2020 HOPE Foundation Scholarships
We are fortunate this year, due to the generosity of our sponsors and the Friends” of HOPE, to be able to award a record number of twelve $6000 University scholarships for research into ageing-related study, for 2020
Please enjoy reading about their projects.
University of Auckland
Voices in Harmony – Community Singing for Adults with Communication Difficulties Related to an Acquired Neurological Disorder: A Music Therapist’s Perspective
My research focuses on “choral singing therapy” for adults who have communication difficulties resulting from an acquired neurological condition, such as stroke, Parkinson’s disease, dementia or brain injury. With an ageing population in New Zealand and worldwide, the number of people living with many of these conditions is rising. Community singing offers a beneficial social, cultural and therapeutic experience for participants, and often also a meaningful activity with their partner or carer. Prior research, both internationally and at the University of Auckland, suggests that singing supports the maintenance or rehabilitation of aspects of voice, speech, language and memory, as well as improving quality of life for people with communication disorders. My project uses an action research methodology, with the aim of improving professional practice guidelines and evaluating participant experiences and outcomes. This is an interdisciplinary project and I am fortunate to have three wonderful supervisors, Dr Te Oti Rakena (University of Auckland School of Music), Prof Suzanne Purdy (University of Auckland School of Psychology), and Dr Daphne Rickson (Music Therapy department, New Zealand School of Music – Te Kōkī, Victoria University of Wellington), and the support of others in the Centre for Brain Research, led by Distinguished Professor Sir Richard Faull. I am very grateful for the award of a HOPE Foundation Scholarship that will allow me to continue as a full-time doctoral candidate in 2020.
Tessa Pocock PhD Candidate in Community Health School of Nursing, University of Auckland
‘Positive ageing’ in Auckland communities: Exploring relationships between the built and social environments of older adults at risk of frailty and their perceptions of ageing in place
Many older adults desire to remain living in their homes and communities as they age, often irrespective of frailty or functional ability. For older adults ageing in place, the importance of a supportive and accessible neighbourhood built environment is well established. Yet, the role of the neighbourhood built environment in contributing to ‘positive ageing’ in place is largely unexplored. Using both qualitative and quantitative approaches, my PhD research seeks to investigate the relationships between the built and social environments of community-dwelling older adults at risk of frailty (≥ 65 years) and ‘positive ageing’ in place, across two ethnically diverse communities in Auckland, New Zealand. Ultimately, I hope my PhD research can be used to inform initiatives aimed at creating enriching environments for community-dwelling older adults.
Optimising nutrient status in older adults – exploring the role of B vitamins and one-carbon metabolites
With a rapidly ageing population, there is an urgent demand to develop strategies that promote successful ageing. We know adequate nutrition plays a crucial role, and within this broader picture B vitamins have emerged as an important group of nutrients in the ageing process. Due to their regulation of one-carbon metabolism, B vitamins are consistently associated with a range of age-related diseases such as cardiovascular disease, dementia, and osteoporosis. My research aims to further elucidate the complex relationships between B vitamin status, one-carbon metabolism, and health outcomes in older adults. These insights, in turn, contribute to the development of strategies needed to optimise nutritional status for healthy ageing.
With a novel lab technique, I am able to analyse a comprehensive array of one-carbon metabolites that provides a more in-depth understanding of pathway regulation in older adults than is typically researched. My research consists of 4 studies using this technique 1) I am investigating the impact of a 10-week dietary intervention that optimises B vitamin intake on one-carbon metabolite status, 2) I am exploring differences in the acute response of one-carbon metabolites to vitamin supplementation in older and younger adults, 3) I am investigating the impact of long-term vitamin supplementation on one-carbon metabolite status in older adults and whether changes in metabolite status is associated with changes in chromosomal and DNA damage, and 4) I am characterising associations between B vitamin intake, one carbon status, and cognitive function in older New Zealand adults.
Marie Jardine - 3rd year PhD candidate at the University of Auckland supervised by Dr Anna Miles and Dr Jacqui Allen.
Age-related swallowing changes
My research is about a process that is typically taken for granted: swallowing. People usually eat and drink without much thought, but this is not the case for those with swallowing difficulties (dysphagia). Not only do swallowing problems involve significant social and emotional consequences, they are also associated with increased risk of malnutrition, dehydration and pneumonia. The prevalence of swallowing difficulties increases in older age due to age-related diseases and comorbidities. As our population is ageing, it is important that swallowing changes in older age are understood to optimise management for older New Zealanders with dysphagia.
In a recently published systematic review, we highlighted that age-related swallowing changes are subtle and do not affect overall function. Future swallowing studies need to plan carefully to recruit adults over 85 years old, who have been underrepresented in the swallowing literature. My research involves quantitative analyses of healthy swallowing across the lifespan using swallowing assessments (videofluoroscopy and high- resolution manometry with impedance) for future comparison with people with dysphagia. It is important that clinicians have a thorough understanding of normal swallowing to prevent under-management or over-management of patients. We have also collected over 1000 responses to a survey about self-reported swallowing and nutrition status of community-living New Zealanders over 65 years old. My research aims to guide future initiatives and research in New Zealand on dysphagia management in older adults within a range of settings.
