Journal articles: 'Older Aboriginal Australians'

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Wettasinghe, Pamela Ming, Wendy Allan, Gail Garvey, Alison Timbery, Sue Hoskins, Madeleine Veinovic, Gail Daylight, et al. "Older Aboriginal Australians’ Health Concerns and Preferences for Healthy Ageing Programs." International Journal of Environmental Research and Public Health 17, no. 20 (October 10, 2020): 7390. http://dx.doi.org/10.3390/ijerph17207390.

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While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.

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Lavrencic, Louise M., Holly A. Mack, Gail Daylight, Sharon Wall, Margaret Anderson, Sue Hoskins, Emily Hindman, Gerald A. Broe, and Kylie Radford. "Staying in touch with the community: understanding self-reported health and research priorities in older Aboriginal Australians." International Psychogeriatrics 32, no. 11 (November 21, 2019): 1303–15. http://dx.doi.org/10.1017/s1041610219001753.

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ABSTRACTObjectives:Aboriginal Australians experience higher rates of non-communicable chronic disease, injury, dementia, and mortality than non-Aboriginal Australians. Self-reported health is a holistic measure and may fit well with Aboriginal views of health and well-being. This study aimed to identify predictors of self-reported health in older Aboriginal Australians and determine acceptable research methodologies for future aging research.Design:Longitudinal, population-based study.Setting:Five communities across New South Wales, Australia (two urban and three regional sites).Participants:Aboriginal and Torres Strait Islander people (n = 227; 60–88 years, M = 66.06, SD = 5.85; 145 female).Measurements:Participants completed baseline (demographic, medical, cognitive, mental health, and social factors) and follow-up assessments (self-reported health quantified with 5-point scale; sharing thoughts on areas important for future research). Predictors of self-reported health were examined using logistic regression analyses.Results:Self-reported health was associated with sex, activities of daily living, social activity participation, resilience, alcohol use, kidney problems, arthritis, falls, and recent hospitalization. Arthritis, kidney problems, and resilience remained significant in multiple logistic regression models.Conclusions:Perceived resilience and the absence of certain chronic age-related conditions predict older Aboriginal peoples’ self-reported health. Understanding these factors could inform interventions to improve well-being. Findings on acceptable research methodologies suggest that many older Aboriginal people would embrace a range of methodologies within long-standing research partnerships, which is an important consideration for Indigenous population research internationally.

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Temple, Jeromey, and Joanna Russell. "Food Insecurity among Older Aboriginal and Torres Strait Islanders." International Journal of Environmental Research and Public Health 15, no. 8 (August 17, 2018): 1766. http://dx.doi.org/10.3390/ijerph15081766.

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It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study examined the prevalence and correlates of food insecurity among older Aboriginal and Torres Strait Islanders. Using nationally representative data, we employed ordinal logistic regression models to investigate the association between socio-demographic characteristics and food insecurity. We found that 21% of the older Aboriginal and Torres Strait Islander population were food insecure, with 40% of this group exposed to food insecurity with food depletion and inadequate intake. This places this population at a 5 to 7-fold risk of experiencing food insecurity relative to their older non-Indigenous peers. Measures of geography, language and low socio-economic status were highly associated with exposure to food insecurity. Addressing food insecurity offers one pathway to reduce the disparity in health outcomes between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Policies that consider both remote and non-remote Australia, as well as those that involve Aboriginal people in their design and implementation are needed to reduce food insecurity.

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Radford, Kylie, Holly A. Mack, Hamish Robertson, Brian Draper, Simon Chalkley, Gail Daylight, Robert Cumming, Hayley Bennett, Lisa Jackson Pulver, and Gerald A. Broe. "The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians." International Psychogeriatrics 26, no. 6 (February 10, 2014): 1033–43. http://dx.doi.org/10.1017/s1041610213002561.

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ABSTRACTBackground:Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians.Methods:We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. “normal” range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of “gold standard” clinical consensus determinations of cognitive impairment and dementia.Conclusion:This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

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Shen, Yu-Tang, Kylie Radford, Gail Daylight, Robert Cumming, Tony Broe, and Brian Draper. "Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians." International Journal of Environmental Research and Public Health 15, no. 3 (March 4, 2018): 447. http://dx.doi.org/10.3390/ijerph15030447.

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Smith, K., L. Flicker, D. Atkinson, A. Dwyer, N. T. Lautenschlager, J. Thomas, O. P. Almeida, and D. LoGiudice. "The KICA Carer: informant information to enhance the Kimberley Indigenous Cognitive Assessment." International Psychogeriatrics 28, no. 1 (August 14, 2015): 101–7. http://dx.doi.org/10.1017/s1041610215001283.

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ABSTRACTBackground:A quality dementia-screening tool is required for older remote Aboriginal Australians who have high rates of dementia and limited access to appropriate medical equipment and clinicians. The Kimberley Indigenous Cognitive Assessment (KICA Cog) is a valid cognitive test for dementia in Aboriginal and Torres Strait Islander peoples. The KICA cognitive informant questionnaire (KICA Carer) had yet to be analyzed to determine validity alone or in combination with the KICA Cog.Methods:The KICA Carer was completed by nominated informants of 349 remote-living Aboriginal Australians in the Kimberley region, Western Australia. Validity was assessed by comparing KICA Carer with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) consensus diagnoses based on a blinded specialist review. KICA Carer and KICA Cog were then compared to determine joint validity.Results:A KICA Carer score of ≥3/16 gave optimum sensitivity (76.2%) and specificity (81.4%), area under curve (AUC) 0.89 (95% CI = 0.85, 0.94) with positive predictive value (PPV) of 35.8%, and negative predictive value (NPV) of 96.2%. A KICA Cog score of ≤33/39 gave a sensitivity of 92.9% and specificity of 89.9%, AUC 0.96 (95% CI = 0.94, 0.98), with PPV of 55.6% and NPV of 98.9%. Cut-off scores of KICA Cog ≤ 33/39 and KICA Carer ≥ 2/16 in series indicate possible dementia, with sensitivity of 90.5% and specificity of 93.5%. In this setting, PPV was 66.5% and NPV was 98.6%.Conclusions:The KICA Carer is an important tool to accurately screen dementia in remote Aboriginal Australians when the KICA Cog is unable to be used for a patient. It is readily accepted by caregivers.Key points:•For the best practice in the cognitive assessment of an Aboriginal Australian aged over 45 years, KICA Cog should be utilized.•In cases where Aboriginal patients are not assessed directly, KICA Carer should be conducted with an informant. A cut-off score of ≥3/16 should be used (these tools can be downloaded fromwww.wacha.org.au/kica.html).

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Radford, Kylie, Holly A. Mack, Brian Draper, Simon Chalkley, Kim Delbaere, Gail Daylight, Robert G. Cumming, Hayley Bennett, and Gerald A. Broe. "Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians." Dementia and Geriatric Cognitive Disorders 40, no. 1-2 (2015): 22–32. http://dx.doi.org/10.1159/000377673.

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Background: Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. Methods: In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. Results: All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. Conclusion: The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.

