ORCID Profile
0000-0001-6739-0152
Current Organisations
Federation University
,
Australian National University
,
Monash University
,
La Trobe University
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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)
Other Behavioural And Cognitive Sciences | Other Psychology and Cognitive Sciences | Aged Health Care | Population Trends And Policies | Social Policy And Planning | Linguistics | Applied Linguistics and Educational Linguistics | Correctional Theory, Offender Treatment and Rehabilitation | Public Health and Health Services | Discourse and Pragmatics | Health Policy | Social Program Evaluation | Pattern Recognition and Data Mining | Computer-Human Interaction | Developmental Psychology and Ageing | Criminology | Psychology | Geriatrics and Gerontology | Public Health and Health Services not elsewhere classified |
ANZSRC Socio-Economic Objective (SEO)
Health related to ageing | The aged | Public services management | Correctional services | Health and Support Services not elsewhere classified | Expanding Knowledge in Psychology and Cognitive Sciences | Health policy economic outcomes | Expanding Knowledge in the Medical and Health Sciences | Expanding Knowledge in Technology | Productivity | Health Related to Ageing | Health Inequalities
Related Links
Publications
Implementing chronic disease self-management approaches in Australia and the United Kingdom
Publisher: Frontiers Media SA
Date: 27-04-2015
'Benign' ovarian teratoma and N-methyl-D-aspartate receptor (NMDAR) encephalitis in a child
Publisher: Springer Science and Business Media LLC
Date: 25-05-2012
The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study
Publisher: Springer Science and Business Media LLC
Date: 28-01-2020
DOI: 10.1186/S12939-020-1124-X
Abstract: The health and aged care workforce must understand and support the erse needs of older people to enhance their care experience. We previously identified five principles of ersity training for this workforce: awareness of unconscious bias and prejudice promotion of inclusion access and equity appropriate engagement and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians. Older people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, ersity. Interviews were thematically analysed using a priori categories based on our previous work on principles of ersity training, and themes were interpreted and expanded upon based on the participants’ experiences and understanding of ersity concepts and their care needs. Fifteen older people (seven female, eight male), mean age 76 years (range 71–85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1) trust and rapport was highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2) intersectionality , that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3) unconscious bias and prejudice by health professionals and its impact on their care. Participants also noted that (4) promotion of inclusion through language was important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5) access and equity of the system. A model articulating these relationships was developed. Health and aged care training should incorporate the five ersity principles to support older people to participate in their own care.
Predisposing factors for occasional and multiple falls in older Australians who live at home
Publisher: Elsevier BV
Date: 2004
DOI: 10.1016/S0004-9514(14)60153-7
Abstract: This study, which was part of a larger study on the Health Status of Older People conducted in Melbourne, Australia, aimed to identify factors that discriminate between multiple and occasional falls amongst older people living at home. It used a survey of 1000 Australians aged 65 years and over. Subjects were classified as multiple fallers (two or more falls in the past year), occasional fallers (one fall in the past year), or non-fallers. Twenty-nine percent of older people who lived at home reported falling once or more in the previous 12 months. Nearly 20% of older people fell once in the previous 12 months and just under 10% fell more than once. Occasional fallers were more likely to be women (OR 1.75, 95% CI 1.26 to 2.45), to have reported back pain (OR 1.54, 95% CI 1.10 to 2.16) and were nearly twice as likely to have more than three medical conditions compared to non-fallers (OR 1.88, 95% CI 1.22 to 2.90). Multiple fallers were also more likely to be women (OR 1.61, 95% CI 1.03 to 2.51). More multiple fallers (17%) than occasional fallers (9%) reported being very afraid of falling. Intervention strategies should take into account these differing predisposing factors for multiple and occasional falls.
Interventions to promote physical activity in older people with type 2 diabetes mellitus: A systematic review
Publisher: Frontiers Media SA
Date: 2013
Secondary school students' knowledge of and attitudes towards older people: Does an education intervention programme make a difference?
Publisher: Cambridge University Press (CUP)
Date: 03-1998
DOI: 10.1017/S0144686X98006874
Abstract: It is now increasingly recognised that if we are to combat ageism the attitudes and knowledge of young people need to be more positively constructed so that they do not hold stereotypic views of ageing. This study evaluates the impact of an educational intervention programme on the attitudes and knowledge of students aged 17–18 years from six secondary schools in Melbourne, Australia. Using Palmore's Facts on Aging Quiz to assess knowledge about and attitudes towards ageing in a quasi-experimental pre-test and post-test design, the results reveal that, in general, students hold low knowledge about older people and negative attitudes about ageing. However, the pre-test mean knowledge scores differed significantly between male and female students and across the various schools, and students who had greater contact with grandparents possessed slightly more knowledge. The post-test results show that the intervention education programme was not successful in raising the student's level of knowledge. The results also show that, in general, the students hold negative attitudes towards older people and that there was little change in their attitudes following the intervention programme. The paper discusses the implications of these results regarding curriculum development in education programmes on ageing intended for young people.
Dual sensory loss in older adults: a systematic review
Publisher: Oxford University Press (OUP)
Date: 27-08-2015
Abstract: Combined vision and hearing loss [dual sensory loss (DSL)] is commonly experienced by older adults. The literature on comorbidities and outcomes associated with DSL in older adults is limited and thus a systematic review was conducted to explore the existing research and identify gaps in the evidence base. A review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Forty-two articles were selected for review. Although several studies evaluated DSL and its comorbidities and impacts, few fully met the criteria for good study design. Reviewed studies primarily investigated DSL and its comorbidities using cross-sectional methods and varying methods of vision and hearing assessment. Many of the studies were large population studies that did not provide sufficient information to draw valid conclusions about the impact of DSL in older adults. Studies focusing specifically on sensory loss in older people across a broad age range are needed to inform clinical practice so that DSL and its impacts in older adults can be identified and managed, leading to improved quality of life for this population.
Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care
Publisher: Wiley
Date: 20-12-2016
DOI: 10.1111/DME.13286
Abstract: The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. Two qualitative methods were used: face-to-face semi-structured in idual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a erse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change.
Diversity training for the community aged care workers: A conceptual framework for evaluation
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.EVALPROGPLAN.2017.03.007
Abstract: Older Australians are an increasingly erse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding ersity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis Reactions Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people's experience of healthcare.
Psychology and ageing in Australia
Publisher: Informa UK Limited
Date: 07-1999
Impacts of illness and disability on the well-being of older people
Publisher: Informa UK Limited
Date: 2000
Abstract: This study examined ways in which aspects of activity may mediate relationships between physical illness and well-being among older people. Data were from the Health Status of Older People survey of 1000 people aged 65 and over who lived in the community in Melbourne, Australia. After controlling for gender, marital status, and perceived social support, multivariate analyses showed that the major impacts of illness and pain were through their effects on activity limitations, which in turn were related to lowered well-being. Limitations with instrumental activities were associated most with lower positive affect, while perceived activity limitations due to major illness had more impact on increased negative affect and depressive symptoms. However, most older people with major illness still scored highly on well-being, and there was in idual variability in well-being. Research on the impacts of illness needs to take more account of impacts on daily living and differences in in idual interpretation of illness and disability. Health promotion and treatment can enhance the well-being of older people by maintaining and regaining independence and activity when in iduals experience major illness.
Performance of screening tools in detecting major depressive disorder among patients with coronary heart disease: a systematic review
Publisher: International Scientific Information, Inc.
Date: 2015
DOI: 10.12659/MSM.892537
Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese
Publisher: Frontiers Media SA
Date: 23-10-2019
Virtual Care Initiatives for Older Adults in Australia: Scoping Review
Publisher: JMIR Publications Inc.
Date: 18-01-2023
DOI: 10.2196/38081
Abstract: There has been a rapid shift toward the adoption of virtual health care services in Australia. It is unknown how widely virtual care has been implemented or evaluated for the care of older adults in Australia. We aimed to review the literature evaluating virtual care initiatives for older adults across a wide range of health conditions and modalities and identify key challenges and opportunities for wider adoption at both patient and system levels in Australia. A scoping review of the literature was conducted. We searched MEDLINE, Embase, PsycINFO, CINAHL, AgeLine, and gray literature (January 1, 2011, to March 8, 2021) to identify virtual care initiatives for older Australians (aged ≥65 years). The results were reported according to the World Health Organization’s digital health evaluation framework. Among the 6296 documents in the search results, we identified 94 that reported 80 unique virtual care initiatives. Most (69/80, 89%) were at the pilot stage and targeted community-dwelling older adults (64/79, 81%) with chronic diseases (52/80, 65%). The modes of delivery included videoconference, telephone, apps, device or monitoring systems, and web-based technologies. Most initiatives showed either similar or better health and behavioral outcomes compared with in-person care. The key barriers for wider adoption were physical, cognitive, or sensory impairment in older adults and staffing issues, legislative issues, and a lack of motivation among providers. Virtual care is a viable model of care to address a wide range of health conditions among older adults in Australia. More embedded and integrative evaluations are needed to ensure that virtually enabled care can be used more widely by older Australians and health care providers.
