INVITED SPEAKERS

Professor Koen Milisen
KU Leuven, Belgium

Bio: Koen Milisen, PhD, RN, is a distinguished health scientist and clinical nurse. He serves as a full Professor of Care for Older Persons and heads the Academic Center for Nursing and Midwifery at the Department of Public Health and Primary Care, KU Leuven (Belgium). Additionally, he is a Clinical Nurse Scientist at the Division of Geriatric Medicine at the University Hospitals of Leuven (Belgium).

Prof. Milisen holds several prominent positions, including President of the Flemish Center of Expertise for Falls and Fracture Prevention, member of the executive council of the World Falls Prevention Society and senior editor at BMC Geriatrics. He was co-workgroup leader of the recent Global Guidelines for Falls in Older Adults initiative, past President of the UZ Leuven Delirium Working Group, and a former council member of the European Delirium Association.

With extensive expertise in clinical practice, teaching, and research, Prof. Milisen has led numerous research projects focused on falls, delirium, restraint use, and the development of geriatric care models. His contributions have been recognized with several national and international awards, including the Borgerhoff Award for Geriatrics for his research on falls prevention, the Scientific Study Award of the Belgian Psycho-Geriatric Association for his work on delirium prevention, the Anna Reynvaan Award for the best scientific nursing publication, and the Book of the Year Award from the American Journal of Nursing.

Prof. Milisen has published over 270 papers in peer-reviewed journals (h-index 45 according to Web of Science®) and is the (co)editor/(co)author of more than 40 national and international books and book chapters. More information can be found at https://orcid.org/0000-0001-9230-1246.

Presentation title: Can Delirium Prevention Reduce In-Hospital Falls in Older Adults?

Abstract: Falls among hospitalized older adults are prevalent and often result in severe adverse outcomes, including fractures and death, leading to significant human and economic burdens. Cognitive impairment is a notable risk factor for falls, yet it is challenging to manage, particularly in acute hospital settings.

Delirium, a common multifactorial syndrome in hospitalized older adults, is characterized by acute and fluctuating changes in attention, consciousness, and cognition. It remains often underreported and can be triggered by various factors such as medications, infections, electrolyte and metabolic disturbances, sleep deprivation, and pain. Beyond its psychosocial impact, delirium frequently worsens outcomes for hospitalized older adults including serious physical complications and falls.

Evidence suggests that a non-pharmacological, multicomponent approach can reduce the risk of delirium by up to 50% in hospitalized older adults. Preliminary findings also indicate that such strategies may lower the risk of falls. Indeed, falls and delirium share many predisposing and precipitating risk factors. This raises the question: can comprehensive strategies improve patient outcomes by simultaneously reducing both delirium and falls in this vulnerable population?

This lecture will explore the characteristics, risk factors, and negative consequences of delirium in hospitalized older adults. It will also discuss the fundamental principles of effective delirium prevention and its potential to decrease in-hospital falls among older adults.

Professor Michele Callisaya
Menzies Institute for Medical Research, University of Tasmania, Hobart

Bio: Prof Michele Callisaya is a principal research fellow at the Menzies Institute for Medical Research, University of Tasmania and a senior research fellow at Monash University. She has worked as a physiotherapist for over 20 years, mainly in rehabilitation and aged care.  Her research focuses on falls, frailty and dementia. She is also passionate about improving access to allied health for people with progressive neurological conditions. She has been awarded over $30 million in research funding and has published over 180 research papers or book chapters.

Presentation title: The right to rehabilitation for people living with dementia – addressing stigma and improving access to evidence-based interventions

Abstract: Dementia is a major cause of disability and loss of quality of life.  In addition, both mild cognitive impairment and dementia double the risk of falls, contributing to higher rates of admission to residential care and mortality.

There is evidence for interventions delivered by allied health professionals to maximise function, improve quality of life and reduce the risk of falls for people living with dementia.  Despite this people with dementia often experience stigma and are denied access to such treatments.

The aims and objectives of the presentation are to:

• learn about interventions that can improve function and reduce the risk of falls in people with dementia
• gain and understanding of the barriers for people with dementia in access evidence-based interventions including at the level of the person, health professional, organisation and wider health system.
• learn about potential solutions to address some of the barriers, including the results of an MRFF funded study to reduce stigma and improve access to allied health for people living with dementia.