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Page, Amy, Zoë Hyde, Kate Smith, Christopher Etherton‐Beer, David N. Atkinson, Leon Flicker, Linda Skeaf, Roslyn Malay, and Dina C. LoGiudice. "Potentially suboptimal prescribing of medicines for older Aboriginal Australians in remote areas." Medical Journal of Australia 211, no. 3 (June 12, 2019): 119–25. http://dx.doi.org/10.5694/mja2.50226.

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Radford, Kylie, Louise M. Lavrencic, Kim Delbaere, Brian Draper, Robert Cumming, Gail Daylight, Holly A. Mack, et al. "Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians." Journal of Alzheimer's Disease 70, s1 (August 13, 2019): S75—S85. http://dx.doi.org/10.3233/jad-180573.

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Smith, Kate, Ailsa Sutherland, Zoë Hyde, Ruth Crawford, Anna Dwyer, Roslyn Malay, Linda Skeaf, Leon Flicker, David Atkinson, and Dina LoGiudice. "Assessment, incidence and factors associated with urinary incontinence in older Aboriginal Australians." Internal Medicine Journal 49, no. 9 (September 2019): 1111–18. http://dx.doi.org/10.1111/imj.14192.

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Smith, Kate, and Lianne Gilchrist. "Well-being of older Aboriginal Australians: The importance of ‘keeping spirit strong’." Australasian Journal on Ageing 36, no. 2 (June 2017): 112–13. http://dx.doi.org/10.1111/ajag.12421.

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Bryant, Joanne, James Ward, Heather Worth, Peter Hull, Sarina Solar, and Sandra Bailey. "Safer sex and condom use: a convenience sample of Aboriginal young people in New South Wales." Sexual Health 8, no. 3 (2011): 378. http://dx.doi.org/10.1071/sh10138.

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Background This paper examines condom use in a sample of Aboriginal young people in New South Wales (NSW) aged 16–30 years. Methods: Cross-sectional data were collected using hand-held computer devices from 293 Aboriginal people attending two Aboriginal events in NSW. Results: Almost two-thirds of respondents reported having had a casual sex partner in the previous 6 months. Of these, 39.2% reported always using a condom with casual partners. Having always used a condom with casual partners varied among respondents, and was more likely among younger respondents (adjusted odds ratio (AOR): 2.7, 95% confidence interval (CI): 1.2–6.1) and less likely among those who used illicit drugs (AOR: 0.2, 95% CI: 0.1–0.7). Conclusions: In comparison to published studies of other Australians, casual sex appears to be more common among this sample of Aboriginal young people; however, the proportion who report having always used condoms with casual partners is very similar. This suggests that although casual sex is more common, Aboriginal young people do not engage in risky behaviour any more often than other young Australians. Further work should be conducted with those who do not always use condoms, such as those who are older and who use illicit drugs, particularly with regards to how abstinence from drug use supports protective behaviours such as condom use among this population of Aboriginal young people.

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Gregory, Mark A. "An Opportunity." Journal of Telecommunications and the Digital Economy 3, no. 3 (September 28, 2015): ii—iii. http://dx.doi.org/10.18080/jtde.v3n3.25.

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The September issue provides an interesting look at the National Broadband Network and how it is perceived to have problems that need to be resolved and how telecommunications is having an effect on the lives of Australians with discussion on how older Australians engage with online news and how mobile phone use in remote Aboriginal and Torres Strait Islander communities is a balance between opportunity and affordability. Papers on future digital service delivery and metadata retention provide a balance between identifying future use and how authorities are looking our telecommunications usage.

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Lukaszyk, Caroline, Lara A. Harvey, Catherine Sherrington, Jacqueline CT Close, Julieann Coombes, Rebecca J. Mitchell, Robyn Moore, and Rebecca Ivers. "Fall‐related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians." Medical Journal of Australia 207, no. 1 (July 2017): 31–35. http://dx.doi.org/10.5694/mja16.01173.

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Minogue, Cecilia, Kim Delbaere, Kylie Radford, Tony Broe, Wendy Sue Forder, and Suncica Lah. "Development and initial validation of the Retrospective Indigenous Childhood Enrichment scale (RICE)." International Psychogeriatrics 30, no. 4 (November 17, 2017): 519–26. http://dx.doi.org/10.1017/s104161021700179x.

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ABSTRACTBackground:Years of education is the most commonly used proxy measure of cognitive reserve. Other forms of cognitive stimulation in childhood may provide similar protection against cognitive decline, particularly in Indigenous groups, where education may have been lacking in quality or quantity. The Retrospective Indigenous Childhood Enrichment (RICE) scale was developed to measure non-school-based activities and environmental stimulation during childhood that are likely to have enhanced cognitive reserve. The aim of the study was to assess the validity and reliability of the RICE scale with a group of older Aboriginal Australians.Methods:294 Aboriginal Australian people (60–92 years), living in urban or regional areas of NSW, completed the RICE scale as part of a longer face-to-face interview. Additional data was collected on their formal education, childhood environment, and childhood trauma (Study 1). Test–retest, inter-method and inter-rater reliability were assessed in a convenience sample of a further 38 participants by re-administration of the RICE scale at two time points, approximately 14 days apart (M = 14.11, SD = 6.78) (Study 2).Results:Factor analyses reduced the scale from 21 items to 18 and identified three factors: (1) Traditional, (2) Intellectual, and (3) Community. Higher scores on the RICE scale were related to higher years of formal education and lower scores on a childhood trauma questionnaire. The RICE scale had good internal consistency (Cronbach's α 0.79), and excellent test–retest reliability (ICC = 0.95, 95% CI 0.90–0.97) and inter-rater reliability (0.99, CI 95% 0.997–0.999).Conclusions:The RICE is, to our knowledge, the first standardized measure that assesses the level of childhood environmental stimulation in older Aboriginal Australians. This could provide an important supplementary measure, in addition to formal education, to investigate cognitive reserve and dementia risk in this population and enhance understanding of the links between childhood experiences and late-life cognitive decline.

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Radford, Kylie, Kim Delbaere, Brian Draper, Gail Daylight, Wendy Allan, Terrence Donovan, Robert Cumming, et al. "P3-564: RESILIENCE, COGNITIVE DECLINE AND DEMENTIA IN OLDER ABORIGINAL AUSTRALIANS: A LONGITUDINAL, POPULATION-BASED STUDY." Alzheimer's & Dementia 14, no. 7S_Part_25 (July 1, 2006): P1340. http://dx.doi.org/10.1016/j.jalz.2018.06.1930.

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Katzenellenbogen, Judith M., Laura J. Miller, Peter Somerford, Suzanne McEvoy, and Dawn Bessarab. "Strategic information for hospital service planning: a linked data study to inform an urban Aboriginal Health Liaison Officer program in Western Australia." Australian Health Review 39, no. 4 (2015): 429. http://dx.doi.org/10.1071/ah14102.

