Publications
178 results found
Lewis ET, Anstey KJ, Radford K, et al., 2024, Levels of frailty and frailty progression in older urban- and regional-living First Nations Australians., Maturitas, Vol: 183
OBJECTIVES: To explore the prevalence of frailty, association between frailty and mortality, and transitions between frailty states in urban- and regional-living First Nations Australians. STUDY DESIGN: Secondary analysis of longitudinal data from the Koori Growing Old Well Study. First Nations Australians aged 60 years or more from five non-remote communities were recruited in 2010-2012 and followed up six years later (2016-2018). Data collected at both visits were used to derive a 38-item Frailty Index (FI). The FI (range 0-1.0) was classified as robust (<0.1), pre-frail (0.1- < 0.2), mildly (0.2- < 0.3), moderately (0.3- < 0.4) or severely frail (≥0.4). MAIN OUTCOME MEASURES: Association between frailty and mortality, examined using logistic regression and transitions in frailty (the percentage of participants who changed frailty category) during follow-up. RESULTS: At baseline, 313 of 336 participants (93 %) had sufficient data to calculate a FI. Median FI score was 0.26 (interquartile range 0.21-0.39); 4.79 % were robust, 20.1 % pre-frail, 31.6 % mildly frail, 23.0 % moderately frail and 20.5 % severely frail. Higher baseline frailty was associated with mortality among severely frail participants (adjusted odds ratio 7.11, 95 % confidence interval 2.51-20.09) but not moderately or mildly frail participants. Of the 153 participants with a FI at both baseline and follow-up, their median FI score increased from 0.26 to 0.28. CONCLUSIONS: Levels of frailty in this First Nations cohort are substantially higher than in similar-aged non-Indigenous populations. Screening for frailty before the age of 70 years may be warranted in First Nations Australians. Further research is urgently needed to determine the factors that are driving such high levels of frailty and propose solutions to prevent or manage frailty in this population.
Rosenau C, Köhler S, Soons LM, et al., 2024, Umbrella review and Delphi study on modifiable factors for dementia risk reduction., Alzheimers Dement, Vol: 20, Pages: 2223-2239
A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta-analyses with a two-round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts. HIGHLIGHTS: An umbrella review was combined with opinions of 18 dementia experts. Various candidate targets for dementia risk reduction were identified. Experts prioritized hearing impairment, social contact, and sleep. Re-assessment of dementia risk scores is encouraged. Future work should evaluate the predictive validity of updated risk scores.
Lim ML, Zammit C, Lewis E, et al., 2024, A 10-week intergenerational program bringing together community-living older adults and preschool children (INTERACTION): a pilot feasibility non-randomised clinical trial., Pilot Feasibility Stud, Vol: 10, ISSN: 2055-5784
BACKGROUND: Social isolation and low levels of physical activity are strong drivers for frailty, which is linked to poor health outcomes and transition to long-term care. Frailty is multifactorial, and thus an integrated approach is needed to maintain older adults' health and well-being. Intergenerational programs represent a novel multifactorial approach to target frailty, social isolation and physical decline but these have not yet been rigorously tested in Australia. Here, we present the results of our pilot study which aimed to test the feasibility of a 10-week intergenerational program between older adults and preschool children. METHODS: A non-randomised wait-listed controlled trial was conducted. Participants were allocated to either the intervention or wait-list control group. The intervention group received 10 weekly 2-h intergenerational sessions led by trained child educators; the control group continued with their usual routine and received their intergenerational program after the 10-week control period. All participants were assessed at baseline and 10 weeks. The primary outcome was the feasibility and acceptability of the program including measures of recruitment eligibility, adherence and effective data collection across the multiple domains important for frailty, including functional mobility and balance, grip strength, cognitive function, mood, social engagement, quality of life and concerns about falling. RESULTS: Nineteen adults were included, with nine in the intervention and ten in the control group. A total of 42% of older adults screened were eligible, 75% of participants were present at each intervention session and the overall attrition rate was 21% (n = 4). The reasons for participant absence were primarily health-related. Missing data was minimal for the majority of assessments but more apparent for the cognitive testing where completion rates ranged from 53 to 79% for baseline tests and 73 to 100% for those who received follow-up testing
Shajahan S, Peters R, Carcel C, et al., 2024, Hypertension and mild cognitive impairment: state-of-the-art review., Am J Hypertens
BACKGROUND: Mid-life hypertension is associated with cognitive decline and dementia in later life. Reducing high blood pressure (BP) with antihypertensive agents is a well-researched strategy to prevent dementia and mild cognitive impairment (MCI). However, there is still limited direct evidence to support the approach, and particularly for the treatment of the very old and those with existing MCI. METHODS: This review presents an overview of the current evidence for the relationship between MCI and hypertension, and of the potential pathophysiological mechanisms related to cognitive decline and incidence dementia in relation to aging. RESULTS: Although observational data are near consistent in showing an association between mid-life hypertension and MCI and/or dementia, the evidence in relation to hypertension in younger adults and the very old (age >80 years) is much more limited. Most of the commonly available antihypertensive agents appear to provide beneficial effects in reducing the risk dementia, but there is limited evidence to support such treatment in those with existing MCI. CONCLUSIONS: Further studies are needed to determine the optimal levels of BP control across different age groups, especially in adults with MCI, and which class(es) of antihypertensive agents and duration of treatment best preserve cognitive function in those at risk of, or with established, MCI.
