Abstracts and Programme for Knowledge Exchange 2026
Friday, 17th April 2026 at University of Auckland
Programme can be downloaded here.
PARTICIPANTS REQUIRED : When to stop driving? An exploration into driving cessation decision-making among people with cognitive impairment
Kushalata Baral, M Parsons, A StewartSchool of Nursing and Midwifery, The University of Waikato, Hamilton, New ZealandIntroduction: Driving cessation among older people with cognitive impairment is a complex and emotionally significant issue with major implications for autonomy, safety, mobility, and quality of life. When memory loss or cognitive decline affects driving ability, decisions about whether, when, and how to stop driving can be challenging for both the individual and those supporting them.
Objective: Phase II of this study aims to understand why driving cessation is challenging, how these decisions are experienced and managed, and what forms of support may be helpful. The survey seeks responses from people who support an older person with memory loss who is still driving or who has recently stopped driving.
Methods: This multi-phase mixed-methods study uses a sequential exploratory design. Phase II involves a national survey informed by findings from Phase I focus groups and developed through iterative refinement, stakeholder engagement, and ethical review. The survey is being distributed across Aotearoa New Zealand, with key support from Dementia New Zealand, and further promoted through the HOPE Foundation for Research on Ageing, Carers New Zealand, professional networks, community organisations, and the University of Waikato platforms.
Progress to date: Ethics approval for Phase II has been secured, and the survey instrument has undergone extensive refinement in Qualtrics to enhance clarity, accessibility, and methodological rigour. National distribution is currently underway.
Significance and expected contribution: This study will generate high-quality evidence on how driving cessation is understood, experienced, and managed in the context of cognitive impairment. Through rigorous statistical analysis, the findings will help identify gaps in current support and inform future practice and service provision that better uphold the safety, dignity, independence, and well-being of older people. The study is expected to benefit older people, family members, carers, health professionals, community organisations, and decision-makers.
Keywords: Driving cessation, memory loss, older people, cognitive impairment, decision-making
Multimodal speech analysis for early detection of mild cognitive impairment: A scalable approach
Mohammed Bilal, Waleed Abdullah, Gary Cheung, Lynette Tippett, Seyed Reza ShahamiriIntroduction: Early detection of mild cognitive impairment (MCI) is crucial for timely intervention in dementia care. Traditional diagnostic methods are resource-intensive and lack scalability. This research develops a novel multimodal speech analysis framework to improve early mild cognitive impairment detection using non-invasive, accessible technology.
Methods: We analyzed spontaneous speech recordings from the TAUKADIAL Challenge dataset, including 186 training recordings (123 MCI, 63 normal cognition (NC)) and 60 test recordings (30 MCI, 30 NC) from English speakers describing standardized images. Speech was transcribed using OpenAI's Whisper-Large model. To address class imbalance, we implemented spectrogram-level and resampling-based data augmentation. Three feature modalities were extracted: (1) textual embeddings from LoRA-finetuned RoBERTa-large, (2) audio embeddings from Whisper encoder, and (3) acoustic features from eGeMAPS. A multimodal fusion architecture combined these features through linear projection and multilayer perceptron classification.
Results: The multimodal framework achieved unweighted average recall of 0.867, outperforming single-modality baselines: text-only (0.81), audio-only (0.80), and acoustic-only (0.70).
Conclusion: Integrating automatic speech recognition, natural language processing, and acoustic analysis provides robust, scalable dementia screening without complex ensemble strategies.
Keywords: mild cognitive impairment, speech analysis, multimodal machine learning, dementia screening
Restorative justice prespectives of Aotearoa New Zealand's Operation Grapple Nuclear Test Veterans
Judy BlakelyIntroduction: Aotearoa's founding agreement between Māori and the British Crown, Te Tiriti o Waitangi (1840), establishes principles of partnership, protection, and participation. These principles guide equitable responses to the legacy of Operation Grapple - the United Kingdom's thermonuclear weapons tests (1957-1958) that involved 551 Royal New Zealand Naval personnel. However, official Veterans' Affairs New Zealand (VANZ) reports only document health impacts through a narrow military lens that lacks transparency, open dialogue and any meaningful collaboration with ageing veterans now in their late eighties.
Methods: A 2025 Wai 2500 Waitangi Tribunal Military Veterans Kapapa Inquiry evidence brief describes how surviving New Zealand Grapple veterans struggled through many decades to secure recognition of their service, and the related health impacts. An archival analysis of contested evidence and systemic responses to claims of radiation-related harm included veteran-led research undertaken in collaborations with multi-disciplinary researchers in Aotearoa and the United Kingdom. British investigative journalist Susie Boniface's 15 March 2026 publication in the Mirror and the subsequent debate in the UK parliament corroborate the concerns expressed.
Results: The findings highlight how the absence of meaningful partnership in Crown reporting has excluded Māori perspectives from the official narratives. Moreover, documented exchanges between veterans, researchers, and the VANZ Expert Medical Panel reveal how compromising transparency has created persistent barriers to accessing justice for ageing veterans and their descendants.
Discussion: Tiriti-based restorative justice frameworks offer pathways for addressing the psychological distress, moral injury, and intergenerational trauma linked to nuclear test service. Embedding partnership and participation principles can facilitate developing restorative justice perspectives that explore Operation Grapple's legacy of disrupted whakapapa and historical harm.
Addressing ageism through nursing education: Preparing nursing students to provide culturally safe care for Māori Kaumātua in Aotearoa New Zealand
Nesca BowlinResearch idea: My research aims to examine undergraduate nursing students' attitudes toward ageing and explore how nursing education prepares students to provide culturally safe care for Māori kaumātua. This study will utilize Kaupapa Māori Research (KMR) principles, incorporating a mixed-methods design. Quantitative data will be collected using a validated ageism scale to assess ageist attitudes among undergraduate nursing students. Qualitative data will be gathered through pūrākau-informed semi-structured interviews to explore students' attitudes towards ageism and their perspectives on ageism education, as well as their experiences of ageism among older Māori people in clinical placements.