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Objectives The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. Methods A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006–11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. Results There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital re-admissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Conclusions Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes. What is known about the topic? The health gap between Aboriginal and non-Aboriginal Australians is well documented. Aboriginal people have significantly higher hospital utilisation rates, as well as higher rates of complications, comorbidities and discharges against medical advice (DAMA). Aboriginal patients receive most of their specialist services in hospital; however, detailed person-based analyses are limited and planning is often based on crude data. What does this paper add? This is the first analysis of linked data focusing on Aboriginal patient flows and volume and 28-day health system outcomes following hospital admission for all causes in a large metropolitan setting. Because the data were linked, admissions belonging to a single episode of care were combined, ensuring that transfers were not counted as re-admissions. Linkage also allowed follow up across time. The results highlight the main disease groups for which Aboriginal patients are admitted, how this varies by age and the high proportion of patients returning to (any) hospital within 28 days, either through EDs or as booked (pre-arranged) admissions. These data aid in the planning of hospital-based Aboriginal health liaison services. What are the implications for practitioners? The paper outlines the complexity with which many Aboriginal patients present to hospital and the risk of DAMA and re-admission. Clinical and organisational strategies can be put in place in hospitals to address these risks and ensure improved continuity of care with community-based primary health services. The Western Australian South Metropolitan Health Service is reviewing these data and will monitor the impact of the hospital-based AHLO program.

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Dutton, Tegan, Wendy Stevens, and Jamie Newman. "Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up." Australian Journal of Primary Health 22, no. 3 (2016): 233. http://dx.doi.org/10.1071/py14120.

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This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

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Thompson, Kelly J., Simon R. Finfer, Julieann Coombes, Sandra Eades, Kate Hunter, Robert Neil F. Leong, Ebony Lewis, and Bette Liu. "Incidence and outcomes of sepsis in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales: population-based cohort study." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 337–45. http://dx.doi.org/10.51893/2021.3.oa11.

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OBJECTIVE: To estimate the incidence and outcomes of sepsis hospitalisations in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales. DESIGN AND PARTICIPANTS: Prospective cohort study of residents aged 45 years and older, recruited between 2006 and 2009, and followed for hospitalisation for sepsis. MAIN OUTCOME MEASURES: Incidence and hazard ratio (HR) of sepsis hospitalisation and intensive care unit (ICU) admission identified using International Classification of Diseases (10th revision) coding on discharge data. Length of stay, readmission and mortality in those admitted for sepsis. RESULTS: Of 264 678 participants, 1928 (0.7%) identified as Aboriginal and/or Torres Strait Islander. Sepsis hospitalisation was higher in Aboriginal and Torres Strait Islander participants (8.67 v 6.12 per 1000 person-years; age- and sex-adjusted HR, 2.35; 95% CI, 1.98–2.80) but was attenuated after adjusting for sociodemographic factors, health behaviour and comorbidities (adjusted HR, 1.56; 95% CI, 1.31–1.86). Among those hospitalised for sepsis, after adjusting for age and sex, there were no differences between the proportions of Aboriginal and Torres Strait Islander and non-Indigenous participants admitted to an ICU (18.0% v 16.1%; P = 0.42) or deceased at 1 year (36.1% v 36.8%; P = 0.92). Aboriginal and Torres Strait Islander participants had shorter lengths of hospital stay (9.98 v 11.72 days; P < 0.001) and ICU stay (4.38 v 6.35 days; P < 0.001) than non-Indigenous participants. Overall, more than 70% of participants were readmitted to hospital within 1 year. CONCLUSION: We found that the rate of sepsis hospitalisation in NSW was higher for Aboriginal and Torres Strait Islander adults. Culturally appropriate, community-led strategies targeting chronic disease prevention and the social determinants of health may reduce this gap. Preventing readmission following sepsis is a priority for all Australians.

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ROWLEY, Kevin, Kerin O'DEA, Qing SU, Alicia J. JENKINS, and James D. BEST. "Low plasma concentrations of diet-derived antioxidants in association with microalbuminuria in Indigenous Australian populations." Clinical Science 105, no. 5 (November 1, 2003): 569–75. http://dx.doi.org/10.1042/cs20030162.

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Microalbuminuria is a risk factor for renal and cardiovascular diseases. Oxidant stress may contribute to vascular disease risk by promoting damage to renal and vascular tissues. This study examined the associations of plasma levels of diet-derived antioxidants with albuminuria in Australian population groups at high risk of renal and cardiovascular disease. Data on microalbuminuria and diet-derived plasma antioxidants were drawn from results of cross-sectional community-based risk factor surveys of Aboriginal and Torres Strait Islander peoples (n=698, 15 years and older). Prevalence of microalbuminuria ranged from 17–21%. After adjustment for age, gender, body mass index, diabetes, smoking status, plasma lipids and blood pressure, microalbuminuria was associated with significantly lower plasma concentrations of lycopene (-29%; P<0.001), β-carotene (-22%; P<0.001), α-carotene (-22%; P<0.001) and cryptoxanthin (-17%; P<0.001) compared with normalbuminuric persons. Significant associations of microalbuminuria with plasma concentrations of α-tocopherol, retinol, lutein plus zeaxanthin and homocysteine were absent. The data are consistent with a protective effect of diets rich in carotenoids on vascular endothelium and/or renal tissues, and support the need for interventions to address affordable food supplies and dietary quality among Indigenous Australians.

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Smith, Kate, and Leon Flicker. "Self-reported health and older Aboriginal Australians – healing, balance, connection, and inner spirit are important learnings for all of us." International Psychogeriatrics 32, no. 11 (November 2020): 1267–70. http://dx.doi.org/10.1017/s1041610219002230.

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McNamara, Bridgette J., Emily Banks, Lina Gubhaju, Anna Williamson, Grace Joshy, Beverley Raphael, and Sandra J. Eades. "Measuring psychological distress in older Aboriginal and Torres Strait Islanders Australians: a comparison of the K-10 and K-5." Australian and New Zealand Journal of Public Health 38, no. 6 (October 12, 2014): 567–73. http://dx.doi.org/10.1111/1753-6405.12271.

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Flicker, Leon, and Dina Logiudice. "What can we learn about dementia from research in Indigenous populations?" International Psychogeriatrics 27, no. 12 (October 29, 2015): 1957–58. http://dx.doi.org/10.1017/s1041610215001684.

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Indigenous peoples represent up to 5% of the world's population (almost 400 million people), representing thousands of individual cultures and language groups. The health status of older Indigenous peoples has been little researched, partly related to lower life expectancy and the consideration that Indigenous peoples do not live long enough to experience the common “geriatric syndromes” such as dementia, frailty, and falls. Statistics from Australia and Canada now report that Indigenous populations are undergoing rapid aging, with many examples of survivorship to old age (Arkleset al., 2010; Jacklinet al., 2012). The systematic review by Warrenet al. (2015) is a timely one, in that it reminds clinicians interested in old age that this “fourth” World population deserves further attention. Researchers that have worked with these groups to produce population estimates are relatively few. In their systematic review, Warrenet al.(2015) demonstrate wide variation in prevalence rates of dementia. They conclude that a major cause of this heterogeneity in prevalence is due to basic methodological differences. In particular, those studies that have utilized already acquired routine data may be biased. The type and direction of this bias can be complex. For example, Cotteret al.(2012) using routinely collected data, concluded that the prevalence of dementia in Aboriginal Australians in the Northern Territory was not higher than non-Aboriginal prevalence. Using similar methodologies some years later the conclusion was that the Aboriginal population had markedly higher rates (Liet al., 2014). In the intervening period, a dementia awareness campaign coupled with the development of a culturally appropriate screening tool probably resulted in greater detection in routine care.

