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  • Dr Nancy A. Pachana is a clinical geropsychologist, neuropsychologist and professor in the School of Psychology at Th... more
    (Dr Nancy A. Pachana is a clinical geropsychologist, neuropsychologist and professor in the School of Psychology at The University of Queensland, and is co-director of the UQ Ageing Mind Initiative, providing a focal point for clinical, translational ageing-related research at UQ. She has an international reputation in the area of geriatric mental health, particularly with her research on late-life anxiety disorders. She is co-developer of the Geriatric Anxiety Inventory, a published brief self-report inventory in wide clinical and research use globally, translated into over two dozen languages. She has published over 200 peer-reviewed articles, book chapters and books on various topics in the field of ageing, and has been awarded more than $20 million in competitive research funding, primarily in the areas of dementia and mental health in later life. Her research is well-cited cited and she maintains a clear international focus in her collaborations and research interests, which include anxiety in later life, psychological interventions for those with Parkinson’s Disease, nursing home interventions, driving safety and dementia, teaching and learning in psychogeriatrics and mental health policy and ageing.<br /><br />Her edited book, Casebook of Clinical Geropsychology (Oxford University Press, 2010), has proven a popular text for clinical geropsychology training in North America. Her edited book, the Oxford Handbook of Clinical Geropsychology (Oxford University Press, 2014), brings together an international perspective on a wide range of current and emerging topics in the field. Her Encyclopedia of Geropsychology (Springer, 2016) contains nearly 350 entries by international experts. Most recently, she has authored Ageing, A Very Short Introduction (2017),part of the popular Oxford University Press VERY SHORT INTRODUCTION series.<br /><br />Nancy was elected a Fellow of the Academy of Social Sciences in Australia in 2014. She is also a Fellow of the Australian Psychological Society, and is the recipient of numerous prizes and awards, including an Australian Davos Connection Future Summit Leadership Award, for leadership on ageing issues in Australia. She serves on the editorial boards of several journals, including the Journals of Gerontology: Psychological Science, one of the top two journals in the world for publication of research in the science of the psychology of aging, as well as The Clinical Gerontologist. Originally from the United States, Nancy was awarded her AB from Princeton University in 1987, her PhD from Case Western Reserve University in 1992, and completed postdoctoral fellowships at the Neuropsychiatric Institute at UCLA, Los Angeles, and the Palo Alto Veterans Medical Center, Palo Alto, California. She is an avid bird watcher and photographer and an intrepid traveller.)
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researcher narrative to &quot;documentary style&quot; to utilize the subjects’ words for primary informing. The &quot;Foreword&quot; identifies the study as a dissertation research project; &quot;Love thy Stranger&quot; provides emotional... more
researcher narrative to &quot;documentary style&quot; to utilize the subjects’ words for primary informing. The &quot;Foreword&quot; identifies the study as a dissertation research project; &quot;Love thy Stranger&quot; provides emotional insight into four family caregivers’ personal Alzheimer’s journey; &quot;Rock n’ Roll to Rocking Chairs&quot; shows the prevalence for becoming a caregiver as the Baby Boomers age into impairment; &quot;Behind the Curtain&quot; explains the research methodology, framework, case study limits and outliers; &quot;Research Reflections&quot; recaps important issues with both researcher and caregiver commentary; and &quot;Endnotes&quot; includes definitions, all participant citations and additional explanations or exhibits. Conclusions: The data from this inverted case-study should provide a non-academic person with an emotional connection to those who have been, or may become, a caregiver to a cognitively impaired family member–then alert them of the impending wave of increased Alzheimer’s patients and the corresponding expansion of stakeholders–while also encouraging individuals take action ahead of encountering the phenomenon themselves.
