<p>A KICA-Dep cut-point of 7/8 (non-case/case) was associated with sensitivity of 78%, spec... more <p>A KICA-Dep cut-point of 7/8 (non-case/case) was associated with sensitivity of 78%, specificity of 82%, positive predictive value of 39% and negative predictive value of 96%. Sensitivity and specificity values for other cut-points were 89% and 63% for 4/5, 89% and 71% for 5/6, 78% and 80% for 6/7, 72% and 90% for 8/9, and 67% and 94% for 9/10.</p
The Australian Journal of Hospital Pharmacy, Oct 1, 1999
As we approach the new millennium, greater emphasis will need to be placed on preventive strategi... more As we approach the new millennium, greater emphasis will need to be placed on preventive strategies that improve the quality oflife in people who survive to old age. This review focuses on medications that may be beneficial in the primary prevention of a number of common conditions that affect older people, where evidence already exists of significant benefit. These common diseases include infectious diseases, cardiovascular and cerebrovascular disease, and osteoporosis.
Australian and New Zealand Journal of Medicine, Aug 1, 1989
With the growing advent of rehabilitation units designed particularly for the needs of the stroke... more With the growing advent of rehabilitation units designed particularly for the needs of the stroke patient, a need has arisen for the evaluation of these units. In particular, several questions have to be asked
Australian and New Zealand journal of public health, Jan 13, 2016
To describe the prevalence of falls and associated risk factors in older Indigenous Australians, ... more To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding...
A cross-sectional survey of all patients reviewed by the Aged Care Assessment Team (ACAT) service... more A cross-sectional survey of all patients reviewed by the Aged Care Assessment Team (ACAT) service and memory clinics between January 1 and December 31 2012. The ACAT catchment included an estimated 14 325 people over the age of 70. To determine the numbers and outcomes of assessments for cognitive problems by the ACAT and hospital memory clinics for patients within a single ACAT catchment area. Data collected included patient demographics, diagnoses, referral and pharmacological treatment. Flow of referrals to the services that diagnose and manage dementia, and the number of incident dementia cases diagnosed in 2012 were determined. The ACAT service assessed 1005 patients from the catchment, of which 241 patients already had a diagnosis of dementia. When compared to the estimated dementia prevalence in Australia, 19% of prevalent dementia cases (n = 1260) within the catchment were reviewed by the ACAT. The two memory clinics saw a combined 186 new referrals (91 and 95 respectively) ...
IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout l... more IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout life. We showed previously that the production of IGF-1 and IGF-2 requires interaction with the chaperone glucose-regulated protein 94 (GRP94) and that the amount of secreted IGFs is proportional to the GRP94 activity. Therefore, we tested the hypothesis that functional polymorphisms of human GRP94 affect IGF production and thereby human health. We describe a hypomorphic variant of human GRP94, P300L, whose heterozygous carriers have 9% lower circulating IGF-1 concentration. P300L was found first in a child with primary IGF deficiency and was later shown to be a noncommon single-nucleotide polymorphism with frequencies of 1%–4% in various populations. When tested in the grp94−/− cell-based complementation assay, P300L supported only approximately 58% of IGF secretion relative to wild-type GRP94. Furthermore, recombinant P300L showed impaired nucleotide binding activity. These in vitro dat...
Falls are the most frequent adverse event reported in hospitals. Patient and staff education deli... more Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators' perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. A qualitative exploratory study. Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a c...
Deficiencies of vitamins B12, B3 and folate, abnormalities of cortisol metabolism, Wilson's d... more Deficiencies of vitamins B12, B3 and folate, abnormalities of cortisol metabolism, Wilson's disease, renal and hepatic failure, chronic obstructive pulmonary disease, hypo- and hypernatremia, thyroid and parathyroid dysfunction, hyper- and hypoglycemia and Marchiafava–Bignani disease are metabolic and endocrinological abnormalities that may be associated with cognitive impairment. In some cases these abnormalities may be causative of impaired cognition and in other situations merely associated with cognitive impairment. The existence of these conditions provides some justification for routine investigations commonly performed on patients presenting with possible early dementia.
Advancing age is associated with increased cancer incidence, but the role of sex hormones as risk... more Advancing age is associated with increased cancer incidence, but the role of sex hormones as risk predictors for common cancers in older men remains uncertain. This study was performed to assess associations of testosterone (T), dihydrotestosterone (DHT) and estradiol (E2), with incident prostate, lung and colorectal cancer in community-dwelling older men. Plasma T, DHT and E2 were assayed using liquid chromatography-mass spectrometry between 2001 and 2004 in 3690 men. Cancer outcomes until 20 June 2013 were ascertained using data linkage. Analyses were performed using proportional hazards competing-risks models, and adjustments were made for potential confounding factors including smoking status. Results are expressed as subhazard ratios (SHR). There were 348, 107 and 137 cases of prostate, lung and colorectal cancers respectively during a median of 9.1-year follow-up. Mean T was comparable in current and non-smokers, whilst mean DHT was lower in ex- and current smokers compared to...
The British journal of psychiatry : the journal of mental science, Aug 1, 2016
Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a com... more Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking. To investigate the 13-year risk of dementia and death in older adults with bipolar disorder. Cohort study of 37 768 men aged 65-85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest. Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80-2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28-1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system. Bipolar disorder in later life is associated ...