Factors influencing the physical activity levels of older people from culturally-diverse communities: An Australian experience
Publisher: Cambridge University Press (CUP)
Date: 11-06-2009
DOI: 10.1017/S0144686X09008617
Abstract: Inactivity has been identified as a major contributor to the burden of disease among older Australians, particularly those in culturally- erse communities. This study assessed the facilitators and barriers to physical activity in older people from culturally- erse communities, and investigated the predictors of physical activity participation by recruiting 333 older people from seven different communities in the western suburbs of Melbourne, Australia. A survey questionnaire that recorded physical activity and the barriers to and facilitators of activity was interviewer-administered in the participants' preferred language. The data were analysed using bivariate and multivariate inferential statistical methods. Personal barriers to physical activity, such as poor health, lacking the energy to exercise, being too tired and low motivation, were highly prevalent in all groups. Specific factors, such as ‘being self-conscious about my looks’, were more prevalent among the Vietnamese, as were concerns about the weather among Macedonians and Croatians. Across all groups, perceptions of health and safety strongly influenced physical activity behaviour, more so than the external environment. Some of the barriers can be addressed with a common approach, but others in some communities will require particular strategies.
Beyond crisis: Enacted sense-making among ethnic minority carers of people with dementia in Australia
Publisher: SAGE Publications
Date: 23-11-2020
Abstract: The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy c aigns as well as initiatives that address structural inequities.
General practice utilisation of Medicare Benefits Schedule items to support the care of older patients: Findings from the REDIRECT study
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17047
Abstract: Medicare Benefits Schedule (MBS) items designed to support the wellbeing of older people may reduce unnecessary emergency department utilisation, however it is unclear to what extent such items are used. This study examined general practitioner (GP) utilisation of these MBS items through an analysis of the Melbourne East Monash General Practice Database (MAGNET), which contains information collected from GP clinics within the inner east Melbourne region. Sociodemographic and MBS claim data were extracted for patients aged ≥75 years attending a GP between 2005 and 2012. Utilisation of 75+ Health Assessments, General Practitioner Management Plans (GPMP), Team Care Arrangements (TCAs) or reviews, or Medication Management Reviews (MMRs) was assessed. There were 12962 (60.6%) patients assigned at least one of the MBS items. The highest level of claiming was for GPMPs (n=4754 35.8%) and TCAs (n=4476 33.7%), with MMRs having the lowest use (n=1023 6.8%). Examination of GP and patient barriers to the uptake of these items is needed, along with a greater understanding as to whether those most at risk of hospitalisation are receiving these services. Strategies that support capacity to implement these items are also required.
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.
Essential oils in poultry nutrition: Main effects and modes of action
Publisher: Elsevier BV
Date: 06-2010
Factors associated with self-reported use of oral health services among older Melbournians: Brief Report
Publisher: Wiley
Date: 09-2013
After-hours medical deputising services: Patterns of use by older people
Publisher: AMPCo
Date: 11-2016
DOI: 10.5694/MJA16.00218
Abstract: To examine how older people use an after-hours medical deputising service that arranges home visits by locum general practitioners to identify differences in how people who live in the community and those who live in residential aged care facilities (RACFs) use this service. Retrospective analysis of routinely collected administrative data from the Melbourne Medical Deputising Service (MMDS) for the 5-year period, 1 January 2008 - 31 December 2012. Data for older people (≥ 70 years old) residing in greater Melbourne and surrounding areas were analysed. Numbers and rates of MMDS bookings for acute after-hours care, stratified according to living arrangements (RACF v community-dwelling residents). Of the 357 112 bookings logged for older patients during 2008-2012, 81% were for RACF patients, a disproportionate use of the service compared with that by older people dwelling in the community. Most MMDS bookings resulted in a locum GP visiting the patient. During 2008-2012, the booking rate for RACFs increased from 121 to 168 per 1000 people aged 70 years or more, a 39% increase the booking rate for people not living in RACFs increased from 33 to 40 per 1000 people aged 70 years or more, a 21% increase. After-hours locum GPs booked through the MMDS mainly attended patients living in RACFs during 2008-2012. Further research is required to determine the reasons for differences in the use of locum services by older people living in RACFs and in the community.
Civic Socialising: A revealing new theory about older people's social relationships
Publisher: Cambridge University Press (CUP)
Date: 15-01-2015
DOI: 10.1017/S0144686X13001049
Abstract: The research reported in this article investigated the nature and the purpose of older people's social interactions in their local neighbourhood shops. Data were collected through face-to-face interviews with and observation of 11 shoppers, aged 67 years and older, and six shopkeepers. Classic grounded theory analysis method revealed a previously uncharted psycho-social process associated with these interactions entitled by the authors as Civic Socialising it highlights that older people's interactions in their local neighbourhood shops embody authentication of themselves as in iduals and as community members, and their co-construction and co-preservation of the milieu of their local neighbourhood shopping precinct with a view to sustaining their ongoing autonomy. The new conceptual theory Civic Socialising highlights that older people can be proactive, resilient and capable, dimensions integral to human fulfilment, and demonstrates that older people can play an active role in their communities where the environment is enabling. The new conceptual theory Civic Socialising has significance for the way we determine and view older people's social relationships. Crucially, in light of a burgeoning older population world-wide, it is clear that policy makers and social planners must ensure that older people can continue to interact in their communities if ageing in place is to be a satisfying and cost-effective experience. Without such consideration, ageing in place could well create dependency and despondency.
The relationship between diabetes distress, medication taking, glycaemic control and self-management
Publisher: Springer Science and Business Media LLC
Date: 29-09-2021
DOI: 10.1007/S11096-021-01322-2
Abstract: Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Aim To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting Various healthcare settings in Australia. Method A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.
Effect of a health coach intervention for the management of individuals with type 2 diabetes mellitus in China: A pragmatic cluster randomized controlled trial
Publisher: Frontiers Media SA
Date: 19-09-2018
Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys
Publisher: Cambridge University Press (CUP)
Date: 23-09-2015
DOI: 10.1017/S1041610214002051
Abstract: Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk. Participants ( N = 14,019 women = 91%), including eventual decedents ( n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk. For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01 p 0.001) more substantive was the risk of low physical health (HR = 1.04 p 0.001). No mediation effects were observed. Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.
Older Women in Australia: Facing the Challenges of Dual Sensory Loss
Publisher: MDPI AG
Date: 30-12-2019
Abstract: With the increase in longevity, the number of women living into old age is rising and higher than that of men. Data was derived from the Melbourne Longitudinal Studies on Healthy Ageing Program, which included 533 women and 467 men aged 65 years and older, in Australia, over 10 years. Logistic regression modeling was used to investigate the prevalence of dual sensory loss and the unmet needs for vision and hearing devices in older women (compared to men) over time, as well as its impacts on self-reported general health, depression, perceived social activities, community service use and ageing in place. Results suggested that the prevalence of dual sensory loss increased for women from the age of 75 years and over. Dual sensory loss was higher for older women and men who were living alone, with government benefits as their main income source or were orced, separated or widowed. Dual sensory loss had significant impacts on poor general health, perceived inadequate social activities and community service use for women and men and on depression for women only. Early identification of dual sensory loss is essential to minimize its effects, ensuring continued well-being for this population.
A social view on healthy ageing: Multi-disciplinary perspectives and Australian evidence
Publisher: SAGE Publications Ltd
Date: 2010
Challenges of providing collaborative care for comorbid depression and hypertension in low resource settings in China
Publisher: Cambridge University Press (CUP)
Date: 12-2020
Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-09-2023
Responsible gambling among older adults: A qualitative exploration
Publisher: Springer Science and Business Media LLC
Date: 04-04-2017
Gambling and family: A two-way relationship
Publisher: Akademiai Kiado Zrt.
