Professor Kaarin Anstey

MyCOACH: Connected Advice for Cognitive Health

Researchers at Neuroscience Research Australia (NeuRA) and University of New South Wales (UNSW) are inviting people with Mild Cognitive Impairment (MCI) or Subjective Cognitive Decline (SCD) to participate in a voluntary online research trial aiming to reduce the risk of dementia.

What is the MyCOACH Trial about?

This research aims to test the effectiveness of an e-learning and behaviour change course designed to support healthy brain ageing and reduce risk of dementia.  The course is tailored for people reporting cognitive difficulties or changes. The trial runs for 12 weeks, with a follow up at 1 and 2 years afterwards.

What is involved in this research trial?

Interested volunteers will be asked to complete some eligibility checks to confirm this study is a good match.    If you decide to take part you would:

• Be placed into either the MyCOACH e-learning group (“Intervention”) or the Control Education group (“Control”). To ensure the research is fair and unbiased, we cannot choose the group for you.   It will be random – like names out of a hat.

MyCOACH e-learning group (“Intervention”):  Volunteers in this group participate in the 12 week online MyCOACH program.  This includes 6 e-learning chapters, as well as three phone consultations with a dietician and/or exercise physiologist, and a 3-month subscription to a brain training app.

Control Education group (“Control”): Volunteers in this group will receive information about cognitive health and risk factors for dementia.  This group is important to be able to measure the effectiveness of the research.  At the end of the study, volunteers in this “control” group can access the full MyCOACH e-learning course.

• Take part in four telephone interviews throughout the study with questions about your health. This includes a follow-up at the end of 12 weeks, and 1 and 2 years 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

Expressions of interest

Contact

If you are interested or know someone who might be, please contact us for more information:

Dinaz Parekh

Email: mycoach@neura.edu.au

Phone: (02) 9399 1815

Own Your Balance

Research investigating the impacts of cognitive behavioural therapy and balance programs on fear of falling, funded by Mindgardens.

Falls and fear of falling affect many older people and can impose limitations upon daily activities. Over one third of community dwelling older people fall each year with about 15% of falls being injurious. However, two thirds of older people express a fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities, and subsequent deterioration of health and wellbeing.

Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs. However, these face-to-face treatments are resource intensive and not readily accessible to people. Furthermore, the effects of these treatments on fear of falling are small and often do not last beyond the duration of the program.

By utilising technology and providing tailored physical activity guidance we are aiming to reduce a fear of falling in an accessible, efficient and lasting way.

A thee-arm randomised clinical trial will be conducted in 189 community-dwelling older adults with a substantial concern of falling. Participants will be randomly allocated into one of three groups in order to test whether a self-managed CBT intervention, alone or in combination with a graded balance activity program, can reduce concerns about falling in older adults when compared to usual care.

We are collaborating with the Black Dog institute to provide a home-based cognitive behavioural therapy program that addresses a fear of falling. We will also be utilising our cutting-edge balance program StandingTall to provide a graded balance program.

Related studies:
https://www.neura.edu.au/project/reducing-fear-of-falling-and-activity-avoidance-in-older-adults-with-disproportionate-levels-of-fear-of-falling/
https://www.neura.edu.au/project/standingtall-plus-a-multifactorial-program-to-prevent-falls-in-older-people/

https://www.neura.edu.au/project/standing-tall/

Healthy and working life expectancies in an ageing Australia

Dr Kim Kiely (Lead Investigator) and Professor Kaarin Anstey (Co-investigator)

Australians are living longer and expected to work for longer than ever before. It is critical that additional years of life are at least matched by the increase in the years lived in good health, and that gains in healthy ageing are experienced across all sectors of society. There is also a great need to balance older adults’ capacity and opportunity to work with societal pressures to delay retirement.

The objective of this three-year project is to better understand individual and societal determinants that underlie variation in healthy ageing. We will identify characteristics that are tied to the years that older adults are able to engage in productive activities and live independently in good health. To achieve this, advanced health expectancy estimation methods are being used to analyse newly available mortality records that have been linked to national longitudinal survey data. These analyses will produce new, refined, estimates for Australia of ‘healthy life expectancy’ with ‘working life expectancy’. We will examine how these differ across sociodemographic strata, change over time, and compare internationally.

