ORCID Profile
0000-0001-5876-3201
Current Organisation
University of Wollongong
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Psychology | Public Health and Health Services | Mortality | Epidemiology | Social Change | Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology) | Computer-Human Interaction | Developmental Psychology and Ageing
ANZSRC Socio-Economic Objective (SEO)
Behaviour and Health | Social Structure and Health | Health Related to Ageing | Ageing and Older People | Injury Control | Health Inequalities |
Related Links
Publications
Estimating the Years Lived With and Without Age-Related Sensory Impairment
Publisher: Oxford University Press (OUP)
Date: 29-10-2016
Abstract: The aim of this study was to estimate the expected years lived with hearing impairment, vision impairment, and dual sensory impairment among older adults. A total of 4,160 adults (45.1% men) from two Australian community based studies were followed for up to 16 years (average 8.9 years). Hearing impairment was defined by a pure-tone average (500-4000 Hz) greater than 25 dB in the better ear. Vision impairment was defined by presenting distance visual acuity worse than 6/12 (20/40). Postliminary analyses were also conducted for moderate levels of sensory impairment. Dual sensory impairment was defined by concurrent hearing and vision impairment. Multistate Markov models were used to calculate sensory life expectancies based on transition probabilities between health states (no sensory impairment, sensory impairment, and death). Based on thresholds for mild impairment, men aged 65 had a total life expectancy of 19.4 years, and were estimated to live for 10.4 years (95% confidence interval [CI]: 9.1, 11.7) with hearing impairment, 2.8 years (95% CI: 2.4, 3.2) with vision impairment, and 2.2 years (95% CI: 1.8, 2.6) with dual sensory impairment. Women aged 65 had a total life expectancy of 23.2 years, and were estimated to live for 12.9 years (95% CI: 11.9, 13.9) with hearing impairment, 3.9 years (95% CI: 3.4, 4.4) with vision impairment, and 3.2 years (95% CI: 2.7, 3.7) with dual sensory impairment. In addition to being highly prevalent, hearing and vision impairment affect older adults for substantial periods of their remaining life. Given their broad ranging impacts on health and well-being, sensory impairments are ideal targets for strategies to compress morbidity in late life.
The symbol digit modalities test: Normative data from a large nationally representative sample of Australians
Publisher: Oxford University Press (OUP)
Date: 28-10-2014
Abstract: Data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey were used to calculate weighted norms for the written version of the Symbol Digits Modalities Test (SDMT) by gender, 5-year age groups and four levels of educational attainment. The s le comprised 14,456 Australians (47% male age range 15-100), of whom 25% reported a tertiary qualification, 30% reported a technical qualification (diploma or trade certificate), 16% reported completing Year 12 (final year of high school), and 29% reported their highest level of educational attainment to be Year 11 or below. Participants were excluded if they reported physical or neurological conditions that limited performance. Age, gender, and education were all significantly associated with SDMT performance, as was poor health, and cultural background. The reported norms are of greater scope and precision than previously available and have utility in a range of clinical and research settings. Indeed, normative data for the SDMT that are representative of a national population have not previously been published.
Effect of speed of processing training on older driver screening measures
Publisher: Frontiers Media SA
Date: 17-10-2017
The contribution of financial hardship, socioeconomic position and physical health to mental health problems among welfare recipients
Publisher: Elsevier BV
Date: 12-2013
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.
Dual sensory loss and depressive symptoms: The importance of hearing, daily functioning, and activity engagement
Publisher: Frontiers Media SA
Date: 2013
Cognitive, health, and sociodemographic predictors of longitudinal decline in hearing acuity among older adults
Publisher: Oxford University Press (OUP)
Date: 13-03-2012
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.