Date: 12-2017
Perspectives on the training of chinese primary health care physicians to reduce chronic illnesses and their burden
Publisher: Frontiers Media SA
Date: 02-07-2019
Psychological interventions for the management of glycemic and psychological outcomes of Type 2 Diabetes Mellitus in China: a systematic review and meta-analyses of randomized controlled trials
Publisher: Frontiers Media SA
Date: 16-11-2015
The value of comparing health outcomes in cohort studies: An example of self-rated health in seven studies including 79 653 participants
Publisher: Wiley
Date: 22-11-2007
Self‐assessed impact of oral health on the psychological well‐being and depressive symptoms of older adults living in Melbourne
Publisher: Wiley
Date: 13-04-2020
DOI: 10.1111/JPHD.12363
Mental health and dual sensory loss in older adults: a systematic review
Publisher: Frontiers Media SA
Date: 14-05-2014
Older adults' spirituality and life satisfaction: a longitudinal test of social support and sense of coherence as mediating mechanisms
Publisher: Cambridge University Press (CUP)
Date: 24-07-2013
DOI: 10.1017/S0144686X12000633
Abstract: Spirituality is proposed to be a component of successful ageing and has been shown to predict wellbeing in old age. There has been conceptual discussion of possible mechanisms that link spirituality with positive psychological functioning in older adults, but few empirical examinations of these linking mechanisms over time. The current study examined the role of Antonovsky's Sense of Coherence (SOC) and social support in mediating the effects of spirituality on life satisfaction in older participants over a four-year period. The study used a cross-lagged panel analysis to evaluate longitudinal mediation within a path analysis framework. Results showed that the meaningfulness dimension of SOC mediated the influence of spirituality on life satisfaction over time, suggesting that spirituality may influence older adults' experience and perception of life events, leading to a more positive appraisal of these events as meaningful. Social support was not found to mediate the pathway between spirituality and life satisfaction. This study may be the first to examine the link between spirituality, sense of coherence, social support and wellbeing, as measured by life satisfaction, using longitudinal data from a community s le of older adults. The study provides evidence for the positive role of spirituality in the lives of older people. This is an area that requires further examination in models of successful ageing.
Introduction: Learning to live at all ages: Education, empowerment, and health promotion
Publisher: Informa UK Limited
Date: 1995
Professor Hal Kendig's Legacy: A fierce advocate for the rights and contributions of older people
Publisher: Wiley
Date: 05-08-2019
DOI: 10.1111/AJAG.12704
The health and service needs of older veterans: a qualitative analysis
Publisher: Wiley
Date: 24-03-2015
DOI: 10.1111/HEX.12190
Late-life education and learning: The role of cognitive factors
Publisher: Informa UK Limited
Date: 1995
Accommodation options in later life: Retirement village or community living?
Publisher: Wiley
Date: 12-2005
Research with older people: Comparison of a general practice and electoral roll sample with the Australian national health survey
Publisher: Wiley
Date: 06-2001
Assisting health professionals to promote physical activity and exercise in older people
Publisher: Elsevier
Date: 2003
Premature deaths of nursing home residents: An epidemiological analysis
Publisher: AMPCo
Date: 02-2018
DOI: 10.5694/MJA17.00642
Diversity training evaluation for community aged care: Tool development
Publisher: Elsevier BV
Date: 05-2020
Design of an evidence-based diversity workshop to support participation of older people in their community care
Publisher: Informa UK Limited
Date: 03-06-2018
Prevalence and determinants of gambling disorder among older adults: a systematic review
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.ADDBEH.2014.10.007
Abstract: This paper aims to systematically review studies on the prevalence of gambling disorder among older adults aged 60years and above and to summarize the evidence on the determinants, risk factors as well as the comorbidities associated with it. A systematic search was conducted for peer-reviewed, journal articles between 1st January 1995 and 1st May 2013. Only original studies which were published in English, included participants older than 60years of age and provided prevalence figures specifically among them, and where participants were assessed to have a gambling disorder by a validated instrument in non-treatment seeking/non-clinical setting were included. 25 eligible studies were identified from the literature. The prevalence of lifetime gambling disorder ranged from 0.01% to 10.6% across studies. Prevalence of gambling disorder is higher among the younger age groups (of older adults) and among males as compared to females. Those with gambling disorder were more likely to be single or orced/separated. Findings indicate that older adults may gamble more in an effort to ameliorate negative emotional states they may have limited access to other exciting activities or they may be unable to participate in activities that they were previously able to and they might attempt to fill this gap with gambling. Gambling disorder among older adults is a significant problem. Fixed incomes and limited prospects of future earnings make them an extremely vulnerable group. There is an urgent need to understand the phenomenon of gambling disorder in older adults.
Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China
Publisher: Springer Science and Business Media LLC
Date: 29-03-2016
Editorial: Chronic Illness and Ageing in China
Publisher: Frontiers Media SA
Date: 09-04-2020
Living well with chronic disease for those older adults living in the community
Publisher: Cambridge University Press (CUP)
Date: 18-01-2017
DOI: 10.1017/S1041610216002398
Abstract: Definitions of successful aging that incorporate dimensions of physical capacity and medical conditions are limited owing to the normative nature of experiencing medical conditions with age. We examine the capacity for older adults living in the community to live well with or without chronic disease as they age. Participants (n = 1,001) were from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) study who were aged 65+ years at baseline, were living in the community and followed for 16 years. Aging was associated with not living well (OR = 1.21 p 0.001) and having a chronic disease (OR = 1.09 p 0.001). There was increasing proportion of older adults not living well with chronic disease as they aged. Those not living well were at a substantial risk of death with (OR = 3.63 p 0.001) or without (OR = 3.59 p 0.001) chronic disease. The defining normative experience for older adults is that they are more likely to have a chronic disease and importantly not be living well with chronic disease as they age. However, it was the state of not living well that reflected the most substantial vulnerability for mortality, not chronic disease.
Factors associated with self-reported dental visits among older melbournians. The MELSHA study 2008 data collection,Factores asociados con visitas dentales autoinformadas entre melbournianos mayores. El estudio MELSHA 2008 recopilación de datos
Publisher: Facultad de Odontologia, Universidad de Concepcion
Date: 30-08-2019
DOI: 10.17126/JORALRES.2019.041
Abstract: Objective: To describe self-reported oral health-care visits and associated factors in older adults in Melbourne, Australia. Material and Methods: 201 older adults, 79-96 years, took part in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) in 2008. Participants who visited a dentist within 12-months prior were identified. Logistic regression examined factors associated with the 12-month visits. Results: 47.7% reported visits to the dentist in the previous 12 months. Multivariate analyses showed dentate participants (OR=11.27 95% CI: 4.38-29.00) were more likely to have a 12-month visit, and those receiving a government pension or benefit were less likely to have a 12-month visit (OR=0.38 95% CI 0.18-0.79). Conclusion: Compared with existing data on the oral health of older Australians, MELSHA participants appear to have lower dental attendance. Findings highlight the need to increase older people sl eeking oral health-care, and the need to collect information to identify influencers of oral health service usage.
Emergency demand, repeat and frequent presentations by older patients in metropolitan melbourne: A retrospective cohort study using routinely collected hospital data
Publisher: Wiley
Date: 18-01-2018
Abstract: To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations. The older metropolitan Melbourne population increased by 10.3% between 2008 and 2012, whereas the number of ED presentations increased by 12.7%. The volume of PAGP-type presentations decreased by 2.6%, with declining rates per 1000 population ≥70 years of repeat (7.2-6.2) and frequent (0.7-0.4) presentation. In contrast, the volume of non-PAGP-type presentations grew by 15.4%, with increasing repeat (57.6-60.7) and frequent (13.1-14.2) presentation rates per 1000 population ≥70 years. The majority (39%) of non-PAGP-type presentations by frequent ED attenders were due to cardiovascular or respiratory problems. The rate of repeat and frequent PAGP-type presentations by older people decreased in 2012 compared with 2008, suggesting that initiatives implemented to reduce avoidable presentations may have had an effect. However, an increase in the rate of frequent non-PAGP-type presentations, predominately for acute exacerbation of cardiovascular and respiratory conditions, has important implications for planning future healthcare delivery hence, the importance of initiatives such as the Health Care Home.
Body mass index and unintentional weight change associated with all-cause mortality in older Australians: The Melbourne Longitudinal Studies on Healthy Ageing (MELSHA)
Publisher: Oxford University Press (OUP)
Date: 27-06-2010
Identifying Public Healthcare Priorities in Virtual Care for Older Adults: A Participatory Research Study
Publisher: MDPI AG
Date: 23-02-2023
Abstract: There has been increasing adoption and implementation of virtual healthcare in recent years, especially with COVID-19 impacting the world. As a result, virtual care initiatives may not undergo stringent quality control processes to ensure that they are appropriate to their context and meet sector needs. The two objectives of this study were to identify virtual care initiatives for older adults currently in use in Victoria and virtual care challenges that could be prioritised for further investigation and scale-up and to understand why certain virtual care initiatives and challenges are prioritised over others for investigation and scale-up. Methods: This project used an Emerging Design approach. A survey of public health services in the state of Victoria in Australia was first carried out, followed by the co-production of research and healthcare priorities with key stakeholders in the areas of primary care, hospital care, consumer representation, research, and government. The survey was used to gather existing virtual care initiatives for older adults and any associated challenges. Co-production processes consisted of in idual ratings of initiatives and group-based discussions to identify priority virtual care initiatives and challenges to be addressed for future scale-up. Stakeholders nominated their top three virtual initiatives following discussions. Results: Telehealth was nominated as the highest priority initiative type for scaling up, with virtual emergency department models of care nominated as the highest priority within this category. Remote monitoring was voted as a top priority for further investigations. The top virtual care challenge was data sharing across services and settings, and the user-friendliness of virtual care platforms was nominated as the top priority for further investigation. Conclusions: Stakeholders prioritised public health virtual care initiatives that are easy to adopt and address needs that are perceived to be more immediate (acute more so than chronic care). Virtual care initiatives that incorporate more technology and integrated elements are valued, but more information is needed to inform their potential scale-up.
