Dr Kim Kiely


Within-Person Associations Between Financial Hardship and Cognitive Performance in the PATH Through Life.

Kiely KM, Anstey KJ, Butterworth P

Estimating the Years Lived With and Without Age-Related Sensory Impairment.

Kiely KM, Mitchell P, Gopinath B, Luszcz MA, Jagger C, Anstey KJ

In addition to being highly prevalent, hearing and vision impairment affect older adults for substantial periods of their remaining life. Given their broad ranging impacts on health and well-being, sensory impairments are ideal targets for strategies to compress morbidity in late life.

Dual sensory loss and depressive symptoms: the importance of hearing, daily functioning, and activity engagement.

Kiely KM, Anstey KJ, Luszcz MA

Vision and HL are highly prevalent among older adults and their co-occurrence may compound their respective impacts on health, functioning, and activity engagement, thereby exerting strong effects on the mental health and wellbeing of those affected. There is therefore a need for rehabilitation programs to be sensitive to the combined effects of sensory loss on individuals.

Personality and Total Health Through Life Project Eye Substudy: Methodology and Baseline Retinal Features.

Wijngaarden PV, Keel S, Hodgson LAB, Kumar DK, Aliahmad B, Paim CC, Kiely KM, Cherbuin N, Anstey KJ, Dirani M

This well-defined sample of older australians provides a unique opportunity to interrogate associations between retinal findings, including retinal vascular geometric parameters, and indices of neurocognitive function.

Using Longitudinal Survey Data to Estimate Mental Health Related Transitions to a Disability Pension: Analysis of an Australian Household Panel Study.

Schofield TP, Kiely KM, Mykletun A, Harvey SB, Butterworth P

This study examined the association between mental ill-health and subsequent receipt of a disability pension in Australia, and assessed how the strength of the association varied in relation to the duration between mental health measurement and reported disability pension receipt. Mental ill-health is an independent risk factor for disability pension receipt, and proximal circumstances better capture this association than mental health measured earlier.

Older drivers in Australia: trends in driving status and cognitive and visual impairment.

Ross LA, Anstey KJ, Kiely KM, Windsor TD, Byles JE, Luszcz MA, Mitchell P

To investigate self-reported driving status within three Australian states; associations between demographic, health, and functional factors and driving status; and the extent to which remaining a driver in spite of cognitive and visual impairments varies as a function of sex. The rate of men with probable dementia or visual impairments who reported driving is of particular concern. Research and policy need to focus on evidence-based assessment of older drivers and development of appropriate interventions and programs to maintain the mobility and independence of older adults.

Effect of Speed of Processing Training on Older Driver Screening Measures.

Eramudugolla R, Kiely KM, Chopra S, Anstey KJ

Computerized training for cognitive enhancement is of great public interest, however, there is inconsistent evidence for the transfer of training gains to every day activity. Several large trials have focused on speed of processing (SOP) training with some promising findings for long-term effects on daily activity, but no immediate transfer to other cognitive tests. Here, we examine the transfer of SOP training gains to cognitive measures that are known predictors of driving safety in older adults. Fifty-three adults aged 65-87 years who were current drivers participated in a two group non-randomized design with repeated measures and a no-contact matched control group. The Intervention group completed an average of 7.9 ( = 3.0) hours of self-administered online SOP training at home. Control group was matched on age, gender and test-re-test interval. Measures included the Useful Field of View (UFOV) test, a Hazard Perception test, choice reaction time (Cars RT), Trail Making Test B, a Maze test, visual motion threshold, as well as road craft and road knowledge tests. Speed of processing training resulted in significant improvement in processing speed on the UFOV test relative to controls, with an average change of -45.8 ms ( = 14.5), and effect size of ω = 0.21. Performance on the Maze test also improved, but significant slowing on the Hazard Perception test was observed after SOP training. Training effects on the UFOV task was associated with similar effects on the Cars RT, but not the Hazard Perception and Maze tests, suggesting transfer to some but not all driving related measures. There were no effects of training on any of the other measures examined. Speed of processing training effects on the UFOV task can be achieved with self-administered, online training at home, with some transfer to other cognitive tests. However, differential effects of training may be observed for tasks requiring goal-directed search strategies rather than diffuse attention.

Why it's important for it to stop: Examining the mental health correlates of bullying and ill-treatment at work in a cohort study.

