2023 HOPE Scholars
We are fortunate this year, due to the generosity of our sponsors and the Friends’ of HOPE, to once again be able to grant University scholarships for research into ageing related study for 2023. These are all very worthy recipients and hopefully their work will make a difference to the lives of New Zealanders in the future.
Enjoy reading about their interesting and inspiring projects.
Khalid Abdul Jabbar
PhD candidate, Population Health, University of Auckland
Examining change in physical activity, sedentary behaviour, and trajectory of functional decline in response to the LifeCurveTM App in at risk community dwelling older adults
Ageing results in multi-system decline, including cognitive and motor deficits, associated with attenuation of functional ability, thus affecting independence. Maintaining functional abilities is important for older adults to be physically and socially active and independent within their homes and communities. But our understanding of the drivers of physical activity and sedentary behaviour, its selective effect on functional status and the trajectory of functional decline, and its integration into daily life is limited.
Application of a novel telehealth intervention via a phone App - the 'LifeCurveTM' App has been developed to help reverse this trajectory through self-enablement. The user self-assesses functional status and aims to improve this by implementing strategies that are prompted by the 'LifeCurveTM' App.
This PhD project aims to provide evidence of how activity changes when using a new health-promoting app. In addition, it seeks to provide a nuanced and comprehensive understanding of how the selective effect of physical activity and sedentary behaviour and their interaction impact the key health-related outcomes for older people – health-related quality of sleep, nutrition, social connectedness and oral health – in community-dwelling older adults to prevent or push-back the progression of disability.
Driver decision making
Decision-making is a prime component of driving and safety on the road. The aim of my quantitative study is to evaluate the decision-making proficiency of older drivers when presented with five different New Zealand-based road-knowledge experiences: (i) local street intersections, (ii) intersections with lights, (iii) roundabouts, (iv) rural roads and (v) highways, therefore acquiring a greater understanding of processes used by drivers.
Study design will include the development and piloting of a simulated route interface facility and a board game. The subject population group will incorporate older drivers, in addition to a general population age grouping and younger drivers. Following the implementation of the Pilot Study the research programme is then intended to be conducted throughout the New Zealand.
PhD candidate, Psychology, University of Waikato
Autobiographical memories in older adults: Age related changes in the shape of our life stories
The way we talk about our personally experienced life events (our autobiographical memories) changes as we age. For example, older adults can demonstrate a change in narrative style when describing their autobiographical memories that focusses less on specific details, and more on imparting meaning. Moreover, compared with younger adults, older adults often remember events more positively, and can report greater wellbeing. Our autobiographical memories also become the stories we tell ourselves to inform our ever-evolving sense of identity. Interestingly, recent evidence has suggested that people can describe these life stories using similar emotional trajectories as found in Western fiction. That is, fictional stories—and people’s memory reports—can demonstrate the same changes in positive and negative emotion at specific points in the story, as they unfold from beginning to end. During the first year of my PhD, I used natural language processing softwares to analyse the content of people’s reports of their autobiographical memories. However, so far we only know how these trajectories behave in younger adults. If we can understand how older adults use emotional trajectories in their memory reports, we may be able to better understand the relationship between how we talk about our autobiographical memories, and the meaning we get from them, and how this relationship changes with age.
PhD candidate, Physiology, University of Otago
Investigating the positive metabolic potential and anti-ageing effects of DHED, a brain selective estrogen, in female mice
Menopause is a natural phase of ageing for women, signaling the reduction of sex hormones and the cessation of menstruation and reproductive capacity. This transition can have significant life altering symptoms, including hot flushes, brain fog, night sweats and increased weight gain.
Hormone replacement therapy (HRT) is commonly used by women to alleviate these symptoms. Estrogens such as 17 beta estradiol (17ßE2) are commonly used in HRT treatments. While commonly used, HRT is unsuitable for a large number of women, often due to family histories of reproductive cancers or cardiovascular events. This can in part be due to undesirable activation of estrogen receptors in the periphery.
My PhD research is interested in the role of novel and under-researched estrogens in metabolism and ageing in females, and how estrogens can ameliorate weight gain, insulin resistance and glucose tolerance. I am also intrigued by understanding changes which happen in the brain following estrogen exposure in ageing, particularly in the hypothalamus, a well-known regulator of food intake and metabolism.