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Lavrencic, Louise M., Hayley Bennett, Gail Daylight, Brian Draper, Robert Cumming, Holly Mack, Gail Garvey, et al. "Cognitive test norms and comparison between healthy ageing, mild cognitive impairment, and dementia: A population‐based study of older Aboriginal Australians." Australian Journal of Psychology 71, no. 3 (January 7, 2019): 249–60. http://dx.doi.org/10.1111/ajpy.12241.

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Pridmore, Saxby A., and Ivor H. Jones. "Long Term Secure Care in Tasmania." Australian & New Zealand Journal of Psychiatry 26, no. 3 (September 1992): 423–28. http://dx.doi.org/10.3109/00048679209072065.

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The aim was to determine the requirement in Tasmania for long term (greater than 28 days) secure ward beds, and to characterise the patients who use them. There was complete enumeration over an 18 month period. The results included that 3.6 long term secure beds were used per 100,000 general population. Compared to those who were discharged during the survey, those who were not discharged were older, had spent longer in psychiatric hospitals and were more likely to be male and to suffer from schizophrenia. All patients were white Australians. The conclusions included that for planning purposes a minimum of 4.6 long term secure beds was required per 100,000 general population. Also, Aboriginal people and people from non-English speaking backgrounds were not over represented in long term secure care in Tasmania. Finally, “good” and “poor” prognosis groups were identified and further work is required to determine how these can best be managed.

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Radford, Kylie, Jade Perdereau, Kim Delbaere, Brian Draper, Olivier Piguet, Caroline Rae, Louise Lavrencic, and G. A. Tony Broe. "P4-157: NEURAL CORRELATES OF EARLY LIFE STRESS IN A POPULATION AT HIGHER RISK FOR DEMENTIA: A PILOT STUDY IN OLDER ABORIGINAL AUSTRALIANS." Alzheimer's & Dementia 14, no. 7S_Part_28 (July 1, 2006): P1499. http://dx.doi.org/10.1016/j.jalz.2018.06.2562.

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de Crespigny, Charlotte, Carol Grbich, and Jennifer Watson. "Older Aboriginal Women's Experiences of Medications in Urban South Australia." Australian Journal of Primary Health 4, no. 4 (1998): 6. http://dx.doi.org/10.1071/py98057.

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Older women are more likely to live alone in poverty than others in the community. They are also likely to maintain their independence well into older life. Recent Australian research into women's health issues has not investigated older women's direct experiences associated with their medication use, or any related interactions with health professionals such as general practitioners, pharmacists or registered nurses. This is despite significant funding, policy and research in most other areas of women's health in the 1990s. Similarly, the medication experiences of older Aboriginal women have been neglected. This paper reports on a cohort of older Aboriginal women (N-10) from a recent South Australian qualitative study into medication use of diverse groups of older women (N-142). In-depth, semi-structured, face to face interviews were conducted, predominantly in participants' suburban homes, and in a community setting. Thematic analysis of the data was undertaken, and comparisons were made with other cohorts in the overall study. Results showed that the experiences and perspectives of the urban Aboriginal women highlighted their connectedness with family, services and community, and that this was largely due to their access to particular Aboriginal services, and to indigenous cultural affiliations and practices. Despite this connectedness, and regular contact with general practitioners and pharmacists, there were significant deficits in their knowledge and skills in managing their medication. It became clear that there is an urgent need for culturally safe medication information, education and support for older Aboriginal women. There is also an urgent need for better education, training and support of all health workers who have critical roles and responsibilities in assisting this group in the community.

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Hansman, D., S. Morris, M. Gregory, and B. McDonald. "Pneumococcal carriage amongst Australian aborigines in Alice Springs, Northern Territory." Journal of Hygiene 95, no. 3 (December 1985): 677–84. http://dx.doi.org/10.1017/s0022172400060782.

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SUMMARYIn Alice Springs and its vicinity, a single nasal swab was collected from 282 Australian aborigines in May 1981 to determine nasal carriage rates of pneumococci. Each swab was inoculated on blood agar and on gentamicin blood agar. The carriage rates were 89% in children, 39% in adolescents and 34% in adults. In all, 27 serotypes of pneumococci were met with and 15 (4%) of subjects yielded two or more serotypes. In children, types 23, 19, 6, 22 and 6 were predominant (in that order), whereas type 3 was commonest in older subjects. Approximately 25% children and 5% adults yielded drug-insensitive pneumococci. Resistance to benzylpenicillin, tetracycline and co-trimoxazole was met with, resistant pneumococci showed five resistance patterns and belonged to nine serotypes, predominantly types 19 and 23. All isolates were sensitive to chloramphenicol, erythromycin, lincomycin and rifampicin. The carriage rate of drug-insensitive pneumococci was 100-fold higher amongst children sampled than in non-aboriginal children in Australia.

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Ivers, Rebecca, Julieann Coombes, Catherine Sherrington, Tamara Mackean, Anne Tiedemann, Anne-Marie Hill, Lisa Keay, et al. "Healthy ageing among older Aboriginal people: the Ironbark study protocol for a cluster randomised controlled trial." Injury Prevention 26, no. 6 (October 7, 2020): 581–87. http://dx.doi.org/10.1136/injuryprev-2020-043915.

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IntroductionOlder Aboriginal people have a strong leadership role in their community including passing on knowledge and teachings around culture and connections to Country. Falls significantly affect older people and are a growing concern for older Aboriginal people and their families. Regular participation in balance and strength exercise has been shown to be efficacious in reducing falls. A pilot study developed in partnership with Aboriginal communities, the Ironbark: Standing Strong and Tall programme, demonstrated high community acceptability and feasibility, and gains in balance and strength in Aboriginal participants. This cluster randomised controlled trial will assess the effectiveness of the programme in reducing the rate of falls in older Aboriginal people.MethodsWe will examine the effectiveness and cost-effectiveness of the Ironbark group-based fall prevention programme compared with a group-based social programme, with Aboriginal people aged 45 years and older in three Australian states. The primary outcome is fall rates over 12 months, measured using weekly self-reported data. Secondary outcomes measured at baseline and after 12 months include quality of life, psychological distress, activities of daily living, physical activity, functional mobility and central obesity. Differences between study groups in the primary and secondary outcomes at 12 months will be estimated.ConclusionThis is the first trial to investigate the effectiveness and cost-effectiveness of a fall prevention programme for Aboriginal peoples aged ≥45 years. The study has strong cultural and community governance, including Aboriginal investigators and staff, and is guided by a steering committee that includes representatives of Aboriginal community-controlled services.Trial registration numberACTRN12619000349145.

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Cox, Terrance, Ha Hoang, Tony Barnett, and Merylin Cross. "Older Aboriginal men creating a therapeutic Men's Shed: an exploratory study." Ageing and Society 40, no. 7 (January 30, 2019): 1455–68. http://dx.doi.org/10.1017/s0144686x18001812.

