Publications by authors named "Ruth Peters"

Addressing modifiable dementia risk factors requires reliable risk assessment methods. We aimed to synthesise knowledge on risk scores for all cause dementia, Alzheimer's disease (AD) and vascular dementia, classify them according to target population, evaluate their content, cost, appropriateness of validation studies, and suitability for implementing risk reduction guidelines. A systematic search was conducted of PubMed, Cochrane Collaboration, ProQuest, Scopus, Embase, and PsycINFO databases using a pre-registered protocol.

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Introduction: Studies on the association between lipid levels and lipid-lowering treatment and the risk of dementia and/or cognitive decline (CD) have shown conflicting results and are few in individuals with type 2 diabetes (T2D). The aim was to evaluate the relationship of baseline LDL cholesterol levels and statin treatment with the development of dementia/CD in patients with T2D from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial.

Methods: Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and CD was defined as at least a 3-point decrement in the Mini Mental State Examination score.

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Background: The importance of patient participation in designing and delivering services for persons affected by neglected tropical diseases (NTDs) has gained increasing recognition. Responding to this, persons affected by NTDs urged NTD-focused non-governmental organisations (NGOs) to take action. These NGOs are pivotal in addressing healthcare disparities and reaching marginalised communities.

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Background: Potentially modifiable risk factors could account for approximately 45% of dementia cases globally. For targeted prevention, understanding population-specific patterns of risk is essential. We aimed to track changes in dementia prevalence across Australia, and calculate population attributable fractions of dementia, for 12 risk factors (ie, low education, hypertension, obesity, high cholesterol, smoking, high alcohol intake, poor diet, physical inactivity, hearing loss, depression, diabetes, and social isolation).

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Leprosy reactions occur in 20-50% of people affected by leprosy. Previous studies have shown that lack of awareness and understanding of leprosy reactions among affected individuals and healthcare workers. This study aims to design and validate a knowledge, attitudes, and practices (KAP) questionnaire to assess understanding of leprosy reactions among leprosy-affected individuals.

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Individuals with stigmatised health conditions face adverse attitudes, social exclusion and discrimination, stemming from preconceived notions about the condition and its associated symptoms or links to disability. Culture plays a role in shaping stigma manifestations. By employing the 'what matters most' framework, this study sought to capture perspectives of men and women living with leprosy, lymphatic filariasis or depressive disorder, and of their families and healthcare providers, regarding key cultural capabilities that 'matter most' for men and women in Cirebon Regency, Indonesia.

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Background: Mild cognitive impairment is a cognitive state that is worse than that of healthy older adults but less severe than dementia. The effectiveness of a nurse-led risk factor modification (RFM) intervention for older adults with mild cognitive impairment is unclear. The study aimed to compare the effects of: (1) a multi-component intervention: combined cognitive training, mind-body physical exercise, and nurse-led RFM (CPR), (2) nurse-led RFM alone, and (3) health advice alone on cognitive function among older adults with mild cognitive impairment in primary care.

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Importance: Recent evidence from a quasi-experiment in Wales showed that herpes zoster (HZ) vaccination appears to prevent or delay dementia. Exploiting a similar quasi-experiment in Australia, this study investigated the effect of HZ vaccination on dementia occurrence in a different population and health system setting.

Objective: To determine the effect of HZ vaccination on the probability of receiving a new diagnosis of dementia.

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The Sungai Buloh Leprosarium in Malaysia, established in 1930, provided relief for many individuals with leprosy, yet their personal narratives remain largely untold. This study explored the lived experiences of older individuals affected by leprosy at the Leprosarium, focusing on their concerns, needs, and challenges. By examining the historical context and key themes from interviews with leprosy-affected participants, the study aimed to enhance their well-being and provide insights applicable to leprosy-affected individuals in the community, other leprosaria, and older individuals in institutional care settings.

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Introduction: Increasing awareness of the high frequency, wide spectrum and disabling nature of symptoms that can persist following COVID-19 infection has prompted the investigation of management strategies. Our study aims to determine the effectiveness of atorvastatin on cognitive function, physical activity, mood, health-related quality of life and features of neurovascular impairment and neuroinflammation in adults with ongoing neurological symptoms after COVID-19 infection.

Methods And Analysis: The STatin TReatment for COVID-19 to Optimise NeuroloGical recovERy study is an ongoing international, investigator-initiated and conducted, multicentre, prospective, randomised, open label, blinded endpoint trial with fixed time points for outcome assessments.

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Leprosy, though curable, continues to present physical and psychosocial challenges for those affected. This study explored how individuals affected by leprosy in Malaysia navigated daily life, societal expectations, and personal challenges through the walk-and-talk technique, a participant-led qualitative approach that fostered spontaneous storytelling and reflexivity. By guiding researchers through their environments, participants shaped the narrative, shifting power dynamics and enabling authentic dialogue.

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Introduction: Neglected tropical diseases (NTDs) comprise a group of twenty diverse diseases or conditions that pose significant public health challenges and adversely impact the quality of life of affected individuals. NTDs are characterised by interconnected biological, social, and environmental factors, which complicate their effective management and eradication. Collaborative research, such as transdisciplinary research (TDR) and participatory approaches that engage scientific, societal, and non-academic stakeholders in co-creating action-driven solutions offer promising strategies to address NTDs.