The project is funded by an Australian Research Council (ARC) Discovery Project (DP190100459).

The Auditory Ageing Study (AUDACIOUS)

Please be aware that as a result of COVID-19 the AUDACIOUS Study has suspended participant visits to NeuRA for the time being as the safety of all our participants comes first. However, you may still be able to participate from the safety of your own home as we make elements of the study available to you online and by phone. If you are interested and would like more information please contact us by filling in your name, phone and email in the space provided below. Thank you for your interest and we hope you keep safe during these challenging times.

Can you hear our call?!  Researchers at Neuroscience Research Australia (NeuRA) and The University of New South Wales are studying how adults experience declines in their hearing, how this interferes with communication and their day-to-day lives.

What is the purpose of this study?

To investigate the relationship between age-related hearing decline and cognitive abilities in older adults.

What does the study involve?

If you are interested in this study you will be invited to our study site at NeuRA in Randwick to complete a two-hour interview.

The interview will include test of your hearing and cognitive functioning including app-based activities testing memory, learning and attention. You will also be asked to complete a questionnaire about your general health, hearing and daily lifestyle.

Who can volunteer?

You may be eligible to participate on our research if

• You are 65 years of age or older
• Are able to make your own way to our interview site at NeuRA in Randwick
• You have not experienced lifelong hearing difficulties
• You do not need to have hearing difficulties to participate in this study.

Will I be reimbursed?

Your participation in the study is totally voluntary. You will be reimbursed $30.00 for participating in the study.

Contact

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

Ms Dominique Sepulveda

Phone: (02) 9399 1135

Email: audacious@neura.edu.au

Or register your interest and we will be in contact with you shortly:

Chief Investigator: Dr Kim Kiely

Phone: (02) 9399 1154

Email: k.kiely@neura.edu.au

Funding

The project is funded by the Dementia Australia Research Foundation (DARF)

Ethical approval

This study has been approved by the UNSW Human Research Ethics Committee.

HREC number: HC190216

Self-management and Health Promotion in early-stage dementia with E-learning for carers (SHAPE)

Receiving a diagnosis of dementia can lead to an overwhelming mix of emotions. It is very important that individuals and families have access to support and advice at this time, to help people regain control, plan for the future and carry on living a life that is meaningful to them.

The ‘SHAPE’ research study is a multi-site trial, working in collaboration with Norway and the UK. This study aims to test a new online training and support group for people in the early stages of dementia and e-leaning programme for care partners.

What does the study involve?

Participants of this study will be randomised into 1 of 2 groups:

Intervention group: People with dementia will be invited to a training and support group, comprising of 10 weekly online sessions, each lasting up to 2 hours. Participants will be supported to develop skills in areas including decision-making, symptom management, healthy habits adapting and coping. Care partners will receive an e-learning program following similar themes with some additional support.

Control group: Participants will not receive the group training from our team but will have access to the online training after the study is complete.

What are the benefits of this study?

We hope the online group sessions will help to put people with dementia at the centre of their care, improve wellbeing, maintain independence and encourage families to discuss and plan for the future together. In the long-term, we hope this research will help inform the type and standard of care which individuals and families receive following a diagnosis of dementia.

Interested in volunteering?

This study may be suited to you if:

• You have a formal diagnosis of dementia
• You are 65 and older
• You are comfortable communicating, reading and writing in English
• You have vision and hearing which allow you to engage comfortably in a group setting
• You have a care partner (family member or friend) who is willing to dedicate a small amount of time to the study

What would happen if you take part in the study?

The study will run over 9 months and you (and your care partner) will:

• Need to participate in three telephone assessment interviews, where you will be required to complete a number of questionnaires relating to health and wellbeing.
• Be randomly allocated to either the (a) intervention or (b) control group of the research study.

a.) The intervention group: This group will have 10 weekly online sessions with each session lasting up to 2 hours. Participants will learn about key skills in areas including: symptom management and healthy habits. Your care partner will receive an e-learning program following similar themes with some additional support.

b.) The control group: Like with a lot of research studies, some participants will be randomised to the control group, which means they will not receive the intervention from our research team. However, after study completion, both participants and families can receive the e-learning course comprising of the educational material used in the group.