Using Longitudinal Survey Data to Estimate Mental Health Related Transitions to a Disability Pension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2018
How financial hardship is associated with the onset of mental health problems over time
Publisher: Springer Science and Business Media LLC
Date: 17-02-2015
DOI: 10.1007/S00127-015-1027-0
Abstract: Poor mental health has been consistently linked with the experience of financial hardship and poverty. However, the temporal association between these factors must be clarified before hardship alleviation can be considered as an effective mental health promotion and prevention strategy. We examined whether the longitudinal associations between financial hardship and mental health problems are best explained by an in idual's current or prior experience of hardship, or their underlying vulnerability. We analysed nine waves (years: 2001-2010) of nationally representative panel data from the Household, Income, and Labour Dynamics in Australia survey (n = 11,134). Two components of financial hardship (deprivation and cash-flow problems) and income poverty were coded into time-varying and time-invariant variables reflecting the contemporaneous experience of hardship (i.e., current), the prior experience of hardship (lagged/12 months), and any experience of hardship during the study period (vulnerability). Multilevel, mixed-effect logistic regression models tested the associations between these measures and mental health. Respondents who reported deprivation and cash-flow problems had greater risk of mental health problems than those who did not. In iduals vulnerable to hardship had greater risk of mental health problems, even at the times they did not report hardship. However, their risk of mental health problems was greater on occasions when they did experience hardship. The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.
Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4
Publisher: Hindawi Limited
Date: 20-09-2018
DOI: 10.1002/DA.22841
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
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.
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.
Mixed Evidence of an Association between Self-Rated Hearing Difficulties and Falls: Prospective Analysis of Two Longitudinal Studies
Publisher: S. Karger AG
Date: 20-05-2023
DOI: 10.1159/000524311
Abstract: b i Introduction: /i /b This study aimed to assess the extent to which a single item of self-reported hearing difficulties is associated with future risk of falling among community-dwelling older adults. b i Methods: /i /b We used data from two Australian population-based cohorts: three waves from the PATH Through Life study (PATH i n /i = 2,048, 51% men, age 66.5 ± 1.5 SD years) and three waves from the Concord Health and Ageing in Men Project (CHAMP i n /i = 1,448, 100% men with mean age 77.3 ± 5.3 SD years). Hearing difficulties were recorded on a four-point ordinal scale in PATH and on a dichotomous scale in CHAMP. The number of falls in the past 12 months was reported at each wave in both studies. In CHAMP, incident falls were also ascertained by triannual telephone call cycles for up to four years. Multivariable-adjusted random intercept negative binomial regression models were used to estimate the association between self-reported hearing difficulties and number of falls reported at the following wave or 4-monthly follow-ups. b i Results: /i /b In PATH, self-reported hearing difficulties were associated with a higher rate of falls at follow-up (incidence rate ratio = 1.15, 95% CI = 1.03–1.27 per a one-level increase in self-reported hearing difficulties), after adjusting for sociodemographic characteristics, health behaviours, physical functioning, balance, mental health, medical conditions, and medications. There were no significant associations between hearing difficulties and the rate of falls based on either repeated survey or 4-monthly follow-ups in CHAMP. b i Conclusion: /i /b Though we find mixed results, findings from PATH data indicate an ordinal measure of self-reported hearing loss may be predictive of falls incidence in young-old adults. However, the null findings in the male-only CHAMP preclude firm conclusions of a link between hearing loss and falls risk.
Cumulative risk, factor analysis, and latent class analysis of childhood adversity data in a nationally representative sample
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.CHIABU.2022.105486
Abstract: Childhood adversity is a multifaceted construct that is in need of comprehensive operationalisation. The aim of this study was to explore the optimal method to operationalise a scale of adverse childhood experiences (ACEs). Data were from Wave 1 of the Personality and Total Health (PATH) Through Life Project (N = 7485, 51% women). Participants from three age groups (20-25, 40-45, 60-65) retrospectively reported their childhood experiences of domestic adversity on a 17-item scale (e.g., physical abuse, verbal abuse, neglect, poverty). We compared three approaches to operationalising the 17-item scale: a cumulative risk approach, factor analysis, and latent class analysis (LCA). The cumulative risk and dimensional models were represented by a unidimensional and two-dimensional model respectively using confirmatory factor analysis (CFA). The cumulative risk approach and LCA were viable approaches to operationalising ACE data in PATH. CFA of the dimensional model produced latent factors of threat and deprivation that were highly correlated, potentially leading to problems with multicollinearity when estimating associations. LCA revealed six classes of ACEs: high adversity, low adversity, low affection, authoritarian upbringing, high parental dysfunction, and moderate parental dysfunction. Our study found multiple latent classes within a 17-item questionnaire assessing domestic adversity. Using both the cumulative method and latent class approach may be a more informative approach when examining the relationship between ACEs and later health outcomes. Future ACE studies may benefit by considering multi-dimensional approaches to operationalising adversity.