‘One size does not fit all’: Perspectives on diversity in community aged care
Publisher: Wiley
Date: 13-05-2018
DOI: 10.1111/AJAG.12534
Abstract: Typically, older people are viewed via a single health condition, yet health outcomes are likely impacted by the intersection of many in idual characteristics. Promoting inclusive health care is underpinned by reducing bias, respectful communication and supporting in idual needs and preferences. This study explores perspectives of community aged care workers on ersity training and implementing training into practice. Ninety community aged care workers were telephone-interviewed three months after a one-day ersity training workshop. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Five themes emerged: 'raising awareness' 'reserving judgement' 'confidence and empowerment to embed ersity into practice' 'communicating effectively' and 'thinking about change … but'. Diversity concepts were positively received, but applying ersity principles into practice is more difficult. Recommendations to promote inclusive health care included raising awareness of bias, communicating with inclusive language and embedding ersity concepts into community aged care practice by addressing in idual, organisational and wider system constraints.
Self-reported medication side effects in an older cohort living independently in the community - The Melbourne Longitudinal Study on Healthy Ageing (MELSHA): Cross-sectional analysis of prevalence and risk factors
Publisher: Springer Science and Business Media LLC
Date: 10-06-2010
Communication and psychosocial consequences of sensory loss in older adults: Overview and rehabilitation directions
Publisher: Informa UK Limited
Date: 2002
DOI: 10.1080/09638280210129162
Abstract: With increasing longevity among populations, age-related vision and hearing impairments are becoming prevalent conditions in the older adult populations. In combination dual sensory loss occurs. Dual sensory loss is becoming a more common condition seen by clinicians and previous research has shown that 6% of non-institutionalized older adults had a dual sensory impairment, whilst 70% of severely vision-impaired older adults also demonstrated a significant hearing loss. Decreased vision and/or hearing acuity interferes with reception of the spoken message and hence people with sensory loss frequently experience communication breakdown. Many personal, situational and environmental triggers are also responsible for communication breakdown. Limited ability to improve communication performance frequently results in poor psychosocial functioning. Older adults with sensory loss often experience difficulty adjusting to their sensory loss. Depression, anxiety, lethargy and social dissatisfaction are often reported. Sensory loss, decreased communication performance and psychosocial functioning impacts on one's quality of life and feelings of well-being. Rehabilitation services for older adults with age-related sensory loss need to accommodate these difficulties. Improved staff education and rehabilitation programmes providing clients and carers with strategies to overcome communication breakdown is required. A multidisciplinary perspective to the assessment and remediation of older adults is recommended.
The communication and psychosocial perceptions of older adults with sensory loss: A qualitative study
Publisher: Cambridge University Press (CUP)
Date: 2004
DOI: 10.1017/S0144686X03001491
Abstract: Sensory loss (visual and/or hearing loss) is prevalent in older adults. Decreased vision and/or hearing acuity often result in poor communication and psychosocial functioning. This qualitative study explores the communication and psychosocial perceptions of a group of older adults with single or dual sensory loss. The aims were to identify the communication difficulties and conversational strategies used by the subjects, and to explore their perceptions of their social adjustment, quality of life and physical and mental well-being. The participants were all older adults with sensory loss who attended the Vision Australia Foundation. In-depth interviews revealed that the participants experienced frequent communication difficulties. They identified the personal, situational and environmental triggers responsible for communication breakdown, and they described the compensation and avoidance strategies that they used. The participants acknowledged that frequent communication breakdown resulted in decreased socialisation. The problems of adjusting to sensory loss, depression, anxiety, lethargy and social dissatisfaction were cited as factors that affected their physical and mental well-being, while being optimistic, coping with their sensory loss, and maintaining social contact contributed to an improved quality of life. All participants expressed interest in being involved in further communication intervention programmes.
Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial
Publisher: BMJ
Date: 2012
Factors affecting walking activity of older people from culturally diverse groups: An Australian experience
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.JSAMS.2009.07.002
Abstract: This study sought to investigate the walking habits of older people from erse cultural backgrounds, and to identify the factors associated with their walking. Three hundred and thirty three people over the age of 60 years were recruited from seven culturally erse groups from the Western suburbs of Melbourne, Australia. A survey questionnaire recording physical activity, and various factors related to activity, was interviewer-administered in the participants' preferred language. Data were analysed using Kruskal-Wallis, chi(2) and Mann-Whitney tests. Forty-seven percent of the participants walked at least 150 min per week, with no significant difference in prevalence between genders or cultural groups. Some cultural differences were found in relation to reasons and locations for walking, and women were more likely than men to report walking in the shopping mall, whilst men were more likely than women to report walking in the park and along walking trails. Those who attained >150 min of walking were more likely to report health and fitness as reasons for walking, to perceive their walking environment as more pleasurable, to use walking trails, and to consider their environment safe and to facilitate social interaction. This study indicates that the continued advocating of walking as a health promoting activity should be central to future c aigns to increase physical activity in this age group. The provision of locations that are accessible, safe, aesthetically pleasing, and encourage social engagement are likely to facilitate older people's participation in walking. For maximum effectiveness, however, strategies may benefit from being tailored to meet specific gender and cultural preferences.
Editorial: Women in science: aging and public health 2022
Publisher: Frontiers Media SA
Date: 13-06-2023
To continue, modify or relinquish driving: Findings from a longitudinal study of healthy ageing
Publisher: S. Karger AG
Date: 2008
DOI: 10.1159/000111489
Abstract: i Background: /i The number and proportion of drivers among people entering later life continues to rise. More information on patterns of driving for older adults is required to improve service provision and traffic planning. i Objectives: /i To map the changes in driving status for a s le of drivers aged 65 years or older over the period 1994–2000, and to identify factors associated with older people continuing, modifying or relinquishing their status as drivers. i Methods: /i The 752 participants were drawn from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) program, a longitudinal study of people aged 65 years and older living in the community. Participants were interviewed or contacted for follow-up in 1994, 1996, 1998 and 2000 on a range of topics including their health, functional independence and driving status. i Results: /i Although the number of recent drivers was smaller as participants died or were admitted to nursing homes over the 6-year data collection period, relatively few participants relinquished driving while remaining in the community. Many drivers reported modifying their driving habits over time, including decisions to restrict their driving to their local area during daylight only. Relationships were explored between driving status and the key variables of age, gender, marital status, instrumental activities of daily living (IADL) independence and self-rated measures of income, health, eyesight and hearing. Multivariate analyses indicated that drivers were more likely to modify their driving habits if they were older, dependent in IADL, and rated their eyesight as poor. Similar factors predicted relinquishing driving, but in addition, women were three times more likely to relinquish driving than men (even when health and disability were taken into account) and people who rated their incomes as ‘comfortable’ were more likely to relinquish driving than those with lower incomes. i Conclusions: /i This study confirmed previous evidence that older drivers self-regulate by modifying their driving behavior as they age. However, since few drivers voluntarily relinquish driving, further research is required to identify ways of supporting older drivers to continue to drive safely.
Culture and age influences upon gambling and problem gambling
Publisher: Elsevier BV
Date: 06-2015
Evidence-based care of older people with suspected cognitive impairment in general practice: Protocol for the IRIS cluster randomised trial
Publisher: Springer Science and Business Media LLC
Date: 19-08-2013
Socio-Ecological Approach to Self-Management of Type 2 Diabetes: Physical Activity and Dietary Intervention
Publisher: InTech
Date: 26-06-2013
DOI: 10.5772/56512
Challenges of recruitment and retention of older people from culturally diverse communities in research
Publisher: Cambridge University Press (CUP)
Date: 05-2008
DOI: 10.1017/S0144686X07006976
Abstract: The substantial and increasing number of older Australian people from culturally erse backgrounds justifies the investigation and inclusion of their experiences in ageing research. Few empirical studies have addressed culturally erse issues in the older population, however, in part because of the particular challenges in recruiting and retaining people from different cultural backgrounds. This article reflects on a research team's experience of recruiting participants from seven cultural groups into a study that sought to explore the links between physical activity and the built environment. Three key issues for recruiting and retaining participants from culturally erse backgrounds were identified: having access to key local informants the central role of paid and trained bilingual interviewers and supporting the research partners in recruitment activities. Furthermore, it appeared that a ‘one size fits all’ approach was not appropriate and that a flexible recruitment strategy may be required to ensure successful recruitment from all cultural groups. The differences observed in this study relating to recruitment and retention rates may be more dependent on the skills and characteristics of those responsible for the recruitment and interviewing, rather than the specific cultural group itself. Older people from some cultural backgrounds may be less likely to respond to traditional recruitment methods and researchers need to be more assiduous and strategic to improve participation rates in research.
