ORCID Profile
0000-0002-1115-9995
Current Organisation
University of Technology Sydney
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Publisher: Cambridge University Press (CUP)
Date: 21-11-2019
DOI: 10.1017/S1041610219001753
Abstract: Aboriginal Australians experience higher rates of non-communicable chronic disease, injury, dementia, and mortality than non-Aboriginal Australians. Self-reported health is a holistic measure and may fit well with Aboriginal views of health and well-being. This study aimed to identify predictors of self-reported health in older Aboriginal Australians and determine acceptable research methodologies for future aging research. Longitudinal, population-based study. Five communities across New South Wales, Australia (two urban and three regional sites). Aboriginal and Torres Strait Islander people ( n = 227 60–88 years, M = 66.06, SD = 5.85 145 female). Participants completed baseline (demographic, medical, cognitive, mental health, and social factors) and follow-up assessments (self-reported health quantified with 5-point scale sharing thoughts on areas important for future research). Predictors of self-reported health were examined using logistic regression analyses. Self-reported health was associated with sex, activities of daily living, social activity participation, resilience, alcohol use, kidney problems, arthritis, falls, and recent hospitalization. Arthritis, kidney problems, and resilience remained significant in multiple logistic regression models. Perceived resilience and the absence of certain chronic age-related conditions predict older Aboriginal peoples’ self-reported health. Understanding these factors could inform interventions to improve well-being. Findings on acceptable research methodologies suggest that many older Aboriginal people would embrace a range of methodologies within long-standing research partnerships, which is an important consideration for Indigenous population research internationally.
Publisher: MDPI AG
Date: 10-10-2020
Abstract: While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.
Publisher: Oxford University Press (OUP)
Date: 05-2008
Abstract: The APOE*E4 allele has been associated with greater gray matter atrophy and with Alzheimer's disease. The aim of this study was to investigate whether the relationship between cerebral gray matter atrophy and APOE*E4 genotype was also present in a community-dwelling, nondemented 60- to 64-year-old cohort. Hippoc al and amygdalar volumes were manually traced and analyzed on 331 cranial T1-weighted magnetic resonance imaging (MRI) scans to detect differences associated with APOE*E4 genotype. Voxel-based morphometric (VBM) analyses were applied to detect regional gray matter volume differences. No total, hippoc al, or amygdalar gray matter volume difference was detected between APOE*E4 carriers and noncarriers. In nondemented 60- to 64-year-olds, there was no association between APOE genotype and gray matter volume using both region-of-interest analysis and VBM.
Publisher: Wiley
Date: 2020
DOI: 10.1002/TRC2.12054
Abstract: Aboriginal Australians have among the highest rates of dementia worldwide, yet no study has investigated the subtypes, risk factors, or longer term outcomes of mild cognitive impairment (MCI) in this population. A total of 336 community‐dwelling Aboriginal Australians aged ≥60 years participated in a longitudinal study, completing a structured interview at baseline. MCI (amnestic subtype, aMCI non‐amnestic subtype, naMCI) and dementia were diagnosed via cognitive screening, medical assessment, and clinical consensus. Associations between life‐course factors and baseline MCI subtypes were examined using logistic regression. Conversion to dementia was assessed at 6‐year follow‐up. Prevalent aMCI ( n = 24) was associated with older age (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.12 to 2.53), head injury (OR = 3.19, 95% CI: 1.35 to 7.56), symptoms of depression (OR = 1.52, 95% CI: 1.04 to 2.24), and lower blood pressure (OR = 0.53, 95% CI: 0.33 to 0.86). Prevalent naMCI ( n = 29) was associated with low education (OR = 4.46, 95% CI: 1.53 to 13.05), unskilled work history (OR = 5.62, 95% CI: 2.07 to 13.90), higher body mass index (OR = 1.99, 95% CI: 1.30 to 3.04), and moderate to severe hearing loss (OR = 2.82, 95% CI: 1.06 to 7.55). A small proportion of MCI cases reverted to intact at follow‐up (15%), but most remained stable (44%), developed dementia and/or died (41%). Sociodemographic and clinical factors both contributed to baseline MCI and were distinct for MCI subtypes, with similar patterns of conversion to dementia for amnestic and non‐amnestic MCI.
Publisher: Informa UK Limited
Date: 09-2019
DOI: 10.1111/AJPY.12241
Publisher: S. Karger AG
Date: 2015
DOI: 10.1159/000377673
Abstract: b i Background: /i /b Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. b i Methods: /i /b In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. b i Results: /i /b All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. b i Conclusion: /i /b The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.
