Dr Ranmalee Eramudugolla

CogDrisk- Cognitive health and Dementia Risk Assessment

Evidence related to dementia risk factors continues to increase with advancement in study methodology and more research being published in the field of dementia prevention. WHO guidelines for risk reduction of cognitive decline and dementia has published the latest evidence on the risk factors in mid and late life. There is a need of a new risk assessment tool that can be used both in population and clinical settings which would incorporate the latest evidence for the risk factors of dementia.

What is CogDrisk?

The CogDrisk project led by Professor Kaarin Anstey at NeuRA. The project aims to develop and validate a new risk assessment tool for assessing individual exposure to risk factors known to be associated with an increased risk of developing dementia. The tool will be developed from risk estimates selected from latest systematic reviews and meta-analyses. External validation of the tool will be carried out using five high standard international cohorts for discrimination and accuracy of predicting dementia cases.

Who will use the CogDrisk?

The assessment tool will be available online to the public, researchers and clinicians. Individuals aged 18 years and above can take the assessment to assess their risk of developing dementia, get a risk profile, and recommendations to reduce their risk of developing dementia. A risk score along with recommendations to reduce their dementia risk will be provided to individuals aged 60 years and above.

What are the benefits of the CogDrisk?

• The CogDrisk website provides latest evidence on dementia, dementia risk factors and risk reduction.

Those who are interested to take the assessment (anyone over the age of 18 years) can do so at a time convenient to them and can redo the assessment later to see if they changed their risk of developing dementia.

• Recommendations provided are based on National and International Guidelines.
• The tool would also be used to identify individuals at high risk of developing dementia before they can be involved in clinical trials for dementia prevention.

Older Drivers’ Use Of Technology

MemTech

For many older adults, driving is essential for independence and participation in life.  However, ageing is associated with a range of physical, sensory, and cognitive changes, some of which can influence driving safety. Neurodegenerative conditions such as dementia can progress very gradually, and regular monitoring is required to identify the point at which driving becomes unsafe. Current methods of monitoring road safety for older drivers relies on regular reviews with doctors or expensive and stressful driving tests. These methods are resource intensive and inefficient. Thus, there is a need for more cost-effective and less invasive ways of monitoring road safety for older drivers. The Changing Memory, Technology and Driving study (MemTech) will investigate whether a dashboard camera and a GPS data logger can be used to accurately measure changes in safety during an older driver’s everyday driving trips. The study will involve older drivers who are experiencing changes in their thinking and memory or early stages of dementia, as well as older drivers without any cognitive difficulties. This will allow data to be compared across the two groups to determine whether the in-vehicle GPS devices can detect changes in driver safety associated with cognitive change. If it can, this will provide valuable research data for the future development of accurate in-vehicle monitoring systems for older driver safety.

This research is being funded by the Office of Road Safety.

If you would like to take part in this research study, please contact

Ms Abirami Raveendran

Phone: (02) 9399 1058

Email: memtech@neura.edu.au

MyCOACH: Connected Advice for Cognitive Health

Please note, due to high recruitment numbers of certain groups, we can now only accept female participants aged 75 years or older and male participants aged 65 years or older.

What is the MyCoach Trial about?

This research aims to test the effectiveness of a healthy lifestyle intervention designed to support healthy brain ageing and reduce dementia risk. The course is tailored for people experiencing changes or concerns in thinking, memory or cognition.  The intervention will run for 12 weeks, and the study will also involve a 13-week, 6-month and 1-year follow-up interview (more information below).

What is involved in this research trial?

Interested volunteers will complete an eligibility screening to confirm this study is a good match. Next, volunteers will be randomised into one of two groups: MyCoach Intervention or Email information. To ensure the research is fair and unbiased, the group is chosen randomly – like pulling names from a hat.