Juraschek SP, Hu J-R, Cluett JL, et al., 2023, Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease: An Individual Participant Meta-Analysis., JAMA, Vol: 330, Pages: 1459-1471
IMPORTANCE: There are ongoing concerns about the benefits of intensive vs standard blood pressure (BP) treatment among adults with orthostatic hypotension or standing hypotension. OBJECTIVE: To determine the effect of a lower BP treatment goal or active therapy vs a standard BP treatment goal or placebo on cardiovascular disease (CVD) or all-cause mortality in strata of baseline orthostatic hypotension or baseline standing hypotension. DATA SOURCES: Individual participant data meta-analysis based on a systematic review of MEDLINE, EMBASE, and CENTRAL databases through May 13, 2022. STUDY SELECTION: Randomized trials of BP pharmacologic treatment (more intensive BP goal or active agent) with orthostatic hypotension assessments. DATA EXTRACTION AND SYNTHESIS: Individual participant data meta-analysis extracted following PRISMA guidelines. Effects were determined using Cox proportional hazard models using a single-stage approach. MAIN OUTCOMES AND MEASURES: Main outcomes were CVD or all-cause mortality. Orthostatic hypotension was defined as a decrease in systolic BP of at least 20 mm Hg and/or diastolic BP of at least 10 mm Hg after changing position from sitting to standing. Standing hypotension was defined as a standing systolic BP of 110 mm Hg or less or standing diastolic BP of 60 mm Hg or less. RESULTS: The 9 trials included 29 235 participants followed up for a median of 4 years (mean age, 69.0 [SD, 10.9] years; 48% women). There were 9% with orthostatic hypotension and 5% with standing hypotension at baseline. More intensive BP treatment or active therapy lowered risk of CVD or all-cause mortality among those without baseline orthostatic hypotension (hazard ratio [HR], 0.81; 95% CI, 0.76-0.86) similarly to those with baseline orthostatic hypotension (HR, 0.83; 95% CI, 0.70-1.00; P = .68 for interaction of treatment with baseline orthostatic hypotension). More intensive BP treatment or active therapy lowered risk of CVD or all-cause mortality among
Lennon MJ, Lam BCP, Lipnicki DM, et al., 2023, Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life An Individual Participant Data Meta-Analysis, JAMA NETWORK OPEN, Vol: 6, ISSN: 2574-3805
Kootar S, Huque MH, Eramudugolla R, et al., 2023, Validation of the CogDrisk Instrument as Predictive of Dementia in Four General Community-Dwelling Populations, JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE, Vol: 10, Pages: 478-487, ISSN: 2274-5807
- Author Web Link
- Cite
- Citations: 1
Kootar S, Huque MH, Kiely KM, et al., 2023, Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk, BMJ OPEN, Vol: 13, ISSN: 2044-6055
Huque MH, Kootar S, Eramudugolla R, et al., 2023, CogDrisk, ANU-ADRI, CAIDE, and LIBRA Risk Scores for Estimating Dementia Risk, JAMA NETWORK OPEN, Vol: 6, ISSN: 2574-3805
Walsh S, Govia I, Peters R, et al., 2023, Authors' response to: A new dementia prevention approach requires new language, ALZHEIMERS & DEMENTIA, Vol: 19, Pages: 3750-3751, ISSN: 1552-5260
Walsh S, Govia I, Peters R, et al., 2023, What would a population-level approach to dementia risk reduction look like, and how would it work?, ALZHEIMERS & DEMENTIA, Vol: 19, Pages: 3203-3209, ISSN: 1552-5260
- Author Web Link
- Cite
- Citations: 6
Xu Y, Aung HLJ, Bateman RJS, et al., 2023, Higher systolic blood pressure in early-mid adulthood is associated with poorer cognitive performance in those with a dominantly inherited Alzheimer's disease mutation but not in non-carriers. Results from the DIAN study, ALZHEIMERS & DEMENTIA, ISSN: 1552-5260