Joanna Hikaka (Ngāruahine) – 3rd year PhD in School of Pharmacy, University of Auckland
Pharmacist-led medicines optimisation for community-dwelling Māori older adults – Collaborative development of a culturally responsive service and framework.
The aim of this PhD is to develop a medicines review service for, and with, community-dwelling Māori older adults, guided by kaupapa Māori research principles. Medicines remain the most common therapeutic intervention in Western medicine.
Although intended to provide therapeutic benefit, medicines can also result in harm. Pharmacist-led medicines reviews have been shown to improve the quality of prescribing and reduce adverse outcomes in older adults, who, compared to younger populations, are more likely to experience adverse effects from medicines. A number of national policies and the NZ health service review have identified the need for an increase in pharmacist-led medicines reviews, which remain underutilised in NZ. A systematic review undertaken earlier in this PhD shows that pharmacist-led medicines review services which currently exist in NZ may not be designed or implemented in a way that meets the particular needs of older adults or Māori, and may in fact increase the disparity in health outcomes. Interviews with key stakeholders (including Māori older adults, health practitioners and DHB stakeholders) have informed the development of a service model which is currently being tested in a feasibility study.
University of Canterbury
In-Vitro Analysis of Haemodynamics in Stented Arteries
The purpose of my research is to identify and investigate the effects stenting can have on the haemodynamics in a compliant artery. Recipients of stents are most commonly between 65 and 84 years of age. Understanding the haemodynamic effects may assist in the identification of an arterial inflammatory response following stent deployment, thereby enabling further development of stenting for improved use in the future. My research is carried out using Particle Image Velocimetry, an optical modelling method, to identify flow patterns through transparent phantom arteries that are manufactured from silicone. Particle Image Velocimetry uses a laser light sheet to identify small tracer particles in a flow within a predetermined region of interest. Image pairs are captured at discrete time steps that enable the displacement and velocity of the particles to be identified. The phantom arteries are designed to closely mimic the behaviour of the physical artery being investigated. A transparent fluid is refractive index matched to the silicone phantom to remove geometrical distortions. The dynamic similarity of the fluid to blood is preserved by matching the in-vitro and in-vivo Reynolds number and Womersley. Particle image velocimetry is an experimental method that enables modelling of stent behaviours without risking patients.
Stroke - Designing an exoskeleton that augments electric motor actuation with functional electrical stimulation (FES)
Stroke is one of the largest causes of disability, and with an increasing elderly population as well, there is great motivation to find ways to improve stroke rehabilitation. Exoskeletons can improve rehabilitation by automating the exercise movement, assisting patients with completing the movement and increasing the exercise frequency. My aim is to design an exoskeleton that augments electric motor actuation with functional electrical stimulation (FES) for the added physiological benefits and to optimise the assistance provided to the patient.
I analyse the electromyography (EMG), or electrical activity of the biceps, to determine the capabilities of the person and how much effort they apply during an exercise. With this knowledge, the exoskeleton can provide the person with the assistance they need to complete the movement (assistance-as-needed). Optimising the assistance provided and maximising patient participation can lead to better recovery from stroke.
An exoskeleton with motor actuation and FES can obtain the control advantages of motors and the physiological benefits of FES. FES is good for strengthening muscle and improving sensory awareness. The disadvantage of FES is that it can cause fatigue after long durations, however, a hybrid exoskeleton can reduce the assistance by FES and increase the motor assistance to counter fatigue and extend the therapy session. With accurate independent control, the FES and motor assistance can be set to suit a patient’s needs and to manage fatigue for extended therapy time. Additionally, with FES a hybrid exoskeleton can be more lightweight and portable with smaller motors.
A hybrid exoskeleton with assistance-as-needed can optimise the assistance provided to a patient and has the potential to lead to greater recovery from stroke. I hope that my work will positively contribute to the health and wellbeing of our ageing population.
Automated breast cancer diagnostic method using Digital Image Elasto Tomography (DIET)
Breast cancer is the most frequent cause of cancer and the leading cause of cancer deaths in women worldwide. In New Zealand, approximately 9 people are diagnosed daily (3300 each year) with over 600 deaths annually. The demographic diagnosed with breast cancer is heavily dominated by women over 50 (over 70%) and the risk of contracting it becomes greater with age. Early detection of breast cancer is associated with better survival rates due to increased treatment options.
The current standard for breast cancer screening is x-ray mammography. X-ray mammography is controversial due to painful breast compression and harmful radiation exposure resulting in a smaller age bracket for screening and poor compliance. Sensitivity recordings for mammography are low due to only a 5~10% contrast in radiodensity between healthy and cancerous tissue, which results in false positives and overdiagnosis. The success of mammography is reliant on the skill of the radiologist and the procedure is high cost, with limited availability in developing countries.