• MyCoach Intervention (12 weeks): Participants will have access to a 12-week online course, consisting of six chapters about cognitive health and dementia risk factors, and they will receive a telephone booster session 3-months later. During the 12-week period, participants will be offered two consultations sessions with a dietician and an exercise physiologist, as well as access to a brain-training app.
• Email information (12 weeks): Participants will receive six email bulletins about cognitive health and risk factors for dementia over a 12-week period. At the end of the study, access to the full MyCoach online course will be provided.
• All participants will take part in four telephone interviews, which will involve answering a number of questionnaires about cognitive function, lifestyle and mental health. These interviews will take place before the intervention period, straight after the intervention and again 6-months and 1 year later.

You may be eligible to participate in the MyCoach Trial if you:

• Have concerns about changes in your memory or thinking OR diagnosed with ‘Mild Cognitive Impairment’
• Are 65 years of age or older*
• Have no other current diagnosed psychiatric or neurological disorders
• Are able to read, write and communicate in English to a comfortable level
• Are willing to complete an online course and interviews over telephone/video call

* We are currently only accepting female participants aged 75 years or older and male participants aged 65 years or older.

Expressions of interest

If you are interested, or know someone who might be, please register below or contact us directly on 02 9399 1853 or mycoach@neura.edu.au.

NHMRC Centre of Research Excellence in Cognitive Health

The Centre of Research Excellence in Cognitive Health focuses on the integrally linked areas of optimising cognitive health and the prevention of cognitive decline.

The centre aims to:

• Build the evidence base in cognitive health promotion and prevention of cognitive decline, focussing on evaluating putative new risks and under researched areas
• Develop methods of transferring, translating and implementing established findings, through the development and evaluation of interventions
• Model population level impacts of cognitive impairment and risk modification to quantify potential economic benefits of risk reduction and to inform policy.

The CRE Cognitive Health led by Professor Kaarin Anstey is a collaboration between Chief and Associate Investigators from the Australian National University, University of Melbourne, University of New South Wales, Australian Catholic University, Baker IDI Heart and Diabetes Institute and University of Exeter.

For more information about the CRE Cognitive Health, please visit the centre website, including more information on research themes, news and events, and recent publications.

The CRE Cognitive Health is funded by the National Health and Medical Research Council.

The Personality and Total Health (PATH) Through Life Project 

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 5^th 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:

• 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 (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.

The Driving, Ageing, Safety and Health (DASH) project

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.

Primary Aims:

• To validate a short screening battery for older drivers called the Multi-D based on the Multifactorial Model of Driving Safety, a theoretical model of the abilities involved in safe driving and knowledge of age-related changes in cognitive, visual and sensorimotor function
• To compare the Multi-D and existing screening approaches including Hazard Perception, Road Rules Knowledge, the Useful Field of View, and the Drivesafe tests to determine whether combining measures improves the accuracy of classification of safe and unsafe drivers.

Secondary Aims:

• To compare the efficacy of the Multi-D and other screening instruments in predicting prospective self-reported crash rates (derived from standardized monthly diaries) between three groups of older drivers
• To evaluate the screening instruments and assessments in relation to mobility outcomes (driving cessation, driving frequency, driving distance) over two years and longer pending further funding
• To collaborate with practitioners to develop clinical practice guidelines for using the Multi-D battery in the context of older driver assessment
• To inform the development and design of interventions to prevent injuries among older drivers.

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.

Better Drive Program

Driving is critical for enabling mobility and community participation in older Australians, with over 90% of those aged in their 70s being licensed drivers. There is an urgent need for evidence-based methods for enhancing and maintaining older drivers’ skills – methods that are ready for translation into cost-effective and practical interventions.

The Better Drive Trial is a three-arm randomised controlled trial that assesses the effectiveness of different driver education types on safety outcomes for older adults. The relative effectiveness of tailored lessons, road-rule workshops and feedback on older drivers on road safety will be assessed in over 384 participants over 2 years. If effective, interventions will improve driving safety, reduce costs associated with crashes, and maintain social participation.

Our multidisciplinary team has expertise in cognitive ageing, psychology, occupational therapy, behaviour change and injury prevention, and proven records of designing and implementing RCTs of behavioural interventions for improving safety in older adults. The outcomes of the project will lead to the development of community programs for older drivers that seek to maintain mobility and community participation.

The Better Drive Trial is funded by the NHMRC and is expected to run for 5 years.