1) Prevention of cognitive decline and dementia - Maintain Your Brain, a randomised controlled trial aiming for over 4000 persons is underway; (2) Cognitive health and ageing: What predicts cognitive decline in older people? We have been following a population based sample of >1037 people aged 79-90 when recruited in 2006/07 in detail every two years in order to discover risk and protective factors for cognitive decline and dementia. (3) Dementia, particularly Alzheimer's disease: a) how to improve its detection and management by GPs; b) the effects on family carers and on how best to help them; c) ways to improve quality of life in people with dementia and d) reduce behavioural and psychological symptoms of dementia (BPSD) 4) Nursing homes: In Australia the 180,000 nursing home beds cost >$4b p.a. Over two thirds of nursing home residents have dementia and they exhibit high rates of BPSD which are distressing to themselves, their families and the staff. We are interested in ways to reduce BPSD and have been trialling different models of care and methods of deprescribing antipsychotics in nursing homes.
Broad Research Areas:
Ageing, Psychiatry, Gerontology - Geriatrics, Neurodegenerative Diseases
MBBS (Syd), MD (UNSW), DSc (UNSW), FRACP, FRANZCP, FAHMS
Society Memberships & Professional Activities:
Faculty of Psychiatry of Old Age, Royal Australian and New Zealand College of Psychiatrists, Royal Australasian College of Physicians, International Psychogeriatric Association, Alzheimer's Association, NSW, Alzheimer's Association, Australia, Alzheimer's Disease International, Australian Association of Gerontology
Specific Research Keywords:
Alzheimer's Disease, Dementia, Depression, Nursing Homes, Behavioural Symptoms, Prevention
Over 500 papers published in refereed journals
KEY CONTRIBUTIONS TO RESEARCH TRANSLATION
GP diagnosis and management of dementia: 1) I developed GPCOG, a brief screening tool designed specifically for primary care, now translated into 22 languages, available on line, adopted in several countries. 2) Program to improve GP diagnosis and management – face-to-face to 1000 GPs, e-learning modules to 2000 GPs, key articles in GP magazines
Management of Behavioural and Psychological Symptoms of dementia (BPSD): 1) Conceptualised model of how to organise services, adopted by Commonwealth and state; 2) led review of guide to management of BPSD - print, online and App versions for clinicians, for carers
Improved quality of nursing home (NH) care: RCTs of a) humour therapy which demonstrated benefits & spawned Arts Health Institute now operating in >100 Nursing homes; b) Demonstrated that Person Centred Care reduced agitation with cost benefit, helped build case for use generally
Carers of people with dementia: first study to demonstrate reduced rate of NH admission following carer training program; emulated internationally.
Dangers of antipsychotics: first study to find increased risk of stroke with antipsychotics, led to finding higher mortality, black box warnings worldwide. Current study of deprescribing antipsychotics in nursing homes, widely quoted in media
Public forums: annual forum on healthy ageing and multiple public forums about research. Multiple media appearances, ≈monthly radio, TV and print.