Dr Kim Kiely

LEAD!- Leveraging Evidence into Action on Dementia

Currently, there is no effective treatment for dementia, highlighting the urgent need to preventing more cases through evidence-based strategies for risk reduction. As there is an overlap between the risk factors for dementia and other preventable non-communicable diseases including stroke, diabetes, and heart disease, it is important to build upon proven risk-reduction strategies.

What is LEAD?

LEAD! is a project funded by the NHMRC Boosting Dementia Research Grant led by Professor Kaarin Anstey. It involves an international collaboration between leading academics, clinicians, consumers, and community members. Organisations involved include the Department of Health, WHO, Dementia Australia, Alzheimer’s Disease International, Diabetes Australia, and Heart Foundation.

The project aims to translate dementia research and implement evidence-based strategies for dementia risk reduction to individuals, communities, and healthcare centres.

Three workstreams

The project has three concurrent workstreams over five years: Development, Implementation, and Evaluation and adoption.

The Development stream, led by Professor Kaarin Anstey and Associate Professor Peters, focuses on building a new tool for predicting dementia and other non-communicable diseases including stroke, diabetes or myocardial infarction. The tool will be available to the public, researchers and clinicians. It will save clinical assessment time, accurately predict multiple outcomes and will be more acceptable in comparison to using individual tools for each disease outcome.

The Implementation stream led by Professor Nicola Lautenschalger’s team at the University of Melbourne, will develop strategies to support the implementation of dementia risk reduction evidence by engaging with consumers, clinicians, policy makers, and the public. The stream will develop strategies for incorporating the new risk assessment tool into various technological platforms (e.g., websites or apps).

The Evaluation and adoption stream, led by Professor Anstey and in collaboration with Professor Louisa Jorm and Dr Heidi Welberry at UNSW, focuses on measuring trajectories of Australian’s national risk factor profiles for multiple chronic diseases. Collaboration with key stakeholders including the WHO will help build an evaluation framework and methodology for implementing evidence on dementia risk reduction based on WHO guidelines at national level and in the global context.

Older Drivers’ Use Of Technology

ARC Centre of Excellence in Population Ageing Research

The ARC Centre of Excellence in Population Ageing Research (CEPAR) is a unique collaboration bringing together academia, government and industry to address one of the major social challenges of the twenty first century. Based at the University of New South Wales with nodes at the Australian National University, The University of Melbourne, The University of Sydney and The University of Western Australia, CEPAR is producing world-class research on population ageing. CEPAR includes cross-disciplinary experts drawn from actuarial science, demography, economics, epidemiology, psychology and sociology. The Centre’s diverse research program which will deliver comprehensive outcomes with the potential to secure Australia’s future as a well-informed nation with world-best policy and practice for an ageing demographic.

Professor Anstey and Professor Mike Keane lead the CEPAR research stream concerned with decision making, expectations and cognitive ageing.

This research stream aims to:

• Develop a comprehensive model of ageing and decision making including identification of typologies of decision makers
• Develop multidisciplinary paradigms and predictive models of decision making and ageing
• Develop and evaluate interventions to increase positive expectations about ageing
• Develop life-cycle models that incorporate investments in health and housing as well as cognitive limitations in ageing.

For more information on CEPAR visit the centre website.

CEPAR has been funded primarily by the Australian Research Council, with generous support from the collaborating universities and partner organisations.

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).

The Personality and Total Health (PATH) Through Life Project 

The Personality and Total Health (PATH) Through Life Project is co-hosted by the Australian National University and the University of New South Wales and has been led by Professor Anstey since 2006. 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 the 5^th wave of data collection underway. 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 (led by Professor Kaarin Anstey) are funded by the ARC Centre of Excellence in Population Ageing Research. 

For more information, please visit the study website at www.pathstudy.org.au. PATH participants can also contact the research team by phone on 1300 917 295.

Better Drive Program

Driving is critical for enabling mobility and community participation in older Australians, with over 90% of those aged in their 70s being licensed drivers. There is an urgent need for evidence-based methods for enhancing and maintaining older drivers’ skills – methods that are ready for translation into cost-effective and practical interventions.

The Better Drive Trial is a three-arm randomised controlled trial that assesses the effectiveness of different driver education types on safety outcomes for older adults. The relative effectiveness of tailored lessons, road-rule workshops and feedback on older drivers on road safety will be assessed in over 384 participants over 2 years. If effective, interventions will improve driving safety, reduce costs associated with crashes, and maintain social participation.

Our multidisciplinary team has expertise in cognitive ageing, psychology, occupational therapy, behaviour change and injury prevention, and proven records of designing and implementing RCTs of behavioural interventions for improving safety in older adults. The outcomes of the project will lead to the development of community programs for older drivers that seek to maintain mobility and community participation.

The Better Drive Trial is funded by the NHMRC and is expected to run for 5 years.