Effectiveness of personalized feedback alone or combined with peer support toiImprove physical activity in sedentary older Malays with type 2 diabetes: a randomized controlled trial
Publisher: Frontiers Media SA
Date: 13-07-2015
Boundary Crossers: How Providers Facilitate Ethnic Minority Families’ Access to Dementia Services
Publisher: Oxford University Press (OUP)
Date: 29-04-2022
Abstract: Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of “boundary crossers,” this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families’ role. In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services.
Understanding diagnosis and management of dementia and guideline implementation in general practice: A qualitative study using the theoretical domains framework
Publisher: Springer Science and Business Media LLC
Date: 03-03-2014
Abstract: Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia however, there are gaps between recommended and current practice. The aim of this study was to explore GPs’ reported practice in diagnosing and managing dementia and to describe, in theoretical terms, the proposed explanations for practice that was and was not consistent with evidence-based guidelines. Semi-structured interviews were conducted with GPs in Victoria, Australia. The Theoretical Domains Framework (TDF) guided data collection and analysis. Interviews explored the factors hindering and enabling achievement of 13 recommended behaviours. Data were analysed using content and thematic analysis. This paper presents an in-depth description of the factors influencing two behaviours, assessing co-morbid depression using a validated tool, and conducting a formal cognitive assessment using a validated scale. A total of 30 GPs were interviewed. Most GPs reported that they did not assess for co-morbid depression using a validated tool as per recommended guidance. Barriers included the belief that depression can be adequately assessed using general clinical indicators and that validated tools provide little additional information (theoretical domain of ‘Beliefs about consequences’) discomfort in using validated tools (‘Emotion’), possibly due to limited training and confidence (‘Skills’ ‘Beliefs about capabilities’) limited awareness of the need for, and forgetting to conduct, a depression assessment (‘Knowledge’ ‘Memory, attention and decision processes’). Most reported practising in a manner consistent with the recommendation that a formal cognitive assessment using a validated scale be undertaken. Key factors enabling this were having an awareness of the need to conduct a cognitive assessment (‘Knowledge’) possessing the necessary skills and confidence (‘Skills’ ‘Beliefs about capabilities’) and having adequate time and resources (‘Environmental context and resources’). This is the first study to our knowledge to use a theoretical approach to investigate the barriers and enablers to guideline-recommended diagnosis and management of dementia in general practice. It has identified key factors likely to explain GPs’ uptake of the guidelines. The results have informed the design of an intervention aimed at supporting practice change in line with dementia guidelines, which is currently being evaluated in a cluster randomised trial.
Barriers and enablers to healthcare access and use among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes mellitus: a qualitative comparative study
Publisher: BMJ
Date: 17-11-2015
The Reporting Of MEdication use in Observational studies (ROMEO) Statement
Publisher: Springer Science and Business Media LLC
Date: 09-05-2015
The experience of ageing: Influences on mental health and well-being
Publisher: Routledge
Date: 10-09-2012
Ageing in Australia
Publisher: Springer New York
Date: 2017
Diversity training for community aged care workers: An interdisciplinary meta-narrative review
Publisher: Informa UK Limited
Date: 28-02-2017
Rehabilitation of older injured workers
Publisher: Informa UK Limited
Date: 1994
DOI: 10.3109/09638289409166292
Abstract: This paper provides a review of international findings in rehabilitation outcomes for older workers. Older workers are disadvantaged in terms of their rehabilitation following injury. They sustain more serious injuries, take longer to recover and are less likely to return to work than younger workers. This results in substantial economic costs to the community as well as a reduction in financial security and quality of life for the older person. A number of possible explanations for the relationship between age and rehabilitation outcomes are discussed. It is proposed that the application of a 'biopsychosocial' model to rehabilitation outcome may be a useful way of conceptualizing the complexity of the rehabilitation process in older workers and predicting rehabilitation outcomes.
Protecting children in low-income and middle-income countries from COVID-19
Publisher: BMJ
Date: 05-2020
Intergenerational and intercultural encounters: Connecting students and older people through language learning
Publisher: Informa UK Limited
Date: 2012
Predictors of injurious falls and fear of falling differ: an 11-year longitudinal study of incident events in older people
Publisher: SAGE Publications
Date: 12-08-2015
Abstract: Objective: The objective of the study is to identify the intrinsic, psychosocial and lifestyle factors, which, over time, predict the incidence of having a fall requiring medical attention (injurious fall) or of acquiring a fear of falling (FOF). Method: Data from 1,000 participants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA, 1994-2005) were analyzed using cox regressions and hazard ratios. Results: The predictors of injurious falls ( n = 900, events = 200) were increasing age, slower gait speed, and being depressed. Main predictors of developing a FOF ( n = 855, events =117) were increasing age, cognitive impairment, reduced social activity, and gender. A history of falls at baseline did not predict acquiring a FOF nor did FOF predict a future fall. Discussion: The profile of the person who will have an injurious fall differs from the profile of the person who develops a FOF and should be considered when designing interventions.
Cardiovascular disease and death associated with depression and antidepressants in the Melbourne longitudinal studies on healthy ageing (MELSHA)
Publisher: Wiley
Date: 15-03-2011
DOI: 10.1002/GPS.2532
Abstract: Cardiovascular disease (CVD) and death may be associated with depression and antidepressants, but published findings remain equivocal. The authors aimed to determine the risk of CVD incidence and death associated with several classifications of depression. A prospective cohort study was conducted (1994-2006) in a regionally representative s le of 1000 non-institutionalised older Australians age 65+ years (47% men). Endpoints were non-fatal CVD incidence and death over 10 and 12-years, respectively. Depression incidence was assessed at 2-years. Depression related predictors were defined by symptoms (Psychogeriatric Assessment Scales, depression scale) and/or antidepressants to determine independent and/or joint effects on endpoints. Cox regressions determined unadjusted and multiple-adjusted (for significant covariates) hazard ratios (HR). Baseline response rate was 70.3%. Aggregate dropout rate was approximately 24% for survivors at biennial follow-ups, but death status was ascertained for all participants. Several classifications of depression predicted death in unadjusted analyses (39-60% >1), but effects disappeared in multiple-adjusted analyses (in which all HRs became <1 and non-significant). Depression related predictors were thus not associated with CVD incidence or death after accounting for confounding mostly by CVD, diabetes and poor functional health covariates. Prevalent arthritis, respiratory disease and daily pain were predictors (P < 0.05) of depression incidence. Depression related predictors were not independently associated with CVD incidence or death in older people. Antidepressants were not associated with CVD or premature death, accounting for whether participants' remained symptomatic or not. Depression co-occurs with and might be partly caused by chronic disease and poor functional health.
The role of psychologists in fostering the wellbeing of older Australians
Publisher: Informa UK Limited
Date: 2003
Health, lifestyle, and gender influences on aging well: an Australian longitudinal analysis to guide health promotion
Publisher: Frontiers Media SA
Date: 02-07-2014
Dual sensory loss, mental health and wellbeing of older adults living in China
Publisher: Frontiers Media SA
Date: 24-04-2019
Therapeutic effects of motivational interviewing on blood pressure control: a meta-analysis of randomized controlled trials
Publisher: Elsevier BV
Date: 03-2014
Health, social and lifestyle factors in entry to residential aged care: An Australian longitudinal analysis
Publisher: Oxford University Press (OUP)
Date: 15-03-2010
Abstract: strategies to enable older people to remain in their own homes require information on potential intervention areas and target groups for health promotion and healthcare services. this study aimed to identify socioeconomic, health and lifestyle factors in entry to residential aged care facilities. a prospective cohort study was conducted from 1994 to 2005. the information source was the Melbourne Longitudinal Studies on Healthy Ageing Program. one thousand Australians aged 65 years and over living in the community were used as baseline s le. socio-medical data were gathered in face-to-face baseline interviews, and outcomes were identified in biennial follow-ups with respondents, informants and death registries over 12 years. Cox regression models identified baseline predictors of subsequent entry to residential aged care for men and women from among socio-demographic, health status and lifestyle factors. the most significant factors were older age, Instrumental Activities of Daily Living (IADL) dependence, cognitive impairment, underweight body mass index (BMI) and low social activity. For men only, the number of medical conditions and healthy nutrition score also emerged as significant. For women only, never having been married, IADL dependence and low BMI also were significant. For men, the risk of entry to residential aged care facilities was associated mainly with disease burden, whereas for women, social vulnerability and functional capacities were more important. Healthy lifestyles were important indirectly insofar as they influenced subjects' health status. to facilitate older people to stay in the community, it is important to treat or ameliorate medical conditions, promote healthy lifestyles and consider gender-specific risks.