ObjectivesEducation affects the attitudes and abilities of health professionals regarding older people. This study examines the nature and amount of ageing‐related content in programs at universities and in continuing education in... more
ObjectivesEducation affects the attitudes and abilities of health professionals regarding older people. This study examines the nature and amount of ageing‐related content in programs at universities and in continuing education in Queensland for disciplines involved in the direct care of older people.MethodsSurveys developed for the different settings were sent to universities and health professional representative bodies.ResultsRepresentatives from thirty (of 71) programs and 12 (of 22) professional bodies responded. Many program representatives (62%) reported ageing content was at an appropriate level. The remainder indicated it was too low. Representatives from professional bodies identified ageing was a priority (81%) and offered ageing‐related education (72%). Time spent on ageing in university programs varied widely (median of 67 hours [interquartile range: 222.5]). Qualitative feedback indicated tensions existed about accreditation standards and perceptions of ageing as a specialty versus a core practice area.ConclusionAgeing‐related education for health professionals requires attention to address shortcomings.
Background driving disruptions have significant impact on individuals living with dementia, their care partners and family members. Previous studies show that for older people with dementia, stopping driving is one of the hardest things... more
Background driving disruptions have significant impact on individuals living with dementia, their care partners and family members. Previous studies show that for older people with dementia, stopping driving is one of the hardest things that they cope with. To date, no studies exist that address the expressed needs and experiences of people living with young onset dementia (YOD) who are adjusting to life without driving, whose needs are not well understood and whose needs might be expected to differ from those of older people with dementia. Methods a multi-perspective, qualitative descriptive phenomenological approach was undertaken. A topic guide was developed in consultation with lived experience experts. In-depth interviews (n = 18) with 10 people with YOD and eight family caregivers were conducted, to elicit lived experiences in relation to changing and cessation of driving. Interviews were recorded and transcribed verbatim. Data were analysed using a hybrid approach, employing ...
Objectives We adapted the CarFreeMe™-Dementia program created by The University of Queensland for drivers in the United States. CarFreeMe™-Dementia aims to assist drivers living with dementia and their care partners as they plan for or... more
Objectives We adapted the CarFreeMe™-Dementia program created by The University of Queensland for drivers in the United States. CarFreeMe™-Dementia aims to assist drivers living with dementia and their care partners as they plan for or adjust to driving retirement. This semistructured program focuses on driving retirement education and support. Topics include how dementia affects driving, lifestyle planning, stress management, and alternative transportation options. This study evaluated the feasibility, acceptability, and utility of the CarFreeMe™-Dementia intervention. Methods This pilot phase of the study included 16 care partners and 11 drivers with memory loss who were preparing for or adjusting to driving retirement. Participants completed 4–8 CarFreeMe™-Dementia intervention telehealth sessions. Online surveys (baseline, 1- and 3-month) and postintervention semistructured interviews informed evaluation of the intervention program using a mixed methods approach. Results This st...
People living with Alzheimer’s disease and related dementias (ADRD) must eventually stop driving. While some will voluntarily retire, many others will continue to drive until a crisis. In Australia, like many other countries, general... more
People living with Alzheimer’s disease and related dementias (ADRD) must eventually stop driving. While some will voluntarily retire, many others will continue to drive until a crisis. In Australia, like many other countries, general physicians/practitioners (“GPs”) play a key role in monitoring driving safety and driver retirement with their patients with ADRD. Advising patients about driving cessation is one of the most challenging aspects of clinical dementia care, complicated by limited time in consultations, lack of patient awareness and insight, and objective screening and assessment measures. We examined how to support best practice in relation to management of driving cessation with patients with ADRD through focus groups with 29 GPs and contrasted their perspectives with those of 11 retired drivers with ADRD. Focus groups and interviews were transcribed and thematically analysed. Themes discovered highlighted the importance of providing education about the effects of dement...
Audiometric tests do not adequately reflect the hearing handicap experienced by individuals with hearing loss and account for only part of the variance in hearing handicap perceptions (Weinstein & Ventry, 1983). The present study... more
Audiometric tests do not adequately reflect the hearing handicap experienced by individuals with hearing loss and account for only part of the variance in hearing handicap perceptions (Weinstein & Ventry, 1983). The present study investigates the relationship between degree of hearing impairment, psychosocial factors and hearing handicap in a New Zealand war veteran sample. Forty-seven veterans (Mean age = 77.51, SD = 5.99) with some degree of hearing impairment completed a questionnaire which included the Hearing Handicap Inventory (HHI) (Newman et al., 1990), the SF36 sub-scales for general health and mental health (Ware, Kosinski & Keller, 1994), questions relating to hearing aid use and demographic details. Audiometric test information for each veteran was accessed through the national war pensions organisation. Analyses revealed no significant relationship between percentage hearing loss and perceptions of hearing handicap. Those who reported lower satisfaction with their heari...