Understanding ageing in older Australians: The contribution of the Dynamic Analyses to Optimise Ageing (DYNOPTA) project to the evidence base and policy
Publisher: Wiley
Date: 10-2011
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.
Cohort Profile Update: The PATH Through Life Project
Publisher: Oxford University Press (OUP)
Date: 24-11-2020
DOI: 10.1093/IJE/DYAA179
Validation of four measures of mental health against depression and generalized anxiety in a community based sample
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.PSYCHRES.2014.12.023
Abstract: There is a need to validate screening measures of affective and generalized anxiety disorders for use in epidemiological surveys of mental health in the general population. This study examined the diagnostic accuracy of the Patient Health Questionnaire (PHQ-9), Goldberg Anxiety and Depression Scales (GAS, GDS) and the 12-item Short Form Health Survey (SF-12) Mental Health Component Summary Scale (MCS-12) in a population based longitudinal study in Australia. We report analyses of two narrow age birth cohorts in the Personality and Total Health (PATH) through life study (ages 32-36 and 52-58). Depressive episodes (severe, moderate, and mild), dysthymia and generalized anxiety disorder were diagnosed according to International Classification of Diseases (ICD-10) criteria using the World Health Organisation (WHO) Composite International Diagnostic Interview (CIDI) as a criterion. All scales had high concordance with their target 30-day diagnoses, with area under the Receiver Operating Characteristic (ROC) curve (AUC) ranging between 0.85 and 0.90. The PHQ-9, GDS, GAS and MCS-12 were all valid instruments for identifying possible cases of depression and anxiety, and assessing the severity of these common mental disorders in the general population. We report recommended cut-points for each scale, though note that the optimal cut-point on mental health screening instruments may vary depending on the context of test administration.
Third-Party Impact of Dual Sensory Loss on Neuropsychiatric Symptom-Related Distress among Friends and Family.
Publisher: S. Karger AG
Date: 2020
DOI: 10.1159/000507856
Abstract: b i Background: /i /b Vision loss and hearing loss are common in later life and are associated with cognitive impairment and neuropsychiatric symptoms. There is a need to better understand how in idual characteristics, such as poor sensory functioning, are linked with familial well-being. b i Objectives: /i /b The aim of this study was to investigate whether, among persons with neuropsychiatric symptoms, age-related sensory loss is related to increased emotional distress reported by their family and friends. b i Methods: /i /b The s le comprised 537 participant-informant dyads from the Personality and Total Health through Life (PATH) study, a community-based cohort. Participants were aged between 72 and 79 years (56% men), and all were reported to exhibit at least 1 neuropsychiatric symptom. Informants were participants’ spouse (50%), child (35%), friend (7%), or other relatives (7%). Neuropsychiatric symptom-related distress of friends and family was assessed with the distress subscale of the Neuropsychiatric Inventory (NPI). Sensory functioning in participants was assessed by visual acuity and self-reported hearing difficulties. Ordinal logistic regression analyses estimated the association between sensory problems and NPI distress. b i Results: /i /b In models adjusted for informant dyadic relationship and socio-demographics, both lower visual acuity (B = 0.23, SE = 0.10) and self-reported hearing difficulty (B = 0.15, SE = 0.06) were associated with increased levels of distress. The increased informant distress associated with poor visual acuity was attenuated after adjusting for neurocognitive disorder and health conditions ( i /i = 0.069). A significant interaction between vision and hearing remained after multivariable adjustment (χ sup /sup (1) = 6.73, i /i = 0.010). b i Conclusions: /i /b Friends and family of persons with poor visual acuity and perceived hearing difficulties report elevated levels of neuropsychiatric symptom-related distress relative to friends and family of persons with poor sensory functioning in only 1 sensory domain or unimpaired levels of vision and hearing. These findings provide evidence of the third-party effects of sensory loss in the context of neuropsychiatric symptoms, and in particular show how dual sensory loss can confer additional challenges over and above the effects of a single sensory loss.
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
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.
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.
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.
Depressive Symptoms Predict Decline in Perceptual Speed in Older Adulthood
Publisher: American Psychological Association (APA)
Date: 09-2011
DOI: 10.1037/A0023313
Age and gender differences in the reciprocal relationship between social connectedness and mental health.
