Abstracts and Presentations for Knowledge Exchange 2025

Posted by on 8 May 2025

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Thursday, 8th May 2025 at University of Auckland

Programme can be downloaded here.

Inclusive Streetscapes: Transport systems leaving no one behind

 Shanthi Ameratunga*,1 Janine Wiles,1 Whaea Julie Wade,1 Whaea Dolly Paul,1 Anneka Anderson,1 Bridget Doran,2 Mythily Meher,1 Malakai ‘Ofanoa,1 Roshini Peiris-John,1 Julie Spray,1 Esther Willing,3 Karen Witten4
 1School of Population Health, Faculty of Medical & Health Sciences, University of Auckland; 2Bridget Doran Consulting, Hamilton; 3Kohatu Centre for Hauora Māori, School of Medicine, University of Otago, Dunedin; 4SHORE Centre, Massey University, Auckland

Introduction: The Government Policy Statement on land transport in New Zealand, which came into effect on 1 July 2024, focuses on four strategic priorities: economic growth and productivity, increased maintenance and resilience, safety, and value for money. The extent to which current policy settings support pathways to mobility and wellbeing for older and/or disabled people is less visible.  

 Research Summary: Inclusive Streetscapes is a community-based participatory research project, funded by the Health Research Council of NZ, investigating how kaumātua/older residents and disabled people residing in ethnically and socio-economically diverse communities construct the meaning, value, and challenges of getting about. The project included 62 in-depth go-along qualitative interviews complemented with photovoice and interactive community workshops in four case study sites in Tāmaki Makaurau (Auckland). A third of the participants were Māori and another third were Pacific peoples. The study explored community perceptions of wellbeing as experienced through the losses, stresses and joys of journeys and travel, navigating everyday life contexts and places. The study also explored transport professionals’ perspectives and practices in relation to these realities. We identified how transport infrastructure and related histories of colonisation and dispossession have powerful, enmeshed influences on people’s day-to-day lives, mobility and wellbeing. We also identified transport practices and consultation processes which produce, reproduce, and amplify inequities. Our findings reveal an urgent need for urgent action embracing a decolonising framework to address policy and practice gaps in transport systems.

 Future directions: Building on discussions with community and transport stakeholders, we are undertaking further analyses of this rich database investigating (a) the importance of ‘third spaces’ in the lives of older communities and disabled people, and (b) influences on their perceptions of safety in environments that can enable or undermine opportunities for mobility, wellbeing and active social participation.

You can download the presentation here

When to stop driving? An exploration into driving cessation decision-making among people with cognitive impairment.

Baral K, Parsons M, Stewart A
School of Nursing and Midwifery, The University of Waikato, Hamilton, New Zealand

Introduction: Driving cessation is a critical, yet emotionally challenging issue for older people with cognitive impairment, particularly in car-dependent societies like New Zealand. This study investigates the determinants of driving cessation decisions, aiming to normalise this transition as a natural part of ageing rather than a failure. It further explores how the loss of driving privileges impacts older people's independence, social connections, and quality of life, while placing a complex emotional and practical burden on families.

Methods: The research uses a mixed-methods approach. Phase I involves qualitative focus groups with families and health care professionals to explore their experiences and decision-making challenges. Phase II expands insights through a national survey to assess the support needs and systemic barriers to driving cessation for families.

Results: The preliminary findings highlight the conflict between safety concerns and the emotional toll on families. Near-miss accidents as early warning signs of unsafe driving, emotional and practical burdens in advocating for cessation, systemic gaps, including inconsistency in medical assessments, difficulties with acceptance relating more to loss of independence, and unaffordable transportation support. Further, healthcare providers emphasised the need for clear guidelines to support driving cessation decisions. They have highlighted the importance of training, standardised protocols, and affordable transportation alternatives to facilitate this transition.

Conclusion: The study underscores the importance of dignity-preserving interventions to support older adults and their families during the driving cessation journey. Findings will inform stakeholders in developing strategies to promote social inclusion, safety, and acceptance. It contributes to a national dialogue on ageing, cognitive impairment, and equitable transport solutions.

Keywords: Driving cessation, older people, cognitive impairment, decision-making

Surroundings, steps and stumbles: The effect of environment on falls in residential care for older people

Bacon CJ1, Neef SP1, Emad Y1, Taylor L2, Moyes SA2, Cavadino A2, Comber K1, Wu XS1, Molloy J1, Kerse N2.
1School of Nursing, FMHS, Waipapa Taumata Rau University of Auckland; 2Department of General Practice & Primary Health Care, FMHS, Waipapa Taumata Rau University of Auckland

Introduction: Although older residents of long-term care are three times more likely to fall than those living in the community there is little research into the influence of facility environment on falls. In a substudy of Staying Upright in Residential Care, we aimed to explore associations between life-space mobility, travel distances from bedrooms to other facility areas, hazards and lighting on falls.

Methods: Caregivers for 126 residents (aged 83.5±7.8 years, 63.5% women) of 12 facilities in the Auckland region reported on their current activity patterns and activity levels at Staying Upright study onset (1.64±0.53 years earlier, around the COVID-19 pandemic onset), to determine Nursing Home Life-Space Diameter (NHLSD)1. Distances for routes taken by each resident and hazards and lighting in areas visited were assessed. Falls were recorded from each facility’s incident report forms. Confounding variables such as physical and cognitive test scores were obtained from the main study database.

Results: Lighting levels were often low, particularly in bedrooms and bathrooms. Overall lighting and lighting in some areas, as well as current NHLSD, total distance indices and hazard scores (paradoxically) were inversely associated with fall rate, whether or not they were adjusted for physical and cognitive performance. Adjusted retrospectively estimated NHLSD from study onset was positively associated with fall rate and reduced 13.5±25.3% over the study duration.

Conclusion: Overall, we have found that life-space mobility is limited for many residents in care and reduced substantially in less than 2 years after the onset of the COVID-19 pandemic. Lighting levels are below recommendations for this setting, with both mobility and lighting inversely associated with fall rate.

