Michele L Callisaya

Monash University (Australia) · Department of Medicine

Background Prior work suggests there may be greater reliance on executive function for walking in older people. The pre-frontal cortex (PFC), which controls aspects of executive function, is known to be active during dual-task walking (DTW). However, there is debate on how PFC activity during DTW is impacted by ageing and the requirements of the co...

Background Exercise therapy is recommended as first line treatment for knee osteoarthritis (OA), but it remains to be sub-optimally applied (1). Movement-evoked pain is a potential barrier to exercise adherence, but recent evidence suggests that such pain can be improved by training (2). Walking programs are low-cost, easily adopted and can be perf...

Importance: Dual decline in gait speed and cognition has been found to be associated with increased dementia risk in previous studies. However, it is unclear if risks are conferred by a decline in domain-specific cognition and gait. Objective: To examine associations between dual decline in gait speed and cognition (ie, global, memory, processin...

Objectives Clusters of low fitness and high obesity in childhood are associated with poorer health outcomes in later life, however their relationship with cognition is unknown. Identifying such profiles may inform strategies to reduce risk of cognitive decline. This study examined whether specific profiles of childhood fitness and obesity were asso...

Background To examine the effect of frailty on cognitive decline independent of cerebral small vessel disease (cSVD) and brain atrophy, and whether associations between neuropathology and cognition differed depending on frailty status. Methods The Tasmanian Study of Cognition and Gait (TASCOG) was a population based longitudinal cohort study with...

Objective: To explore older persons' perceptions of the impact of COVID-19 restrictions on participating in community activities after discharge from inpatient rehabilitation. Methods: Mixed-methods study design. Participants were older adults who were discharged home following inpatient rehabilitation. Interviews were conducted with 70 particip...

Background: falls share risk factors with cognitive decline but whether falls predict cognitive decline, pre-dementia syndromes and dementia is poorly understood. Objectives: this study aimed to examine if falls are associated with cognitive decline in specific domains and the risk of Motoric Cognitive Risk (MCR) syndrome and dementia. Design:...

Objective The purpose of this study was to determine physical therapists’ and physical therapist students’ attitudes and beliefs, knowledge, and confidence in working with people with dementia. Methods This was a mixed-methods systematic review. Participants included physical therapists working in any clinical specialty and physical therapist stud...

Purpose: To explore the experiences of physiotherapy students on working with people with dementia during their clinical placements. Methods: Qualitative study using a Web-based survey of students in a 2-year entry-level Masters of Physical Therapy (MPT) program. Students were asked to reflect on their experiences during clinical placements with...

Pain at multiple sites is prevalent among older people. Yet, studies investigating the relationship between pain and falls focus largely on single‐site pain. This study aims to examine the association between pain at multiple sites and falls among community‐dwelling older Australians. Participants aged >60 years were randomly selected from the elec...

Background: Clinical care for people with dementia as a primary diagnosis, or as a co-morbidity, can be complex. Physiotherapists play a key role in the care of people living with dementia in multiple settings. The aim of this systematic review is to understand the attitudes, beliefs, knowledge and confidence of physiotherapists and physiotherapy...

Background There are few large population-based studies of outcomes after subarachnoid hemorrhage (SAH) than other stroke types. Methods We pooled data from 13 population-based stroke incidence studies (10 studies from the INternational STRroke oUtComes sTudy (INSTRUCT) and 3 new studies; N=657). Primary outcomes were case-fatality and functional...

This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...

Introduction Guidelines for hip fracture care state that patients with hip fracture should be mobilised on the day after surgery and at least once a day thereafter. However, compliance with these guidelines is poor. One approach that would assist physiotherapists to meet mobility guidelines after hip fracture is to delegate the provision of daily m...

Purpose To assess whether meeting criteria for community ambulation and ambulatory self-confidence on discharge from inpatient rehabilitation are associated with participation in community activities. Methods Prospective longitudinal observational study design. Participants were assessed within 48-hours of discharge on ability to complete tasks re...

Background The mid-life emergence of higher levels of total cholesterol (TC) for women than for men has been observed in different Western and Asian populations. The aim of this study was to investigate whether there is evidence of this in Vietnam and, if so, whether it can be explained by ageing, by body size and fatness, or by socio-demographic c...