Outline strategies to assist attendees advocate and take action to improve access to evidence-based therapies for people living with dementia in their workplace

Associate Professor Ruth Peters
The George Institute for Global Health, UNSW, Sydney

Bio: Dr Ruth Peters, BSc Hons, MSc, PhD, Program Lead for Dementia, The George Institute for Global Health Sydney, Conjoint Associate Professor UNSW.  Dr Peters research uses clinical trials and evidence synthesis to identify ways to prevent, delay or treat three of the most significant disorders of ageing: dementia, hypertension and frailty. She was one of the first to start synthesizing the evidence on dementia risk factors as part of her PhD and her NIHR Post Doctoral fellowship at Imperial College London, where she also led the cognition outcomes for a seminal multinational guideline-changing clinical trial. Her research continues to be influential and her work is cited by multiple WHO guidelines, influential reports from the World Bank and UN and learned societies clinical practice guidelines. She has worked with WHO on the development and update of their dementia risk reduction guidelines, and her most recent work focuses on blood pressure lowering, where she has delivered the first Class 1A evidence for blood pressure lowering, reducing the risk of dementia and multidomain risk reduction. For multidomain risk reduction, this includes leading an NHMRC Clinical Trials and Cohorts Grant to evaluate the use of a novel community-based approach, which is what she will talk about today.

Presentation Title: Risk factors for dementia…and falls, a novel multidomain community-based approach to risk reduction

Abstract: Dementia and frailty represent some of the most significant health issues facing us as we age. Both have multiple overlapping and lifestyle-orientated risk factors, including low physical activity and low cognitive and social engagement.

Multidomain risk-reduction trials use interventions that target more than one risk factor, for example, by including a physical activity component, cognitive training, and dietary advice. Such trials currently offer some of the best evidence to support the prevention or delay of cognitive decline and frailty. Furthermore, since they can incorporate physical activity, strength and balance, they may also help to reduce the risk of falling. However, multidomain approaches can be hard to operationalise in community settings without significant resources, and significant commitment from community members.

By taking a novel approach using ‘intergenerational practice’ we have a potential means to help to solve some of the complexities of operationalising multidomain risk reduction. Intergenerational practice brings together two age groups, most commonly by combining older adults with preschool or primary school children to participate in joint activities that include games and crafts in a fun engaging setting but which incorporate physical, cognitive and social aspects. Such intergenerational activities further tap into older adult generativity, that is a desire to share knowledge and support younger generations. Intergenerational activities can take place in community settings, can be delivered in a relatively inexpensive way and can support multidomain risk reduction alongside building relationships and friendships within and across generations.

This talk will discuss the strategies we are using in our current flagship multisite multidomain intergenerational clinical trial and our wider research program and will provide updates on feasibility, acceptability and practical delivery of such programs in community settings. Intergenerational practice may represent one of the most translatable means to tackle multiple risk factors for the health issues of dementia, falls and frailty. Our work is taking the first steps to provide the empirical evidence towards this.

Professor Cathy Said
The University of Melbourne, Melbourne

Bio: Professor Cathy Said [PhD, B App Sci (Physio)] is the inaugural Professor Physiotherapy, Western Health & The University of Melbourne and a program director with the Australian Institute of Musculoskeletal Science.  Cathy has over 25 years’ experience working in neurological and gerontological rehabilitation. Her research focuses on fall prevention and the rehabilitation of gait and balance in older people and people with stroke.   She is also passionate about how to bridge the divide between research evidence and practice, including how we can better meet the needs of people from culturally and linguistically diverse communities.

Presentation Title: Exercise and Falls Prevention for older people from CALD communities

Abstract: Australia is a multicultural society; one in three Australians over 65 years of age were born overseas and most were born in a non-English speaking country. People from ethnically diverse communities face extensive barriers to accessing healthcare, including language barriers and cultural differences. In addition, people from CALD communities are under-represented in research, which further reinforces health inequity. The MOVE Together: Reduce Falls research team is currently addressing this gap through a collaborative research program focussed on supporting older people from CALD communities to engage in exercise to reduce falls risk. Our Move Together: Reduce Falls team brings together researchers, clinicians, people from Italian, Arabic speaking and Chinese communities and organisations that working with CALD communities.  This talk will provide an overview of our progress to date, including outcomes of the co-design of an intervention to support regular exercise to reduce falls risk in CALD communities and the preliminary outcomes of a pilot randomised trial evaluating this intervention.  The talk will also highlight potential challenges faced when delivering health care and conducting research with older people from CALD communities, as well as strategies that have contributed to the success of the project.

