2010

DOI: 10.1063/1.3458466

An epidemiological study of falls in older community‐dwelling women: the Randwick falls and fractures study

Publisher: Wiley

Date: 12-02-1993

DOI: 10.1111/J.1753-6405.1993.TB00143.X

Abstract: Seven hundred and four women aged between 65 and 99 years (mean age 74.6 years), who were randomly selected from the community, took part in a study to determine whether health and lifestyle factors were associated with falls. In the 12 months before the survey, 66.1 per cent of the subjects experienced no falls, 19.7 per cent fell once and 14.2 per cent fell on two or more occasions. The proportion of women who fell outside the home decreased with age, with a corresponding increase in the proportion who fell inside the home on a level surface. The most common causes of falls reported were trips, slips and loss of balance. Some (27 per cent) suffered injuries as a result of a fall, and the proportion suffering injuries increased with age. Those who rated their health and balance as impaired, those with a limitation in activities of daily living, those receiving community services, those taking psychoactive drugs, and those taking four or more drugs had significantly more falls. On the other hand, those taking part in planned exercise and those active for seven or more hours per week had fewer falls. Smoking and alcohol consumption were not significantly associated with falls. Stepwise logistic regression analysis revealed poor vision, inactivity and subjective fall risk as variables that were independently and significantly associated with falling. These findings highlight possible intervention strategies for reducing falls risk in older people.

Subjective Well-Being Mediates the Effects of Resilience and Mastery on Depression and Anxiety in a Large Community Sample of Young and Middle-Aged Adults

Publisher: SAGE Publications

Date: 03-2011

DOI: 10.3109/00048674.2010.529604

Abstract: Objective: The tripartite model of depression and anxiety hypothesizes that positive and negative affect is related to depression and anxiety. However, the specific role of cognitive or psychological well-being constructs like resilience and mastery within a tripartite context and throughout adulthood is unclear. Method: Data was drawn from two longitudinal population-based cohorts, aged 20–24 and 40–44 based in Canberra, Australia (N = 3989). We sought to determine the interrelatedness of two affective measures of subjective well-being, positive and negative affect, with two cognitive measures of psychological well-being, resilience and mastery. We then tested their independent effects on depression and anxiety, and hypothesized, following the tripartite model, that subjective well-being would mediate the effects of the psychological well-being variables on mental health and that the psychological well-being variables would be more strongly related to positive subjective well-being. Results: Principal axis factoring delineated four affective and cognitive dimensions of well-being comprising positive and negative affect, resilience and mastery. Structural equation models identified the psychological well-being variables as significantly related to subjective well-being, which fully mediated the effects of resilience and partially mediated the effect of mastery on depression and anxiety. These findings were consistent throughout both young and middle adulthood. Conclusions: Psychological well-being components are significant predictors of subjective well-being affect states that increase vulnerability to depression and anxiety.

Dementia Stigma Reduction (DESeRvE): Study protocol for a randomized controlled trial of an online intervention program to reduce dementia-related public stigma

Publisher: Elsevier BV

Date: 06-2019

DOI: 10.1016/J.CONCTC.2019.100351

Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies.

Publisher: Wiley

Date: 12-12-2014

DOI: 10.1002/GPS.4245

Abstract: Dementia has a multifactorial etiology, but the importance of in idual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning. A mixed-method approach combined findings from a systematic literature review and a Delphi consensus study. The literature search was conducted in PubMed and updated an earlier review by the United States National Institutes of Health from 2010. We reviewed the available evidence from observational epidemiological studies. The online Delphi study asked eight international experts to rank and weigh each risk factor for its importance for dementia prevention. Out of 3127 abstracts, 291 were included in the review. There was good agreement between modifiable risk factors identified in the literature review and risk factors named spontaneously by experts. After triangulation of both methods and re-weighting by experts, strongest support was found for depression, (midlife) hypertension, physical inactivity, diabetes, (midlife) obesity, hyperlipidemia, and smoking, while more research is needed for coronary heart disease, renal dysfunction, diet, and cognitive activity. Findings provide good support for several somatic and lifestyle factors and will be used to inform the design of a new multicenter trial into dementia prevention.

Hippocampus and amygdala volumes in a random community-based sample of 60-64 year olds and their relationship to cognition

Publisher: Elsevier BV

Date: 12-2007

DOI: 10.1016/J.PSCYCHRESNS.2007.06.005

Abstract: Reduced volumes of the hippoc us (HC) and amygdala (AG) are potential biomarkers for Alzheimer's disease (AD) and other neuropsychiatric disorders. Published studies on HC and AG volumes suffer from methodological limitations, and a valid and reliable normative database does not exist. This study aimed to establish a database of HC and AG volumes from a large community s le of participants 60-64 years old and relate them to cognition. A total of 452 randomly selected participants (from 622 approached) were retained in the study (238 males, 214 females), and all received brain MRI scans, as well as cognitive and physical assessments. HC and AG volumes were estimated from manual tracings on T1-weighted images, and intracranial volume (ICV) was obtained from an automated program. In both sexes, right hippoc i were larger than left, while left amygdala were larger than right. The only correlation to remain significant after normalization was left HC volume and percent retention of a word list in females. This study provides a HC and AG volumetrics database and describes its relationship with cognitive performance in a representative s le using a standard methodology that will be a reference for future studies. It will therefore have clinical applicability in early AD and other disorders.

Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice

Publisher: Wiley

Date: 03-10-2016

DOI: 10.1111/1440-1630.12309

Abstract: The first evidence-based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence-based recommendations for occupational therapists. The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy. Common characteristics of effective occupational therapy programmes for people with dementia are described. Guideline development involved adaptation of existing high-quality guidelines developed overseas and 17 systematic reviews to ensure that the most recent high-quality evidence was included. One of the systematic reviews involved examining the evidence for interventions to promote independence in people with dementia. Specifically, we looked at the evidence for occupational therapy and its effect on activities of daily living, quality of life and carer impact. A total of 109 recommendations are included in the Guidelines. Occupational therapy was found to significantly increase independence in activities of daily living and improve quality of life. Effective occupational therapy programmes involve: environmental assessment, problem solving strategies, carer education and interactive carer skills training. Occupational therapists working with people with dementia in community settings should ensure that their time is spent on those aspects of intervention that are shown to be effective.

Midlife susceptibility to the effects of poor diet on diabetes risk

Publisher: Springer Science and Business Media LLC

Date: 10-07-2020

DOI: 10.1038/S41430-020-0673-9

Blood pressure and dementia: What the SPRINT-MIND trial adds and what we still need to know.

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 24-04-2019

DOI: 10.1212/WNL.0000000000007543

Sex differences in cortical thickness in middle aged and early old-aged adults: Personality and Total Health Through Life study

Publisher: Springer Science and Business Media LLC

Date: 07-03-2013

DOI: 10.1007/S00234-013-1144-Y

Abstract: The study investigated sex differences in cortical thickness in middle-aged (MA, 44-48 years old, n = 397) and early old-aged (OA, 64-68 years old, n = 398) adults in a community-based s le. T1-weighted three-dimensional structural magnetic resonance imaging scans were acquired in a Fast Field Echo sequence, and cortical thickness was measured with a surface-based segmentation procedure ( surfer.nmr.mgh.harvard.edu ). Results showed that after correcting for age, MA males had predominantly thicker superior temporal cortices, while MA females had thicker occipital, posterior cingulate, precentral, and postcentral cortices. Sex differences in OA adults were less prominent than those in MA adults with females showing thicker temporal and posterior cingulate cortices and males showing thicker rostral middle frontal regions. Between-cohort comparisons revealed that when compared with MA males, OA males showed many regions with significantly thinner cortices, but this pattern was less pronounced for OA females. Our results suggest that sex differences in cortical thickness are age specific, as larger differences in cortical thickness were found in MA compared to OA adults. The results of the present study indicate that the inconsistencies in sexual dimorphism that have been reported in the literature are partly due to the variable and transitory nature of cortical thickness differences with age.

Effect of tailored on-road driving lessons on driving safety in older adults: A randomised controlled trial

Publisher: Elsevier BV

Date: 06-2018

DOI: 10.1016/J.AAP.2018.02.016

Abstract: We evaluated the effectiveness of in idually tailored driving lessons compared with a road rules refresher course for improving older driver safety. Two arm parallel randomised controlled trial, involving current drivers aged 65 and older (Mean age 72.0, 47.4% male) residing in Canberra, Australia. The intervention group (n = 28) received a two-hour class-based road rules refresher course, and two one-hour driving lessons tailored to improve poor driving skills and habits identified in a baseline on-road assessment. The control group (n = 29) received the road rules refresher course only. Tests of cognitive performance, and on-road driving were conducted at baseline and at 12-weeks. Main outcome measure was the Driver safety rating (DSR) on the on-road driving test. The number of Critical Errors made during the on-road was also recorded. 55 drivers completed the trial (intervention group: 27, control group: 28). Both groups showed reduction in dangerous/hazardous driver errors that required instructor intervention. From baseline to follow-up there was a greater reduction in the number of critical errors made by the intervention group relative to the control group (IRR = 0.53, SE = 0.1, p = .008). The intervention group improved on the DSR more than the control group (intervention mean change = 1.07 SD = 2.00, control group mean change = 0.32 SD = 1.61). The intervention group had 64% remediation of unsafe driving, where drivers who achieved a score of 'fail' at baseline, 'passed' at follow-up. The control group had 25% remediation. Tailored driving lessons reduced the critical driving errors made by older adults. Longer term follow-up and larger trials are required.

Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition

Publisher: Cambridge University Press (CUP)

Date: 14-04-2021

DOI: 10.1017/S1041610221000375

Abstract: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. Cross-sectional observational study. The s le comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years) ided into subgroups representing middle, early old, and advanced old age. We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables – alongside psychological variables – related to perceived cognitive losses.

The accuracy of self-reported physical activity questionnaires varies with sex and body mass index

Publisher: Public Library of Science (PLoS)

Date: 11-08-2021

DOI: 10.1371/JOURNAL.PONE.0256008

Abstract: Factors contributing to the accurate measurement of self-reported physical activity are not well understood in middle-aged adults. We investigated the associations between two self-reported surveys and objectively measured physical activity in middle-aged adults, and the influence of in idual and sociodemographic factors on these associations, at different intensities utilizing an observational study design. Participants (n = 156) wore a SenseWear Armband ™ (SWA) for a continuous seven-day period over the triceps of the left arm, to measure energy expenditure in metabolic equivalents. Participants also completed the Physical Activity Recall questionnaire (PAR) and Active Australia Survey (AAS). Associations were analyzed separately in general linear models for each intensity. The influence of in idual and sociodemographic factors was assessed through moderator analyses. The PAR and SWA were significantly positively associated at moderate (β = 0.68, 95% CI 0.16–1.20), vigorous (β = 0.36, 95% CI 0.20–0.53), moderate-to-vigorous physical activity (MVPA) (β = 0.52, 95% CI 0.20–0.83), and total METmins (β = 0.63, 95% CI 0.35–0.90), the AAS and SWA were associated at all intensities (moderate (β = 0.41, 95% CI 0.15–0.67), vigorous (β = 0.32, 95% CI 0.19–0.46), MVPA (β = 0.42, 95% CI 0.18–0.65) and total METmins (β = 0.62, 95% CI 0.29–0.96). A significant interaction between the PAR and sex for vigorous-intensity unveiled a weaker association in women. Both surveys tended to under-report physical activity. The largest margins of error were present at light and moderate intensities. For the PAR, participants reported over 20 hours, or 69% less light physical activity than recorded by the SWA per week. For the AAS, participants reported over 7 hours, or 38% less moderate physical activity. Compared to lighter intensities, time spent at a vigorous intensity was overreported by participants with the PAR and AAS by 91 and 43 minutes per week, respectively. The addition of Body Mass Index (BMI) resulted in non-significant interactions between the PAR and SWA for moderate-intensity, and the AAS and SWA for vigorous-intensity a significant interaction between AAS and BMI indicated that the strength of the association differed by BMI for vigorous-intensity. The PAR and AAS are not equivalent to the SWA, and sex and BMI may alter the associations between the measures.

Genetic factors moderate everyday physical activity effects on executive functions in aging: Evidence from the Victoria Longitudinal Study.

Publisher: American Psychological Association (APA)

Date: 2016

DOI: 10.1037/NEU0000217

Anxiety disorders in late life—Why are we not more worried?

Publisher: Wiley

Date: 07-05-2020

DOI: 10.1002/GPS.5300

Body mass index is associated with cortical thinning with different patterns in mid- and late-life

Publisher: Springer Science and Business Media LLC

Date: 10-10-2018

DOI: 10.1038/IJO.2017.254

Abstract: High BMI at midlife is associated with increased risk of dementia as well as faster decline in cognitive function. In late-life, however, high BMI has been found to be associated with both increased and decreased dementia risk. The objective of this study was to investigate the neural substrates of this age-related change in body mass index (BMI) risk. We measured longitudinal cortical thinning over the whole brain, based on magnetic resonance imaging scans for 910 in iduals aged 44-66 years at baseline. Subjects were s led from a large population study (PATH, Personality and Total Health through Life). After attrition and exclusions, the final analysis was based on 792 in iduals, including 387 in iduals aged 60-66 years and 405 in iduals aged 44-49 years. A mixed-effects model was used to test the association between cortical thinning and baseline BMI, as well as percentage change in BMI. Increasing BMI was associated with increased cortical thinning in posterior cingulate at midlife (0.014 mm kg The pattern of cortical thinning-in association with increasing BMI at both midlife and late-life-is consistent with known obesity-related dementia risk. Increased cortical thinning in association with decreasing BMI at late-life may help explain the 'obesity paradox', where high BMI in midlife appears to be a risk factor for dementia, but high BMI in late-life appears, at times, to be protective.

Smoking as a risk factor for dementia and cognitive decline: A meta-analysis of prospective studies

Publisher: Oxford University Press (OUP)

Date: 14-06-2007

DOI: 10.1093/AJE/KWM116

Abstract: The authors assessed the association of smoking with dementia and cognitive decline in a meta-analysis of 19 prospective studies with at least 12 months of follow-up. Studies included a total of 26,374 participants followed for dementia for 2-30 years and 17,023 participants followed up for 2-7 years to assess cognitive decline. Mean study age was 74 years. Current smokers at baseline, relative to never smokers, had risks of 1.79 (95% confidence interval (CI): 1.43, 2.23) for incident Alzheimer's disease, 1.78 (95% CI: 1.28, 2.47) for incident vascular dementia, and 1.27 (95% CI: 1.02, 1.60) for any dementia. Compared with those who never smoked, current smokers at baseline also showed greater yearly declines in Mini-Mental State Examination scores over the follow-up period (effect size (beta)=-0.13, 95% CI: -0.18, -0.08). Compared with former smokers, current smokers at baseline showed an increased risk of Alzheimer's disease (relative risk=1.70, 95% CI: 1.25, 2.31) and an increased decline in cognitive abilities (effect size (beta)=-0.07, 95% CI: -0.11, -0.03), but the groups were not different regarding risk of vascular dementia or any dementia. The authors concluded that elderly smokers have increased risks of dementia and cognitive decline.

Joining forces to prevent dementia: The International Research Network on Dementia Prevention (IRNDP)

Publisher: Cambridge University Press (CUP)

Date: 13-09-2017

DOI: 10.1017/S1041610217001685

Abstract: Dementia is a neurodegenerative disorder with global impact, with the largest proportion of cases occurring in low- and middle-income countries. It is estimated that there are 46.8 million cases globally with approximately 10 million new cases each year or a new case occurring every 3 sec (Prince et al. , 2015). For comparison there are 36.7 million HIV cases with an estimated 2 million new cases each year (WHO, 2017). The rise in dementia prevalence is largely due to population ageing, with the oldest being at highest risk. To date there are no diseases modifying medications for Alzheimer's disease or the other causes of dementia. Academics and research groups are increasingly focused on prevention or delay of dementia (Brayne and Miller, 2017) and a number of organizations now prioritize dementia, indicating a strong and coherent international effort to address this problem. Ex les include the World Health Organisation (WHO), which has established a Global Dementia Observatory the World Dementia Council the Organisation for Economic Co-operation and Development (OECD) the U.S. National Alzheimer's Project Act (NAPA) and the Global Council on Brain Health.

Behavioral approach and behavioral inhibition as moderators of the association between negative life events and perceived control in midlife

Publisher: Elsevier BV

Date: 04-2008

DOI: 10.1016/J.PAID.2007.10.036

Within-Occasion Intraindividual Variability and Preclinical Diagnostic Status: Is Intraindividual Variability an Indicator of Mild Cognitive Impairment?

Publisher: American Psychological Association (APA)

Date: 05-2005

DOI: 10.1037/0894-4105.19.3.309

Abstract: Intrain idual variability in cognitive test performance has the potential to be a good marker of preclinical Alzheimer's disease status (S. C. Li & U. Lindenberger, 1999). Using cross-sectional community data from 2,317 in iduals aged 60-64 years, the authors of this study found that variability was greater in in iduals who met criteria for mild cognitive impairment or aging-associated cognitive decline but not for age-associated memory impairment. Higher variability was associated with lower education and a non-English-speaking background. In contrast to previous findings, variability in this study did not contribute uniquely to meeting criteria for mild cognitive impairment. The reasons for the differences may reside in the authors' method of estimating mean independent variability, the use of an occasion-specific measure, or the relatively younger age of the participants. Follow-up of the cohort in 4 years will yield data on the prospective validity of variability as a risk factor for impairment.

Associations of Awareness of Age-Related Change With Emotional and Physical Well-being: A Systematic Review and Meta-analysis

Publisher: Oxford University Press (OUP)

Date: 27-07-2019

DOI: 10.1093/GERONT/GNZ101

Abstract: This systematic review aimed to synthesize and quantify the associations of awareness of age-related change (AARC) with emotional well-being, physical well-being, and cognitive functioning. We conducted a systematic review with a correlational random effects meta-analysis. We included quantitative studies, published from January 1, 2009 to October 3, 2018, exploring associations between AARC and one or more of the following outcomes: emotional well-being, physical well-being, and cognitive functioning. We assessed heterogeneity (I2) and publication bias. We included 12 studies in the review, 9 exploring the association between AARC and emotional well-being and 11 exploring the association between AARC and physical well-being. No study explored the association between AARC and cognitive functioning. Six articles were included in the meta-analysis. We found a moderate association between a higher level of AARC gains and better emotional well-being (r = .33 95% CI 0.18, 0.47 p & .001 I2 = 76.01) and between a higher level of AARC losses and poorer emotional (r = −.31 95% CI −0.38, −0.24 p & .001 I2 = 0.00) and physical well-being (r = −.38 95% CI −0.51, −0.24 p & .001 I2 = 83.48). We found a negligible association between AARC gains and physical well-being (r = .08 95% CI 0.02, 0.14 p & .122 I2 = 0.00). Studies were of medium to high methodological quality. There is some indication that AARC gains and losses can play a role in emotional well-being and that AARC losses are associated with physical well-being. However, the number of included studies is limited and there was some indication of heterogeneity. CRD42018111472.

Hippocampal volume is positively associated with behavioural inhibition (BIS) in a large community-based sample of mid-life adults: The PATH through life study

Publisher: Oxford University Press (OUP)

Date: 29-07-2008

DOI: 10.1093/SCAN/NSN018

Olfactory impairment is associated with functional disability and reduced independence among older adults

Publisher: Elsevier BV

Date: 05-2012

DOI: 10.1016/J.MATURITAS.2012.01.009

Abstract: Despite its relatively high prevalence, population-based data are lacking on whether olfactory impairment influences the functional status and independence of older adults. We assessed associations between olfactory impairment with activities of daily living (ADL) measures and the likelihood of using community support services and/or reliance on non-spouse family/friend support among older adults. Olfaction was measured using the San Diego Odor Identification Test (SDOIT) among 1636 participants of the Blue Mountains Eye Study (2002-4). Functional status was determined by the Older Americans Resources and Services ADL scale. Use of services and non-spouse family/friend support was self-reported. Use of community support services was reported by 15.2% and 5.2% of persons with and without olfactory impairment, respectively. After multivariable adjustment including for cognitive function, participants with compared to those without olfactory impairment were more likely to use community support services and non-spouse family/friend support, odds ratio, OR, 1.82 (95% confidence intervals, CI 1.16-2.86) and OR 1.62 (95% CI 1.14-2.32), respectively. ADL difficulty was reported by 16.9% (n=57) and 4.4% (n=45) of participants with and without olfactory loss, respectively. Olfactory impairment was associated with increased likelihood of experiencing ADL difficulty, multivariable-adjusted OR 1.98 (95% CI 1.10-3.57). Olfactory loss was significantly associated with impaired basic ADL, OR 1.57 (95% CI 1.12-2.20). The functional ability and independence of older adults is significantly impaired in the presence of olfactory impairment. Early diagnosis of olfactory loss by primary physicians and geriatricians could facilitate timely interventions assisting the maintenance of functional independence in later life.

Not All Older Adults Have Insight Into Their Driving Abilities: Evidence From an On-road Assessment and Implications for Policy

Publisher: Oxford University Press (OUP)

Date: 02-08-2012

DOI: 10.1093/GERONA/GLS150

Abstract: To compare self-reported driving ability with objective measures of on-road driving performance in a large cohort of older drivers. Two hundred and seventy community-living adults aged 70-88 years recruited via the electoral roll completed a standardized assessment of on-road driving performance and questionnaires determining perceptions of their own driving ability, confidence, and driving difficulties. Retrospective self-reported crash data over the previous 5 years were recorded. Participants reported difficulty with only selected driving situations, including driving into the sun, in unfamiliar areas, in wet conditions, and at night or dusk. The majority of participants rated their own driving as good to excellent. Of the 47 (17%) drivers who were rated as potentially unsafe to drive, 66% rated their own driving as good to excellent. Drivers who made critical errors, where the driving instructor had to take control of the vehicle, had no lower self-rating of driving ability than the rest of the group. The discrepancy in self-perceptions of driving ability and participants' safety rating on the on-road assessment was significantly associated with self-reported retrospective crash rates, where those drivers who displayed greater overconfidence in their own driving were significantly more likely to report a crash. This study demonstrates that older drivers with the greatest mismatch between actual and self-rated driving ability pose the greatest risk to road safety. Therefore, licensing authorities should not assume that when older in iduals' driving abilities begin to decline they will necessarily be aware of these changes and adopt appropriate compensatory driving behaviors rather, it is essential that evidence-based assessments are adopted.

Memory and Aging

Publisher: Psychology Press

Date: 04-05-2012

DOI: 10.4324/9780203156513

Is exposure to secondhand smoke associated with cognitive parameters of children and adolescents?-a systematic literature review

Publisher: Elsevier BV

Date: 10-2013

DOI: 10.1016/J.ANNEPIDEM.2013.07.001

Abstract: Despite the known association of second hand smoke (SHS) with increased risk of ill health and mortality, the effects of SHS exposure on cognitive functioning in children and adolescents are unclear. Through a critical review of the literature we sought to determine whether a relationship exists between these variables. The authors systematically reviewed articles (dated 1989-2012) that investigated the association between SHS exposure (including in utero due to SHS exposure by pregnant women) and performance on neurocognitive and academic tests. Eligible studies were identified from searches of Web of Knowledge, MEDLINE, Science Direct, Google Scholar, CINAHL, EMBASE, Zetoc, and Clinicaltrials.gov. Fifteen articles were identified, of which 12 showed inverse relationships between SHS and cognitive parameters. Prenatal SHS exposure was inversely associated with neurodevelopmental outcomes in young children, whereas postnatal SHS exposure was associated with poor academic achievement and neurocognitive performance in older children and adolescents. Furthermore, SHS exposure was associated with an increased risk of neurodevelopmental delay. Recommendations should be made to the public to avoid sources of SHS and future research should investigate interactions between SHS exposure and other risk factors for delayed neurodevelopment and poor cognitive performance.

Association of genetic risk factors with cognitive decline: The PATH through life project

Publisher: Elsevier BV

Date: 05-2016

DOI: 10.1016/J.NEUROBIOLAGING.2016.02.016

Abstract: We examined the association of 28 single nucleotide polymorphisms (SNPs), previously associated with dementia or cognitive performance, with tests assessing episodic memory, working memory, vocabulary, and perceptual speed in 1689 nondemented older Australians of European ancestry. In addition to testing each variant in idually, we assessed the collective association of the 12-risk SNPs for late-onset Alzheimer's disease using weighted and unweighted genetic risk scores. Significant associations with cognitive performance were observed for APOE ε4 allele, ABCA7-rs3764650, CR1-rs3818361, MS4A4E-rs6109332, BDNF-rs6265, COMT-rs4680, CTNNBL-rs6125962, FRMD4A-rs17314229, FRMD4A-rs17314229, intergenic SNP chrX-rs12007229, PDE7A-rs10808746, SORL1-rs668387, and ZNF224-rs3746319. In addition, the weighted genetic risk score was associated with worse performance on episodic memory. The identification of genetic risk factors, that act in idually or collectively, may help in screening for people with elevated risk of cognitive decline and for understanding the biological pathways that underlie cognitive decline.