Background There is limited research on the provision of evidence-based care and its association with outcomes after aneurysmal subarachnoid hemorrhage (aSAH). Aims We examined adherence to evidence-based care after aSAH and associations with survival and discharge destination. Also, factors associated with evidence-based care including age, sex,...

Greater gait variability predicts dementia. However, little is known about the neural correlates of gait variability. The aims of this study were to determine (1) grey matter volume covariance patterns associated with gait variability and (2) whether these patterns were associated with specific cognitive domains. Participants (n = 351; mean age 71....

Introduction Greater double support time (DST) variability is associated with falls and memory decline. The underlying neurophysiological mechanisms of DST variability are poorly understood. Simple reaction time (SRT) variability, a measure of attention-processing speed is associated with falls and dementia and, may underlie greater DST variability...

Background: Evidence-based interventions to improve mobility in older people include balance, strength and cognitive training. Digital technologies provide the opportunity to deliver tailored and progressive programs at home. However, it is unknown if they are effective in older people, especially in those with cognitive impairment. Objective: T...

The COVID‐19 pandemic has resulted in the rapid implementation of telehealth. However, little is known about its suitability for the older population. We evaluated the use of telehealth in geriatric outpatient clinics. Half of the appointments needed to be re‐scheduled due to language barrier, poor connection, hard of hearing and inability to perfo...

Background: Muscle strength and balance are major modifiable factors of falls in older adults, but their associations with falls in middle-aged adults are under investigated. We aimed to examine the association of baseline and change in leg muscle strength (LMS) and balance with the incidence of falls in a cohort of middle-aged women. Methods: T...

Background and purpose: Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedenta...

Background: The motoric cognitive risk (MCR) syndrome is a pre-clinical stage of dementia characterized by slow gait and cognitive complaint. Yet, the brain substrates of MCR are not well established. Objective: To examine cortical thickness, volume, and surface area associated with MCR in the MCR-Neuroimaging Consortium, which harmonizes image...

Introduction Falls have a multifactorial aetiology, which may limit the effectiveness of the common approach of exercise as the sole intervention strategy. Multifactorial interventions could be more effective in people at high risk of falling; however, the focus of such interventions has traditionally been quite narrow. This paper describes the des...

Objectives To describe the patterns of personal emergency response systems (PERS) use in a statewide cohort of older Australians. Methods PERS data from clients enrolled in the Personal Alarm Victoria program between January 2014 and June 2017 were analysed. Alarm activation reasons were extracted, and a medical record audit was performed for a su...

Physical activity is recommended after stroke. However, the rehabilitation day is largely spent sedentary. Understanding patterns of physical activity across the rehabilitation week may help identify opportunities to improve participation. We aimed to examine: (1) differences between weekday and weekend sedentary time and physical activity, (2) the...

Background Physical inactivity is a risk factor for type 2 diabetes (T2D) and dementia. However, it is unknown if physical activity (PA) intensity is associated with brain health in people with T2D. Therefore, this study aimed to determine 1) associations between PA intensity and step count with both cognition and brain structure and 2) if apolipop...

Background: Outcomes after subarachnoid hemorrhage (SAH) have been rarely examined in large cohorts. Methods: This is an extension of the International Stroke Outcomes Study (INSTRUCT) pooling 13 ‘ideal’ stroke incidence studies (n=657 with SAH from 1993-2017, median age 56 years; 46% men). The primary outcomes were mortality and functional outcome...

Objective: The objective of this review is to explore the attitudes and beliefs of physiotherapists and physiotherapy students working with people with dementia. A second objective is to explore their knowledge and confidence in this area. Introduction: Dementia is a leading cause of disability. It poses a challenge to individuals and health sys...

Objective This study aimed to develop and test the feasibility of using an electronic tool to ascertain falls and their circumstances (TASeFALL) in people aged over 60 years. Methods Forty participants (mean age: 69.3 ± 5.4 years, 55% women) were randomised to receive a monthly paper‐based questionnaire (control group n = 19), compared with the sa...

Introduction: Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignor...

Purpose We aimed to understand from the perspective of stroke survivors and their carers (1) factors contributing to sedentary time and physical activity during inpatient rehabilitation and the transition home, and (2) actual and perceived opportunities to reduce sedentary time and increase physical activity. Material and methods Qualitative study...

It is now recognized that physical functioning is affected in people living with dementia. Impairments include poorer reaction time, weaker muscle strength, reduced coordination, and impaired balance. Along with cognitive impairment, physical impairments contribute to increased risk of adverse events such as falls and fractures. This chapter outlin...

