Henry Brodaty's research while affiliated with The University of Sydney and other places
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Publications (961)
Objectives
To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia.
Design
Three longitudinal cohort studies.
Setting
Particip...
INTRODUCTION
Long‐term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differ...
Background
Social health markers, including marital status, contact frequency, network size, and social support, have shown associations with cognition. However, the underlying mechanisms remain poorly understood. We investigated whether depressive symptoms and inflammation mediated associations between social health and subsequent cognition.
Metho...
Research involving people with dementia has highlighted the need to improve engagement in the conduct of interviews and focus groups. Projective and enabling techniques may be useful and avoid some of the drawbacks associated with direct questioning. However, researcher-driven projective techniques have not been extensively tested in research with...
Psychiatric disorders such as schizophrenia, major depressive disorder, and bipolar disorder have areas of significant overlap across multiple domains including genetics, neurochemistry, symptom profiles, and regional gray matter alterations. Various structural neuroimaging studies have identified a combination of shared and disorder-specific patte...
Importance
The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested.
Objectives
To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and rac...
Background:
The 1q21.1 distal and 15q11.2 BP1-BP2 CNVs exhibit regional and global brain differences compared to non-carriers. However, interpreting regional differences is challenging if a global difference drives the regional brain differences. Intra-individual variability measures can be used to test for regional differences beyond global diffe...
INTRODUCTION:
White matter hyperintensities (WMH) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well-documented in populations of different ethnicities and/or from different geographical regions.
METHOD:
Magnetic resonance imaging data of five population-based coh...
Background:
This study was conducted to assess Vietnam's dementia service delivery.
Methods:
Using WHO methodology, website searches of key organisations focused on three aspects of Vietnam's healthcare system: (1) Health and social workforce; (2) Services, supports and treatment programs; and (3) Promotion of awareness and understanding. Data w...
Introduction:
In this study we examine whether social health markers measured at baseline are associated with differences in cognitive capability and in the rate of cognitive decline over an 11-to-18-year period among older adults and compare results across studies.
Methods:
We applied an integrated data analysis approach to 16,858 participants...
Objectives: To examine sex differences in the associations between vascular risk factors and 6-year changes in the volume of white matter hyperintensities (WMH), and between changes in WMH volumes and changes in cognitive performance, in a cohort of non-demented older adults. Methods: WMH volumes at 3 time-points (baseline, and 2- and 6-year follow...
Background:
Individuals living with Alzheimer's disease (AD) demonstrate extensive deficits in social cognition. To date, no studies have investigated the feasibility of an intranasal oxytocin (INOT) treatment to improve social cognition in individuals living with AD.
Objective:
We conducted a pilot trial to determine recruitment feasibility, en...
Objectives:
Olfactory dysfunction and depression are common in later life, and both have been presented as risk factors for dementia. Our purpose was to investigate the associations between these two risk factors and determine if they had an additive effect on dementia risk.
Design:
Olfactory function was assessed using the Brief Smell Identific...
Objectives:
The 10-item Kessler Psychological Distress Scale (K-10) is a widely applied distress measure; however, its psychometric properties were not established with older populations using advanced methodology. The aim of this study was to examine psychometric properties of the K-10 through application of Rasch methodology and if possible, dev...
Objective
Few studies have focused on the contribution of long-term exposure to elevated BP to dementia and deaths, particularly among older adults. We examined the prognostic value of cumulative BP (cBP) and cBP load in relation to incident dementia, cognitive decline, all-cause and cardiovascular deaths among adults aged 70 years and above, follo...
The Telephone Interview for Cognitive Status-modified (TICS-M) is a well-established and widely used screening instrument for dementia and assessment of global cognitive function in older people. This study aimed to evaluate the psychometric properties of the TICS-M and to enhance the accuracy of the instrument using Rasch methodology. Partial Cred...
Background:
The modified Telephone Interview for Cognitive Status (TICS-M) is a widely used tool for assessing global cognitive functions and screening for cognitive impairments. The tool was conceptualised to capture various cognitive domains, but the validity of such domains has not been investigated against comprehensive neuropsychological asse...
Background:
Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring.
Methods:
For this cross-sectional study, we...
Background
Forward with Dementia is a co-designed campaign to improve communication of dementia diagnosis and post-diagnostic support.
Methods
Webinars, a website, social and traditional media, and promotions through project partners were used to disseminate campaign messages to health and social care professionals (primary audience) and people wit...