Residential aged care staff perceptions and responses towards neuropsychiatric symptoms: a mixed methods analysis of electronic healthcare records

Publisher: Informa UK Limited

Date: 31-01-2022

DOI: 10.1080/13607863.2022.2032597

Abstract: To investigate electronic care notes to better understand reporting and management of neuropsychiatric symptoms (NPS) by residential aged care (RAC) staff. We examined semi-structured care notes from electronic healthcare notes of 77 residents (67% female aged 67-101 79% with formal dementia diagnosis) across three RAC facilities. As part of standard clinical practice, staff documented the NPS presentation and subsequent management amongst residents. Using a mixed-method approach, we analyzed the type of NPS reported and explored care staff responses to NPS using inductive thematic analysis. 465 electronic care notes were recorded during the 18-month period. Agitation-related behaviors were most frequently reported across residents (48.1%), while psychosis (15.6%), affective symptoms (14.3%), and apathy (1.3%) were less often reported. Only 27.5% of the notes contained information on potential causes underlying NPS. When faced with NPS, care staff responded by either providing emotional support, meeting resident's needs, removing identified triggers, or distracting. Results suggest that RAC staff primarily detected and responded to those NPS they perceived as distressing. Findings highlight a potential under-recognition of specific NPS types, and lack of routine examination of NPS causes or systematic assessment and management of NPS. These observations are needed to inform the development and implementation of non-pharmacological interventions and care programs targeting NPS in RAC. Supplemental data for this article is available online at 0.1080/13607863.2022.2032597 .

Dementia risk reduction in practice: the knowledge, opinions and perspectives of Australian healthcare providers

Publisher: CSIRO Publishing

Date: 11-02-2021

DOI: 10.1071/PY20189

Abstract: This study examined Australian primary healthcare providers’ knowledge about dementia risk factors and risk reduction and their perspectives on barriers and enablers to risk reduction in practice. Primary healthcare providers were recruited through Primary Health Networks across Australia (n = 51). Participants completed an online survey that consisted of fixed-responses and free-text components to assess their knowledge, attitudes and current practices relating to dementia risk factors and risk reduction techniques. The results showed that Australian primary healthcare providers have good knowledge about the modifiable risk factors for dementia however, face several barriers to working with patients to reduce dementia risk. Commonly reported barriers included low patient motivation and healthcare system level limitations. The most commonly reported recommendations to helping primary healthcare providers to work with patients to reduce dementia risk included increasing resources and improving dementia awareness and messaging. While the results need to be interpreted in the context of the limitations of this study, we conclude that collaborative efforts between researchers, clinicians, policy makers and the media are needed to support the uptake of risk reduction activities in primary care settings.

Anxiety and comorbid depression following traumatic brain injury in a community-based sample of young, middle-aged and older adults

Publisher: Elsevier BV

Date: 04-2017

DOI: 10.1016/J.JAD.2016.09.045

Abstract: Anxiety is common following a traumatic brain injury (TBI), but who is most at risk, and to what extent, is not well understood. Longitudinal data from a randomly-selected community s le (Wave 1: 7397, Wave 2: 6621 and Wave 3: 6042) comprising three adult cohorts (young: 20-24 years of age, middle-aged: 40-44, older: 60-64), were analysed. The association between TBI history, anxiety and comorbid depression was assessed, controlling for age, sex, marital/employment status, medical conditions, recent life events, alcohol consumption, social support and physical activity. Thirteen percent of the s le had sustained a TBI by Wave 3, 35% of whom had sustained multiple TBIs. Cross-sectional analyses revealed that clinically-significant anxiety was more common in people who had sustained a TBI. Longitudinal analyses demonstrated an increased risk of anxiety post-TBI, even after controlling for potential demographic, health and psychosocial confounds. Anxiety was more common than depression, although 10% of those with a TBI experienced comorbid anxiety/depression. TBIs were not medically confirmed and anxiety and depression were only assessed every four years by self-report, rather than clinical interview. S le attrition resulted in the retention of healthier in iduals at each wave. TBIs are associated with a lifelong increased risk of experiencing clinically-significant anxiety, highlighting the chronic nature of TBI sequelae. Positive lifestyle changes (e.g., increasing physical activity, reducing alcohol consumption) may decrease the risk of anxiety problems in the early years after a TBI. Comorbid anxiety and depression was common, indicating that both should be monitored and treated.

Association Between Blood Pressure Variability and Cerebral Small‐Vessel Disease: A Systematic Review and Meta‐Analysis

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 07-01-2016

DOI: 10.1161/JAHA.119.013841

Abstract: Research links blood pressure variability ( BPV ) with stroke however, the association with cerebral small‐vessel disease ( CSVD ) remains unclear. As BPV and mean blood pressure are interrelated, it remains uncertain whether BPV adds additional information to understanding cerebrovascular morphological characteristics. A systematic review was performed from inception until March 3, 2019. Eligibility criteria included population, adults without stroke ( weeks) exposure, BPV quantified by any metric over any duration comparison, (1) low versus high or mean BPV and (2) people with versus without CSVD and outcomes, (1) CSVD as subcortical infarct, lacunae, white matter hyperintensities, cerebral microbleeds, or enlarged perivascular spaces and (2) standardized mean difference in BPV . A total of 27 articles were meta‐analyzed, comprising 12 309 unique brain scans. A total of 31 odds ratios ( OR s) were pooled, indicating that higher systolic BPV was associated with higher odds for CSVD ( OR, 1.27 95% CI, 1.14–1.42 I 2 =85%) independent of mean systolic pressure. Likewise, higher diastolic BPV was associated with higher odds for CSVD ( OR, 1.30 95% CI, 1.14–1.48 I 2 =53%) independent of mean diastolic pressure. There was no evidence of a pairwise interaction between systolic/diastolic and BPV /mean OR s ( P =0.47), nor a difference between BPV versus mean pressure OR s ( P =0.58). Fifty‐four standardized mean differences were pooled and provided similar results for pairwise interaction ( P =0.38) and difference between standardized mean differences ( P =0.70). On the basis of the available studies, BPV was associated with CSVD independent of mean blood pressure. However, more high‐quality longitudinal data are required to elucidate whether BPV contributes unique variance to CSVD morphological characteristics.

Brain atrophy in ageing: Estimating effects of blood glucose levels vs. other type 2 diabetes effects

Publisher: Elsevier BV

Date: 02-2018

DOI: 10.1016/J.DIABET.2017.06.004

Concurrent lifestyle risk factors: Clusters and determinants in an Australian sample

Publisher: Elsevier BV

Date: 03-2016

DOI: 10.1016/J.YPMED.2015.12.009

Abstract: To examine clustering among three major lifestyle risk factors for chronic disease (smoking, alcohol, and physical inactivity) and define sociodemographic subgroups with elevated risks of multiple lifestyle risk factors. Data on 6052 adults aged 28-32, 48-52, and 68-72 from wave 3 (2007-2010) of the PATH Through Life Cohort Study, Australia, were used to estimate prevalence of in idual and combinations of risk factors, and multinomial regression analysis undertaken to examine demographic factors associated with number of risks. Clustering of risks varied by age and gender, with more people than expected having none or all of the risk factors. Smoking clustered with harmful alcohol use, as well as physical inactivity. No relationship was observed between physical inactivity and alcohol use. Several sociodemographic characteristics were associated with the number of lifestyle risk factors including partner status, gender, age, education, and physical and mental health related quality of life. The tendency for lifestyle risk factors to aggregate in different subgroups has meaningful implications for health promotion strategies. Better insight in the more vulnerable subpopulations that are at higher risk of displaying multiple lifestyle risk factors is of importance if we wish to reduce the population propensity for chronic disease.

Neuropsychological predictors of transition from healthy cognitive aging to mild cognitive impairment: The PATH through life study

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1097/JGP.0B013E3181CDECF1

Abstract: To identify neuropsychological predictors of transition from healthy cognitive aging to mild cognitive impairment (MCI) or any mild cognitive disorder (any-MCD) in a community-based longitudinal study of aging. Longitudinal Two thousand eighty-two in iduals, aged 60–64 years and participating in a prospective epidemiologic study of mental health, and aging were assessed at two time points 4 years apart for MCI using the International Consensus Criteria, the clinical dementia rating scale (CDR, 0.5), or any of a suite of criteria sets for MCDs (any-MCD). Logistic regression was used to assess the neuropsychological predictors of conversion to diagnosis including the Mini-Mental State Examination, immediate and delayed recall (IR and DR), Digit Backward, Spot-the-Word (STW), Symbol Digits Modalities Test (SDMT), simple and choice reaction time, and reaction time variability. Of the 2,082 participants with no cognitive impairment in the first wave of data collection, 18 participants were diagnosed with MCI, 32 with CDR 0.5, and 64 participants presented with any-MCD 4 years later. The main neuropsychological predictors of conversion identified in multivariate analyses were measures of IR/DR, STW, Symbol Digit Modalities Task, and reaction time variability. Although most measures were significant predictors of conversion to MCI or any-MCD when assessed independently, four tests (IR/DR, STW, SDMT, and simple reaction time variability) accounted for the explained variance in diagnosis when all tests were assessed together. When predictive value, stability across clinical categories, and psychometric characteristics were considered together, the reaction time variability measure was the best predictor of future cognitive disorder.

Factors that Explain the Poorer Mental Health of Caregivers: Results from a Community Survey of Older Australians

Publisher: SAGE Publications

Date: 07-2010

DOI: 10.3109/00048671003620202

Abstract: Objectives: To contrast the level of anxiety and depression reported by older Australians providing assistance to someone who is ill, disabled or elderly with that of non-caregivers and to identify secondary stressors and mediating factors which explain caregivers’ poorer mental health. Method: Analysis of data from wave 2 of the PATH Through Life Study, a community survey of 2,222 adults aged 64–69 years conducted in Canberra and Queanbeyan, Australia. Mental health was assessed using the Goldberg depression and anxiety scales. Analyses focused on those who identified themselves as a primary carer and/or reported providing care for more than 5 hours per week. Analyses evaluated whether the association between caregiver status and mental health was mediated by financial factors, role strain, physical health, and social support and conflict with family and friends after adjusting for demographics. Results: Caregivers reported significantly poorer mental health than non-caregivers, and also reported poorer physical health, greater financial stress, greater responsibility for household tasks, and more conflict and less social support from their family and spouse. Mediation analysis showed that the poorer mental health of caregivers reflected elevated rates of their own physical impairment, a lack of social support and greater conflict. Conclusions: The relationship between caregiving and mental health was largely explained by social support and levels of conflict within the family, which are modifiable and potentially amenable to change through policy and intervention. Research such as this can assist the development of appropriate interventions to improve the circumstances of informal caregivers in Australia.

Body, Brain, Life for Cognitive Decline (BBL-CD): protocol for a multidomain dementia risk reduction randomized controlled trial for subjective cognitive decline and mild cognitive impairment

Publisher: Informa UK Limited

Date: 11-2018

DOI: 10.2147/CIA.S182046

Strength in the lower limbs, visual contrast sensitivity, and simple reaction time predict cognition in older women.

Publisher: No publisher found

DOI: 10.1037//0882-7974.12.1.137

A simple measure with complex determinants: Investigation of the correlates of self-rated health in older men and women from three continents

Publisher: Springer Science and Business Media LLC

Date: 13-08-2012

DOI: 10.1186/1471-2458-12-649

Reproductive period and cognitive function in a representative sample of naturally postmenopausal women aged 60-64 years

Publisher: Informa UK Limited

Date: 2005

DOI: 10.1080/13697130500345240

Abstract: Greater lifetime estrogen exposure has been postulated to result in better cognition in later life, particularly in the area of verbal memory. In women, the highest levels of endogenous estrogen occur during their reproductive period, between menarche and menopause. To investigate the association between reproductive period and cognition. The s le consisted of 760 naturally postmenopausal women aged 60-64 years (mean age 62.5 +/- 1.5 years) participating in the PATH Through Life Study who were randomly drawn from the population of Canberra, Australia. Participants were administered a verbal learning test (immediate recall and 1-minute delay), the Mini-Mental State Examination (MMSE), digit span backwards, the Symbol-Digit Modalities Test and simple and choice reaction time tests. There were no significant associations detected between reproductive period and performance on any of the cognitive tests, either before or after controlling for potential confounding variables. Reproductive period, a surrogate measure of endogenous estrogen exposure, had no detectable effect on cognitive performance in this s le.

Chronological Age and Age-Related Cognitive Deficits Are Associated With an Increase in Multiple Types of Driving Errors in Late Life

Publisher: American Psychological Association (APA)

Date: 2011

DOI: 10.1037/A0023835

Abstract: Older driver research has mostly focused on identifying that small proportion of older drivers who are unsafe. Little is known about how normal cognitive changes in aging affect driving in the wider population of adults who drive regularly. We evaluated the association of cognitive function and age with driving errors. A s le of 266 drivers aged 70 to 88 years were assessed on abilities that decline in normal aging (visual attention, processing speed, inhibition, reaction time, task switching) and the UFOV®, which is a validated screening instrument for older drivers. Participants completed an on-road driving test. Generalized linear models were used to estimate the associations of cognitive factors with specific driving errors and number of errors in self-directed and instructor navigated conditions. All error types increased with chronological age. Reaction time was not associated with driving errors in multivariate analyses. A cognitive factor measuring speeded selective attention and switching was uniquely associated with the most errors types. The UFOV® predicted blind-spot errors and errors on dual carriageways. After adjusting for age, education, and gender, the cognitive factors explained 7% of variance in the total number of errors in the instructor-navigated condition and 4% of variance in the self-navigated condition. We conclude that among older drivers, errors increase with age and are associated with speeded selective attention, particularly when that requires attending to the stimuli in the periphery of the visual field, task switching, errors inhibiting responses, and visual discrimination. These abilities should be the target of cognitive training.

Use of medications with anticholinergic properties and cognitive function in a young-old community sample

Publisher: Wiley

Date: 06-2009

DOI: 10.1002/GPS.2157

Abstract: To examine whether anticholinergic medications have effects on the level of cognitive function or cognitive decline in persons in their early to mid 60s. A randomly selected community-based s le of 2058 persons aged 60-64 at baseline was interviewed twice over four years. Anticholinergic medication use was determined from self-report medication data using the Anticholinergic Drug Scale. Cognition was assessed with the California Verbal Learning Test I (one trial), Digits Backwards, the Symbol Digit Modalities Test, the Mini-Mental State Exam and simple and choice reaction time. Persons meeting criteria for Mild Cognitive Impairment were identified in a clinical substudy. Mixed models adjusting for age, sex, self-rated depression and physical health, and total number of medications were used to analyse the data. There was a significant main effect of anticholinergic group averaged across time for the Symbol Digits Modalities Test with poorer performance among anticholinergic medication users. Main effects for the other cognitive tests and mild cognitive impairment were non-significant. No time by anticholinergic group interactions were significant. This study suggests that exposure to anticholinergic medication is associated with lower level of complex attention in the young-old, but not with greater cognitive decline over time. Although the clinical significance of this is not clear, caution should be taken when prescribing medications with anticholinergic effects to older persons.

Self-management and HeAlth Promotion in Early-stage dementia with e-learning for carers (SHAPE): study protocol for a multi-centre randomised controlled trial

Publisher: Springer Science and Business Media LLC

Date: 09-10-2020

DOI: 10.1186/S12889-020-09590-9

Abstract: With an increasing number of people with dementia worldwide and limited advancement in medical treatments, the call for new and cost-effective approaches is crucial. The utility of self-management has been proven in certain chronic conditions. However, very little work has been undertaken regarding self-management in people with dementia. The SHAPE trial will include 372 people with mild to moderate dementia to evaluate the effectiveness and cost-effectiveness of an educational programme combining approaches of self-management, health promotion, and e-learning for care partners. The study is a multi-site, single-randomised, controlled, single-blinded trial with parallel arms. The intervention arm is compared with treatment as usual. The intervention comprises a 10-week course delivered as group sessions for the participants with dementia. The sessions are designed to develop self-management skills and to provide information on the nature of the condition and the development of healthy behaviours in a supportive learning environment. An e-learning course will be provided for care partners which covers similar and complementary material to that discussed in the group sessions for the participant with dementia. This trial will explore the effect of the SHAPE group intervention on people with mild to moderate dementia in terms of self-efficacy and improvement in key health and mental health outcomes and cost-effectiveness, along with carer stress and knowledge of dementia. ClinicalTrials.gov Identifier: NCT04286139, registered prospectively February 26, 2020, t2/show/NCT04286139

Evaluation of screening tests for predicting older driver performance and safety assessed by an on-road test

Publisher: Elsevier BV

Date: 2013

DOI: 10.1016/J.AAP.2012.09.009

Abstract: A number of tests and test batteries are available for the prediction of older driver safety, but many of these have not been validated against standardized driving outcome measures. The aim of this study was to evaluate a series of previously described screening tests in terms of their ability to predict the potential for safe and unsafe driving. Participants included 79 community-dwelling older drivers (M=72.16 years, SD=5.46 range 65-88 years 57 males and 22 females) who completed a previously validated multi-disciplinary driving assessment, a hazard perception test, a hazard change detection test and a battery of vision and cognitive tests. Participants also completed a standardized on-road driving assessment. The multi-disciplinary test battery had the highest predictive ability with a sensitivity of 80% and a specificity of 73%, followed by the hazard perception test which demonstrated a sensitivity of 75% and a specificity of 61%. These findings suggest that a relatively simple and practical battery of tests from a range of domains has the capacity to predict safe and unsafe driving in older adults.

The effect of opioids on the cognitive function of older adults: results from the Personality and Total Health through life study

Publisher: Oxford University Press (OUP)

Date: 22-03-2021

DOI: 10.1093/AGEING/AFAB048

Abstract: chronic pain, a common complaint among older adults, affects physical and mental well-being. While opioid use for pain management has increased over the years, pain management in older adults remains challenging, due to potential severe adverse effects of opioids in this population. we examined the association between opioid use, and changes in cognitive function of older adults. prospective study. community dwelling older adults. study population consisted of 2,222 in iduals aged 65–69 years at baseline from the Personality and Total Health Through Life Study in Australia. medication data were obtained from the Pharmaceutical Benefits Scheme. Cognitive measures were obtained from neuropsychological battery assessment. Opioid exposure was quantified as Total Morphine Equivalent Dose (MED). The association between change in cognitive function between Wave 2 and Wave 3, and cumulative opioid use was assessed through generalized linear models. cumulative opioid exposure exceeding total MED of 2,940 was significantly associated with poorer performance in the Mini Mental State Examination (MMSE). Compared with those not on opioids, in iduals exposed to opioids resulting in cumulative total MED of greater than 2,940 had significantly lower scores in the MMSE (Model 1: β = −0.34, Model 2: β = −0.35 and Model 3: β = −0.39, P & 0.01). Performance in other cognitive assessments was not associated with opioid use. prolonged opioid use in older adults can affect cognitive function, further encouraging the need for alternative pain management strategies in this population. Pain management options should not adversely affect healthy ageing trajectories and cognitive health.

The relationship between cognition and mortality in patients with stroke, coronary heart disease, or cancer

Publisher: Hogrefe Publishing Group

Date: 2006

DOI: 10.1027/1016-9040.11.3.182

Abstract: Numerous studies have reported an association between cognitive impairment and an increased risk for mortality. Most results are from large epidemiological studies and control for medical conditions that may relate to cognitive decline, as well as an increased mortality risk. The aim of this review was to evaluate the association between cognitive performance and mortality within patient s les of stroke, cancer, or coronary heart disease. After reviewing the PubMed literature for articles on stroke, cancer, and cardiovascular related illnesses, 47 longitudinal studies were identified that met the cognition/mortality search criteria. In general, the results demonstrated that within the clinical groups studied, cognitive performance and cognitive impairment both predict mortality, although results were less consistent for coronary heart disease. This study adds further support for the ubiquity of the association of cognitive performance with health outcomes and mortality. Optimizing health has implications for both cognitive performance and longevity.

Positive components of mental health provide significant protection against likelihood of falling in older women over a 13-year period

Publisher: Cambridge University Press (CUP)

Date: 14-03-2012

DOI: 10.1017/S1041610212000154

Abstract: Background: In late life, falls are associated with disability, increased health service utilization and mortality. Physical and psychological risk factors of falls include falls history, grip strength, sedative use, stroke, cognitive impairment, and mental ill-health. Less understood is the role of positive psychological well-being components. This study investigated the protective effect of vitality on the likelihood of falls in comparison to mental and physical health. Methods: Female participants were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) harmonization project. Participants ( n = 11,340) were aged 55–95 years (Mean = 73.68 SD = 4.31) at baseline and observed on up to four occasions for up to 13 years (Mean = 5.30 SD = 2.53). Results: A series of random intercept logistic regression models consistently identified vitality's protective effects on falls as a stronger effect in the reduction of the likelihood of falls than the effect of mental health. Vitality is a significant predictor of falls likelihood even after adjusting for physical health, although the size of effect is substantially explained by its covariance with mental and physical heath. Conclusions: Vitality has significant protective effects on the likelihood of falls. In comparison with mental health, vitality reported much stronger protective effects on the likelihood to fall in comparison with the risk associated with poor mental health in a large s le of older female adults. Both physical health and mental health account for much of the variance in vitality, but vitality still reports a protective effect on the likelihood of falls.

Longitudinal study of factors associated with informal care provision: Evidence from older Australians

Publisher: Wiley

Date: 27-02-2019

DOI: 10.1111/AJAG.12613

Abstract: To explore the factors associated with informal care provision by older Australians. Longitudinal cohorts of the Personality and Total Health Through Life project (PATH) were used to build a generalised estimating equation model. Older adults who are engaged in volunteer and religious activities are 27.6% and 33.8%, respectively, more likely to provide informal care than their counterparts who are not engaged in these activities. Older adults who formerly provided care are four times more likely to have a continued caregiving role than their counterparts who did not formerly provide care. Those in marriage-type relationships are 50.9% more likely, and those with primary responsibility for household and income tasks are respectively 28.0% and 31.0% more likely, to provide care than their counterparts. Personal values for social responsibility and role responsibility are significant predictors of informal care provision by older Australians.

Alcohol exposure and cognitive development: An example of why we need a contextualized, dynamic life course approach to cognitive ageing - A mini-review

Publisher: S. Karger AG

Date: 2008

DOI: 10.1159/000161735

Abstract: i Background: /i A substantial literature exists that demonstrates associations between putative risk factors and cognitive decline in late life. However, there is a need to integrate this broad literature within a framework that incorporates the interaction of behavioral and ecological influences with cognitive development. Such a framework is required for developing a range of personal and environmental interventions to optimize cognitive development in the population, and to reduce the risk of cognitive impairment in late life. i Objective: /i This review aims to identify the key considerations for developing a life course model of the various factors that influence cognitive development and cognitive decline. A contextualized, dynamic approach to life course epidemiology is proposed. i Methods: /i A theoretical evaluation of key methodological and interpretational issues relating to how risk factors influence cognitive development and cognitive impairment was conducted. This focused on the ex le of alcohol consumption as a risk factor for cognitive decline and dementia. i Results: /i This review identified dimensions that need to be accounted for in life course theories of cognitive development and cognitive impairment. These include: (a) intergenerational influences (b) methodological and interpretational issues (c) in idual differences (personal factors) (d) contextual factors (environmental or ecological factors), and (e) cognitive ability as determinant. The methodological and interpretational factors included measurement of exposure and outcome variables the important distinction between level of ability versus change over time nonlinear relationships among exposures and outcomes, and outcomes and age the distinction between association and cause, and between short-term effects and long-term change. i Conclusion: /i A contextualized, dynamic approach to life course epidemiology accounts for the complex range of influences over the life course that interact to determine normal and pathological cognitive ageing. This approach provides a framework for the development of interventions to maximize cognitive gains in early life, and minimize cognitive loss in late life.

Cognitive ability, intraindividual variability, and common genetic variants of Catechol-O-Methyltransferase and Brain-Derived Neurotrophic Factor: A longitudinal study in a population-based sample of older adults

Publisher: American Psychological Association (APA)

Date: 06-2014

DOI: 10.1037/A0035702

Abstract: Genetic differences play a significant role in generating in idual differences in cognitive abilities. Studies have linked common polymorphisms (valine to methionine substitution VAL/MET) in the catechol-O-methyltransferase (COMT) and brain-derived neurotrophic factor (BDNF) to cognitive differences between in iduals. However, not all studies support these associations and hence, the impact of these polymorphisms on cognition is unclear. Here, we investigated the effect of COMT VAL158MET and BDNF VAL66MET polymorphisms and their interaction on cognitive performance measured longitudinally over 8 years in a population-based s le of older adults (60-64 years at baseline n = 400). We used multilevel models to examine differences between in iduals with different genotypes in performance on psychometric tests while controlling for age, sex, and education. We observed significant main and interaction effects of COMT and BDNF genotypes on reaction time (RT) and intrain idual variability in RT (IIV-RT). Subjects with at least one copy of the COMT*MET allele (which is associated with higher prefrontal dopamine) had significantly faster RT (both simple and choice RT) and less IIV-RT in both tasks than those without the COMT*MET allele when they also carried one or more BDNF*MET alleles (which is associated with lower activity-dependent BDNF secretion). However, RT and IIV-RT did not differ significantly between the COMT genotypes in the absence of the BDNF*MET allele. These polymorphisms had no significant effect on within person change in RT or IIV-RT. Our findings indicate that the interaction between common variants of COMT and BDNF explain in idual differences in RT and IIV-RT but do not explain age-related decline in these abilities.

APOE genotype and cognitive change in young, middle-aged, and older adults living in the community

Publisher: Oxford University Press (OUP)

Date: 31-07-2014

DOI: 10.1093/GERONA/GLT103

Abstract: We examined whether the apolipoprotein E (APOE) ε4 allele was associated with cognitive benefits in young adulthood and whether it reversed to confer cognitive deficits in later life ("antagonistic pleiotropy") in the absence of dementia-related neuropathology. We also tested whether the ε2 allele was associated with disadvantages in early adulthood but offered protection against cognitive decline in early old age. Eight-year cognitive change was assessed in 2,013 cognitively normal community-dwelling adults aged 20-24, 40-44, or 60-64 years at baseline. Although cognitive decline was associated with age, multilevel models contrasting the ε2 and ε4 alleles provided no evidence that the APOE genotype was related to cognitive change in any of the age groups. The findings suggest that in the absence of clinically salient dementia pathology, APOE ε2 and ε4 alleles do not exhibit antagonistic pleiotropy in relation to cognition between the ages of 20 and 72 years.

Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis

Publisher: BMJ

Date: 02-2017

DOI: 10.1136/BMJOPEN-2016-011146

Deriving prevalence estimates of depressive symptoms throughout middle and old age in those living in the community

Publisher: Cambridge University Press (CUP)

Date: 17-11-2011

DOI: 10.1017/S1041610211002109

Abstract: Background: There is considerable debate about the prevalence of depression in old age. Epidemiological surveys and clinical studies indicate mixed evidence for the association between depression and increasing age. We examined the prevalence of probable depression in the middle aged to the oldest old in a project designed specifically to investigate the aging process. Methods: Community-living participants were drawn from several Australian longitudinal studies of aging that contributed to the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Different depression scales from the contributing studies were harmonized to create a binary variable that reflected “probable depression” based on existing cut-points for each harmonized scale. Weighted prevalence was benchmarked to the Australian population which could be compared with findings from the 1997 and 2007 National Surveys of Mental Health and Well-Being (NSMHWB). Results: In the DYNOPTA project, females were more likely to report probable depression. This was consistent across age levels. Both NSMHWB surveys and DYNOPTA did not report a decline in the likelihood of reporting probable depression for the oldest old in comparison with mid-life. Conclusions: Inconsistency in the reports of late-life depression prevalence in previous epidemiological studies may be explained by either the exclusion and/or limited s ling of the oldest old. DYNOPTA addresses these limitations and the results indicated no change in the likelihood of reporting depression with increasing age. Further research should extend these findings to examine within-person change in a longitudinal context and control for health covariates.

Alcohol and dementia — risk or protective factor?

Publisher: Springer Science and Business Media LLC

Date: 13-09-2018

DOI: 10.1038/S41582-018-0073-0

Adapting to Retirement Community Life: Changes in Social Networks and Perceived Loneliness

Publisher: Cambridge University Press (CUP)

Date: 2015

DOI: 10.1017/JRR.2015.5

Abstract: Improved social relationships and connectedness is a frequently cited benefit of retirement community living. However, few studies have prospectively investigated changes in loneliness or social networks following relocation. This study involved 83 Australians (aged 57–90 years) relocating to independent living units within a retirement community. A prospective longitudinal design was employed whereby data was collected prior to relocation, and 1, 6 and 12 months post relocation. Comparisons were made with a s le of community-dwelling ( N = 549) residents of the same age. In idual characteristics (e.g., personality characteristics) associated with change were also explored. Results indicated reduced loneliness and increased neighbour support networks following relocation. A reduction in contact with friends was also observed. This study provides an important contribution to our understanding of the initial impact of transitioning into a retirement community on personal relationships. Through exploring factors associated with successful transition, we can begin to understand the characteristics of those in iduals most likely to thrive in this type of environment.

Sex and symmetry differences in hippocampal volumetrics: Before and beyond the opening of the crus of the fornix

Publisher: Wiley

Date: 31-10-2006

DOI: 10.1002/HIPO.20133

Abstract: Published normative volumetrics of the hippoc us (HC) vary substantially. While the protocol suggested by Watson et al. (Neurology 42 (1992) 1743-1750 Arch Neurology 54 (1997) 1521-1531) is the most frequently adhered to, this leaves the posterior section of the HC tail unmeasured, which has been estimated to be in the order of 2-4 mm, representing 5-10% of total HC volume. The objective of the current study was to compare HC volumes according to the method of Watson et al. (Neurology 42 (1992) 1743-1750 Arch Neurology 54 (1997) 1521-1531) against those measured to include the posterior tail section. From a random community s le of 60-64 yr old in iduals, 478 subjects underwent magnetic resonance imaging brain scans. Of these, 452 scans (238 males and 214 females) were adequate for hippoc al measurement. The scans comprised whole brain T1- weighted and T2-weighted FLAIR images. One hundred and fifty scans were randomly selected for the measurement of HC volumes beyond the opening of the crus of the fornix by manual tracings on T1-weighted images by a trained operator. Intracranial volume (ICV) and total brain volume (TBV) were measured using an automated program. We found that the posterior HC tail extended for a mean of just over 5 mm and comprised 11% of total HC volume. Males had significantly larger raw HC volumes, and while normalization with ICV or TBV reversed this pattern, it was significant only when the posterior HC tail was included in the measurement. In conclusion, this study showed that including the posterior part of the tail can influence the results of HC measurement. An argument is presented that accurate HC volumes should include the entire HC and not exclude the tail.

Life Expectancy with and without Cognitive Impairment in Seven Latin American and Caribbean Countries

Publisher: Public Library of Science (PLoS)

Date: 23-03-2015

DOI: 10.1371/JOURNAL.PONE.0121867

Clinical practice guidelines for dementia in Australia

Publisher: AMPCo

Date: 03-2016

DOI: 10.5694/MJA15.01339

Abstract: About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis living well with dementia and delaying functional decline managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance and training and supporting families and carers to provide care.

White matter hyperintensities in the forties: Their prevalence and topography in an epidemiological sample aged 44-48

Publisher: Wiley

Date: 08-05-2009

DOI: 10.1002/HBM.20586

A Critical Review of Grading Systems: Implications for Public Health Policy

Publisher: SAGE Publications

Date: 10-05-2017

DOI: 10.1177/0163278716645161

Abstract: Grading instruments are an important part of evidence-based medicine and are used to inform health policy and the development of clinical practice guidelines. They are extensively used in the development of clinical guidelines and the assessment of research publications, having particular impact on health care and policy sectors. The positive effects of using grading instruments are, however, potentially undermined by their misuse and a number of shortcomings. This review found eight key concerns about grading instruments: (1) lack of information on validity and reliability, (2) poor concurrent validity, (3) may not account for external validity, (4) may not be inherently logical, (5) susceptibility to subjectivity, (6) complex systems with inadequate instructions, (7) may be biased toward randomized controlled trial (RCT) studies, and (8) may not adequately address the variety of non-RCTs. This narrative review concludes that there is a need to take into account these criticisms and domain-specific limitations, to enable the use and development of the most appropriate grading instruments. Grading systems need to be matched to both the research question being asked and the type of evidence being used.

Traumatic Brain Injury and Depression in a Community-Based Sample: A Cohort Study Across the Adult Life Span

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 2018

DOI: 10.1097/HTR.0000000000000311

Subjective Health and Memory Predictors of Mild Cognitive Disorders and Cognitive Decline in Ageing: The Personality and Total Health (PATH) through Life Study

Publisher: S. Karger AG

Date: 09-12-2011

DOI: 10.1159/000322373

Abstract: i Aims: /i To investigate self-reports of memory and health as predictors of transition to mild cognitive impairment (MCI) or any mild cognitive disorder (any MCD) in a community-based study. i Method: /i 2,082 in iduals, aged 60–64 years, were assessed at 2 time points 4 years apart for MCI using either the International Consensus Criteria, the Clinical Dementia Rating scale (CDR, 0.5), or a suite of criteria sets for mild cognitive disorders (any MCD) and global cognitive change. Logistic and multiple regression was used to assess conversion to diagnosis and cognitive change from the SF-12 self-rated health (SRH) and physical health subscale measures, as well as reports of memory problems. i Results: /i Of the 2,082 participants with no cognitive impairment at wave 1, 18 participants had a diagnosis of MCI, 32 a CDR score of 0.5, and 64 participants presented with any MCD 4 years later. After controlling for age, sex and education, SRH and physical health were significant predictors of MCD, memory interference was the only significant predictor of MCI, and cognitive change was associated with SRH, physical health and memory interference. i Conclusion: /i Brief, short, easily collected self-reports of health, disability and memory can provide useful information on the risk of MCD and cognitive decline in young-old adults.

CORRIGENDUM

Publisher: Cambridge University Press (CUP)

Date: 12-03-2007

DOI: 10.1017/S0033291707000232

The effect of health behavior change on self-rated health across the adult life course: A longitudinal cohort study

Publisher: Elsevier BV

Date: 2014

DOI: 10.1016/J.YPMED.2013.10.017

Abstract: While it is clear that health behaviors are related to self-rated health (SRH), it is less clear if maintaining positive behaviors, or improving, can protect SRH over time. SRH trajectories were modeled in a large representative Australian s le (n=7485 at baseline), of three age cohorts (20-24, 40-44 and 60-64 years at baseline 1999, 2000 & 2001 respectively), over an 8 year period. Change in smoking, alcohol consumption and physical activity on SRH trajectories were examined, controlling for demographic, physical and mental health factors. SRH became poorer over time across the s le. Being a non-smoker was associated with more positive SRH levels across all groups. Maintaining or increasing moderate physical activity was associated with less decline in SRH. Findings highlight the benefits of positive health behaviors, particularly performing regular physical activity over time, for reducing the risk of subjective health becoming poorer across the adult life course.

Longitudinal associations between activity and cognition vary by age, activity type, and cognitive domain.

Publisher: American Psychological Association (APA)

Date: 12-2014

DOI: 10.1037/A0036960

Abstract: The demonstration of correlated change is critical to understanding the relationship between activity engagement and cognitive functioning in older adulthood. Changes in activity have been shown to be related to changes in cognition, but little attention has been devoted to how this relationship may vary between specific activity types, cognitive domains, and age groups. Participants initially aged 65-98 years (M = 77.46 years) from the Australian Longitudinal Study of Ageing (n = 1,321) completed measurements of activity (i.e., cognitive, group social, one-on-one social, and physical) and cognition (i.e., perceptual speed, and immediate and delayed episodic memory) at baseline, 2, 8, 11, and 15 years later. Bivariate latent growth curve models covarying for education, sex, and baseline age and medical conditions revealed multiple positive-level relations between activity and cognitive performance, but activity level was not related to later cognitive change. Change in perceptual speed over 15 years was positively associated with change in cognitive activity, and change in immediate episodic memory was positively associated with change in one-on-one social activity. Old-old adults showed a stronger change-change covariance for mentally stimulating activity in relation to perceptual speed than did young-old adults. The differentiation by activity type, cognitive domain, and age contributes to the growing evidence that there is variation in the way cognitive ability at different ages is related to activity.

Machine Learning for Prediction of Cognitive Health in Adults Using Sociodemographic, Neighbourhood Environmental, and Lifestyle Factors

Publisher: MDPI AG

Date: 02-09-2022

DOI: 10.3390/IJERPH191710977

Abstract: The environment we live in, and our lifestyle within this environment, can shape our cognitive health. We investigated whether sociodemographic, neighbourhood environment, and lifestyle variables can be used to predict cognitive health status in adults. Cross-sectional data from the AusDiab3 study, an Australian cohort study of adults (34–97 years) (n = 4141) was used. Cognitive function was measured using processing speed and memory tests, which were categorized into distinct classes using latent profile analysis. Sociodemographic variables, measures of the built and natural environment estimated using geographic information system data, and physical activity and sedentary behaviours were used as predictors. Machine learning was performed using gradient boosting machine, support vector machine, artificial neural network, and linear models. Sociodemographic variables predicted processing speed (r2 = 0.43) and memory (r2 = 0.20) with good accuracy. Lifestyle factors also accurately predicted processing speed (r2 = 0.29) but weakly predicted memory (r2 = 0.10). Neighbourhood and built environment factors were weak predictors of cognitive function. Sociodemographic (AUC = 0.84) and lifestyle (AUC = 0.78) factors also accurately classified cognitive classes. Sociodemographic and lifestyle variables can predict cognitive function in adults. Machine learning tools are useful for population-level assessment of cognitive health status via readily available and easy-to-collect data.

Longitudinal Assessment of Hippocampal Atrophy in Midlife and Early Old Age: Contrasting Manual Tracing and Semi-automated Segmentation (FreeSurfer)

Publisher: Springer Science and Business Media LLC

Date: 04-07-2018

DOI: 10.1007/S10548-018-0659-2

Abstract: It is important to have accurate estimates of normal age-related brain structure changes and to understand how the choice of measurement technique may bias those estimates. We compared longitudinal change in hippoc al volume, laterality and atrophy measured by manual tracing and FreeSurfer (version 5.3) in middle age (n = 244, 47.2[1.4] years) and older age (n = 199, 67.0[1.4] years) in iduals over 8 years. The proportion of overlap (Dice coefficient) between the segmented hippoc i was calculated and we hypothesised that the proportion of overlap would be higher for older in iduals as a consequence of higher atrophy. Hippoc al volumes produced by FreeSurfer were larger than manually traced volumes. Both methods produced a left less than right volume laterality difference. Over time this laterality difference increased for manual tracing and decreased for FreeSurfer leading to laterality differences in left and right estimated atrophy rates. The overlap proportion between methods was not significantly different for older in iduals, but was greater for the right hippoc us. Estimated middle age annualised atrophy rates were - 0.39(1.0) left, 0.07(1.01) right, - 0.17(0.88) total for manual tracing and - 0.15(0.69) left, - 0.20(0.63) right, - 0.18(0.57) total for FreeSurfer. Older age atrophy rates were - 0.43(1.32) left, - 0.15(1.41) right, - 0.30 (1.23) total for manual tracing and - 0.34(0.79) left, - 0.68(0.78) right, - 0.51(0.65) total for FreeSurfer. FreeSurfer reliably segments the hippoc us producing atrophy rates that are comparable to manual tracing with some biases that need to be considered in study design. FreeSurfer is suited for use in large longitudinal studies where it is not cost effective to use manual tracing.

Lifetime cigarette smoking is associated with striatal volume measures

Publisher: Wiley

Date: 11-03-2012

DOI: 10.1111/J.1369-1600.2010.00301.X

Abstract: Nicotine, the primary addictive component of tobacco, affects the mammalian brain. Smokers' brains have smaller cortical grey matter volumes and/or lower densities compared with non-smokers'. Differences in subcortical structures like the striatum are however, less clear. A high concentration of nicotinic receptors makes the striatum a potential target for nicotine. In addition, striatal nuclei are essential components of the reward/reinforcement pathway involved in addiction. The aim of this study was to explore the relationship between striatal nuclei (caudate, putamen and nucleus accumbens area) volumes and lifetime smoking in a large community-based s le of 'young-old' in iduals. Brain volumes were measured using a semi-automated method in 315 participants aged 64-70 years who were selected from a larger randomly s led cohort and who consented to a magnetic resonance imaging scan. Multiple regression analysis was used to assess the relationship between striatal volumes and cigarette smoking measures while controlling for age, sex, intracranial and total brain volumes and general physical and mental health measures. Greater lifetime use of cigarettes (measured in pack-years) was associated with smaller left nucleus accumbens area volume (P = 0.018) and larger left putamen volume (P = 0.025). Greater putaminal volume was also associated with a lower age at smoking initiation (P = 0.004). In this generally healthy cohort, lifetime use of cigarettes is significantly associated with striatal volume measures. These changes could indicate predisposing factors for nicotine addiction, or an effect of chronic nicotine exposure or a combination of both.

The Connor-Davidson Resilience Scale (CD-RISC): Testing the invariance of a uni-dimensional resilience measure that is independent of positive and negative affect

Publisher: Elsevier BV

Date: 04-2010

DOI: 10.1016/J.PAID.2009.11.026

The relationship between alcohol use and dementia in adults aged over 60 years: A combined analysis of prospective, individual-participant data from 15 international studies

Publisher: Center for Open Science

Date: 08-09-2021

DOI: 10.31234/OSF.IO/7835K

Abstract: Objective: To synthesise international findings on the alcohol-dementia relationship and provide a cross-national comparison of the alcohol-dementia relationship with critical evidence for the relationship between alcohol use and dementia in under-studied populations. Design and setting: In idual participant data meta-analysis of 15 prospective epidemiological cohort studies from countries situated in five continents. Cox regression investigated the dementia risk associated with alcohol use. Sensitivity analyses compared lifetime abstainers with former drinkers, adjusted extensively for demographic and clinical characteristics, and assessed the competing risk of death. Participants: 24,472 community-dwelling in iduals without a history of dementia at baseline and at least one follow-up dementia assessment. Main outcome measure: All-cause dementia as determined by clinical interview. Results: During 151,574 person-years of follow-up, there were 2,137 incident cases of dementia (14.1 per 1,000 person-years). In the combined s le, when compared with occasional drinkers (& .3g/day), the risk for dementia was higher for current abstainers (HR: 1.29 95% CI: 1.13, 1.48) and lower for moderate drinkers (25g/day-44.9g/day HR: 0.79 95% CI: 0.64, 0.98). When the combined s le was stratified by sex and gross domestic product, current abstainers had a greater risk of incident dementia when compared with light-to-moderate drinkers in both sexes and in the higher income countries. When comparing lifetime abstainers and former drinkers there were no consistent differences in dementia risk. Among current drinkers, there was no consistent evidence to suggest that the amount of alcohol consumed in later life was significantly associated with dementia risk. Adjusting for additional demographic and clinical covariates, and accounting for competing risk of death, did not substantially affect results. When analysed at the cohort level, there was considerable heterogeneity in the alcohol-dementia relationship. Conclusions: In a large and erse international s le of older adults, the current study found that abstinence from alcohol is associated with an increased risk for all-cause dementia. Among current drinkers, there was no consistent evidence to suggest that the amount of alcohol consumed in later life was significantly associated with dementia risk.

Hippocampal sulcal cavities: Prevalence, risk factors and relationship to memory impairment

Publisher: Elsevier BV

Date: 2011

DOI: 10.1016/J.BRAINRES.2010.10.089

Abstract: While hippoc al volumes have been extensively examined in neuropsychiatric disorders and ageing, small areas of signal variation within the hippoc us commonly observed on MRI, described as hippoc al sulcal cavities (HSCs), have received less attention. We review the published literature on HSCs to examine their prevalence, putative aetiological factors such as hypertension, and possible cognitive correlates. HSCs were reported in 77% (66% weighted mean) of patients with memory disorders and 48% (47% weighted mean) of controls, and the prevalence increased with age in healthy subjects (r=0.64, p=0.047). A number of studies reported hypertension as a risk factor, and related their presence to poorer memory function. Further work is needed to fully understand the clinical significance of these lesions.

Age-related cortical thinning in cognitively healthy individuals in their 60s: The PATH Through Life study

Publisher: Elsevier BV

Date: 03-2016

DOI: 10.1016/J.NEUROBIOLAGING.2015.12.009

Abstract: Although it is recognized that the human cortex thins with age, longitudinal estimates of thinning patterns specific to healthy young-old age (<75 years) in iduals are lacking. Importantly, many neurodegenerative disorders first manifest between midlife and old age, and normative estimates may provide a reference for differential change associated with such disorders. Here, we provide longitudinal estimates of cortical thinning observed over 12 years in a large group (n = 396) of healthy in iduals, aged 60-66 years at baseline scan, who were scanned with magnetic resonance imaging (1.5T) on 4 occasions. Longitudinal age-related thinning was observed across most of the cortices, with a mean change of -0.3% per year. We measured significant thinning in heteromodal association cortex, with less thinning in regions expected to atrophy later in life (e.g., primary sensory cortex). Men showed more extensive thinning than women. Our comparison of cross-sectional and longitudinal estimates adds to growing evidence that cross-sectional designs may underestimate age-related changes in cortical thickness.

Covariation of intraindividual variability in cognitive speed and cognitive performance across young, middle, and older adulthood

Publisher: American Psychological Association (APA)

Date: 05-2019

DOI: 10.1037/DEV0000688

Abstract: Intrain idual variability (IIV) in cognitive speed, or moment-to-moment changes in ability, is a developmental phenomenon indicative of neurological integrity that increases gradually across adulthood. Past research has shown that IIV negatively covaries with cognitive performance, in which higher IIV at one occasion is associated with poorer cognitive ability at the same occasion. However, this association has been demonstrated only in older adulthood. Further, all past examinations of IIV change with cognitive change did not remove the average or between-person effect from within-person change in IIV. Using the PATH Through Life Study, we evaluated whether there were differences across 3 age cohorts (20-24, 40-44, and 60-64 years at baseline) in the relationship between 8-year change in IIV and change in cognitive ability (N = 7,485). Change in IIV was partitioned into between-person and within-person components, and multilevel models covarying for education, sex, diabetes, hypertension, and anxiety and depressive symptoms were conducted. IIV was negatively related to baseline cognitive performance at the between-person level. Notably, this relation was apparent and, in fact, strongest for those in young adulthood. Level of IIV was also negatively associated with cognitive change, but primarily for the youngest cohort. In contrast to previous research, there was minimal evidence of significant covariation in which within-person changes in IIV were associated with changes in cognitive performance, regardless of age group. Overall, IIV is a stable characteristic negatively associated with cognition in adulthood, but this link may primarily exist at the between-person level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Follow-up of mild cognitive impairment and related disorders over four years in adults in their sixties: The PATH through life study

Publisher: S. Karger AG

Date: 2008

DOI: 10.1159/000154646

Abstract: i Aims: /i The study aimed to estimate incidence rates of mild cognitive impairment and related disorders, and conversion to dementia. i Methods: /i The data are drawn from the PATH Through Life Study. Baseline assessment in 2001–2002 included 2,551 participants 60–64 years old with 2,222 participating in a 4-year follow-up. Those screened positive with a cognitive assessment received clinical assessment for diagnoses of mild cognitive disorders (MCD) or dementia using established clinical criteria. Prevalence and incidence rates for the cohort were estimated with predictive regression models. i Results: /i Annual incidence of dementia was 0.25%. Prevalence of mild cognitive impairment was 4.2%, age-associated memory impairment was 2.4%, age-associated cognitive decline was 7.6%, mild neurocognitive disorders occurred in 12.9% and other cognitive disorders in 7.3%. Prevalence of any diagnosis of any MCD (Any-MCD) was 29.5% and the annual incidence rate for Any-MCD was 5.7%. Agreement for specific diagnoses between waves 1 and 2 was fair to poor (0–47.0%), but agreement for Any-MCD over 4 years was 89.0%. i Conclusion: /i MCD diagnoses do not predict dementia at a 4-year follow-up in young-old adults. Prevalence rates for MCD vary greatly depending on the criteria and time of assessment.

Is suicidality distinguishable from depression? Evidence from a community-based sample

Publisher: SAGE Publications

Date: 2009

DOI: 10.1080/00048670802653331

Abstract: Objective: Suicidal behaviour is often considered in the context of depression. Taking an empirical, dimensional and population-based approach, this investigation examines two issues: first, whether it is justifiable to regard suicidality as a symptom of depression or an independent construct. Second, although suicidal behaviour has been shown to decline with increasing age and differ across gender, little is known about the stability of the underlying construct across the lifespan and between genders. Method: Data were derived from a community-based s le consisting of 7485 people aged 20–24, 40–44 or 60–64 years. Confirmatory factor analysis was used to assess the adequacy of model fit and measurement invariance across gender and then age groups. Results: The data fitted a two-factor model of depression and suicidality better than a single-factor model. Multi-group analysis indicated strict measurement invariance for both gender and age groups, indicating no significant differences between groups in measurement model fit. Conclusions: These analyses establish that suicidality is distinguishable from depression, although the factors are substantially correlated. Results suggest that the underlying factorial relationship between suicidality and depression appears not to vary considerably between genders or across cohorts aged 20–24, 40–44 and 60–64 years. Finally, the analyses also highlight the necessity of inventories with scales identifying symptoms of suicidality independent of depression symptoms.

Dementia literacy: Recognition and beliefs on dementia of the Australian public

Publisher: Wiley

Date: 2009

DOI: 10.1016/J.JALZ.2008.03.011

Abstract: Dementia is a growing health problem worldwide and in Australia. Little research has been conducted on dementia literacy in the community. The aim of this study was to investigate the recognition of dementia and beliefs regarding prognosis, cause, and risk reduction in the Australian public. A cross-sectional telephone survey of 2,000 randomly selected community-dwelling adults (23.4% response rate) was conducted. Eighty-two percent of the s le correctly identified "dementia" or "Alzheimer's" from a vignette. There were no differences in recognition rates between vignettes describing mild or moderate dementia symptoms. Almost half thought that at least partial recovery would occur, given appropriate treatment. More than 80% of the s le thought that genetics, old age, brain disease, and stroke or mini-stroke contributed to a person getting dementia. Seventy-two percent thought that the risk of dementia could be reduced. The most frequently suggested methods for risk reduction were mental exercise (38.8%), eating healthily (31.0%), physical exercise (30.2%), and socializing more (13.9%). Sociodemographic characteristics were associated with dementia knowledge and beliefs. The majority of the Australian public recognize the symptoms of dementia and think dementia risk can be reduced. However, most do not know of the association between dementia and cardiovascular factors. Public awareness c aigns need to increase accurate knowledge of factors consistently found to be associated with dementia.

Body mass index in midlife and late-life as a risk factor for dementia: A meta-analysis of prospective studies

Publisher: Wiley

Date: 27-04-2011

DOI: 10.1111/J.1467-789X.2010.00825.X

Utility of intraindividual reaction time variability to predict white matter hyperintensities: A potential assessment tool for clinical contexts?