Recent evidence suggests increased activity of the pre-frontal cortex (PFC) is associated with sensorimotor disturbances of standing balance. Here we manipulate sensorimotor inputs and concurrently load cognitive resources in order to investigate the functional role of PFC activity during standing balance, and how this changes with healthy ageing....

Background Physical distancing restrictions, including recommendations to ‘stay home’ during the COVID-19 pandemic has restricted exercise opportunities for older adults. Our group of academic and clinical physiotherapists and a communications expert identified the need to support safe exercise at home to minimise the impact of these restrictions....

Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Participants (n=350, mean age 71.9±7.1) were randomly se...

Objective To evaluate the dementia knowledge of allied health professionals and identify their specific learning needs. Methods An online survey was conducted with allied health professionals enrolled in the Understanding Dementia Massive Open Online Course, a free course open to anyone, worldwide. The primary outcome measure was the Dementia Kn...

The motoric cognitive risk (MCR) syndrome is characterized by slow gait and cognitive complaint, and increases the risk for both Alzheimer’s disease and vascular dementia. Our recently established MCR neuroimaging consortium aims to identify the brain substrates and pathologies in MCR – and consists of > 3,000 MRIs from 6 different older adult coho...

Background An inflammatory diet is related to poorer cognition, but the underlying brain pathways are unknown. Objective The aim of this study was to examine associations between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and brain volume, small vessel disease, and cognition in people with and without type 2 diabetes mellitus (T2DM)....

Objectives Age and female sex are risk factors for dementia, and menopause is associated with cognitive dysfunction. Previous work largely considered the effects of sex and menopause as being independent of age. We studied whether age interacts with sex or menopause in explaining imaging biomarkers of dementia during midlife. Methods In this cross...

Background: A socioeconomic gradient exists in the utilisation of total hip replacements (THR) and total knee replacements (TKR) for osteoarthritis. However, the relations between socioeconomic status (SES) and time to THR or TKR is unknown. Aim: To describe the association between SES and time to THR and TKR. Methods: 1072 older-adults residi...

This was the first study assessing falls prospectively in middle-aged women. The 1-year incidence was 42% for any fall, which suggest falls are a major issue in middle-aged women. Middle-aged women, particularly those sustaining a fall, could be a target group for fall-prevention strategies. Purpose: Incidence and circumstances of falls in middle...

Background Women are over-represented in aSAH cohorts, but whether their outcomes differ to men remains unclear. We examined if sex differences in neurological complications and aneurysm characteristics contributed to aSAH outcomes.Methods In a retrospective cohort (2010–2016) of all aSAH cases across two hospital networks in Australia, information...

Background & aims Dual-task walking is an emerging marker of cognitive impairment. However, there is uncertainty regarding which dual-task test and measure to use. The aims of this study were to determine the association between three different dual-tasks and 1) global cognition and 2) individual cognitive domains. Methods Participants (n = 91) we...

Background Sedentary time is prevalent following stroke, limiting functional improvement, and increasing cardiovascular risk. At discharge we examined: 1) change in sedentary time and activity over the following 3 months’ and 2) physical, psychological or cognitive factors predicting any change. A secondary aim examined cross-sectional associations...

BACKGROUND To determine if pre-existing dementia is associated with poorer quality of care and outcomes after stroke in the acute hospital phase. METHODS This was a retrospective analysis of pooled data from the Australian Stroke Foundation national audit conducted in 2015 and 2017. Dementia status was obtained from the medical records. Processes...

Background Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Methods Participants (n=350, mean age 71.9±7...

Background: Cognitive dysfunction is common in older adults, particularly in those with type 2 diabetes (T2D). Higher adherence to the Dietary Guidelines for Americans is associated with better brain health. However, it is unclear if adherence to the Australian Dietary Guidelines (ADG) is associated with cognition or brain structure in older adult...

Background The contribution of cerebral small vessel disease (cSVD) to the pathogenesis of frailty remains uncertain. We aimed to examine the associations between cSVD with progression of frailty in a population-based study of older people. Methods People aged between 60 and 85 years were randomly selected form the electoral roll to participate in...

Objectives To identify subgroups of community-dwelling older adults and to assess their longitudinal associations with long-term osteoarthritis (OA) outcomes. Methods 1046 older adults aged 50–80 years were studied. At baseline, body mass index (BMI), pedometer-measured ambulatory activity (AA), and Western Ontario and McMaster Universities Osteoa...

