Brian Draper

Brian Draper
UNSW Sydney | UNSW · School of Psychiatry

About

430
Publications
70,034
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
11,401
Citations
Citations since 2017
143 Research Items
6850 Citations
201720182019202020212022202302004006008001,0001,2001,400
201720182019202020212022202302004006008001,0001,2001,400
201720182019202020212022202302004006008001,0001,2001,400
201720182019202020212022202302004006008001,0001,2001,400

Publications

Publications (430)
Article
Full-text available
Objectives To examine the sociodemographic and diagnostic factors associated with a discharge from hospital to residential aged care (RAC) for younger people (aged 15–64 years) with neuropsychiatric disorders. Design An exploratory case–control study using a historic cohort of people with neuropsychiatric disorders. Cases were people transferred t...
Article
Background : The majority of suicide deaths occur in men. Men are also less likely to receive formal mental health services prior to dying by suicide compared to women. Identifying correlates of non-receipt of services among men at risk of suicide may aid the development of tailored interventions and service pathways. Methods : A total of 415 Aust...
Article
Access to a “gold‐standard” in‐person neuropsychological assessment to detect cognitive decline in older adults using paper‐and‐pencil (PnP) tests is limited. Computerized neuropsychological assessments (CNAs) potentially provide lower cost, scalable, accessible alternatives but critical psychometric data on the validity, reliability and user‐exper...
Article
Objectives: Cognitive screening via telehealth is increasingly employed, particularly during the COVID-19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26-point telephone adaptation of the Mini-Mental State Examination (tMMSE) in...
Article
Objective: To review studies reporting on the effectiveness of psychiatry service delivery for older people and people with dementia in hospital and residential aged care. Methods: A systematic search of four databases was conducted to obtain peer-reviewed literature reporting original research published since June 2004 evaluating a psychiatry s...
Article
Post‐diagnosis young onset dementia (YOD) care is often fragmented, with services delivered across aged care, healthcare, and social care sectors. The aim of this project was to test the feasibility and potential effectiveness of a learning collaborative implementation strategy for improving the cross‐sector integration of care for people with YOD...
Article
Full-text available
Objective: To ascertain palliative physicians’ and consultation-liaison psychiatrists’ perceptions of depression care processes in patients with very poor prognoses, exploring key challenges and postulating solutions. Methods: A qualitative focus group study involving three 1-h online focus groups (2 palliative medicine and 1 psychiatry) were condu...
Article
Full-text available
Objective Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how...
Article
Emergency Department (ED) is an important site for assessing people presenting with self-harm or suicidal behaviors. Digital mental health services (DMHS) offer evidence-based interventions for mental health issues, but are often under-utilised, and information about them is rarely provided in ED. This feasibility study explored whether offering in...
Article
Full-text available
Background Increasing both the frequency and quality of social interactions within treatments for anxiety and depressive disorders in older adults may improve their mental health outcomes and quality of life. This study aims to evaluate the clinical efficacy and cost utility of an enhanced cognitive behavioural therapy (CBT) plus social participati...
Article
BACKGROUND AND OBJECTIVES Aboriginal Australians are disproportionately affected by dementia, with incidence in remote populations approximately double non-Indigenous populations. This study aimed to identify dementia incidence and risk factors in Aboriginal Australians residing in urban areas, which are currently unknown. METHODS A population-bas...
Article
Full-text available
Background Depression is prevalent in people with very poor prognoses (days to weeks). Clinical practices and perceptions of palliative physicians towards depression care have not been characterised in this setting. The objective of this study was to characterise current palliative clinicians’ reported practices and perceptions in depression screen...
Article
Background The majority of people who die by suicide are unknown to formal mental health services. The current review identified predictors of non-receipt of mental health services among individuals experiencing suicidal thoughts or behaviours. Such data provides insight into the needs and preferences of these individuals and inform improvements to...
Article
Full-text available
Background People with young onset dementia (YOD) have unique needs and experiences, requiring care and support that is timely, appropriate and accessible. This relies on health professionals possessing sufficient knowledge about YOD. This study aims to establish a consensus among YOD experts about the information that is essential for health profe...
