NeuRA Magazine #22

Dementia Research

PREVALENCE OF DEMENTIA IN INDIGENOUS COMMUNITIES

Research led by Prof Tony Broe and Dr Kylie Radford has highlighted the high prevalence of dementia, particularly Alzheimer’s disease, in Aboriginal communities. We are working towards understanding the causes of cognitive decline and dementia, building capacity in dementia care and supporting Aboriginal family carers, and developing culturally appropriate strategies to promote healthy brain ageing.

The next decade will see a dramatic increase in the number and proportion of older people within the Aboriginal and Torres Strait Islander population. Close to 80% of these older people live in regional and urban parts of Australia (a third in our major cities). Recently, the Koori Growing Old Well Study (KGOWS) has shown that dementia prevalence in Aboriginal Australians across NSW is three times higher than the overall Australian population, at ages 60 years and older.

What is it that helps one person age successfully, and causes another to develop age-related diseases like dementia? Scientifically, we know too little about normal ageing and what factors influence some people, and not others, to develop diseases that affect the brain. Only by studying healthy elderly people, as well as those with problems, can we know what normal ageing looks like and learn more about staying healthy as we age. In collaboration with our Aboriginal community partners, our rigorous population- based approach allowed us to accurately assess the prevalence of dementia, not just those already ‘in the system’ and seeking treatment or care.

NeuRA’s Aboriginal health and ageing team, with collaborators, are now conducting a follow-up study (KGOWS-II) to determine the social and biomedical risk and protective factors for dementia across the lifespan. In 2016, NeuRA also initiated the Koori Active and Healthy Ageing Project. This research will develop effective, culturally appropriate, and accessible strategies to promote vitality and healthy brain ageing and prevent dementia in Aboriginal communities. This research is supported by NeuRA’s ongoing Koori Dementia Care Project, which aims to build capacity in dementia understanding and care with Aboriginal community controlled and mainstream service providers.

As one older Aboriginal participant observed: “Healthy ageing is your mind staying young”.

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FEEL THE BUZZ IN THE AIR? US TOO.

Abdominal Functional Electrical Stimulation for Orthostatic Hypotension in Spinal Cord Injury

Spinal cord injury (SCI) results in the loss of function to not only voluntary motor control, but also to the regulatory systems that control bodily processes. Orthostatic (postural) hypotension (OH) is a common clinical feature in SCI patients, affecting up to 73% of patients with cervical spine and upper thoracic spine injuries during mobilisation and postural changes. This often results in symptoms of dizziness, light-headedness, fatigue and confusion, in turn limiting individual participation in physical rehabilitation and restricting progress towards regaining function and independence. Therapeutic interventions are centred around ameliorating symptoms of OH; however, options for patients remain limited. Non-pharmacological treatments have had little success at treating hypotension in the long-term, while pharmacological interventions are used only when necessary as they may contribute to hypertension and even worsen episodes of autonomic dysreflexia, a life-threatening condition. Functional Electrical Stimulation (FES) is one of the only interventions that has been shown to display some benefit in improving OH. Recently, stimulation of the lower limbs has been shown to acutely increase blood pressure in patients with SCI. Our recent projects have involved the use of FES applied over the abdominal muscles, termed abdominal FES, for SCI patients at risk of respiratory complications with promising results. As this same population is at risk of orthostatic hypotension, this study aims to determine whether abdominal stimulation can also be used to help this condition. Based on our previous research, we believe that abdominal FES will increase blood pressure acutely during an orthostatic challenge in individuals with acute spinal cord injury, allowing for a longer time spent in a standing position. This will facilitate more effective rehabilitation, therefore improving quality of life and decreasing associated medical complications.
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