Butterworth P, Leach LS, Kiely KM

There is limited Australian information on the prevalence and mental health consequences of bullying and ill-treatment at work. The aims of this study were to use data from an ongoing Australian longitudinal cohort study to (1) compare different measures of workplace bullying, (2) estimate the prevalence of bullying and ill-treatment at work, (3) evaluate whether workplace bullying is distinct from other adverse work characteristics and (4) examine the unique contribution of workplace bullying to common mental disorders in mid-life. This study provides unique information on the prevalence and mental health impacts of workplace bullying and ill-treatment in Australia. Workplace bullying is a relatively common experience, and is associated with increased risk of depression and anxiety. Greater attention to identifying and preventing bullying and ill-treatment in the workplace is warranted.

Gender differences in the trajectories of late-life depressive symptomology and probable depression in the years prior to death.

Burns RA, Luszcz MA, Kiely KM, Butterworth P, Browning C, Mitchell P, Anstey KJ

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.

Multiple imputation was an efficient method for harmonizing the Mini-Mental State Examination with missing item-level data.

Burns RA, Butterworth P, Kiely KM, Bielak AA, Luszcz MA, Mitchell P, Christensen H, Von Sanden C, Anstey KJ

The Mini-Mental State Examination (MMSE) is used to estimate current cognitive status and as a screen for possible dementia. Missing item-level data are commonly reported. Attention to missing data is particularly important. However, there are concerns that common procedures for dealing with missing data, for example, listwise deletion and mean item substitution, are inadequate. Our adaptation of MI to obtain a probable estimate for missing MMSE item level data provides a suitable method when the proportion of missing item-level data is not excessive.

Depressive symptoms predict decline in perceptual speed in older adulthood.

Bielak AA, Gerstorf D, Kiely KM, Anstey KJ, Luszcz M

Depressive symptoms and cognitive decline are associated in older age, but research is inconsistent about whether one condition influences the development of the other. We examined the directionality of relations between depressive symptoms and perceptual speed using bivariate dual change score models. Assessments of depressive symptoms and perceptual speed were completed by 1,206 nondemented older adults at baseline, and after 2, 8, 11, and 15 years. After controlling for age, education, baseline general cognitive ability, and self-reported health, allowing depressive symptoms to predict subsequent change in perceptual speed provided the best fit. More depressive symptoms predicted subsequently stronger declines in perceptual speed over time lags of 1 year.

The influence of smoking, sedentary lifestyle and obesity on cognitive impairment-free life expectancy.

Anstey KJ, Kingston A, Kiely KM, Luszcz MA, Mitchell P, Jagger C

Population level reductions in smoking, sedentary lifestyle and obesity increase longevity and number of years lived without cognitive impairment. Years lived with cognitive impairment may also increase.

Indigenous Australians are under-represented in longitudinal ageing studies.

Anstey KJ, Kiely KM, Booth H, Birrell CL, Butterworth P, Byles J, Luszcz MA, Gibson R

Evidence-based policy depends on the availability of high-quality research that is relevant to the population. This study aimed to identify the available data on the health of older Indigenous Australians in population-based longitudinal studies of ageing. Within the existing Australian longitudinal ageing studies, Indigenous Australians are under-represented. This means there is a significant gap in the evidence base relating to the health of older Indigenous Australians. Research approaches specifically designed to address the health and wellbeing of older Indigenous Australians are urgently required.

Effect of tailored on-road driving lessons on driving safety in older adults: A randomised controlled trial.

Anstey KJ, Eramudugolla R, Kiely KM, Price J

Tailored driving lessons reduced the critical driving errors made by older adults. Longer term follow-up and larger trials are required.

Estimates of probable dementia prevalence from population-based surveys compared with dementia prevalence estimates based on meta-analyses.

Anstey KJ, Burns RA, Birrell CL, Steel D, Kiely KM, Luszcz MA

This study shows that estimates of probable dementia based on MMSE in studies where cognitive decline and dementia are a focus, are a useful adjunct to clinical studies of dementia prevalence. Such information and may be used to inform projections of dementia prevalence and the concomitant burden of disease.

Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter's indicators of adversity.

Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, Mick E, Ablon S, Warburton R, Reed E

A positive association appears to exist between adversity indicators and the risk for ADHD as well as for its associated psychiatric, cognitive, and psychosocial impairments. These findings support the work of Rutter and stress the importance of adverse family-environment variables as risk factors for children with ADHD.

Functional equivalence of the National Adult Reading Test (NART) and Schonell reading tests and NART norms in the Dynamic Analyses to Optimise Ageing (DYNOPTA) project.