Article
Background: Understanding how the age of dementia symptom onset affects the longitudinal course of dementia can assist with prognosis and care planning. Objective: To synthesize evidence regarding the relationship of age of symptom onset with the longitudinal course of sporadic Alzheimer's disease (AD), vascular dementia (VaD), and frontotempora...
Article
Hip fracture trajectories have not been examined for older adults in aged care or living in the community. Trajectories of health care use were defined by distinct predictive factors. These results can inform the development of targeted strategies to reduce health service use following hip fracture.Objective To examine hospital service use trajecto...
Article
Behavioural and Psychological Symptoms of Dementia (BPSD) and Neuropsychiatric Symptoms (NPS, in people without dementia) have not been examined in the Aboriginal Australian population despite high rates of dementia and cognitive decline. BPSD/NPS contribute significantly to poorer wellbeing, institutionalisation, and adverse outcomes. This study a...
Article
Cognitive assessment via telehealth is being increasingly employed, particularly in the context of the COVID‐19 pandemic. Widespread access to video call software has improved the availability and quality of telehealth services however inequity of access to such technologies remains for some communities, especially when restricted to home‐based tel...
Article
Dementia rates in Aboriginal Australians are 3‐5 times higher than in the broader Australian population, and among the highest rates reported globally. Existing evidence suggests that dementia types are similar to those found in non‐Indigenous Australian populations. Neuroimaging, however, has not been previously available in any study of dementia...
Article
Objective To provide a biography of G Vernon Davies who took up a career in old age psychiatry in 1955 at the age of 67 at Mont Park Hospital in an era when there few psychiatrists working in the field. Conclusion In the 1950s and 1960s, Vernon Davies worked as an old age psychiatrist and published papers containing sensible practical advice infor...
Article
Summary of recommendations and levels of evidence Chapter 2: Screening and assessment for unhealthy alcohol use Screening • Screening for unhealthy alcohol use and appropriate interventions should be implemented in general practice (Level A), hospitals (Level B), emergency departments and community health and welfare settings (Level C). • Quantit...
Article
Background: Medical practitioners experience high levels of mental disorders but may be reluctant to seek care. Aims: To determine medical practitioner attitudes towards other doctors with anxiety/depression, barriers to seeking mental healthcare, treatments received for depression and the effects of age. Methods: Data from the National Mental...
Article
Older people had high admission rates to hospitals for the insane in New South Wales, Australia, in the second half of the nineteenth century. The medical casebooks of 226 patients aged 60 years and over admitted to two hospitals for the insane between 1849 and 1905 were examined. Aggressive behaviour (35.4%), suicidal behaviour (23.9%), fears of h...
Article
Background: Recent studies cast doubt on the net effect of antipsychotics for delirium. Aim: To investigate the influence of these studies and other factors on clinicians' delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework. Design: Australia-wide online survey of rel...
Article
Full-text available
Introduction Major depressive disorder (MDD) in people with advanced life-limiting illnesses can have significant impact on the quality-of-life of those affected. The management of MDD in the palliative care setting can be challenging as typical antidepressants may not work in time nor be tolerated due to coexisting organ dysfunctions, symptom burd...
Article
Objective Post-diagnosis service delivery for young-onset dementia (with onset prior to 65 years) recently moved to the disability system in an attempt to address systemic barriers to best practice in aged care. The objective of this study was to examine experiences and satisfaction with disability services so far among people with young-onset deme...
Article
Objectives Indigenous Australians experience higher levels of psychological distress compared to the general population. Physical activity is a culturally acceptable approach, associated with reduction of depressive symptoms. The protective properties of physical activity for depressive symptoms are yet to be evaluated in older Indigenous Australia...
Article
Background With expected increases in the number of older adults worldwide, the delivery of stepped psychological care for depression and anxiety in older populations may improve both treatment and allocative efficiency for individual patients and the health system. Design A multisite pragmatic randomised controlled trial evaluating the clinical a...
Article
Objective To determine if severe perivascular space (PVS) dilation is associated with longitudinal cognitive decline and incident dementia over four and eight years respectively, we analyzed data from a prospective cohort study. Methods 414 community dwelling older adults aged 72-92 were assessed at baseline and biennially for up to eight years, w...
