Robert Graham Cumming

The University of Sydney

Research on Aging

Background: We quantified the individual and joint contribution of contemporaneous causal behavioural exposures on the future burden of oesophageal and stomach cancers and their subtypes and assessed whether these burdens differ between population groups in Australia, as such estimates are currently lacking. Methods: We combined hazard ratios fr...

Introduction: Due to discrepancy of the relationship between visceral adipose tissue (VAT) and bone mineral density (BMD), this study was performed to determine the relationship between BMD and VAT in the elderly. Methodology: This cross-sectional study is part of the second wave of Amirkola Health and Ageing Project (AHAP), including 1,200 peop...

Importance: Falls and fractures are frequent and deleterious to the health of older people. Aspirin has been reported to reduce bone fragility and slow bone loss. Objective: To determine if daily low-dose aspirin (100 mg) reduces the risk of fractures or serious falls (fall-related hospital presentations) in healthy older men and women. Design,...

Introduction: This study aimed to assess the extent to which a single item of self-reported hearing difficulties is associated with future risk of falling among community-dwelling older adults. Methods: We used data from two Australian population-based cohorts: three waves from the PATH Through Life study (PATH; n = 2,048, 51% men, age 66.5 ± 1....

Objectives: The aims of this study were to assess oral health-related quality of life (OHRQoL) in a cohort of older Australian men and explore the association between their general health conditions, socio-demographic factors and OHRQoL. Methods: The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representa...

Importance: Among older adults, there is limited and inconsistent evidence on the association between socioeconomic position (SEP) and elective and nonelective hospitalization. Objective: To evaluate the association between SEP and all-cause and cause-specific elective and nonelective hospitalization and hospital length of stay among older men....

Background Nutritional intake could influence the development of frailty. The aim was to evaluate the associations between dietary iron intakes and changes in dietary iron intakes with frailty. Methods Cross-sectional analyses involved 785 men with Fried frailty phenotype (FP) and 758 men with Rockwood frailty index (FI) data aged 75 years and ove...

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...

BACKGROUND Anemia is associated with increased risk of all-cause mortality in older populations. However, the relationship between hemoglobin and major adverse cardiovascular events (MACE), and whether this is modulated by frailty, is unclear. METHODS CHAMP (Concord-Health-and-Ageing-in-Men-Project) is a prospective study of community-dwelling men...

To compare the Australian Dietary Guideline Index (DGI-2013) and the Pyramid-based Mediterranean Diet Score (pyrMDS) as measures of diet quality in an ethnically diverse group of older men. Seven hundred and ninety-four older men aged ≥75 participated in wave 3 (2012–2013) of the Concord Health and Ageing in Men Project. Dietary intake was assessed...

Thyroid cancer incidence and the prevalence of overweight and obesity are increasing, but the future thyroid cancer burden attributable to contemporary levels of overweight and obesity has not been evaluated before. We quantified this burden in Australia, and assessed whether the overweight/obesity-attributable burden differed by sex or other popul...

The original cohort The Concord Health and Ageing in Men Project (CHAMP) was established in 2005 to investigate health in older men, with a focus on the major geriatric syndromes and reproductive hormones. As outlined in the original cohort profile paper,¹ CHAMP is a population-based longitudinal study of men aged ≥70 years. Men were the focus of t...

Background and Aims Mediterranean dietary patterns may exert favourable effects on various health conditions. This study aimed to determine associations of adherence to Mediterranean diet as well as its components, with circulating cytokine levels, musculoskeletal health and incident falls in community-dwelling older men. Methods Seven hundred nin...

Background Estimates of the future burden of invasive cancer attributable to current modifiable causal exposures can guide cancer prevention. Methods We linked pooled data from seven Australian cohort studies (N = 367,058) to national cancer and death registries, and estimated exposure-cancer and exposure-death associations using adjusted proporti...

Objective Inadequate nutrient intakes have been linked with poor dentition in older adults. The aim of this study was to investigate the associations between composition of Functional Tooth Units (FTUs) and nutrient intakes in older men. Design A cross-sectional study with a standardized validated diet history assessment and comprehensive oral hea...

