Dr Ranmalee Eramudugolla is a research manager in the Anstey Lab at NeuRA. She has a background in clinical neuropsychology and cognitive neuroscience, and works on projects examining cognitive ageing, dementia, and driving safety in older adults. This work involves longitudinal cohort studies and randomised controlled trials of behavioural interventions. She is currently involved in the Driving, Ageing Safety and Health (DASH) project, the Better Drive 2 Trial, and the PATH Through Life Project at NeuRA, and as an associate investigator on an Aboriginal dementia prevention trial led by BakerIDI. Her research interests include neurocognitive assessment, cognitive interventions and risk factors for cognitive decline.
Dr Kim Kiely (Lead Investigator), Professor Kaarin Anstey (Associate Investigator) and Dr Ranmalee Eramudugolla (Associate Investigator)
With increasing age, nearly all adults experience progressive, irreversible, and bilateral declines in hearing ability. As a result, hearing loss is one of the most common chronic health conditions affecting older adults and if unmanaged its impacts are wide ranging and long lasting.
There is good evidence indicating that older adults with significant hearing difficulties are more likely to experience cognitive decline and dementia, but reasons for this association are unknown.
This project will investigate how hearing loss is related to cognitive impairment. Firstly, it will compare levels of hearing function and use of hearing services by cognitive status. Second, it will examine if the relationship between poor hearing and impaired cognitive functioning is explained by lower levels of participation in activities that are good for brain health. Third, it will investigate if hearing rehabilitation services and hearing aids protect against poorer levels of cognitive function.
The project is funded by a Dementia Australia Research Foundation (DARF) Project Grant
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 5th 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:
Several design features of the PATH project contribute to its unique standing among population-based longitudinal cohort studies.
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.
Older adults represent a growing sector of the driving population in Australia, and while driving can be important for maintaining social engagement in late life, age-related changes such as cognitive and visual impairment can impact on driving safety.
The Driving, Ageing, Safety and Health (DASH) project is designed to develop and validate screening measures for older drivers to support determinations of driving safety. The DASH project is a collaboration with Joanne Wood and the Queensland University of Technology.
Over 550 older drivers, across three groups, were followed for two years to evaluate how well laboratory assessments and an on-road test predict driving outcomes. The three groups included a) older drivers referred for assessment by GPs and Road Safety Authorities, b) older drivers with eye disease and c) older drivers drawn from the community.
Findings from this research project will enable health professionals and licensing authorities to assist in their decision-making regarding the fitness to drive of older adults.
DASH is funded by the National Health and Medical Research Council.
Current road safety policy for at-risk older drivers involves ‘fitness to drive’ assessment and either license restriction or revocation. However, research indicates that there is no clear evidence that mandatory testing lowers crash rates amongst older drivers, and that driving cessation in older adults is associated with increased rates of depression, social isolation, and general health decline.
The Better Drive program includes a series of studies evaluating interventions to improve driver skill. Two trials have been completed to date.
Trial 1 used a two-arm randomised controlled trial (RCT) approach to investigate the efficacy of individually tailored driving refresher lessons against a group-based refresher course on on-road driving performance, safety and crash risk in older adults. Findings indicate that although classroom based road rules workshops for seniors can lead to improvements in on-road driving skill, the inclusion of tailored driving instruction can significantly enhance safety and reduce crash-causing on-road errors relative to classroom based workshops alone.
Trial 2 used a two group (training, no-contact control) non-randomised design to examine the transfer of computerised speed of processing (SOP) training gains to cognitive measures that are known predictors of driving safety in older adults. Findings indicate that SOP training effects can be achieved with self-administered, online training at home, with some transfer to other known cognitive predictors of driving safety. However, differential effects of training may be observed for tasks requiring goal-directed search strategies rather than diffuse attention.
A third trial is currently underway. This trial uses a three-arm randomised controlled trial approach to assess the effectiveness of computerised cognitive training and tailored on-road skills training on driver safety in older adults. Data collection for this trial will be completed in 2019.
The Better Drive program has been funded by the NRMA Road Safety Trust.
DR CRAIG SINCLAIR
Postdoctoral Fellow School of Psychology UNSW
: (02) 9399 1095
: 9399 1021
Tailored driving lessons reduced the critical driving errors made by older adults. Longer term follow-up and larger trials are required.
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.
Driving is normative for many older Australians in their 70s. Similar factors are associated with actual cessation and expectation of driving suggesting that older adults do have a sense of their expected driving life.