Chapter
Despite the general decline in the number of suicides in the world, suicide rates among older adults remain the highest in most countries. Unfortunately, suicide in late life also remains a somewhat neglected topic, and ageistic visions of age-related problems often make suicidal behaviour a justifiable choice. This chapter examines the most import...
Article
Addressing midlife hearing loss could prevent up to 9% of new cases of dementia, the highest of any potentially modifiable risk factor identified in the 2017 commissioned report in The Lancet. In Australia, hearing loss is the second-most common chronic health condition in older people, affecting 74% of people aged over 70. Estimates indicate that...
Article
Introduction Fall injuries are one of the leading causes of hospitalisation for adults aged ≥65 years. Distinguishing key characteristics of older adults who are either living in aged care or in the community who have multiple hospital readmissions after a fall injury may inform targeted approaches to the prevention of hospital readmissions. Objec...
Article
The latent continuous construct delta (δ) has been proposed as a novel approach to model dementia phenotype using structural equation modelling that reflects the “cognitive correlates of functional status” (Royall & Palmer, 2012. J Neuropsychiatry Clin Neurosci; Royall et al., 2012. J Alzheimers Dis). This δ factor has been demonstrated to be assoc...
Article
People with dementia (PwD) can face barriers when trying to access care after a diagnosis, particularly in young‐onset dementia (YOD). Little is known however about the effects of ethnicity on access to anti‐dementia medication and how these differ between age groups. The aim of this study was to analyse national data on variations in the current u...
Article
Computer‐administered neuropsychological assessment batteries (CNAs) have the potential to allow large‐scale cognitive screening and monitoring, increasing older adults’ access to cognitive assessment, and earlier diagnosis of and intervention for cognitive impairment. There is, however, little research on whether experience with and attitudes to c...
Article
Computers and related technologies are increasingly used for cognitive assessment. However, few studies have considered older adults’ experience using computerized neuropsychological assessment (CNA), or individual characteristics that may influence acceptability and emotional responses to computerized tests. 205 community‐dwelling native English s...
Article
Aboriginal Australians are disproportionately affected by dementia compared to other Australians and many populations globally. Dementia incidence and risk factors have not been identified for Aboriginal Australians living in urban or regional areas (comprising ∼80% of First Nations Australians). There is also a pressing need in this population for...
Article
Objectives To determine preferences for health and aged care services in Aboriginal and Torres Strait Islander Australians and explore related factors. Methods Mixed‐method, cross‐sectional study including 336 Aboriginal and Torres Strait Islander people aged 60 years and older from regional and urban areas. Results Exclusive preference for Abori...
Article
Background While midlife hypertension is deleterious, late-life hypertension has been associated with better cognitive outcomes in several studies. Many questions remain, including the relative benefit or harm of a blood pressure (BP) target and antihypertensive therapy of <120 in very old individuals. Methods The Sydney Memory and Aging Study (n...
Article
Background: Aboriginal and Torres Strait Islander Australians have a relatively high prevalence of multimorbidity requiring treatment with medications. This study examines medication use and anticholinergic burden (ACB) among a cohort of older Aboriginal and Torres Strait Island people. Method: This cross-sectional study involving five Aborigina...
Article
Full-text available
Objective: Type 2 diabetes (diabetes) is characterized by accelerated cognitive decline and higher dementia risk. Controversy exists regarding the impact of metformin, which is associated with both increased and decreased dementia rates. The objective of this study was to determine the association of metformin use with incident dementia and cognit...
Article
Full-text available
Objective Most of the published data on the psychological health of physicians has focused on the youngest members of the profession. The aims of this analysis were to determine how psychological morbidity changes across the career cycle. Methods We report data from the cross-sectional National Mental Health Survey of Doctors and Medical Students,...
Article
Objectives To examine the role of frailty in risk of re‐hospitalisation and mortality for aged care residents following a fall injury hospitalisation. Methods Retrospective analysis of linked hospitalisation and aged care data of adults aged ≥65 years residing in aged care. A semi‐competing risk analysis examined risk of hospital readmission. Res...
Article
Background: In Australia, informal caregivers (family, friends and neighbours) play a crucial role in supporting people with dementia to remain at home. Within the community aged care policy, informal caregivers are acknowledged as assisting with managing care. However, they usually receive very limited dementia care education and training to supp...