Kiely KM, Luszcz MA, Piguet O, Christensen H, Bennett H, Anstey KJ

This study investigates the functional equivalence of two measures of irregular word pronunciation–National Adult Reading Test (NART) and Schonell–which are popular instruments used to assess verbal neurocognitive functioning and to estimate premorbid IQ. We report norms for the NART in a pooled sample from 3 Australian population-based studies of adults aged 65-103 years. Norms were stratified by sex and age left school in 5-year age groups. The NART and the Schonell had a strong linear relation, allowing for the imputation of NART scores based on Schonell performance within 1 study. Neither measure was sensitive to the effects of sex after adjusting for the effects of age and education. Early school leavers performed worse on both measures. Data pooling enables greater precision and improved generalizability of NART norms than do methods that use single older adult samples.

How financial hardship is associated with the onset of mental health problems over time.

Kiely KM, Leach LS, Olesen SC, Butterworth P

The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.

Cognitive, health, and sociodemographic predictors of longitudinal decline in hearing acuity among older adults.

Kiely KM, Gopinath B, Mitchell P, Luszcz M, Anstey KJ

Faster rates of decline in hearing are predicted by probable cognitive impairment and hypertension.

Evaluating a dichotomized measure of self-reported hearing loss against gold standard audiometry: prevalence estimates and age bias in a pooled national data set.

Kiely KM, Gopinath B, Mitchell P, Browning CJ, Anstey KJ

To evaluate a harmonized binary measure of self-reported hearing loss against gold standard audiometry in an older adult population.

The Symbol Digit Modalities Test: Normative data from a large nationally representative sample of Australians.

Kiely KM, Butterworth P, Watson N, Wooden M

Data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey were used to calculate weighted norms for the written version of the Symbol Digits Modalities Test (SDMT) by gender, 5-year age groups and four levels of educational attainment. The sample comprised 14,456 Australians (47% male; age range 15-100), of whom 25% reported a tertiary qualification, 30% reported a technical qualification (diploma or trade certificate), 16% reported completing Year 12 (final year of high school), and 29% reported their highest level of educational attainment to be Year 11 or below. Participants were excluded if they reported physical or neurological conditions that limited performance. Age, gender, and education were all significantly associated with SDMT performance, as was poor health, and cultural background. The reported norms are of greater scope and precision than previously available and have utility in a range of clinical and research settings. Indeed, normative data for the SDMT that are representative of a national population have not previously been published.

Validation of four measures of mental health against depression and generalized anxiety in a community based sample.

Kiely KM, Butterworth P

There is a need to validate screening measures of affective and generalized anxiety disorders for use in epidemiological surveys of mental health in the general population. This study examined the diagnostic accuracy of the Patient Health Questionnaire (PHQ-9), Goldberg Anxiety and Depression Scales (GAS, GDS) and the 12-item Short Form Health Survey (SF-12) Mental Health Component Summary Scale (MCS-12) in a population based longitudinal study in Australia. We report analyses of two narrow age birth cohorts in the Personality and Total Health (PATH) through life study (ages 32-36 and 52-58). Depressive episodes (severe, moderate, and mild), dysthymia and generalized anxiety disorder were diagnosed according to International Classification of Diseases (ICD-10) criteria using the World Health Organisation (WHO) Composite International Diagnostic Interview (CIDI) as a criterion. All scales had high concordance with their target 30-day diagnoses, with area under the Receiver Operating Characteristic (ROC) curve (AUC) ranging between 0.85 and 0.90. The PHQ-9, GDS, GAS and MCS-12 were all valid instruments for identifying possible cases of depression and anxiety, and assessing the severity of these common mental disorders in the general population. We report recommended cut-points for each scale, though note that the optimal cut-point on mental health screening instruments may vary depending on the context of test administration.

Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt.

Kiely KM, Butterworth P

Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.

Social disadvantage and individual vulnerability: a longitudinal investigation of welfare receipt and mental health in Australia.

Kiely KM, Butterworth P

To examine longitudinal associations between mental health and welfare receipt among working-age Australians. The poor mental health of welfare recipients may limit their opportunities to gain work and participate in community life. In part, this seems to reflect their adverse social and personal circumstances. However, there remains evidence of a direct link between welfare receipt and poor mental health that could be due to factors such as welfare stigma or other adverse life events coinciding with welfare receipt for those receiving unemployment or disability payments. Understanding these factors is critical to inform the next stage of welfare reform.

Differential associations between sensory loss and neuropsychiatric symptoms in adults with and without a neurocognitive disorder.

Kiely KM, Mortby ME, Anstey KJ

The extent to which this association is the result of underlying neuropathology, unmet need, or interpersonal factors is unclear. These findings have significant implications for dementia care settings, including hospitals and respite care, as patients with sensory loss are at increased risk of neuropsychiatric symptoms and may require additional psychosocial support. Interventions to manage sensory loss and reduce the impact of sensory limitations on neuropsychiatric symptoms are needed.