NHMRC-ARC Dementia Research Development Fellow
02 9399 1269
Dr Kylie Radford is a clinical neuropsychologist and Research Fellow leading the Aboriginal Health and Ageing Group at NeuRA. She completed her PhD in 2010 at the University of Sydney. Her diverse clinical research experience has involved studying early onset dementia, alcohol dependence, and cognitive rehabilitation for acquired brain injuries, mild cognitive impairment and epilepsy, as well as population brain ageing. This has included experience in a range of research methodologies, such as randomized controlled trials, multicentre studies, longitudinal observational cohort studies, development of psychometric instruments and validation studies.
Since 2009, she has worked with the Koori Growing Old Well Study (KGOWS), an epidemiological study investigating ageing and dementia in urban and regional Aboriginal communities in New South Wales. Her current NHMRC-ARC Dementia Research Development Fellowship focuses on understanding social and biomedical risk factors for cognitive decline and dementia, and promoting healthy brain ageing in collaboration with urban and rural Aboriginal communities.
Research investigating the impacts of cognitive behavioural therapy and balance programs on fear of falling, funded by Mindgardens.
Falls and fear of falling affect many older people and can impose limitations upon daily activities. Over one third of community dwelling older people fall each year with about 15% of falls being injurious. However, two thirds of older people express a fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities, and subsequent deterioration of health and wellbeing.
Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs. However, these face-to-face treatments are resource intensive and not readily accessible to people. Furthermore, the effects of these treatments on fear of falling are small and often do not last beyond the duration of the program.
By utilising technology and providing tailored physical activity guidance we are aiming to reduce a fear of falling in an accessible, efficient and lasting way.
A thee-arm randomised clinical trial will be conducted in 189 community-dwelling older adults with a substantial concern of falling. Participants will be randomly allocated into one of three groups in order to test whether a self-managed CBT intervention, alone or in combination with a graded balance activity program, can reduce concerns about falling in older adults when compared to usual care.
We are collaborating with the Black Dog institute to provide a home-based cognitive behavioural therapy program that addresses a fear of falling. We will also be utilising our cutting-edge balance program StandingTall to provide a graded balance program.
An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.
According to the Australian Bureau of Statistics, about 60 per cent of Australians (15-74 years old) have less than adequate levels of health literacy and only 6% of the population have high health literacy. Health literacy was also found to be lower in old age. The majority of Australians with inadequate health literacy were aged 65 to 74 years. Similarly, in another Australian survey, only 8% of 1454 older adults were aware that balance training can prevent falls, or that falls could be prevented at all. This is indicative of poor health literacy among older Australians related to fall risk and fall prevention. With the increasing complexity of health information and services, health literacy is an issue for older Australians. Health literacy may affect individuals’ understanding of health information and in turn influence their health decisions and uptake of health preventive interventions such as engaging in physical activities to prevent falls.
This project will address a crucial gap in empowering older adults to take care of their own health and increase the uptake and efficacy of evidence-based fall prevention programs. An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.
The Caring for Spirit project is focused on providing a centralised online source of evidence-based resources and information that are culturally appropriate and appealing to Aboriginal and Torres Strait Islander communities. The team is translating the results of current research into culturally relevant and accessible information, education and training for people living with dementia, their families and carers, as well as for Aboriginal Health Workers.
We have engaged the services of Aboriginal staff, consultants, and graphic and website designers to achieve the appropriate look and feel. Community engagement and approval is essential and we are working with our Aboriginal community partners across NSW, as well as through our diverse networks to ensure national impact. Advice and feedback from these partners will be used to refine the resources. Growing old well is something we all want for our communities, but we also know that many things happen in our lives that could influence this process. A diagnosis of dementia can have an influence on our mind, body and spirit. This project is focused on translating the results of current research to keep our mind, body and spirit well, through education and training. This is important for people living with dementia, their families and carers, as well as for Aboriginal Health Workers. It is anticipated that these resources will contribute to enhancing the lives of Aboriginal and Torres Strait Islander people and their carers who are living with dementia, and contribute to alleviating the high burden of dementia in this population.
“Healthy ageing is your mind staying young” – Koori Growing Old Well Study participant
Healthy Ageing calls for cognitively, physically and socially active lifestyles. The current project seeks to recognise existing community strengths but work to enhance participation and engagement, provide new resources specific to healthy ageing and develop an accessible platform for rolling out this intervention to diverse older people and communities, enabling widespread benefit. We will trial a cutting-edge approach to advance healthy ageing with implications for many Australians to benefit, particularly older Aboriginal people.
The project examines how to implement evidence based healthy ageing programs in urban and regional Aboriginal communities. Elders play a vital role in Indigenous communities, providing leadership, caring for family, and transmitting cultural knowledge and practices. However, the health, well-being and quality of life of the increasing numbers of older Indigenous people, are threatened by high rates of dementia, falls and depression. Novel culturally-safe approaches are needed to better engage and support Indigenous peoples in terms of healthy ageing. This research will develop and evaluate effective, culturally appropriate, and accessible strategies to promote healthy ageing in Aboriginal communities. It will also investigate whether and how resilience related to social and cultural cohesion can protect well-being in Indigenous communities.
ABSTRACTBackground:Years of education is the most commonly used proxy measure of cognitive reserve. Other forms of cognitive stimulation in childhood may provide similar protection against cognitive decline, particularly in Indigenous groups, where education may have been lacking in quality or quantity. The Retrospective Indigenous Childhood Enrichment (RICE) scale was developed to measure non-school-based activities and environmental stimulation during childhood that are likely to have enhanced cognitive reserve. The aim of the study was to assess the validity and reliability of the RICE scale with a group of older Aboriginal Australians.
To examine associations between fall risk factors identified previously in other populations and falls among Aboriginal people aged 60 years and older, living in New South Wales, Australia. Falls were experienced by one-quarter of study participants. Fall risk factors identified for older Aboriginal people appear to be similar to those identified in the general population. Understanding of fall risk factors may assist with the development of appropriate and effective community-led fall prevention programs.