<p>A KICA-Dep cut-point of 7/8 (non-case/case) was associated with sensitivity of 78%, spec... more <p>A KICA-Dep cut-point of 7/8 (non-case/case) was associated with sensitivity of 78%, specificity of 82%, positive predictive value of 39% and negative predictive value of 96%. Sensitivity and specificity values for other cut-points were 89% and 63% for 4/5, 89% and 71% for 5/6, 78% and 80% for 6/7, 72% and 90% for 8/9, and 67% and 94% for 9/10.</p
The Australian Journal of Hospital Pharmacy, Oct 1, 1999
As we approach the new millennium, greater emphasis will need to be placed on preventive strategi... more As we approach the new millennium, greater emphasis will need to be placed on preventive strategies that improve the quality oflife in people who survive to old age. This review focuses on medications that may be beneficial in the primary prevention of a number of common conditions that affect older people, where evidence already exists of significant benefit. These common diseases include infectious diseases, cardiovascular and cerebrovascular disease, and osteoporosis.
Australian and New Zealand Journal of Medicine, Aug 1, 1989
With the growing advent of rehabilitation units designed particularly for the needs of the stroke... more With the growing advent of rehabilitation units designed particularly for the needs of the stroke patient, a need has arisen for the evaluation of these units. In particular, several questions have to be asked
Australian and New Zealand journal of public health, Jan 13, 2016
To describe the prevalence of falls and associated risk factors in older Indigenous Australians, ... more To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding...
A cross-sectional survey of all patients reviewed by the Aged Care Assessment Team (ACAT) service... more A cross-sectional survey of all patients reviewed by the Aged Care Assessment Team (ACAT) service and memory clinics between January 1 and December 31 2012. The ACAT catchment included an estimated 14 325 people over the age of 70. To determine the numbers and outcomes of assessments for cognitive problems by the ACAT and hospital memory clinics for patients within a single ACAT catchment area. Data collected included patient demographics, diagnoses, referral and pharmacological treatment. Flow of referrals to the services that diagnose and manage dementia, and the number of incident dementia cases diagnosed in 2012 were determined. The ACAT service assessed 1005 patients from the catchment, of which 241 patients already had a diagnosis of dementia. When compared to the estimated dementia prevalence in Australia, 19% of prevalent dementia cases (n = 1260) within the catchment were reviewed by the ACAT. The two memory clinics saw a combined 186 new referrals (91 and 95 respectively) ...
IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout l... more IGFs are critical for normal intrauterine and childhood growth and sustaining health throughout life. We showed previously that the production of IGF-1 and IGF-2 requires interaction with the chaperone glucose-regulated protein 94 (GRP94) and that the amount of secreted IGFs is proportional to the GRP94 activity. Therefore, we tested the hypothesis that functional polymorphisms of human GRP94 affect IGF production and thereby human health. We describe a hypomorphic variant of human GRP94, P300L, whose heterozygous carriers have 9% lower circulating IGF-1 concentration. P300L was found first in a child with primary IGF deficiency and was later shown to be a noncommon single-nucleotide polymorphism with frequencies of 1%–4% in various populations. When tested in the grp94−/− cell-based complementation assay, P300L supported only approximately 58% of IGF secretion relative to wild-type GRP94. Furthermore, recombinant P300L showed impaired nucleotide binding activity. These in vitro dat...
Falls are the most frequent adverse event reported in hospitals. Patient and staff education deli... more Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators' perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. A qualitative exploratory study. Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a c...
Deficiencies of vitamins B12, B3 and folate, abnormalities of cortisol metabolism, Wilson's d... more Deficiencies of vitamins B12, B3 and folate, abnormalities of cortisol metabolism, Wilson's disease, renal and hepatic failure, chronic obstructive pulmonary disease, hypo- and hypernatremia, thyroid and parathyroid dysfunction, hyper- and hypoglycemia and Marchiafava–Bignani disease are metabolic and endocrinological abnormalities that may be associated with cognitive impairment. In some cases these abnormalities may be causative of impaired cognition and in other situations merely associated with cognitive impairment. The existence of these conditions provides some justification for routine investigations commonly performed on patients presenting with possible early dementia.
Advancing age is associated with increased cancer incidence, but the role of sex hormones as risk... more Advancing age is associated with increased cancer incidence, but the role of sex hormones as risk predictors for common cancers in older men remains uncertain. This study was performed to assess associations of testosterone (T), dihydrotestosterone (DHT) and estradiol (E2), with incident prostate, lung and colorectal cancer in community-dwelling older men. Plasma T, DHT and E2 were assayed using liquid chromatography-mass spectrometry between 2001 and 2004 in 3690 men. Cancer outcomes until 20 June 2013 were ascertained using data linkage. Analyses were performed using proportional hazards competing-risks models, and adjustments were made for potential confounding factors including smoking status. Results are expressed as subhazard ratios (SHR). There were 348, 107 and 137 cases of prostate, lung and colorectal cancers respectively during a median of 9.1-year follow-up. Mean T was comparable in current and non-smokers, whilst mean DHT was lower in ex- and current smokers compared to...
The British journal of psychiatry : the journal of mental science, Aug 1, 2016
Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a com... more Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking. To investigate the 13-year risk of dementia and death in older adults with bipolar disorder. Cohort study of 37 768 men aged 65-85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest. Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80-2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28-1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system. Bipolar disorder in later life is associated ...
Decline in linguistic function has been associated with decline in cognitive function in previous... more Decline in linguistic function has been associated with decline in cognitive function in previous research. This research investigated the informativeness of written language samples of Australian men from the Health in Men's Study (HIMS) aged from 76 to 93 years using the Computerised Propositional Idea Density Rater (CPIDR 5.1). In total, 60 255 words in 1147 comments were analysed using a linear-mixed model for statistical analysis. Results indicated no relationship with education level (p = 0.79). Participants for whom English was not their first learnt language showed Propositional Idea Density (PD) scores slightly lower (0.018 per 1 word). Mean PD per 1 word for those for whom English was their first language for comments below 60 words was 0.494 and above 60 words 0.526. Text length was found to have an effect (p=<0.0001). The mean PD was higher than previously reported for men and lower than previously reported for a similar cohort for Australian women.
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