Objectives:
The study aims to describe people with dementia and informal caregivers' respective experiences of support after diagnosis and compares these experiences. Additionally, we determine how people with dementia and informal caregivers who are satisfied with support differ from those dissatisfied.
Methods:
A cross-sectional survey study i...
Background:
Evidence suggests that lifestyle activities impact cognitive and mental health in older populations. However, how lifestyle factors are associated with one another, and which factors are most important for cognitive function and mental health has received comparatively little attention.
Design:
Bayesian-Gaussian network analysis was...
Introduction:
Previous meta-analyses have linked social connections and mild cognitive impairment, dementia, and mortality. However, these used aggregate data from North America and Europe and examined a limited number of social connection markers.
Methods:
We used individual participant data (N = 39271, Mage = 70.67 (40-102), 58.86% female, Med...
Purpose:
This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population.
Methods:
The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zo...
Objectives:
We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).
Design:
Prospective cohort study with assessments every 2 years (for up to 6 years).
Setting:
Community, Sydney, Australia.
Participants:
Four hundre...
Background and objectives:
Past studies on post-stroke cognitive function have focused on the average performance or change over time, but few have investigated patterns of cognitive trajectories after stroke. This project used latent class growth analysis (LCGA) to identify clusters of patients with similar patterns of cognition scores over the f...
Perivascular space (PVS) burden is an emerging, poorly understood, magnetic resonance imaging marker of cerebral small vessel disease, a leading cause of stroke and dementia. Genome-wide association studies in up to 40,095 participants (18 population-based cohorts, 66.3 ± 8.6 yr, 96.9% European ancestry) revealed 24 genome-wide significant PVS risk...
Background
The number of people with dementia in multicultural Australia is rapidly increasing. Despite its culturally diverse population, there is limited research about how people from ethnic minority groups understand and approach help-seeking and support for dementia. The aim of this study is to understand the perceptions of dementia symptoms,...
Background:
Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates, across Australia, Asia, and African countries.
Methods:
We used data from six population-based cohorts of adults 65+ from six countries an...
Cognitive, social, and physical activities, collectively linked to cognitive reserve, are associated with better late-life cognitive outcomes. To better understand the building of cognitive reserve, we investigated which of these activities, during which stages of life, had the strongest associations with late-life cognitive performance. From the S...
Objectives:
This study aimed to test whether prospective memory (PM) was an early cognitive marker of future cognitive decline and incident dementia using longitudinal data spanning eight years from the Sydney Memory and Ageing Study.
Methods:
121 participants aged 72-91 years were tested in PM at baseline using a validated PM task, Virtual Week...
Background:
The Maintain Your Brain (MYB) trial aims to prevent cognitive decline and dementia through multidomain, web-based risk-reduction. To facilitate translation, it is important to understand drivers of participation.
Objective:
To describe characteristics associated with participation in MYB.
Methods:
This was an observational ancillar...
Introduction:
Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups.
Methods:
A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and wome...
People with dementia and their care partners report a lack of support, treatment, and information, fragmented services, and a lack of inclusion in decisions about their care. Care planning may address these issues; however, there is scarce literature on the process or benefits of care planning for people with dementia. This review describes the lit...
Background
Prior work suggests that higher fruit and vegetable consumption may protect against depression in older adults. Better understanding of the influence of genetic and environmental factors on fruit and vegetable intakes may lead to the design of more effective dietary strategies to increase intakes. In turn this may reduce the occurrence o...
Background:
The 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) is a well-validated and widely-used measure of cognitive changes (CCs) among older adults. This study aimed to use Rasch methodology to establish psychometric properties of the IQCODE-16 and validate the existing ordinal-to-interval transformation algor...
Normative modeling is a statistical approach to quantify the degree to which a particular individual-level measure deviates from the pattern observed in a normative reference population. When applied to human brain morphometric measures it has the potential to inform about the significance of normative deviations for health and disease. Normative m...
Objectives:
Apathy is a common symptom in mild cognitive impairment (MCI) and may predict progression to dementia. Little research, however, has investigated the longitudinal trajectory of apathy in patients with MCI or controlled for depression, which can mimic apathy, when examining its clinical correlates. The current study sought to address th...
Background
Dementia is a leading cause of disease burden in Australia, with almost half a million people living with dementia and a steady increase over time in dementia-related deaths. Strengthening the evidence base for dementia risk factors is critical for an effective and efficient public health and policy response. However, the number of Austr...