Foot and leg problems are important determinants of functional status in community dwelling older people
Publisher: Informa UK Limited
Date: 08-2005
DOI: 10.1080/09638280500030506
Abstract: To determine whether foot and leg problems are independently associated with functional status in a community s le of older people after adjusting for the influence of socio-demographic, physical and medical factors. Data were analysed from the Health Status of Older People project, a population-based study involving a random s le of 1000 community-dwelling people aged 65 - 94 years (533 females, 467 males, mean age 73.4 years +/- 5.87). A structured interview and brief physical examination were used to investigate the associations between self-reported foot and leg problems and functional status. Functional status was assessed using: (i) timed 'Up & Go' test, (ii) self-reported difficulty climbing stairs, (iii) self-reported difficulty walking one kilometer, (iv) self-reported difficulty performing instrumental activities of daily living (IADLs), and (v) self-reported history of one or more falls in the previous 12 months. These associations were then explored after adjusting for socio-demographic, physical and medical factors. Thirty-six percent of the s le reported having foot or leg problems. Univariate analyses revealed that people with foot and leg problems were significantly more likely to exhibit poorer functional status in all parameters measured. After adjusting for socio-demographic, physical and medical factors, foot and leg problems remained significantly associated with impaired timed 'Up & Go' performance (OR = 2.15, 95%CI 1.55 - 2.97), difficulty climbing stairs (OR = 3.33, 95%CI 1.98 - 5.61), difficulty walking one kilometer (OR = 3.13, 95%CI 2.09 - 4.69), and history of falling (OR = 1.73, 95%CI 1.26 - 2.37). Foot and leg problems are reported by one in three community-dwelling people aged 65 years and older. Independent of the influence of age, gender, common medical conditions and other socio-demographic factors, foot and leg problems have a significant impact on the ability to perform functional tasks integral to independent living.
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.
Improved Flow Dynamics of Extracorporeal Membrane Oxygenation via Design Modification of Dual-Lumen Cannulas
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-02-2022
DOI: 10.1097/MAT.0000000000001669
Abstract: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports patients with severe respiratory failure not responding to conventional treatments. Single-site jugular venous cannulation with dual-lumen cannulas (DLC) have several advantages over traditional single-lumen cannulas, however, bleeding and thrombosis are common, limiting their clinical utility. This study numerically investigated the effects of DLC side holes on blood flow dynamics since the maximum wall shear stress (WSS) occurs around the side holes. A DLC based on the Avalon Elite 27Fr model was implanted into an idealized 3D model of the vena cava and right atrium (RA). Eight DLCs were developed by changing the number, diameter, and spacing of side holes through an iterative design process. Physiologic flow at the inferior vena cava (IVC) and superior vena cava (SVC) were applied along with a partial ECMO support of 2 L/min. The SST k-ω turbulent model was solved for 6.4 seconds. WSS, washout, stagnation volume, and recirculation were compared. For all DLCs, no stasis region lasted more than one cardiac cycle and a complete washout was obtained in less than 4 seconds. Due to the IVC and SVC backflows, maximum WSS occurred around the DLC side holes at late systole and late diastole. A DLC with 16 and three side holes within the IVC and SVC, respectively, reduced the maximum WSS by up to 67% over the Avalon Elite 27Fr. Improved DLCs provided a more uniform WSS distribution with lower WSS around the side holes, potentially reducing the chance of thrombosis and bleeding.
HOspitals and patients WoRking in Unity (HOW R U?): Telephone peer support to improve older patients' quality of life after emergency department discharge in Melbourne, Australia - A multicentre prospective feasibility study
Publisher: BMJ
Date: 06-2018
Cohort profile: The dynamic analyses to optimize ageing (DYNOPTA) project
Publisher: Oxford University Press (OUP)
Date: 17-01-2010
DOI: 10.1093/IJE/DYN276
The PROblem Gambling RESearch Study (PROGRESS) research protocol
Publisher: BMJ
Date: 11-2015
Sensory loss in China: Prevalence, use of aids, and impacts on social participation
Publisher: Frontiers Media SA
Date: 24-01-2019
Diabetes incidence associated with depression and antidepressants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA)
Publisher: Wiley
Date: 05-10-2010
DOI: 10.1002/GPS.2409
Abstract: Diabetes may be associated with depression and antidepressant medication (ADM) use, but published findings remain equivocal. The authors' aimed to determine the risk of diabetes incidence associated with baseline depression exposures (symptoms and/or ADM use). A prospective cohort study was conducted in a regionally representative s le of non-institutionalised older Australian people (N = 1000, aged 65 + year), who were followed up biennially between 1994 and 2004 (attrition was approximately 24%). Analyses excluded participants for prevalent diabetes at baseline, determined by self-report or specific medications. Diabetes incidence was ascertained by first self-report at any follow-up wave. Depression exposures (baseline predictors) were defined by the Psychogeriatric Assessment Scales (PAS) depression scale and ADM use, and classified as: (1) 'symptomatic' (PAS score 5+) (2) 'ADM use' (3) 'symptomatic or ADM use' (4) 'symptomatic and no ADM use' (5) 'asymptomatic (PAS score <5) and ADM use' and (6) 'symptomatic and ADM use'. Covariates were demographic, lifestyle, functional health and chronic disease factors. Cox regressions were used to determined hazard ratios with 95% confidence intervals (HR [95% CI]) for diabetes incidence according to depression exposures, adjusted for significant covariates. Baseline response rate was 70.3%. Depression predictors of diabetes incidence were 'symptomatic' (2.29 [1.28,4.10]), 'symptomatic or ADM use' (2.13 [1.32,3.44]) and 'symptomatic and no ADM use' (2.38 [1.28,4.45]), after adjustment for significant covariates. Being asymptomatic was not a protective factor among those prescribed antidepressants. Older people with depressive symptoms are at least twice more likely to develop diabetes than those without depressive symptoms, regardless of antidepressants.
Preferences and Predictors of Aging in Place: Longitudinal Evidence from Melbourne, Australia
Publisher: Informa UK Limited
Date: 02-03-2017
Community values and preferences in transplantation organ allocation decisions
Publisher: Elsevier BV
Date: 03-2001
DOI: 10.1016/S0277-9536(00)00187-8
Abstract: This paper is concerned with community values and preferences in organ transplantation allocation decisions. With recent trends in organ shortages, transplant teams face difficult allocation decisions amongst increasing numbers of "worthy" potential recipients. It is argued that the debate about these decisions ought to be informed in part by a systematic knowledge of prevailing community standards. A community s le of 238 adults (140 women and 98 men, with a mean age of 47.0 years) completed a questionnaire concerning which factors ought to affect recipient priority for transplantation. Longer waiting time, better prognosis, younger age and being a parent were the most frequently selected criteria for organ allocation decisions. The participants also rank ordered 16 potential recipients presented in the form of case scenarios in terms of priority for transplantation. The 16 case scenarios were constructed from a factorial combination of four variables: age of recipient (young vs old) the time the recipient had been on a waiting list (long vs short) recipient prognosis (excellent vs fair) and parental status (children vs no children). It was found that one case scenario involving a young parent with an excellent prognosis and long waiting time was ranked first by 75.2% of all participants. Analysis revealed that transplant recipient age and prognosis were the most influential factors in determining the priority rankings for organ allocation. The study has demonstrated that judgement and decision analysis procedures can be used to elicit community values and preferences about complex resource allocation decisions.
Predictors of outcomes of psychological treatments for disordered gambling: A systematic review
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.CPR.2016.06.004
Abstract: This systematic review aimed to synthesise the evidence relating to pre-treatment predictors of gambling outcomes following psychological treatment for disordered gambling across multiple time-points (i.e., post-treatment, short-term, medium-term, and long-term). A systematic search from 1990 to 2016 identified 50 articles, from which 11 socio-demographic, 16 gambling-related, 21 psychological sychosocial, 12 treatment, and no therapist-related variables, were identified. Male gender and low depression levels were the most consistent predictors of successful treatment outcomes across multiple time-points. Likely predictors of successful treatment outcomes also included older age, lower gambling symptom severity, lower levels of gambling behaviours and alcohol use, and higher treatment session attendance. Significant associations, at a minimum of one time-point, were identified between successful treatment outcomes and being employed, ethnicity, no gambling debt, personality traits and being in the action stage of change. Mixed results were identified for treatment goal, while education, income, preferred gambling activity, problem gambling duration, anxiety, any psychiatric comorbidity, psychological distress, substance use, prior gambling treatment and medication use were not significantly associated with treatment outcomes at any time-point. Further research involving consistent treatment outcome frameworks, examination of treatment and therapist predictor variables, and evaluation of predictors across long-term follow-ups is warranted to advance this developing field of research.