 Reference:

1Tinetti ME, Ginter SF. The nursing home life-space diameter. A measure of extent and frequency of mobility among nursing home residents. J Am Geriatr Soc. 1990;38(12):1311-1315.

Organisational support for older registered nurses (RNs)’ continuation of practice.

Chunxu Chen1, Dr Kay Shannon1, Professor Eleanor Holroyd2, Dr Sara Napier1
1Centre for Active Ageing, School of Clinical Sciences, Auckland University of Technology; 2Centre for Migrant and Refugee Health Research, Auckland University of Technology.

Introduction: Global ageing and the increasing number of patients with complex health needs have heightened the demand for skilled and experienced healthcare workers. Many older nurses possess a wealth of knowledge and clinical expertise that is highly valued. Nonetheless, organisational support for older RNs’ continuation of practice remains underexplored. This doctoral study aims to explore how RNs aged 60 years or older (50 years or older if Māori or Pasifika) and organisational representatives perceive organisational support for older RNs’ continuation of practice.

Methods: Semi-structured interviews were conducted with thirteen RNs and four organisational representatives. The RN participants worked part-time and full-time in various clinical areas, mostly as clinical nurse specialists. The RN cohort included one Māori RN, one Pasifika RN, one Eurasian RN, and the remaining participants were of European descent. Three organisational representatives were team leads or clinical managers responsible for both leadership duties and maintaining a patient load in their clinical settings. One representative held a senior management position at the organisational level.

Preliminary Findings: These findings indicate that the older RNs are deeply passionate about their work and are highly valued by their colleagues. However, tensions exist around the perceived social stigma associated with working as older individuals and adapting to an ever-evolving healthcare system. Many are also navigating complexities related to age-related physical changes and retirement planning. These older RNs often address these challenges through self-directed strategies, with limited organisational support.

Implications for Practice, Policy, and Research: This research will contribute to understanding organisational support for older RNs within the Aotearoa New Zealand healthcare context. Recommendations will be made to strengthen strategies for supporting older nurses. The study will also lay the groundwork for future research focusing on the continuation of practice for older nurses in the nursing workforce.

You can download the presentation here

Disparities in Health and Wellbeing Outcomes Among Older Adults: An Analysis by Housing Tenure

Ayodeji Fasoro
He Kāinga Oranga and NZ Centre for Sustainable Cities, Department of Public Health, University of Otago, Wellington, New Zealand 

Research Idea: This study aims to explore the demographic, health and wellbeing differences among older adults in Aotearoa New Zealand based on their tenure types. The Integrated Data Infrastructure (IDI) database will be used to explore the 2023 Census data and other administrative data and identify older adults aged 65 years and over. Their interactions with government agencies will be assessed. Variables to be explored include, but are not limited to, socio-demographic characteristics (age, gender, ethnicity, work status, disability status, area deprivation), health (private and public hospital admissions, interaction with mental health services, pharmacy dispensing, ACC claims, GP visits, ED visits, immunisation), recorded crimes (victims), housing quality (heating, mould, damp, overcrowding), and income (benefits, wages and salaries).

Evidence: Later life is often spent indoors, especially at home due to factors like reduced physical ability and a preference for staying close to family, friends, and essential services. Older people are particularly vulnerable to the effects of poor housing, as they spend proportionally more time indoors. In New Zealand, older people in public housing have been reported to be economically disadvantaged, engage in unhealthy behaviours, and have poor self-reported physical and mental health status compared to public renters and homeowners (Pledger et al., 2019). Grimes et al. (2024) found that the tenure security public housing offers was a significant factor in making public tenants have a higher subjective wellbeing than private renters, but similar to the wellbeing of homeowners.

Questions for the audience: Is anyone using the IDI to research older people or to look at the impact of housing on older people’s health and wellbeing? What other variables (in the IDI) are important for consideration?

Co-designing technology for brain health in older adults with mild cognitive impairment

Yuan Gao, Department of Psychological Medicine, University of Auckland

Research Idea: This project involves working with older adults, caregivers, and aged care experts to co-design and evaluate socially assistive robots (SARs) and virtual humans (VHs) that support lifestyle changes for people with mild cognitive impairment (pwMCI). The goal is to promote sustained engagement in physical, cognitive, and social activities, which are known to benefit brain health. The research will take place in three phases: 1) co-design sessions to gather feedback from stakeholders, 2) a one-week feasibility study in participants’ homes, and 3) a three-month randomized controlled trial comparing the technologies with a standard educational app.

Supporting Evidence: Older adults with MCI are at heightened risk for dementia, yet many face barriers to sustained engagement in activities that promote brain health (Zhu et al., 2023). Prior research shows that interactive technologies like VHs and SARs can improve motivation, cognition, quality of life, and loneliness (Karami et al., 2024; Loveys et al., 2021; Dino et al., 2024). However, several gaps remain in the current literature:

1. Existing SARs and VHs are rarely designed with the unique needs of pwMCI in mind.

2. User-centred co-design approaches are often missing, limiting the real-world relevance and effectiveness of these tools.

3. The integration of large language models, which could enable more natural and personalized interactions, has not yet been fully explored in this population.

Questions for Audience

1. How can we balance personalization and ethical safeguards in AI-driven interactions with cognitively vulnerable populations?

2. What strategies can improve long-term engagement with technologies in real-world settings?

3. Where should we draw the line between emotional support and emotional dependency in human-robot interaction?

4. Could technologies change the way we think about companionship and caregiving in aging? Should they?

5. What would it take for you (as a researcher, clinician, or policymaker) to confidently recommend these technologies for use in real-world aged care?

Quality Improvement from the Clinical Utility Working Group

Hikaka, J, Kerse, N, Wilkie, J, Shawadun, Bloomfield, K., University of Auckland.

