Health, Wellbeing, Disability And Service Pathways In Older (80+) Australians
Funder
National Health and Medical Research Council
Funding Amount
$373,792.00
Summary
Over the next 40 years there will be a rapid increase in the numbers of people aged 80 year and over. In this study we will examine the health status and service use needs and patterns of a sample of older Australian who form part of an existing 12 year longitudinal study on ageing and who are now moving intoold-old age. The study will provide inmportant insights for service planners and older people themselves about the health and community service needs for people in the study age group.
Mechanisms For Ageing Changes In The Hepatic Sinusoid
Funder
National Health and Medical Research Council
Funding Amount
$413,750.00
Summary
We recently discovered changes in the blood vessels of the liver that occur with old age that we have called pseudocapillarisation. These changes include thickening of the liver sinusoidal endothelium, deposition of basal lamina and collagen, and marked loss of specialized pores within the endothelium called fenestrations. These changes have profound effects on the transfer of many substrates including toxins, drugs, oxygen, hormones and lipids from the blood into the liver and thus may explain ....We recently discovered changes in the blood vessels of the liver that occur with old age that we have called pseudocapillarisation. These changes include thickening of the liver sinusoidal endothelium, deposition of basal lamina and collagen, and marked loss of specialized pores within the endothelium called fenestrations. These changes have profound effects on the transfer of many substrates including toxins, drugs, oxygen, hormones and lipids from the blood into the liver and thus may explain in part the fact that old age is the major risk factor for many diseases and adverse drug reactions. To further understand the mechanisms for these important ageing liver changes, we are proposing several studies. First, the effects of caloric restriction on the liver blood vessels will be studied because caloric restriction delays the primary ageing process. Second we will study the effects of ageing on F-actin, ATP, caveolin-1 and VEGF because these mechanisms have established roles in regulating the structure and function of the liver blood vessels and in particular their fenestrations. Finally we will determine whether VEGF can reverse the ageing changes in the liver blood vessels and stimulate the formation of new fenestrations within these blood vessels. Our research provides one mechanism for the inexorable association between old age and susceptibility to disease - based on primary ageing changes in the liver. As well as increasing our understanding of the cellular changes for ageing and the basic mechanisms involved in the regulation of the liver endothelial cells and their fenestrations, this proposed research will provide a foundation for the development of therapeutic interventions for the prevention and treatment of some age-related disorders.Read moreRead less
Evaluating The Active Communication Education Program For Older People With Hearing Impairment
Funder
National Health and Medical Research Council
Funding Amount
$240,550.00
Summary
Hearing loss is one of the most prevalent disabilities in older people and as the Australian population ages, the number of people with hearing loss will also increase. Hearing loss can lead to social isolation and depression and has a profound effect on quality of life. Hearing aids are often seen as the panacea for hearing loss in older people but approximately 35% of people who have obtained a hearing aid use it infrequently or not at all. Even those who do use the hearing aid frequently may ....Hearing loss is one of the most prevalent disabilities in older people and as the Australian population ages, the number of people with hearing loss will also increase. Hearing loss can lead to social isolation and depression and has a profound effect on quality of life. Hearing aids are often seen as the panacea for hearing loss in older people but approximately 35% of people who have obtained a hearing aid use it infrequently or not at all. Even those who do use the hearing aid frequently may still have difficulty hearing in everyday situations. In addition, there are many older people with a hearing impairment who do not want a hearing aid. Cost is often cited as a factor but reasons such as cosmetic appearance and attitude towards hearing loss are also major reasons for not using hearing aids. Hearing is just one element of successful communication. The ability to communicate despite the presence of a hearing impairment is the focus of a new intervention, the Active Communication Education (ACE) program. Participants develop problem-solving strategies to help with communication in everyday life. The program uses a positive approach aimed at enabling older people themselves to try new solutions to old problems. The aim of this project is to evaluate the effectiveness of ACE for a range of older people with hearing impairment: those who are already using hearing aids, and those who have not sought a hearing aid. Some of the questions answered in this study are: Does the ACE program improve communication and quality of life for older people with hearing impairment? Do some people respond better to ACE , and if so, why? Are there long term effects of ACE? A simple low cost and effective program such as ACEwill have a major impact on the social and psychological health of older people.Read moreRead less
Completion Of A Study To Determine If Vitamin D Supplementation Prevents Fractures In Older Women In Residential Care
Funder
National Health and Medical Research Council
Funding Amount
$140,285.00
Summary
Vitamin D deficiency is a common and easily reversible nutritional problem in older people in residential care. Publication of benefits from vitamin D and calcium supplementation in older women in residential care in France has made the evaluation of population based interventions in Australia a priority. The French study demonstrated substantial reductions in the incidence of hip fractures, the most serious of osteoporotic fractures in terms of morbidity, mortality and financial costs. As yet, ....Vitamin D deficiency is a common and easily reversible nutritional problem in older people in residential care. Publication of benefits from vitamin D and calcium supplementation in older women in residential care in France has made the evaluation of population based interventions in Australia a priority. The French study demonstrated substantial reductions in the incidence of hip fractures, the most serious of osteoporotic fractures in terms of morbidity, mortality and financial costs. As yet, there are no data to inform rational policy in the Australian context, where 10% of women over the age of 70 reside in residential care and where the availability of sunlight and differing diets may alter the effects seen with vitamin D supplementation. Also, we do not understand the mechanism by which this effect occurs, either by strengthening bone or decreasing the rates of falls. Our general aim is to evaluate a simple, cost effective and immediately available intervention, vitamin D supplementation, in the prevention of osteoporotic fractures, especially hip fracture. The specific targeted population will be the high risk population of elderly female nursing home and hostel residents. This study will address whether it is justified to treat all women in these settings with vitamin D supplementation or alternatively to screen and supplement those women with demonstrable vitamin D deficiency.Read moreRead less
Predicting Health And Disease In Australian Men Over The Age Of 80 Years - The Health In Men Study
Funder
National Health and Medical Research Council
Funding Amount
$528,754.00
Summary
Australia is ageing rapidly but we still do not know whether the risk factors, such as health and lifestyle, that predict ill health in middle aged people, apply to people as they reach old age. This study of a large group of older men will examine the type and level of risk factors that apply to men aged beyond 75 years. It will not only determine rates of disability and mortality but also health service outcomes, including hospitalisation, and residential and community care usage.