Wilson N-A, Peters R, Lautenschlager NTT, et al., 2023, Testing times for dementia: a community survey identifying contemporary barriers to risk reduction and screening, ALZHEIMERS RESEARCH & THERAPY, Vol: 15
Xu Y, Bouliotis G, Beckett NS, et al., 2023, Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension, JOURNAL OF HUMAN HYPERTENSION, Vol: 37, Pages: 307-312, ISSN: 0950-9240
Xu Y, Phu J, Aung HL, et al., 2023, Frequency of coexistent eye diseases and cognitive impairment or dementia: a systematic review and meta-analysis, EYE, ISSN: 0950-222X
- Author Web Link
- Cite
- Citations: 1
Peters R, Anderson C, 2023, BLOOD PRESSURE, ANTIHYPERTENSIVES AND DEMENTIA, AN INDIVIDUAL PATIENT DATA META-ANALYSIS, 29th Scientific Meeting of the International Society of Hypertension (ISH), Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E15-E16, ISSN: 0263-6352
Chong TWH, Rego T, Lai R, et al., 2023, Preferences and Perspectives of Australian General Practitioners Towards a New "Four-in-One" Risk Assessment Tool for Preventative Health: The LEAD! GP Project, JOURNAL OF ALZHEIMERS DISEASE, Vol: 94, Pages: 801-814, ISSN: 1387-2877
Huque H, Eramudugolla R, Chidiac B, et al., 2023, Could Country-Level Factors Explain Sex Differences in Dementia Incidence and Prevalence? A Systematic Review and Meta-Analysis, JOURNAL OF ALZHEIMERS DISEASE, Vol: 90, Pages: 1231-1241, ISSN: 1387-2877
- Author Web Link
- Cite
- Citations: 5
Peters R, Xu Y, Fitzgerald O, et al., 2022, Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis, EUROPEAN HEART JOURNAL, Vol: 43, Pages: 4980-4990, ISSN: 0195-668X
- Author Web Link
- Cite
- Citations: 18
Xu Y, Warwick J, Eramudugolla R, et al., 2022, No clear associations between subjective memory concerns and subsequent change in cognitive function: the PATH through life study, EUROPEAN JOURNAL OF AGEING, Vol: 19, Pages: 1181-1188, ISSN: 1613-9372
Xu Y, Warwick J, Eramudugolla R, et al., 2022, No clear associations between subjective memory concerns and subsequent change in cognitive function: the PATH through life study., Eur J Ageing, Vol: 19, Pages: 1181-1188, ISSN: 1613-9372
The literature on subjective memory concerns (SMC) as a predictor for future cognitive decline is varied. Furthermore, recent research has pointed to additional complexity arising from variability in the experience of SMC themselves (i.e. whether they are remitting or sustained over time). We investigated the associations between SMC and objectively measured cognition in an Australian population-based cohort. Four waves (4-year intervals between waves) of data from 1236 participants (aged 62.4 ± 1.5 years, 53% male) were used. We categorized participants as experiencing SMC, when they indicated that their memory problems might interfere with their day-to-day life and/or they had seen a doctor about their memory. SMC was categorized as "no" reported SMC, "remitting", "new-onset" or "sustained" SMC. Cognitive assessment of immediate and delayed recall, working memory, psychomotor speed, attention and processing speed were assessed using a neuropsychological battery. Eighteen percent of participants were characterised as having SMC: 6% (77) "remitting", 6% (77) "new-onset" and 6% (69) "sustained" SMC. There was no consistent evidence for an association between SMC and subsequent decline in cognition. However, SMC was associated with poorer performance on contemporaneous tasks of attention and processing speed compared to "no" SMC. Asking about SMC may indicate a current decline in cognitive function but, in this sample at least, did not indicate an increased risk of future decline.