Publisher: American Physiological Society
Date: 02-2009
DOI: 10.1152/PHYSIOLGENOMICS.00035.2008
Abstract: A quantitative trait locus (QTL) approach was used to define the genetic architecture underlying variation in systolic blood pressure (SBP) and heart rate (HR), measured indirectly on seven occasions by the tail cuff procedure. The tests were conducted in 395 F 2 adult mice (197 males, 198 females) derived from a cross of the C57BL/6J (B6) and DBA/2J (D2) strains and in 22 BXD recombinant-inbred (RI) strains. Interval mapping of F 2 data for the first 5 days of measurement nominated one statistically significant and one suggestive QTL for SBP on chromosomes (Chr) 4 and 14, respectively, and two statistically significant QTL for HR on Chr 1 (which was specific to female mice) and Chr 5. New suggestive QTL emerged for SBP on Chr 3 (female-specific) and 8 and for HR on Chr 11 for measurements recorded several weeks after mice had undergone stressful blood s ling procedures. The two statistically significant HR QTL were confirmed by analyses of BXD RI strain means. Male and female F 2 mice did not differ in SBP or HR but RI strain analyses showed pronounced strain-by-sex interactions and a negative genetic correlation between the two measures in both sexes. Evidence for a role for mitochondrial DNA was found for both HR and SBP. QTL for HR and SBP may differ in males and females and may be sensitive to different environmental contexts.
Publisher: Wiley
Date: 21-02-2023
DOI: 10.1111/AJAG.13171
Abstract: The study explored the experiences of Australian aged care providers in supporting clients on a home care package to die at home. Semistructured interviews were conducted with 13 aged care managers responsible for delivering services under the Home Care Package Program. Interviews were analysed thematically. Four themes emerged that illuminated managers' experiences: struggling to meet a preference to die at home lack of opportunities to build workforce capacity in end‐of‐life care challenges in negotiating fragmented funding arrangements between health and aged care providers and mixed success in collaborating across sectors. Aged care providers want to support older Australians who prefer to stay at home at the end of life. However, most clients are admitted to a residential facility when their care needs exceed a home care budget long before a specialist palliative care team will intervene. Budgets for health and aged care providers must be sufficient and flexible to support timely access to end‐of‐life care, to reward collaboration across sectors and to invest in building palliative care skills in the nursing and personal care workforce.
Publisher: Elsevier BV
Date: 07-2009
Publisher: Wiley
Date: 28-06-2014
DOI: 10.1016/J.JALZ.2014.03.007
Abstract: This study aimed to determine the prevalence of dementia in collaboration with urban/regional Aboriginal communities. A census of Aboriginal and Torres Strait Islander men and women aged 60 years and above in the target communities identified 546 potential participants, with 336 (61.5%) participating in this cross-sectional study. Participants completed a structured interview and cognitive screening tests. One hundred fifty-three participants also completed a detailed medical assessment. Assessment data were reviewed by a panel of clinicians who determined a diagnosis of dementia or mild cognitive impairment (MCI) according to standard criteria. Crude prevalence of dementia was 13.4%, and age-standardized prevalence was 21.0%. The most common types of dementia were Alzheimer's dementia (44%) and mixed dementia diagnoses (29%). Estimated prevalence of MCI was 17.7%. Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2018
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.JAGP.2017.05.008
Abstract: High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. A cross-sectional study with a representative s le of community-dwelling older Aboriginal Australians. Urban and regional communities in New South Wales, Australia. 336 Aboriginal and/or Torres Strait Islander Australians aged 60-92 years, of whom 296 were included in the current analyses. Participants completed a life course survey of health, well-being, cognition, and social history including the Childhood Trauma Questionnaire (CTQ), with consensus diagnosis of dementia and Alzheimer disease. CTQ scores ranged from 25-117 (median: 29) and were associated with several adverse childhood indicators including separation from family, poor childhood health, frequent relocation, and growing up in a major city. Controlling for age, higher CTQ scores were associated with depression, anxiety, suicide attempt, dementia diagnosis, and, specifically, Alzheimer disease. The association between CTQ scores and dementia remained significant after controlling for depression and anxiety variables (OR: 1.61, 95% CI: 1.05-2.45). In contrast, there were no significant associations between CTQ scores and smoking, alcohol abuse, diabetes, or cardiovascular risk factors. Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians.
Publisher: Wiley
Date: 09-2009
DOI: 10.1359/JBMR.090418
Publisher: Springer International Publishing
Date: 2017
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.