Background: Estimates of future burden of cancer attributable to current modifiable causal exposures can guide cancer prevention. We quantified future head and neck cancer burden in Australia attributable to individual and joint causal exposures, and assessed whether these burdens differ between population subgroups. Methods: We estimated the st...

Background The association between socioeconomic position (SEP) and health is well-established. However, the association between SEP and healthy ageing as a multidimensional construct is unclear. Methods We conducted a systematic review of peer-reviewed cross-sectional and longitudinal studies on the associations between SEP and multidimensional h...

Background Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a...

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...

Although characteristic changes in amino acid concentrations occur in obesity and sarcopenia, amino acids concentrations have not been reported in sarcopenic obesity. We studied n=831 men aged 75 years and older from the five-year follow-up of the Concord Health and Ageing in Men Project (CHAMP). Sarcopenia was defined using the Foundation of the N...

Background: Type 2 diabetes mellitus (T2DM) increases falls and fracture risk. Our objective was to compare incidence and risk factors for falls and fractures in community-dwelling older men with and without T2DM. Methods: A total of 1,705 men (471 with T2DM; 1234 without T2DM) aged ≥70 years were assessed at baseline. Men were contacted every 4...

Background: Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP). Method: CHAMP is a population-based prospective cohort study of men aged...

PurposeThe objectives of the study were to evaluate the associations between antioxidant intake, dietary patterns and depressive symptoms among older men.Method794 men participated in a detailed diet history interview at the Concord Health and Ageing in Men Project 3rd wave (considered baseline nutrition) and 781 men participated at the 4th wave (c...

Objective To investigate the association between home ownership and health in older men. Methods Cross‐sectional analysis of 909 community‐dwelling Australian men (mean age: 81.3 ± 4.6) from the Concord Health and Ageing in Men Project (CHAMP, 2012‐2013). We considered self‐rated health, frailty status, multimorbidity, and anxiety and depressive s...

High‐impact physical activities with bone strains of high magnitude and frequency may benefit bone health. This study aimed to investigate the longitudinal associations between changes in loading intensities and application rates, estimated from self‐reported physical activity, with bone mineral density (BMD) changes over five years, and also with...

Background 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 pop...

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...

Falls are major issues affecting the older population with potentially serious complications, including fractures, head injury, institutionalization, fear of falling and depression. While risk factors for falls have been established across Western Europe and North America, geographical differences in falls risk have not been well researched. We aim...

Background Among older people, the extent to which psychosocial factors explain socioeconomic inequalities in mortality is debated. We aimed to investigate the potential mediating effect of psychosocial factors on socioeconomic inequalities in mortality. Methods We used data from a prospective population-based cohort (the Concord Health and Ageing...

Objective: To assess the associations between nutrient intake and dietary patterns with different sarcopenia definitions in older men. Design: Cross-sectional study. Setting: Sarcopenia was defined using the Foundation for the National Institutes of Health (FNIH), the European Working Group on Sarcopenia in Older People (EWGSOP) and the Europe...

Background: Assessing perceived needs for dental treatment is important in understanding and predicting people's health behaviours. The purpose of this study is to examine older men's perceptions regarding dental treatment needs, and to investigate the disparity between perceived needs and the actual oral health of a population of community-dwelli...

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...

Objectives: To examine changes in micronutrient intake over 3 years and identify any associations between socio-economic, health, lifestyle and meal-related factors and these changes in micronutrient intakes among older men. Design: Prospective study. Setting: Dietary adequacy of individual micronutrient was compared to the estimated average requ...

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...

Background: Conflicting evidence exists regarding the association of socioeconomic status (SES) with mortality among older people and little is known about the mechanisms underlying this association. We investigated the association of SES with mortality among older Australian men. We also investigated potential mediating effects of health-related...

Background Obese older adults have higher bone mineral density (BMD), but other characteristics of obesity may predispose these individuals to fracture. We aimed to compare clinical risk factors for incident fracture in obese and non-obese older men. Methods Body mass index (BMI) and body fat percentage were assessed at baseline by anthropometry a...

APOE genotype has been associated with various age-related outcomes including Alzheimers disease, frailty and mortality. In this study, the relationship between health, particularly cognitive function, and APOE was investigated in older men from the Concord Health and Ageing in Men Project (n=1616; age 76.9±5.5 yrs (range 70-97 yrs); Australia). Ba...