Publisher: Cambridge University Press (CUP)

Date: 08-08-2013

DOI: 10.1017/S1355617713000830

Abstract: Intrain idual variability (IIV) refers to reaction time (RT) variation across the trials of a given cognitive task. Little research has contrasted different measures of IIV or assessed how many RT trials are required to provide a robust measure of the construct. We, therefore, investigated three measures of IIV (raw SD , coefficient of variation, and intrain idual SD statistically removing time-on-task effects) in relation to frontal white matter hyperintensities (obtained through structural MRI) in 415 cognitively normal community-dwelling adults aged 44 to 48 years. Results indicated the three IIV measures did not differ greatly in predictions of white matter hyperintensities, although it is possible that time-on-task effects were influential. As few as 20 trials taking approximately 52 s to administer provided a reliable prediction of frontal white matter hyperintensities. We conclude that future work should evaluate the comparative utility of different IIV measures in relation to persons exhibiting clear neuropathology. ( JINS , 2013, 19 , 1–6)

Role of dietary pattern analysis in determining cognitive status in elderly Australian adults

Publisher: MDPI AG

Date: 04-02-2015

DOI: 10.3390/NU7021052

Dementia stigma reduction (DESeRvE) through education and virtual contact in the general public: A multi-arm factorial randomised controlled trial

Publisher: SAGE Publications

Date: 31-01-2021

DOI: 10.1177/1471301220987374

Abstract: To examine the efficacy of the Dementia Stigma Reduction (DESeRvE) programme, aimed at reducing the general public dementia-related stigma utilising ‘education’ and ‘contact’ approaches. A total of 1024 Australians aged between 40 and 87 years (M = 60.8, SD = 10.1) participated in a factorial randomised controlled trial. This trial examined four conditions: online education programme (ED), contact through simulated contact with people with dementia and carers (CT), education and contact (ED+CT) and active control. Cognitive, emotional and behavioural aspects of dementia-related stigma were measured with a modified Attribution Questionnaire, and dementia knowledge was measured with the Dementia Knowledge Assessment Scale at the baseline, immediately and 12 weeks after the completion of the intervention. All four groups improved (reduction in scores) significantly from baseline to week 12 in dementia-related stigma, and the effects were stronger for those with higher baseline stigma scores. Intervention groups also improved significantly from baseline in dementia knowledge. Especially, the ED (β = .85, SE = .07 p .001) and ED+CT (β = .78, SE = .08 p .001) groups at immediate follow-up and CT (β = .21, SE = .09 p .05) and ED+CT (β = .32, SE = .09 p .001) at 12-week follow-up showed significant effects. Findings suggest that DESeRvE can be a valuable tool to enhance public’s dementia knowledge and reduce dementia-related stigma, especially for those with higher levels of stigma. Reduction in stigma, however, may take a longer time to achieve, whereas improvement in dementia knowledge is instant.

Combining modifiable risk factors and risk of dementia: A systematic review and meta-analysis

Publisher: BMJ

Date: 2019

DOI: 10.1136/BMJOPEN-2018-022846

Abstract: To systematically review the literature relating to the impact of multiple co-occurring modifiable risk factors for cognitive decline and dementia. A systematic review and meta-analysis of the literature relating to the impact of co-occurring key risk factors for incident cognitive decline and dementia. All abstracts and full text were screened independently by two reviewers and each article assessed for bias using a standard checklist. A fixed effects meta-analysis was undertaken. Databases Medline, Embase and PsycINFO were searched from 1999 to 2017. For inclusion articles were required to report longitudinal data from participants free of cognitive decline at baseline, with formal assessment of cognitive function or dementia during follow-up, and an aim to examine the impact of additive or clustered comorbid risk factor burden in with two or more core modifiable risk factors. Seventy-nine full-text articles were examined. Twenty-two articles (18 studies) were included reporting data on 000 participants. Included studies consistently reported an increased risk associated with greater numbers of intrain idual risk factors or unhealthy behaviours and the opposite for healthy or protective behaviours. A meta-analysis of studies with dementia outcomes resulted in a pooled relative risk for dementia of 1.20 (95% CI 1.04 to 1.39) for one risk factor, 1.65 (95% CI 1.40 to 1.94) for two and 2.21 (95% CI 1.78 to 2.73) for three or more, relative to no risk factors. Limitations include dependence on published results and variations in study outcome, cognitive assessment, length of follow-up and definition of risk factor exposure. The strength of the reported associations, the consistency across studies and the suggestion of a dose response supports a need to keep modifiable risk factor exposure to a minimum and to avoid exposure to additional modifiable risks. Further research is needed to establish whether particular combinations of risk factors confer greater risk than others. 42016052914.

A longitudinal examination of the relationship between cannabis use and cognitive function in mid-life adults

Publisher: Elsevier BV

Date: 12-2016

DOI: 10.1016/J.DRUGALCDEP.2016.10.022

Abstract: The relationship between cannabis use and cognitive function in mid-life has rarely been examined despite verbal learning deficits in young adults. A longitudinal cohort study of 1,897 Australians recruited at 40-46 years of age and followed up 4 years (94%) and 8 years (87%) later. Random effects regression was used to assess within- and between-person associations between cannabis use and cognitive function across waves of data, and examine whether age-related changes in cognitive performance were modified by cannabis use. The first list of the California Verbal Learning Test (immediate and delayed recall), Symbol Digit Modality Test, Digit Backwards, simple and choice reaction time tasks, were administered at each wave. The Spot-the-Word test was used to assess premorbid verbal ability. Self-reported cannabis use in the past year (no use, < weekly use,≥weekly use) was assessed at each wave. Participants who used cannabis≥weekly had worse immediate recall (b=-0.68, p=0.014) and showed a trend toward worse delayed recall (b=-0.55, p=0.062) compared to non-users after adjusting for correlates of cannabis use and premorbid verbal ability. These effects were due to between-person differences. There were no significant within-person associations between cannabis use and recall, nor was there evidence of greater cognitive decline in cannabis users with age. Mid-life cannabis users had poorer verbal recall than non-users, but this was not related to their current level of cannabis use, and cannabis use was not associated with accelerated cognitive decline.

Associations between corpus callosum size and ADHD symptoms in older adults: The PATH through life study

Publisher: Elsevier BV

Date: 10-2016

DOI: 10.1016/J.PSCYCHRESNS.2016.08.009

Abstract: Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life. Here, we investigated in a large population-based s le of 280 adults (150 males, 130 females) in their late sixties and early seventies whether ADHD symptoms correlate with callosal thickness. In addition, we tested for significant sex interactions, which were followed by correlation analyses stratified by sex. Within males, there were significant negative correlations with respect to inattention and hyperactivity in various callosal regions, including the anterior third, anterior and posterior midbody, isthmus, and splenium. A thinner corpus callosum may be associated with fewer fibers or less myelination of fibers. Thus, the observed negative correlations suggest impaired inter-hemispheric communication channels necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. Interestingly, within females, callosal thickness was positively related to hyperactivity in a small area within the rostral body, suggesting a sexually dimorphic neurobiology of ADHD symptoms. Altogether, the present results may reflect a lasting relationship between callosal morphology and ADHD symptoms throughout life.

Validated Alzheimer’s Disease Risk Index (ANU-ADRI) is associated with smaller volumes in the default mode network in the early 60s

Publisher: Springer Science and Business Media LLC

Date: 14-12-2019

DOI: 10.1007/S11682-017-9789-5

Right, left, and center: How does cerebral asymmetry mix with callosal connectivity?

Publisher: Wiley

Date: 15-03-2013

DOI: 10.1002/HBM.22022

Alcohol use and depression from middle age to the oldest old: Gender is more important than age

Publisher: Cambridge University Press (CUP)

Date: 20-02-2012

DOI: 10.1017/S1041610212000087

Abstract: Background: Alcohol use disorders are associated with other mental health disorders in young adults, but there are few data on alcohol use and mental health outcomes in older adults, particularly the oldest old. This study examines the relationship between alcohol consumption and depressive symptoms. Methods: Data were collected from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project, which has pooled nine Australian longitudinal studies. Alcohol consumption was classified using standard drinks (10 g alcohol)/day as: abstinent, low risk ( –≤2 standard drinks), long-term risk ( –≤4) and short-term risk ( ). Probable depression was classified from harmonized scores on various standard instruments (e.g. Centre for Epidemiological Studies Depression scale). Results: Overall, 39,104 (86%) participants contributed data. Alcohol classification at baseline showed 7,526 abstinent, 28,112 low risk, 2,271 long-term risk, and 1,195 short-term risk participants. Age ranged from 45 to 103 year (median 60). Using generalized estimating equations (GEE), there were significant gender by alcohol and gender by age interactions, so the analysis was split by gender. Among males, the abstinent and short-term risk groups had increased likelihood of depression: in females the abstinent, long- and short-term risk groups had increased odds of depression. Increased odds of depression was also associated with former and current smoking, younger age-group, not being partnered, leaving school before age 15 and increasing levels of health-impaired walking, dressing, or bathing. Conclusion: The impact of alcohol use differs by gender, nevertheless those using higher levels of alcohol or who smoke should be screened for depression and may benefit from interventions.

Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study

Publisher: S. Karger AG

Date: 2009

DOI: 10.1159/000229025

Abstract: i Aims: /i The aim of this study was to identify physical and mental health and lifestyle predictors of transition from normal cognition to mild cognitive disorder (MCD). i Methods: /i A total of 2,082 in iduals, aged 60–64 years, were assessed at 2 time-points 4 years apart for mild cognitive impairment (MCI) and other MCDs. i Results: /i The main predictors of conversion to MCI and to other mild cognitive disorders were past alcohol intake, current anxiety and depression medication, increased systolic blood pressure, and past smoking. i Conclusion: /i Participants with a history of smoking or harmful alcohol consumption, hypertension, or who took medication for anxiety or depression were at increased risk of transitioning to MCI or any MCD. Strategies targeted at managing the above risk factors may have benefits in preventing mild cognitive decline in relatively healthy middle-aged in iduals living in the community.

A Scoping Review of Workplace Interventions to Promote Positive Attitudes Toward Older Workers and Reduce Age-Based Discrimination

Publisher: Oxford University Press (OUP)

Date: 30-05-2023

DOI: 10.1093/WORKAR/WAAD013

Abstract: Population aging trends have created a need for effective policies to extend adult working lives. Previous research has identified the prevalence of negative attitudes (age-related stereotypes, prejudice, and discriminatory behaviors) directed toward older workers in the workplace context. The current scoping review aimed to describe and assess the current evidence in support of different types of interventions aimed at promoting positive attitudes and reducing age-based discrimination in the workplace context. A search of peer-reviewed and grey literature databases identified 22 relevant studies, including data from 5,078 adult participants, across laboratory and field settings. From examination of these studies, we propose and describe four thematic categories of interventions, as a way of organizing this literature: “de-biasing interventions,” “brief attitudinal interventions,” “age ersity workshop interventions,” and “structural or contextual interventions.” At the current point in time, studies assessing age ersity workshop interventions appear to be the strongest, having a clear theoretical basis, having a focus on interventions that can be delivered in workplace settings, and providing evidence for positive effects on measures that are meaningful for organizations and older workers. While a number of promising interventions have been tested, most studies were only able to demonstrate improvements in explicit measurements of attitudes toward older adults, immediately following the intervention. Collaborative partnerships with organizations and further high-quality studies (particularly in field settings) are required to support the development, evaluation, and implementation of interventions to promote positive attitudes toward older adults in real-world workplace settings.

Using sulcal and gyral measures of brain structure to investigate benefits of an active lifestyle

Publisher: Elsevier BV

Date: 05-2014

DOI: 10.1016/J.NEUROIMAGE.2014.01.008

Abstract: Physical activity is associated with brain and cognitive health in ageing. Higher levels of physical activity are linked to larger cerebral volumes, lower rates of atrophy, better cognitive function and a lower risk of cognitive decline and dementia. Neuroimaging studies have traditionally focused on volumetric brain tissue measures to test associations between factors of interest (e.g. physical activity) and brain structure. However, cortical sulci may provide additional information to these more standard measures. Associations between physical activity, brain structure, and cognition were investigated in a large, community-based s le of cognitively healthy in iduals (N=317) using both sulcal and volumetric measures. Physical activity was associated with narrower width of the Left Superior Frontal Sulcus and the Right Central Sulcus, while volumetric measures showed no association with physical activity. In addition, Left Superior Frontal sulcal width was associated with processing speed and executive function. These findings suggest sulcal measures may be a sensitive index of physical activity related to cerebral health and cognitive function in healthy older in iduals. Further research is required to confirm these findings and to examine how sulcal measures may be most effectively used in neuroimaging.

Cross-sectional and longitudinal patterns of dedifferentiation in late-life cognitive and sensory function: The effects of age, ability, attrition, and occasion of measurement.

Publisher: American Psychological Association (APA)

Date: 2003

DOI: 10.1037/0096-3445.132.3.470

Multi-domain prognostic models used in middle aged adults without known cognitive impairment for predicting subsequent dementia

Publisher: Wiley

Date: 04-06-2021

DOI: 10.1002/14651858.CD014885

Predicting driving cessation over 5 years in older adults: Psychological well-being and cognitive competence are stronger predictors than physical health

Publisher: Wiley

Date: 15-09-2006

DOI: 10.1111/J.1532-5415.2005.00471.X

Abstract: To examine psychological, medical, and sensorimotor risk factors that predict driving cessation in older adults. Prospective cohort study including five waves of data collected in 1992, 1993, 1994, 1995, and 1997. The Australian Longitudinal Study of Aging. One thousand four hundred sixty-six men and women aged 70 and older drawn from the electoral roll and including 753 drivers at baseline. Interviews, including assessments of self-rated health (indicating general well-being) medical conditions driving status and clinical assessments of vision, hearing, cognitive function, and grip strength, were conducted in 1992 (baseline) and 1994. Information on current driving status was obtained at baseline and four subsequent waves (1993, 1994, 1995, and 1997). Drivers and nondrivers were compared at baseline. Risk factors for driving cessation were identified using logistic regression. Drivers were younger and more likely to be male and had better self-rated health, vision, hearing, and cognitive performance than nondrivers at baseline. Seventeen percent of drivers in the study had vision of 6/18 or worse, and 7.3% were classified as possibly cognitively impaired. In those identified as drivers at baseline, subsequent cessation was associated with increasing age, low grip strength, poorer cognitive performance, and poorer self-rated health. Self-rated health and cognitive function were more important than medical conditions or sensory function for predicting driving cessation.

Psychoactive medication use, sensori‐motor function and falls in older women.

Publisher: Wiley

Date: 03-1995

DOI: 10.1111/J.1365-2125.1995.TB04441.X

Abstract: 1. A 1 year prospective study was undertaken to identify possible mediating physiological mechanisms for the association between psychoactive medication use and falls in 414 women aged 65 to 99 years (mean age 73.7 years, s.d. = 6.3) who were randomly selected from the community. 2. Women taking certain psychoactive medications showed impaired performance in a number of sensori-motor measures, including tactile sensitivity, lower limb muscle strength, reaction time and balance control compared with women not taking these medications. Those using psychoactive medications were also comparatively inactive--taking part in only 1.1 h of planned exercise per week compared with 2.6 h for non-users (F = 12.44, df = 1,412, P < 0.01). 3. Multiple logistic regression analysis revealed that use of long-acting benzodiazepines (OR = 7.03, 95% CI = 2.12-23.28) and antidepressants (OR = 2.84, 95% CI = 1.00-8.02) was significantly associated with multiple falls, whilst adjusting for age, other drug category use, frequency of alcohol use, and number of medical conditions. Use of any two psychoactive medications was also significantly associated with falling frequency (Chi-square = 13.91, df = 1, P < 0.01). 4. Path analysis revealed a significant direct association (P < 0.001) between psychoactive medication use and falls, and a significant indirect association mediated via reduced physiological functioning (P < 0.001). Postural hypotension was not significantly associated with falls (RR = 1.37, 95% CI = 0.84-2.22). 5. The findings suggest that psychoactive medication use may predispose older people to falling by impairing important sensori-motor systems that contribute to postural stability.

Help-seeking and service use for dementia in Italian, Greek and Chinese Australians

Publisher: Informa UK Limited

Date: 04-2011

DOI: 10.1080/13607863.2010.536134

Abstract: To explore the help-seeking strategies and the acceptance of services among a national s le of Italian, Greek and Chinese compared to third generation Australians. A cross-sectional telephone survey of 350 Italian, 414 Greek, 437 Chinese and 500 third generation Australians whose households were randomly selected from the national telephone directory was carried out. Participants were asked how they would seek help for a character in a vignette with dementia and what aged care services they would use. The most frequently reported sources of help for all participants were general practitioners (55%), community organisations (27%) and family (26%). Significantly more racial minority participants reported that they would seek help from their families (32%) than did third generation Australians (13%). The percentage of participants who reported they would use aged care services were 96% for day activities, 95% for community nursing, 93% for bus outings, 91% for home help with housework, 88% for carer's support groups, 83% for nursing home care, 78% for one-week respite and 67% for Meals-on-Wheels. Racial minorities were equally or more likely to say that they would use some community-based services than third generation Australians and less likely to use residential respite. Italians were less likely to use permanent residential care. Acculturation parameters were inconsistently associated with help-seeking and service acceptability. Racial minority groups have a greater preference for community services than third generation Australians. There are differences between racial minority groups on help-seeking and acceptability of services. Education and outreach to these groups needs to be tailored.

Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey

Publisher: Springer Science and Business Media LLC

Date: 29-03-2010

DOI: 10.1186/1471-2458-10-171

Visual abilities in older adults explain age-differences in stroop and fluid intelligence but not face recognition: Implications for the vision-cognition connection

Publisher: Informa UK Limited

Date: 12-2002

DOI: 10.1076/ANEC.9.4.253.8770

Cognitive development over 8 years in midlife and its association with cardiovascular risk factors

Publisher: American Psychological Association (APA)

Date: 07-2014

DOI: 10.1037/NEU0000044

Abstract: We describe population-level cognitive development in early middle-age and evaluate whether cardiovascular risk factors for late-onset dementia influence cognitive change in midlife. The s le from the PATH Through Life (PATH) Project (N = 2,530 40-44 years of age at baseline) was drawn randomly from the community, followed for 8 years, and assessed on cognitive function, health, and lifestyle risk factors at 4 yearly intervals. A summary risk score (PATHrisk) was computed for presence of smoking, hypertension, depression, high body mass index, diabetes, and insufficient physical activity. Decline in processing speed and reaction time (RT) and improvement in memory and verbal ability were observed. Higher PATHrisk score was associated with poorer performance on all cognitive tests, except for RT. Participants with higher PATHrisk scores had greater slowing on choice RT over 8 years. Education was associated with cognitive test performance and was weakly protective against slowing of RT. In idual risk factors, primarily diabetes, smoking, and depression, were associated with cognitive function, and smoking was associated with decline in simple RT. Reliable change in cognitive function was detected in midlife, and decline occurred primarily in measures of cognitive speed. It appears that in midlife, the overall burden of cardiovascular risk factors is more important than in idual risk factors. Midlife is a critical period for identifying modifiable risk factors for dementia in late-life, and evaluation of burden of risk factors is indicated for developing strategies to prevent cognitive decline in ageing.

Can the intensity of physical activity be accurately measured in older adults using questionnaires?

Publisher: Elsevier BV

Date: 07-2019

DOI: 10.1016/J.JSAMS.2019.01.004

Abstract: This study assessed the accuracy of two questionnaires for measuring the duration of physical activity (PA) by intensity compared to an objective measure in older adults. Cross-sectional observation METHODS: A total of 169 (female=43.8%) participants aged 73-78 years (mean: 75.1 y SD: 1.3) wore a SenseWear™ Armband (SWA) for seven-days and reported the duration of PA by intensity with a Physical Activity Recall (PAR) questionnaire and the Active Australia Survey (AAS). In addition, the duration of moderate-to-vigorous-PA (MVPA) and overall active time, weighted for intensity (Total PA MET: min/week) was assessed. Univariate general linear models were used to compare the questionnaire and SWA measures of PA while controlling for age, sex and education. The PAR was associated with SWA moderate intensity PA (b=0.19 95% CI 0.03-0.35), MVPA (b=0.19 95% CI 0.02-0.37) and Total PA (b=0.33 95% CI 0.11-0.55). Although significant correlations were present, the models explained a small proportion of the variance in the SWA variables. The AAS was not associated with the SWA for any PA outcome. There was also significant under-reporting of PA duration for both questionnaires in comparison to the SWA. The PAR questionnaire may be suitable for determining the effect of greater levels of PA on health outcomes. However, neither questionnaire can be considered valid in determining the duration of PA ided by intensity. In addition, questionnaire and objectively measured PA are not equivalent and absolute measures of PA derived from questionnaires should be interpreted with caution.

Online memory screening-are older adults interested and can it work?

Publisher: Informa UK Limited

Date: 09-2012

DOI: 10.1080/13607863.2012.684667

Abstract: Subjective memory concerns are common in older adults and may prompt the use of web-based cognitive screening. Websites which purport to provide memory screening are numerous and can influence health behaviours however there is currently limited evidence regarding their validity. The current research aims to assess potential user's attitudes and motivations regarding online cognitive screening and to evaluate the preliminary evidence for the feasibility and validity of two subjective online cognitive measures. The s le consisted of community-based older adults, 30 with, and 30 without, memory concerns. Participants rated their likelihood of their accessing online cognitive screening and gave rationales. Participants' performance on objective pen and paper measures of cognition was compared to performance on subjective online screening measures. The majority of participants indicated they would access online cognitive screening. A total of 100% of participants were able to use the online tools without assistance. None of the online measures was positively associated with the pen and paper screening measures. Anxiety and depression were significantly associated with subjective memory concerns. This study provided no supporting evidence for the validity of either subjective online screening measure assessed. Anxiety and depression were significantly associated with subjective cognition, indicating that, although they may not predict objective cognition, complaints about memory in older adults should be taken seriously by health professionals.

Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: A COSMIC study

Publisher: Cold Spring Harbor Laboratory

Date: 26-05-2020

DOI: 10.1101/2020.05.20.20106526

Abstract: Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer`s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. Therefore, we combined in idual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. The s le comprised 39,387 cognitively unimpaired in iduals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI=23.3%-24.4%) and IRT (25.6%, 95%CI=25.1%-26.1%) however, prevalence estimates varied largely between studies (QH: 6.1%, 95%CI=5.1%-7.0%, to 52.7%, 95%CI=47.4%-58.0% IRT: 7.8%, 95%%CI=6.8%-8.9%, to 52.7%, 95%CI = 47.4%-58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in in iduals with Asian and African ancestry compared to European ancestry, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. Data harmonization and application of uniform criteria across erse cohorts yielded more accurate estimates of SCD prevalence. Having a quarter of older in iduals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help in iduals with SCD who seek medical advice.

An Australian survey of cognitive health beliefs, intentions, and behaviours through the adult life course

Publisher: Elsevier BV

Date: 2015

DOI: 10.1016/J.PMEDR.2015.06.008

Putting Fine Particulate Matter and Dementia in the Wider Context of Noncommunicable Disease: Where are We Now and What Should We Do Next: A Systematic Review

Publisher: S. Karger AG

Date: 2021

DOI: 10.1159/000515394

Abstract: b i Introduction: /i /b A significant proportion of the global population regularly experience air quality poorer than that recommended by the World Health Organization. Air pollution, especially fine particulate matter (PM sub .5 /sub ), is a risk factor for various noncommunicable diseases (NCDs) and is emerging as a risk factor for dementia. To begin to understand the full impact of PM sub .5 /sub , we review the longitudinal epidemiological evidence linking PM sub .5 /sub to both dementia and to other leading NCDs and highlight the evidence gaps. Our objective was to systematically review the current epidemiological evidence for PM sub .5 /sub as a risk factor for cognitive decline and incident dementia and to put this in context with a systematic overview of PM sub .5 /sub as a potential risk factor in other leading NCDs. b i Methods: /i /b We performed 2 systematic reviews. A high-level review of reviews examining the relationship between PM sub .5 /sub and leading NCDs and an in-depth review of the longitudinal epidemiological data examining relationships between PM sub .5 /sub incident dementia and cognitive decline. b i Results: /i /b There were robust associations between PM sub .5 /sub and NCDs although in some cases the evidence was concentrated on short rather than longer term exposure. For those articles reporting on incident dementia, all reported on longer term exposure and 5 of the 7 eligible articles found PM sub .5 /sub to be associated with increased risk. b i Conclusion: /i /b The evidence base for PM sub .5 /sub as a risk factor for dementia is growing. It is not yet as strong as that for other NCDs. However, varied measurement/methodology h ers clarity across the field. We propose next steps.

Olfactory impairment in older adults is associated with depressive symptoms and poorer quality of life scores

Publisher: Elsevier BV

Date: 09-2011

DOI: 10.1097/JGP.0B013E318211C205

Interrelationships among biological markers of aging, health, activity, acculturation and cognitive performance in late adulthood

Publisher: No publisher found

Date: 1999

DOI: 10.1037//0882-7974.14.4.605

Western diet is associated with a smaller hippocampus: A longitudinal investigation

Publisher: Springer Science and Business Media LLC

Date: 08-09-2015

DOI: 10.1186/S12916-015-0461-X

Associations of biomarkers, cognition and self-reports of sensory function with self-reported driving behaviour and confidence

Publisher: S. Karger AG

Date: 2003

DOI: 10.1159/000069177

Abstract: i Background: /i Older adults report self-regulating their driving habits but little is known about factors associated with driving habits and driving confidence. i Objective: /i We aimed to evaluate cognitive performance, biomarkers and self-reported sensory function as correlates of self-reported driving behaviour and confidence. i Methods: /i A volunteer s le of 153 drivers aged between 60 and 90 were assessed on biomarkers (vision, hearing, vibration sense, grip strength and FEV sub /sub ), and cognitive performance. A subs le of 121 also completed a questionnaire on driving behaviour, driving confidence and self-reported sensory function. Structural equation modelling techniques were used to evaluate the relative importance of subjective and performance-based variables. i Results: /i Driving behaviour and confidence were associated with cognitive performance, biomarkers, chronological age and one question on self-rated hearing difficulty. Structural equation modelling showed that biomarkers were most important in predicting self- reported driving behaviour. i Conclusion: /i These results suggest that in iduals self-monitor according to their physiological well-being and report their driving behaviour accordingly.

The metabolic syndrome and cancer: Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components?

Publisher: Elsevier BV

Date: 12-2015

DOI: 10.1016/J.DIABET.2015.04.006

Abstract: The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its in idual components, which components drive the association, or if the MetS predicts future cancer risk. We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. The MetS was inversely associated with prostate cancer (HR 0.85 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38 1.13-1.70) and elevated blood pressure (1.29 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.

