ABSTRACT Objective Age‐related loss of lean mass is a hallmark of sarcopenia and a contributor to functional decline and morbidity in ageing populations. This study aimed to identify long‐term determinants of lean mass during ageing. Methods Data from 3033 participants (ages 20–96 years; 49% women) in the Geelong Osteoporosis Study were analysed using linear mixed effect models with random intercepts. Appendicular lean mass (ALM) was derived from arm and leg lean mass measured using dual‐energy X‐ray absorptiometry. Time‐varying covariates were included; missing data were imputed using predictive mean matching. Results Over 16.7 years (IQR 9.7–23.2), women and older participants had lower ALM ( β = −8.36; 95% CI –8.58, –8.15; β = −0.07; 95% CI –0.08, –0.06). Higher ALM was associated with socio‐economic status (0.33; 0.14, 0.51), dietary calcium intake (0.46; 0.20, 0.67), femoral neck BMD (0.38; 0.29, 0.47) and thyroid hormone therapy (0.52; 0.04, 0.99). Physical inactivity (−0.48; −0.65, –0.31), smoking (−0.24; −0.46, –0.06) and stroke history (−0.51; −0.96, –0.07) were associated with lower ALM. Non‐linear associations were observed for follow‐up duration (fu: β = −0.16; fu 2 : β = 0.01; − p < 0.001), body mass index (BMI: β = 0.55; BMI 2 : β = −0.00; p < 0.001), systolic blood pressure (SBP: β = 0.06; SBP 2 : β = −0.00; p < 0.001), serum C‐terminal telopeptide of type I collagen (CTx: β = 0.14, p < 0.001; CTx 2 : β = −0.01, p = 0.03) and high‐sensitivity Creactive protein (hsCRP: β = −10.38; hsCRP 2 : β = 11.70; − p < 0.001). In fat‐mass‐adjusted models, low‐density lipoprotein cholesterol (0.14; 0.04, 0.24) and triglycerides (0.22; 0.11, 0.33) were positively associated with ALM, whereas high‐density lipoprotein cholesterol (−0.53; −0.81, –0.25) was inversely associated with ALM. Conclusions Sociodemographic, lifestyle, anthropometric, clinical, biochemical and treatment‐related factors show independent associations with longitudinal changes in ALM.
ABSTRACT Objective To determine the potential feasibility and acceptability of combined screening for raised blood pressure (BP), atrial fibrillation (AF) and cognitive impairment (CI) in older adults within a setting of hearing health assessment for detection of hearing loss. Methods We recruited participants aged 65 years or older ( n = 35; mean age 73 ± 6 years, 51% females) from the community to attend a single visit lasting approximately 60–90 min. Prior to a comprehensive hearing assessment, BP was measured with an automatic BP monitor with AF detection, and CI screening was conducted using the patient section of the General Practitioner Assessment of Cognition instrument. A subset of participants ( n = 16, 50% females) was interviewed post study to evaluate acceptability. Results A total of 21 positive screens (six raised BP; two possible AF; 13 hearing loss) and 12 potential positive screens for possible CI were detected in 25 (71%) participants. Eight participants (23%) had more than one newly detected condition. Interviews revealed that combined screening was feasible and acceptable as participants felt it was ‘ convenient, ’ ‘ saves time ’ and ‘ more efficient .’ Conclusions Combined screening for raised BP, AF and CI in older adults within a hearing health assessment setting appears feasible and was generally perceived positively by participants in this pilot study. Further implementation studies should be conducted with process and outcome evaluation embedded to confirm feasibility and acceptability as well as to evaluate cost‐effectiveness and health outcomes for combined screening in older adults.
OBJECTIVES:Australia is expecting a growing ageing population from culturally and linguistically diverse (CALD) backgrounds. This study explored how older Indonesian immigrants in Australia negotiate their multicultural identities and family roles, and how participants experienced these negotiations in relation to their psychological well-being. METHODS:In-depth semi-structured qualitative interviews were conducted with 31 older Indonesian immigrants (aged 65 years and over) residing in Southeast Queensland, Australia. Participants were recruited through purposive and snowball sampling via Indonesian community networks. Data were analysed using Braun and Clarke's inductive thematic analysis with adherence to COREQ guidelines. RESULTS:Three themes emerged: (1) navigating belonging between cultural contexts, describing participants' ongoing evaluation of Australia and Indonesia across affective, practical and identity dimensions; (2) actively exercising heritage multicultural identities, capturing how participants deliberately maintained, rediscovered and performed their heritage identities through personal agency, cultural anchors and diaspora community engagement; and (3) negotiating roles and authority within family, documenting caregiving, moral guidance and heritage cultural transmission as the roles through which elder identity was enacted and experienced as meaningful. Cultural identity was not a fixed attribute but a continuously negotiated practice, enacted through roles in family and diaspora contexts. CONCLUSIONS:Older Indonesian immigrants actively negotiate their multicultural identities and family roles in ways associated with sustained psychological well-being. Role performance sustains meaning, cultural continuity and social purpose in later life. Aged care and policy frameworks should attend to these role-enabling dimensions as central to well-being among older immigrants from CALD backgrounds.
OBJECTIVES:Patients living with Parkinson's disease (PD) and related disorders are at increased risk of osteoporosis and fractures. However, bone health remains under-assessed in clinical practice. The aim of this study was to evaluate whether the FRAGILE tool that we previously developed improved osteoporosis screening and referral practices in a PD and related diseases clinic. METHODS:We performed an audit of 283 outpatient consultation letters evaluating the use of the FRAGILE tool for screening osteoporosis risk. RESULTS:Following implementation of the FRAGILE tool our referral rate for osteoporosis screening improved from 23% to 48% of at-risk patients. Specifically, marked improvements were seen in referrals for patients with osteopenia, falls and fractures, but factors such as osteoporosis-associated medications and medical comorbidities were still often overlooked. CONCLUSIONS:Osteoporosis screening referrals improved after introduction of the FRAGILE tool in clinical practice. Further efforts are required to address less overt risk factors.
OBJECTIVES:The Australian Transition Care Program (TCP) is a short-term rehabilitation service designed to help older adults regain function following hospitalisation. This study aimed to better understand service trends by examining client demographics, utilisation, expenditure and functional status over 18 years. METHODS:This descriptive study analysed aggregated statistics from publicly available reports spanning 2006-2007 to 2023-2024 of the Transition Care Program (TCP) across Australia. RESULTS:A total of 351,981 people accessed TCP during the study period. The number of clients per annum increased 143% from 10,355 (2006-2007) to 25,202 (2016-2017), then declined to 14,388 in 2022-2023 despite increases in number of allocated places (2000-4570; +129%) and combined expenditure (A$68.0-A$519.3 million; +664%) across Australia. Admissions per 1000 of the population decreased from 6.3 in 2011-2012 to 3.6 in 2023-2024 (-43%). There was minimal change in entry modified Barthel Index (MBI) (69.7-72.1) or exit MBI scores (79.5-83). Total length of stay increased from 48 to 77 days (+60%). Average cost/episode also increased 261%, from A$9996 to A$36,093, whereas cost/occupied place day increased from A$208 to A$463 (+123%). State-based variations were also evident. CONCLUSIONS:Our data suggest TCP clients are spending longer in the program and incur greater costs to state and federal government potentially without greater gains in functional status. Fewer people have access to the program despite increasing population levels. Variability between states is evident and requires further exploration. There is an opportunity to capitalise on aged care reforms to optimise the Australian Transition Care Program.