Jicha GA, Abner EL, Arnold SE, et al., 2022, Committee on High-quality Alzheimer's Disease Studies (CHADS) consensus report, ALZHEIMERS & DEMENTIA, Vol: 18, Pages: 1109-1118, ISSN: 1552-5260
- Author Web Link
- Cite
- Citations: 3
Chong TWH, Kootar S, Wilding H, et al., 2022, Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review, THERAPEUTIC ADVANCES IN PSYCHOPHARMACOLOGY, Vol: 12, ISSN: 2045-1253
- Author Web Link
- Cite
- Citations: 4
Peters R, Xu Y, Eramudugolla R, et al., 2022, Diastolic Blood Pressure Variability in Later Life May Be a Key Risk Marker for Cognitive Decline, HYPERTENSION, Vol: 79, Pages: 1037-1044, ISSN: 0194-911X
- Author Web Link
- Cite
- Citations: 8
Lancaster K, Xu Y, Savage G, et al., 2022, Blood pressure change and cognition in childhood and early adulthood: a systematic review, THERAPEUTIC ADVANCES IN CHRONIC DISEASE, Vol: 13, ISSN: 2040-6223
- Author Web Link
- Cite
- Citations: 1
Peters R, Dodge HH, James S, et al., 2022, The epidemiology is promising, but the trial evidence is weak. Why pharmacological dementia risk reduction trials haven't lived up to expectations, and where do we go from here?, ALZHEIMERS & DEMENTIA, Vol: 18, Pages: 507-512, ISSN: 1552-5260
- Author Web Link
- Cite
- Citations: 5
Chowdhary N, Barbui C, Anstey KJ, et al., 2022, Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations, FRONTIERS IN NEUROLOGY, Vol: 12, ISSN: 1664-2295
- Author Web Link
- Cite
- Citations: 23
Anstey KJ, Zheng L, Peters R, et al., 2022, Dementia Risk Scores and Their Role in the Implementation of Risk Reduction Guidelines, FRONTIERS IN NEUROLOGY, Vol: 12, ISSN: 1664-2295
- Author Web Link
- Cite
- Citations: 7
Walsh S, Govia I, Wallace L, et al., 2022, A whole-population approach is required for dementia risk reduction, LANCET HEALTHY LONGEVITY, Vol: 3, Pages: E6-E8, ISSN: 2666-7568
- Author Web Link
- Cite
- Citations: 21
Keay L, Ren K, Nguyen H, et al., 2022, Risk factors common to leading eye health conditions and major non-communicable diseases: a rapid review and commentary, F1000Research, Vol: 11, ISSN: 2046-1402
Background: To gain an understanding of the intersection of risk factors between the most prevalent eye health conditions that are associated with vision impairment and non-communicable diseases (NCDs). Methods: A series of rapid reviews of reviews reporting on non-modifiable risk factors, age and sex, and modifiable risk factors, including social determinants, were conducted for five common eye health conditions that are the leading causes of vision impairment globally (refractive error including uncorrected refractive error, cataract, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy) and five prevalent NCDs (cancer, cardiovascular disease, chronic respiratory disease, dementia, and depressive disorders). Articles published within approximately 5 years to the end of 2019 were identified through expert recommendation, PubMED, Ovid Medline, the Lancet Global Burden of Disease series, the International Agency for Research on Cancer and World Cancer Research Fund. Results: Of 9,213 records identified, 320 records were eligible. Eye health conditions and NCDs share many risk factors. Increased age was found to be the most common shared risk factor, associated with increased risks of AMD, cataract, diabetic retinopathy, glaucoma, refractive error, cancer, cardiovascular disease, chronic obstructive pulmonary disease, and dementia. Other shared risk factors included smoking, obesity, alcohol consumption (mixed results), and physical activity was protective, though limited evidence was found for eye conditions. Social determinants are well documented as risk factors for NCDs. Conclusion: There is substantial overlap in common established risk factors for the most frequent vision impairing eye conditions and leading NCDs. Increasing efforts should be made to integrate preventative and risk reduction interventions to improve health, with greatest shared benefits for initiatives which aim to reduce smoking, improve diet, and promote phys
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.