Expression of Interest

You can find out even more about the study by visiting the study website: www.shapeproject.eu

You can also watch a video from the lead investigators talking about how and why the study is being run: https://shapeproject.eu/video-reportage-from-recent-meeting-in-norway/

Contact

For further information about this research study, please contact us on:

Jana Koch (Research Assistant)

E-mail: j.koch@neura.edu.au

Phone: (02) 9399 1116

Jessica Amos (Project Manager)

Email: j.amos@neura.edu.au

Phone: (02) 9399 1853

This research study 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 General Practice Knowledge Translation (GP-KT) project

The General Practice Knowledge Translation (GP-KT) project is an online survey designed to help us understand what people already know about dementia risk and dementia risk reduction in frontline healthcare settings.

In particular we are keen to understand the barriers that might delay or prevent dementia risk reduction activities so that we can work to reduce these over time.

At the moment we are recruiting Australian General practitioners and their teams. International versions are the survey are also in development.

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

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.

Interested in volunteering in this program? Find out more here. 

The Body-Brain-Life Project

A growing number of modifiable risk and preventative factors for dementia have been identified. Primary care offers a natural setting for the identification of those who may be at particular risk and who may subsequently benefit most from risk reduction interventions.

The Body, Brain, Life – General Practice (BBL-GP) project – a continuation of the original Body Brain Life study – evaluates the efficacy of lifestyle management programs for reducing risk profiles for dementia in adults recruited from primary care. The project compares three different interventions: a BBL-GP intervention designed to reduce the risk of cognitive decline, a Lifestyle Modification Program (LMP) designed to enhance general wellbeing and improve lifestyle to reduce risk of chronic disease, and an Active Control condition. A total of 120 adults participated in the trial.

The BBL-GP intervention group completed eight online e-learning modules designed to improve dementia literacy, knowledge of risk factors, physical activity, nutrition, health, cognitive activity, social activity and mood. This group also received tailored face-to-face physical activity and nutrition sessions. Participants in the LMP group participated in group sessions on basic nutrition, meal planning, physical activity, health conditions, motivation and goals, medications and sleep. The Active Control group received weekly emails with links to information regarding lifestyle risk factors and disease management.

Primary Outcome:

• Dementia risk as measured by the ANU-Alzheimer’s Disease Risk Index (ANU-ADRI)

Secondary Outcomes:

• Cognitive function
• Physical activity
• Depressive symptoms
• Diet quality
• Sleep quality

Outcomes were assessed immediately following the intervention, 18-weeks post-intervention, and 36-weeks post-intervention. The final follow-up at 62-weeks post-intervention is due to be completed in mid-2018. A cost evaluation of the two interventions will also be completed.

Read more about the BBL-GP protocol here.

The BBL-GP project is funded by the National Health and Medical Research Council Centre of Research Excellence in Cognitive Health.

ARC Centre of Excellence in Population Ageing Research

The ARC Centre of Excellence in Population Ageing Research (CEPAR) is a unique collaboration bringing together academia, government and industry to address one of the major social challenges of the twenty first century. Based at the University of New South Wales with nodes at the Australian National University, The University of Melbourne, The University of Sydney and The University of Western Australia, CEPAR is producing world-class research on population ageing. CEPAR includes cross-disciplinary experts drawn from actuarial science, demography, economics, epidemiology, psychology and sociology. The Centre’s diverse research program which will deliver comprehensive outcomes with the potential to secure Australia’s future as a well-informed nation with world-best policy and practice for an ageing demographic.

Professor Anstey and Professor Mike Keane lead the CEPAR research stream concerned with decision making, expectations and cognitive ageing.

This research stream aims to:

• Develop a comprehensive model of ageing and decision making including identification of typologies of decision makers
• Develop multidisciplinary paradigms and predictive models of decision making and ageing
• Develop and evaluate interventions to increase positive expectations about ageing
• Develop life-cycle models that incorporate investments in health and housing as well as cognitive limitations in ageing.