Background:
While Australian guidelines promote person-centered healthcare (PCC) for persons with dementia, healthcare systems, routines, rules, and workplace cultures can pose challenges in the provision of PCC.
Objective:
To present a knowledge translation protocol of the PCC model in a sub-acute rehabilitation hospital.
Methods:
The two-yea...
Subjective cognitive decline (SCD), in the absence of impaired clinical testing, may be a clinical indicator of early Alzheimer’s disease (AD) and other dementias. However, not all individuals with SCD have cognitive decline. Corroboration of decline by an informant (i.e., close friend or family member) is one feature of SCD thought to increase the...
The Social Health and Reserve in the Dementia patient journey (SHARED) project is an international collaboration investigating the association between social health and cognitive function. We conducted an individual participant‐level meta‐analysis of the associations between social health variables and cognitive function (global cognition, memory,...
Technology and web‐based approaches potentially provide scalable population‐based interventions to reduce modifiable risk factors for dementia such as physical inactivity, suboptimal nutrition and low cognitive activity. Our aim was to reduce cognitive decline with ageing using an online package of interventions delivered intensively for 12 months...
Individuals living with Alzheimer’s disease (AD) demonstrate global deficits in social cognition. These deficits have been associated with impaired interpersonal relationships amongst caregivers, in turn contributing to a greater sense of caregiver ‘burden’. In other areas of neuropsychiatric disease (i.e., autism spectrum disorder), intranasal oxy...
Objective
The recognition of dementia as a multifactorial disorder encourages the exploration of new pathways to understand its origins. Social health might play a role in cognitive decline and dementia, but conceptual clarity is lacking and this hinders investigation of associations and mechanisms. The objective is to develop a conceptual framewor...
Introduction:
There are limited data on prevalence of dementia in centenarians and near-centenarians (C/NC), its determinants, and whether the risk of dementia continues to rise beyond 100.
Methods:
Participant-level data were obtained from 18 community-based studies (N = 4427) in 11 countries that included individuals ≥95 years. A harmonization...
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...
Objectives
This study aimed to conduct a feasibility pilot of the Dementia Lifestyle Coach program; an individual coaching and counselling program for people recently diagnosed with dementia, to help them to adjust to the diagnosis and live well.
Methods
A randomised controlled pilot trial (n = 11) with wait-list control group was undertaken over...
Background: Multidomain interventions have been shown to be effective in improving cognition, quality of life, reducing neuropsychiatric symptoms and delaying progression of functional impairment or disability in dementia patients. To investigate the multidomain intervention in other populations and diverse cultural and geographical settings, this...
Objectives:
Informal carers play a critical role in supporting people with dementia. We conducted a scoping review and a qualitative study to inform the identification and development of carer-reported measures for a dementia clinical quality registry.
Methods:
Phase 1-Scoping review: Searches to identify carer-reported health and well-being mea...
Objective:
To examine the language of the behaviour assessment in the new Australian National Aged Care Classification (AN-ACC) funding instrument. We explored whether the (BRUA) will support an inclusive and progressive approach for people living with dementia in residential aged care.
Methods:
Databases were searched to identify publicly avail...
Objectives
This study investigated the views of people living with dementia and their families/care partners on (i) what they find helpful or unhelpful regarding behavioral changes, i.e. which coping strategies they used for themselves and/or which responses from others, and (ii) what they consider to be appropriate terminology to describe behavior...
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...
Background:
Self-administered computerized neuropsychological assessments (CNAs) provide lower cost, more accessible alternatives to traditional in-person assessments but lack critical information on psychometrics and subjective experience of older adults in remote testing environments.
Objective:
We used an online brief battery of computerized...
Background
Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between so...
The nondemented old-old over the age of 80 comprise a rapidly increasing population group; they can be regarded as exemplars of successful aging. However, our current understanding of successful aging in advanced age and its neural underpinnings is limited. In this study, we measured the microstructural and network-based topological properties of b...
A novel framework is proposed for handling the complex task of modelling and analysis of longitudinal, multivariate, heterogeneous clinical data. This method uses temporal abstraction to convert the data into a more appropriate form for modelling, temporal pattern mining, to discover patterns in the complex, longitudinal data and machine learning m...
We examined associations between structural and functional aspects of social health, and subsequent trajectories of cognitive capability (memory, executive functioning, and processing speed).
