Postdoctoral Fellow, NeuRA
NHMRC-ARC Dementia Research Development Fellow.
Conjoint Lecturer, Prince of Wales Clinical School, Medicine.
UNSW Honorary Research Fellow, Sydney Medical School, The University of Sydney.
Morag is an NHMRC-ARC Dementia Research Fellow (2016-2019) undertaking a suite of studies investigating disability and fall prevention in community-dwelling older people living with dementia. She completed her PhD (part-time) in 2014, titled ‘Understanding fall risk in cognitively impaired older people’. Prior to this, Morag completed her Bachelor of Applied Science in Physiotherapy in 1999. She worked clinically for more than 15 years, predominantly at the Prince of Wales Hospital in Sydney on the Aged Care Rehabilitation ward and in the Falls, Balance and Bone Health Clinic.
What factors influence participation and adherence to a fall prevention intervention in community-dwelling older people with dementia?
Falls and functional decline are common in people with dementia. Falls are more likely to result in injury, death and institutionalisation when compared to older people without dementia. There is limited evidence that falls can be prevented in people with dementia. Strategies aimed at maintaining independence and preventing decline and falls are urgently needed. This research will a) further our understanding of fall risk and functional decline and b) explore novel fall and decline prevention programs, including the use of technology in older people with dementia.
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ELIZABETH ARMSTRONG Senior Research Facility Manager
CHRISTINA NORRIS PhD student
BARBARA TOSON Bio-statistician
ASSOCIATE PROFESSOR REBECCA MITCHELL Visiting Senior Research Scientist
LYNDELL WEBSTER Research assistant
NARELLE PAYNE Research assistant
JACQUELINE WESSON Research assistant
CECELIA KOCH Research assistant
GENEVIEVE ZELMA Research assistant
ROSLYN SAVAGE Research assistant
SANDRA O’ROURKE Research assistant
BEATRICE JOHN Research assistant
White Matter Hyperintensities (WMHs) are associated with impaired gait, balance and cognition and increased fall risk in cognitively healthy older people. However, few studies have examined such relationships in older people with dementia. Understanding the role of WMHs in falls may assist in developing effective fall prevention strategies. We investigated the relationship between baseline WMHs, cognitive and sensorimotor function and prospective falls in older people with dementia. Twenty-eight community-dwelling older people with mild-moderate dementia (MMSE 11-23; ACE-R < 83) underwent magnetic resonance imaging and assessment of sensorimotor and cognitive (global and processing speed) function at baseline. WMHs, were quantified using a fully automated segmentation toolbox, UBO Detector ( https://cheba.unsw.edu.au/group/neuroimaging-pipeline ). Falls were ascertained prospectively for 12-months using monthly calendars with the assistance of carers. The median age of the participants was 83 years (IQR 77-86); 36% were female; 21 (75%) fell during follow-up. Using Generalized Linear Models, larger volumes of total WMHs were found to be significantly associated with poorer global cognitive and sensorimotor function. Using modified Poisson regression, total, periventricular and deep WMHs were each associated with future falls while controlling for age, sex, intracranial volume and vascular risk. Each standard deviation increase in total and periventricular WMH volume resulted in a 33% (RR 1.33 95%CI 1.07-1.66) and 30% (RR 1.30 95%CI 1.06-1.60) increased risk of falling, respectively. When the deep WMH volume z-scores were dichotomized at the median, individuals with greater deep WMH volumes had an 81% (RR 1.81 95% CI 1.02-3.21) increased risk of falling. WMHs were associated with poorer sensorimotor and cognitive function in people with dementia and total, periventricular and deep WMHs were associated with falls. Further research is needed to confirm these preliminary findings and explore the impact of vascular risk reduction strategies on WMHs, functional performance and falls.
The aim of this study was to investigate physical decline over 1-year in a cohort of older people across the cognitive spectrum.
This study aimed to document change in neuropsychological, physical and functional performance over one year and to investigate the relationship between baseline gait speed and cognitive decline in this period in older people with dementia. Older people with mild to moderate dementia demonstrate significant decline in neuropsychological, physical and functional performance over one year. Baseline gait speed is associated with decline in executive function over one year, suggesting shared pathways/pathology between gait and cognition.