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Establishing The Safety And Effectiveness Of A Diagnostic Therapeutic Trial For Asthma In Community Elderly
Funder
National Health and Medical Research Council
Funding Amount
$397,155.00
Summary
Asthma is a major Australian health priority affecting over 2 million people. It is under-diagnosed and a source of significant morbidity in older people. Previous work by the investigators for the Commonwealth of Australia has shown that in the over 55-year age group approximately 40% of asthma is undiagnosed. In this age group severity is comparable with those diagnosed and worse than those diagnosed under the age of 55 years. Most (80%) of asthma deaths occur in the people aged greater than 5 ....Asthma is a major Australian health priority affecting over 2 million people. It is under-diagnosed and a source of significant morbidity in older people. Previous work by the investigators for the Commonwealth of Australia has shown that in the over 55-year age group approximately 40% of asthma is undiagnosed. In this age group severity is comparable with those diagnosed and worse than those diagnosed under the age of 55 years. Most (80%) of asthma deaths occur in the people aged greater than 55 years. There are clear patient and system factors that contribute to under diagnosis. The patient factors are currently being addressed in a general practice patient pilot study. System issues make the diagnosis of asthma in general practice a difficult task. The study is important, as older people are more likely to access the general practitioner than a specialist for respiratory problems. Spirometry in general practice is not common and is of variable quality. The most common approach to diagnosis by the general practitioner is a diagnostic trial of medication to provide evidence of asthma. This can be broken down into four elements of: entry criteria to a therapeutic trial; choice of drug in a therapeutic trial; length of time for a therapeutic trial, and; assessment criteria in a therapeutic trial. No evidence-based guidelines are available to assist the general practitioner in each of these stages making the therapeutic trial a safety and effectiveness issue of major importance, especially in the older person. The purpose of the study proposed is to conduct a randomised controlled trial in a representative population sample of older people to determine the evidence-based components of a diagnostic therapeutic trial for the guidance of general practitioners. The study will also assess which diagnostic questions and medical tests provide greatest assistance to the general practitioner in diagnosing asthma in the older person.Read moreRead less
Cognitive changes after surgery occur in the elderly, yet the cause remains unknown. We plan to study cognition in patients having hip surgery in which general and spinal anaesthesia are used together. This allows us to sample spinal fluid which will be analysed for substances which identify a predisposition to Alzheimer’s disease. By comparing the results to a group of subjects who have not undergone surgery, we hope to identify if anaesthesia and surgery exacerbate this predisposition.
Disentangling Aphasic Syndromes In Alzheimer's Disease
Funder
National Health and Medical Research Council
Funding Amount
$682,936.00
Summary
Alzheimer’s disease, the main cause of disability in older Australians, can present with diverse and complex manifestations. Language disturbances are not entirely characterised and raises diagnostic difficulties. By development of novel clinical tools and cutting-edge structural brain imaging, this project aims to refine the spectrum of language disturbances, analyse the pattern of brain atrophy and investigate susceptibility factors across Alzheimer's presentations.
Obesity In The Elderly: Effect Of Exercise And Weight Loss Therapies On Physiology And Function
Funder
National Health and Medical Research Council
Funding Amount
$69,729.00
Summary
The population is ageing and the prevalence of obesity is increasing. The “Baby Boomer” generation has the highest prevalence of obesity of all age groups, hence increasing numbers of older adults (age over 65) are obese, and this is unprecedented. We know that obesity predisposes to loss of physical function and independence in older adults, and may increase the risk of dementia. Our trial will compare multiple treatments for obesity in older persons, including newer treatments.
Gastric, Small Intestinal And Cardiovascular Mechanisms Of Postprandial Hypotension.
Funder
National Health and Medical Research Council
Funding Amount
$701,521.00
Summary
A fall in blood pressure after a meal (known as postprandial hypotension) is an important clinical problem, particularly in the elderly, and is associated with an increase in the incidence of falls, stroke, as well as mortality. The mechanisms responsible for postprandial hypotension are not well understood and current therapies are less than optimal. The studies proposed in the current application have important implications for the management of postprandial hypotension.
There are many unresolved issues regarding nutrition in old age such as the obesity paradox, protein intake requirements, and dietary needs of obese and frail older people. We have developed a nutritional model, the Geometric Framework, which has the capacity to address complex questions about the relationship between nutrition and ageing and have an established cohort of older men that will allow us to investigate multiple factors involved in age-related changes in nutrition and obesity.
Improving Postural Stability In People With Parkinson's Disease Using Textured Insoles.
Funder
National Health and Medical Research Council
Funding Amount
$968,538.00
Summary
Falls are a major health and injury problem for people with Parkinson's disease (PD). In this study we propose to undertake a randomised control trial to determine the efficacy of textured insoles to improve postural stability and reduce falls risk in people with Parkinson’s disease. The success of such an inexpensive device would result in improved health outcomes for individuals and large savings in health care through a reduction in fall-related injuries.
Evaluation Of An Instrument For Management Of Behavioural And Psychological Symptoms Of Dementia.
Funder
National Health and Medical Research Council
Funding Amount
$598,468.00
Summary
Behavioural and Psychological Symptoms of Dementia (BPSD) distress the patient and others. The behaviours, and not the underlying causes, are often treated with antipsychotics, despite side effects and low efficacy. An assessment instrument for care staff to determine and address causes of BPSD will be implemented. We predict training will reduce inappropriate prescribing and other reasons for distress. Where medication is required, detailed information will assist more targeted prescribing.
The Effects Of Testosterone And A Nutritional Supplement On Hospital Admissions In Under-nourished, Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,054,231.00
Summary
Weight loss and undernutrition in older people are assocated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalisations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentiallly important finding.