Principal Research Fellow, NeuRA
Conjoint Professor, UNSW
Consultant Geriatrician, Prince of Wales Hospital
+612 9399 1055
Prof Jacqui Close is a consultant in Orthogeriatrics at the Prince of Wales Hospital in Sydney and Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia. Her primary research area is falls in people with cognitive impairment and dementia and particularly the relationship of cognitive function to postural stability, falls and fractures. She also has an epidemiological interest in the impact of falls and injury to health service use and the way in which health services are designed to prevent and manage falls and injury in older people. She sits on a number of State and National committees in relation to Aged Health and is Co-Chair of the ANZ Hip Fracture Registry, Chair of the ACSQHC Clinical Care Standards Working Group for Hip Fracture and the President of the Australian and New Zealand Society of Geriatric Medicine.
This program of research evaluates the performance of commonly used comorbidity measures (Charlson Comorbidity Index, Elixhauser and Multipurpose Australian Comorbidity Scoring System) on the prediction of 30-day and 1-year mortality, 28 day re-admission, and length of stay in an older hip fracture population.
This research program explores the influence of dementia on the pattern of hospital admissions, clinical care, health outcomes and economic costs of older people with an injury-related hospitalisation. It provides data on the impact of injury on a person with dementia and the health system more generally.
This research examines the age-specific population prevalence and predictors of uptake of home modifications and exercise to prevent falls in the older population in NSW.
The IFOCIS study aims to determine the ability of an individualised exercise and home hazard reduction program to reduce the rates of falls in older people living in the community with cognitive impairment or dementia. To do this, we have two groups– an ‘intervention’ group and a ‘control’ group. The Intervention program involves: an exercise program and a home hazard reduction program delivered by experienced therapists tailored to the participant’s cognitive and physical abilities. Carers are an integral part of the intervention team, as some participants require supervision for exercise sessions. We work with carers to help them understand how to get the best from the participant they are caring for, in terms of their ‘functional cognition’, completing the exercises and preventing falls.
Taking this individual approach means that participants can have very different cognitive abilities and still be included in our study. No other study has done this to date.
All participants will undergo an assessment at baseline with re tests at 6 and 12 months to compare each of these groups on things like strength & balance. The primary outcome is the rate of falls during the 12 month study period which is collected using falls diaries on a monthly basis.
Recruitment for the project is now in the 2nd year. We have enrolled 184 participants and their carers into the trial from the Prince of Wales hospital / NeuRA site and the Hornsby hospital site. We hope to have 360 participants enrolled by the end of 2017. We continue to recruit from Prince of Wales and Hornsby hospital wards and outpatient clinics and other Sydney metropolitan hospital dementia day clinics.
Incidence, circumstances, treatment and outcome of high-level cervical spinal fracture without associated spinal cord injury in New South Wales, Australia over a 12 year period.
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.
There are approximately 17,000 new hip fractures in Australia and 4,000 in New Zealand annually. The cost of the event is enormous, both for the individual and their family, as well as the health care system. There is variation in models of hip fracture care within and between States and Territories (Aus) and District Health Boards (NZ). Much of what happens in the acute and rehabilitation settings impacts directly on the longer term outcomes for the person with the fracture. The ANZHFR allows for timely comparison of meaningful data that can be used by providers of care to understand clinical practice, and trigger a case for change in places where improvement can be made.
: +612 9399 1124
ELIZABETH ARMSTRONG Senior Research Facility Manager
DR LARA HARVEY Postdoctoral Fellow
STEFANIE MIKOLAIZAK Postdoctoral Fellow
DR MORAG TAYLOR Postdoctoral Fellow
CHRISTINA NORRIS PhD student
BARBARA TOSON Bio-statistician
ASSOC PROF 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
To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors, i.e., poor balance, reduced leg muscle strength, and freezing of gait, in people with Parkinson disease. An exercise program targeting balance, leg strength, and freezing of gait did not reduce falls but improved physical and psychological health. Falls were reduced in people with milder disease but not in those with more severe Parkinson disease.
With population ageing, self-harm injuries among older people are increasing. Further examination of the association of physical illness and self-harm among older people is warranted. This research aims to identify the association of physical illness with hospitalisations following self-harm compared to non-self-harm injury among older people. Older people who are experiencing chronic health conditions, particularly tinnitus, malignancies, diabetes and chronic pain may be at risk of self-harm. Targeted screening may assist in identifying older people at risk of self-harm.
The authors would like to apologise for a typographical error in the abstract of the above mentioned article. In the results section of the abstract on the first page of the article, the first odds ratio that refers to 'aged care facilities' should be (OR 5.44; 95% CI 4.43-6.67) and the second odds ratio that refers to health service facilities should be (OR 4.56; 95%CI 4.06-5.13).