Introduction: Anecdotally, clinicians report difficulty in accessing and interpreting interRAI assessments to inform clinical practice. The sheer volume of data can be overwhelming (Elliot 2020). There is low interoperability with other software and systems (DeAlmeida 2023). Some clinicians feel the data is cumbersome, time consuming to navigate and interpret, and typically they do not have the level of expertise to fully interpret or utilise the information (Guthrie 2014),or are unaware of all the intention/use of data outputs (Bloomfield, 2024).  Low expertise in navigation, understanding intention and interpretation, esp. for infrequent users

A co-creation process was established to pull together knowledge about interRAI reports and data use. The clinical working group discussed three focus areas for clinical utility, Organisational Quality Improvement, Individual Patient Summaries and Data Security including perceptions of AI.

 Methods: The survey was developed with a mixture of demographic questions, multi-choice, Likert responses and free-text answers. One for Sector professionals and one for Person assessed.

The survey was sent using Qualtrics online survey platform via email, Face book and Linked In. The survey is currently in analysis stage. Qualitative data will be thematic analysis in NVivo Quantitative data using will be analysed using simple descriptive statistics with Excel, SPSS.

Results: We will report SECTOR SURVEY results of 130 Respondents, mostly female, approximately 50% clinicians and 25% management roles. Clinicians want a lay summary of reports. Homecare want social aspiration/changes, QIs, benchmarking, summary of CAPS, IADLs (Instrumental Activities of Daily Living) and ADLs (Activities of Daily Living). Long Term Care Facility want ADLs, software compatibility in NZ, comparison of previous assessment, clinical hours needed daily.

Conclusions: Excellent potential and valued by many, but areas to improve… particularly for ‘casual’ users. Next steps are focus groups and draft reports for piloting in aged care. Apply for further funding to develop reports for individuals and whānau.

You can download the presentation here

Health navigators facilitate comprehensive wellbeing assessment and care planning for Indigenous elders using self-report tool

Hikaka JF,a Foxcroft M,b Foley K, b Aydon S,b Spencer RJ,c Meehan Bba The University of Auckland, Auckland, New Zealand; b interRAI Services, Health New Zealand, Wellington, New Zealand; c Health Analytics, Health New Zealand, Hastings, New Zealand

 Introduction: Completion of an interRAI assessment by trained health professional assessors is required for access to publicly-funded aged care services in Aotearoa New Zealand (NZ). The interRAI Check-Up Self-Report (CU-SR) is used to gain a person’s perspective on their own health and wellbeing and is internationally validated. We investigated the feasibility and acceptability of facilitated CU-SR completion by paeārahi (unregulated health navigators) with older Māori in NZ.

Methods: This was a prospective non-randomised, non-comparator intervention study. The study site was one NZ health practice with approximately 1000 eligible people (Māori, 55 years or older, community-dwelling, not known to require formal needs assessment).

Paeārahi facilitated CU-SR assessment and developed a care plan with recruited participants. Pre- and post-intervention measurements of predefined feasibility and acceptability outcomes were collected and reported using descriptive statistics. Focus groups were held with paeārahi, participants, family members and other health professionals (n=14) to further explore feasibility and acceptability.

Results:  The 50 participants (mean 65.3 years, 66% female) felt the majority of items were acceptable. Mean completion time was 33 minutes and 28% of participants were referred to their general practitioner as a result of the assessment. The paeārahi-facilitated assessment was generally acceptable, feasible to undertake, and it was perceived that the intervention improved health care access.

Conclusions: Use of a validated assessment tool, with culturally relevant assessment and care practices by a culturally safe, unregulated workforce, is feasible and has the potential to improve equitable access to appropriate aged care services particularly in rural and under-resourced communities.

You can download the presentation here

Retinal Dopamine Dysregulation in a Dopamine Transporter Knockout (DAT-KO) Model of ADHD

Idowu GP 1, Lloyd JT 1,3, Freestone P 2,3 , Acosta ML 1,3
1School of Optometry and Vision Science; New Zealand National Eye Centre, University of Auckland; 2Department of Physiology, University of Auckland; 3Centre for Brain Research, University of Auckland

Introduction: Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological condition commonly diagnosed in childhood but often overlooked in adults, where it can significantly affect quality of life if undetected. Affecting 2-4% of the adult population, ADHD is characterized by hyperactivity, impulsivity, and poor sustained attention, and remains challenging to diagnose in adulthood. 

Dopamine is a key neuromodulator implicated in the pathophysiology of ADHD and measuring its concentration in the body may support diagnosis. Animal models such as the Dopamine Transporter Knockout (DAT-KO) rat have been developed to study ADHD by altering the dopamine system. The retina, a dopamine-rich neuronal tissue and an embryological extension of the central nervous system offers a more accessible site for investigating dopamine-related dysfunction.

This study aims to quantify retinal dopamine levels and assess responses to varying light spectra and dopamine-modulating drugs to identify dopamine dysregulation relevant to ADHD.

Methods: Retinal tissues were obtained from 6-weeks old DAT-KO and Wildtype (WT) female and male littermate rats. Fast-Scan Controlled-Adsorption Voltammetry (FSCAV) was employed to measure absolute extracellular dopamine in central and peripheral regions of freshly dissected retinas.

Results: Dopamine levels were higher in central regions than in the periphery in both DAT-KO and WT rats. DAT-KO rats showed elevated dopamine overall, indicating reduced reuptake and increased tonic dopamine. Additionally, there were no differences between males and females.

Conclusions: Elevated dopamine in central regions confirms its neuromodulatory role in visual processing. Regional variations in retinal dopamine linked to light adaptation and circadian rhythms may serve as an objective clinical marker of dysregulation. Further studies correlating dopamine levels with visual function could aid in identifying physiological markers of ADHD.

Housing Insecurity in Aotearoa’s Older People

Rachel Mackay, The New Zealand Council of Christian Social Services

Introduction: Some older people experience housing insecurity, but there are no official figures for this. We have sought to quantify this and explore insights using data on government social assistance.

Methods: Official information was obtained on the location, duration, and gender-distribution of applicants to Emergency Housing Special Needs Grants (EH SNGs) (MSD funding for individuals who have nowhere safe to stay in the next week) and the Public Housing Register (PHR) (People awaiting public housing) in March 2024. This information was compared with the general over-55 cohort and the overall housing insecurity dataset.