For more information on CEPAR visit the centre website.

CEPAR has been funded primarily by the Australian Research Council, with generous support from the collaborating universities and partner organisations.

NHMRC Dementia Centre for Research Collaboration

The NHMRC Dementia Centre for Research Collaboration (DCRC) was established in 2006 under the Australian Government’s Dementia Initiative.  DCRC projects are diverse and map onto the priorities of the NHMRC National Network for Dementia Research (NNIDR). A key focus is applied research on topics meaningful to people with dementia and their family carers.

There are three DCRC hubs located at UNSW, NeuRA and QUT, respectively. The three-hub framework aims to grow partnerships and strengthen ties with consumers and service providers, Dementia Training Australia and Dementia Support Australia in order to progress prevention, assessment, care and translation of knowledge into everyday practice, as well as building the next generation of dementia researchers.

The primary focus of the DCRC NeuRA hub is risk reduction and prevention including individual, community and population-based interventions targeting lifestyle risk factors for dementia.

The flagship project of the DCRC NeuRA hub is the International Research Network on Dementia Prevention (IRNDP). Founded in 2017, the IRNDP is a multinational network bringing together researchers who are working to reduce the risk of dementia across the world. For more information on the network, visit the IRNDP website, including news and updates, an evidence hub on cohort studies, an evidence synthesis on clinical trials, and information on how to join.

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

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.

International Research Network on Dementia Prevention

Globally, dementia cases are increasing at a rate of 21 per cent annually, and most of these are occurring in low to middle-income countries. With no cure for neurodegeneration or the diseases that cause dementia, there is an urgent need to link both knowledge translation and researchers more closely together in a global effort to tackle prevention more effectively.

Founded in 2017, the International Research Network on Dementia Prevention (IRNDP) is a multinational network bringing together researchers who are working to reduce the risk of dementia across the world.

IRNDP aims to:

• Increase dementia risk reduction messaging worldwide
• Develop targeted research to answer questions about the detailed impact of known and emerging risk factors in preventing dementia
• Welcome membership from researchers in both high and low or middle income countries
• Collaborate and work closely with public health stakeholders, policy makers and those who have a diagnosis of dementia and carers.

The goals of the IRNDP have particular relevance in low- to middle-income (LMIC) countries as exposure to lifestyle and clinical risk factors becomes more common as LMIC economies grow.

While there are many current overlapping public health, patient, research, policy and practice initiatives aimed at prevention or treatment of dementia, IRNDP is the first single collaborative network of researchers to focus attention on prevention that is truly global.

For further information, visit the IRNDP website, including news and updates, an evidence hub on cohort studies, an evidence synthesis on clinical trials, and information on how to join the network.

IRNDP is chaired by Professor Kaarin Anstey and is a project of the Dementia Centre for Research Collaboration funded by the NHMRC National Institute for Dementia Research (NNIDR).

The Dementia Risk Factors and Assessment (DemRisk) program

The Dementia Risk Factors and Assessment (DemRisk) program involves over ten years of research performed by the Anstey group on the identification and assessment of risk factors for Dementia.

The DemRisk program includes:

• Systematic reviews and meta-analyses of dementia risk and protective factors
• Analysis of cohort studies to identify dementia risk and protective factors
• Development of evidence-based interventions for dementia risk reduction
• Development of innovative e-learning resources to support dementia risk reduction
• Development of risk assessment tools validated for assessing individual exposure to risk factors known to be associated with an increased risk of developing dementia
• Development of guidelines (e.g. physical activity guidelines) to reduce risk of cognitive decline and dementia in collaboration with other researchers and organisations including the World Health Organisation
• Training of early career researchers with a focus on identifying and targeting dementia risk

Read Professor Kaarin Anstey and Dr Ruth Peters’ recent invited commentary on second-hand smoke as an under-recognised risk factor for cognitive decline here. You can also watch Professor Anstey’s NeuRAtalk on ageing well to reduce your risk of dementia here.