Objectives Assessing late-life anxiety using an instrument with sound psychometric properties including cross-cultural invariance is essential for cross-national aging research and clinical assessment. To date, no cross-national research... more
Objectives Assessing late-life anxiety using an instrument with sound psychometric properties including cross-cultural invariance is essential for cross-national aging research and clinical assessment. To date, no cross-national research studies have examined the psychometric properties of the frequently used Geriatric Anxiety Inventory (GAI) in depth. Method Using data from 3,731 older adults from 10 national samples (Australia, Brazil, Canada, The Netherlands, Norway, Portugal, Spain, Singapore, Thailand, and United States), this study used bifactor modeling to analyze the dimensionality of the GAI. We evaluated the “fitness” of individual items based on the explained common variance for each item across all nations. In addition, a multigroup confirmatory factor analysis was applied, testing for measurement invariance across the samples. Results Across samples, the presence of a strong G factor provides support that a general factor is of primary importance, rather than subfactors...
Hearing loss is the third most prevalent chronic disability among older adults, with older adults the prime users of aural rehabilitation services. Ex-service personnel, in particular, frequently develop hearing-related disorders, and yet... more
Hearing loss is the third most prevalent chronic disability among older adults, with older adults the prime users of aural rehabilitation services. Ex-service personnel, in particular, frequently develop hearing-related disorders, and yet research on hearing aid utilisation in this group is sparse. The present study explored predictors of hearing aid use in a randomly selected sample of 1249 New Zealand veterans. Perceived benefit, performance and ease of use of aid(s) were related to increased use. Older veterans were more likely to use their aid(s) and greater overall hearing loss also increased adherence; however, inexperienced wearers were less adherent. Satisfaction with audiological service and overall satisfaction with the performance of the aid(s) was also linked to use. Health related variables were unrelated to frequency of aid use. These results highlight the need to provide ongoing support for all veterans, but in particular novice users, who become engaged in ongoing au...
The relationship between social support, mental health, and posttraumatic stress disorder (PTSD) symptomatology was investigated in a sample of 229 former New Zealand military personnel. It was hypothesised that veterans reporting greater... more
The relationship between social support, mental health, and posttraumatic stress disorder (PTSD) symptomatology was investigated in a sample of 229 former New Zealand military personnel. It was hypothesised that veterans reporting greater satisfaction with their social support networks would also report better mental health and lower levels of PTSD symptomatology, and that social support would buffer the relationship between trauma and PTSD. The number of social supports was expected to be unrelated to both PTSD and mental health. Among the subsample of combat veterans (N = 166), results from multiple regression analyses revealed that satisfaction with social support was significantly related to PTSD severity but unrelated to general mental health. The moderating model of social support on the relationship between trauma and PTSD was not supported in hierarchical regression analysis in the total sample (N = 229). Methodological limitations and other explanations for these results ar...
... Improving outcomes of driving cessation for older people. Gustafsson, L., Liddle, J., Pachana, NA, McKenna, K., Mitchell, G. and Haynes, M. (2009). Improving outcomes of driving cessation for older people. In: Ricardo Nitrini,... more
... Improving outcomes of driving cessation for older people. Gustafsson, L., Liddle, J., Pachana, NA, McKenna, K., Mitchell, G. and Haynes, M. (2009). Improving outcomes of driving cessation for older people. In: Ricardo Nitrini, Dementia &amp;amp;amp; Neuropsychologia. ...