Results: We found distinct ethnic and regional differences in the over 55 cohort. Māori and MELAA applicants were overrepresented in both forms of support based on population size, however when compared to the applicant cohort, Māori over 55 were underrepresented in both forms of support. Older Asian applicants made up 27% of EH SNGs and 54% of PHR applications for all Asians. Wellington and the East Coast were overrepresented in EH SNGs but not for PHR applications. Over 55s waited on average 187 days longer than the overall cohort to be housed on the PHR, and tended to remain on EH SNGs for longer.

Conclusions: Older people are seldom identified in conversations about housing insecurity supports but must be accounted for. Gaps in data collection may be masking further need, as will other factors such as cultural expectations and gendered supports. We aim to track these facets of housing supports on an annual basis to highlight the need in this cohort.

Note – this report is the culmination of the poster that won the HOPE prize at the 2024 NZAG conference. Poster and full report available at https://nzccss.org.nz/resource/housing-insecurity-inaotearoas-older-people/

The effect of daily oral administration of tonabersat on cellular pathology in a mouse model of Alzheimer’s Disease

Mills A, Acosta M, Green C, Danesh-Meyer H, Kwakowsky A, Mugisho O
Department of Ophthalmology and Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand

Introduction: This study aimed to understand the impact of an anti-inflammasome drug, tonabersat, on cellular pathological features of Alzheimer’s Disease (AD) in an induced mouse model. AD is the most common form of dementia and is growing in prevalence with an ageing population. Chronic inflammasome activation is hypothesised to be a large contributor to pathology in age-related diseases such as AD. Therefore, we hypothesise that the use of therapeutics that demonstrate anti-inflammasome effects will benefit various age-related diseases. Using an induced mouse model of AD, we demonstrate neuroprotective and potentially anti-inflammatory cellular changes with daily oral anti-inflammasome treatment.

Research Summary: 17 days after introducing the AD-associated pathogenic peptide amyloid beta 1-42 (AB1-42) to the mouse hippocampus, we observed significant neuron loss and increased inflammatory cell and inflammasome markers such as Ionized calcium-binding adapter 1 (Iba1), Cleaved Caspase-1 (CC1), and Apoptosis-associated Speck-like protein containing a Caspase activation and recruitment domain (ASC). Daily oral administration of the anti-inflammasome therapeutic (tonabersat), beginning 1 day after AB1-42 introduction, prevented the loss of neuron area and the inflammation-associated increase in Iba1 and ASC, demonstrating promising potential to prevent important aspects of AB1-42 pathology.

Future Directions: Future directions will investigate the benefits of tonabersat treatment to cognition and memory in the widely used 5xFAD transgenic mouse model of AD that shows chronic development of symptoms with ageing. Additionally, we will analyse the level of pro-inflammatory cytokines and pathological disease markers at various time points to determine if a single treatment block can modify the disease course.

You can download the presentation here

Healthy Ageing and Wellbeing: Exploring the perspectives of older Indian Migrants in Aotearoa New Zealand.

Jayanthi Nagalingam
Supervisors: Dr Kay Shannon, Professor Eleanor Holroyd
Centre for Active Ageing, School of Clinical Sciences, Auckland University of Technology.

 Introduction: This study explores how older Indian migrants in Aotearoa New Zealand perceive and experience healthy ageing and wellbeing. In Auckland, older adults constitute approximately 12% of the population (Roberts, 2020). Among them, 16.1% (31,356) identified as Asian, with older Indians comprising 29.8% (9,345) of this group (Roberts, 2020). Despite their significant presence, the needs of older Indian adults remain underexplored due to broad ethnic categorisations. Understanding these experiences is critical for designing equitable, culturally appropriate health and social services.

Research Summary: As part of an ongoing PhD study, this research adopts a qualitative interpretive descriptive methodology to explore the influence of cultural, linguistic, religious, social, and economic factors on ageing experiences. Semi-structured interviews will be conducted with 10-15 older Indian migrants and 10 representatives from government and non-governmental organisations. The research aims to identify enablers and barriers to healthy ageing and wellbeing across individual, family, community, and societal levels. It also critically examines current strategies and policies to highlight gaps in addressing the specific needs of this growing population. Data collection will be iterative, with early insights informing subsequent interviews. Thematic analysis will be employed to identify key patterns and compare perspectives across both participant groups. The overarching goal is to inform the development of a culturally responsive, migrant-centred framework that supports healthy ageing and wellbeing in Auckland’s diverse population.

Future Directions:  The study is currently in the recruitment stage.Two pilot interviews have been completed to refine the interview approach, and a scoping review is underway to map global literature on healthy ageing and wellbeing in older Indian migrant populations. Preliminary results from this doctoral research will be presented to share emerging themes and invite feedback to strengthen the study’s relevance and impact.

Reference: Roberts, L. (2020). Older Aucklanders: results from the 2018 Census. Auckland Council technical report, TR2020/023.

You can download the presentation here

Ageing Sustainably Together: Co-designing projects for a collective, sustainable future

Neef, S. P., School of Psychology, Univeristy of Auckland, Waipapa Taumata Rau

Research Idea: Establish an Ageing and Sustainability Ac:on Group that will co-design research and action-oriented projects and initiatives with older adults to inform policy, practices and services. This action group will include older adults, academics, community leaders, NGOs, aged-care providers, advocates, and students. All actions, research and initiatives will take a strength-based, holistic approach that will be guided by Indigenous models of health and ways of knowing. The goal is to lead co-created, multi-stakeholder, interdisciplinary projects advocating for a whole society and community focus on ageing and sustainability that is led by older adults.

Supporting evidence: There has been an increased global, regional, and national focus on ageing and sustainability. There is extensive literature on the benefits of being in nature, green spaces, and gardening in promoting wellbeing and improving mood in older adults in the community and people living in residential aged-care. Research and projects are increasingly shifting focus towards ageing well and improving quality of life. Additionally, addressing and reducing ageism, social isolation, and loneliness have been noted across numerous studies as being key priorities. Multistakeholder and intergenerational community projects have shown promising results in several countries. Co-design is an essential facet of research and programmes to tailor projects and activities to the lived experiences and needs of older adults. While it is evident that there has been increased focus on ageing, sustainability, and co-design, it is essential that research and projects continue inform local, national, regional, and global policies and practices to promote sustainable, healthy ageing in the community in Aotearoa and the rest of the world.