Article
Full-text available
Introduction: Aboriginal Australians have among the highest rates of dementia worldwide, yet no study has investigated the subtypes, risk factors, or longer term outcomes of mild cognitive impairment (MCI) in this population. Methods: A total of 336 community-dwelling Aboriginal Australians aged ≥60 years participated in a longitudinal study, co...
Article
Background In international studies, cognitive impairment is a common but underdetected issue in dialysis patients. Chronic Kidney Disease (CKD) shares risk factors with and is an independent risk factor for cognitive impairment. There is a lack of Australian data of cognitive impairment in this at‐risk population. This has implications on service...
Article
Context Currently, systematic evidence of prevalence of clinically significant depressive symptoms in people with extremely short prognoses is not available to inform its global burden, assessment, and management. Objectives To determine the prevalence of clinically significant depressive symptoms in people with advanced life-limiting illnesses an...
Article
Objectives People with dementia can face barriers when trying to access care after a diagnosis, particularly in young-onset dementia (YOD). Little is known about the effects of ethnicity on the use of anti-dementia medication and variations between age groups. The aim of this study was to analyze national data on variations in the uptake of anti-de...
Article
Full-text available
Subjective Cognitive Complaints (SCCs) may represent one of the earliest stages of preclinical dementia. The objective of the present study was to extend previous work by our group to examine the relationship between participant-reported and informant-reported memory and non-memory SCCs, cognitive decline and incident dementia, over a six-year peri...
Conference Paper
Full-text available
Background Metformin use in diabetes has been associated with both increased and decreased dementia rates in observational studies of people with diabetes. Objective: To examine changes in global cognition and specific cognitive domains over 6 years in older adults with diabetes treated with metformin, compared to other glucose lowering medications...
Article
Full-text available
Covid-19: The implications for suicide in older adults - Anne Pamela Frances Wand, Bao-Liang Zhong, Helen Fung Kum Chiu, Brian Draper, Diego De Leo
Article
Full-text available
Background: Despite increasing investment in suicide prevention, Australian suicide rates have increased steadily in the past decade. In response to growing evidence for multicomponent intervention models for reducing suicide, the LifeSpan model has been developed as the first multicomponent, evidence-based, system-wide approach to suicide prevent...
Article
Psychological impact of lifetime trauma in older adults - Volume 32 Issue 4 - Brian Draper
Article
Objective: The aims were to estimate the prevalence of CNCP in suicide decedents, and compare sociodemographic and clinical characteristics of people who die by suicide (i) with and without a history of CNCP and (ii) among decedents with CNCP who are younger (<65 years) and older (65 + years). Method: We examined all closed cases of intentional...
Article
Introduction: Certain cognitive and physical conditions have been associated with increased risk of injury, particularly risk of vehicle crashes among older car drivers. This study aims to examine the association of seven select medical conditions among hospitalised road users compared to other hospitalised injuries, and to estimate the hospitalise...
Article
Full-text available
Objectives Use of antipsychotic drugs in long-term aged care (LTC) is prevalent and commonly exceeds the recommended duration, but contributors to this problem are not well understood. The objective of this study is to provide a snapshot of the features of and contributors to prolonged use of antipsychotic medications (>12 weeks) among a sample of...
Article
Clinicians may lack knowledge and confidence regarding self-harm in older adults and hold attitudes that interfere with delivering effective care. A 1-hour educational intervention for hospital-based clinicians and general practitioners (GPs) was developed, delivered, and evaluated. Of 119 multidisciplinary clinicians working in aged care and menta...
Article
This study examined hip fracture hospitalisation trends and predictors of access to rehabilitation for adults aged ≥ 65 years living with and without dementia. The hospitalisation rate was 2.5 times higher for adults living with dementia and adults who lived in aged care were between 4.8 and 9.3 times less likely to receive rehabilitation. Introdu...
Article
Background Hip fracture risk is higher for older adults living in residential aged care facilities (RACF) and their health outcomes worse compared to older adults living in the community. Pre-hip fracture residential status is not well recorded within hospital records, necessitating linkage of hospital and residential aged care data to better ascer...
