Dr Moyra Mortby

TEAM LEADER PROFILE

Research Fellow

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Dr Moyra Mortby is a Psychologist specialised in neuropsychiatric symptoms in dementia and pre-clinical stages of dementia and is an NHMRC-ARC Dementia Research Development Fellow. She was awarded her PhD with Laudatio Magna Cum Laude from the University of Zurich, Switzerland for her research on apathy and depression in Mild Cognitive Impairment and Alzheimer’s disease, and completed her MSc in Research Methods in Psychology and BSc in Criminology and Psychology both at Keele University, UK.

Her research program focuses on neuropsychiatric symptoms in dementia and pre-clinical stages of dementia, neuroimaging and epidemiology. 2015 International Society to Advance Alzheimer’s Research and Treatment (ISTAART) and the Neuropsychiatric Syndromes (NPS) in Neurodegenerative diseases Professional Interest Area (PIA) New Investigator Award.

Her research program is structured around 4 key areas which aim to: 1) improve our understanding of dementia, its risk factors and trajectories; 2) better understand the impact of neuropsychiatric symptoms on dementia trajectories, quality of life and the provision of formal and informal care; 3) validate the concept of Mild Behavioural Impairment as a pre-clinical stage of dementia; and 4) develop and evaluate interventions to reduce neuropsychiatric symptoms associated with dementia, improve quality of life for people living with dementia and those providing care and develop useful support mechanisms.

Projects Dr Moyra Mortby is currently involved with

CURRENT PROJECTS

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.

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The Personality and Total Health (PATH) Through Life Project 

Behavioural Symptoms in Dementia (BeSyDe)

It is estimated that 1.2 million Australians are currently caring for someone with dementia. Caring for somebody with dementia can become more complicated by the presence of behavioural problems (e.g. depression, anxiety, apathy, aggression) in the person with dementia. These behavioural problems can contribute significantly to carer burden and distress. This study aims to improve our understanding of how interactions between the carer and the care-recipient affect behavioural problems in dementia. A better understanding of these interactions will help us develop programmes which can be used to assist the carer and those suffering from dementia to minimise the negative impact of problem behaviours in dementia.

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Behavioural Symptoms in Dementia (BeSyDe)

BPSD PLUS: A person-centred approach to managing behavioural and psychological symptoms of dementia

Rates of behavioural and psychological symptoms of dementia (BPSD) amongst people living in residential aged care facilities (RACF) are high. Over 90% of Australian aged care residents exhibit clinically significant BPSD. Physical aggression, agitation and disinhibition, especially when severe, are difficult to manage and can put patients, carers and other residents at risk. Management of BPSD has recently become a focus of attention for the Australian Government, especially in relation to inappropriate overprescribing of antipsychotics. The discrepancy between international and national recommendations and the continued over-prescription of medication to manage BPSD must be addressed. Australia urgently needs better programs to support RACF to implement non-pharmacological, cost-effective management programs.

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BPSD PLUS: A person-centred approach to managing behavioural and psychological symptoms of dementia in residential care

RESEARCH TEAM

IRIS CARTER Research Assistant

JENCIE CASTLES Research Assistant

PUBLICATIONS

Special Issue on mild behavioral impairment and non-cognitive prodromes to dementia.

Mortby ME, Lyketsos CG, Geda YE, Ismail Z

This Special Issue provides a systematic examination of the neuropsychiatric symptoms (NPS) and non-cognitive prodromes of dementia, with an eye toward validating the construct of mild behavioral impairment (MBI).

Dementia clinical trial implications of mild behavioral impairment.

Mortby ME, Black SE, Gauthier S, Miller D, Porsteinsson A, Smith EE, Ismail Z

The World Alzheimer Report 2016 estimated that 47 million people are living with dementia worldwide (Alzheimer's Disease International, 2016). In the inaugural World Health Organization Ministerial Conference on Global Action against Dementia, six of the top ten research priorities were focused on prevention, identification, and reduction of dementia risk, and on delivery and quality of care for people with dementia and their carers (Shah et al., 2016). While the Lancet Neurology Commission has suggested that even minor advances to delay progression or ameliorate symptoms might have substantial financial and societal benefits (Winblad et al., 2016), advances have been slow.

Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults.

Mortby ME, Ismail Z, Anstey KJ

This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.

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