Supporting evidence: Evidence shows a significant impact of ageism on health inequity. As reported by the WHO (2021), ageism leads to undertreatment, exclusion from services, and worse physical and mental health. Researchers argue that there is a strong link between ageism and health, indicating that ageism affects people’s health outcomes and life expectancy (Chang et al., 2020). In Aotearoa New Zealand, kaumatua continue to experience disparities in health outcomes and access to culturally safe healthcare. Nursing education institutions hold a responsibility to prepare nurses to deliver equitable and culturally safe care for Māori under its nursing competency framework Pou 1 (Te Tiriti o Waitangi). However, little research has explored how nursing students understand ageism and its intersection with Māori health and well-being.
Questions:
1. In your experience, how is ageism experienced or manifested among Māori kaumātua in healthcare settings?
2. What teaching strategies have you found effective in addressing ageism in nursing education?
References:
Chang, E-Shien., Kannoth, S., Levy, S., Wang, S.-Y., Lee, J. E., & Levy, B. R. (2020). Global reach of ageism on older persons’ health: A systematic review. PLOS ONE, 15(1). https://doi.org/10.1371/journal.pone.0220857
World Health Organization. (2021, March 18). Ageism is a global challenge: UN. ww.who.int; World Health Organization. https://www.who.int/news/item/18-03-2021-ageism-is-a-global-challenge-un
Organisational support for older registered nurses (RNs)' continuation of practice
Chunxu Chen1,2, Dr Kay Shannon1, Professor Eleanor Holroyd2, Dr Sara Napier11Centre for Active Ageing, School of Clinical Sciences, Auckland University of Technology; 2Centre for Migrant and Refugee Health Research, Auckland University of Technology.Introduction: Healthcare needs are increasing globally as populations age, while the nursing workforce is also ageing. Older nurses are highly valued for their clinical expertise; however, they may also experience age‑related challenges. Organisational support plays a crucial role in enabling older nurses to continue practising, yet limited research has examined how older nurses perceive such support. This doctoral study aims to explore how registered nurses aged 60 years and over (or 50 years and over for Māori and Pasifika nurses), and organisational representatives, perceive organisational support for older registered nurses' continuation of practice.
Methods: Semi-structured interviews were conducted with thirteen RNs and four organisational representatives. 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 line managers or charge nurse.
Preliminary Findings: Four themes were identified from the RNs’ dataset: (1) Tensions in continuation of practice, (2) Drivers for continuation of practice, (3) The experience of being an older RN in practice, and (4) Retirement from a large organisation. Three themes were identified from organisaitonal representatives’ dataset: (1) Perceived complexities in continuation of practice, (2) Managerial-level support, and (3) Support at organisational level.
Implications for Practice, Policy, and Research: This research contextualises older registered nurses’ continuation of practice within Aotearoa New Zealand. Challenges to continuation of practice exist at intrapersonal, interpersonal, and organisational levels. A more inclusive workplace culture is needed to enable older registered nurses, nurse managers, and nursing leaders to engage in open discussion about support needs and to implement appropriate organisational supports more effectively. This study also lays the groundwork for future research examining the continuation of practice of older nurses within the nursing workforce.
Using hearing games to train the cognition of older adults with mild cognitive impairment
Reese Ducusin, Suzanne Purdy, Lynette Tippet, J LeungSchool of Psychology, Faculty of Science, University of AucklandIntroduction: There is a growing need for non-pharmacological interventions to delay or prevent the onset of dementia. Mild cognitive impairment (MCI) is a precursor to dementia and offers a critical window to provide intervention. Hearing loss is the highest modifiable risk factor of dementia, and is strongly linked with cognition. This study explores whether remote assessment and gamified auditory-cognitive training can improve cognitive abilities in older adults with MCI.
Methods: Participants with MCI, aged 65 years and above, will play two commercial auditory training games for 20 minutes daily at home for two weeks. Three hearing and cognitive assessments will occur throughout the intervention period – two to determine a stable baseline and one post-intervention. Within-subject, baseline comparison analyses will be used to determine the training's effectiveness. Following training completion, participants and their support person will also be invited to share their feedback on the training experience in an in-person interview.
Preliminary Findings: The training improved temporal processing of auditory information, executive functioning, and cognitive flexibility in older adults with MCI. The interviews also revealed mixed participant feedback on the training, due to the nature of the games and the technology used.
Implications: Gamified auditory-cognitive training is a promising intervention for improving auditory processing and cognitive abilities of older adults with MCI. Participant feedback provides insight into aspects of the intervention they liked or disliked. This study will inform future research aimed at co-creating a gamified auditory-based cognitive training tool with older adults with MCI, support persons, and health professionals.
Perceptions of eye and hearing care services in New Zealand’s aged care services
Lucy Goodman, Jacqueline RamkeSchool of Optometry and Vision Science, University of AucklandIntroduction: Older people living in residential aged care facilities commonly experience problems with vision or hearing, which can increase the risk of falls, social isolation, depression, and dementia. To support healthy ageing, our long-term aim is to strengthen eye care services in aged care facilities. To do this, we first need to understand how many aged care facilities in Aotearoa provide eye and hearing health services for their residents, the types of services that are available, and the main challenges that the facilities and the residents face in accessing these services.
Methods: A nationwide online survey was distributed to managers of aged care facilities between June and December 2025. Respondents provided information about the delivery features of any on site eye and hearing services, perceived importance, and barriers to offering on-site eye and hearing care services.
Results: Managers from 132 facilities completed the survey. Only a very small number offered comprehensive optometry (n=5) or audiology (n=12) services on-site. Facilities perceived hearing care services as more important than vision care services (p<0.05). The most frequently cited barriers to accessing hearing or eye care services were resident immobility, distress or confusion during off site appointments, lack of family availability to escort residents, rural distance to providers, and the cost of services and devices, which are not funded under aged residential care contracts. Many facilities expressed willingness to host mobile providers, but noted low commercial viability, especially in small or rural sites.
Implications: Findings indicate substantial unmet need for accessible eye and hearing care among aged care. On site or mobile services (ideally affordable and routinely scheduled) may reduce inequities, improve resident wellbeing, and support safer, more person centred care.