What are older adults seeking? Factors encouraging or discouraging retirement village living

Publisher: Wiley

Date: 09-08-2012

DOI: 10.1111/J.1741-6612.2012.00623.X

Abstract: (1) To identify factors that older adults find encouraging or discouraging about the prospect of relocation to a retirement village and (2) to identify features or facilities often associated with retirement communities that are most appealing to prospective residents. Randomly selected community residents (n = 517), aged 55-94 years, from the Australian Capital Territory completed postal surveys to identify the characteristics associated with retirement villages that influence relocation decisions. The provision of outdoor living areas, support in maintaining independence, assisted living facilities and accessibility to medical facilities were identified as factors that would encourage relocation. Luxury services (e.g. heated swimming pools) were indicated as least likely to encourage relocation. Negative perceptions most influential in discouraging relocation reflected a fear of losing independence and privacy. Through identifying the expectations of prospective residents, retirement village providers may better tailor facilities to the needs of their target demographic.

White matter hyperintensities and within-person variability in community-dwelling adults aged 60-64 years

Publisher: Elsevier BV

Date: 2007

DOI: 10.1016/J.NEUROPSYCHOLOGIA.2007.02.006

Abstract: Estimates of white matter hyperintensities (WMH) derived from T2-weighted MRI were investigated in relation to cognitive performance in 469 healthy community-dwelling adults aged 60-64 years. Frontal lobe WMH but not WMH from other brain regions (temporal, parietal, and occipital lobes, anterior and posterior horn, periventricular body) were associated with elevated within-person reaction time (RT) variability (trial to trial fluctuations in RT performance) but not performance on several other cognitive tasks including psychomotor speed, memory, and global cognition. The findings are consistent with the view that elevated within-person variability is related to neurobiological disturbance, and that attentional mechanisms supported by the frontal cortex play a key role in this type of variability.

The Parent Adult-Child Relationship Questionnaire (PACQ): The assessment of the relationship of adult children to their parents

Publisher: Informa UK Limited

Date: 02-1999

DOI: 10.1080/13607869956415

Recall of depressive episode 25 years previously

Publisher: Cambridge University Press (CUP)

Date: 07-1999

DOI: 10.1017/S0033291799008648

Abstract: Background. Lifetime rates of depression reported in epidemiological surveys are generally only twice the 12 month rates. Either people forget the symptoms of depression or many people who have a depressive episode remain depressed for many years. Both may be true. There is a need to examine the long-term clinical validity of interviews that are used to make lifetime diagnoses. Methods. Forty-five patients who were part of a long-term follow-up study of depression were interviewed 25 years after the index episode. The diagnoses from the original, fully structured interviews were compared with the responses people made for that period when interviewed using the CIDI 25 years later. Results. Twenty-seven patients met CIDI DSM-III-R criteria for depression at index episode. At the 25 year follow-up, 19 of the 27 reported the essential symptoms of ‘depression or loss of interest’ being present at the index time, and in 14 of the 27 the depressive symptoms recalled met criteria for DSM-III-R major depressive episode at that time. Conclusions. Seventy per cent of people who were hospitalized for a major depressive episode can recall being depressed but only half can recall sufficient detail to satisfy the diagnostic criteria when interviewed 25 years later. As depressive episodes, especially those severe enough to warrant admission, are recalled better than many other diagnoses, one must be cautious about the lifetime rates for mental disorders reported in retrospective epidemiological surveys.

Hazard Perception in Older Drivers With Eye Disease

Publisher: Association for Research in Vision and Ophthalmology (ARVO)

Date: 22-01-2021

DOI: 10.1167/TVST.10.1.31

Psychosocial factors, gender and late-life mortality

Publisher: Springer Science and Business Media LLC

Date: 03-2002

DOI: 10.1007/S12126-002-1003-3

Does reverse causality explain the relationship between diet and depression?

Publisher: Elsevier BV

Date: 04-2015

DOI: 10.1016/J.JAD.2015.01.007

Abstract: Observational studies have repeatedly demonstrated relationships between habitual diet quality and depression. However, whilst reverse causality has not been the identified mechanism for these associations in prospective studies, the relationship between diet and depression is likely complex and bidirectional. Thus explicit investigation of the reverse causality hypothesis is warranted. Data were drawn from the Personality and Total Health (PATH) Through Life Study, a longitudinal community survey following three age cohorts from Australia. Analyses evaluated the relationships between past depression and treatment, current depressive symptoms and dietary patterns. In iduals with current depression had lower scores on a healthy dietary pattern however, those who had been previously depressed and sought treatment had higher scores on the healthy dietary pattern at the later baseline assessment. Moreover, those who had reported prior, but not current, depression also had lower scores on the western dietary pattern than those without prior depression, regardless of whether they had been previously treated for their symptoms. Self-report data and possible recall bias limit our conclusions. In this study, prior depression was associated with better quality diets at the later time point. Thus, while current depression is associated with poorer dietary habits, a history of depression may prompt healthier dietary behaviours in the long term. Given the demonstrated relationships between diet quality and depressive illness, clinicians should advocate dietary improvement for their patients with depression and should not be pessimistic about the likelihood of adherence to such recommendations.

Protocol of a 12-month multifactorial eHealth programme targeting balance, dual-tasking and mood to prevent falls in older people: the StandingTall+ randomised controlled trial

Publisher: BMJ

Date: 04-2021

DOI: 10.1136/BMJOPEN-2021-051085

Abstract: Falls have a multifactorial aetiology, which may limit the effectiveness of the common approach of exercise as the sole intervention strategy. Multifactorial interventions could be more effective in people at high risk of falling however, the focus of such interventions has traditionally been quite narrow. This paper describes the design of a randomised controlled trial that will evaluate the effectiveness of an eHealth programme, which addresses cumulative effects of key fall-risk factors across the triad of physical, affective and cognitive functions on falls in older people. 518 older people aged 65 years and over with high fall risk, defined as having a history of falls in the past 6 months, self-reported fear of falling or being aged 80 years or over, will be recruited via local advertisements, newsletters and presentations, and randomised to an intervention or health education control group. The intervention comprises balance exercise, cognitive-motor exercise and cognitive–behavioural therapy, with their dosage based on participant’s baseline balance, executive function and mood. The primary outcome is the rate of falls in the 12 months after randomisation. Secondary outcomes at 6 and 12 months comprise programme adherence, healthcare use, physical activity, balance and mobility, cognitive function, psychological well-being, quality of life, health literacy and user experience and attitudes towards the programme. Data will be analysed following intention to treat to gauge real-world effectiveness. We will further determine complier averaged causal effects to correct for varying adherence and conduct economic analyses to gain insight into cost-effectiveness and cost–utility. Ethical approval was obtained from the University of New South Wales (UNSW) Human Research Ethics Committee in December 2017. Outcomes will be disseminated via peer-reviewed articles, conference presentations, community events and media releases. ACTRN12619000540112.

The impact of type 2 diabetes and body mass index on cerebral structure is modulated by brain reserve

Publisher: Wiley

Date: 20-09-2019

DOI: 10.1111/ENE.13780

Abstract: Body mass index (BMI), hyperglycaemia and type 2 diabetes and their interactive effects are associated with brain volume atrophy in ageing. It remains to be established if these risk factors are particularly concerning in in iduals with high or low brain volumes. Demographics, venous blood and magnetic resonance imaging data were collected for 494 healthy community-living adults aged 53-78 (mean 65) years, as part of the Personality and Total Health Through Life study. Associations between BMI, blood glucose, diabetes status and brain volume (whole brain, grey matter, white matter and subcortical structures) were investigated using quantile regression. Quantile regression revealed vulnerability to BMI × glucose interactions particularly in lower volumes and significant main effects for type 2 diabetes particularly in higher volumes. Diabetes was most strongly associated with brain volumes. The association between BMI, blood glucose and diabetes was not consistent across the full range of brain volumes. Explicit investigation of the upper and lower boundaries of brain volume distributions was valuable. We found evidence of protective reserve from higher brain volumes and that a combination of high BMI and higher blood glucose was particularly concerning for in iduals with lower brain volumes.

The role of cognitive and visual abilities as predictors in the Multifactorial Model of Driving Safety

Publisher: Elsevier BV

Date: 03-2012

DOI: 10.1016/J.AAP.2011.10.006

Abstract: The current study evaluated part of the Multifactorial Model of Driving Safety to elucidate the relative importance of cognitive function and a limited range of standard measures of visual function in relation to the Capacity to Drive Safely. Capacity to Drive Safely was operationalized using three validated screening measures for older drivers. These included an adaptation of the well validated Useful Field of View (UFOV) and two newer measures, namely a Hazard Perception Test (HPT), and a Hazard Change Detection Task (HCDT). Community dwelling drivers (n=297) aged 65-96 were assessed using a battery of measures of cognitive and visual function. Factor analysis of these predictor variables yielded factors including Executive/Speed, Vision (measured by visual acuity and contrast sensitivity), Spatial, Visual Closure, and Working Memory. Cognitive and Vision factors explained 83-95% of age-related variance in the Capacity to Drive Safely. Spatial and Working Memory were associated with UFOV, HPT and HCDT, Executive/Speed was associated with UFOV and HCDT and Vision was associated with HPT. The Capacity to Drive Safely declines with chronological age, and this decline is associated with age-related declines in several higher order cognitive abilities involving manipulation and storage of visuospatial information under speeded conditions. There are also age-independent effects of cognitive function and vision that determine driving safety.

Long-term cognitive correlates of traumatic brain injury across adulthood and interactions with APOE genotype, Sex, and age cohorts

Publisher: Cambridge University Press (CUP)

Date: 26-03-2014

DOI: 10.1017/S1355617714000174

Abstract: There is continuing debate about long-term effects of brain injury. We examined a range of traumatic brain injury (TBI) variables (TBI history, severity, frequency, and age of injury) as predictors of cognitive outcome over 8 years in an adult population, and interactions with apolipoprotein E ( APOE ) genotype, sex, and age cohorts. Three randomly s led age cohorts (20–24, 40–44, 60–64 years at baseline N = 6333) were each evaluated three times over 8 years. TBI variables, based on self-report, were separately modeled as predictors of cognitive performance using linear mixed effects models. TBI predicted longitudinal cognitive decline in all three age groups. APOE ε4 + genotypes in the young and middle-aged groups predicted lower baseline cognitive performance in the context of TBI. Baseline cognitive performance was better for young females than males but this pattern reversed in middle age and old age. The findings suggest TBI history is associated with long-term cognitive impairment and decline across the adult lifespan. A role for APOE genotype was apparent in the younger cohorts but there was no evidence that it is associated with impairment in early old age. The effect of sex and TBI on cognition varied with age cohort, consistent with a proposed neuroprotective role for estrogen. ( JINS , 2014, 20 , 444–454)

A Longitudinal Analysis of General Practitioner Service Use by Patients with Mild Cognitive Disorders in Australia

Publisher: S. Karger AG

Date: 2016

DOI: 10.1159/000447123

Abstract: b i Background: /i /b The aim of this study was to ascertain if participants diagnosed with any mild cognitive disorder (MCD) visited a general practitioner (GP) more than those without MCD and the effect of either depression or arthritis on GP use longitudinally. b i Methods: /i /b 2,551 participants aged 60-64 years at baseline completed the Personality and Total Health Through Life (PATH) study in Canberra. Follow-up data were collected after 4 and 8 years. A cognitive screening battery was used to screen participants into a substudy of MCD. b i Results: /i /b Participants with any MCD had greater GP use than cognitively healthy participants across all three waves (wave 1, M = 7.35 vs. 5.59 wave 2, M = 7.77 vs. 5.86 wave 3, M = 9.01 vs. 6.81). After adjusting for demographic and health factors, MCD was a significant predictor of GP use at all three waves (p 0.05, CI 0.84-0.99). b i Conclusion: /i /b This study has shown that MCD is associated with a higher use of GP visits, especially if the patient has a comorbid condition.

Prevalence, incidence, and risk factors of lacunar infarcts in a community sample.

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 27-07-2009

DOI: 10.1212/WNL.0B013E3181AA52EA

The effect of perceived control on self-reported cardiovascular disease incidence across adulthood and old age

Publisher: Informa UK Limited

Date: 26-06-2018

DOI: 10.1080/08870446.2017.1341513

Abstract: To examine whether rates of change in perceived control are predictive of cardiovascular disease (CVD) incidence across adulthood and old age. We used the PATH Through Life Project (n = 7103, M = 40, SD = 16 52% women), a longitudinal panel survey that encompasses three cohorts at Time 1, ages 20-24, 40-44 and 60-64, who have been assessed three times at four-year intervals. We examined whether rates of change in perceived control were associated with CVD incidence over 8 years of time, over and above that of baseline levels of perceived control and known risk factors for CVD. Self-reported CVD incidence. Increases in perceived control over time were associated with decreased likelihood of 8-year incidence of CVD and these effects were independent of socio-demographics, covariates and baseline levels of perceived control. The effects were consistent across young adulthood, midlife and old age and for men and women. Findings demonstrate the importance of changes in perceived control as a predictor of CVD incidence across adulthood and old age. We suggest future research using mediation analysis to test reverse causality and mechanisms underlying the effects of perceived control on CVD incidence.

Activity engagement is related to level, but not change in cognitive ability across adulthood

Publisher: American Psychological Association (APA)

Date: 2012

DOI: 10.1037/A0024667

Abstract: It is unclear whether the longitudinal relation between activity participation and cognitive ability is due to preserved differentiation (active in iduals have higher initial levels of cognitive ability), or differential preservation (active in iduals show less negative change across time). This distinction has never been evaluated after iding time-varying activity into its two sources of variation: between-person and within-person variability. Further, few studies have investigated how the association between activity participation and cognitive ability may differ from early to older adulthood. Using the PATH Through Life Project, we evaluated whether between- and within-person variation in activity participation was associated with cognitive ability and change within cohorts aged 20-24 years, 40-44 years, and 60-64 years at baseline (n = 7,152) assessed on three occasions over an 8-year interval. Multilevel models indicated that between-person differences in activity significantly predicted baseline cognitive ability for all age cohorts and for each assessed cognitive domain (perceptual speed, short-term memory, working memory, episodic memory, and vocabulary), even after accounting for sex, education, occupational status, and physical and mental health. In each case, greater average participation was associated with higher baseline cognitive ability. However, the size of the relationship involving average activity participation and baseline cognitive ability did not differ across adulthood. Between-person activity and within-person variation in activity level were both not significantly associated with change in cognitive test performance. Results suggest that activity participation is indeed related to cognitive ability across adulthood, but only in relation to the starting value of cognitive ability, and not change over time.

Cardiovascular risk factors and life events as antecedents of depressive symptoms in middle and early-old age: Path through life study

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-2009

DOI: 10.1097/PSY.0B013E3181BEAB60

Evaluation of High Cholesterol and Risk of Dementia and Cognitive Decline in Older Adults Using Individual Patient Meta-Analysis

Publisher: S. Karger AG

Date: 2021

DOI: 10.1159/000519452

Abstract: b i Introduction: /i /b Although increased cholesterol level has been acknowledged as a risk factor for dementia, evidence synthesis based on published data has yielded mixed results. This is especially relevant in older adults where in idual studies report non-linear relationships between cholesterol and cognition and, in some cases, find higher cholesterol associated with a lower risk of subsequent cognitive decline or dementia. Prior evidence synthesis based on published results has not allowed us to focus on older adults or to standardize analyses across studies. Given our ageing population, an increased risk of dementia in older adults, and the need for proportionate treatment in this age group, an in idual participant data (IPD) meta-analysis is timely. b i Method: /i /b We combined data from 8 studies and over 21,000 participants aged 60 years and over in a 2-stage IPD to examine the relationship between total, high-density, and low-density lipoprotein (HDL and LDL) cholesterol and subsequent incident dementia or cognitive decline, with the latter categorized using a reliable change index method. b i Results: /i /b Meta-analyses found no relationship between total, HDL, or LDL cholesterol (per millimoles per litre increase) and risk of cognitive decline in this older adult group averaging 76 years of age. For total cholesterol and cognitive decline: odds ratio (OR) 0.93 (95% confidence interval [CI] 0.86: 1.01) and for incident dementia: OR 1.01 [95% CI 0.89: 1.13]. This was not altered by rerunning the analyses separately for statin users and non-users or by the presence of an i APOE /i e4 allele. b i Conclusion: /i /b There were no clear consistent relationships between cholesterol and cognitive decline or dementia in this older adult group, nor was there evidence of effect modification by statin use. Further work is needed in younger populations to understand the role of cholesterol across the life-course and to identify any relevant intervention points. This is especially important if modification of cholesterol is to be further evaluated for its potential influence on risk of cognitive decline or dementia.

An examination of the effects of intra and inter-individual changes in wellbeing and mental health on self-rated health in a population study of middle and older-aged adults

Publisher: Springer Science and Business Media LLC

Date: 15-03-2014

DOI: 10.1007/S00127-014-0864-6

Abstract: Self-rated health is frequently used as an indicator of health and quality of life in epidemiological studies. While the association between self-rated health and negative mental health is well established, associations with indictors of positive wellbeing are less clear. Data from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project were used to compare the effects of vitality and mental health on self-rated health. Participants (n = 40,712) provided information on vitality, mental health and self-rated health, were aged 45-95 years at baseline, and were followed between 1 and 10 years (M = 5.6 SD = 2.9). In comparison with mental health, multi-level modelling indicated between- and within-person change in vitality was more strongly associated with self-rated health. Bivariate dual change score modelling of the cross-lagged associations between vitality and self-rated health indicated vitality to be a stronger predictor of change in self-rated health. Self-rated health was unrelated to change in vitality. Vitality accounted for most of the mental health effect on self-rated health and was identified as a significant predictor of change in self-rated health over a 10-year period. Promoting wellbeing and psychological functioning may have significant protective effects on negative health outcomes throughout the adult lifespan and into late life.

Sex differences in regional gray matter in healthy individuals aged 44-48 years: a voxel-based morphometric study.

Publisher: Elsevier BV

Date: 07-2007

DOI: 10.1016/J.NEUROIMAGE.2007.03.063

Abstract: The study examined sex-related differences in regional gray matter (GM) in 44-48 year old healthy in iduals. T1-weighted MRI scans were acquired in 411 subjects aged 44-48 from a random community s le and optimized voxel-based morphometry was applied to detect regional GM difference between men and women, correcting for effects of age, years of education, handedness, and total intracranial volume (TIV). Men had larger brain volumes and higher white matter (WM) to TIV ratios compared with women. Women had higher GM to TIV ratios than men. After controlling for age, years of education, handedness, and TIV, there were no significant differences between men and women in the total GM volumes. Regional sex dimorphism was present, with men having more GM volume in midbrain, left inferior temporal gyrus, right occipital lingual gyrus, right middle temporal gyrus, and both cerebellar hemispheres. Women showed more GM in dorsal anterior, posterior and ventral cingulate cortices, and right inferior parietal lobule. Our results suggest sex dimorphism in GM in middle aged healthy in iduals, which is not likely to be explained by brain pathology. These differences may provide the structural brain basis for sex differences in certain cognitive functions.

Gender differences in cognitive development in cohorts of young, middle, and older adulthood over 12 years.

Publisher: American Psychological Association (APA)

Date: 08-2021

DOI: 10.1037/DEV0001210

Risk factors for chronic disease in young, midlife and older adults: The PATH Through Life study

Publisher: Elsevier BV

Date: 06-2013

DOI: 10.1111/1753-6405.12055

Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis

Publisher: BMJ

Date: 12-2015

DOI: 10.1136/BMJOPEN-2015-008853

A Latent Growth Curve Analysis of Late-Life Sensory and Cognitive Function Over 8 Years: Evidence for Specific and Common Factors Underlying Change.

Publisher: American Psychological Association (APA)

Date: 12-2003

DOI: 10.1037/0882-7974.18.4.714

Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study.

Publisher: Springer Science and Business Media LLC

Date: 12-2020

DOI: 10.1186/S13195-020-00734-Y

Abstract: Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer’s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. We combined in idual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. The s le comprised 39,387 cognitively unimpaired in iduals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3–24.4%) and IRT (25.6%, 95%CI = 25.1–26.1%) however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1–7.0%, to 52.7%, 95%CI = 47.4–58.0% IRT: 7.8%, 95%CI = 6.8–8.9%, to 52.7%, 95%CI = 47.4–58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. SCD is frequent in old age. Having a quarter of older in iduals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help in iduals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.

Exposure to air pollution and cognitive functioning across the life course – A systematic literature review

Publisher: Elsevier BV

Date: 05-2016

DOI: 10.1016/J.ENVRES.2016.01.018

Abstract: Air pollution is associated with increased risk of respiratory, cardiovascular and cerebrovascular disease, but its association with cognitive functioning and impairment is unclear. The aim of this systematic review was to examine whether a relationship exists between these variables across the life course. We searched Web of Knowledge, Pubmed, SciVerse Scopus, CINAHL, PsychInfo and Science Direct up to October 2015 to identify studies that investigated the association between air pollution and performance on neurocognitive tests. Variations in exposure assessment and outcome measures make meta-analysis impossible. Thirty one studies published between 2006 and 2015, from the Americas (n=15), Asia (n=5) and Europe (n=11), met the criteria for inclusion. Many showed weak but quantified relationships between various air pollutants and cognitive function. Pollution exposure in utero has been associated with increased risk of neuro-developmental delay. Exposure in childhood has been inversely associated with neuro-developmental outcomes in younger children and with academic achievement and neurocognitive performance in older children. In older adults, air pollution has been associated with accelerated cognitive decline. The evidence to date is coherent in that exposure to a range of largely traffic-related pollutants has been associated with quantifiable impairment of brain development in the young and cognitive decline in the elderly. There is insufficient evidence at present to comment on consistency, in view of the different indices of pollution and end-points measured, the limited number of studies, and the probability at this stage of publication bias. However, plausible toxicological mechanisms have been demonstrated and the evidence as a whole suggests that vehicular pollution, at least, contributes to cognitive impairment, adding to pressure on governments and in iduals to continue to reduce air pollution.

APOE ε4 and the Influence of Sex, Age, Vascular Risk Factors, and Ethnicity on Cognitive Decline.

Publisher: Oxford University Press (OUP)

Date: 12-05-2020

DOI: 10.1093/GERONA/GLAA116

Abstract: We aimed to examine the relationship between Apolipoprotein E ε4 (APOE*4) carriage on cognitive decline, and whether these associations were moderated by sex, baseline age, ethnicity, and vascular risk factors. Participants were 19,225 in iduals aged 54–103 years from 15 longitudinal cohort studies with a mean follow-up duration ranging between 1.2 and 10.7 years. Two-step in idual participant data meta-analysis was used to pool results of study-wise analyses predicting memory and general cognitive decline from carriage of one or two APOE*4 alleles, and moderation of these associations by age, sex, vascular risk factors, and ethnicity. Separate pooled estimates were calculated in both men and women who were younger (ie, 62 years) and older (ie, 80 years) at baseline. Results showed that APOE*4 carriage was related to faster general cognitive decline in women, and faster memory decline in men. A stronger dose-dependent effect was observed in older men, with faster general cognitive and memory decline in those carrying two versus one APOE*4 allele. Vascular risk factors were related to an increased effect of APOE*4 on memory decline in younger women, but a weaker effect of APOE*4 on general cognitive decline in older men. The relationship between APOE*4 carriage and memory decline was larger in older-aged Asians than Whites. In sum, APOE*4 is related to cognitive decline in men and women, although these effects are enhanced by age and carriage of two APOE*4 alleles in men, a higher numbers of vascular risk factors during the early stages of late adulthood in women, and Asian ethnicity.

Cohort profile: The dynamic analyses to optimize ageing (DYNOPTA) project

Publisher: Oxford University Press (OUP)

Date: 17-01-2010

DOI: 10.1093/IJE/DYN276

Age group differences in psychological distress: The role of psychosocial risk factors that vary with age

Publisher: Cambridge University Press (CUP)

Date: 09-2005

DOI: 10.1017/S0033291705004976

Abstract: Background. There is continuing controversy about how age affects depression and anxiety, with a lack of consistent results across studies. Two reasons for this inconsistency are age bias in measures and different patterns of exposure to risk factors across age groups in various studies. Method. Data on anxiety and depression symptoms were collected in a community survey of 7485 persons aged 20–24, 40–44 or 60–64 years. These measures were investigated for factorial invariance across age groups. Data were also collected on a wide range of potential risk factors, including social, physical health and personal factors, with the aim of determining whether these factors might partly or wholly account for age group differences. Results. The invariance of correlated latent factors representing anxiety and depression was examined across age groups, and a generalized measure of psychological distress was computed. Depression, anxiety and psychological distress showed a decline across age groups for females and a decline from 40–44 to 60–64 years for males. Some of these age differences were accounted for by other risk factors, with the most important being recent crises at work and negative social relationships with family and friends. Conclusion. Psychological distress generally declined across the age range 20–64 years and this was not attributable to measurement bias. Differential exposure to risk factors explained some, but not all, of the age group difference. Therefore other mechanisms that explain the lower level of distress in older age groups remain to be identified.