Questions for audience:

What are some key topics and themes to focus on?

What global, regional, and national organizations should we approach to get involved?

How can we connect local, national, regional, and global levels?

You can download the presentation here

 

“Everybody's different and they all have different experiences”: Experiences of People with Parkinson’s navigating wellbeing and hope through community engagement

S.P. Neef, School of Psychology, University of Auckland, Waipapa Taumata Rau
Co-authors: Anna Miles, School of Psychology; Alison Talmage, Centre for Brain Research;
Catherine Bacon, School of Nursing. University of Auckland. Waipapa Taumata Rau.

Introduction: Despite increasing recognition of the psychosocial dimensions of living with Parkinson’s, there remains significant gaps in the literature around the role of community activities, the experiences of hope in the context of Parkinson’s, and little understanding of how people respond to a diagnosis and research about Parkinson’s.

This research takes on a strength-based, holistic approach to understand how people with Parkinson’s navigate wellbeing and hope through community engagement. Methods: Ten people with Parkinson’s who are part of community groups in Tāmaki Makaurau were interviewed. Semi-structured interviews were transcribed and analysed in NVivo using reflexive thematic analysis.

Results: The overarching theme that was “Everybody's diHerent and they all have diHerent experiences”, highlighting the individual and unique experiences of each person with Parkinson’s. Five major themes were conceptualised: (1) My life has changed quite dramatically, (2) Just don’t sit around. If you can, do something to slow it down, (3) The community things that keep us sort of together, (4) There's not enough known about it, (5) I was trying to think about it, what hope means. Several sub-themes explored the deeper and diHerent sides and perspectives, emphasising the individual and unique experiences that each person with Parkinson’s has.

Conclusion: It is crucial to improve the understanding of people’s experiences with Parkinson’s, and the role of community activities in supporting self- management, maintaining hope, and promoting living well with Parkinson’s. Future research should look to better highlight people’s lived experiences with Parkinson’s to take on more person- and community-centred approaches to health, wellbeing, and understandings of Parkinson’s.

You can download presentation here

Integrating oral care into daily nursing practice in aged residential care facilities with interprofessional collaboration and education

Oda, Keiko1, Gluestein, Sarah1, Parsons, John1, Boyd, Michal1, Smith, Moira2
 1Faculty of Medical and Health Sciences, University of Auckland (New Zealand); 2Department of Public Health, University of Otago Wellington (New Zealand) 

Introduction: My research aimed to integrate oral health care into daily nursing care practice in aged residential care facilities (ARCs) through interprofessional collaboration and education (IPC/IPE), and ultimately, to improve older people’ oral health and their quality of life.

Research Summary: Three stages of improving nursing oral health care practice for older people in ARCs by utilising mixed method with participatory action studies is involved my project. First, we developed an oral health assessment guideline, called the Oral Health Assessment Care and Planning (OHCAP) Tool, and a training module called Nursing Oral Health Assessment (NOHAT) with IPC/IPE with oral health professionals to improve oral care provision among nursing staff. Second, we delivered theoretical education sessions by using OHCAP and NOHAT in 5 ARCs. Then, we determined the research sites three ARCs in Auckland. Second, I delivered oral health promotion session for residents, whanau, allied health, and carer stakeholders to obtain informed consent from the research participants in residents from three ARCs.  Third, I tested the effect of OHCAP and NOHAT with ARC nursing staff to determine their effectiveness in improving nursing oral health care in their clinical settings. OHCAP and NOHAT are well-accepted by nursing staff, and their confidence and self-efficacy in oral health care practice improved.

Future directions: Further research is required to determine whether nursing oral health care practice that can support older adults’ oral health and overall health in primary health settings becomes normalized as a result of OHCAP and NOHAT.

The application of non-invasive brain stimulation to improve paretic handgrip performance in chronic stroke patients

Afifa Safdar1,2, Harry Jordan1,2, Winston Byblow2,3, Cathy Stinear1,2
1Department of Medicine, Faculty of Medical and Health Sciences; 2Centre for Brain Research; 3Movement Neuroscience Laboratory, Department of Exercise Sciences

Introduction: Non-invasive brain stimulation (NIBS) techniques have predominantly been used to suppress the contralesional primary motor cortex (cM1) in stroke patients to improve their paretic upper limb performance. However, recent studies have shown that suppressing the cM1 may be detrimental in stroke patients with severe upper limb impairment with absent motor evoked potentials (MEPs). The objective was to identify the effects of cM1 facilitation using NIBS on paretic hand performance in chronic stroke patients stratified according to presence (MEP+) and absence (MEP-) of MEP biomarker.

Methods: In this double-blinded study, facilitatory intermittent theta burst stimulation (iTBS) and sham iTBS were applied to cM1 of 19 chronic stroke participants in two separate sessions in randomized order. Repeated squeeze and release (RSR) of a handgrip dynamometer was used to assess total force released and squeezed with the paretic hand before and after the application of real and sham iTBS.

Results: After the application of real iTBS, the total force released and total force squeezed with the paretic hand was significantly higher compared to baseline in 9 MEP- participants (p = 0.047 and p = 0.048, respectively).  The application of sham iTBS in 9 MEP- participants and real and sham iTBS in 10 MEP+ participants did not affect paretic hand grip performance (all p > 0.87).

Conclusions: The facilitation of cM1 is beneficial for paretic hand grip performance in MEP- but not MEP+ chronic stroke patients. The consideration of the MEP status of chronic stroke patients might enable the targeted application of NIBS techniques.

You can download the presentation here

Effects of LSVT LOUD and EMST in individuals with Parkinson’s disease: A two arm non-randomized clinical trial

Shakeela Saleem1, Anna Miles1, Jaqui Allen2.
1Speech Science, School of Psychology, University of Auckland; 2Surgery, Faculty of Medical and Health Sciences, University of Auckland.

