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Study design:Literature review/semi-structured interviews.Objective:To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand.Setting:Australia.Methods:The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document.Results:A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting.Conclusion:The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises.Sponsorship:This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network. [ABSTRACT FROM AUTHOR]

Study design:Focus Group.Objectives:To develop a unified, regional spinal cord injury (SCI) research strategy for Australia and New Zealand.Setting:Australia.Methods:A 1-day structured stakeholder dialogue was convened in 2013 in Melbourne, Australia, by the National Trauma Research Institute in collaboration with the SCI Network of Australia and New Zealand. Twenty-three experts participated, representing local and international research, clinical, consumer, advocacy, government policy and funding perspectives. Preparatory work synthesised evidence and articulated draft principles and options as a starting point for discussion.Results:A regional SCI research strategy was proposed, whose objectives can be summarised under four themes. (1) Collaborative networks and strategic partnerships to increase efficiency, reduce duplication, build capacity and optimise research funding. (2) Research priority setting and coordination to manage competing studies. (3) Mechanisms for greater consumer engagement in research. (4) Resources and infrastructure to further develop SCI data registries, evaluate research translation and assess alignment of research strategy with stakeholder interests. These are consistent with contemporary international SCI research strategy development activities.Conclusion:This first step in a regional SCI research strategy has articulated objectives for further development by the wider SCI research community. The initiative has also reinforced the importance of coordinated, collective action in optimising outcomes following SCI. [ABSTRACT FROM AUTHOR]

Aim: To determine adherence, persistence and continuation beyond 6 months with cholinesterase inhibitors in Australians with Alzheimer's disease. Methods: Adherence and persistence with cholinesterase inhibitors were assessed by data linkage using the Pharmaceutical Benefits Scheme (PBS) Authority database and other health databases. Results: Over 18 000 people commenced cholinesterase inhibitors during 2004. Adherence was 79.4% while the medication possession ratio was 0.88. Some 70.3% of people filled all six scripts for the initial trial period of therapy. Some 57.3% of evaluable patients accessed funding beyond six prescriptions, indicating that their clinicians had declared that there was a two-point or more greater improvement in the Mini-Mental State Examination. Despite the high rate of continuation beyond 6 months, the rates of institutionalisation and death were no different to those reported in clinical trials. Conclusions: Persistence and adherence with cholinesterase inhibitors was reasonable once treatment was established. There was an unexpectedly high continuation rate beyond six prescriptions. [ABSTRACT FROM AUTHOR]

Background: past research suggests that fall rates in older persons may differ by ethnicity. The aim of this study was to compare the incidence of falls between older male Italian-born immigrants and their Australian-born counterparts.Methods: this study analysed data from 335 Italian-born and 848 Australian-born men aged 70 years and over participating in the Concord Health and Ageing in Men Project (CHAMP). Prospective falls data were collected by 4 monthly phone calls (mean follow-up time: 26.7 months). Negative binomial regression compared falls incidence rate ratios (IRR) between the two groups of men.Results: there were 37 (11%) Italian-born men and 185 (22%) Australian-born men who had two or more falls during follow-up (P < 0.001). Negative binomial analysis demonstrated that Italian-born men had half the incidence rate of falls compared with Australian-born men (IRR = 0.51, 95% CI = 0.38–0.67). After adjustment for falls risk factors, Italian-born men remained significantly less likely to fall with a 43% lower fall rate (IRR = 0.57, 95% CI = 0.39–0.85).Conclusion: older male Italian-born immigrants are less likely to fall than their Australian-born counterparts. Differences in fall rates between the two groups are not explained by established falls risk factors. [ABSTRACT FROM AUTHOR]

Summary: The association between socioeconomic status (SES) and bone health, specifically in men, is unclear. Based upon data from the large prospective Concord Health in Ageing Men Project (CHAMP) Study of community-dwelling men aged 70 years or over, we found that specific sub-characteristics of SES, namely, marital status, living circumstances, and acculturation, reflected bone health in older Australian men. Introduction: Previous studies reported conflicting results regarding the relationship between SES and bone health, specifically in men. The main objective of this study was to investigate associations of SES with bone health in community-dwelling men aged 70 years or over who participated in the baseline phase of the CHAMP Study in Sydney, Australia. Methods: The Australian Socioeconomic Index 2006 (AUSEI06) based on the Australian and New Zealand Standard Classification of Occupations was used to determine SES in 1,705 men. Bone mineral density and bone mineral content (BMC) were determined by dual-energy X-ray absorptiometry. Bone-related biochemical and hormonal parameters, including markers of bone turnover, parathyroid hormone, and vitamin D, were measured in all men. Results: General linear models adjusted for age, weight, height, and bone area revealed no significant differences across crude AUSEI06 score quintiles for BMC at any skeletal site or for any of the bone-related biochemical measures. However, multivariate regression models revealed that in Australian-born men, marital status was a predictor of higher lumbar BMC ( β = 0.07, p = 0.002), higher total body BMC ( β = 0.05, p = 0.03), and lower urinary NTX-I levels ( β=−0.08, p = 0.03), while living alone was associated with lower BMC at the lumbar spine ( β=−0.05, p = 0.04) and higher urinary NTX-I levels ( β=0.07, p = 0.04). Marital status was also a predictor of higher total body BMC ( β = 0.14, p = 0.003) in immigrants from Eastern and South Eastern Europe. However, in immigrants from Southern Europe, living alone and acculturation were predictors of higher femoral neck BMC ( β = 0.11, p = 0.03) and lumbar spine BMC ( β = 0.10, p = 0.008), respectively. Conclusions: Although crude occupation-based SES scores were not significantly associated with bone health in older Australian men, specific sub-characteristics of SES, namely, marital status, living circumstances, and acculturation, were predictors of bone health in both Australia-born men and European immigrants. [ABSTRACT FROM AUTHOR]