Body brain life: A randomized controlled trial of an online dementia risk reduction intervention in middle-aged adults at risk of Alzheimer's disease

Publisher: Wiley

Date: 06-2015

DOI: 10.1016/J.TRCI.2015.04.003

Impact of the COVID‐19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study

Publisher: Wiley

Date: 18-06-2021

DOI: 10.1111/DME.14611

Abstract: To examine psychosocial and behavioural impacts of the novel coronavirus disease 2019 (COVID‐19) pandemic and lockdown restrictions among adults with type 2 diabetes. Participants enrolled in the PRogrEssion of DIabetic ComplicaTions (PREDICT) cohort study in Melbourne, Australia ( n = 489 with a baseline assessment pre‐2020) were invited to complete a phone/online follow‐up assessment in mid‐2020 (i.e., amidst COVID‐19 lockdown restrictions). Repeated assessments that were compared with pre‐COVID‐19 baseline levels included anxiety symptoms (7‐item Generalised Anxiety Disorder scale [GAD‐7]), depressive symptoms (8‐item Patient Health Questionnaire [PHQ‐8]), diabetes distress (Problem Areas in Diabetes scale [PAID]), physical activity/sedentary behaviour, alcohol consumption and diabetes self‐management behaviours. Additional once‐off measures at follow‐up included COVID‐19‐specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance). Among 470 respondents (96% aged 66 ± 9 years, 69% men), at least ‘moderate’ worry about COVID‐19 infection was reported by 31%, and 29%–73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional well‐being). Younger participants reported more negative impacts ( p 0.05). Overall, anxiety/depressive symptoms were similar at follow‐up compared with pre‐COVID‐19, but diabetes distress reduced ( p 0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID‐19‐specific worry or negative QoL impacts ( p 0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose‐monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need. COVID‐19 lockdown restrictions negatively impacted QoL, some behavioural risk factors and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.

Response to Yucel and MacQueen's letter to the editor [2]

Publisher: Wiley

Date: 2006

DOI: 10.1002/HIPO.20197

Simulated Visual Impairment Leads to Cognitive Slowing in Older Adults

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 12-2010

DOI: 10.1097/OPX.0B013E3181FE64D7

Dementia Prevention and Individual and Socioeconomic Barriers: Avoiding “Lifestyle” Stigma

Publisher: Oxford University Press (OUP)

Date: 24-09-2023

DOI: 10.1093/GERONT/GNAD130

The Effect of Diabetes Medication on Cognitive Function: Evidence from the PATH Through Life Study

Publisher: Hindawi Limited

Date: 2016

DOI: 10.1155/2016/7208429

Abstract: Objective . To examine the effect of diabetes treatment on change of measures of specific cognitive domains over 4 years. Research Design and Methods . The s le was drawn from a population-based cohort study in Australia (the PATH Through Life Study) and comprised 1814 in iduals aged 65–69 years at first measurement, of whom 211 were diagnosed with diabetes. Cognitive function was measured using 10 neuropsychological tests. The effect of type of diabetes treatment (diet, oral hypoglycemic agents, and insulin) on measures of specific cognitive domains was assessed using Generalized Linear Models adjusted for age, sex, education, smoking, physical activity level, BMI, and hypertension. Results . Comparison of cognitive function between diabetes treatment groups showed no significant effect of type of pharmacological treatment on cognitive function compared to diet only group or no diabetes group. Of those on oral hypoglycaemic treatment only, participants who used metformin alone had better cognitive function at baseline for the domains of verbal learning, working memory, and executive function compared to participants on other forms of diabetic treatment. Conclusion . This study did not observe significant effect from type of pharmacological treatment for diabetes on cognitive function except that participants who only used metformin showed significant protective effect from metformin on domain of verbal learning, working memory, and executive function.

Memory Resilience to Alzheimer’s Genetic Risk: Sex Effects in Predictor Profiles

Publisher: Oxford University Press (OUP)

Date: 26-12-2016

DOI: 10.1093/GERONB/GBW161

DRD4-exoniii-VNTR moderates the effect of childhood adversities on emotional resilience in young-adults

Publisher: Public Library of Science (PLoS)

Date: 27-05-2011

DOI: 10.1371/JOURNAL.PONE.0020177

Proportion of dementia in Australia explained by common modifiable risk factors

Publisher: Springer Science and Business Media LLC

Date: 17-02-2017

DOI: 10.1186/S13195-017-0238-X

Cognitive benefits of social dancing and walking in old age: The dancing mind randomized controlled trial

Publisher: Frontiers Media SA

Date: 22-02-2016

DOI: 10.3389/FNAGI.2016.00026

An Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled Tr

Publisher: JMIR Publications Inc.

Date: 24-09-2020

DOI: 10.2196/19431

Abstract: There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation (2) a single clinician–led group, Lifestyle Modification Program (LMP) and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means −3.86, 95% CI −6.81 to −0.90, P=.01 week 18: difference in means −4.05, 95% CI −6.81 to −1.28, P .001 week 36: difference in means −4.99, 95% CI −8.04 to −1.94, P .001 and week 62: difference in means −4.62, 95% CI −7.62 to −1.62, P .001). A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small s le size, and replication on a larger s le with longer follow-up will strengthen the results. Australian clinical trials registration number (ACTRN): 12616000868482 anzctr.org.au/ACTRN12616000868482.aspx.

Alzheimer’s environmental and genetic risk scores are differentially associated with ‘g’ and δ

Publisher: Cold Spring Harbor Laboratory

Date: 08-03-2018

DOI: 10.1101/279018

Abstract: We investigated the association of the Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI) and an AD genetic risk score (GRS) with cognitive performance. The ANU-ADRI (composed of 11 risk factors for AD) and GRS (composed of 25 AD risk loci) were computed in 1,061 community-dwelling older adults. Participants were assessed on 11 cognitive tests and activities of daily living. Structural equation modelling was used to evaluate the association of the ANU-ADRI and GRS with: 1) general cognitive ability (g) 2) dementia related variance in cognitive performance (δ) and 3) verbal ability, episodic memory, executive function and processing speed. A worse ANU-ADRI score was associated with poorer performance in ‘g’, δ, and each cognitive domain. A worse GRS was associated with poorer performance in δ and episodic memory. The ANU-ADRI was broadly associated with worse cognitive performance, validating its further use in early dementia risk assessment. An environmental/lifestyle dementia risk index is broadly associated with cognitive performance An Alzheimer’s genetic risk score is associated with dementia severity and episodic memory The environmental risk index is more strongly associated with dementia severity than genetic risk The authors reviewed the literature using online databases (e.g. PubMed). Previous research has highlighted the need for dementia risk assessment tools to be evaluated on outcomes prior to dementia onset, such as cognitive performance. The relevant citations have been appropriately cited. The Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI) was more broadly associated with cognitive performance than Alzheimer’s genetic risk. For the ANU-ADRI, stronger effects were observed for dementia-related variance in cognitive task performance that for variance in general cognitive function. This suggests that ANU-ADRI is more specifically associated with dementia-related processes and further validates its use in early risk assessment for dementia. Accordingly, future studies should seek to evaluate the association of the ANU-ADRI and genetic risk with AD biomarkers and longitudinal cognitive performance to evaluate differential trajectories in ‘g’ and δ.

Thirty years of the United Nations and global ageing: An Australian perspective

Publisher: Wiley

Date: 10-2013

DOI: 10.1111/AJAG.12101

Abstract: Over the past three decades, the United Nations (UN) has slowly devoted increasing attention to global ageing. Concern for in idually based welfare or health-care programs for older people in developed countries has progressed to also consider the contributions of older people and implications of ageing for socioeconomic advancement in developing countries, including those in Asia Oceania. These shifts are evident in the International Plans of Action on Ageing from Vienna in 1982 to Madrid in 2002 recent 10-year reviews of the Madrid Plan and current advocacy for inclusion of ageing in the influential UN Millennium Plan post-2015. Australia has demonstrated progressive policies and contributed to ageing developments by the UN, International Federation on Ageing the World Health Organization and the International Association of Gerontology. Key ideas driving further action are the importance of valuing people at all ages, addressing inequalities over the life-course and implementing human rights approaches to ageing.

Alcohol Consumption as a Risk Factor for Dementia and Cognitive Decline: Meta-Analysis of Prospective Studies

Publisher: Elsevier BV

Date: 07-2009

DOI: 10.1097/JGP.0B013E3181A2FD07

Mild cognitive disorders are associated with different patterns of brain asymmetry than normal aging: The PATH through life study

Publisher: Frontiers Media SA

Date: 2010

DOI: 10.3389/FPSYT.2010.00011

Developing Age-Friendly Cities and Communities in Australia

Publisher: SAGE Publications

Date: 12-2014

DOI: 10.1177/0898264314532687

Abstract: Objective: The aim of the study is to present case studies and assess the impact of political, policy, consultative, and research processes used to implement Age Friendly Cities (AFC) initiatives in Australia. Method: A review and interpretation was conducted based on public documents, community consultations, survey analyses, and participant observation. Results: Governments in Australia have drawn on World Health Organization (WHO) concepts to establish AFC initiatives. In Melbourne, state political leadership established Positive Ageing plans that have reinforced local government actions. In Canberra, a baseline survey and an Older Persons Assembly were followed by modest positive ageing plans. In Sydney, a State Ageing Strategy developed a whole-of-government plan that has yet to be incorporated into budget processes. Discussion: AFC initiatives in Australia have had promising and varied starts with some aims to benefit disadvantaged older people. Notwithstanding the potential benefits, AFC influence on mainstream actions of government has been limited by uncertain political commitment and growing fiscal austerity.

Depressive Symptoms Predict Decline in Perceptual Speed in Older Adulthood

Publisher: American Psychological Association (APA)

Date: 09-2011

DOI: 10.1037/A0023313

Road safety in an aging population: Risk factors, assessment, interventions, and future directions

Publisher: Cambridge University Press (CUP)

Date: 18-02-2016

DOI: 10.1017/S1041610216000053

Abstract: With the number of older drivers projected to increase by up to 70% over the next 20 years, preventing injury resulting from crashes involving older drivers is a significant concern for both policy-makers and clinicians. While the total number of fatal crashes per annum has steadily decreased since 2005 in Australia, the rate of fatalities has demonstrated an upward trend since 2010 in drivers aged 65 years and above (8.5 per 100,000), such that it is now on par with the fatality rate in drivers aged 17–25 years (8.0 per 100,000) (Austroads, 2015). Similar statistics are reported for the United States (NHTSA, 2012), implying there is a need for better identification of those older drivers who are unsafe and implementation of strategies that can enhance mobility while maximizing road safety.

Regional Brain Volumes and ADHD Symptoms in Middle-Aged Adults: The PATH Through Life Study

Publisher: SAGE Publications

Date: 24-02-2017

DOI: 10.1177/1087054714523316

Abstract: Objective: We investigated whether volumetric differences in ADHD-associated brain regions are related to current symptoms of inattention and hyperactivity in healthy middle-aged adults and whether co-occurring anxiety/depression symptoms moderate these relationships. Method: ADHD Self-Report Scale and Brief Patient Health Questionnaire were used to assess current symptoms of inattention, hyperactivity, anxiety, and depression in a population-based s le ( n = 269). Brain volumes, measured using a semi-automated method, were analyzed using multiple regression and structural equation modeling to evaluate brain volume–inattention/hyperactivity symptom relationships for selected regions. Results: Volumes of the left nucleus accumbens and a region overlapping the dorsolateral prefrontal cortex were positively associated with inattention symptoms. Left hippoc al volume was negatively associated with hyperactivity symptoms. The brain volume–inattention/hyperactivity symptom associations were stronger when anxiety/depression symptoms were controlled for. Conclusion: Inattention and hyperactivity symptoms in middle-aged adults are associated with different brain regions and co-occurring anxiety/depression symptoms moderate these brain–behavior relationships.

Comparison of a Virtual Older Driver Assessment with an On-Road Driving Test

Publisher: Wiley

Date: 22-10-2016

DOI: 10.1111/JGS.14548

Abstract: To design a low-cost simulator-based driving assessment for older adults and to compare its validity with that of an on-road driving assessment and other measures of older driver risk. Cross-sectional observational study. Canberra, Australia. Older adult drivers (N = 47 aged 65-88, mean age 75.2). Error rate on a simulated drive with environment and scoring procedure matched to those of an on-road test. Other measures included participant age, simulator sickness severity, neuropsychological measures, and driver screening measures. Outcome variables included occupational therapist (OT)-rated on-road errors, on-road safety rating, and safety category. Participants' error rate on the simulated drive was significantly correlated with their OT-rated driving safety (correlation coefficient (r) = -0.398, P = .006), even after adjustment for age and simulator sickness (P = .009). The simulator error rate was a significant predictor of categorization as unsafe on the road (P = .02, sensitivity 69.2%, specificity 100%), with 13 (27%) drivers assessed as unsafe. Simulator error was also associated with other older driver safety screening measures such as useful field of view (r = 0.341, P = .02), DriveSafe (r = -0.455, P < .01), and visual motion sensitivity (r = 0.368, P = .01) but was not associated with memory (delayed word recall) or global cognition (Mini-Mental State Examination). Drivers made twice as many errors on the simulated assessment as during the on-road assessment (P < .001), with significant differences in the rate and type of errors between the two mediums. A low-cost simulator-based assessment is valid as a screening instrument for identifying at-risk older drivers but not as an alternative to on-road evaluation when accurate data on competence or pattern of impairment is required for licensing decisions and training programs.

The On-Road Difficulties of Older Drivers and Their Relationship with Self-Reported Motor Vehicle Crashes

Publisher: Wiley

Date: 27-10-2009

DOI: 10.1111/J.1532-5415.2009.02498.X

Abstract: To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes. Prospective cohort study. On-road driving assessment. Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll. Performance on a standardized measure of driving performance. Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes every instructor intervention almost doubled prospective crash risk. These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.

Determinants of self-rated health items with different points of reference: Implications for health measurement of older adults

Publisher: SAGE Publications

Date: 09-2008

DOI: 10.1177/0898264308321035

Abstract: Objective: This study assessed whether three commonly used self-rated health (SRH) items (global, age-comparative, and self-comparative) are equivalent measures of health perception for older adults. Method: Regression analyses were used to simultaneously contrast the associations between physical, psychological, and social factors relating to health for three SRH items, in a large ( N = 2,034) population-based s le of older adults (65 years and older) from the Australian Longitudinal Study of Aging. Results: Health perceptions were more positive for the age-comparative SRH measure, compared to the pessimistic ratings of the self-comparative measure, particularly for the oldest-old adults. Different patterns of associations between the health factors and SRH measures were found. Discussion: These results show the three SRH items are not equivalent measures of health and cannot be used interchangeably. The reference point of the SRH item has a considerable influence on health perceptions of older adults as it encapsulates unique health information.

Association of AKAP6 and MIR2113 with cognitive performance in a population-based sample of older adults.

Publisher: Wiley

Date: 26-01-2017

DOI: 10.1111/GBB.12368

Abstract: Genetic factors make a substantial contribution to inter-in idual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113, that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal non-linear change across a broad spectrum of cognitive domains in a community-based cohort of older adults without dementia. Two single nucleotide polymorphisms (SNPs), MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes were observed for this SNP. These results confirm the previous finding that AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

A longitudinal investigation of perceived control and cognitive performance in young, midlife and older adults

Publisher: Informa UK Limited

Date: 11-11-2008

DOI: 10.1080/13825580802348570

Abstract: Longitudinal associations between generalized control beliefs (one's perceived capacity to influence events) and cognitive test performance were examined in a population-based s le of young, midlife and older adults. Participants provided measures of perceived control, self-assessed health, education and depression and anxiety symptoms, and completed cognitive tests at two assessments, 4 years apart. For each age group, baseline (between-person) control was positively related to performance on tests of memory (immediate recall and digits backwards), speed (Symbol Digit Modalities Test and choice reaction time) and verbal intelligence (Spot-the-Word). Interaction effects indicated stronger associations of between-person control beliefs with indices of speed for the older age group relative to the younger groups. Within-person changes in control were not significantly associated with changes in cognitive test performance over the study interval. Implications of the findings for self-efficacy based interventions designed to promote cognitive functioning are discussed.

Mixed handedness is associated with greater age-related decline in volumes of the hippocampus and amygdala: The PATH through life study

Publisher: Wiley

Date: 11-2011

DOI: 10.1002/BRB3.24

Protocol for a pragmatic randomised controlled trial of Body Brain Life—General Practice and a Lifestyle Modification Programme to decrease dementia risk exposure in a primary care setting

Publisher: BMJ

Date: 03-2018

DOI: 10.1136/BMJOPEN-2017-019329

Abstract: It has been estimated that a 10%–25% reduction in seven key risk factors could potentially prevent 1.1–3.0 million Alzheimer’s disease cases globally. In addition, as dementia is preceded by more subtle cognitive deficits which have substantial social and economic impact, effective preventative interventions would likely have more extensive benefits. The current study evaluates in primary care a multidomain risk-reduction intervention targeting adults with high risk of developing dementia. A randomised controlled trial (RCT) is being conducted to evaluate three intervention programmes using a pragmatic approach suitable to the clinic: (1) a 12-week online and face-to-face dementia risk-reduction intervention (Body Brain Life—General Practice (BBL-GP)) (2) a 6-week face-to-face group lifestyle modification programme (LMP) and (3) a 12-week email-only programme providing general health information. We aim to recruit 240 participants, aged 18 and over, to undergo a comprehensive cognitive and physical assessment at baseline and follow-ups (postintervention, 18, 36 and 62 weeks). The primary outcome is dementia risk measured with the modified version of the Australian National University—Alzheimer’s Disease Risk Index Short Form. Secondary outcomes are cognitive function measured with Trails A and B, and the Digit Symbol Modalities Test physical activity with moderate-vigorous physical activity and the International Physical Activity Questionnaire depression with the Centre for Epidemiological Studies Depression cost evaluation with the 12-item Short Form Health Survey, Framingham Coronary Heart Disease Risk Score and Australian Type 2 Diabetes Risk Assessment Tool diet quality with the Australian Recommended Food Score and sleep quality with the Pittsburgh Sleep Quality Index. This RCT is a novel pragmatic intervention applied in a primary care setting to reduce the dementia risk exposure in adults at high risk. If successful, BBL-GP and LMP will provide a versatile, evidence-based package that can be easily and quickly rolled out to other primary care settings and which can be scaled up at relatively low cost compared with other strategies involving intensive interventions. ACTRN12616000868482

Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care

Publisher: Elsevier BV

Date: 06-2007

DOI: 10.1097/JGP.0B013E31802E21D8

Oxidative stress, inflammation and risk of neurodegeneration in a population sample

Publisher: Wiley

Date: 17-06-2019

DOI: 10.1111/ENE.13985

Abstract: Inflammation and oxidative stress (OS) have been clearly linked to neurodegeneration. However, studies investigating the associations between peripheral markers of inflammation and cognitive decline have produced mixed results. This is possibly due to the fact that markers are typically tested in idually despite the fact that biologically they function interactively. Thus, the aim of this study was to investigate the association between a combination of OS/inflammation markers and outcomes including mild cognitive impairment (MCI) diagnosis, cognitive decline and hippoc al atrophy. Oxidative stress/inflammation status was assessed in 380 older community-living in iduals. Thirteen blood markers were assayed. Principal component analysis (PCA) of all markers was conducted to identify the more salient inflammatory components. Associations between significant principal components, MCI diagnosis, previous change in Mini-Mental State Examination (MMSE) score and hippoc al atrophy were investigated through logistic and linear multiple regression. Two factors (PC1 and PC2) reflecting predominantly broad pro-inflammatory activity and two factors (PC3 and PC4) reflecting predominantly OS activity were identified by PCA analysis. PC3 and PC4 were predictive of MCI. PC3 was also predictive of prior MMSE change. PC1, PC2 and PC3 were significantly associated with hippoc al atrophy. Combined analysis of complex and interacting biomarkers revealed a protective association between antioxidant activity and MCI that is consistent with lifestyle factors shown to reduce risk of cognitive decline. OS and broad systemic inflammation were also found to be associated with hippoc al atrophy further highlighting the benefits of the PCA methodology applied in this study.

Navigating Community-Based Aged Care Services From the Consumer Perspective: A Scoping Review

Publisher: Oxford University Press (OUP)

Date: 29-04-2023

DOI: 10.1093/GERONT/GNAD017

Abstract: The shift to consumer-directed aged care means that older adults need to play a more active role in navigating the complex aged care system for adequate health and social services. Challenges in the navigation process result in unmet needs and difficulty accessing available resources. This scoping review investigates how aged care navigation is conceptualized in literature and interrogates research on the experiences of older adults navigating community-based aged care services with or without support from their informal carers. This review follows the Joanna Briggs Institute methodological guidelines. PubMed, Scopus, and ProQuest were searched for relevant literature published from 2008 to 2021, supplemented by grey literature and manual reference list searching. Data were extracted using a predefined data-extraction table and synthesized with an inductive thematic analysis. The current conceptualization of aged care navigation focuses on the support provided to older adults, rather than actions taken by older adults themselves. Thematic analysis from the included studies (n = 26) revealed shared themes (lack of knowledge, social networks as information providers, complex care systems) among older adults and informal carers unique challenges faced by older adults (difficulties with technology, waiting game), and informal carers (structural burden) in aged care navigation. Findings suggest the need to comprehensively assess in idual circumstances including social networks and access to informal carers as predictors of successful navigation. Changes that reduce the complexity of the aged care system and improve coordination will relieve the structural burden experienced by consumers.

The association of APOE genotype and cognitive decline in interaction with risk factors in a 65-69 year old community sample.

Publisher: Springer Science and Business Media LLC

Date: 14-07-2008

DOI: 10.1186/1471-2318-8-14

APOE genotype and cognitive functioning in a large age-stratified population sample.

Publisher: American Psychological Association (APA)

Date: 2007

DOI: 10.1037/0894-4105.21.1.1

Abstract: There is evidence that the cognitive effects of Alzheimer's disease can be seen decades before disease diagnosis. If this is the case, then the apolipoprotein E (APOE) *E4 allele might be expected to have effects on cognitive functioning earlier in the life span. To assess such effects, the authors examined data on the *E4 allele and cognitive functioning from a population s le of 6,560 Caucasians covering the age groups of 20-24, 40-44, and 60-64 years. Participants were assessed on tests of episodic memory, working memory, mental speed, reaction time, and reading vocabulary. Although performance on all tests except reading vocabulary declined across age groups, there was no effect of the APOE *E4 allele at any age. These results indicate that APOE *E4 does not have preclinical effects early in the life span on these cognitive functions. Cognitive aging effects between the ages of 20 and 64 years must not be due to preclinical Alzheimer's disease.

Informant-Reported Cognitive Decline and Activity Engagement across Four Years in a Community Sample

Publisher: S. Karger AG

Date: 2017

DOI: 10.1159/000475594

Abstract: b i Background: /i /b Subtle age-related cognitive decline may be associated with the capacity to remain engaged in mental, physical, and social activities. Informant reports of cognitive decline potentially provide additional information to psychometric tests on change in everyday cognitive function relevant to activity engagement. b i Objective: /i /b To investigate relations between decline in everyday cognitive function as assessed by informant report and activity engagement in community-dwelling older adults. b i Methods: /i /b A s le of cognitively normal older adults was drawn from the 2 latest waves of the PATH Through Life Study ( i n /i = 1,391 mean age 74.5 ± 1.5, 48.4% female). PATH is a 16-year longitudinal cohort study set in the Canberra/Queanbeyan district, Australia. Assessments were carried out at baseline, and at 3 subsequent time-points 4 years apart. At wave-4, the IQCODE, an informant measure of 4-year cognitive decline was provided by a spouse, family member, or friend of each participant. Activity engagement was assessed by the abbreviated RIASEC Mental Activity List, self-reported frequency and duration of physical activity (Whitehall Questionnaire) and the Lubben Social Network Scale that assessed interaction with family/friends. Participants provided demographic information, self-reported health status (SF-12), and responses to the Goldberg Depression Scale. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test (CVLT) were used to measure objective 4-year cognitive change. Those with MMSE score of ≤27 were excluded. b i Results: /i /b IQCODE score predicted disengagement from mental activities over 4 years in cognitively healthy adults (β = -0.056, standard error [SE] = 0.019, i /i = 0.004). This association was robust to covariate control and change on the SDMT which was also significantly related to mental activity disengagement. In models adjusted for change scores on the SDMT and the CVLT, the IQCODE was associated with less physical (β = -0.692, SE = 0.24, i /i = 0.004) and social engagement (β -0.046, SE = 0.021, i /i = 0.032), but relationships were attenuated with the inclusion of covariates. b i Conclusion: /i /b Informant-reported cognitive decline in a non-clinical s le was linked to activities that support cognitive health. Associations were robust to adjustment for cognitive change scores. Utilising informant reports prior to the manifestation of clinically relevant decline may identify those who would benefit most from personalised activity interventions.

The Effect of Cumulative Anticholinergic Use on the Cognitive Function of Older Adults: Results from the Personality and Total Health (PATH) Through Life Study

Publisher: Oxford University Press (OUP)

Date: 08-06-2020

DOI: 10.1093/GERONA/GLAA145

Abstract: Multiple comorbidities are common in older adults, resulting in polypharmacy that often includes medications with anticholinergic properties. These medications have multiple side effects, which are more pronounced in the older population. This study examined the association between the use of anticholinergics and changes in the cognitive function of older adults. The study population consisted of 2,222 in iduals aged 65–69 years at baseline from the Personality and Total Health (PATH) Through Life Study in Australia. Medication data were obtained from the Pharmaceutical Benefits Scheme (PBS). Cognitive measures were obtained from neuropsychological battery assessment. Exposure to cumulative anticholinergic use was quantified to a total standardized daily dose (TSDD). The association between change in cognitive measures between baseline and 4-year follow-up, and cumulative use of anticholinergic was assessed through generalized linear models. During the study period, 18.6% (n = 413) of participants filled at least one prescription for anticholinergics. Compared to those not on anticholinergics, participants on anticholinergics were more likely to be woman (62.7% compared to 45.1%) and spent lesser time engaging in vigorous physical activity (0.4 h/week compared to 0.9 h/week). Cumulative use of anticholinergic resulting in a TSDD exceeding 1,095 was significantly associated with poorer performance in Trail Making Test Part B (Model 1: β = 5.77, Model 2: β = 5.33, Model 3: β = 8.32, p & .01), indicating impairment in processing speed. In our study, except for speed of processing, other cognitive domains measured were not affected by cumulative anticholinergic use over a 4-year period.