Publisher: Springer Science and Business Media LLC
Date: 03-10-2020
How has Welfare to Work reform affected the mental health of single parents in Australia?
Publisher: Elsevier BV
Date: 12-2014
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.
Why it's important for it to stop: Examining the mental health correlates of bullying and ill-treatment at work in a cohort study
Publisher: SAGE Publications
Date: 11-07-2016
Abstract: There is limited Australian information on the prevalence and mental health consequences of bullying and ill-treatment at work. The aims of this study were to use data from an ongoing Australian longitudinal cohort study to (1) compare different measures of workplace bullying, (2) estimate the prevalence of bullying and ill-treatment at work, (3) evaluate whether workplace bullying is distinct from other adverse work characteristics and (4) examine the unique contribution of workplace bullying to common mental disorders in mid-life. The s le comprised 1466 participants (52% women) aged 52–58 from wave four of the Personality and Total Health (PATH) through Life study. Workplace bullying was assessed by a single item of self-labelling measure of bullying and a 15-item scale of bullying-related behaviours experienced in the past 6 months. Factor analysis the identified underlying factor structure of the behavioural bullying scale. Current bullying was reported by 7.0% of respondents, while 46.4% of respondents reported that they had been bullied at some point in their working life. Person-related and work-related bullying behaviours were more common than violence and intimidation. The multi-dimensional scale of bullying behaviours had greater concordance with a single item of self-labelled bullying (Area Under the Curve = 0.88) than other adverse work characteristics (all Area Under the Curves 0.67). Self-labelled bullying and scales reflecting person-related and work-related bullying were independent predictors of depression and/or anxiety. This study provides unique information on the prevalence and mental health impacts of workplace bullying and ill-treatment in Australia. Workplace bullying is a relatively common experience, and is associated with increased risk of depression and anxiety. Greater attention to identifying and preventing bullying and ill-treatment in the workplace is warranted.
The use of driver screening tools to predict self-reported crashes and incidents in older drivers
Publisher: Elsevier BV
Date: 10-2023
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
Social disadvantage and individual vulnerability: A longitudinal investigation of welfare receipt and mental health in Australia
Publisher: SAGE Publications
Date: 10-04-2013
Abstract: To examine longitudinal associations between mental health and welfare receipt among working-age Australians. We analysed 9 years of data from 11,701 respondents (49% men) from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Mental health was assessed by the mental health subscale from the Short Form 36 questionnaire. Linear mixed models were used to examine the longitudinal associations between mental health and income support adjusting for the effects of demographic and socio-economic factors, physical health, lifestyle behaviours and financial stress. Within-person variation in welfare receipt over time was differentiated from between-person propensity to receive welfare payments. Random effect models tested the effects of income support transitions. Socio-demographic and financial variables explained the association between mental health and income support for those receiving student and parenting payments. Overall, recipients of disability, unemployment and mature age payments had poorer mental health regardless of their personal, social and financial circumstances. In addition, those receiving unemployment and disability payments had even poorer mental health at the times that they were receiving income support relative to the times when they were not. The greatest reductions in mental health were associated with transitions to disability payments and parenting payments for single parents. The poor mental health of welfare recipients may limit their opportunities to gain work and participate in community life. In part, this seems to reflect their adverse social and personal circumstances. However, there remains evidence of a direct link between welfare receipt and poor mental health that could be due to factors such as welfare stigma or other adverse life events coinciding with welfare receipt for those receiving unemployment or disability payments. Understanding these factors is critical to inform the next stage of welfare reform.
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.
Quality Output Checklist and Content Assessment (QuOCCA): a new tool for assessing research quality and reproducibility
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2022-060976
Abstract: Research must be well designed, properly conducted and clearly and transparently reported. Our independent medical research institute wanted a simple, generic tool to assess the quality of the research conducted by its researchers, with the goal of identifying areas that could be improved through targeted educational activities. Unfortunately, none was available, thus we devised our own. Here, we report development of the Quality Output Checklist and Content Assessment (QuOCCA), and its application to publications from our institute’s scientists. Following consensus meetings and external review by statistical and methodological experts, 11 items were selected for the final version of the QuOCCA: research transparency (items 1–3), research design and analysis (items 4–6) and research reporting practices (items 7–11). Five pairs of raters assessed all 231 articles published in 2017 and 221 in 2018 by researchers at our institute. Overall, the results were similar between years and revealed limited engagement with several recommended practices highlighted in the QuOCCA. These results will be useful to guide educational initiatives and their effectiveness. The QuOCCA is brief and focuses on broadly applicable and relevant concepts to open, high-quality, reproducible and well-reported science. Thus, the QuOCCA could be used by other biomedical institutions and in idual researchers to evaluate research publications, assess changes in research practice over time and guide the discussion about high-quality, open science. Given its generic nature, the QuOCCA may also be useful in other research disciplines.