Introduction: Aerodigestive tract dysfunction and laryngeal incompetence are common in people with Parkinson’s Disease (PD) and are often non-responsive to medical and surgical therapy. Aspiration pneumonia is the leading cause of death in the PD population, therefore novel therapy approaches that primarily focus on improving pharyngolaryngeal deglutitive functions in PD are needed. This study compared the effects of Lee Silverman Voice Treatment (LSVT) and Expiratory Muscle Strength Training (EMST) on swallow, cough, and voice function in individuals with Parkinson’s disease.

Method: Fifty-eight individuals with mild-moderate PD (male = 45, M = 69 years, SD = 8) were enrolled in a two-treatment clinical trial and completed four consecutive weeks of either LSVT or EMST. All participants completed standard protocol videofluoroscopic swallow study, spirometry- cough tests, acoustic-voice assessment, and self-rated questionnaires pre- and post-therapy. Data were analysed by masked clinicians using specialised software. Mixed-model repeated measures and t-tests were performed.

Result: Both groups showed significant improvements in specific swallow and cough parameters. EMST resulted in significantly greater change in maximum hyoid displacement (Hmax; p=.04, d=.48) and decreased Hmax duration (p<.01, d=.65) compared to LSVT group. There were significant effects on pharyngoesophageal segment maximum opening (p=.01, d= .49) following LSVT. LSVT resulted in greater effects in acoustic aerodynamic voice measures (loudness, pitch-range, and aerodynamic-efficiency; p< .05, d>0.7) compared to the EMST. No voluntary or reflexive cough measures and self-reported questionnaires significantly differed between groups with both groups improving posttreatment.

Conclusion: Both LSVT and EMST improved specific swallow efficiency and airway defence capacity despite differences in task and therapeutic dose. Only LSVT improved vocal intensity. Both treatments are feasible options for individuals with mild-moderate PD.

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Effectiveness and carers’ perception of the e-DiVA website

Sani TP1, Moller E1, Cheung G1, Peri K1, Yates S1, Whaanga H2, Cullum S1
1Faculty of Medicine and Health Sciences, University of Auckland; 2Te Pūtahi-a-Toi (School of Māori Knowledge), Massey University

Introduction: This study is part of Empowering Dementia Carers with an iSupport Virtual Assistant (e-DIVA). We adapted the WHO’s iSupport into the New Zealand context and developed an online course hosted at the e-DIVA website. This study examined the possible effects of the website in reducing carers’ stress, evaluated its acceptability, and gathered feedback for future improvements.

Methods: A pilot randomised controlled trial was conducted with family carers of people living with dementia between March 2024 and February 2025. Participants were randomised into intervention (immediate access to e-DiVA) or waitlist control (access after 3 months). Outcome measures were assessed at baseline, 3, and 6 months: Perceived Stress Scale, Kessler Psychological Distress Scale, Zarit Burden Interview, and quality-of-life visual analog scale. At 6 months, participants underwent a semi-structured exit interview. Quantitative data were analysed using an intention-to-treat approach; qualitative data were analysed thematically.

Results: Fifty-two carers (42 non-Māori, 10 Māori) were recruited. No significant differences were found between groups in the outcome measures at 3 months. However, 6-month exit interviews (n=29) revealed that carers perceived the website as a trustworthy, easy-to-use, one-stop source of information, especially helpful for new carers with limited access to in-person support. More experienced carers found that, despite not finding much new information, e-DiVA reaffirmed their practices and decisions in the caring journey. Carers wanted the website to be publicly available and would recommend it to other carers. They also suggested features to connect carers to each other and to local services (e.g., message board).

Conclusion: No statistical improvement was seen in stress, burden, or quality of life, but this may have been due to a lack of statistical power. Participants highlighted e-DiVA’s practical value and relevance to their caring journey. Carers viewed the website as a valuable resource, particularly for its potential to support new carers.

The TWIST studies: Predicting Time to Independent Walking after STroke

Marie-Claire Smith PhD1,3, Ben Scrivener2,3, Cathy M Stinear PhD2,3

1Department of Exercise Sciences, University of Auckland; 2Department of Medicine, University of Auckland; 3Centre for Brain Research, University of Auckland

Introduction: After stroke, most people want to know how long it will take to be able to walk independently again. Yet clinicians are hesitant to respond to these questions, due to concerns about providing inaccurate or misleading information and whether providing difficult news to the patient will jeopardize post-stroke recovery.

Research Summary: The TWIST (Time to Walking Independently After STroke) prediction tool was developed and validated over the last 10 years at Auckland, North Shore and Waitakere hospitals. The TWIST tool uses 3 simple bedside measures at 1-week post-stroke to predict when a patient will achieve independent walking. TWIST is easy for clinicians to use and is very accurate. TWIST is the only tool internationally that predicts how long it will take for patients to achieve independent walking after stroke.

In addition to developing the prediction tool, the TWIST studies have established that accuracy of physiotherapist predictions for time taken to achieve independent walking is low and is not related to years of experience or clinician confidence. We also explored patient and whānau wishes for prediction information with surveys at 1 week and 6 months post-stroke. Ninety percent of patients and whānau wanted to know whether and when they would walk independently. Interviews were conducted to explore what sort of information patients and whānau would like, when they would like it, in what format and who should deliver it. Interviews were also conducted with clinicians to explore barriers and facilitators to using prediction information.

Future Directions: The next steps are international external validation and developing an implementation plan. We are working with a group of researchers in the UK to achieve these goals. This research could transform how we provide information to our patients and whānau and support safe and effective discharge planning after stroke. 

Exploring the relationship between technology and mental health among older people in Aotearoa New Zealand.

PhD Student Researcher: Stowell M
Supervisors: Dobson R, McCool J, Nosa V, Whittaker R.
School of Population Health, University of Auckland 

Research idea: The aim of this PhD is to co-create an evidence-based resource to support the development of age-friendly, mental health-affirming digital health tools for older people in Aotearoa New Zealand.