More Highly Myelinated White Matter Tracts are Associated with Faster Processing Speed in Healthy Adults

Publisher: Cold Spring Harbor Laboratory

Date: 27-06-2017

DOI: 10.1101/152546

Abstract: The objective of this study was to investigate whether the myelin content of white matter tracts is predictive of cogni–tive processing speed and whether such associations are modulated by age. Associations between myelin content and processing speed was assessed in 570 community-living in iduals (277 middle-age, 293 older-age). Myelin content was measured using the mean T1w/T2w magnetic resonance ratio, in six white matter tracts (anterior corona radiata, superior corona radiata, pontine crossing tract, anterior limb of the internal capsule, genu of the corpus callosum, and splenium of the corpus callosum). Processing speed was estimated by extracting a principal component from 5 sep–arate tests of processing speed. It was found that myelin content of the bilateral anterior limb of the internal capsule and left splenium of the corpus callosum were significant predictors of processing speed, even after controlling for socio-demographic, health and genetic variables and correcting for multiple comparisons. A 1 SD increase in the myelin content of the anterior limb of the internal capsule was associated with 2.53% increase in processing speed and within the left splenium of the corpus callosum with a 2.20% increase in processing speed. In addition, significant differences in myelin content between middle-age and older participants were found in all six white matter tracts. The present results indicate that myelin content, estimated in vivo using a neuroimaging approach in healthy older adults is sufficiently precise to predict variability in processing speed in behavioural measures.

Interrelationships among biological markers of aging, health, activity, acculturation, and cognitive performance in late adulthood.

Publisher: American Psychological Association (APA)

Date: 1999

DOI: 10.1037/0882-7974.14.4.605

Multiple imputation was an efficient method for harmonizing the Mini-Mental State Examination with missing item-level data

Publisher: Elsevier BV

Date: 07-2011

DOI: 10.1016/J.JCLINEPI.2010.10.011

Abstract: The Mini-Mental State Examination (MMSE) is used to estimate current cognitive status and as a screen for possible dementia. Missing item-level data are commonly reported. Attention to missing data is particularly important. However, there are concerns that common procedures for dealing with missing data, for ex le, listwise deletion and mean item substitution, are inadequate. We used multiple imputation (MI) to estimate missing MMSE data in 17,303 participants who were drawn from the Dynamic Analyses to Optimize Aging project, a harmonization project of nine Australian longitudinal studies of aging. Our results indicated differences in mean MMSE scores between those participants with and without missing data, a pattern consistent over age and gender levels. MI inflated MMSE scores, but differences between those imputed and those without missing data still existed. A simulation model supported the efficacy of MI to estimate missing item level, although serious decrements in estimation occurred when 50% or more of item-level data were missing, particularly for the oldest participants. Our adaptation of MI to obtain a probable estimate for missing MMSE item level data provides a suitable method when the proportion of missing item-level data is not excessive.

Primary Aging, Secondary Aging, and Intelligence

Publisher: American Psychological Association (APA)

Date: 1993

DOI: 10.1037/0882-7974.8.4.562

Psychological resilience provides no independent protection from suicidal risk

Publisher: Hogrefe Publishing Group

Date: 03-2016

DOI: 10.1027/0227-5910/A000364

Abstract: Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk

Publisher: BMJ

Date: 09-2023

DOI: 10.1136/BMJOPEN-2023-076860

Functional equivalence of the National Adult Reading Test (NART) and Schonell reading tests and NART norms in the Dynamic Analyses to Optimise Ageing (DYNOPTA) project

Publisher: Informa UK Limited

Date: 04-12-0008

DOI: 10.1080/13803395.2010.527321

Abstract: This study investigates the functional equivalence of two measures of irregular word pronunciation--National Adult Reading Test (NART) and Schonell--which are popular instruments used to assess verbal neurocognitive functioning and to estimate premorbid IQ. We report norms for the NART in a pooled s le from 3 Australian population-based studies of adults aged 65-103 years. Norms were stratified by sex and age left school in 5-year age groups. The NART and the Schonell had a strong linear relation, allowing for the imputation of NART scores based on Schonell performance within 1 study. Neither measure was sensitive to the effects of sex after adjusting for the effects of age and education. Early school leavers performed worse on both measures. Data pooling enables greater precision and improved generalizability of NART norms than do methods that use single older adult s les.

Non-pharmacological strategies to delay cognitive decline

Publisher: Elsevier BV

Date: 10-2014

DOI: 10.1016/J.MATURITAS.2014.07.012

Abstract: Non-pharmacological preventive strategies to delay cognitive decline have become the focus of recent research. This review aims to discuss evidence supporting the use of physical and cognitive activity to reduce the risk of cognitive decline and dementia in later life. Both strategies are associated with better cognitive health in older adults. This positive effect seems stronger for middle-aged and older adults with normal cognition and less clear when cognitive impairment is present. Physical and cognitive activities have been linked to indirect and direct biological factors affecting brain health. Future research will need to explore details about type, intensity, duration and combination of interventions. An important aim is standardization between studies, as well as evidence of improved clinical outcomes and cost-effectiveness. Identifying strategies that succeed at sustaining improved lifestyle is necessary, and the use of modern technology could play a crucial role in this regard. In the meantime advice on physical and cognitive activities should be included when health advice is given to middle-aged and older adults.

Alzheimer’s Genetic Risk Score linked to Incident Mild Behavioral Impairment

Publisher: Cold Spring Harbor Laboratory

Date: 10-10-2017

DOI: 10.1101/200840

Abstract: Mild Behavioral Impairment (MBI) describes the emergence of later-life Neuropsychiatric Symptoms (NPS) as an at-risk state for cognitive decline and dementia and as a potential manifestation of prodromal dementia. How NPS mechanistically link to the development of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) is not fully understood. Potential mechanisms include either shared risk factors that are related to both NPS and cognitive impairment, or AD pathology promoting NPS. This is the first study to examine whether AD genetic loci, in idually and as a genetic risk score, are a shared risk factor with MBI. 1377 older adults (aged 72-79 738 males 763 normal cognition) from the PATH Through Life project. MBI was assessed in accordance with Criterion 1 of the ISTAART-AA diagnostic criteria using the Neuropsychiatric Inventory. 25 LOAD risk loci were genotyped and a weighted genetic risk score (GRS) was constructed. Binomial logistic regression adjusting for age, gender, and education examined the association between LOAD GRS and MBI domains. An increase in the LOAD GRS and APOE*ε4 were associated with higher likelihood of Affective Dysregulation MS4A4A -rs4938933*C and MS4A6A -rs610932*G were associated with a reduced likelihood of Affective Dysregulation ZCWPW1 -rs1476679*C was associated with a reduced likelihood of Social Inappropriateness and Abnormal Perception BIN1 -rs744373*G and EPHA1 -rs11767557*C were associated with higher likelihood of Abnormal Perception NME8 -rs2718058*G was associated with a reduced likelihood Decreased Motivation. These findings suggest a common genetic etiology between MBI and traditionally recognized memory problems observed in AD and improve our understanding of the pathophysiological features underlying MBI.

Personality and Total Health Through Life Project Eye Substudy: Methodology and Baseline Retinal Features

Publisher: Asia Pacific Academy of Ophthalmology

Date: 2017

DOI: 10.22608/APO.2016187

Within-Person Associations Between Financial Hardship and Cognitive Performance in the PATH Through Life Study

Publisher: Oxford University Press (OUP)

Date: 13-03-2019

DOI: 10.1093/AJE/KWZ051

Abstract: The aim of this study was to investigate the within-person associations between the experience of financial hardship and cognitive performance throughout adulthood. Three waves of data provided by 6,343 participants (49% men) were analyzed from a representative community-based s le from Canberra, Australia (2003–2015). The outcome was a composite measure reflecting fluid cognitive abilities. Financial hardship was assessed by markers of scarcity (being unable to heat the home, missing meals, and going without other basic needs) and behavioral responses to hardship (pawning items and seeking help from community welfare organizations). Multivariable-adjusted fixed-effect regression models for panel data with robust standard errors tested time-dependent associations between measures of financial hardship and fluid cognitive abilities. Declines in cognitive performance coincided with the experience of scarcity (β = −0.07 standard error, 0.018). There was no association between behavioral responses to hardship and cognitive performance, and there was no difference in the associations across age cohorts or by sex. There was no evidence that mastery or mental health attenuated the time-dependent link between hardship and cognition. This study provides new evidence that the onset (shock) of financial hardship is a potent stressor associated with occasion-specific deficits in fluid cognitive abilities.

The choice of self-rated health measures matter when predicting mortality: Evidence from 10 years follow-up of the Australian longitudinal study of ageing

Publisher: Springer Science and Business Media LLC

Date: 20-04-2010

DOI: 10.1186/1471-2318-10-18

Characterizing mild cognitive disorders in the young-old over 8 years: Prevalence, estimated incidence, stability of diagnosis, and impact on IADLs

Publisher: Wiley

Date: 07-03-2013

DOI: 10.1016/J.JALZ.2012.11.013

Abstract: Few studies report incidence of mild cognitive impairment (MCI) and other mild cognitive disorders (MCD) in cohorts in their 60s, at an age when diagnoses are less stable. The authors' goal was to estimate the incidence and prevalence of MCI and MCD, characterize subgroups with stable vs nonstable diagnoses, and evaluate the impact of diagnosis on daily life in a young-old cohort. A community-based cohort age 60 to 64 years in 1999 (n = 2551) was monitored for 8 years and assessed every 4 years. A two-stage s ling design was used to identify MCI and MCD through a neuropsychological and neurological assessment. A panel of physicians blind to previous diagnoses reviewed each case using published criteria. The prevalence of MCDs in the cohort aged 68 to 72 years at the last follow-up was approximately 10%. An estimated 141 subjects (7.7%) progressed to MCI and 183 subjects (10.0%) progressed to MCD between years 4 and 8. Only eight participants received a dementia diagnosis at any wave, five of whom progressed from MCDs. More than 45% of diagnoses were unstable during the 8 years of follow-up. Stable diagnoses were associated with lower Mini-Mental State Examination scores, history of neurological disorder, higher cardiovascular risk, and depression at baseline. MCDs were associated with impairments in instrumental activities of daily living and higher rates of reporting memory problems prior to diagnosis. MCDs in in iduals in their 60s occur in at least 10% of the population and are likely to be heterogeneous in terms of their etiology and long-term prognosis, but may cause a significant impact in everyday life.

Selective non-response to clinical assessment in the longitudinal study of aging: Implications for estimating population levels of cognitive function and dementia

Publisher: Wiley

Date: 2002

DOI: 10.1002/GPS.651

Abstract: to identify the cognitive outcome of interviewed participants who did not progress to partake in clinical assessments in a longitudinal aging study. a retrospective study was conducted on participants who were interviewed but who did not complete the clinical assessment (including an extended cognitive assessment) at either Wave 1 or both Wave 1 and Wave 3 of the Australian Longitudinal Study of Ageing. A total of 1947 participants aged 70 and older commenced the study, 246 participants without clinical data at either or both Waves 1 and 3 were identified for the sub-s le followed-up retrospectively. The Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) was administered to informants and medical records were reviewed. participants who did not complete the clinical assessment at Wave 3 reported poorer health and had poorer cognitive function at Wave 1 independent of age and gender. Rates of possible dementia or cognitive decline were higher in the group who did not undertake the clinical assessment compared with both those who did the clinical assessment and with population data. selective non-response to clinical assessment in a longitudinal aging study is associated with higher risk of cognitive decline and probable dementia. Longitudinal aging studies may underestimate rates of dementia and population levels of cognitive decline.

Cortical Thinning at Midlife: The PATH Through Life Study

Publisher: Springer Science and Business Media LLC

Date: 23-07-2016

DOI: 10.1007/S10548-016-0509-Z

Abstract: Cortical thinning is a part of normal ageing. Recent studies suggest that accelerated cortical thinning in vulnerable regions may be a useful biomarker for neuropathologies including Alzheimer's disease (AD). Longitudinal studies, which have largely focused on older adults, have provided estimates of normative rates and patterns of age-related cortical thinning. Very little, however, is known about healthy cortical thinning at midlife. Here we provide longitudinal estimates of age-related cortical thinning observed over 8 years, in a large (n = 404) group of healthy in iduals aged 44-49 years at baseline, who were scanned with MRI (1.5T) on up to three occasions. Age-related cortical thinning was assessed across the whole cortex. We measured a mean annual decrease in cortical thickness of 0.26 % on the left and 0.17 % on the right hemisphere, and largely affecting frontal and cingulate cortices. Medial and lateral temporal regions were generally spared. Studying regions that are specifically vulnerable to-or spared from-healthy age-related cortical thinning at midlife may be important for the early identification of neurodegeneration, including AD.

Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys

Publisher: Cambridge University Press (CUP)

Date: 23-09-2015

DOI: 10.1017/S1041610214002051

Abstract: Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk. Participants ( N = 14,019 women = 91%), including eventual decedents ( n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk. For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01 p 0.001) more substantive was the risk of low physical health (HR = 1.04 p 0.001). No mediation effects were observed. Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.

Association of cognitive function with glucose tolerance and trajectories of glucose tolerance over 12 years in the AusDiab study

Publisher: Springer Science and Business Media LLC

Date: 12-07-2015

DOI: 10.1186/S13195-015-0131-4

Relating education, brain structure, and cognition: The role of cardiovascular disease risk factors

Publisher: Hindawi Limited

Date: 2014

DOI: 10.1155/2014/271487

Abstract: The protective effect of education on cognitive and brain health is well established. While the direct effects of in idual cardiovascular disease (CVD) risk factors (i.e., hypertension, smoking, diabetes, and obesity) on cerebral structure have been investigated, little is understood about the possible interaction between the protective effect of education and the deleterious effects of CVD risk factors in predicting brain ageing and cognition. Using data from the PATH Through Life study ( N = 266 ) , we investigated the protective effect of education on cerebral structure and function and tested a possible mediating role of CVD risk factors. Higher education was associated with larger regional grey/white matter volumes in the prefrontal cortex in men only. The association between education and cognition was mediated by brain volumes but only for grey matter and only in relation to information processing speed. CVD risk factors did not mediate the association between regional volumes and cognition. This study provides additional evidence in support for a protective effect of education on cerebral structures and cognition. However, it does not provide support for a mediating role of CVD risk factors in these associations.

Physiological Factors Associated with Falls in Older Community‐Dwelling Women

Publisher: Wiley

Date: 10-1994

DOI: 10.1111/J.1532-5415.1994.TB06218.X

Abstract: To determine the prevalence of impaired vision, peripheral sensation, lower limb muscle strength, reaction time, and balance in a large community-dwelling population of women aged 65 years and over, and to determine whether impaired performances in these tests are associated with falls. One-year prospective study. Conducted as part of the Randwick Falls and Fractures Study, in Sydney, Australia. Four hundred fourteen women aged 65 to 99 years (mean age 73.7 years, SD = 6.3) were randomly selected from the community 341 of these women were included in the 1-year prospective study. The prevalence of impairment in all tests increased with age. In the year following assessment, 207 subjects (60.7%) experienced no falls, 63 subjects (18.5%) fell one time only, and 71 subjects (20.8%) fell on two or more occasions. After controlling for age, multiple falling was associated with low contrast visual acuity and contrast sensitivity, poor vibration sense and proprioception, reduced lower limb strength, slow reaction time, and impaired balance, as indicated by four sway tests and two clinical stability measures. Discriminant function analysis identified visual contrast sensitivity, proprioception in the lower limbs, quadriceps strength, reaction time, and sway on a compliant (foam rubber) surface with the eyes open as the variables that significantly discriminated between subjects who experienced multiple falls and subjects who experienced no falls or one fall only (Wilks' lambda = 0.73 (P < 0.001), canonical correlation = 0.52). This procedure correctly classified 75% of subjects into multiple faller or nonmultiple faller groups. These findings support previous results conducted in retirement village and institutional setting and indicate that the test procedure aids in the identification of older community-dwelling women at risk of falls.

Sex Differences in the Impact of <b><i>BDNF</i></b> Genotype on the Longitudinal Relationship between Physical Activity and Cognitive Performance

Publisher: S. Karger AG

Date: 2018

DOI: 10.1159/000486369

Abstract: b i Background: /i /b Physical activity may preserve cognitive function in older adults, but benefits vary by sex and genetic factors. b i Objective: /i /b We tested the longitudinal association between physical activity and cognitive performance to de termine whether a common genetic polymorphism for brain-derived neurotrophic factor i (BDNF /i Val66Met i ) /i moderated this effect. b i Methods: /i /b In a 12-year longitudinal population-based s le of older adults ( i n /i = 2,218), we used growth curve modeling to investigate whether the benefits of physical activity on cognitive preservation differed by i BDNF /i genotype and sex across multiple cognitive domains including processing speed, attention, working memory, and episodic verbal memory. b i Results: /i /b The relationship between physical activity and cognitive performance was dependent on i BDNF /i carrier status in males (Δχ sup /sup [Δdf] = 12.94 [4], i /i = 0.01), but not in females (Δχ sup /sup [Δdf] = 4.38 [4], i /i = 0.36). Cognition benefited from physical activity in male i BDNF /i i met /i noncarriers, but not i met /i carriers, whereas cognition was not statistically significantly related to physical activity in females regardless of genotype. b i Conclusion: /i /b We observed longitudinal, but not cross-sectional, effects of physical activity on cognitive performance. Our study highlights the importance of longitudinal follow-up and consideration of sex differences in the relationships between physical activity, i BDNF /i genotype, and cognitive decline. The findings contribute to understanding gene-lifestyle interactions in promoting cognitive health.

Lower cognitive test scores observed in alcohol abstainers are associated with demographic, personality, and biological factors: the PATH Through Life Project

Publisher: Wiley

Date: 15-07-2005

DOI: 10.1111/J.1360-0443.2005.01159.X

Abstract: To identify variables that explain the association between alcohol abstention and cognitive performance. We hypothesized that demographic and personality variables would be important for explaining the association in all age cohorts, but that health variables would be more important in the older age-cohorts. Three age cohorts (20-24, 40-44, 60-64 years) were s led randomly, yielding a total of 7485 participants, with data from 602 alcohol abstainers and 4158 light or moderate drinkers used in this study. Setting The s le was drawn from the cities of Canberra and Queanbeyan, Australia. Scales measuring demographic, health and personality variables and cognitive and physical tests were administered. Participants drinking at hazardous or harmful levels were excluded from the analysis. A range of demographic and physical function measures were found to explain partially the finding of abstainers having lower cognitive test scores. The effects of independent variables were largest in the 60-64-year-old age group with a trend for physical variables such as lung function and grip strength to become more important in the older age groups. In the 20-24-year-olds, the majority of the effect remained unexplained. There is evidence that poorer cognitive test performance by abstainers reflects in part selection effects and poorer physical functioning, but does not appear to be due to mental or physical health conditions or personality.

Alzheimer's genetic risk intensifies neurocognitive slowing associated with diabetes in nondemented older adults

Publisher: Wiley

Date: 02-09-2015

DOI: 10.1016/J.DADM.2015.08.002

Normative data and longitudinal invariance of the Life Engagement Test (LET) in a community sample of older adults

Publisher: Springer Science and Business Media LLC

Date: 16-03-2013

DOI: 10.1007/S11136-012-0146-2

Abstract: Interest in evaluating purpose in life as an important component of ageing well is growing however, investigation into the appropriate measurement of this construct is required. The purpose of this paper was to examine the measurement properties of the Life Engagement Test (LET) and to provide normative data for a non-clinical s le of community-dwelling older adults. A random s le of 545 adults, aged 55-94 years, completed the LET twice over a 12-month period as part of a larger survey on relocation in later life. Consistent with previous research, participants typically reported high levels of purpose in life. Scores were also observed to vary over the 12-month duration, with, on average, an increase in purpose in life at Time 2. However, tests of longitudinal invariance were inconclusive. Future research is needed to further examine the content validity of the LET, and its factorial invariance over longer measurement intervals, and across different populations including non-residential/aged care settings.

The association between financial hardship and amygdala and hippocampal volumes: Results from the PATH through life project

Publisher: Oxford University Press (OUP)

Date: 06-05-2012

DOI: 10.1093/SCAN/NSR027

The association between blood pressure variability (BPV) with dementia and cognitive function: a systematic review and meta-analysis protocol.

Publisher: Springer Science and Business Media LLC

Date: 15-10-2018

DOI: 10.1186/S13643-018-0811-9

Putting age-related hearing loss on the public health agenda in Australia

Publisher: The Sax Institute

Date: 02-12-2021

DOI: 10.17061/PHRP3152125

Abstract: Hearing loss is one of the most common long-term health conditions associated with ageing, and a considerable contributor to Australia's late-life disability burden. Acquired hearing loss in adulthood presents significant challenges for the social, physical, mental and cognitive health of many Australians. These wide-ranging in idual and societal impacts have been highlighted by a number of high-profile national inquiries into Australia's hearing health during the past decade. Yet hearing loss remains poorly recognised and is undertreated in many communities. In this perspective article we argue that effective public health measures such as limiting occupational and recreational exposure to hazardous noise and ototoxic chemicals, promoting hearing health behaviours, early detection, improved access to hearing health services, and urban design, are all critical to mitigating these adverse outcomes. We also make the case for updated epidemiological data about hearing loss among older Australians.

Gray matter reduction is correlated with white matter hyperintensity volume: A voxel-based morphometric study in a large epidemiological sample

Publisher: Elsevier BV

Date: 02-2006

DOI: 10.1016/J.NEUROIMAGE.2005.08.057

Abstract: Both brain atrophy and T2-weighted white matter hyperintensities (WMH) are common findings in the brains of asymptomatic elderly in iduals as well as in disease-specific brains. The study of the relationship between these two salient features is therefore important. To investigate such a relationship, we performed a brain magnetic resonance imaging (MRI) study on 397 asymptomatic in iduals aged between 60 and 64 years, who were recruited randomly from a large community s le. WMH were delineated on T2-weighted fluid attenuation inversion recovery (FLAIR) whole brain scans using an automated procedure. The results showed that gray matter reduction, subarachnoid CSF (SA-CSF) increase and lateral ventricular dilation were significantly correlated with WMH load. Deep white matter hyperintensity (DWMH) had significant correlation with all three global atrophy indices, but periventricular white matter hyperintensity (PVWMH) was correlated only with gray matter volume. Voxel-based morphometric (VBM) analysis showed that regional gray matter reduction correlated more closely with WMH load of the proximate region than with WMH elsewhere. The results suggest that WMH have a relationship with brain atrophy in middle age, although the study cannot determine which process, i.e. the development of WMH or atrophy, is primary. The study also demonstrates that DWMH has a more significant relationship with structural brain changes, and may therefore be more functionally relevant than PVWMH. Further delineation of this relationship needs a longitudinal study of the changes in both WMH and indices of brain atrophy.

Cognitive Aging and Functional Biomarkers: What Do We Know, and Where to From Here?

Publisher: SAGE Publications, Inc.

Date: 2008

DOI: 10.4135/9781412976589.N20

Role of Physical Activity in the Relationship Between Mastery and Functional Health

Publisher: Oxford University Press (OUP)

Date: 21-05-2014

DOI: 10.1093/GERONT/GNU042

Abstract: To examine the influence of mastery, physical activity levels, and subsequent trajectories of domains of functional health across the adult life course. We examined 8-year trajectories of physical functioning (handgrip strength) and functional health (physical [RAND PHC12], psychological [RAND MHC12], and cognitive [processing speed]) in a large Australian s le (n = 7,485 at baseline) of 3 cohorts (20–24, 40–44, and 60–64 years). Within- and between-person indirect effects of physical activity on the relationship between mastery and health were examined using multilevel structural equation models. Mastery was positively related to within-person change in physical and psychological health for all cohorts, and processing speed for the 60s. Between-person mastery was positively associated with all health domains across all cohorts. Physical activity indirectly influenced the between-person relationships between mastery and handgrip strength, physical health, and psychological health in all cohorts, and between mastery and processing speed for the 60s. Psychological resources are important mechanisms for functional health as they may drive adaptive behaviors such as physical activity. The within-person association connecting mastery with physical and psychological health trajectories provides promise for interventions that foster or improve a sense of mastery. The findings contribute to the understanding of complex relationships between personal resources and behaviors that aid in successful aging across the life span.

Education, atrophy, and cognitive change in an epidemiological sample in early old age

Publisher: Elsevier BV

Date: 03-2009

DOI: 10.1097/JGP.0B013E3181961A84

Memory complaints in a community sample aged 60-64 years: associations with cognitive functioning, psychiatric symptoms, medical conditions, APOE genotype, hippocampus and amygdala volumes, and white-matter hyperintensities.

Publisher: Cambridge University Press (CUP)

Date: 11-2004

DOI: 10.1017/S0033291704003162

Abstract: Background. Previous research has found that depression is a major cause of memory complaints. However, there is evidence that memory complaints also weakly predict cognitive decline and dementia. The present study examined a range of possible determinants of memory complaints, covering psychiatric and personality factors, medical history, cognitive test performance, and biological risk factors for dementia (APOE genotype, hippoc us and amygdala volumes, and white-matter hyperintensities). Method. A community survey was carried out with 2546 persons aged 60–64 years living in Canberra and Queanbeyan, Australia. Participants were asked about memory problems which interfered with daily life and whether medical help had been sought. A randomly selected subs le of 476 persons was given a brain MRI scan. Results. Participants with memory complaints were found to have poorer memory test performance, more depression and anxiety symptoms, have higher scores on personality traits involving negative affect, and to have worse physical health. Multivariate analyses showed that measures of cognitive performance did not make a unique contribution to the prediction of memory complaints above that of the other categories of predictors. Those with memory complaints did not differ on any of the biological risk factors for dementia. Conclusion. In a community s le aged 60–64 years, memory complaints were most closely related to psychiatric symptoms, personality characteristics and poor physical health. There was no evidence of brain changes indicating early dementia.