Gait impairments and cognitive decline are common among older people and are the hallmarks of functional decline in advancing age. Until recently, it was thought that gait is an automated motor task with little or no reliance on cognitive function. The understanding of gait as a complex cognitive task and findings that poor gait precedes cognitive...

Purpose: Repetitive task practice after stroke is important to improve function, yet adherence to exercise is low. The aim of this study was to determine whether using the internet, a tablet application, and a chair sensor that connected to a therapist was feasible in monitoring adherence and progressing a functional exercise at home. Methods: Ten...

Manual measurement of blood pressure (BP) during exercise testing is the recommended standard. Automated measurement of BP is an alternative method used during clinical exercise testing, but there is little data comparing manual and automated BP in this setting. The aim of this study was to determine the concordance between manual and automated BP...

Background: Aneurysmal subarachnoid haemorrhage (aSAH) disproportionally affects women. We conducted a systematic review and meta-analysis to explore sex differences in aSAH risk factors. Methods: Case-control/cohort studies were searched to November 2017 with sex-specific risk factors for aSAH. Meta-analysis was performed when a risk factor was...

Purpose of review Type 2 diabetes (T2D) is a well-established risk factor for the development of dementia. Dementia and T2D share some underlying pathophysiology that has led to interest in the potential to repurpose drugs used in the management of T2D to benefit brain health. This review describes the scientific data available on the use of T2D me...

Objectives Poor health literacy (HL) is associated with poorer health outcomes in diabetes but little is known about its effects on foot disease. This study was aimed to determine the associations between HL and diabetic foot disease. Design This is a cross-sectional analysis of baseline data from a prospective study of foot disease. Setting Atte...

Background: Unhealthy dietary patterns (DPs) are associated with poorer cognition, but few studies have investigated the underlying brain structural mechanisms. Objective: We aimed to examine the relations between DPs, brain structure, and cognition in older people with and without type 2 diabetes. Methods: This cross-sectional study consisted...

Whilst the links between a healthy diet and healthy heart are firmly established and well documented, the relationship between diet and brain health is less well understood. Emerging research is ensuring however, that the maxim of ‘what is good for your heart, is also good for your brain’ is gaining momentum. Nutritional status and dietary habits h...

Background: High levels of sedentary time increases the risk of cardiovascular disease, including recurrent stroke. Objective: This study aimed to identify factors associated with high sedentary time in community-dwelling people with stroke. Methods: For this data pooling study, authors of published and ongoing trials that collected sedentary time...

Accelerated gait decline in aging is associated with many adverse outcomes, including an increased risk for falls, cognitive decline, and dementia. Yet, the brain structures associated with gait speed, and how they relate to specific cognitive domains, are not well-understood. We examined structural brain correlates of gait speed, and how they rela...

Background: Gait impairments are emerging predictors of dementia. However, few studies have examined whether gait predicts decline in specific cognitive domains. Objective: This study aimed to determine whether gait speed or other gait characteristics were associated with decline in specific cognitive domains and the role of the ApoE4 genotype i...

Background: Hypertension is an established risk factor for dementia. However, it is unclear whether there are differential effects of angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blockers (ARB) on brain health. In human observational studies, the evidence for superiority of either agent remains unclear. Objective: To co...

Aims/hypothesis The aims of the study were to examine whether type 2 diabetes mellitus is associated with greater brain atrophy and cognitive decline, and whether brain atrophy mediates associations between type 2 diabetes and cognitive decline. Methods Participants without dementia aged 55–90 years from the Cognition and Diabetes in Older Tasmani...

Background: Aneurysmal subarachnoid hemorrhage (aSAH) affects women more than men, unlike other stroke types. We completed a systematic review and meta-analysis of risk factors associated with the occurrence of aSAH in women. Methods: A systematic search was conducted using the Pubmed, Scopus, Embase, and Medline databases from inception to Novembe...

Background: Aneurysmal subarachnoid hemorrhage (aSAH) disproportionally affects women. The etiology of this is unclear, and the contribution of sex differences in aSAH risk factors is unknown. We aimed to identify sex differences in aSAH risk factors in a systematic review and meta-analysis. Methods: A systematic search was conducted using the Pubm...

Data S1. Supporting information

Aim: To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. Methods: 1032 participants (52% women; mean age 62.9±7.4 y...