In Year 1, I conducted a scoping review to clarify the components involved in existing digital tools to promote mental health and how these have been tailored for older people. Now in Year 2, I have completed 21 qualitative interviews with older people to understand their perspectives on mental health in later life, their feelings about technology and its relationship to mental health, and thoughts on how to better support older people to have positive experiences with technology. After analysing these interviews, I aim to convene a transdisciplinary group of people interested in co-creating a strengths-based solution to ensure that current and future technologies are accessible to all older New Zealanders.  

Supporting evidence: As emerging technologies continue to transform the way we go about our lives, an age-related ‘digital divide’ has been observed and poses a threat to the potential for technology to make essential services (like healthcare and financial management) more accessible to everyone (Bentley et al., 2024). At the same time, loneliness and social isolation are growing among older New Zealanders and represent a significant public health concern for our ageing population (NZ Herald, 2024). My own research has revealed that while technology has some important and useful purposes for older people, many feel that technology is rarely developed with older people in mind. Stakeholders have similarly indicated that technology can be distressing for older people, particularly as they live further into retirement years and experience more isolation.

Questions for audience: Any overall questions, comments or suggestions about this research? Who should I seek to involve in a future transdisciplinary co-creator group to ensure its success?

References

Bentley, S.V., Naughtin, C.K., McGrath, M.J. et al. The digital divide in action: how experiences of digital technology shape future relationships with artificial intelligence. AI Ethics 4, 901–915 (2024). https://doi.org/10.1007/s43681-024-00452-3

NZ Herald. The lonely statistics: Age Concern calls for Ministry for Loneliness to support elderly New Zealanders: NZ Herald; 2024 [11 November 2024]. Available from: https://www.nzherald.co.nz/kahu/the-lonely-statistics-age-concern-calls-for-ministry-for-loneliness-to-support-elderly-new-zealanders/MIS7K4G435D5XOFOWDPNTXTIXE/

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Embodied Identity – Making a connection between Dementia Prevention and Dance Movement Therapy in Aotearoa, New Zealand

 Ann Way1, Suzanne Purdy1, Joan Leung1, Ralph Buck2, Bonnie Meekums1
1School of Psychology, Faculty of Science, The University of Auckland, Building 507, Grafton Campus, 22-30 Park Avenue, Grafton Auckland 1023; 2Dance Studies Programme, Faculty of Arts and Education, The University of Auckland, Building 201, City Campus, 10 Symonds St, Auckland Central, Auckland, 1010, New Zealand

 Keywords: dance movement therapy, mild cognitive impairment, clinical research, interview, gerontology, non-pharmaceutical approach 

Research ideas: This research examines intervention strategies for reducing the risks of dementia by interviewing those involved in dementia care (specifically with dance movement therapists, healthcare professionals, and caregivers of individuals living with mild cognitive impairment). The researcher proposes a staged project using various methodologies. The initial stage to assess the need will involve semi-structured interviews. Data will be analysed using thematic analysis to identify themes. These themes will form the development of the subsequent stage. The outcome of the initial stage will inform the development of a pilot programme and trial in the subsequent stage. The research uses mixed analysis for multivariable data, such as markers of change using blood pressure or electroencephalogram (EEG) scans, including movement observation data and self-report. The outcome of the subsequent stage is to validate the themes and determine the pilot programme's effectiveness. The research findings will inform the improvement of care and enhance the quality of life for individuals living with mild cognitive impairment (MCI) who are at a higher risk of developing dementia-related conditions.

Supporting evidence: Research on the benefits of dance in dementia care is limited in Aotearoa (Choo, Barak & East, 2019), and dance movement therapy (DMT) has not been thoroughly investigated (Ho et al., 2020; Karkou et al., 2023; Menezes, Drumond & Shigaeff, 2022). This study investigates the role of DMT in preventing dementia, particularly in individuals living with MCI. The motivation behind this research is to explore the therapeutic benefits of DMT for individuals living with MCI in Aotearoa, New Zealand, with the aim of preventing, delaying, or slowing the progression of dementia while improving overall well-being. Additionally, the inclusion of caregiver perspectives ensures a comprehensive understanding of how DMT can benefit both individuals at risk of dementia and their support networks. Caregivers who often experience isolation (Terada et al., 2019) may find participation meaningful, as it offers a sense of acknowledgement and purpose (Ross, Ziegert & Rodriguez, 2024). The altruistic satisfaction that caregivers derive from their role can enhance the quality of informal care provided to individuals with dementia (Basu & Rosenman, 2014).

Questions to the audience: What role do you see families and caregivers playing in the care process, and how do you support them? Have you ever experienced a DMT session in New Zealand? If yes, where and who provides them? What do you think about the approach? Would you like to share any culturally specific approaches or considerations when working with Māori or Pasifika individuals with MCI?

References

Basu, R., & Rosenman, R. E. (2014). Altruism and informal care for dementia. International Journal of Social Science Studies, 2(1), 70 - 82. http://dx.doi.org/10.11114/ijsss.v2i1.185

Choo, T., Barak, Y., & East, A. (2020). The effects of intuitive movement reembodiment on the quality of life of older adults with dementia: a pilot study. American Journal of Alzheimer's Disease & Other Dementias, 35. https://doi.org/10.1177/1533317519860331

Ho, R. T. H., Fong, T. C. T., Chan, W. C., Kwan, J. S. K., Chiu, P. K. C., Yau, J. C. Y., & Lam, L. C. W. (2020). Psychophysiological effects of Dance Movement Therapy and physical exercise on older adults with mild dementia: a randomised controlled trial. The Journals of Gerontology: Series B, 7(3), 560–570. https://doi.org/10.1093/geronb/gby145

Karkou, V., Aithal, S., Richards, M., Hiley, E., & Meekums, B. (2023). Dance movement therapy for dementia. The Cochrane database of systematic reviews, 8(8), CD011022. https://doi.org/10.1002/14651858.CD011022.pub3

Menezes, A. C., Drumond, G., & Shigaeff, N. (2022). Dance therapy and cognitive impairment in older people: A review of clinical data. Dementia & Neuropsychologia, 16(4), 373–383. https://doi.org/10.1590/1980-5764-DN-2021-0103