Professor Rebecca Ivers
University of New South Wales, Sydney

Bio: Scientia Professor Rebecca Ivers is Head, School of Population Health, UNSW Sydney, and Honorary Professorial Fellow at the George Institute for Global Health.  Ivers leads a global research program focusing on the prevention and management of injury. Her work has a strong focus on equity, implementation, sustainability and capacity development.  She has published over 300 peer reviewed publications and supervised 20 PhD students.   Ivers is currently Chair of the Council of Academic Public Health Institutions Australasia; Chair of the National Injury Surveillance Unit (Australian Institute of Health and Welfare) Advisory Committee (2022-); Co-Chair of Virtual Care Monitoring and Evaluation Committee, NSW Ministry of Health (2022-) and Chair of International Advisory Committee, Nepal Injury Research Centre (2017-). She represents UNSW at the United Nations Road Safety Collaboration

Presentation title: The Ironbark Program: Working together to improve mobility and balance in older Aboriginal people

Abstract: Prevention of falls aids healthy ageing, but there are few Aboriginal-led and designed programs to address falls in older Aboriginal people globally. This presentation will outline background, development and evaluation of the Ironbark program, an Aboriginal led fall prevention program.  With oversight from an Aboriginal steering committee, and building on previous work in NSW and WA, a pre-post study was conducted in New South Wales (NSW) and Western Australia (WA) in 2022-2023. The aim was to evaluate the effectiveness of a fall prevention program incorporating exercises and yarning circles targeting fall risk factors (Ironbark Standing Strong and Tall) compared to a social program (Ironbark Healthy Communities Program). Data were collected at baseline and after 12 months of follow-up on functional mobility (primary outcome) and a range of secondary outcomes. This presentation will present results of the Ironbark Trial but also highlight how our team of Aboriginal and non-Aboriginal researchers in partnership with health services together co-designed and delivered a program for older Aboriginal people based on the stated priorities of Aboriginal older people.

Professor Alison Hutchinson
Deakin University, Geelong

Bio: Deakin Distinguished Professor Hutchinson is a registered nurse and the Chair in Nursing at Barwon Health. She is also a Professor at Deakin University in the School of Nursing and Midwifery and Co-Director of the Centre for Quality and Patient Safety Research (QPS) in Deakin’s Institute for Health Transformation. As Co-Director of QPS, Prof Hutchinson provides strategic direction for the Centre, comprising 40 researchers undertaking research in patient safety, patient experience and workforce development. Prof Hutchinson is one of only a few Australian nurses to have completed a formal postdoctoral fellowship program overseas(Canada). She is internationally recognised for her work in implementation science and is the Protocols Editor for journals, ‘Implementation Science’ and ‘Implementation Science Communications’. She has attracted competitive research funding from a range of funding bodies and has more than 200 publications, including co-authorship of several book chapters. Prof Hutchinson currently leads a Medical Research Futures Fund-funded study evaluating BrainTrack, Dementia Australias’ recently released app to monitor brain health. In 2019, she was awarded the title of Deakin Distinguished Professor, the highest honour Deakin University can bestow upon an academic staff member. In July 2021, she was inducted into the Sigma International Nurse Researcher Hall of Fame.

Presentation Title: Using machine learning to determine falls risk among hospitalised adults

Abstract:

Background: Effective fall prevention programs are reliant on identifying patients at high risk of falling. With the advent of electronic medical record systems, large datasets are now available in many health services to support data-informed decision-making.

Aim: Our aim was to determine factors associated with falls risk and to develop risk prediction models to identify at-risk patients in acute and sub-acute care settings.

Methods: A retrospective study was undertaken of more than 670,000 patients admitted during a three-year period to a large metropolitan tertiary health service in Victoria, Australia. Data were extracted from the Department of Health Victorian Admitted Episodes Dataset, RiskManTM, electronic health records, and the health workforce dataset. Random Forest and Deep Neural Network machine learning models were used to analyse the data.

Results: The models demonstrated high accuracy and specificity in predicting patient falls. We compared the top 20 predictors of falls identified in both models. There were 12 factors in common, which were classified as: patient-related, staffing-related, and admission-related factors. While not all factors are modifiable, they can inform fall prevention planning and initiatives.

Conclusion: Machine learning techniques hold promise for predicting falls and identifying key risk factors to inform fall prevention planning and decision-making. The models require further validation in other settings.