Professor G A (Tony) Broe AM

PUBLICATIONS

Use of tricyclic antidepressants and other anticholinergic medicines by older Aboriginal Australians: association with negative health outcomes.

Mate K, Kerr K, Priestley A, Weaver N, Broe GA, Daylight G, Draper B, Cumming R, Robinson-Kingi H, Delbaere K, Radford K

Clinically significant ACB was common in older Aboriginal Australians and was largely attributable to inappropriate use of tricyclic antidepressants. Greater awareness of medication-related risk factors among both health care professionals and Aboriginal communities can play an important role in improving health and quality of life outcomes.

Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians.

Radford K, Lavrencic LM, Delbaere K, Draper B, Cumming R, Daylight G, Mack HA, Chalkley S, Bennett H, Garvey G, Hill TY, Lasschuit D, Broe GA

Development and initial validation of the Retrospective Indigenous Childhood Enrichment scale (RICE).

Minogue C, Delbaere K, Radford K, Broe T, Forder WS, Lah S

The RICE is, to our knowledge, the first standardized measure that assesses the level of childhood environmental stimulation in older Aboriginal Australians. This could provide an important supplementary measure, in addition to formal education, to investigate cognitive reserve and dementia risk in this population and enhance understanding of the links between childhood experiences and late-life cognitive decline.

Development and initial validation of the Retrospective Indigenous Childhood Enrichment scale (RICE).

Minogue C, Delbaere K, Radford K, Broe T, Forder WS, Lah S

ABSTRACTBackground:Years of education is the most commonly used proxy measure of cognitive reserve. Other forms of cognitive stimulation in childhood may provide similar protection against cognitive decline, particularly in Indigenous groups, where education may have been lacking in quality or quantity. The Retrospective Indigenous Childhood Enrichment (RICE) scale was developed to measure non-school-based activities and environmental stimulation during childhood that are likely to have enhanced cognitive reserve. The aim of the study was to assess the validity and reliability of the RICE scale with a group of older Aboriginal Australians.

Risk factors for falls among older Aboriginal and Torres Strait Islander people in urban and regional communities.

Lukaszyk C, Radford K, Delbaere K, Ivers R, Rogers K, Sherrington C, Tiedemann A, Coombes J, Daylight G, Draper B, Broe T

To examine associations between fall risk factors identified previously in other populations and falls among Aboriginal people aged 60 years and older, living in New South Wales, Australia. Falls were experienced by one-quarter of study participants. Fall risk factors identified for older Aboriginal people appear to be similar to those identified in the general population. Understanding of fall risk factors may assist with the development of appropriate and effective community-led fall prevention programs.

Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians.

Radford K, Delbaere K, Draper B, Mack HA, Daylight G, Cumming R, Chalkley S, Minogue C, Broe GA

High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

Radford K, Mack HA, Draper B, Chalkley S, Delbaere K, Daylight G, Cumming RG, Bennett H, Broe GA

The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.

Prevalence of dementia in urban and regional Aboriginal Australians.

Radford K, Mack HA, Draper B, Chalkley S, Daylight G, Cumming R, Bennett H, Delbaere K, Broe GA

Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

Radford K, Mack HA, Robertson H, Draper B, Chalkley S, Daylight G, Cumming R, Bennett H, Jackson Pulver L, Broe GA

This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Cardiovascular variability in Parkinson's disease and extrapyramidal motor slowing.

Brown R, Duma S, Piguet O, Broe GA, Macefield VG

Parkinson's disease (PD) is a degenerative neurological condition, associated with cardiovascular dysfunction. Many studies have utilised heart rate variability (HRV) to assess the autonomic nervous system in PD, but blood pressure variability (BPV) has received less attention. The purpose of the present study was to compare HRV and BPV between participants with established PD, extrapyramidal motor slowing (EPMS) (not reaching clinical criteria for PD), older healthy controls (OHC), and young healthy controls (YHC), in order to ascertain whether either of these measures can be used as an early marker of non-motor symptoms in PD.

Association of SORL1 gene variants with hippocampal and cerebral atrophy and Alzheimer's disease.

Assareh AA, Piguet O, Lye TC, Mather KA, Broe GA, Schofield PR, Sachdev PS, Kwok JB

To investigate the relationship between SORL1 gene variants with ADrelated brain morphologies and AD, testing for sex-specific effects. The results provide evidence that the association of polymophisms in the sortilin-related receptor gene (SORL1) with AD and its MRI biomarkers of brain and hippocampal atrophy are moderated by sex.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

Radford K, Mack HA, Robertson H, Draper B, Chalkley S, Daylight G, Cumming R, Bennett H, Jackson Pulver L, Broe GA

This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

Radford K, Mack HA, Draper B, Chalkley S, Delbaere K, Daylight G, Cumming RG, Bennett H, Broe GA

The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.

Prevalence of dementia in urban and regional Aboriginal Australians.

Radford K, Mack HA, Draper B, Chalkley S, Daylight G, Cumming R, Bennett H, Delbaere K, Broe GA

Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia.

Clinical practice guidelines for dementia in Australia.

Laver K, Cumming RG, Dyer SM, Agar MR, Anstey KJ, Beattie E, Brodaty H, Broe T, Clemson L, Crotty M, Dietz M, Draper BM, Flicker L, Friel M, Heuzenroeder LM, Koch S, Kurrle S, Nay R, Pond CD, Thompson J, Santalucia Y, Whitehead C, Yates MW

About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care.