Publisher: American Physiological Society
Date: 17-11-2005
DOI: 10.1152/PHYSIOLGENOMICS.00062.2005
Abstract: Quantitative trait locus (QTL) analyses were conducted to identify chromosomal regions that contribute to variability in serum alkaline phosphatase (AP) enzyme activity in mice derived from the C57BL/6J (B6) and DBA/2J (D2) inbred strains. Serum AP was measured in 400 B6D2 F 2 mice at 5 mo and 400 B6D2 F 2 mice at 15 mo of age that were genotyped at 96 microsatellite markers, and in 19 BXD recombinant inbred (RI) strains at 5 mo of age. A QTL on the distal end of chromosome 4 was present in all sex- and age-specific analyses with a peak logarithm of odds (LOD) score of 20.36 at 58.51 cM. The Akp2 gene, which encodes the major serum AP isozyme, falls within this QTL region at 70.2 cM where the LOD score reached 13.2 (LOD significance level set at 4.3). Serum AP activity was directly related to the number of D2 alleles of a single nucleotide polymorphism in the 5′-flanking region of the Akp2 gene, although no strain-related differences in hepatic expression of Akp2 RNA were found. A variety of sequence polymorphisms in this chromosomal region could be responsible for the differences in serum AP activity the Akp2 gene, however, with several known amino acid substitutions between protein sequences of the B6 and D2 strains, is a leading candidate.
Publisher: Wiley
Date: 30-01-2018
DOI: 10.1002/HPJA.29
Abstract: Australian Aboriginal children have a higher risk of dental caries yet there is limited focus on oral health risk factors for urban Aboriginal preschool children. This study examined the oral health behaviours and fluid consumption practices of young children from an urban Aboriginal community in south-western Sydney, Australia. In total, 157 Aboriginal children who were recruited to the "Gudaga" longitudinal birth cohort participated in this study. A survey design was employed and parents responded to the oral health questions when their child was between 18 and 60 months. Few parents (20%) were concerned about their child's oral health across the time period. By 60 months, only 20% of children had seen a dentist while 80% were brushing their teeth at least once daily. High levels of bottle use were seen up to 30 months. Consumption of sugary drinks was also very high in the early years, although this was replaced by water by 36 months. While there are some encouraging findings, such as the rates of tooth brushing and increasing rates of water consumption, the findings do highlight the poor uptake of dental services and high levels of bottle usage among urban aboriginal children during their early years. SO WHAT?: Targeted oral health promotional programs are needed in the urban Aboriginal community to better support parents understanding of good oral health practices in the early years and engagement with dental health services.
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.
Publisher: Cambridge University Press (CUP)
Date: 10-02-2014
DOI: 10.1017/S1041610213002561
Abstract: Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random s le of those scoring above (i.e. “normal” range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of “gold standard” clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative s le of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.
Publisher: Wiley
Date: 10-2009
Publisher: Wiley
Date: 20-10-2009
DOI: 10.1002/AJHB.21003
Publisher: Oxford University Press (OUP)
Date: 12-03-2014
DOI: 10.1093/AJH/HPU035
Abstract: White matter lesions (WMLs), seen as hyperintensities on T2-weighted magnetic resonance imaging brain scans, are common in the brains of healthy older in iduals. They are thought to be related to cerebral small vessel disease and to have a genetic component to their aetiology, and hypertension is thought to be an important risk factor. Genetic polymorphisms in hypertension-related genes may therefore be associated with the formation of WMLs. In this study, a s le of 445 Australians aged 60-65 years was drawn from a larger longitudinal epidemiological study, the Personality and Total Health Through Life Project. The associations of single nucleotide polymorphisms (SNPs) in the genes encoding angiotensinogen (AGT, rs699), angiotensin-converting enzyme (ACE, rs4362), and angiotensin II receptor type 1 (AGTR1, rs5182) with WMLs were examined. No in idual SNPs showed a significant association with WMLs for the whole s le. When the cohort was stratified by sex, ACE rs4362 and AGT rs699 showed significant associations with WMLs in men only (P = 0.01 and P = 0.03, respectively), and remained significant after controlling for hypertension. Although the AGTR1 SNP did not show any association with WMLs, the interaction of the AGT rs699 and AGTR1 rs5182 SNPs with WMLs was significant before (P = 0.03) and after adjustment for hypertension (P = 0.045). The results provide evidence for association of polymorphisms in the renin-angiotensin system genes with WMLs, independent of hypertension. Male-only associations with WMLs were found for the AGT rs699 and ACE rs362 polymorphisms. Moreover, for the entire s le an interaction between AGT and AGTR1 rs5182 genotypes on WMLs was observed.
Publisher: Wiley
Date: 05-2005
DOI: 10.1359/JBMR.041224
Publisher: Wiley
Date: 2005
DOI: 10.1359/JBMR.041001
Publisher: Wiley
Date: 2005
Publisher: Springer Science and Business Media LLC
Date: 14-07-2008
No related grants have been discovered for Holly Mack.