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AbstractMen's Sheds are entrenched throughout Australian and international communities due to their popularity in attracting mainly older men to come together and undertake various social and workshop activities. A growing body of research has emerged where men associate regular Shed participation with improved social, emotional and physical wellbeing. However, few studies have examined Aboriginal men's engagement in Men's Sheds. This article reports on a study that investigated how a cohort of older Aboriginal men from one rural Tasmanian community consider the benefits of engaging in their local Shed. A community-based participatory research approach was developed in consultation with Aboriginal community leaders to ensure the study supported the community's expectations. Interview data from ten Aboriginal men combine to represent the Shed environment as an enabling therapeutic landscape, with key themes represented as domains of belonging, hope, mentoring and shared illness experiences. Shed activities were premised on these men co-creating an informal, culturally safe and male-friendly community environment to enjoy the company of other men. The created Shed environment was mutually beneficial as the participants reported improved wellbeing despite living with the effects of declining health and ageing. The findings inform Aboriginal communities and health-care stakeholders to consider the unique role of Men's Sheds for enhancing the health of an ageing male population.

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Arkles, Rachelle, Claire Jankelson, Kylie Radford, and Lisa Jackson Pulver. "Family caregiving for older Aboriginal people in urban Australia: Disclosing worlds of meaning in the dementia experience." Dementia 19, no. 2 (June 7, 2018): 397–415. http://dx.doi.org/10.1177/1471301218776761.

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Dementia in Australia’s Aboriginal and Torres Strait Islander population is an area of significant health and community concern. In this article, we use a hermeneutic mode of interpretation to deepen understanding of experience and meaning in dementia for family carers of older Aboriginal people in urban Australia. Specifically, we draw from the hermeneutic concept of “world disclosure” to illuminate the dementia experience in three ways: through an artwork of the brain and dementia; through concrete description of the lived relation of caregiving; and through an epochal perspective on the significance of contemporary caregiving in dementia. Using narrative and visual knowledge, this three-fold approach brings to the forefront the importance of ontological and existential meanings which resonate for Aboriginal families in the dementia caregiving experience.

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Ford, Margot. "Language Nests in New Zealand. Implications for the Australian Aboriginal and Torres Strait Islander Context." Australian Journal of Indigenous Education 24, no. 2 (1996): 15–19. http://dx.doi.org/10.1017/s1326011100002416.

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In the past ten years there has been an increasing interest in early childhood education in Aboriginal communities, particularly for 4-year-olds and under. The reasons for this are varied. One of the main reasons is the existence of the Community Development Employment Project (CDEP) where Aboriginal people in remote communities receive the equivalent of the unemployment benefit in exchange for work and training, usually four hours per day for five days. Other larger communities, for example Yuendemu or Maningrida in the Northern Territory, have considerable numbers of people studying, often at Batchelor College, and therefore some type of support is needed to take care of their young children. Increasingly Aboriginal people are taking on professional jobs in communities — teachers, health care workers and office administrators. All these factors are leading to a need to re-evaluate traditional forms of child care, which in these changing times is putting an unacceptable burden on older women and the extended family generally. Other pertinent reasons are the need for a more cohesive strategy to pass on cultural knowledge, to support language maintenance and language revival and support very young mothers who need the support of older women with more experience.

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Ranzijn, Rob. "Active Ageing —Another Way to Oppress Marginalized and Disadvantaged Elders?" Journal of Health Psychology 15, no. 5 (July 2010): 716–23. http://dx.doi.org/10.1177/1359105310368181.

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This article questions whether the concept of active ageing unintentionally devalues the life experiences of disadvantaged groups of older people. It is argued that talking up the expectation that older people will continue to be physically active may further marginalize significant groups of elders, including those from diverse non-dominant cultural groups. The article draws on a study of Australian Aboriginal Elders to illustrate this point, with suggestions about culturally appropriate ageing policies. The article concludes that alternative conceptions of ageing, such as ‘ageing well’ or ‘authentic ageing’, may better capture the cultural diversity of ageing and promote social inclusion.

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Mansfield, John Basil. "Consonant lenition as a sociophonetic variable in Murrinh Patha (Australia)." Language Variation and Change 27, no. 2 (June 8, 2015): 203–25. http://dx.doi.org/10.1017/s0954394515000046.

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AbstractIn recent years, the typological and geographic range of languages subjected to sociophonetic study has been expanding, though until now Australian Aboriginal languages have been absent from this subdiscipline. This first sociophonetic study of an Australian language, Murrinh Patha, shows a type of consonant lenition that is notably distinct from the better known examples in Standard Average European languages, effecting /p/ and /k/ primarily in the onset of stressed, usually word-initial syllables. Young men lenite more frequently than older men do, and paternal heritage from the neighboring Marri language group also predicts more frequent lenition. The latter influence may be the result of intense language contact brought about by recent settlement of diverse language groups at the Catholic Mission of Port Keats.

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Dixon, R. M. W. "A changing language situation: The decline of Dyirbal 1963–1989." Language in Society 20, no. 2 (June 1991): 183–200. http://dx.doi.org/10.1017/s0047404500016262.

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ABSTRACTDyirbal was probably originally spoken by about 5,000 people across its 10 dialects. In 1963, the northern dialects had just a few speakers (now all dead save one), but two southern dialects had formed a language community with several score speakers, including a number of children. Over the past quarter-century, younger people have switched to English, while among the older ones a new “merged dialect” has developed. The social situations and attitudes of speakers are described, in addition to changing language identifications. The writer has seen Dyirbal contract in lexical and grammatical complexity as it has moved toward an inevitable extinction. (Sociolinguistics, language death, Australian Aboriginal languages, field methods)

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Tinashe, Dune, Stewart Jo., Tronc Wendy, Lee Vanessa, Mapedzahama Virginia, Firdaus Rubab, and Mekonnen Tensae. "Redefining Constructions of Sexuality and Sexual Wellbeing across Generations: Lessons from Ageing Aboriginal Women." International Journal of Social Science Studies 6, no. 3 (February 9, 2018): 40. http://dx.doi.org/10.11114/ijsss.v6i3.3014.

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This study explored how Indigenous women living in Australia understand, experience and construct sexuality within contexts dominated by revealed the impact of Eurocentric conceptualisations of gender, embodiment and intimacy. This project was informed by feminist methodology and collected data using semi-structured focus groups, which naturally took on the yarning method. The discussions, held on the Sunshine Coast in Queensland, were had with women aged 42 to 73 years, across three focus groups. The women primarily constructed sexuality within Australia’s history of colonisation, discrimination and prejudice against Indigenous people, the uptake of European values and their impact on Indigenous people over time and across generations. Self-esteem was a central feature across all major themes and described as integral to health constructions of sexuality and health relationships. Changes over time were characterised by the women’s commitment to instilling self-esteem in following generations as well as limitations to self-esteem resulting from discrimination. Socialising future generations to display and embrace intimacy was also central to a healthy construction of sexuality. The findings from this study reinforce that learning from Indigenous women about sexuality and ageing is key to enriching the evidence-base as well as health worker and researcher capacity while reinforcing the importance of self-care among Indigenous older women. Integrating such an approach with Indigenous women has the potential to increase the effectiveness and relevance of health promotion and wellbeing programmes aimed at older Indigenous women in the present and future.

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De Rooy, Kathleen, Sarah Bennett, and Michelle Sydes. "Women Released From Custody: Investigating Risk Factors and Reoffending." International Journal of Offender Therapy and Comparative Criminology 63, no. 13 (May 12, 2019): 2239–63. http://dx.doi.org/10.1177/0306624x19845778.

