���������¼�

��

Current research projects include:

• A Dementia Australia funded project on self-harm in people with dementia. Dementia and deliberate self-harm represent substantial public health burdens in the older population. However, the health outcomes, referral pathways and predictors of death are not well understood. This project uses linked population data to characterise the health profiles, health service use and predictors of death including from suicide in individuals with dementia who self-harmed to unveil pathways into suicide and to inform targeted treatments and intervention strategies to improve health care. An advocate advisory group is involved in all steps of the project to inform data analysis, interpretation of findings and development of targeted resources.��
• The development of a computerised, performance-based tool to measure complex activities of daily living. Maintaining intact functional ability is an indicator of successful ageing. Instrumental activities of daily living (IADL) are complex everyday functional skills necessary for independent living, like managing medications, shopping, or handling finances. The distinction between dementia and mild cognitive impairment relies upon the evaluation of independence in IADL. Given the increasing ageing population, it is essential to have time- and resource-efficient tools to assess IADL in clinical practice and in research studies. Self- and informant reports are prone to bias and clinician-based performance tests are limited by long administration times, restricted access, or inadequate validation. We developed and validated a new computerised diagnostic tool (Computerised Sydney Test of Activities of Daily Living in Memory Disorders; C-STAM) to assess functional ability that can be administered remotely to increase accessibility. The C-STAM realistically simulates everyday activities to assess functional performance. The tool will be freely available for clinical use and in research once validated.��The C-STAM was developed by a multidisciplinary team of psychologists, old age psychiatrists, occupational therapists, and computer scientists. An international Delphi study was conducted to select and refine suitable tasks. An advisory group of older people with and without cognitive impairment and caregivers has an active role in shaping the C-STAM. A pilot study including 20 people aged 60 and above with normal cognition and 15 people with MCI or dementia assessed feasibility and user-experience. A larger validation study is currently underway.��The C-STAM will facilitate early diagnosis of dementia. Automated data exporting and reporting will be useful for clinical referrals and facilitate interpretation and communication of results across different clinical and research settings. Results will be used to inform service development to better meet the needs of people with dementia to gain access to appropriate assessments of functional performance.
• Various projects on social determinants of health in ageing and dementia.��Social determinants of health can be broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources. Social Determinants of Health have a major impact on health, well-being, and quality of life as we age. As much as 40% of the risk for dementia can be explained by modifiable risk factors, and many of these are in the social context. Social isolation for example is noted to increase the risk of dementia significantly. The trajectory of dementia, including the assessment, treatment and care, life expectancy and quality of life, is very different based on socioeconomic status and ethnocultural backgrounds. Living in a disadvantaged and socially fragmented neighbourhood reduces the lifespan and leads to more chronic ill-health in late life, to brain abnormalities such as reduced brain volume and to greater dementia risk.

��