My research is focused on the development of an automated breast cancer diagnostic method using Digital Image Elasto Tomography (DIET). DIET is a non-invasive breast cancer screening approach, which uses the significant contrast in elastic properties (400~1000%) of cancerous and healthy tissue. It involves sinusoidal vibration of breast tissue and uses surface motion analysis to obtain underlying tissue properties. It is low cost, non-invasive, with no adverse effects or discomfort and will be safe to use for women of all ages. I am currently working with clinical data to develop diagnostic methods using nonlinear mechanics models that will be suitable for population breast cancer screening and benefit the older population.
Philip Mecredy - Marketing
Information processing and purchase behaviour of older consumers
Age-related differences in brand choice are seldom studied by marketers, despite the increasing importance of the elderly population as a segment due to its growing size and purchase power. Existing research has indicated that older consumers are more brand loyal and prefer to purchase well-established national brands in high-involvement categories, such as cars and perfume. However, there is mixed results for age-related purchase differences in low involvement product categories, such as FMCGs. Age is also shown to have a negative impact on consumers’ ability to gather and process information. However, there is debate over the reasons for age-related differences with cognitive decline, category experience and familiarity, social influence, risk aversion, and attachment all proposed as possible explanations.
My PhD research aims to investigate whether age-related differences in purchase patterns exist in alternative product and service categories, as well as the underlying reasons for these differences (e.g. cognitive decline, category experience). The research also examines whether alternative measures of age (cognitive, biological and social age) are better determinants of behaviour than chronological age. The research will provide knowledge on product decision making that can assist companies, across a range of industries, to provide products and services that cater to the mature market. It will also advise policy makers on the information processing of older consumers that can inform product-packaging regulations to ensure elderly consumers can easily process product information.
University of Otago
Developing a Guideline for Alternatives to Anticholinergic Medications in Individuals with Dementia:
Older adults comprise a significant proportion of the population of New Zealand (NZ) and are known to be prescribed the highest number of medications. Several medications have to be prescribed with caution in older adults due to their compromised biological functions that can impact and reduce drug clearance. Potentially inappropriate medications (PIMs) may be defined as the prescription of drugs where the risks outweigh the clinical benefits or there may be under-prescribing of beneficial treatments. In the first phase of our project, we observed a high prevalence of prescription of potentially inappropriate medications in community dwelling older adults in NZ.
- We then analysed the factors associated with prescribing PIMS, and found that individuals diagnosed with certain disorders like dementia, insomnia, depression, cancer, anxiety; or those who were hospitalized were more likely to be prescribed PIMs than the other individuals.
- A literature review of the existing tools for reducing PIMS was then undertaken to assess the merits and demerits of each tool with a view to suggest methods to reduce inappropriate prescribing, which include meticulously reviewing prescriptions and de-prescribing as a way forward.
- Based on the current literature review of the anticholinergic burden (ACB) scales and serum anticholinergic activity of various medications, we collated known information of the level of anticholinergic activity for each medication, and developed recommendations for prescribers, focussing on pharmacological alternatives for the currently prescribed MAP for older adults with dementia presenting with co-morbidities.
University of Waikato
An Exploration of Elderly Experiences with Hardship in Aotearoa
National Statistics show that New Zealand has an increasingly aging population, and that many elderly individuals report that they live in hardship. Elderly economic hardship is an issue of importance, as it is found to have a strong impact on an individual’s loneliness, mental health and access to social support. Previous studies have identified the rate and degrees of hardship experienced by older adults, yet little is known regarding the impact that economic hardship has on everyday lived experiences. Through qualitative interviews with participants in the community, my research will examine the challenges involved with living in hardship as an older New Zealander and identify the strategies and coping skills that are applied by those experiencing hardship. The study will explore the connections between hardship, social support and mental well-being. This research is designed in a strength based and participant-led manner that will lead to further exploration of an important topic which is not frequently addressed in New Zealand fields. As a result of the research, we expect to develop recommendations for public policy change and advances in older adult access to support.
University of Wellington
Liam Sargison – PhD in Chemistry/Ferrier Research Institute
Heparan Sulfate for Bone Repair
Orthopaedic surgeries and interventions, especially related to joint repair, are common among older New Zealanders and frequently these procedures have slow recovery times and moderately high rates of malunion and non-union. The restricted mobility following surgery or fracture healing reduces a person’s quality of life and comes with other medical risks. I am chemically modifying diverse populations of polysaccharides to bind and potentiate the effect of the bone growth factor Bone Morphogenetic Protein 2 (BMP-2) By the end of my PhD I expect to provide a process for the generation of a relatively inexpensive population of chemically modified polysaccharides. Preliminary biological characterisation will suggest their effectiveness for use in open orthopaedic surgeries to enhance both rate of success and rate of healing for bone. If approved for clinical use this technology should be economically viable for use in the public health system, providing improved bone healing outcomes for New Zealanders, particularly for our aging population.
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