Ross, S. D., Ziegert, N., & Rodriguez, F. S. (2024). Implementation of non-pharmacological interventions in dementia care: Family caregiver perspective. Home Health Care Management and Practice, 36(1), 20-30. doi:10.1177/10848223231174226

Terada, S., Nakashima, M., Wakutani, Y., Nakata, K., Kutoku, Y., Sunada, Y., Kondo, K., Ishizu, H., Yokota, O., Maki, Y., Hattori, H., & Yamada, N. (2019). Social problems in daily life of patients with dementia. Geriatrics and Gerontology International, 19(2), 113–118. https://doi.org/10.1111/ggi.13554

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Impact of Dementia mate wareware and solutions for Equity in Aotearoa (IDEA): A work in progress

 Xiaojing (Sharon) Wu1, Sarah Cullum2, Gary Cheung2, Rita Krishnamurthi3, Susan Yates4, Claudia Rivera5, Jackie Broadbent6, Lynette Tippett4, Ngaire Kerse1
1Department General Practice and Primary Health Care, University of Auckland; 2Department of Psychological Medicine, University of Auckland; 3National Institute for Stroke and Applied Neurosciences, Auckland University of Technology; 4School of Psychology, University of Auckland; 5Department of Statistics, University of Auckland; 6Health NZ Te Whatu Ora- Canterbury Waitaha, Christchurch NZ

 Aims: Ageing is the strongest risk factor for dementia, and with New Zealand’s ageing population, dementia cases are projected to triple in 30 years. However, true prevalence remains unknown, as estimates rely on overseas data. The IDEA programme aims to determine dementia prevalence in Pākehā, Chinese, and Indian populations, enabling equity analyses with Māori and Pacific groups. This fundamental data will inform culturally appropriate dementia services to address ethnic disparities in care.

Methods: This is a cross-sectional screen-interview survey of individuals aged ≥65. This study employs a door-knocking approach in selected urban and rural meshblocks in Auckland and Christchurch. Trained multiethnic interviewers who are proficient in the relevant languages perform door-step cognitive screenings and recruit a random sample for comprehensive interviews using the 10/66 dementia protocol. With a margin of error of 3%, and a confidence level of 5%, a total of 485 European, 410 Chinese and 425 Indian/Fijian-Indian people will be interviewed.

Results: In the first 9 months, 18,220 doors were knocked, 2650 participants were screened, and 584 were interviewed, with 30% of selected participants declining interviews and 35% refusing door-step screenings. The presentation will discuss the successes and challenges experienced by the door-knocking team, alongside preliminary insights into dementia prevalence across ethnic groups.

Conclusions: The IDEA programme represents a critical step toward understanding dementia prevalence in NZ’s diverse populations. By providing accurate, population-specific data, this study will inform equitable and culturally appropriate health service planning and contribute to improved outcomes for people with dementia in NZ.

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Older people’s perception of mobility in the urban environment: Wellington as a case study

Younes SR. School of Architecture, Victoria University of Wellington

Introduction: With increasing number of older people in New Zealand which mostly reside in urban areas, the importance of the urban environment as an immediate surrounding and living environment is increasing. Being mobile is highly relevant to independence in old age, which in turn can enhance quality of life. While there is evidence on the impact of street design on active mobility among older people, the exploration of mobility, barriers, and facilitators in New Zealand has not been adequately addressed. This research aims to fill this gap by exploring older people’s perceptions of mobility in the outdoor environment in Wellington.

Method: This study employed a qualitative approach, using semi-structured interviews to collect data from older adults aged 75 and over living in the study area. A non-probability, purposive, criterion-based sampling strategy was used to ensure participants met the study criteria. Recruitment involved multiple strategies, including advertising, networking with older individuals, outreach to organisations serving older populations, and on-site engagement.

Results: The results indicated that older people in Wellington are generally satisfied with the quality of the urban environment and public transport. However, their concerns primarily relate to conflicts with other users, social and psychological impacts, surface safety issues, and weather-related barriers. Participants also emphasised the importance of benches and handrails as critical enablers of mobility.

Conclusion: Although the urban environment in Wellington generally offers a supportive setting for older adults, several challenges remain that require attention. While older adults’ physical mobility and the availability of a supportive environment both play important roles in facilitating mobility, this study concludes that older adults’ perceptions of their mobility are strongly associated with their actual mobility status and physical capabilities.

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Eye care services for older adults with vision impairment

 Justine H Zhang1,2, Katrina K Poppe1, Thomas Lumley3, Jacqueline Ramke1,2
1Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 2International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; 3Department of Statistics, University of Auckland, Auckland, New Zealand

Research idea: Among older adults, what are the barriers to accessing eye services in Aotearoa New Zealand and how can we improve eye care for underserved older adults?

Supporting evidence: With age, prevalence of vision impairment increases. This has a direct impact on activities of daily living, quality of life, and the ability to function independently, particularly for older adults who may live alone or with limited social support. In Aotearoa New  Zealand, for those aged 65 and over, approximately 10-12% of people have vision impairment (Stats NZ). The major causes of vision impairment in older adults are cataracts, age-related macular degeneration (AMD), glaucoma and diabetic retinopathy. With the exception of dry AMD, all the other major causes of vision impairment have treatments available that can improve vision or slow disease progression. However, vision outcomes are often worse when an eye condition is diagnosed late, so it is important that older adults are able to access and engage with eye services early to ensure optimal vision outcomes.

Questions for audience: Do you frequently encounter older adults who are likely to have high eye care needs but have difficulty accessing eye services? If so, what are the main social and clinical risk factors? (e.g. older adults in residential care, dementia, disability)

Our group will be working with data from the national Health Data Platform, which contains routinely-collected health service data from the Ministry of Health. How could health contact data from services not directly related to eye health (e.g. data from inpatient admissions) be used to help identify ‘at risk groups’ who are not accessing eye services?

Could a multi-disciplinary approach be the way forward to improve access to eye services, and if so, how?

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