Importance Long‐term data on age‐related cataract, a leading cause of blindness and visual impairment, is scarce in Asian populations. Background We report the 6‐year incidence and progression of age‐related cataract and associated risk factors in Malay adults living in Singapore. Design Population‐based cohort study Participants 3280 Malays age...

Aim To compare and contrast falls characteristics between older adults with body mass index of 25.0 kg/m ² or greater and less than 25.0 kg/m ² and to further identify potential underlying mechanisms if differences existed. Subjects and Methods This was a cross-sectional study using data from fallers identified during the first wave of the Malaysi...

Background Several studies have examined the relationship between cognition and oral health in older populations. To further understand this relationship, we examined the associations between cognitive function, chewing capacity and the number of teeth present in community‐dwelling older males in Australia. Methods Data were obtained from cross‐se...

The present study aims to investigate the effect of wholegrain and legume consumption on the incidence of age-related cataract in an older Australian population-based cohort. The Blue Mountains Eye Study (BMES) is a population-based cohort study of eye diseases among older adults aged 49 years or older (1992-1994, n=3654). Of 2334 participants of t...

Objectives The types of medical conditions leading to hospitalization in frail older people have not been investigated. The objectives were to evaluate associations between frailty and (a) risk of all-cause and cause-specific hospitalization, and (b) rate of all-cause and cause-specific hospitalizations.Design, Setting and ParticipantsCommunity-dwe...

Italian migrants are one of the largest groups of older migrants in Australia. Past research has found lower mortality rates in Italian migrants but it is unclear if this persists into older age. Data came from 334 Italian-born and 849 Australian-born men aged 70 years and over participating in a longitudinal study of men’s ageing. Male Italian mig...

Objectives This review provides insights into the potential for aspirin to preserve bone mineral density (BMD) and reduce fracture risk, building knowledge of the risk-benefit profile of aspirin. Methods We conducted a systematic review and exploratory meta-analysis of observational studies. Electronic searches of MEDLINE and Embase, and a manual...

Objective: To investigate whether poorer oral health, tooth loss and lower usage of dental services are associated with depressive symptoms in older Australian men. Methods: Cross-sectional study of data collected from participants of the Concord Health and Ageing in Men Project. Depressive symptoms were evaluated by the Geriatric Depression Sca...

Knee pain is often underreported, underestimated and undertreated. This study was conducted to estimate the prevalence, burden and further identify socioeconomic factors influencing ethnic differences in knee pain and symptoms of OA among older adults aged 55 years and over in Greater Kuala Lumpur (the capital city of Malaysia). The sample for the...

The current evidence on the relationship between a higher body mass index (BMI) and falls in older adults is conflicting. This study, therefore, evaluated the relationship between BMI and falls and explored underlying mechanisms for this relationship. Data from 1,340 individuals from the Malaysian Elders Longitudinal Research study, obtained throug...

Long-term studies investigating hormone-dependent cancers and reproductive health often require prolonged frozen storage of serum which assumes that the steroid molecules and measurements are stable over that time. Previous studies of reproducibility of circulating steroids have relied upon flawed historical rather than contemporaneous controls. We...

Background: The relations between diet, chronic inflammation, and musculoskeletal health are unclear, especially among older men. Objective: This study aimed to determine associations of the Dietary Inflammatory Index (DII) with inflammatory biomarkers, musculoskeletal health, and falls risk in community-dwelling older men. Methods: The cross-...

Objective Low levels of total cholesterol (TC) are associated with adverse outcomes in older populations. Whether this phenomenon is independent of statin use is unknown. We investigated the association between low TC levels and long-term major adverse cardiovascular events (MACE) in a prospective study of men aged ≥70 years without ischaemic heart...

Objective: To examine whether frailty in older men is associated with poorer oral health and lower levels of dental service utilisation. Background: Poor oral health has been associated with some frailty components. Less is known about the link between frailty and oral health outcomes. Methods: A cross-sectional analysis. Data were collected f...

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...