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This article draws on life-course and desistance theory to explore the relationship between the factors of age, ethnicity, offence type, and incarceration history for a sample of 1,035 women released from custody between January 2013 and January 2014, data gathered from the Australian Queensland Corrective Services administrative dataset. It also explores their impact on recidivism and the time between release and reoffending (known as “time to failure”) until September 2017. The data indicate substantial rates of reoffending with 70% of the sample reoffending (a return to custody/parole/probation) within the 2- to 4-year observation period. Notably, 50% of women reoffended in their first year post-release, 36% within 6 months, and 23% within the first 3 months. Regression results show that violent offenders are considerably more likely to be recidivists and older offenders are less likely to be recidivists; Aboriginal and Torres Strait Islander offenders were also more likely to reoffend. Incarceration history is significantly associated with reoffending and “time to failure”. It is clear that there needs to be increased intervention and support for female offenders during the first 2 years post-release from custody. This is particularly important for Aboriginal and Torres Strait Islander women and those with an extensive history of incarceration.

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Mackenzie, Grant, Jonathan Carapetis, Amanda J. Leach, Kim Hare, and Peter Morris. "Indirect effects of childhood pneumococcal vaccination on pneumococcal carriage among adults and older children in Australian Aboriginal communities." Vaccine 25, no. 13 (March 2007): 2428–33. http://dx.doi.org/10.1016/j.vaccine.2006.09.015.

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Waller, Lisa, and Kerry McCallum. "How television moved a nation: media, change and Indigenous rights." Media, Culture & Society 40, no. 7 (February 1, 2018): 992–1007. http://dx.doi.org/10.1177/0163443718754650.

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This article examines the role of television in Australia’s 1967 referendum, which is widely believed to have given rights to Aboriginal and Torres Strait Islander peoples. It presents an analysis of archival television footage to identify five stories that moved the nation: Australia’s shame, civil rights and global connections, admirable activists, ‘a fair go’ and consensus. It argues that television shaped the wider culture and opened a channel of communication that allowed Indigenous activists and everyday people to speak directly to non-Indigenous people and other First Nations people throughout the land for the first time. The referendum narrative that television did so much to craft and promote marks the shift from an older form of settler nationalism that simply excluded Indigenous people, to an ongoing project that seeks to recognise, respect and ‘reaccredit’ the nation-state through incorporation of Indigenous narratives. We conclude that whereas television is understood to have ‘united’ the nation in 1967, 50 years later seismic shifts in media and society have made the quest for further constitutional reform on Indigenous rights and recognition more sophisticated, diffuse, complex and challenging.

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Armstrong, Gregory, Georgina Sutherland, Eliza Pross, Andrew Mackinnon, Nicola Reavley, and Anthony F. Jorm. "Talking about suicide: An uncontrolled trial of the effects of an Aboriginal and Torres Strait Islander mental health first aid program on knowledge, attitudes and intended and actual assisting actions." PLOS ONE 15, no. 12 (December 17, 2020): e0244091. http://dx.doi.org/10.1371/journal.pone.0244091.

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Objective Suicide is a leading cause of death among Aboriginal and Torres Strait Islander people. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is at risk of suicide. We developed culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islander people experiencing suicidal thoughts or behaviour and used this as the basis for a 5-hour suicide gatekeeper training course called Talking About Suicide. This paper describes the outcomes for participants in an uncontrolled trial of this training course. Methods We undertook an uncontrolled trial of the Talking About Suicide course, delivered by Aboriginal and Torres Strait Islander Mental Health First Aid instructors to 192 adult (i.e. 18 years of age or older) Aboriginal and Torres Strait Islander (n = 110) and non-Indigenous (n = 82) participants. Questionnaires capturing self-report outcomes were self-administered immediately before (n = 192) and after attending the training course (n = 188), and at four-months follow-up (n = 98). Outcome measures were beliefs about suicide, stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a suicidal person. Results Despite a high level of suicide literacy among participants at pre-course measurement, improvements at post-course were observed in beliefs about suicide, stigmatising attitudes, confidence in ability to assist and intended assisting actions. While attrition at follow-up decreased statistical power, some improvements in beliefs about suicide, stigmatising attitudes and intended assisting actions remained statistically significant at follow-up. Importantly, actual assisting actions taken showed dramatic improvements between pre-course and follow-up. Participants reported feeling more confident to assist a suicidal person after the course and this was maintained at follow-up. The course was judged to be culturally appropriate by those participants who identified as Aboriginal and/or Torres Strait Islanders. Implications The results of this uncontrolled trial were encouraging, suggesting that the Talking About Suicide course was able to improve participants’ knowledge, attitudes, and intended assisting actions as well as actual actions taken.

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Thurber, Katherine, Emily Colonna, Roxanne Jones, Gilbert Gee, Naomi Priest, Rubijayne Cohen, David Williams, Joanne Thandrayen, Tom Calma, and Raymond Lovett. "Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia." International Journal of Environmental Research and Public Health 18, no. 12 (June 18, 2021): 6577. http://dx.doi.org/10.3390/ijerph18126577.

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Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a national sample of Aboriginal and Torres Strait Islander (Australia’s Indigenous peoples) adults surveyed from 2018 to 2020 (≥16 years, n = 8108). It quantifies Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) for wellbeing outcomes by level of discrimination exposure, and tests if associations vary by attribution of discrimination to Indigeneity. Of the participants, 41.5% reported no discrimination, 47.5% low, and 11.0% moderate-high. Discrimination was more commonly reported by younger versus older participants, females versus males, and those living in remote versus urban or regional areas. Discrimination was significantly associated in a dose-response manner, with measures of social and emotional wellbeing, culture and identity, health behaviour, and health outcomes. The strength of the association varied across outcomes, from a 10–20% increased prevalence for some outcomes (e.g., disconnection from culture (PR = 1.08; 95% CI: 1.03, 1.14), and high blood pressure (1.20; 1.09, 1.32)), to a five-fold prevalence of alcohol dependence (4.96; 3.64, 6.76), for those with moderate-high versus no discrimination exposure. The association was of consistent strength and direction whether attributed to Indigeneity or not—with three exceptions. Discrimination is associated with a broad range of poor wellbeing outcomes in this large-scale, national, diverse cohort of Aboriginal and Torres Strait Islander adults. These findings support the vast potential to improve Aboriginal and Torres Strait Islander peoples’ wellbeing, and to reduce Indigenous-non-Indigenous inequities, by reducing exposure to discrimination.

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Grimmer, Karen, Kate Beaton, Saravana Kumar, Kevan Hendry, John Moss, Susan Hillier, John Forward, and Louise Gordge. "Estimating the risk of functional decline in the elderly after discharge from an Australian public tertiary hospital emergency department." Australian Health Review 37, no. 3 (2013): 341. http://dx.doi.org/10.1071/ah12034.