Using data from 16,858 participants (mean age 65.8 years; 56% female) from the National Survey for Health and Development (NSHD), the English Longitudinal Stu...
Aim:
To synthesise international findings on the alcohol-dementia relationship, including representation from low- and middle-income countries.
Methods:
Individual participant data meta-analysis of 15 prospective epidemiological cohort studies from countries situated in six continents. Cox regression investigated the dementia risk associated wit...
Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1,...
Healthy metabolic measures in humans are associated with longevity. Dysregulation leads to metabolic syndrome (MetS) and negative health outcomes. Recent exceptional longevity (EL) genome wide association studies have facilitated estimation of an individual’s polygenic risk score (PRS) for EL. We tested the hypothesis that individuals with high ELP...
Objectives
Apathy is a common symptom in dementia, though can be difficult to distinguish from depression due to shared features and frequent co-occurrence. As such, a significant limitation of much previous research on apathy is the failure to control for depression. The current study sought to address this by examining the trajectory and clinical...
Prior to the usual clinical symptoms of dementia, there can be subtle changes in cognitive function that differ from the normal age-related cognitive decline, which has been termed mild cognitive impairment (MCI). The increase in the numbers of individuals with possible MCI presenting to health care professionals, notably, General Practitioners (GP...
Background
Prioritizing the maintenance of healthy cognitive aging and personalizing preventive interventions to enhance their effectiveness is crucial as the global population ages. Systemic inflammation and depression in older people have been associated with decreased levels of cognition but results have been inconsistent.
Aims
To explore the i...
Background
Large-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theo...
Polygenic risk scores (PRSs) can boost risk prediction in late-onset Alzheimer’s disease (LOAD) beyond apolipoprotein E (APOE) but have not been leveraged to identify genetic resilience factors. Here, we sought to identify resilience-conferring common genetic variants in (1) unaffected individuals having high PRSs for LOAD, and (2) unaffected APOE-...
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...
Resting state low-frequency brain activity may aid in our understanding of the mechanisms of aging-related cognitive decline. Our purpose was to explore the characteristics of the amplitude of low-frequency fluctuations (ALFF) in different frequency bands of fMRI to better understand cognitive aging. Thirty-seven cognitively normal older individual...
Healthcare datasets often contain groups of highly correlated features, such as features from the same biological system. When feature selection is applied to these datasets to identify the most important features, the biases inherent in some multivariate feature selectors due to correlated features make it difficult for these methods to distinguis...
Healthcare datasets present many challenges to both machine learning and statistics as their data are typically heterogeneous, censored, high-dimensional and have missing information. Feature selection is often used to identify the important features but can produce unstable results when applied to high-dimensional data, selecting a different set o...
Background
Home-based dementia care is common in the Chinese-Australian community. However, dementia education programs for Chinese-Australians in the language of their choice are scarce. The World Health Organization has developed iSupport for Dementia, an online education program for informal caregivers. Cultural adaptation of the program for Chi...
Objectives
Prior work suggests that higher fruit and vegetable consumption may protect against depression in older adults. By better understanding the influence of genetic and environmental factors on fruit and vegetable intakes, more effective interventions could be designed to increase intakes in older adults to reduce and/or assist with the trea...
Background
The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protoc...
There is still little data on stigmatization and knowledge of dementia in Poland. Looking at these issues from the perspective of current students of medical and social faculties may be important for capacity building in dementia care in Poland.
The aim of this study is to assess the level of stigmatization and the knowledge of dementia among stud...
Dementia is a syndrome where the origins are not fully understood, and we have no cure. New thinking through exploration of paradigms beyond biological approaches has scope to improve knowledge about this complex condition. We aim to explore the role of social health in cognitive decline and the onset of dementia. We performed a scoping and a syste...
Objective
Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in o...
Mechanisms underpinning neurotypical age-related variations in cortical thickness in the human brain remain insufficiently specified. Here we used cell-specific marker genes, followed by gene ontology and enrichment analyses, to quantify the association between gene-expression levels and inter-regional age-related variations in neurotypical cortica...
Objectives: This paper aimed to review and synthesise the qualitative research evidence on the experiences and perceptions of dementia in Vietnam and among the Vietnamese diaspora.
Methods: Systematic searches were conducted in June 2019 using Medline, Embase, Emcare, PsycINFO and Cochrane electronic databases, as well as grey literature. Keywords...