Abstract: Back pain is common in older people and is associated with functional disability and poor self-rated health. Older persons are under-represented in back pain research, and research on back pain in older persons from ethnic minorities is particularly sparse. We investigated differences in back pain characteristics, effects and medication use in a population-based sample of 335 Italian-born immigrants and 849 Australian-born men aged 70years and over. There were 189 (62%) Italian-born men and 507 (63%) Australian-born men who reported experiencing back pain in the past 12months. Despite no difference in the reported prevalence of back pain between the two groups of men, Italian-born men were more likely to report that their pain was frequent, severe and chronic. Italian-born men were also more likely to report having other sites of pain and that they had limited their activities in the past 12months due to back pain. Despite these differences, the use of analgesic medication was the same in both groups. Multivariate analyses showed that differences in pain characteristics and effects between the two groups of men were explained by socioeconomic factors such as years of education and occupation history. [ABSTRACT FROM AUTHOR]

To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men. Cross-sectional study of older men participating in the Concord Health and Ageing in Men Project (CHAMP). Elderly men living in a defined geographical region in Sydney, Australia. One thousand seven hundred five community-dwelling men aged 70 and older who participated in the baseline assessments of CHAMP. Upper and lower extremity strength were measured using dynamometers for grip and quadriceps strength. Appendicular skeletal lean mass was assessed using dual X-ray absorptiometry. Muscle quality was defined as the ratio of strength to mass in upper and lower extremities. For each parameter, subjects in the lowest 20% of the distribution were defined as below normal. Functional limitation was assessed according to self-report and objective lower extremity performance measures. Physical disability was measured according to self-report questionnaire. After adjusting for important confounders, the prevalence ratio (PR) for poor quadriceps strength and self-reported functional limitation was 1.91 (95% confidence interval (CI)=1.10-2.40); for performance-based functional limitation the PR was 1.81 (95% CI=1.45-2.24). The adjusted PR for poor grip strength and physical disability in instrumental activities of daily living (IADLs) was 1.37 (95% CI=1.20-1.56). The adjusted PR for low skeletal lean mass (adjusted for fat mass) and physical disability in basic activities of daily living was 2.08 (95% CI=1.37-3.15). For muscle quality, the PR for lower extremity specific force and functional limitation and physical disability was stronger than upper extremity specific force. Muscle strength is the single best measure of age-related muscle change and is associated with physical disability in IADLs and functional limitation. [ABSTRACT FROM AUTHOR]

The article highlights the results of a study on the prevalence and efficiency of treatment of osteoporosis in older men in Australia. According to the authors, 25 percent of older men met one or more of the Pharmaceutical Benefits Scheme (PBS) criteria while 90 percent of men who met the PBS criteria were not aware of having osteoporosis. They add that only small proportion of men had taken drugs to treat osteoporosis. The study illustrates the low level of awareness among men despite high incidence of osteoporosis in the country.

Objective: to describe the prevalence and impact on quality of life of urinary incontinence in a population-based cohort of older community-dwelling Australian men. [ABSTRACT FROM PUBLISHER]

Background: frailty is a concept used to describe older people at high risk of adverse outcomes, including falls, functional decline, hospital or nursing home admission and death. The associations between frailty and use of specific health and community services have not been investigated. [ABSTRACT FROM PUBLISHER]

The article provides information on the Concord Health and Ageing in Men Project (CHAMP), a study on the prevalence of depressive symptoms in older male Italian immigrants in Australia. Results found that these Italian men have a higher prevalence of depressive symptoms at 18% compared with the 10% of the older men born in Australia. The results are said to support previous findings that Italian-speaking older immigrants have higher rates of psychological morbidity.

Assesses the effectiveness of tacrine and lecithin in treating patients with Alzheimer's disease in Australia. Effectiveness of acetylcholine precursors and cholinergic receptor agonists; Aim of treatment of Alzheimer's disease; Side effects of the treatment; Characteristics of patients undergoing treatment.