I am currently investigating a novel estrogen called “DHED”, an inactive form of 17ßE2 in mouse models of metabolic dysfunction. When DHED reaches the brain, a central nervous system specific enzyme converts DHED to 17ßE2 and critically, the estrogen then remains within the brain. Our hypothesis is that DHED will reach the hypothalamus and cause positive changes in metabolism such as reducing body weight and improving insulin and glucose tolerance, without exposing the periphery to estrogen. Our ultimate goal is that we can continue to improve our understanding of potential alternative forms of HRT in Aotearoa, improving healthcare for women in our ageing society.
PhD candidate, University of Canterbury
Narrow-band optical methods for blood analyte measurement
The prevalence of type 2 diabetes is increasing epidemically, and ~250,000+ people in New Zealand live with this disease. Type 2 diabetes significantly increases with age and is expected to increase by 70%-90% by 2040 (far faster than the population). Increased insulin resistance leads to high blood glucose, which, over time, leads to serious complications such as heart disease, blindness, limb amputations, and early death. It is almost exclusively a disease of the elderly.
Poor blood glucose management is the primary culprit behind these complications and carries an estimated economic cost of 1% GDP/year (~2-3NZ$B/year) and growing. The key to good control is easily accessed, low-cost, high adherence, and non-invasive/pain-free glucose measurement. To date, the pin-stick (painful, low adherence) and implanted glucose sensors ($50-100/week) available do not meet these needs. The result is very poor compliance to regular blood glucose measurement and resulting poor control.
Thus, there is an urgent need to develop low-cost, non-invasive blood glucose monitoring methods to increase compliance, accessibility, and thus, health outcomes for people living with diabetes in New Zealand and internationally. My research focuses on creating and validating optical methodologies for blood analyte sensing with a key focus on blood glucose. The technology utilises small, narrow-band, near-infrared light-emitting diodes to both emit and detect signals. I work within a diverse team of researchers to integrate the sensor into a Low-cost Equitable Artificial Pancreas System (LEAPS). The project will provide significant impact on health care and outcomes for the elderly.
PhD candidate, Biological Science, University of Auckland
Targeting malic enzymes in the war against cancer
Cancer is a leading cause of death both worldwide and in New Zealand. In 2020, New Zealand recorded 35,934 new cancer cases, with 10,508 cancer-related deaths, with over 50% being aged 60 or older. Consequently, the rapid development of highly selective anticancer treatments is paramount.
One of the emerging hallmarks of cancer is that it alters its metabolism to facilitate rapid cell growth, changing how it breaks down glucose. Malic enzymes are thought to play a crucial role in allowing this modified metabolic profile to function by converting malate into pyruvate in the mitochondria to maintain TCA cycle flux. This modified metabolic profile may be able to be exploited to develop selective anti-cancer drugs.
My research examines two known small molecule inhibitors of malic enzyme 2, NPD-389 and embonic acid. One of my research goals this year is to undertake protein-inhibitor crystallisation studies to determine the exact binding interactions between the inhibitors and the enzymes. This will tell us whether there is a potential for more extensive structural-based drug design to improve the binding affinity of these compounds.
PhD candidate, Biomedical Science, University of Auckland
Anti-GluN1 antibodies as a therapeutic approach to treating cognitive decline in ageing
As the aged population continues to grow, new therapies are needed to prevent the predicted escalation in the number of people affected by age-related neurodegenerative diseases. Our lab has developed an antibody-based immunotherapy targeting the GluN1 subunit of NMDA glutamate receptors. These receptors are believed to be essential to the process of learning and memory, and we have previously demonstrated that treatment with these antibodies has neuroprotective and cognitive-enhancing properties in rodent models. This project takes the next step towards bringing a GluN1 antibody therapy to clinical trial.
My PhD aims to determine whether this therapy is effective at modifying disease progression in models of Huntington's disease through passive antibody delivery. Additionally, I will be investigating the viability of a viral vector approach to treatment. This would essentially be a vaccine using a modified non-pathogenic adeno-associated virus to cause the immune system to make these therapeutic anti-GluN1 antibodies internally. This system would be useful as a tool for rapidly screening models of additional age-related illnesses such as Alzheimer's disease or frontotemporal dementia with a much shorter lead time. Additionally, this style of vaccine could eventually be modified to be used as a therapeutic as well.
