Dr Kim Kiely

Healthy and working life expectancies in an ageing Australia

Dr Kim Kiely (Lead Investigator) and Professor Kaarin Anstey (Co-investigator)

Australians are living longer and expected to work for longer than ever before. It is critical that additional years of life are at least matched by the increase in the years lived in good health, and that gains in healthy ageing are experienced across all sectors of society. There is also a great need to balance older adults’ capacity and opportunity to work with societal pressures to delay retirement.

The objective of this three-year project is to better understand individual and societal determinants that underlie variation in healthy ageing. We will identify characteristics that are tied to the years that older adults are able to engage in productive activities and live independently in good health. To achieve this, advanced health expectancy estimation methods are being used to analyse newly available mortality records that have been linked to national longitudinal survey data. These analyses will produce new, refined, estimates for Australia of ‘healthy life expectancy’ with ‘working life expectancy’. We will examine how these differ across sociodemographic strata, change over time, and compare internationally.

The project is funded by an Australian Research Council (ARC) Discovery Project (DP190100459).

Making sense of hearing-related neurocognitive impairment: The Auditory Ageing and Cognitive Impairm

Dr Kim Kiely (Lead Investigator), Professor Kaarin Anstey (Associate Investigator) and Dr Ranmalee Eramudugolla (Associate Investigator)

With increasing age, nearly all adults experience progressive, irreversible, and bilateral declines in hearing ability. As a result, hearing loss is one of the most common chronic health conditions affecting older adults and if unmanaged its impacts are wide ranging and long lasting.

There is good evidence indicating that older adults with significant hearing difficulties are more likely to experience cognitive decline and dementia, but reasons for this association are unknown.

This project will investigate how hearing loss is related to cognitive impairment. Firstly, it will compare levels of hearing function and use of hearing services by cognitive status. Second, it will examine if the relationship between poor hearing and impaired cognitive functioning is explained by lower levels of participation in activities that are good for brain health. Third, it will investigate if hearing rehabilitation services and hearing aids protect against poorer levels of cognitive function.

Contact: audacious@neura.edu.au

The project is funded by a Dementia Australia Research Foundation (DARF) Project Grant

The Personality and Total Health (PATH) Through Life Project 

The Personality and Total Health (PATH) Through Life Project has been led by Professor Anstey since 2006 and has been based at ANU since 1999. It is a large on-going population-based longitudinal cohort study comprising approximately 7500 participants. The study includes three cohorts including a younger (aged 20–24 at baseline), midlife (aged 40–44 at baseline) and older (aged 60–64 at baseline) adults randomly sampled from the electoral roll of the ACT and the nearby city of Queanbeyan. Additional waves of data collection have occurred in 4-year increments, with wave 5 of data collection being completed for the younger cohort and soon to commence for the midlife cohort. The study involves many national and international collaborations.

The broad aims of the PATH study relate to clinical outcomes that constitute the major burden of disease within the Australian community.

Primary PATH Objectives:

• To delineate the course of depression, anxiety, substance use and cognitive ability with increasing age across the adult life span
• To identify environmental risk, genetic risk and protective factors influencing individual differences in the course of these characteristics
• To investigate interrelationships over time between the three domains of: depression and anxiety, substance use, and cognitive ability and dementia
• To examine the mental health related impact of various personal, social and lifestyle transitions and events experienced by the different age cohorts, including infertility, fertility and pregnancy, changes in family structure, relationship formation and separation, menopause, and retirement.

Several design features of the PATH project contribute to its unique standing among population-based longitudinal cohort studies.

• Obtaining measures of genetic, biological (including MRI), psychosocial and lifestyle risk and protective factors for mental health and wellbeing
• Use of a narrow age cohort design with longitudinal follow ups as an optimal means of separating age and cohort effects
• Assessment of participants across the full adult lifespan, permitting investigation of developmentally significant, though under-studied periods such as midlife
• Recruitment and follow up of a young-old population, providing important pre-clinical data for studying the development of age-related changes in memory and cognition.

This project has been funded primarily by the National Health and Medical Research Council. Wave 5 40s and 60s follow-ups are funded by the ARC Centre of Research Excellence in Population Ageing.

PATH participants can contact the research team by phone on 1300 917 295.

Better Drive Program

Current road safety policy for at-risk older drivers involves ‘fitness to drive’ assessment and either license restriction or revocation. However, research indicates that there is no clear evidence that mandatory testing lowers crash rates amongst older drivers, and that driving cessation in older adults is associated with increased rates of depression, social isolation, and general health decline.

The Better Drive program includes a series of studies evaluating interventions to improve driver skill. Two trials have been completed to date.

Trial 1 used a two-arm randomised controlled trial (RCT) approach to investigate the efficacy of individually tailored driving refresher lessons against a group-based refresher course on on-road driving performance, safety and crash risk in older adults. Findings indicate that although classroom based road rules workshops for seniors can lead to improvements in on-road driving skill, the inclusion of tailored driving instruction can significantly enhance safety and reduce crash-causing on-road errors relative to classroom based workshops alone.

Trial 2 used a two group (training, no-contact control) non-randomised design to examine the transfer of computerised speed of processing (SOP) training gains to cognitive measures that are known predictors of driving safety in older adults. Findings indicate that SOP training effects can be achieved with self-administered, online training at home, with some transfer to other known cognitive predictors of driving safety. However, differential effects of training may be observed for tasks requiring goal-directed search strategies rather than diffuse attention.

A third trial is currently underway. This trial uses a three-arm randomised controlled trial approach to assess the effectiveness of computerised cognitive training and tailored on-road skills training on driver safety in older adults. Data collection for this trial will be completed in 2019.

The Better Drive program has been funded by the NRMA Road Safety Trust.