Modelling the ageing brain to better understand Huntington Disease
Jess Kelly, A McCaughey-Chapman, N Grimsey, Bronwen ConnorDepartment of Pharmacology, Faculty of Medical and Health Sciences, University of AucklandIntroduction: Investigations into neurological diseases of aging are impeded by a lack of access to relevant disease models. Human brain tissue represents only the end stage of disease, rodent models lack important biological features, and many cell models lose all information related to aging. Direct-to-induced neural precursor (iNP) cell reprogramming, developed in our lab, creates brain cells from readily available human skin cells in a way that maintains the changes a person has accumulated through aging in their lifetime. This provides a more physiologically relevant cell model, however traditional 2-Dimensional cell culture methods miss other important aspects of cell behaviour.
Research summary: This work progresses the direct-to-iNP reprogramming technology by creating a 3-dimensional model, called ‘organoids’, to more accurately capture cell behaviour. Specifically, neurons specific to a brain region called the Striatum are generated and are grown in cell culture plates that ensure the cells remain suspended in solution. Through natural cell behaviours, these cells group together, forming organoids. A variety of analyses reveal that the organoids express markers specific to striatal neurons and form complex networks. We have demonstrated the ability to create this model using cells from donors with Huntington’s Disease (HD), a genetic neurological condition. The HD organoids display relevant phenotypes including differences in neuron maturity, protein expression changes, and expression of mutant huntingtin protein, the main pathology in HD.
Future Directions: Upcoming work seeks to understand the role of key proteins in HD pathology. Further work could also trial therapeutic agents to find therapies to reduce symptoms or prevent the onset of disease. In a broader scope, we can also generate neurons from different brain regions, including cortical and dopaminergic cells, which are implicated in diseases including Alzheimer’s and Parkinson’s. In all, this novel protocol gives researchers an improved ability to understand and treat neurological conditions.
The history of Selwyn Village and trends in the housing of the elderly
Peter LinehamSelwyn Village was a pioneer of the village model for the housing of the elderly. The official opening took place in April 1953, and offered the new concept of a village with rental accommodation for the elderly poor. The village received international attention and became a model for others. The Selwyn Foundation, which separated from the Auckland City Mission in 1967, eventually adopted the “own your own” model, along the lines of commercial operators. Many other charities found it impossible to compete, and the Foundation took over several of these villages. Then in 2022 it sold off five villages to MetLifeCare and refocused on “the Selwyn Way”. This paper will focus on changing perceptions of the needs of the elderly and the operating environment within and beyond the Selwyn Foundation.
Peter Lineham has been commissioned to write a history of the Selwyn Foundation. (He had previously written a history of the Auckland City Mission, Agency of Hope (Massey University Press, 2020) along with many other works primarily on religious history.
Advanced directives in New Zealand :The law, the lawyer, the user
Annie Meates, Mark HenaghanUniversity of AucklandThere are currently more than 800,000 New Zealanders aged 65 years and over. Yet, in New Zealand and internationally there is a low uptake of future care documents with the main reason being a lack of awareness of the documents and a lack of understanding of what the documents do. The term future care documents (FCDs) refers to an enduring power of attorney, an advance directive and an advance care plan.
My research addresses 3 questions. First, what the law is that applies to FCDs as there is a lack of certainty. Second, what are the motivators and barriers for a User (a person aged between 65 – 80 years of age) to complete FCDs and third, in legal practice how are FCDs being promoted to clients.
This study is a mixed methods design involving black letter law as to applicable law, and a socio-legal empirical inquiry with semi-structured interviews of Users and lawyers with a qualitative analysis. Question 1 is a legal doctrinal inquiry of primary sources of legislation, case law, regulations and secondary sources. Questions 2 and 3 have a paradigm of realism to emphasise the real-world application of the law and its social consequences. There is little socio-legal empirical research undertaken in New Zealand.
From the lawyer and User interviews to date the prevailing issues are a lack of certainty of the legal framework that applies to FCDs, a lack of knowledge of document options, and a lack of understanding of FCDs generally.
Our law provides for people to make decisions for themselves to refuse medical treatment as a competent adult. Our law also provides for people, as an adult with capacity, to make decisions to refuse medical treatment for a time in the future when they no longer have capacity, yet the majority of Users do not seem to know this.
The effect of beetroot juice supplementation on blood pressure in high blood pressure adults
Reder Mohammedsalih, Kaio Vitzel, Aj Ali, Marie Wong, Blake Perry, Mershen PillayDepartment of Health Science, Massey University, Auckland, New ZealandIntroduction: Hypertension is a major risk factor for cardiovascular disease (CVD)and contributes to disability and premature mortality. In New Zealand, 22.5% of adults have hypertension, with 25.8% of diagnosed individuals untreated, particularly among Māori (38.1%), Pacific (57.7%), and Asian (46.9%) populations. Age-related endothelial dysfunction and diminished nitric oxide bioavailability are key mechanisms underlying elevated blood pressure. Dietary nitrate supplementation, such as beetroot juice, may restore nitric oxide and improve vascular function, yet dose-response evidence in untreated hypertensive adults is limited.
Research summary: "The Beet-Pressure Trial" is a double-blind randomised controlled trial investigating the acute effects of four doses of nitrate-rich beetroot juice (placebo, 400 mg, 600 mg, 800 mg) on blood pressure in adults aged 30-75 years with untreated high blood pressure (systolic 120-159 mmHg; diastolic 80-99 mmHg). Participants will be monitored to determine the optimal dietary nitrate dose. Prior studies indicate beetroot juice reduces blood pressure via nitric oxide restoration, with enhanced effects in untreated individuals. Research in young, healthy populations shows dose-responsive reductions, but evidence in older adults at higher CVD risk is inconsistent, highlighting the need for this targeted trial.
Future directions: This trial will provide evidence on the dose-response relationship of dietary nitrate in untreated hypertensive adults, informing potential non-pharmacological strategies to reduce cardiovascular risk. Results may guide future clinical trials and public health interventions aimed at improving blood pressure management and addressing disparities in populations with high rates of untreated hypertension.
"Ageing Together": Intersectoral community-based support for the wellbeing of older Indian migrants in Aotearoa New Zealand
Jayanthi Nagalingam, Kay Shannon, Eleanor HolroydCentre for Active Ageing, School of Nursing, Auckland University of TechnologyIntroduction: Older Indian migrants in Aotearoa New Zealand face distinct challenges associated with ageing in a culturally unfamiliar environment, including language barriers, diminished family networks, and social isolation. As one of the largest Asian subgroups in Auckland, the wellbeing of this growing population calls for a deeper understanding of community-based support systems that promote healthy ageing (Wright- St Clair et al., 2018). This presentation is situated within broader doctoral research that examines how older Indian migrants perceive and experience healthy ageing and wellbeing, with a particular focus on the contributions of non-governmental organisations (NGOs) in supporting this population.