Urinary incontinence in a community sample of older adults: Prevalence and impact on quality of life
Publisher: Informa UK Limited
Date: 2011
DOI: 10.3109/09638288.2010.532284
Abstract: To measure the prevalence of urinary incontinence (UI) in a community-dwelling s le and the impact of self-reported UI on well-being and activity in older men and women. Participants were older adults aged ≥65 years. Measures included the frequency of urgency incontinence, depression, positive and negative affect and social activity, independence in activities of daily living (IADL) and self-rated health. The data were collected by face to face interview (1994) and computer assisted telephone interviews (1996). Of the 796 participants, 28% experienced urgency incontinence and 21% reported stress incontinence occasionally or often, with higher rates among women. The threshold for the impact on depression, negative affect and IADL was with occasional occurrence of urinary urgency incontinence. For positive affect and self-rated health, the threshold was experiencing urinary urgency incontinence often. The presence of urinary stress incontinence was associated with depression, IADL dependence, self-rated health and positive affect. Overall, women with incontinence had higher negative affect scores, but men with stress incontinence had higher scores than those without. The impact of incontinence highlights the need for more effective management of the condition. The threshold for the effects of urinary urgency incontinence on mental health and functionality is lower than for the effects on general health. There is a need to consider how older people judge the impact of UI in the design of targeted health promotion programmes.
Communication perceptions of older adults with sensory loss and their communication partners: Implications for intervention
Publisher: Informa UK Limited
Date: 2002
DOI: 10.1080/09638280110096250
Abstract: Vision and hearing loss are prevalent disorders in older adults although their effects on communication are not well documented. The purpose of this study was to investigate the perceptions of older adults with sensory loss and their communication partners with regard to their communication, situational difficulties and conversational needs. Questionnaire results revealed that the sensory loss group experienced a range of functional vision and hearing difficulties. Over two-thirds of subjects reported frequent conversational difficulty, particularly in background noise and group conversations. Most subjects used clarification requests (mainly non-specific clarification and repetition requests) to overcome misunderstandings. By contrast, the communication partners reported few communication difficulties and claimed that they proactively eliminated or controlled environmental, speaker and listener variables to optimize conversation. The most frequently reported strategy was repetition. The findings suggest that older adults with sensory loss experience communication disruptions, which in many instances are not resolved. To optimize communication efficacy in this population, a communication training programme for people with sensory loss and their communication partners is highly recommended.
Management of type 2 diabetes in China
Publisher: BMJ
Date: 03-2016
Implementing a chronic disease self-management program into China: The Happy Life Club
Publisher: Frontiers Media SA
Date: 27-04-2015
Cohort profile: The Melbourne longitudinal studies on healthy ageing program
Publisher: Oxford University Press (OUP)
Date: 05-09-2010
DOI: 10.1093/IJE/DYQ137
Emergency department utilisation by older people in metropolitan Melbourne, 2008-12: Findings from the Reducing Older Patient's Avoidable Presentations for Emergency Care Treatment (REDIRECT) study
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/AH16191
Abstract: Objective Older patients are over-represented in emergency departments (ED), with many presenting for conditions that could potentially be managed in general practice. The aims of the present study were to examine the characteristics of ED presentations by older patients and to identify patient factors contributing to potentially avoidable general practitioner (PAGP)-type presentations. Methods A retrospective analysis was performed of routinely collected data comprising ED presentations by patients aged ≥70 years at public hospitals across metropolitan Melbourne from January 2008 to December 2012. Presentations were classified according to the National Healthcare Agreement definition for PAGP-type presentations. Presentations were characterised according to patient demographic and clinical factors and were compared across PAGP-type and non-PAGP-type groups. Results There were 744 519 presentations to the ED by older people, of which 103 471 (13.9%) were classified as PAGP-type presentations. The volume of such presentations declined over the study period from 20 893 (14.9%) in 2008 to 20 346 (12.8%) in 2012. External injuries were the most common diagnoses (13 761 13.3%) associated with PAGP-type presentations. Sixty-one per cent of PAGP-type presentations did not involve either an investigation or a procedure. Patients were referred back to a medical officer (including a general practitioner (GP)) in 58.7% of cases. Conclusion Older people made a significant number of PAGP-type presentations to the ED during the period 2008–12. A low rate of referral back to the primary care setting implies a potential lost opportunity to redirect older patients from ED services back to their GPs for ongoing care. What is known about the topic? Older patients are increasingly attending EDs, with a proportion attending for problems that could potentially be managed in the general practice setting (termed PAGP-type presentations). What does this paper add? This study found that PAGP-type presentations, although declining, remain an important component of ED demand. Patients presented for a wide array of conditions and during periods that may indicate difficulty accessing a GP. What are the implications for practitioners? Strategies to redirect PAGP-type presentations to the GP setting are required at both the primary and acute care levels. These include increasing out-of-hours GP services, better triaging and appointment management in GP clinics and improved communication between ED clinicians and patients’ GPs. Although some strategies have been implemented, further examination is required to assess their ongoing effectiveness.
HOspitals and patients WoRking in Unity (HOW R U?)
Publisher: BMJ
Date: 12-2016
The Happy Life Club™ study protocol: A cluster randomised controlled trial of a type 2 diabetes health coach intervention
Publisher: Springer Science and Business Media LLC
Date: 09-02-2011
Abstract: The Happy Life Club™ is an intervention that utilises health coaches trained in behavioural change and motivational interviewing techniques to assist with the management of type 2 diabetes mellitus (T2DM) in primary care settings in China. Health coaches will support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with T2DM. A cluster randomised controlled trial involving 22 Community Health Centres (CHCs) in Fengtai District of Beijing, China. CHCs will be randomised into a control or intervention group, facilitating recruitment of at least 1320 in idual participants with T2DM into the study. Participants in the intervention group will receive a combination of both telephone and face-to-face health coaching over 18 months, in addition to usual care received by the control group. Health coaching will be performed by CHC doctors and nurses certified in coach-assisted chronic disease management. Outcomes will be assessed at baseline and again at 6, 12 and 18 months by means of a clinical health check and self-administered questionnaire. The primary outcome measure is HbA1c level. Secondary outcomes include metabolic, physiological and psychological variables. This cluster RCT has been developed to suit the Chinese health care system and will contribute to the evidence base for the management of patients with T2DM. With a strong focus on self-management and health coach support, the study has the potential to be adapted to other chronic diseases, as well as other regions of China. Current Controlled Trials ISRCTN01010526
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
Trajectories of older adults' hearing difficulties: Examining the influence of health behaviors and social activity over 10 years
Publisher: Wiley
Date: 14-01-2013
DOI: 10.1111/GGI.12030
Abstract: The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining in idual differences in patterns of change over time. As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity. Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time. Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people.
A simple measure with complex determinants: Investigation of the correlates of self-rated health in older men and women from three continents
Publisher: Springer Science and Business Media LLC
Date: 13-08-2012
Food, eating, and happy aging: The perceptions of older Chinese people
Publisher: Frontiers Media SA
Date: 05-04-2019
The Development of a Competency Assessment Standard for General Practitioners in China
Publisher: Frontiers Media SA
Date: 20-02-2020
Age-based testing for driver's license renewal: Potential implications for older Australians
Publisher: Wiley
Date: 02-2011
Social inclusion and the Fatosphere
Publisher: Wiley
Date: 22-01-2016
Abstract: Overweight and obesity are one of the most salient issues within society today, and the stigmatisation of overweight in iduals is prevalent and widespread. Utilising interviews with 44 in iduals who blog within an online fat acceptance community known as the Fatosphere, participants' perceptions of inclusion and exclusion were examined within their offline and online environments. Additionally, the effect this had on their offline lives was examined. Participants described a profound sense of exclusion within their offline lives through three agencies: the medicalisation of 'fatness', the weight loss industry and the media, which echoed descriptions of moral judgement. Furthermore, a sense of inclusion was described within the Fatosphere through the protection and support that they found within this 'safe space'. The effects of the Fatosphere influenced their lives in both negative and positive ways, allowing them to better deal with stigma and discrimination, but sometimes effecting their offline relationships in a negative manner. The Fatosphere provides a unique opportunity for corpulent in iduals to engage in a community that is removed from the prominent weight-related discourse within modern society.
Trajectories of ageing well among older Australians: A 16-year longitudinal study
Publisher: Cambridge University Press (CUP)
Date: 28-03-2018
DOI: 10.1017/S0144686X17000162
Abstract: In this study we used in idual differences concepts and analyses to examine whether older people achieve different ageing-well states universally or whether there are identifiable key groups that achieve them to different extents. The data used in the modelling were from a prospective 16-year longitudinal study of 1,000 older Australians. We examined predictors of trajectories for ageing well using self-rated health, psychological wellbeing and independence in daily living as joint indicators of ageing well in people aged over 65 years at baseline. We used group-trajectory modelling and multivariate regression to identify characteristics predicting ‘ageing well’. The results showed three distinct and sizeable ageing trajectory groups: (a) ‘stable-good ageing well’ (classified as ageing well in all longitudinal study waves which was achieved by 30.2% of women and 28.0% of men) (b) ‘initially ageing well then deteriorating’ (50.5% women and 47.6% men) and (c) ‘stable-poor’ (not ageing well in any wave 19.3% women and 24.4% men). Significant gender differences were found in membership in different ageing-well states. In the stable-poor groups there were 103/533 females which was significantly lower than 114/467 men ( z -statistic = −2.6, p = 0.005) women had a ‘zero’ probability of progressing to a better ageing-well classification in later years, whilst males had a one-in-five probability of actually improving. Robust final state outcome predictors at baseline were lower age and fewer medical conditions for both genders restful sleep and Australian-born for women and good nutrition, decreased strain, non-smoker and good social support for men. These results support that ageing-well trajectories are influenced by modifiable factors. Findings will assist better targeting of health-promoting activities for older people.