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Objective. To estimate the risk of functional decline after discharge for older people presenting to, and discharged from, a large emergency department (ED) of a tertiary hospital. Methods. The cohort was generated by consecutive sampling of non-Indigenous males and females aged 65 years or over or Aboriginal and Torres Strait Islander males and females aged 45 years or more, without diagnosed dementia, who were living independently in the community before presenting at ED and who were not admitted to hospital as an inpatient after presenting to ED. The hospital assessment risk profile (HARP) was administered to all eligible participants. Sociodemographic information was collected. Results. Approximately 40 patients per day over two 14-week data collection periods were potentially eligible for inclusion in the study. In total, 597 (17.6% of individuals who presented to ED) were eligible, agreed to participate and continued to be eligible on discharge from ED. Their HARP scores suggested that ~52% were at-risk of functional decline (14.1% high risk, 38.5% intermediate risk). Conclusions. Elderly patients present to and are discharged from ED every day. The routinely administered HARP instrument scores suggested that approximately half these individuals were at-risk of functional decline in one large hospital ED. Given this instrument’s moderate diagnostic accuracy, the true figure may be higher. We suggest that all over-65 year olds presenting at ED without being admitted as an inpatient should be considered for routine screening for potential downstream functional decline, and for intervention if indicated. What is known about the topic? Older individuals often present to ED in lieu of consulting a general medical practitioner, and are not admitted to a hospital bed. Patient demographics, functional and mental capacity and reasons for presentation may be flags for functional decline in the coming months. These could be used by ED staff to implement targeted assessment and intervention. What does this paper add? This paper highlights the high percentage of older individuals who, at time of ED presentation, are at-risk of downstream functional decline. What are the implications for practitioners? Older people who are discharged from ED without a hospital admission may ‘slip through the net’, as an ED presentation presents a limited window of opportunity for ED staff to undertake targeted assessment, and intervention, to address the potential for downstream functional decline. The busy nature of ED, resource implications and the range of presenting conditions of older people may preclude this. This research suggests a reality that a large percentage of older people who present at ED but do not require a subsequent hospital admission have the potential for functional decline after discharge. Addressing this, in terms of specific screening processes and interventions, requires a rethink of hospital and community resources, and relationships.

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Lakhan, Prabha, Uchechukwu L. Osuagwu, Deborah Askew, Noel Hayman, and Geoffrey Spurling. "Visual impairment among Aboriginal and Torres Strait Islander patients attending an Australian Indigenous primary health service: a cross-sectional study." Australian Journal of Primary Health 26, no. 4 (2020): 287. http://dx.doi.org/10.1071/py19119.

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This cross-sectional study aimed to identify the period prevalence of visual impairment (VI) and blindness among Aboriginal and Torres Strait Islander people attending an Indigenous urban primary healthcare service, eye care practitioner referrals for those with VI and any opportunities to improve care delivery. Visual acuity (VA) examinations, using a Snellen chart, are performed as part of routine annual health assessments offered to children and adults. This study included patients aged ≥5 years (n=1442) who had a health assessment conducted between 1 January 2015 and 31 December 2016 and provided consent for the use of their health assessment information for research. Of patients with available data, 2.4% (33/1374) experienced VI, defined as presenting VA worse than 6/12 to 6/60 in the better-seeing eye. VI was more common in those aged ≥60 years (14/136; 10.3%) and was significantly associated with increasing age (P<0.001). No patients experienced blindness, defined as presenting VA worse than 6/60 in the better-seeing eye. All patients with VI were aged ≥16 years. Nine (27%) of the 33 patients with VI in the better-seeing eye were referred to an optometrist or an ophthalmologist. The low period prevalence of VI and no blindness in this study are positive findings. The findings also indicate that routine VA testing of older adults, especially those aged ≥60 years, should be conducted to avoid missing those not having an annual health assessment.

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Armstrong, Gregory, Jane Pirkis, Kerry Arabena, Dianne Currier, Matthew J. Spittal, and Anthony F. Jorm. "Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups." Australian & New Zealand Journal of Psychiatry 51, no. 12 (April 9, 2017): 1240–48. http://dx.doi.org/10.1177/0004867417704059.

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Objectives: We compare the prevalence of suicidal thoughts and attempts between Indigenous and non-Indigenous males in urban and regional Australia, and examine the extent to which any disparity between Indigenous and non-Indigenous males varies across age groups. Methods: We used data from the baseline wave of The Australian Longitudinal Study on Male Health (Ten to Men), a large-scale cohort study of Australian males aged 10–55 years residing in urban and regional areas. Indigenous identification was determined through participants self-reporting as Aboriginal, Torres Strait Islander or both. The survey collected data on suicidal thoughts in the preceding 2 weeks and lifetime suicide attempts. Results: A total of 432 participants (2.7%) identified as Indigenous and 15,425 as non-Indigenous (97.3%). Indigenous males were twice as likely as non-Indigenous males to report recent suicidal thoughts (17.6% vs 9.4%; odds ratio = 2.1, p < 0.001) and more than three times as likely to report a suicide attempt in their lifetime (17.0% vs 5.1%; odds ratio = 3.6; p < 0.001). The prevalence of recent suicidal thoughts did not differ between Indigenous and non-Indigenous males in younger age groups, but a significant gap emerged among men aged 30–39 years and was largest among men aged 40–55 years. Similarly, the prevalence of lifetime suicide attempts did not differ between Indigenous and non-Indigenous males in the 14- to 17-years age group, but a disparity emerged in the 18- to 24-years age group and was even larger among males aged 25 years and older. Conclusion: Our paper presents unique data on suicidal thoughts and attempts among a broad age range of Indigenous and non-Indigenous males. The disparity in the prevalence of suicidal thoughts increased across age groups, which is in contrast to the large disparity between the Indigenous and non-Indigenous suicide rates in younger age groups.

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Kouris-Blazos, Antigone, and Mark Wahlqvist. "Indigenous Australian food culture on cattle stations prior to the 1960s and food intake of older Aborigines in a community studied in 1988." Asia Pacific Journal of Clinical Nutrition 9, no. 3 (September 23, 2000): 224–31. http://dx.doi.org/10.1046/j.1440-6047.2000.00189.x.

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Chan, Samuel, Mark R. Marshall, Robert J. Ellis, Dwarakanathan Ranganathan, Carmel M. Hawley, David W. Johnson, and Martin J. Wolley. "Haemodialysis withdrawal in Australia and New Zealand: a binational registry study." Nephrology Dialysis Transplantation 35, no. 4 (August 9, 2019): 669–76. http://dx.doi.org/10.1093/ndt/gfz160.

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Abstract Background Withdrawal from dialysis is an increasingly common cause of death in patients with end-stage kidney disease (ESKD). As most published reports of dialysis withdrawal have been outside the Oceania region, the aims of this study were to determine the frequency, temporal pattern and predictors of dialysis withdrawal in Australian and New Zealand patients receiving chronic haemodialysis. Methods This study included all people with ESKD in Australia and New Zealand who commenced chronic haemodialysis between 1 January 1997 and 31 December 2016, using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Competing risk regression models were used to identify predictors of dialysis withdrawal mortality, using non-withdrawal cause of death as the competing risk event. Results Among 40 447 people receiving chronic haemodialysis (median age 62 years, 61% male, 9% Indigenous), dialysis withdrawal mortality rates increased from 1.02 per 100 patient-years (11% of all deaths) during the period 1997–2000 to 2.20 per 100 patient-years (32% of all deaths) during 2013–16 (P < 0.001). Variables that were significantly associated with a higher likelihood of haemodialysis withdrawal were older age {≥70 years subdistribution hazard ratio [SHR] 1.77 [95% confidence interval (CI) 1.66–1.89]; reference 60–70 years}, female sex [SHR 1.14 (95% CI 1.09–1.21)], white race [Asian SHR 0.56 (95% CI 0.49–0.65), Aboriginal and Torres Strait Islander SHR 0.83 (95% CI 0.74–0.93), Pacific Islander SHR 0.47 (95% CI 0.39–0.68), reference white race], coronary artery disease [SHR 1.18 (95% CI 1.11–1.25)], cerebrovascular disease [SHR 1.15 (95% CI 1.08–1.23)], chronic lung disease [SHR 1.13 (95% CI 1.06–1.21)] and more recent era [2013–16 SHR 3.96 (95% CI 3.56–4.48); reference 1997–2000]. Conclusions Death due to haemodialysis withdrawal has become increasingly common in Australia and New Zealand over time. Predictors of haemodialysis withdrawal include older age, female sex, white race and haemodialysis commencement in a more recent era.