Methods: The study is guided by a qualitative interpretive descriptive methodology and involves semi-structured interviews with approximately ten representatives from NGOs and government agencies engaged in service provision or policy development for older Indian migrants. Participants are purposively selected for their community-level experience and knowledge. The research design is iterative, allowing emerging insights from the field to inform culturally responsive engagement and data interpretation.
Results: Preliminary findings highlight the critical yet often under-recognised role of community-based ethnic organisations in addressing not only physical health, but also the cultural, spiritual, and emotional wellbeing of older migrants. These organisations collaborate with health providers and local agencies to deliver culturally tailored services such as language support, social programmes, and health education that foster connection and reduce social isolation. However, such grassroots initiatives often operate with limited resources and within mainstream systems that are not always responsive to cultural diversity, creating challenges for coordination and sustainability.
Conclusion: The findings underscore the importance of intersectoral and community-led approaches in supporting healthy ageing among migrant populations. Strengthening partnerships between NGOs, health providers, and policymakers is essential to enhance culturally responsive services and enable older Indian migrants to age with dignity, inclusion, and a strong sense of belonging in Aotearoa New Zealand.
Reference:
Wright-St Clair, V.A., Nayar S., Kim, H., Wang, S.M., Sodhi, S.K., Chung, A., Suchdev, J., & Hu, C. (2018). Late-life Asian immigrants managing wellness through contributing to socially embedded networks. Journal of Occupational Science,25:1,51-64. https://doi.org/10.1080/14427591.2017.1370607
Exploring predictors of malnutrition risk among older adults in Fiji
Salanieta Naliva, Marlena Kruger, Tasa Havea, Carol WhamMassey UniversityIntroduction: This study aimed to assess factors independently associated with malnutrition risk among older adults in Fiji.
Methods: Among 299 older adults (mean age 69.68 ± 9.29 years), socio-demographic, health, and physical characteristics were established. Malnutrition risk was assessed using the Mini Nutritional Assessment-Short Forma (MNA-SF).
Results: Two-thirds of the participants were Fijian iTaukei (66%), with 33% Fijian Indians. Over half lived in rural areas (56%), while 44% lived in urban areas, and one quarter (25%) were at malnutrition risk. In the fully adjusted model, increasing age was independently associated with higher malnutrition risk, with each additional year corresponding to a 4.8% increase in odds (aOR 1.05, 95% CI 1.01–1.09). Suggestive but non-significant trends were observed for ethnicity (lower odds for Fijian Indian vs iTaukei; aOR 0.53, 95% CI 0.27–1.03), rural locality (higher odds vs urban; aOR 1.69, 95% CI 0.93–3.05), and each additional comorbidity was associated with a 22% increase in the odds of malnutrition risk (aOR 1.22 per condition, 95% CI 0.97–1.54)
Conclusion: Participants at great risk for malnutrition were older, iTaukei, rural living, and having >1 comorbidities. Differences by locality and ethnic groups suggest that at-risk communities could benefit from focused, culturally responsive screening initiatives to enable targeted interventions.
a 'well-nourished' (MNA-SF score >11), 'at risk of malnutrition' (MNA-SF 8-11) or 'malnourished' (MNA-SF score 0-7)
Betting on silver and hoping for gold
Otila Osborne, Jason LandonAuckland University of TechnologyIntroduction: Gambling is increasing worldwide with gambling harms rising accordingly. Older adults have been identified as an at-risk gambling population. Recovery from gambling harms can be challenging for older adults due to age related conditions and declining financial resources. Gambling studies mostly focus on problem gambling, despite the greatest burden of harm over-time arising from recreational gambling (Browne et al, 2018). Few studies explore recreational gambling among older adults. This Ministry of Health funded research was undertaken to inform gambling harm prevention initiatives and policies directed towards older adults in New Zealand.
Research summary: Seventy-three semi-structured qualitative interviews were carried out with a stratified sample of adults (aged 50 – 84 years). Participants were classified according to birth cohort, ethnicity, gender and PGSI (Problem Gambling Severity Index) score. Interviews were interpreted via a social constructivist lens. Findings reveal older adults are a heterogeneous group. Cultural values, social capital, familial roles, and social norms influenced gambling attitudes across all ethnicities with 'lived experience' with gambling harm protecting against problematic gambling. Older adults gamble to meet financial, social, psychological and cultural needs. Lotto is most popular with 73% of participants using the MYLotto Application. Both genders gamble for financial gain, men gamble more for socialisation than women, and women gamble more online than men. Psychological motivations feelings of loneliness, isolation, stress and anxiety coupled with the financial challenges of caring for adult children, and grandchildren along with critical life stage events such as the death of a loved one, moving away from family, retirement, loss of employment, and certain personality traits triggered problematic gambling
Future directions: Research focussed on online gambling is needed. Online gambling is the most dangerous form of gambling. Recent legislative changes have increased online gambling options, thereby increasing the potential for harm, particularly for older women.
Reference: Browne, M., & Rockloff, M. J. (2018). Prevalence of gambling-related harm provides evidence for the prevention paradox.Journal of Behavioral Addictions, 7(2), 410–422. https://doi.org/10.1556/2006.7.2018.41
A feasibility assessment framework for age-friendly retrofit of existing housing in New Zealand
Chen Qian, Don Amila Sajeevan Samarasinghe, Claire Flemmer, Vishal KumarSchool of Built Environment, College of Sciences, Massey University, AucklandIntroduction: Global population ageing is accelerating, making ageing-in-place an increasingly important policy direction. However, a substantial proportion of New Zealand's existing housing stock performs poorly in accessibility, safety, spatial adaptability, and integration with care and support services, limiting its capacity to meet older people's housing and care needs. Age-friendly retrofitting has therefore become urgent.