The Diagnosis Of Depression In Alzheimer's Disease
Funder
National Health and Medical Research Council
Funding Amount
$361,000.00
Summary
During the next 3 decades the number of persons older than 85 years will more than double, and the health care need of this burgeoning population are assuming greater importance. Among the most significant but often overlooked conditions in the elderly is depression, which is associated with marked disability, functional decline, risk of hospitalization, diminished quality of life, caregiver burden, increased service utilization, and mortality from comorbid medical conditions or suicide. The Wor ....During the next 3 decades the number of persons older than 85 years will more than double, and the health care need of this burgeoning population are assuming greater importance. Among the most significant but often overlooked conditions in the elderly is depression, which is associated with marked disability, functional decline, risk of hospitalization, diminished quality of life, caregiver burden, increased service utilization, and mortality from comorbid medical conditions or suicide. The World Health Organization predicts that by 2020 depression will be second only to heart disease as a cause of disability and premature death in established market economies. Depression is missed in approximately half of all elderly persons with mood disorder, and this frequency is certainly higher among individuals with dementia. The strategy to diagnose depression in dementia needs to be revised. Patients' reports are often unreliable due to memory problems and lack of full insight into their mood and behavioural changes. Caregivers may overestimate patients' symptoms of depression, especially when they themselves are depressed and overburdened, and clinicians' diagnoses are sometimes based on biased information and short observation periods. The situation in nursing homes is even worse, and there is a shortage of studies on how to diagnose depression in institutionalised patients with dementia. Using specific instruments to assess mood, behaviour and cognition we will develop valid and reliable criteria to diagnose depression in the different stages of dementia, and for patients living in different settings. This will facilitate the early recognition and adequate treatment of depression in individuals with dementia, it will greatly improve patient's quality of life, and will have a positive impact on caregivers' psychological well-being.Read moreRead less
Iron is essential for brain health. Too little iron can cause problems with memory, concentration and attention and can result in below average intellectual performance or even stroke in children. Too much iron can also be harmful. In the iron overload disease haemochromatosis, iron deposition throughout the body can lead to organ damage in the liver and other tissues. Concentrations of iron in the brain can equal those in liver. Yet surprisingly little is known about the effects of iron on the ....Iron is essential for brain health. Too little iron can cause problems with memory, concentration and attention and can result in below average intellectual performance or even stroke in children. Too much iron can also be harmful. In the iron overload disease haemochromatosis, iron deposition throughout the body can lead to organ damage in the liver and other tissues. Concentrations of iron in the brain can equal those in liver. Yet surprisingly little is known about the effects of iron on the adult human brain. Although the adult brain has traditionally been considered to be protected from the effects of high body iron by the blood-brain barrier, modern techniques show brain iron loading in patients with iron overload disorders or with various brain diseases such as Alzheimer's disease and Parkinson's disease. Several recent studies, including our own, have found associations between mutations in genes important in iron metabolism and brain diseases such as Alzheimer's disease. As many as 30% of Australians have abnormal iron levels (too high or too low) that are often undiagnosed and untreated. There is growing reason to believe these men and women are more likely to have memory problems as well as being at increased risk of brain diseases such as Alzheimer's disease. There is an urgent need for a large-scale study of the short-term and long-term effects of iron levels and related genetic factors on brain health and function. Residents of the Western Australian town of Busselton have participated in a set of health surveys since 1966. We have studied the iron status and related genetic factors in over 3,000 Busselton people. We now propose to perform tests of memory, attention, concentration and related brain activities on the older members of this community group. This will allow us to discover the effects of relevant gene factors, and short- and long-term iron status on memory and other brain functions and on Alzheimer's disease and related disorders.Read moreRead less
Randomised Trial Of Homocysteine Lowering Treatment Of Depression In Later Life (B-VITAge)
Funder
National Health and Medical Research Council
Funding Amount
$775,530.00
Summary
The causes of depression in later life are varied and complex, but available evidence suggests that cardiovascular disease plays an important role. High homocysteine (a robust risk factor for myocardial infarction and strokes) accounts for about 20% of all cases of depression in older age. We have previously shown that treatment with vitamins B12, B6 and folate reduces homocysteine. We propose to run a trial to test if lowering homocysteine decreases the severity and prevalence of depression.