PhD candidate, Nursing, University of Auckland
Integrating oral care into nursing practice from home to hospital - putting the mouth into the head-to-toe assessment
The goal of my research is to integrate oral health assessment and care planning into daily nursing care for older adults. To achieve this, we first implemented a nursing oral health assessment training protocol (NOHAT) that was co-developed with an oral health therapist. We trained four champion nurses in home care and an aged residential care facility using this protocol, which includes an oral health assessment care planning guideline, OHCAP, that we also developed. We confirmed that NOHAT increased nurses’ knowledge and confidence in using OHCAP. The next step, currently in progress, is trialling nurses’ use of OHCAP for older adults to determine whether it is feasible and appropriate for nurses to employ in clinical settings. The final stage will evaluate whether oral health care practice, using OHCAP via NOHAT training, is translated into nurses’ daily care and will measure its impact on clients’ oral health outcomes following a four-week trial. My overall goal is to normalise daily nursing oral health practice for older adults to support their independence and maintain overall health through the upskilling and empowering of nurses at the organisational level. In doing so, I hope to achieve sustainable healthcare change and contribute to older adults’ wellbeing.
PhD candidate, Public Health, Massey University
Fostering wellness: exploring companion animal fostering as a health promoting initiative for older adults
Can caring for a companion animal be part of successful aging? Most but not all research supports the belief that pets are good for us and that animal companionship may benefit the mental and physical health of older adults specifically. But barriers to owning a pet may be greater in older age. Cost or concerns about dying before a pet may interfere. Families or institutions may discourage pet ownership because of concerns about infection, or fears that adequate care for pets may become a challenge in the long term.
Ownership is the not the only way an older person can benefit from human animal interaction. Regular contact may also benefit health, although fleeting contact may provide little benefit and direct involvement in caregiving appears to be important.
This is where animal fostering, which usually involves being a short-term animal guardian comes in. My research focuses on cat fostering programmes and will explore the health promoting potential of cat fostering for older adults.
I hope that this research will lead to two things: a greater understanding of the benefits of the human animal bond for older people and more opportunities for those older people who wish to, to have companion animals in their lives.
PhD candidate, Psychological Medicine, University of Auckland
Empowering dementia carers with iSupport Virtual Assistant (eDIVA)
My PhD project is titled Empowering Dementia Carers with an iSupport Virtual Assistant (eDIVA). It is part of a cross-country project between Australia, Indonesia, New Zealand, and Vietnam. In this project, we aim to develop an online-based psychosocial intervention based on the WHO’s iSupport for Dementia, a self-paced training manual for family carers of people with dementia. Our project will develop a website called the iSupport Virtual Assistant (iSupportVA) which will consist of seven versions across the four countries.
For my PhD, I am working to develop a culturally-relevant adaptation of the iSupport manual and the iSupportVA website for use in New Zealand, by co-designing it with carers of people with dementia. I will also examine the usability, feasibility and possible effects of this website through a pilot randomised-controlled trial.
The iSupportVA will hopefully be an effective and accessible tool to improve the well-being and quality of life for carers and people with dementia across New Zealand. After the pilot randomised controlled trial, I hope to engage with national stakeholders in planning the national roll-out of this tool, to ensure it can benefit carers and people with dementia in New Zealand.
Wen Jie (Jenny) Song
PhD candidate, Health Science, University of Waikato
Living in limbo: Perceptions of ageing and healthcare among older Chinese adults in New Zealand
I am a registered nurse and a third-year PhD candidate at the University of Waikato with a background in nursing education in New Zealand.
Aotearoa-New Zealand has an ageing population and is becoming increasingly pluralistic in terms of cultural and ethnic identity due to the growing globalisation of international migration. Chinese migrants are among the fastest-growing ethnic group in Aotearoa-New Zealand and amongst this group, older people are growing at a rapid rate. Although ageing can bring certain challenges to health and well-being, Chinese elders may adopt coping strategies to deal with age-related challenges. The complex interplay of ageing, well-being, health service utilisation, and filial care support amongst older Chinese adults in an immigrant context is under-researched and not understood. It is hoped that this research project will provide a unique insight into the needs of Chinese older people in Aotearoa-New Zealand with an aim to improve the understanding of the Chinese elderly in relation to their healthcare, disability support, and ageing.
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