Methods: This research uses a mixed-methods design to develop an early-stage feasibility assessment framework for judging whether an existing dwelling in New Zealand is worth retrofitting and whether it is suitable for age-friendly retrofit. A systematic literature review synthesises barriers and opportunities in age-friendly retrofitting and examines their interactions to establish initial assessment dimensions. Semi-structured interviews, case studies, and questionnaire surveys will then be conducted with multiple stakeholder groups, including local government and housing providers, built environment and construction professionals, aged-care and support service organisations, and older people and their families, to refine indicators and decision logic.
Results: In practice, retrofit programmes often face financial constraints, fragmented policies and responsibilities, and a lack of robust pre-retrofit feasibility assessment tools. These challenges weaken early-stage decision evidence, reduce transparency, contribute to inconsistent outcomes, and can result in inefficient investment where completed retrofits still fail to meet older residents' needs. The review-informed assessment dimensions focus on economic viability, structural and constructability conditions, location characteristics, and service accessibility, providing a basis for transparent pre-retrofit screening.
Conclusion: The study will develop an evidence-based feasibility assessment framework and translate it into a web-based decision-support tool to enable rapid early screening and more transparent, consistent and scalable decision-making for age-friendly housing upgrades in New Zealand.
e-DiVA in Aotearoa, New Zealand: Where next with digital support for dementia carers?
Tara Sani1, E Moller1, Gary Cheung1, Kathy Peri1, S Yates1, H Whaanga2, Sarah Cullum11 Faculty of Medicine and Health Sciences, University of Auckland, 2 Te Pūtahi-a-Toi (School of Māori Knowledge), Massey UniversityIntroduction: The Empowering Dementia Carers with an iSupport Virtual Assistant (e-DiVA) project adapted the WHO's iSupport for Dementia programme to the Aotearoa New Zealand context as a free online resource (ediva.org). Family carers were involved throughout content adaptation, website user-testing, and pilot evaluation. With the website now publicly available, attention is shifting to questions of implementation and future development.
Research summary: A pilot randomised controlled trial was conducted between March 2024 and February 2025 with 52 family carers of people with dementia randomised to receive immediate or delayed access to e-DiVA website. Qualitative exit interviews at six months indicated that carers viewed e-DiVA as a trustworthy and empowering resource. Participants valued its trustworthiness, flexibility and practical information, particularly for newer carers. While some felt that the website required a peer support component, they also recognised safeguarding and moderation challenges should a peer-interaction feature be introduced. Carers also suggested that introducing the website through face-to-face engagement may improve awareness and confidence, particularly for those less familiar with digital tools.
Following this feedback, we have conducted ongoing roadshows with communities in different regions of New Zealand to introduce e-DiVA in person and support carers to access the resource. Reflections and emerging feedback from these roadshows will be discussed.
Future directions: Future research needs to consider how digital dementia support can be strengthened while complementing existing human support. Potential areas include exploring whether conversational technologies such as chatbot or avatar-based guidance may enhance emotional support, identifying priority language adaptations for culturally and linguistically diverse communities, and developing partnerships with health and community organisations to support dissemination and long-term implementation. This presentation invites discussion on which directions may be most valuable and feasible in the New Zealand context.
The effect of creatine monohydrate supplementation on cognitive function in older adults (age-related, non-clinical)
Pratibha Sharma, David Rowlands, Aj AliSchool of Sport, Exercise and Nutrition, College of Health, Massey University, AucklandIntroduction: Creatine is a naturally occurring compound found in foods like fish and meat that provides energy for rapid, powerful bursts of maximal efforts in sports. Creatine monohydrate (CrM) supplementation may also have potential benefits for brain health and function in memory and challenging tasks. Cognitive function, a crucial function of the nervous system, is one of the top-defining physiological characteristics of human beings. In normal cognitive aging, functions like verbal ability, general knowledge, and some numerical skills show minimal decline.
Mild cognitive function impairment (MCFI) is a syndrome that represents an early stage of functional disabilities, which may further develop to dementia and Alzheimer's disease. A recent review reported the global prevalence of MCFI to be 23.7% (95% CI: 18.6-29.6) in older adults. Conversely, complaints of memory problems are common among older adults and can be a significant source of concern.
One nutritional intervention that may offset or benefit cognitive abilities and performance in humans is creatine monohydrate supplementation.
Research Summary: This study aims to assess the effects of creatine monohydrate supplementation on cognitive function in New Zealand's older adult population with mild cognitive function impairment (age-related). The objective is to estimate the effect size and potential clinical utility of CrM supplementation on performance in cognitive domains, including memory, executive function, and attention.
The study will be a randomised, double-blind, placebo-controlled, crossover design with baseline and post-test measurements. Eighteen older adults aged 60 years or older with mild cognitive impairment will be recruited from the local Auckland community, retirement villages, and regular health check-up facilities through promotional advertisements and activities. The initial screening will be conducted at the local facility, the Nutrition & Dietetics Lab, based in the IC building, Massey University, Auckland Campus.
Future Directions: The results will contribute to understanding the potential of Cr supplementation as a non-pharmacological intervention for MCFI, provide effect size estimates for future larger trials, and may provide safe and effective supplementation guidelines for older age populations in New Zealand.
Outdoor fitness equipment as a resource for ageing well: An exploratory study
Alexandria (Lexie) Sharp, Carl Webber, Janine WilesUniversity of AucklandIntroduction: Outdoor fitness equipment typically includes calisthenics (bars) or resistance equipment such as a stationary cycle, either located in clusters or along trails in parks. Research and anecdotal evidence suggest outdoor fitness equipment may be a valuable and potentially equitable public health tool for encouraging physical activity and improving physical health among local populations, including older people. Increasingly there is interest in whether such spaces might also enhance social interaction and connection, also addressing issues such as isolation and loneliness. In this exploratory study we investigated how outdoor fitness equipment placed in public parks around the Auckland isthmus is used by older people.
Research question: Are older people using outdoor fitness equipment in Auckland? Do these resources enhance social interactions with diverse others?
Methods: We conducted a scoping review, then audited a range of outdoor fitness equipment across the Auckland isthmus. We selected three examples of resistance equipment in clusters located in socio-economically diverse communities. We systematically observed how they were used across different times of day and the week (weekdays, weekend). Plans for brief interviews were less successful.
Findings: Where outdoor fitness equipment was high quality and well maintained we observed a steady flow of users, particularly early and late in the day, including people who presented as likely ‘older’. We identified two main types of use: intentional and curious/playful. The proportion of intentional use varied between sites and by type of user. We observed little obvious social interaction between groups but considerable non-verbal interaction (e.g., turn taking etiquette).