The goal of this study was to describe researchers&#39; experiences in submitting ethical proposals focused on older adult populations, including studies with persons with dementia, to ethical review boards. Ethical approval was granted... more
The goal of this study was to describe researchers&#39; experiences in submitting ethical proposals focused on older adult populations, including studies with persons with dementia, to ethical review boards. Ethical approval was granted for an online survey. Researchers were recruited via listservs and snowballing techniques. Participants included 157 persons (73% female) from Australia and the United States, with a mean age of 46 (±13). Six main issues were encountered by researchers who participated in this survey. In descending order, these included questions regarding: informed consent and information requirements (61.1%), participants&#39; vulnerability, particularly for those with cognitive impairments (58.6%), participant burden (44.6%), data access (29.3%), adverse effects of data collection/intervention (26.8%), and study methodology (25.5%). An inductive content analysis of responses revealed a range of encounters with ethical review panels spanning positive, negative, and...
We examined differences in response latencies obtained during a validated video-based hazard perception driving test between three healthy, community-dwelling groups: 22 mid-aged (35–55 years), 34 young–old (65–74 years), and 23 old-old... more
We examined differences in response latencies obtained during a validated video-based hazard perception driving test between three healthy, community-dwelling groups: 22 mid-aged (35–55 years), 34 young–old (65–74 years), and 23 old-old (75–84 years) current drivers, matched for gender, education level, and vocabulary. We found no significant difference in performance between mid-aged and young-old groups, but the old-old group was significantly slower than the other two groups. The differences between the old-old group and the other groups combined were independently mediated by useful field of view (UFOV), contrast sensitivity, and simple reaction time measures. Given that hazard perception latency has been linked with increased crash risk, these results are consistent with the idea that increased crash risk in older adults could be a function of poorer hazard perception, though this decline does not appear to manifest until age 75+ in healthy drivers. (JINS, 2009, 15, 799–802.)
ABSTRACTBackground:Driving cessation has demonstrated impacts on well-being and lifestyle. Despite the recognized reluctance of older people to plan for driving cessation, this study has identified a new group who has a stated plan to... more
ABSTRACTBackground:Driving cessation has demonstrated impacts on well-being and lifestyle. Despite the recognized reluctance of older people to plan for driving cessation, this study has identified a new group who has a stated plan to stop driving within 12 months. Although gradual reduction of driving has been documented as part of the usual driving cessation, this study explored the differences between retired drivers and those with a stated plan to retire within 12 months in sociodemographic, well-being and lifestyle outcomes.Methods:This study extracted all baseline data from a clinical trial exploring the effectiveness of a group program for older retiring and retired drivers. Sociodemographic data included age, gender, health status, educational level, and living situation. All participants completed measures related to episodes away from home, well-being, and lifestyle. These were compared using parametric and nonparametric statistical analysis.Results:Participants (n= 131) i...
ABSTRACTBackground: This study explored the transport and lifestyle issues of older retired and retiring drivers participating in the University of Queensland Driver Retirement Initiative (UQDRIVE), a group program to promote adjustment... more
ABSTRACTBackground: This study explored the transport and lifestyle issues of older retired and retiring drivers participating in the University of Queensland Driver Retirement Initiative (UQDRIVE), a group program to promote adjustment to driving cessation for retired and retiring older drivers.Methods: A mixed method research design explored the impact of UQDRIVE on the transport and lifestyle issues of 55 participants who were of mean age 77.9 years and predominantly female (n = 40). The participants included retired (n = 32) and retiring (n = 23) drivers. Transport and lifestyle issues were identified using the Canadian Occupational Performance Measure and rated pre- and post-intervention.Results: Paired t-tests demonstrated a statistically significant improvement in performance (t = 10.5, p &lt; 0.001) and satisfaction (t = 9.9, p &lt; 0.001) scores of individual issues. Qualitative content analysis identified three categories of issues including: protecting my lifestyle; a bet...
Background There are well-established risk factors, such as lower education, for attrition of study participants. Consequently, the representativeness of the cohort in a longitudinal study may deteriorate over time. Death is a common form... more
Background There are well-established risk factors, such as lower education, for attrition of study participants. Consequently, the representativeness of the cohort in a longitudinal study may deteriorate over time. Death is a common form of attrition in cohort studies of older people. The aim of this paper is to examine the effects of death and other forms of attrition on risk factor prevalence in the study cohort and the target population over time. Methods Differential associations between a risk factor and death and non-death attrition are considered under various hypothetical conditions. Empirical data from the Australian Longitudinal Study on Women&#39;s Health (ALSWH) for participants born in 1921-26 are used to identify associations which occur in practice, and national cross-sectional data from Australian Censuses and National Health Surveys are used to illustrate the evolution of bias over approximately ten years. Results The hypothetical situations illustrate how death an...