'We want a peaceful life here and hereafter': healthy ageing perspectives of older Malays in Malaysia
Publisher: Cambridge University Press (CUP)
Date: 18-05-2012
DOI: 10.1017/S0144686X11000316
Abstract: Healthy ageing concepts have been extensively studied in Western societies but few studies have explored the perceptions of older people from other cultural backgrounds. The aim of the study was to explore the conceptualisations of healthy ageing and perceived influences on ageing well amongst relatively healthy older Malays, a major ethnic group in Malaysia. Eight focus groups were conducted, with 38 participants recruited via community groups and leaders. Six themes were identified: spirituality, physical health and function, peace of mind, financial independence, family, and living environment. In this paper, we focus on the role of spirituality in healthy ageing which was a core resource in participants' lives. Participants reported that good physical health was an important resource that facilitated commitment to their spiritual activities. Furthermore, deteriorating functional ability appeared to provide an opportunity to optimise their spirituality, rather than hinder it. Participants wished for a ‘peaceful life’ and experienced this by enhancing their spirituality. Other ingredients for a peaceful life were financial independence, living in a place they love and having family members who live in harmony. In this community where religious affiliation is a tradition, spirituality can be fundamental for healthy ageing and its inclusion in aged care policy is imperative. However, further exploration on the ersity of in idual expression of spirituality is important.
Challenges and Opportunities for an Ageing Australia
Publisher: Springer New York
Date: 19-11-2017
Mainstream versus ethno-specific community aged care services: It's not an either or
Publisher: Wiley
Date: 06-2009
DOI: 10.1111/J.1741-6612.2008.00342.X
Abstract: Approximately 16% of the Australian population speak a language other than English at home. Older people from culturally and linguistically erse (CALD) backgrounds face many barriers to accessing services which may explain their under-utilisation of community aged care services. The aim of this review is to critique the literature related to the delivery of community aged care services to people from CALD backgrounds. The merits of a partnership model approach are highlighted, in addition to key points for future policy and planning. Understanding the complexities of delivering services to older people from CALD backgrounds is challenging, and requires a stronger empirical base.
Falls: A comparison of trends in community, hospital and mortality data in older Australians
Publisher: Springer Science and Business Media LLC
Date: 02-2002
DOI: 10.1007/BF03324413
Prevalence of physical activity behaviour in older people: Findings from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and Australian national survey data
Publisher: Wiley
Date: 17-10-2014
DOI: 10.1111/J.1741-6612.2012.00648.X
Abstract: Many older people lead sedentary lives. National Health Survey physical activity prevalence data provide limited coverage of the 'old old' (≥75 years). The Dynamic Analyses to Optimise Ageing (DYNOPTA) project's dataset provided physical activity data for 13,420 participants. Physical activity (walking, moderate- and vigorous-intensity activities in the previous week) was measured. Data were weighted and prevalence was calculated. The frequency of walking in DYNOPTA was similar to that in the national s le. Walking remained relatively stable until a decline among persons aged 80 years and over moderate and vigorous activity declined in all but a minority of persons aged 70 years and over. Although DYNOPTA participants reported more physical activity than those in the contemporary national survey, the rates of sedentary behaviour were high. We require more information about the 'oldest old' (85+ years). There is great scope for increasing physical activity, even walking, among older people.
The influence of the built environment and other factors on the physical activity of older women from different ethnic communities
Publisher: Informa UK Limited
Date: 12-02-2009
DOI: 10.1080/08952840802633669
Abstract: Inactivity has been identified as a major contributor to the burden of disease in older women. Study aims were: (a) to assess the personal, social, and environmental facilitators and impediments to physical activity in older women from ethnic communities and (b) to determine the factors associated with physical activity participation. Older women (aged 60-84 years) were recruited from the local Italian (n = 20), Vietnamese (n = 26) and Anglo-Celtic (n = 26) communities. A survey questionnaire was administered in the participants' preferred language. The most common barriers were: "I am not in good health," "I am self-conscious about my looks," "I am too tired," "I don't have time," and "The weather is bad." When comparing the ethnic groups, the Vietnamese women reported fewer barriers than the Italian women (2.6 vs. 5.9). While the Vietnamese women were much more likely to report being "self-conscious about my looks," the Italian women more commonly reported poor health, being too tired, and not liking exercise as barriers. Overall, those living alone were more likely to be active and those who reported fear of injury, less active. Recognizing ethnospecific differences in the prevalence of barriers may be important when devising strategies to increase activity levels of older women.
Patterns of social engagement in the transition to later life
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.MATURITAS.2016.03.016
Abstract: As social roles in later life are shaped by significant life events and changes occurring in the late-life transition, examining social engagement in midlife may provide a context for interpreting the ageing social identity. This is particularly important for women, who are heavily dependent on social relationships and are more influenced by social losses and change. To examine major social changes occurring in the decade prior to late-life, starting from approximately 45-55 years of age. The study accessed data from the longitudinal prospective Women's Healthy Ageing Project (WHAP). Participants were 493 women who had completed at least one assessment in the first 12 years of the study. Living with a partner was common and stable amongst participants, while the proportion with children still at home decreased markedly (79-44%). Full-time employment also decreased as participants approached the average retirement age (40-13%). Volunteer work was popular throughout the study, increasing slightly with age, and minding grandchildren was common at the end of the study period (80%). Taken together, these findings suggest a notable deficit in participants' social lives as they transition into later life, but with some evidence of compensation by increasing other social activities.
Examining the 16-year trajectories of mental health and wellbeing through the transition into widowhood
Publisher: Cambridge University Press (CUP)
Date: 08-04-2015
DOI: 10.1017/S1041610215000472
Abstract: Becoming widowed is a significant event. There is considerable evidence that surviving partners report substantial changes in their wellbeing and mental health. Changes can occur prior to partner's death as an anticipatory effect and consequently during the period after partner's death. For most, declines in wellbeing and mental health dissipate over time. However, there is a limited long-term evidence to compare age-normative trajectories in mental health and wellbeing with the trajectories of those who transition into widowhood. Participants ( n = 652) were older adults (aged 65–94 years at baseline) from the 16-year Melbourne Longitudinal Studies on Healthy Ageing project who were either married or de facto ( n = 577), or recently widowed ( n = 75). Generalized Estimating Equations (GEE) examined the immediate and long-term impact of widowhood. GEE piecewise regression analyses examined the trajectories of wellbeing and mental health in those who transitioned into widowed with time centered at time of partner's death. Analyses were stratified by gender. For both men and women, becoming widowed was strongly related to a strong decline in positive affect post partner's death. Otherwise, no long-term impact of widowhood on negative affect or depressive symptomology was reported. The impact of widowhood reports differential impacts on different indicators of wellbeing and mental health, which were inconsistent between men and women.
The rhetoric and reality of nursing in aged care: views from the inside
Publisher: Informa UK Limited
Date: 06-05-2016
DOI: 10.1080/10376178.2016.1221326
Abstract: Aged care services and nursing roles are evolving in response to policy reform and increasing consumer expectations, however the nursing workforce is declining in numbers. To examine registered nurses' perceptions and experiences of working in aged care. Descriptive, exploratory study involving thematic analysis of in idual interviews. Key issues related to: professional role strain workforce challenges managing expectations, relationships and communication balancing rights and risk in decision-making changing models of care and impacts of policy and regulation. Expectations and perceptions of aged care nursing are unclear and conflicted. Nurses face significant challenges in meeting consumer, profession, organisational, and policy expectations amidst workforce instability and resource constraints. Structural barriers and aged care policy environments represent significant threats to sustaining nursing in aged care.
Cognitive distortions among older adult gamblers in an Asian context
Publisher: Public Library of Science (PLoS)
Date: 18-05-2017
Predictors of exercise program participatíon in older women
Publisher: Informa UK Limited
Date: 08-1997
Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JDIACOMP.2016.09.015
Abstract: Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s assessed falls-related outcomes older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI: 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI: 0.22 to 0.96). No RCTs assessed falls-risk one RCT reported 12month falls-rate, with no differential treatment effect observed. Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes.
Methodological and ethical issues in conducting research with older people
Publisher: Palgrave Macmillan UK
Date: 2007
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