Future directions: Outdoor fitness equipment has great potential as an equitable resource to support ageing well, both physically and socially. The design and location of outdoor fitness equipment (within a park, adjacent to other resources like playgrounds) is critical. Future research will include observation across different seasons and participant involvement.
Experiences and perceptions of ageing and health in Aotearoa New Zealand
Jenny Song, Matthew Parsons, Allison KirkmanSchool of Health, University of WaikatoIntroduction: Aotearoa New Zealand has an ageing population due to its highest fertility rate during the post-Second World War period and increased life expectancy, alongside growing cultural and ethnic diversity. The impact of an ageing, yet culturally diverse population on healthcare systems, especially the utilisation of healthcare services, emphasises the importance of the current research project. This study seeks to understand the unique factors shaping older Chinese immigrants' ageing journey with a particular focus on the challenges they encounter and the support they may need to enhance their quality of later life in the context of Aotearoa New Zealand.
Methods: Semi-structured interviews with 12 families, including older Chinese adults (n=16) and their family members (n=12), were conducted for this study. Using an inductive analysis approach, dominant themes emerged. An integrated comparison of the perspectives of older Chinese immigrants and their family members was provided, highlighting the contributing factors to happiness in later years, challenges encountered in accessing healthcare services, and the coping mechanisms employed by older Chinese immigrants in navigating the ageing process and achieving positive experiences and wellbeing in later life.
Results: Older Chinese immigrants and their family members faced substantial challenges stemming from divergent cultural and social values surrounding ageing and healthcare. Challenges in accessing healthcare services created a pervasive sense of uncertainty and liminality, which caused feelings of 'ageing-in-limbo'. Nevertheless, older Chinese immigrants employed a variety of adaptive strategies to navigate these difficulties.
Conclusion: Ageing in an immigrant-specific context involves unique challenges including complex cultural, social, and healthcare-related obstacles. Feelings of living-in-limbo are dehumanizing experiences that may cause negative consequences. However, older Chinese individuals in this study demonstrated resilience by actively managing these challenges and leveraging all available resources. Drawing on insights from both Eastern and Western philosophies of ageing, particularly the human ecosystem proposed by Machlis and others (1997), this study calls for the development of an age-friendly human ecosystem that incorporates critical social and cultural resources to promote positive ageing experiences amongst older immigrants living in Aotearoa New Zealand
Reference: /p>
Machlis, G. E., Force, J. E., & Burch, W. R. (1997). The human ecosystem Part I: The human ecosystem as an organizing concept in ecosystem management. Society & natural resources, 10(4), 347-367. https://doi.org/10.1080/08941929709381034
Co-creating a framework to support older people’s digital inclusion in Aotearoa New Zealand
Melanie Stowell, R Dobson, J McCool, V Nosa, R WhittakerCentre for Co-Created Ageing Research & School of Population Health, University of AucklandResearch idea: The aim of this research is to develop a resource to improve older people's digital inclusion in Aotearoa New Zealand. The current phase will involve co-development of a framework that outlines the risks of digital exclusion and provides guidance for the development and design of more inclusive technologies. The framework will be relevant to policymakers, digital service providers, researchers, developers and designers in Aotearoa New Zealand and those working in similar contexts. It is intended that the framework will be adaptable to evolving digital contexts.
Specific objectives include:
1. To clarify key information to include in a framework that describes the risks of digital exclusion of older people and provides guidance for the development and design of age-friendly technologies.
2. To obtain input on optimal ways to visualise, deliver and disseminate the framework.
Supporting evidence: Digital exclusion is about more than just access: it also includes barriers to literacy, confidence or skills which lead to an inability to benefit from digital technologies. Impacts of digital exclusion include cognitive impairment, access to healthcare and social services, social exclusion, technology-related anxiety ('technostress'), and depressive symptoms. The widespread impacts of digital exclusion make it a possible 'super social determinant of health', due to the potential impacts of digital exclusion on all other social determinants of health.
Recent qualitative research with older people and interest-holders as part of this PhD, to be summarised in this presentation, has found that mainstream digital technologies are infrequently developed with older people in mind and that this can have negative implications for their wellbeing.
Questions for audience: Does anyone in the group have:
- thoughts on who should be invited to the workshops (e.g. digital equity experts, community advocates, older people)?
- experience co-developing a framework or guidelines and advice/learnings from the experience?
Accessing music matters: Equity for older people in residential care
Alison Talmage & Music Matters Research Development GroupResearch idea: Music Matters is a 2026 Research Development Group (RDG), funded by the Centre for Co-Created Ageing Research. The Research Development Group is a university-community collaboration exploring current and desired opportunities for music listening and participation. We aim to hold listening conversations with residents, care staff, and whānau following in-house concerts and music activities, with the aim of developing a full research proposal. One aspect of this initial consultation is community feedback about playlists and the Simple Music Player, an accessible device that plays mp3 files from a USB flash drive. While developed for people living with dementia mate wareware, this device might have wider applications.
Supporting evidence: Playlists have evolved from mix tapes to digitally curated anthologies using streaming technologies, such as Spotify. Research indicates that familiar, preferred music is more enjoyable and more beneficial than listening to live radio. However, personalised playlists can be challenging to implement in residential care. Setting up the Simple Music Player requires an investment of time, but it is then relatively easy to use, with a large on/off switch and a “next track” button.
Questions for audience
We will demonstrate the Simple Music Player – who would this device appeal to?
Is the Simple Music Player affordable (approx. $350)?
What pros and cons do you foresee in our consultation process?
Simple assessments of physical function, memory and weight loss improve mortality prediction in older patients with cardiovascular disease
Steven Vates1, Ralph Stewart1, Katherine Bloomfield1, Zhenqiang Wu11 Auckland City Hospital, 2 North Shore Hospital, 3 Faculty of Medical and Health Sciences, University of AucklandIntroduction: In patients with cardiovascular disease treatment decisions may be modified because of older age or frailty. Frailty is commonly assessed using clinical judgment alone. Objective was to determine whether simple objective measures of physical and cognitive function improve mortality prediction beyond age and a subjective clinical assessment of frailty in patients with a recent acute coronary syndrome.
