Honorary Post-Doctoral Fellow
Ying Xu holds a PhD from the University of Sydney. She is a postdoctoral fellow reporting to Dr. Ruth Peters, and a conjoint lecturer in the School of Psychology UNSW. Before migrating to Sydney, Ying was a clinician in ophthalmologic residency training. In the current position, she will use systematic review and advanced statistical approaches to exam how lifecourse high blood pressure increases the risk of cognitive decline or dementia.
High blood pressure is related to the development of cerebral small vessel disease, retinal microvascular abnormalities, eye diseases (e.g. cataract and glaucoma), reduced visual acuity, and dementia. Cerebral small vessel disease, retinal microvascular abnormalities, eye diseases and vision are also related to the risk of dementia. Moreover, socioeconomic inequalities are related to blood pressure and dementia and may consequently shape the associations between blood pressure and risk of cerebral small vessel disease, retinal microvascular abnormalities, eye diseases and dementia.
To date, there is no study investigating the indirect effects of cerebral small vessel disease, retinal microvascular abnormalities, eye diseases and vision impairment on dementia or cognitive decline and no study evaluating the influence of different socioeconomic indicators on these associations.
In the last 30 years we have learned an enormous amount about the risk factors for dementia and cognitive decline and whether they have their biggest impact in mid and/or late life. Now we are starting to extend our understanding to earlier adult life and even childhood. To do this we are synthesizing the academic evidence using systematic review and meta-analysis techniques to deliver an overview of the current evidence at younger ages. We have recently published an article bringing together the available data on the impact of high blood pressure in childhood and early adulthood on cognitive function and are now looking at other modifiable risk factors that might be present in earlier life. This is important because the more we can understand about when and how the risk factors for poorer cognitive function have their impact, the better we can target our risk reduction strategies.
This project is funded by the UNSW Ageing Futures Institute. The aim of this project is to use fundus photography as a tool to identify those with greater risk of developing cognitive decline with a view to early intervention and risk reduction. We will investigate the relationship between retinopathies and changes in brain structure. A systematic review approach will be used to summarize current evidence on the epidemiology of co-existent eye diseases and dementia/cognitive impairment.
We know that having high blood pressure increases the chance that we will develop dementia and cognitive decline as we grow older but we are still trying to understand whether using blood pressure-lowering treatments (antihypertensives) can help to prevent this. To explore the relationship between blood pressure, blood pressure lowering and cognition we will combine global data from the highest quality placebo-controlled trials of antihypertensive drugs. Working across three institutions, The George Institute for Global Health https://www.georgeinstitute.org.au/, Neuroscience Research Australia and Imperial College London https://www.imperial.ac.uk/ this project will deliver knowledge and targeted clinical recommendations for antihypertensive use to support reduction of dementia risk.
DR GAIL KENNING
Interdisciplinary Fellow Ageing Futures Institute
: 02 8936 0598
Epilepsy influences the ability to drive. We undertook a systematic review to determine the prevalence of driving or holding a driver's license among people with seizures, the prevalence of traffic accidents among those who drive, and factors that may explain heterogeneity in these point estimates. There is considerable variation in the prevalence of driving after a diagnosis of epilepsy and in reported motor vehicle accidents. Further efforts are required to better understand the impact of epilepsy, and epilepsy surgery, on driving and road safety, especially where driving continues in violation of restrictions. Policy changes are needed to encourage the introduction of available and affordable alternatives for driving, for example, developing public transport networks, and promoting subsidy schemes to encourage use of public transport, taxis, Uber, and Lyft, among people experiencing seizures.
To determine the patterns and predictors of disability over the first 12 months after a diagnosis of epilepsy. Most people report problems with emotional health after a diagnosis of epilepsy but many recover over the next 12 months. Services addressing the social and psychological impact of diagnosis may be needed to improve outcome.