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Leprosy-related stigma in Nepal adversely affects socioeconomic and health outcomes. The cultural shaping of stigma is often overlooked in stigma (reduction) research. Therefore, this study aimed to (i) identify cultural capabilities in daily life that "matter most" for men and women; (ii) extend and corroborate perspectives and experiences of leprosy-related stigma; and (iii) explore how "what matters most" (WMM) intensifies or protects against leprosy-related stigma in Far-Western Nepal.

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Objective: To determine the effects of intensive blood pressure treatment on orthostatic hypertension.

Design: Systematic review and individual participant data meta-analysis.

Data Sources: MEDLINE, Embase, and Cochrane CENTRAL databases through 13 November 2023.

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Aims: Individuals with cardiovascular disease (CVD) are more likely to become frail. However, no study has determined whether an incident CVD event alters frailty trajectories in older individuals. This study aims to determine the extent to which an incident CVD event modifies frailty trajectories and to identify factors that influence those changes.

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Background: To explore whether healthy lifestyle factors (HLFs) predict a lower risk of major macrovascular and microvascular events and death in people with type 2 diabetes (T2D) with a high risk of vascular complications.

Methods: Post hoc analyses of 11,133 participants with T2D in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial who were assigned a score ranging from 0 to 4 based on the number of baseline HLFs: never smoked, moderate-to-vigorous physical activity, ideal waist/hip ratio, and low-to-moderate alcohol consumption. Multivariable Cox models were used to determine associations of 0, 1, 2, and ≥ 3 HLFs with vascular events and all-cause mortality.

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Background: Leprosy reactions (LR) are immune-mediated complications of leprosy that may be associated with severe and irreversible nerve damage. Non-medical aspects, such as financing, service provision, and healthcare resources in the management of LR are generally overlooked as studies tend to concentrate on clinical features and treatment. Barriers to accessing care and services are a major cause of suboptimal care for people with leprosy.

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Introduction: Cumulative blood pressure metrics may provide greater precision for measuring temporal risk exposure, especially in later life where data are mixed regarding associations of high blood pressure (BP) on cognitive function. We examined the relationship between greater cumulative exposure to high BP in later life and several domains of cognitive function.

Methods: Individual cognitive assessment scores and BP measurements in older adults (age ≥70 years) at baseline and over approximately 8 years of follow-up were available in the population-based Canadian Victoria Longitudinal Study (VLS) and Swedish Gothenburg H70 Birth Cohort Studies (H70).

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Background: The association between systolic blood pressure and all-cause mortality differs between frail and nonfrail individuals, highlighting uncertainties about the effectiveness of antihypertensive treatments in frail populations.

Methods: Using data from the SHEP trial (Systolic Hypertension in the Elderly Program), a baseline frailty index (FI), including 55 variables, was constructed. Fine-Gray subdistribution hazard models and Cox proportional hazards regression models were used to explore the association between baseline FI and the risks of stroke, cardiovascular disease, and all-cause death, as well as to examine whether the impact of antihypertensive treatment on these outcomes was modified by baseline FI.

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Background: A brain healthy lifestyle, consisting of good cardiometabolic health and being cognitively and socially active in midlife, is associated with a lower risk of cognitive decline years later. However, it is unclear whether lifestyle changes over time also affect the risk for mild cognitive impairment (MCI)/dementia, and rate of cognitive decline.

Objectives: To investigate if lifestyle changes over time are associated with incident MCI/dementia risk and rate of cognitive decline.

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Introduction: Individuals with ADHD continue to face stigma, which can negatively impact their access to, adherence to, and quality of mental health services, as well as their overall wellbeing. Perspectives of various stakeholders regarding priorities for stigma reduction remain underexplored. This study explores young adult, parent, teacher, and mental health care professional perspectives on unmet needs of children and young adults with ADHD in the Netherlands, in the context of stigma reduction.

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Background: We aimed to develop risk tools for dementia, stroke, myocardial infarction (MI), and diabetes, for adults aged ≥ 65 years using shared risk factors.

Methods: Data were obtained from 10 population-based cohorts (N = 41,755) with median follow-up time (years) for dementia, stroke, MI, and diabetes of 6.2, 7.

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Health-related stigma plays a significant role in the burden of various health conditions such as neglected tropical diseases and mental illnesses, and undermines successful health outcomes. Stigmatised individuals can face lifelong socioeconomic consequences because of their condition. It is broadly recognised that culturally salient factors interact with the way stigma is expressed in different local contexts.

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Article Synopsis
  • The study focuses on understanding frailty among Aboriginal Australians, a group significantly affected by this health issue, highlighting the need for research that acknowledges their unique perspectives compared to Western frameworks.
  • Utilizing qualitative methods, specifically the Indigenous research technique of Yarning, the study engaged 22 Aboriginal adults aged 45+ to gather insights on their experiences and perceptions of frailty.
  • The research identified seven thematic areas related to frailty, emphasizing the importance of cultural, social, and psychological factors in managing frailty, ultimately indicating that culturally relevant assessments and community connection are crucial for better health outcomes.
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Objectives: The Action To promote brain HEalth iN Adults study aimed to determine the feasibility and applicability of recruitment using home blood pressure (BP) monitoring, routine blood biochemistry and videoconference measures of cognition, in adults at high risk of dementia.

Design: A decentralised double-blind, placebo-controlled, randomised feasibility trial with a four-stage screening process.

Setting: Conducted with participants online in the state of New South Wales, Australia.

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