Methods: In a prospective cohort of 1,174 older adults admitted to five New Zealand hospitals with an acute coronary syndrome, frailty was assessed using the Clinical Frailty Scale, the Timed Up and Go test, and several standard frailty instruments. Multivariable Cox models identified assessments which were independently associated with all-cause mortality during follow-up, from which a Simple Frailty Assessment score (SiFA) was developed.
Results: During median follow-up of 7.1 years, 506 (43%) of patients died. Age (median 76, IQR 72-80 years) and Clinical Frailty Scale (median score 3, IQR 2-4) were both associated with all-cause mortality (C-statistic 0.63 and 0.64). In multivariable cox modelling the timed up and go test, inability to walk 1km unassisted, a simple memory recall test and recent weight loss were also independently associated with mortality. The SiFA score which included these variables was associated with a graded increase in mortality. SiFA improved discrimination for all-cause mortality (C-statistic 0.70 95% CI 0.67-0.72) compared to either age or Clinical Frailty Scale alone.
Conclusions: In older adults hospitalized with an acute coronary syndrome adding simple assessments of physical function, memory, and weight loss improve discrimination of mortality risk compared to age and a subjective assessment of frailty alone.
World Teahouse: Co-designing social engagement and participation pathways for Mandarin-speaking Chinese older adults in a smart urban future
Cassie(Xi)Wang, Cath Conn, Julie TraffordSchool of Community and Public Health, Faculty of Health & Environmental Sciences, Auckland University of TechnologyIntroduction: This study explores how Mandarin-speaking Chinese older adults in Aotearoa New Zealand experience social engagement and participation within an increasingly digital and smart urban environment. In Auckland, older adults aged 65 and over are a rapidly growing population, with Asian communities projected to form a substantial proportion of the city's ageing demographic. Chinese older adults represent one of the largest and fastest-growing groups within this population, yet their participation experiences are often obscured by broad ethnic categorisations and assumptions about digital capability. As urban services, information, and civic participation become increasingly mediated through digital-first systems, understanding how older Chinese migrants navigate and reshape participation pathways is critical for inclusive urban governance and healthy ageing strategies.
Research summary: This ongoing PhD research is framed by critical realism, recognising that participation is shaped by both lived experience and the structural design of smart urban systems. Rather than focusing on individual digital skills, the study asks who benefits, who is left behind, and how governance might adapt to future uncertainties such as artificial intelligence, biotechnology, and climate change. The research adopts a co-design approach centred on World Teahouse, a culturally adapted iteration of the World Café inspired by Asian tea culture. Across 2-4 workshops, older adults and local stakeholders engage in storytelling, games, and mapping to explore how healthy ageing, migration, technology, and governance intersect in Auckland's urban future. The study will generate shared artefacts, such as participation pathway maps or narrative scenarios, analysed through participatory sense-making and reflexive thematic analysis. It contributes by reframing healthy ageing as a governance and urbanism challenge, foregrounding older adults' voice rather than treating ageing solely as a medical or service issue.
Future directions: The study is currently in the preparatory and piloting phase. Subject to ethics approval, a potential opportunity has been identified to embed optional World Teahouse sessions within Age Concern Auckland's regular Chinese older adults' support groups in Northcote and Sunnynook in 2026. This offers a trusted community setting aligned with the study's iterative design. Preliminary findings will be shared to invite feedback and explore collaboration and policy relevance in healthy ageing and smart urban governance.
Population pharmacokinetic-pharmacodynamic modelling of antibody therapy in Alzheimer's disease: Transient or durable benefit?
Zack Wang, Jacqueline HannamDepartment of Pharmacology and Clinical Pharmacology, Faculty of Medical and Health Sciences, University of Auckland.Research idea: Donanemab (Kisunla®) is among the first monoclonal antibody therapies shown to slow cognitive and functional decline in early symptomatic Alzheimer's disease (Sims et al., 2023). Understanding whether its clinical benefits represent transient symptomatic relief, or a disease-modifying effect that continues to slow disease progression even after treatment ends, informs better treatment optimisation, health policy, and the long-term expectations of older patients and their whānau.
This project aims to apply population pharmacokinetic-pharmacodynamic (Pop-PKPD) and disease-progression modelling to anonymized patient-level data from the TRAILBLAZER-ALZ 2 clinical trial (conducted by Eli Lilly). Using nonlinear mixed-effects models in NONMEM with R, and grounded in a disease-progression framework (Holford, 2015), we will quantify symptomatic effects (baseline offset) and disease-modifying effects (change in progression rate). Covariate analyses will systematically examine how patient-specific factors, including body weight, age and ApoE ε4 genotype, drive variability between patients in drug exposure and treatment response. Monte Carlo simulations will then support the optimization of personalized dosing regimens for older patients.
Supporting evidence: Alzheimer's disease is a leading cause of dementia. In New Zealand, dementia prevalence is 13.7-14.4% in adults aged ≥80, with a disproportionate burden among Māori and Pacific communities (Hsu et al., 2025). In the TRAILBLAZER-ALZ 2 randomized controlled trial, donanemab slowed decline on the iADRS and CDR-SB scales (Sims et al., 2023), yet long-term disease trajectories following treatment cessation remain incompletely characterized (Lu et al., 2025). Disease-progression modelling has successfully distinguished symptomatic from disease-modifying effects of levodopa in Parkinson's disease (Holford et al., 2006), providing a validated methodological foundation for the present work.
Questions for audience:
1. If donanemab does turn out to be disease-modifying, what would that actually mean for how long patients need to stay on treatment — and could your model help answer that?
2. Do you think the covariate effects you're modelling are strong enough to meaningfully change dosing recommendations in practice, or are they more of an academic finding?