Increased blood levels of branched chain amino acids (BCAAs) have been associated with cardiometabolic risk factors. Here we studied 918 community dwelling older men to determine the relationship between BCAAs and other amino acids with cardiometabolic risk factors, major cardiovascular endpoints (MACE) and mortality. BCAAs had robust associations...

Background Weight loss increases fracture risk in older adults. We aimed to determine associations of two-year body composition trajectories with subsequent falls and fractures in older men. Methods We measured appendicular lean mass (ALM) and total fat mass (FM) by dual-energy X-ray absorptiometry at baseline and Year 2 in 1,326 community-dwellin...

Protein and branched-chain amino acid (BCAA) intake are associated with changes in circulating BCAAs and influence metabolic health in humans and rodents. However, the relationship between BCAAs and body composition in both species is unclear, with many studies questioning the translatability of preclinical findings to humans. Here, we assessed and...

Background: The obesity-cataract association has been inconsistently reported. The fat mass and obesity-related (FTO) single-nucleotide polymorphism (SNP) rs9939609 is a major SNP associated with obesity and has been used as an instrumental variable for obesity in a Mendelian randomization (MR) approach. An interaction between the FTO SNP and macr...

Context: Periodontal disease is a chronic inflammatory gum condition that is more prevalent in older populations. The development of periodontal disease has been directly linked to inflammatory dietary habits. Objective: This systematic review aimed to 1) describe the relationship and 2) describe the direction of the relationship between dietary...

The Sustainable Development Goal 5 aims to achieve gender equality and the empowerment of women and girls by the year 2030. However, few studies have been written about female empowerment in sub-Saharan Africa (SSA). We examined the prevalence of female empowerment for women aged 15-49 across 31 SSA countries – using four Demographic and Health Sur...

Background: In sub-Saharan Africa (SSA), health system resilience and preparedness for wars is an urgent concern if the region is to meet the Sustainable Development Goals. SSA has the highest maternal mortality, and some countries on the continent have experienced wars. This paper is the first to test whether health system indicators differ betwee...

Background: while both negative and positive impacts of caregiving on health have been reported, findings regarding caregiver's mortality may be biased by the lack of consideration of changes in their health and caregiving status during follow-up. This study examines the impact of caregiving on the risk of death in older men, allowing for caregivi...

Background: Greater adherence to dietary guidelines has previously been found to be associated with decreased risk of visual impairment. However, whether or not this association extends to age-related cataract, 1 of the leading causes of visual impairment, is unknown. Objectives: The aim of this study was to assess the association between adhere...

Substantial changes in the prevalence of the principal kidney and bladder cancer risk factors, smoking (both cancers) and body fatness (kidney cancer), have occurred but the contemporary cancer burden attributable to these factors has not been evaluated. We quantified the kidney and bladder cancer burden attributable to individual and joint exposur...

Background Advanced kidney disease is associated with reduced muscle strength and physical performance. However, associations between early stages of renal impairment and physical outcomes are unclear. Methods The Concord Health and Ageing in Men Project (CHAMP) is a prospective study of 1,705 community-dwelling men aged 70 and over. Participants...

Background The objective of the study is to evaluate the prospective associations between antioxidant intake and incident frailty among older Australian men aged ≥75 years. Methods Seven hundred and ninety-four men participated in a detailed diet history interview at the Concord Health and Ageing in Men Project (CHAMP) study third wave (considered...

Background The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of older Australian men. The aim of this paper is to describe the oral health behaviours and dental service use of CHAMP participants and explore associations between oral health behaviours with and general health status. Meth...

Objective Evidence on the endometrial and ovarian cancer burden preventable through modifications to current causal behavioural and hormonal exposures is limited. Whether the burden differs by population subgroup is unknown. Methods We linked pooled data from six Australian cohort studies to national cancer and death registries, and quantified exp...

Estimates of the future breast cancer burden preventable through modifications to current behaviours are lacking. We assessed the effect of individual and joint behaviour modifications on breast cancer burden for premenopausal and postmenopausal Australian women, and whether effects differed between population subgroups. We linked pooled data from...

Introduction: Every year millions of people in developing countries suffer from snakebite, causing a large number of deaths and long term complications. Prevention and appropriate first aid could reduce the incidence and improve the health outcomes for those who suffer bites. However, many communities where snakebite is a major issue suffer from a...