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Kapellas, Kostas, Jaquelyne T. Hughes, Alan Cass, Louise J. Maple-Brown, Michael R. Skilton, David Harris, Lisa M. Askie, et al. "Oral health of aboriginal people with kidney disease living in Central Australia." BMC Oral Health 21, no. 1 (February 4, 2021). http://dx.doi.org/10.1186/s12903-021-01415-4.

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Abstract Background Associations between kidney disease and periodontal disease are not well documented among Aboriginal people of Australia. The purpose of this investigation was to report and compare demographic, oral health, anthropometric and systemic health status of Aboriginal Australians with kidney disease and to compare against relevant Aboriginal Australians and Australian population estimates. This provides much needed evidence to inform dental health service provision policies for Aboriginal Australians with kidney disease. Methods Sample frequencies and means were assessed in adults represented in six datasets including: (1) 102 Aboriginal Australians with kidney disease residing in Central Australia who participated in a detailed oral health assessment; (2) 312 Aboriginal participants of the Northern Territory’s PerioCardio study; (3) weighted estimates from 4775 participants from Australia’s National Survey of Adult Oral Health (NSAOH); (4) Australian 2016 Census (all Australians); (5) National Health Survey 2017–2018 (all Australians) and; (6) Australian Health Survey: Biomedical Results for Chronic Diseases, 2011–2012 (all Australians). Oral health status was described by periodontal disease and experience of dental caries (tooth decay). Statistically significant differences were determined via non-overlapping 95% confidence intervals. Results Aboriginal Australians with kidney disease were significantly older, less likely to have a tertiary qualification or be employed compared with both PerioCardio study counterparts and NSAOH participants. Severe periodontitis was found in 54.3% of Aboriginal Australians with kidney disease, almost 20 times the 2.8% reported in NSAOH. A higher proportion of Aboriginal Australians with kidney disease had teeth with untreated caries and fewer dental restorations when compared to NSAOH participants. The extent of periodontal attachment loss and periodontal pocketing among Aboriginal Australians with kidney disease (51.0%, 21.4% respectively) was several magnitudes greater than PerioCardio study (22.0%, 12.3% respectively) and NSAOH (5.4%, 1.3% respectively) estimates. Conclusions Aboriginal Australians with kidney disease exhibited more indicators of poorer oral health than both the general Australian population and a general Aboriginal population from Australia’s Northern Territory. It is imperative that management of oral health among Aboriginal Australians with kidney disease be included as part of their ongoing medical care.

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Smith, Kate, Lianne Gilchrist, Kevin Taylor, Christine Clinch, Dina Logiudice, Paula Edgill, Julie Ratcliffe, et al. "Good Spirit, Good Life: A Quality of Life Tool and Framework for Older Aboriginal Peoples." Gerontologist, March 19, 2020. http://dx.doi.org/10.1093/geront/gnz185.

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Abstract Background and Objectives The lack of appropriate quality of life (QoL) measures is a major barrier to planning and delivering health and aged care services for older Indigenous peoples worldwide. QoL is dependent on cultural values and priorities may vary between age groups. This project aims to develop a QoL tool for older Aboriginal Australians. Research Design and Methods The study was completed with Aboriginal Australians aged over 45 years living in Perth and Melbourne, Australia. Participatory Action Research methods were applied with an Indigenous research paradigm. Semistructured interviews were undertaken to identify the factors important to having a good life. Factors were further explored in yarning groups with older Aboriginal peoples to develop the draft QoL tool questions. Face validity of the tool was completed in two regions. Results The participants preferred the term “a good life” to QoL. Having a good spirit is at the core of having a good life. The protective factors for a good life were family and friends, health, culture, Elder role, respect, Country, spirituality, services and supports, community, future plans, safety and security, and basic needs. Discussion and Implications Twelve factors were identified and developed into key questions for the Good Spirit, Good Life tool. The draft tool will undergo quantitative validity testing, prior to embedding in service provision to inform care for older Aboriginal peoples. With local adaptation, the tool, accompanying framework, and participatory methods for development may have wider applicability to other Indigenous populations worldwide.

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Mate, Karen, Karen Kerr, Alison Priestley, Natasha Weaver, Gerald A. Broe, Gail Daylight, Brian Draper, et al. "Use of tricyclic antidepressants and other anticholinergic medicines by older Aboriginal Australians: association with negative health outcomes." International Psychogeriatrics, September 28, 2020, 1–8. http://dx.doi.org/10.1017/s104161022000174x.

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ABSTRACT 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 Aboriginal communities (two in metropolitan Sydney and three on the mid-north coast of New South Wales) used a structured interview process to assess cognition, depression, and activities of daily living for a cohort of older adults (aged 60 years and over). Participants also reported on their health status, medical history, and prescription medications during the interview. ACB was calculated, and its association with adverse health outcomes including cognitive impairment, falls, hospitalization, and depressive symptoms were examined. Results: Most participants (95%) were taking at least one regular medication with polypharmacy (≥5 medications) observed in 43% of participants; 12.2% had a significant ACB (≥3) with antidepressants being a major contributor. Anticholinergic medication use was associated with cognitive impairment, recent hospitalization (past 12 months), and depressive symptoms. After controlling for age, sex, and comorbidity, only the presence of depressive symptoms remained significantly associated with the use of anticholinergic medication (odds ratio 2.86; 95% confidence interval 1.48–5.51). Conclusions: Clinically significant ACB was common in older Aboriginal Australians and was largely attributable to inappropriate use of tricyclic antidepressants. Greater awareness of medication-related risk factors among both health care professionals and Aboriginal communities can play an important role in improving health and quality of life outcomes.

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Gregory, Mark A. "An Opportunity." Australian Journal of Telecommunications and the Digital Economy 3, no. 3 (September 28, 2015). http://dx.doi.org/10.18080/ajtde.v3n3.25.

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The September issue provides an interesting look at the National Broadband Network and how it is perceived to have problems that need to be resolved and how telecommunications is having an effect on the lives of Australians with discussion on how older Australians engage with online news and how mobile phone use in remote Aboriginal and Torres Strait Islander communities is a balance between opportunity and affordability. Papers on future digital service delivery and metadata retention provide a balance between identifying future use and how authorities are looking our telecommunications usage.

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Journal articles on the topic 'Older Aboriginal Australians'

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