Screening measures of cognitive status are traditionally administered face to face. In survey research such screening mcasurcs, while desirable, must he administered by other means. As part of pilot survey research on a New Zealand war... more
Screening measures of cognitive status are traditionally administered face to face. In survey research such screening mcasurcs, while desirable, must he administered by other means. As part of pilot survey research on a New Zealand war veteran population with some degree of hearing impairment, a face-to-face administration of the Mini-Mental State Examination (MMSE; Folstein, Folstein and McHugh, 1975) and a telephoneadministration of the Telephonc Interview for Cognitive Status (TICS; Brandt, Spencer and Folstein. 1988) were compared. Brandt (&#39;/ u/. (1988) reported a very strong linear relationship between scores on the MMSE and the TICS (r=0.94, p &lt; .0001) in an Alzheimer patient population with a mcan MMSE score of 12.06 (6.78). For a sample of 44 mildly to moderately hearing impaired veterans, with a mean MMSE score of 25.52 (2.16) and a mean TICS score of 32.52(5.43), the correlation between the instruments was .39. When veterans who wore hearing aids during the telephone interview ( N = 2 2 ) wcrc separated out from those who did not, the correlation rose to .54. Age was ncgatively correlated with the MMSE ( r = -0.41, / I &lt; .01) and not significantly correlated with the TICS. Education level was unrelated to either measure. The data suggest that the wearing or non-wearing of hearing aids may contribute significantly to the reliability of the TICS. Furthermore, on non-demented populations with a less restricted range of scores. the correlation of the MMSE and TICS may he lower than previously reported.
Background. Driving cessation can lead to negative consequences, such as depression and reduced social activities. Purpose. The University of Queensland Driver Retirement Initiative (UQDRIVE) intensive support program is a six-week... more
Background. Driving cessation can lead to negative consequences, such as depression and reduced social activities. Purpose. The University of Queensland Driver Retirement Initiative (UQDRIVE) intensive support program is a six-week program to assist older people with driving cessation. Methods. Fifty-five participants completed a survey of satisfaction with the program, including identification of the aspects of the program that were useful and they had applied in real life. Findings. There was overall satisfaction with the program, and content analysis identified three areas that were highlighted as particularly useful: “Finding alternative means: transport and service options,” “Planning with more wisdom: thinking about driving cessation,” and “Being with people: sharing experiences with peers.” Implications. These findings indicate that program participants were satisfied with the current UQDRIVE intensive support group program and found both the psychosocial supports and practic...
Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches,... more
Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents&#39; driving; involvement of older family members in road crashes; and provision of support during family members&#39; driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in drivi...
Interpretation of changes in health and health care utilization patterns across the life span depends on an understanding of the effects of age, period, and cohort. The purpose of this article is to illustrate differences among three... more
Interpretation of changes in health and health care utilization patterns across the life span depends on an understanding of the effects of age, period, and cohort. The purpose of this article is to illustrate differences among three generations of women in demographic factors, health risk factors, and health status indicators from 1996 to 2008. The article examines data from the Australian Longitudinal Study on Women’s Health, a broad-ranging project funded by the Australian Government Department of Health and Ageing (DoHA) and involving three age groups of women (born in the periods 1973—1978, 1946—1951, and 1921—1926) who were first surveyed in 1996 and will be surveyed every 3 years until at least 2015. Patterns in selected demographic factors (marital status and level of educational qualification), health risk factors (smoking, alcohol consumption, physical activity, and body mass index [BMI]), and health status indicators (asthma, hypertension, diabetes and depression; physica...
While empirical research to date has generally supported positive effects of estrogen on verbal memory performance in women, the literature examining specific effects of Hormone Replacement Therapy (HRT) on cognitive functioning in... more
While empirical research to date has generally supported positive effects of estrogen on verbal memory performance in women, the literature examining specific effects of Hormone Replacement Therapy (HRT) on cognitive functioning in mid-life women is more equivocal ...
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