Normative data on neuropsychological tests for very old adults living in retirement villages and hostels

Publisher: Informa UK Limited

Date: 08-2000

DOI: 10.1076/1385-4046(200008)14:3;1-P;FT309

Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: An integrated evidence review and analysis of a large older adult hypertensive cohort

Publisher: Oxford University Press (OUP)

Date: 24-07-2018

DOI: 10.1093/EURHEARTJ/EHY418

Children of a cohort of depressed patients 25 years later: Psychopathology and relationships

Publisher: Elsevier BV

Date: 06-2004

DOI: 10.1016/J.JAD.2004.03.002

Abstract: While many studies have examined cross-sectional or short-term effects of parental depression on children, few have studied such children many years later when they reach adulthood. It was hypothesised that children of patients hospitalised for depression 25 years ago would have more psychological morbidity and relationship difficulties than children of a surgical comparison group. Children (n=94) of depressed patients and a surgical control group (n=31) admitted to a teaching hospital 25 years ago were compared on measures of psychiatric morbidity, personality, marital and family relationships. Compared with control children, children of depressed patients demonstrated trends for higher rates of non-phobic anxiety and substance disorders, but neither psychological morbidity overall nor affective disorder specifically. Compared with control children, children of depressed patients rated their relationships with fathers who were spouses of female patients more negatively. Having consciously tried to make their own intimate relationships different from that of their parents, children of depressed patients and their partners reported significantly more caring in their relationships compared with control children and their partners. In this study of the effects of parental depression on children 25 years on, adult children of depressed patients demonstrated significant resilience as evidenced by similar rates of overall psychiatric morbidity and quality of intimate relationships to controls. They may be at risk for specific disorders such as anxiety and substance disorder and have problematic relationships with the "well" spouses of depressed patients particularly if the "well" spouse is their father.

A self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: The ANU-ADRI

Publisher: Public Library of Science (PLoS)

Date: 23-01-2014

DOI: 10.1371/JOURNAL.PONE.0086141

Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults

Publisher: Cambridge University Press (CUP)

Date: 21-09-2017

DOI: 10.1017/S1041610217001909

Abstract: A dearth of population-based epidemiological research examines neuropsychiatric symptom (NPS) in sub-clinical populations across the spectrum from normal aging to mild cognitive impairment (MCI). The construct of mild behavioral impairment (MBI) describes the emergence of sustained and impactful NPS in advance of or in combination with MCI. This is the first epidemiological study to operationalize the recently published diagnostic criteria for MBI and determine prevalence estimates across the spectrum from cognitively normal to MCI. MBI was assessed in 1,377 older (age range 72–79 years 52% male MCI = 133 cognitively normal, but-at-risk = 397 cognitively healthy = 847). MBI was assessed in accordance with the ISTAART-AA diagnostic criteria for MBI using the neuropsychiatric inventory. 34.1% of participants met the criteria for MBI. High prevalence of MBI across the cognitive spectrum was reported (48.9% vs. 43.1% vs. 27.6%). Irrespective of level of cognitive impairment, impulse dyscontrol (33.8% vs. 28.7% vs. 17.2%) and decreased motivation (32.3% vs. 26.2% vs. 16.3%) were the most frequently met MBI domains. MBI was more prevalent in men (χ 2 = 4.98, p = 0.026), especially the domains of decreased motivation and impulse dyscontrol. This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.

Primary aging, secondary aging, and intelligence.

Publisher: No publisher found

DOI: 10.1037//0882-7974.8.4.562

The effect of cataract surgery on neuropsychological test performance: A randomized controlled trial

Publisher: Cambridge University Press (CUP)

Date: 09-2006

DOI: 10.1017/S1355617706060954

Abstract: Recent cross-sectional studies have reported strong associations between visual and cognitive function, and longitudinal studies have shown relationships between visual and cognitive decline in late life. Improvement in cognitive performance after cataract surgery has been reported in patients with Mild Cognitive Impairment. We investigated whether improving visual function with cataract surgery would improve neuropsychological performance in healthy older adults. A randomized clinical trial of cataract surgery performed at acute hospitals was conducted on 56 patients (mean age 73) with bilateral cataract, after excluding a total of 54 patients at the screening stage, of whom 53 did not meet visual acuity criteria and one did not have cataract. In-home assessments included visual and neuropsychological function, computerized cognitive testing and health questionnaires. Results showed no cognitive benefits of cataract surgery in cognitively normal adults. We conclude that visual improvement following cataract surgery is not strongly associated with an improvement in neuropsychological test performance in otherwise healthy adults. Joint associations between visual and cognitive function in late life are likely to be due to central factors, and unlikely to be strongly related to eye disease. Short-term increased neural stimulation from improved visual function does not appear to affect cognitive performance. ( JINS , 2006, 12 , 632–639.)

Gender differences in alcohol consumption among middle-aged and older adults in Australia, the United States and Korea

Publisher: Elsevier BV

Date: 08-2014

DOI: 10.1111/1753-6405.12227

Abstract: To compare gender differences in alcohol use and the socioeconomic correlates of at-risk drinking among middle-aged and older adults in Australia, the United States (US) and South Korea. Data were drawn from large nationally representative surveys of people aged 45 years and older, collected in 2006. Rates of any drinking and at-risk drinking (>14 US standard drinks/week) were higher for males than females in all countries and these gender differences were largest in Korea. Socioeconomic differentials for at-risk drinking varied by country and gender. In the US, at-risk drinking was associated with lower educational levels among men, but higher educational levels among women in Korea, it was associated with being unpartnered, particularly for women and in Australia, at-risk drinking was associated with higher income. Gender-role expectations differ between countries and may influence both the levels at which older adults consume alcohol and the ways in which at-risk drinking is associated with socioeconomic factors. Heavy alcohol use in middle-aged and older adults is a cause for concern. Health promotion strategies should target older age groups and consider the ways in which gender, marital status and education influence norms and opportunities for risky alcohol use.

Retirement and the Sense of Control in Young-Old Adults: The Mediating Role of Engagement in Goal-Directed Activities

Publisher: SAGE Publications

Date: 2007

DOI: 10.2190/HA.9.1.B

Intergenerational Programmes bringing together community dwelling non-familial older adults and children: A Systematic Review

Publisher: Elsevier BV

Date: 05-2021

DOI: 10.1016/J.ARCHGER.2021.104356

Interventions to reduce the adverse psychosocial impact of driving cessation on older adults.

Publisher: Informa UK Limited

Date: 08-2006

DOI: 10.2147/CIIA.2006.1.3.205

The Association of Sedentary Behaviour and Cognitive Function in People Without Dementia: A Coordinated Analysis Across Five Cohort Studies from COSMIC

Publisher: Springer Science and Business Media LLC

Date: 16-09-2020

DOI: 10.1007/S40279-019-01186-7

Abstract: Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia. We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0–8.1 years). Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7–75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075 0.160), P 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline ( P 0.05). Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.

Cross-national insights into the relationship between wealth and wellbeing: a comparison between Australia, the United States of America and South Korea

Publisher: Cambridge University Press (CUP)

Date: 24-02-2011

DOI: 10.1017/S0144686X11000080

Abstract: The positive relationship between wealth and wellbeing has received considerable attention over the last three decades. However, little is known about how the significance of wealth for the health and wellbeing of older adults may vary across societies. Furthermore, researchers tend to focus mainly on income rather than other aspects of financial resources even though older adults often rely on fixed income, particularly after retirement. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey (N=1,431), the Health and Retirement Study (HRS) in the United States of America (USA N=4,687), and the Korean Longitudinal Study of Ageing (KLoSA N=5,447), this exploratory cross-national study examined the relationship between wealth satisfaction and objective wealth and wellbeing (measured as self-rated health and life satisfaction) among older Australians, Americans and Koreans (50+ years). Regression analyses showed that wealth satisfaction was associated with wellbeing over and above monetary wealth in all three countries. The relationship between monetary wealth and self-rated health was larger for the US than Australian and Korean s les, while the additional contribution of wealth satisfaction to life satisfaction was larger for the Korean than the Australian and US s les. These findings are discussed in terms of the cultural and economic differences between these countries, particularly as they affect older persons.

The Impact of Smoking and Obesity on Disability-Free Life Expectancy in Older Australians

Publisher: Oxford University Press (OUP)

Date: 29-11-2021

DOI: 10.1093/GERONA/GLAA290

Abstract: Smoking and obesity are 2 modifiable risk factors for disability. We examine the impact of smoking and obesity on disability-free life expectancy (DFLE) at older ages, using 2 levels of disability. We used the DYNOPTA dataset, derived by harmonizing and pooling risk factors and disability outcomes from 5 Australian longitudinal aging studies. We defined mobility disability as inability to walk 1 km, and more severe (activities of daily living [ADL]) disability by the inability to dress or bathe. Mortality data for the analytic s le (N = 20 401 81.2% women) were obtained from Government Records via data linkage. We estimated sex-specific total life expectancy, DFLE, and years spent with disability by Interpolated Markov Chain (IMaCh) software for each combination of smoking (never vs ever), obesity (body mass index ≥30 vs 18.5 to & ), and education (left school age 14 or younger vs age 15 or older). Compared to those without either risk factor, high educated nonobese smokers at age 65 lived shorter lives (men and women: 2.5 years) and fewer years free of mobility disability (men: 2.1 years women: 2.0 years), with similar results for ADL disability. Obesity had the largest effect on mobility disability in women high educated obese nonsmoking women lived 1.3 years less than nonsmoking, not obese women but had 5.1 years fewer free of mobility disability and 3.2 fewer free of ADL disability. Differences between risk factor groups were similar for the low educated. Our findings suggest eliminating obesity would lead to an absolute reduction of disability, particularly in women.

Heavy cannabis users at elevated risk of stroke: Evidence from a general population survey

Publisher: Elsevier BV

Date: 06-2016

DOI: 10.1111/1753-6405.12477

Abstract: Case reports and hospital-based case-control studies suggest that cannabis use may increase the risk of stroke. We examined the risk of non-fatal stroke or transient ischemic attack (TIA) among cannabis users in the general community. A general population survey of Australians aged 20-24 years (n=2,383), 40-44 years (n=2,525) and 60-64 years (n=2,547) was used to determine the odds of lifetime stroke or TIA among participants who had smoked cannabis in the past year while adjusting for other stroke risk factors. There were 153 stroke/TIA cases (2.1%). After adjusting for age cohort, past year cannabis users (n=1,043) had 3.3 times the rate of stroke/TIA (95% CI 1.8-6.3, p<0.001). The incidence rate ratio (IRR) reduced to 2.3 after adjustment for covariates related to stroke, including tobacco smoking (95% CI 1.1-4.5). Elevated stroke/TIA was specific to participants who used cannabis weekly or more often (IRR 4.7, 95% CI 2.1-10.7) with no elevation among participants who used cannabis less often. Heavy cannabis users in the general community have a higher rate of non-fatal stroke or transient ischemic attack than non-cannabis users.

In Vivo Hippocampal Measurement and Memory: A Comparison of Manual Tracing and Automated Segmentation in a Large Community-Based Sample

Publisher: Public Library of Science (PLoS)

Date: 16-04-2009

DOI: 10.1371/JOURNAL.PONE.0005265

Longitudinal Change of Self-Perceptions of Aging and Mortality

Publisher: Oxford University Press (OUP)

Date: 18-02-2013

DOI: 10.1093/GERONB/GBT005

Social Cognition and Social Functioning in MCI and Dementia in an Epidemiological Sample

Publisher: Cambridge University Press (CUP)

Date: 06-09-2021

DOI: 10.1017/S1355617721000898

Abstract: Social cognition is impaired in mild cognitive impairment (MCI) and dementia. However, its relationship to social functioning and perceived social support has yet to be explored. Here, we examine how theory of mind (ToM) relates to social functioning in MCI and dementia. Older adults (cognitively normal = 1272 MCI = 132 dementia = 23) from the PATH Through Life project, a longitudinal, population-based study, were assessed on the Reading the Mind in the Eyes Test (RMET), measures of social functioning, and social well-being. The associations between RMET performance, social functioning, and cognitive status were analysed using generalised linear models, adjusting for demographic variables. Participants with MCI ( b =−.52, 95% CI [−.70, −.33]) and dementia ( b =−.78, 95% CI [−1.22, −.34]) showed poorer RMET performance than cognitively normal participants. Participants with MCI and dementia reported reduced social network size ( b =−.21, 95% CI [−.40, −.02] and b =−.90, 95% CI [−1.38, −.42], respectively) and participants with dementia reported increased loneliness ( b = .36, 95% CI [.06, .67]). In dementia, poorer RMET performance was associated with increased loneliness ( b =−.07, 95% CI [−.14, −.00]) and a trend for negative interactions with partners ( b =−.37, 95% CI [−.74, .00]), but no significant associations were found in MCI. MCI and dementia were associated with poor self-reported social function. ToM deficits were related to poor social function in dementia but not MCI. Findings highlight the importance of interventions to address social cognitive deficits in persons with dementia and education of support networks to facilitate positive interactions and social well-being.

Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: The PATH through life project

Publisher: Wiley

Date: 15-07-2005

DOI: 10.1111/J.1360-0443.2005.01158.X

Abstract: To investigate associations, including non-linear relationships, between cognitive function and alcohol consumption, testing for moderating effects of age and gender and for differences across outcome measures. Design Cross-sectional general population s les of three age cohorts. Setting Canberra and Queanbeyan, Australia. The total s le of 7485 consisted of 2404 men and women aged 20-24 years, 2530 aged 40-44 years, and 2551 aged 60-64 years, selected from the electoral rolls. Measurements Self-report data using hand-held computers provided weekly alcohol consumption from the Alcohol Use Disorders Identification Test (AUDIT) frequency, quantity and binge-drinking items, and socio-demographic factors. Spot-the-Word, digits backwards, the Symbol-Digit Modalities Test (SDMT), immediate recall and reaction-time tests were conducted by trained interviewers. Findings varied across dependent variables, but there was a general tendency for light drinkers (up to 20/10 g alcohol per day in men/women, respectively) to perform better than abstainers, occasional drinkers or those drinking at hazardous/harmful levels (>40/20 g per day in men/women). Poorer performance of hazardous/harmful drinkers was seen only in men, whereas that of abstainers was evident in both sexes but was stronger in women. After adjustment for education and race, male hazardous/harmful drinkers no longer performed significantly less well than light drinkers, whereas male and female abstainers and occasional drinkers still did so. Abstainers have poorer cognitive function than light drinkers and further investigation is needed to determine what factors contribute to this.

Could ignoring higher blood sugar levels in the normal range in nondiabetics compromise cerebral health?

Publisher: Future Medicine Ltd

Date: 2013

DOI: 10.2217/FNL.12.86

From urban neighbourhood environments to cognitive health: a cross-sectional analysis of the role of physical activity and sedentary behaviours

Publisher: Springer Science and Business Media LLC

Date: 12-2021

DOI: 10.1186/S12889-021-12375-3

Abstract: There is a dearth of studies on the effects of the neighbourhood environment on adults’ cognitive function. We examined how interrelated aspects of the built and natural neighbourhood environment, including air pollution, correlate with adults’ cognitive function, and the roles of physical activity and sedentary behaviours in these associations. We used data from 4,141 adult urban dwellers who participated in the Australian Diabetes, Obesity and Lifestyle 3 study on socio-demographic characteristics, neighbourhood self-selection, physical activity and sedentary behaviours, and cognitive function. Neighbourhood environmental characteristics included population density, intersection density, non-commercial land use mix, and percentages of commercial land, parkland and blue space, all within 1 km residential buffers. We also calculated annual mean concentrations of NO 2 and PM 2.5 . Generalised additive mixed models informed by directed acyclic graphs were used to estimate the total, direct and indirect effects of environmental attributes on cognitive functions and the joint-significance test was used to examine indirect effects via behaviours. In the total effects models, population density and percentage of parkland were positively associated with cognitive function. A positive association of PM 2.5 with memory was also observed. All neighbourhood environmental attributes were directly and/or indirectly related to cognitive functions via other environmental attributes and/or physical activity but not sedentary behaviours. Engagement in transportation walking and gardening frequency partially mediated the positive effects of the neighbourhood environment on cognitive function, while frequency of transportation walking mediated the negative effects. In the context of a low-density country like Australia, denser urban environments with access to parkland may benefit residents’ cognitive health by providing opportunities for participation in a ersity of activities. A more fine-grained characterisation of the neighbourhood environment may be necessary to tease out the negative and positive impacts of inter-related characteristics of urban neighbourhood environments on cognitive function.

Cohort profile: The Australian Longitudinal Study of Ageing (ALSA)

Publisher: Oxford University Press (OUP)

Date: 12-2016

DOI: 10.1093/IJE/DYU196

Blood pressure, brain structure, and cognition: Opposite associations in men and women

Publisher: Oxford University Press (OUP)

Date: 26-08-2015

DOI: 10.1093/AJH/HPU120

Abstract: Research on associations between blood pressure, brain structure, and cognitive function has produced somewhat inconsistent results. In part, this may be due to differences in age ranges studied and because of sex differences in physiology and/or exposure to risk factors, which may lead to different time course or patterns in cardiovascular disease progression. The aim of this study was to investigate the impact of sex on associations between blood pressure, regional cerebral volumes, and cognitive function in older in iduals. In this cohort study, brachial blood pressure was measured twice at rest in 266 community-based in iduals free of dementia aged 68-73 years who had also undergone a brain scan and a neuropsychological assessment. Associations between mean blood pressure (MAP), regional brain volumes, and cognition were investigated with voxel-wise regression analyses. Positive associations between MAP and regional volumes were detected in men, whereas negative associations were found in women. Similarly, there were sex differences in the brain-volume cognition relationship, with a positive relationship between regional brain volumes associated with MAP in men and a negative relationship in women. In this cohort of older in iduals, higher MAP was associated with larger regional volume and better cognition in men, whereas opposite findings were demonstrated in women. These effects may be due to different lifetime risk exposure or because of physiological differences between men and women. Future studies investigating the relationship between blood pressure and brain structure or cognitive function should evaluate the potential for differential sex effects.

Who displays dementia-related stigma and what does the general public know about dementia? Findings from a nationally representative survey

Publisher: Informa UK Limited

Date: 20-02-2022

DOI: 10.1080/13607863.2022.2040428

Abstract: To identify the characteristics of those who tend to hold stigmatising beliefs and behaviours towards people living with dementia to inform dementia education and the targeting of interventions to reduce dementia-related stigma. A nationally representative telephone survey of 1000 Australians aged 18-93 years was conducted to assess general knowledge of dementia and dementia-related stigma. A single open-ended question was used to assess participants' general knowledge of dementia. Modified items from the Lay Public Dimension of the Family Stigma in Alzheimer's Disease Scale were used to assess dementia-related stigma. Only 26% of participants demonstrated good dementia knowledge while almost half of the participants had a mixed understanding of dementia. Dementia-related negative cognitive attributions were found to be higher in (1) the older age cohorts, (2) amongst in iduals who know someone with dementia, (3) speak a language other than English at home, and (4) have a better understanding of dementia. Older age cohorts, men, those who do not know someone with dementia, and those who speak a non-English language at home also reported significantly higher discriminatory behavioural reactions compared to the younger age cohorts, females, those who know someone with dementia, and those who speak English only at home. This study identifies a need for improved public education about dementia. A structured approach to the development of strategies that is specifically tailored to different age, gender and cultural groups may provide a beneficial approach to help improve dementia knowledge and reduce dementia-related stigma in the population.

Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts

Publisher: Wiley

Date: 06-04-2015

DOI: 10.1002/IJC.29529

Abstract: Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an in iduals' risk of cancer.

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.ARCHGER.2020.104112

Dietary patterns and depressive symptoms over time: Examining the relationships with socioeconomic position, health behaviours and cardiovascular risk

Publisher: Public Library of Science (PLoS)

Date: 29-01-2014

DOI: 10.1371/JOURNAL.PONE.0087657

Disability and depressive symptoms in later life: The stress-buffering role of informal and formal support

Publisher: S. Karger AG

Date: 28-04-2011

DOI: 10.1159/000314158

Abstract: i Background: /i Despite the increasing utilization of formal services by older adults in many nations, there is a paucity of research that has examined the relationships between disability, i formal /i support and depressive symptoms in later life. i Objective: /i We investigated whether support received for daily activities, either from formal and/or informal sources, weakened the deleterious relationship between disability and depression symptoms in later life and whether these stress-buffering effects were stronger in later years of older adulthood. i Methods: /i Participants were 1,359 community-dwelling older adults drawn from Wave 1 of the Australian Longitudinal Study of Ageing. Hierarchical multiple regression was used. i Results: /i In iduals receiving support from (1) informal sources only and (2) both informal and formal sources had weaker relationships between disability and depressive symptoms, relative to those receiving no support. The interaction between informal and formal support and disability also revealed that for in iduals with above average functional limitations, receipt of this support type was associated with fewer depressive symptoms. However, for in iduals with no functional limitations, receipt of both informal and formal support was not associated with depressive symptoms. The stress-buffer age variation hypothesis received no support. i Conclusions: /i Findings suggest that receiving a combination of informal and formal support may be sufficient to offset the harmful association between disability and depressive symptoms in later life. In addition, findings further emphasized the importance of informal support in later life. In contrast, formal support in isolation may not be sufficient to confer a protective effect. Given the expected increase in utilization of formal services among older adults in the coming decades, it is essential that future research investigates the possible factors that underlie this null result.

Higher Fasting Plasma Glucose is Associated with Increased Cortical Thinning Over 12 Years: The PATH Through Life Study

Publisher: Springer Science and Business Media LLC

Date: 27-01-2017

DOI: 10.1007/S10548-017-0544-4

Abstract: Recent evidence suggests that type 2 diabetes (T2D) is associated with accelerated brain ageing, consistent with the observation of increased risk of cognitive impairment and dementia in affected in iduals. Even non-diabetic in iduals with impaired fasting plasma glucose (IFG) levels have shown increased cerebral atrophy, compared to in iduals with normal glucose levels. We tested whether longitudinal rates of age-related cortical thinning were associated with fasting plasma glucose levels in a large s le (n = 322) of early-old age in iduals (60-66 years) who were scanned with magnetic resonance imaging (1.5 T) on up to four occasions over 12 years. Higher plasma glucose levels (measured on up to three occasions) were associated with increased cortical thinning in in iduals with T2D as well as those with IFG, with a similar trend for in iduals with normal fasting glucose (NFG) levels. Across groups, a 1 mmol/l increase in plasma glucose (above 5 mmol/l in NFG and IFG and above 6.1 mmol/l in T2D) resulted in a 10-13% increase in annual cortical thinning. Increased cortical thinning was detected in insular cortex, as well as posterior cingulate, parahippoc us and medial orbitofrontal cortex. Our results provide support for the idea that raised plasma glucose levels, even in the normal range, are associated with accelerated age-related cortical atrophy.

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Publisher: Wiley

Date: 04-1995

DOI: 10.1002/GPS.930100403

Dementia Risk Reduction in Practice: The Knowledge, Opinions and Perspectives of Australian Healthcare Providers

Publisher: Cold Spring Harbor Laboratory

Date: 02-07-2020

DOI: 10.1101/2020.07.01.20144550

Abstract: The aim of this paper was to assess Australian primary healthcare providers’ perspectives and knowledge about dementia risk factors and risk reduction. Primary healthcare providers were recruited through Primary Health Networks across Australia (N = 51). Participants completed an online survey that consisted of fixed-response and free-text components to assess their knowledge, attitudes and current practices relating to dementia risk factors and risk reduction techniques. The survey results showed that over 85% of participants agree that quitting smoking, increasing physical activity, increasing social activity, and treating diabetes can help to reduce the risk of developing dementia. The top suggestions for dementia risk reduction by Australian primary healthcare providers included living a healthy lifestyle (36%), managing cardiovascular risk (17%), and cognitive stimulation (14%). The primary barriers identified for working with patients to reduce dementia risk included low patient motivation and healthcare system level limitations. The most common recommendations were increasing resources and improving dementia awareness and messaging. Collaborative efforts between researchers, media, clinicians, and policy makers are likely needed to support the uptake of risk reduction activities into primary care settings.

Factors distinguishing suicide attempters from suicide ideators in a community sample: social issues and physical health problems

Publisher: Cambridge University Press (CUP)

Date: 31-05-2006

DOI: 10.1017/S0033291706007823

Abstract: Background. Few studies have focused on factors that uniquely distinguish suicide attempters from suicide ideators. This study assesses prevalence of suicide attempts among suicide ideators within a community s le explores demographics, employment status, mental and physical health conditions, personality, life stresses and social environment as factors that may distinguish these groups examines effects of age and gender upon suicide attempts and associated factors and investigates the increase in suicide attempts when multiple factors related to this behaviour are present. Method. Data were drawn from the PATH Through Life Project, a community survey of 7485 people in Canberra, Australia. A subs le of 522 suicide ideators were used for this study. Results. Logistic regression was used to identify factors associated with suicide attempts. Physical medical conditions (OR 1·95) and negative interactions with friends (OR 1·20) were associated with an increased likelihood of suicide attempts among suicide ideators. Age and gender interaction effects for suicide attempts were found involving physical medical condition and mastery among men (OR 3·78 and 0·83 respectively) and not being employed for those aged 40–44 years (OR 8·94). A cumulative effect was found when multiple factors associated with suicide attempts were present, and the probability of an attempt was significantly elevated. Conclusions. Factors distinguishing those who attempt suicide from suicide ideators involve being unemployed, physical ill health and relationship difficulties. Contrary to expectation, this study found that ideators and attempters experience comparable levels of depression and anxiety.