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.
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
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.
Gender, mental health and ageing
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.MATURITAS.2019.09.004
Abstract: This article presents a broad narrative review of the epidemiological evidence on how and why the mental health of older adults varies by gender. We draw upon international research literatures spanning gerontology and population mental health, as well as major reports from global health agencies. Compared with older men, older women are more likely to experience common mental disorders such as depression and anxiety, although the gender gap is smaller than it is at younger ages. In contrast, the mortality-related impacts of poor mental health, including suicide, are more severe for older men. These gendered patterns vary by country and other social contexts. Factors proposed to account for these findings include cultural and social norms, differentiation of gender roles, disadvantage and (dis)empowerment across the life course, and the coping styles of older men. However, little research has explicitly tested these explanations. Research to date has overwhelmingly focused on identifying differences in the mental health of older men and women. Notably, most studies have been restricted to binary comparisons, lacking the data to disentangle sex and gender dynamics, and few studies have examined the mental health of minority gendered adults in later life. Finally, there remains a need for high-quality population-based research into the mental health of those aged over 80 that includes coverage of people living in residential aged care settings.
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.
Lifecourse socioeconomic position and cohort differences in health expectancy in Australia: a longitudinal cohort study
Publisher: Elsevier BV
Date: 04-2022
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.
Cohort profile: The dynamic analyses to optimize ageing (DYNOPTA) project
Publisher: Oxford University Press (OUP)
Date: 17-01-2010
DOI: 10.1093/IJE/DYN276
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.
The Impact of Smoking and Obesity on Disability-Free Life Expectancy in Older Australians
Publisher: Oxford University Press (OUP)
Date: 29-11-2021
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.
Gender, education, and cohort differences in healthy working life expectancy at age 50 years in Australia: a longitudinal analysis
Publisher: Elsevier BV
Date: 08-2023
The influence of smoking, sedentary lifestyle and obesity on cognitive impairment-free life expectancy
Publisher: Oxford University Press (OUP)
Date: 22-08-2014
DOI: 10.1093/IJE/DYU170
Abstract: Smoking, sedentary lifestyle and obesity are risk factors for mortality and dementia. However, their impact on cognitive impairment-free life expectancy (CIFLE)has not previously been estimated. Data were drawn from the DYNOPTA dataset which was derived by harmonizing and pooling common measures from five longitudinal ageing studies. Participants for whom the Mini-Mental State Examination was available were included (N¼8111,48.6% men). Data on education, sex, body mass index, smoking and sedentary lifestyle were collected and mortality data were obtained from Government Records via data linkage.Total life expectancy (LE), CIFLE and years spent with cognitive impairment (CILE)were estimated for each risk factor and total burden of risk factors. CILE was approximately 2 years for men and 3 years for women, regardless of age. For men and women respectively, reduced LE associated with smoking was 3.82and 5.88 years, associated with obesity was 0.62 and 1.72 years and associated with being sedentary was 2.50 and 2.89 years. Absence of each risk factor was associated with longer LE and CIFLE, but also longer CILE for smoking in women and being sedentary in both sexes. Compared with participants with no risk factors, those with 2þ had shorter CIFLE of up to 3.5 years depending on gender and education level. Population level reductions in smoking, sedentary lifestyle and obesity increase longevity and number of years lived without cognitive impairment. Years lived with cognitive impairment may also increase.
Mental health selection and income support dynamics: Multiple spell discrete-time survival analyses of welfare receipt
Publisher: BMJ
Date: 10-12-2014
Abstract: The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.
Response letter to DRS. O'Callaghan and O'neill
Publisher: Wiley
Date: 06-2010
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
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