References:
Holford, N. (2015). Clinical pharmacology = disease progression + drug action. British Journal of Clinical Pharmacology, 79(1), 18–27. https://doi.org/10.1111/bcp.12170 IF: 3.0 Q2
Holford, N. H., Chan, P. L., Nutt, J. G., Kieburtz, K., Shoulson, I., & Parkinson Study Group. (2006). Disease progression and pharmacodynamics in Parkinson disease — evidence for functional protection with levodopa and other treatments. Journal of Pharmacokinetics and Pharmacodynamics, 33(3), 281–311. https://doi.org/10.1007/s10928-006-9012-6 IF: 2.8 Q2
Hsu, J. L., Park, K. H., Panegyres, P. K., Huang, Y. H., Eom, Y. I., Prusty, V., & Shea, Y. F. (2025). Early Alzheimer's disease (mild cognitive impairment or mild dementia): Prevalence, diagnostics, treatment options, and guidelines in Asia, Australasia, and Pacific nations countries. Journal of Prevention of Alzheimer's Disease, 12(9), 100362. https://doi.org/10.1016/j.tjpad.2025.100362 IF: 7.8 Q1
Lu, M., Kim, M. J., Collins, E. C., Shcherbinin, S., Ellinwood, A. K., Yokoi, Y., & Mintun, M. A. (2025). Posttreatment amyloid levels and clinical outcomes following donanemab for early symptomatic Alzheimer disease: A secondary analysis of the TRAILBLAZER-ALZ 2 randomized clinical trial. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.3869 IF: 21.3 Q1
Sims, J. R., Zimmer, J. A., Evans, C. D., Lu, M., Ardayfio, P., Sparks, J., & TRAILBLAZER-ALZ 2 Investigators. (2023). Donanemab in early symptomatic Alzheimer disease: The TRAILBLAZER-ALZ 2 randomized clinical trial. JAMA, 330(6), 512–527. https://doi.org/10.1001/jama.2023.13239 IF: 55.0 Q1
Dance movement therapy and the experience of memory loss in mild cognitive impairment
Ann Way, Suzanne Purdy, Joan Leung7, Bonnie Meekums, Ralph BuckUniversity of AucklandObjectives: Dance Movement Therapy (DMT) is a non-pharmacological intervention that integrates the psychotherapeutic use of dance and movement to enhance physical, cognitive, emotional, and social well-being. This project aims to examine the effectiveness of a DMT pilot programme for individuals living with mild cognitive impairment (MCI) in Aotearoa New Zealand, while also addressing the relational care for family members and caregivers.
Methods: Our exploratory study used semi-structured interviews with three focus groups: dance movement therapists, healthcare practitioners, and caregivers/family members of individuals with MCI. Participants (n≈45) are recruited according to the following criteria: aged 25+, and either (a) registered DMT practitioners working with dementia or neurological conditions; (b) healthcare professionals in New Zealand aged care; or (c) caregivers/family members of people with MCI. Data is thematically analysed to identify key themes and inform the development of a DMT pilot programme.
Results: Preliminary findings from our exploratory study suggest that multiple preventive factors for cognitive health, including physical activity, cognitive stimulation, emotional regulation, and social engagement, could be integrated into a DMT programme. We are currently developing a protocol and principal guideline for the pilot programme, which will be conducted in late 2026.
Conclusions: These preliminary findings emphasise DMT’s potential as a valuable non-pharmacological approach in dementia prevention and early intervention. By integrating functional and expressive movement, it simultaneously addresses physical, cognitive, emotional, and social well-being.
An Intergenerational Participatory Action Research study on walking football for health and cultural adaptation among East Asian immigrant families
Z Xiao, Richard Wright, RO AjieeSchool of Sport and Recreation, Auckland University of Technology.Introduction: New Zealand's ageing population faces isolation, with East Asian immigrants particularly underrepresented in mainstream sport. While Walking Football is recognized for promoting health in older adults, its potential for fostering intergenerational connection remains underexplored. Existing research largely focuses on youth or women, or single-generation Walking Football applications, neglecting family-centered approaches essential for Asian immigrant integration.
Methods: Guided by Intergenerational Participatory Action Research, this study engages East Asian families in Auckland and Dunedin. Grounded in social constructionism, participants will co-design and refine the Walking Football intervention through iterative cycles of planning, acting, observing, and reflecting. Data collection includes semi-structured interviews, focus groups, and observations, processed via thematic analysis to evaluate shifts in health, social capital, and cultural adaptation.
Results: As a study protocol, empirical data is forthcoming. However, drawing on social capital theory, this study anticipates that co-designed Walking Football interventions will mitigate intergenerational tension and significantly enhance social belonging compared to traditional, segregated sport models.
Conclusions: This study addresses the critical need for culturally responsive sport initiatives. It contributes to Sport for Development literature by demonstrating how intergenerational Walking Football can serve as a vehicle for health improvement and social inclusion among East Asian immigrant communities in Aotearoa.
Factors associated with mortality in people living with young onset dementia: A systematic review
Jiaxin Zhu, Xiaoge (Grace) Li, Gary Cheung, Brigid Ryan , Ryan San DiegoUniversity of AucklandIntroduction: Young-onset dementia (YOD is associated with substantial social and clinical burden and an increased risk of premature mortality. However, determinants of mortality in YOD have not been systematically synthesised. This review aimed to identify and evaluate factors associated with mortality among people living with YOD within a biopsychosocial framework.
Methods: This systematic review was conducted and reported in accordance with PRISMA guidelines. MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and DOAJ were searched from inception to 14 May 2025. Quantitative studies examining factors associated with mortality in YOD were included. Study quality was assessed using the National Heart, Lung, and Blood Institute tool. Due to methodological heterogeneity, findings were synthesised narratively within the biopsychosocial framework.
Results: Sixteen studies (1986-2024) met the inclusion criteria. Most were observational cohort studies with sample sizes (71-239,602) and follow-up durations (4-18 years). Mortality was most consistently associated with biological fixed factors, particularly increasing age and male sex. Evidence for tractable biological factors, such as clinical symptom profiles and comorbid conditions, was mixed, although diabetes mellitus showed a relatively consistent association with increased mortality. Psychosocial determinants, including socioeconomic disadvantage, were examined in a small number of studies (n = 5), with positive associations observed in some analyses (n = 2). Health and social service factors were rarely investigated. Psychosocial contextual factors and interventions were not examined in the included studies. Most determinants were examined in single studies, limiting quantitative synthesis.
Conclusion: Evidence on mortality in YOD is largely dominated by non-modifiable biological factors, with limited investigation of modifiable clinical and psychosocial determinants. More rigorous, prospective studies integrating biological, psychological, and social factors are needed to better understand survival and inform targeted interventions in YOD.
Keywords: Young-onset dementia; Mortality; Survival; Risk factors; Biopsychosocial model; Systematic review
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