Article
Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, r...
Article
Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, r...
Article
Full-text available
In this commentary, we highlight the availability of two newly developed instruments that measure grief in adolescents. We present similarities and differences regarding their content, factor structure, and characteristics of the validated populations. Given the small body of adolescent grief instruments, these two new scales will prove to be usefu...
Article
Early-life stress (ELS) has previously been identified as a risk factor for cognitive decline, but this work has predominantly focused on clinical groups and indexed traditional cognitive domains. It, therefore, remains unclear whether ELS is related to cognitive function in healthy community-dwelling older adults, as well as whether any effects of...
Article
Introduction: Both genetic and nongenetic factors contribute to the risk profile of young onset dementia (YOD), but risk factors often co-occur. This matched case-control study examined whether nongenetic risk factors cluster together, to inform targeted prevention efforts. Methods: Ninety-six participants with non-autosomal-dominant degenerativ...
Article
Background and objectives: Neglect of older people is common and may result in fatal and nonfatal outcomes. Normal changes of aging and disease-related symptoms may overlap with markers of neglect and lead to under-detection. This review aims to delineate medical, psychiatric, and pathophysiological indicators in the victim-identified in forensic...
Article
This study identified group-based trajectories of hospitalisation for older adults who were living in residential aged care facilities (RACF) or the community for up to 4 years after an index fall injury hospitalisation. Greater than 3 subsequent fall injury hospitalisations and time until move to a RACF were key predictors of RACF and community-li...
Article
Purpose: To enhance understanding of access to rehabilitation services in Australian and New Zealand acute care facilities for older adults living with dementia and/or living in residential aged care facilities (RACFs) following a hip fracture. Methods: Information on hip fracture rehabilitation was obtained from an online survey of 40 health profe...
Article
Working with interpreters in the psychiatric assessment of older adults from culturally and linguistically diverse backgrounds - Anne Pamela Frances Wand, Diba Pourmand, Brian Draper
Chapter
Agitation, a term that includes behaviour such as excessive motor activity, verbal and physical aggression, is common in people with dementia. The assessment and management of agitation in older people can be challenging in primary care. Agitation may be the initial presentation of an early dementia, with a differential diagnosis that includes deli...
Article
Objective Depression in dialysis patients is often undetected despite associations with poor outcomes. The aim was to determine the prevalence and associations of depressive symptoms and physician recognition of depression within a typical Australian dialysis population. Method A cross-sectional study examined haemodialysis and peritoneal dialysis...
Article
Objectives To follow-up a cohort of older people who self-harmed, their carer, and general practitioner (GP) and examine their reflections on the self-harm, care experiences, and outcomes. Design Qualitative in-depth interviews. Setting Two teaching hospitals and associated community services. Participants Twelve-month follow-up of participants...
Article
Objectives: To describe the injury profile, hospitalisation rates and health outcomes for older people with cognitive impairment and to determine whether these differ from those with normal cognition. Methods: Participants were 867 community-dwelling 70-90 year olds enrolled in the population-based longitudinal Sydney Memory and Ageing Study (MA...
Article
Full-text available
Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provide...
Article
Introduction In an ageing population, very old men appear most vulnerable to suicide. Most suicide research in late life is quantitative and focuses on determining the risk factors for suicidal behaviour. There is a close relationship between self-harm in older people and suicide; with shared risk factors and greater intent to die and lethality of...
Article
The importance of better care integration is emphasized in many national dementia plans. The inherent complexity of organizing care for people with dementia provides both the justification for improving care integration and the challenges to achieving it. The prevention, detection, and early diagnosis of cognitive disorders mainly resides in primar...
Article
Full-text available
Objective The prevalence of dementia and cognitive impairment is higher in Aboriginal Australians compared to the national population, increasing the need to understand cognitive impairment in this at‐risk population. This article reports normative data for a range of commonly used cognitive tests, in a population‐based small normative sample of ol...
Article
Objective: Assault is a global public health issue that affects individuals of all ages. This study describes the epidemiological profile of assault-related hospitalization and health outcomes across different age groups in New South Wales, Australia. Methods: Population-based linked hospitalization and mortality data from January 1, 2010, to Ju...