PATH Through Life Project 2007
Project Overview
The PATH Through Life Project is a 20 year longitudinal study of 7,485 adult community residents randomly selected from the Electoral Rolls of Canberra and Queanbeyan. It aims to investigate the causes of three classes of common mental health problems: (1) anxiety and depression (2) alcohol and other substance abuse (3) cognitive functioning and dementia. The project investigates four broad themes that are relevant to each of these problems: ageing vs cohort effects; social, psychological, nutritional and genetic risk factors; and co-morbidity of mental health problems.
We are hoping to interview our participants every four years for 20 years to monitor changes in their lives, and their health and well-being. Following individuals over time allows us to not only compare participants at one point in time (cross sectional analysis) but to examine changes in individuals over time (longitudinal analysis). Longitudinal analyses will help to explain what factors influence change over time in the health areas of interest, and the interrelationships between them, at the individual level.
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Project Staff
Karen Maxwell (above left) is the PATH
Project Manager. Trish Jacomb (above right) is the PATH
Data Manager.
Contact: Trish Jacomb 02 61258408
PATH Through Life Project Interviewers:
Below (left to right):
1st row: Barbara Banvill, Elizabeth Parkes, Kay Bowman, Cathy Muggleton
2nd row: Denise Melville, Margaret Chapman, Jean Bennett, Virginia Crisp
3rd row: David Fryer, Betty Smith, Sharon Glynn, Dimity Crisp
4th row: Tess Macdonald-Smith
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Procedures and Progress
To provide a high level of confidentiality, the participant completes most of the interview themselves using a computer with a touch-sensitive screen. However, the physical testing and memory tests have to be completed by the interviewer. Cheek swabs were also taken at the time of the Wave 1 interview. DNA was then isolated from these swabs for genetic analysis. Participants are also asked for permission to access their Health Insurance Commission records giving number of visits to their GP over a given period of time.
Above: Participant using a laptop to complete the questionnaire.
In 1999, 2404 Persons aged 20 to 24 years were interviewed for the PATH Through Life Project then in 2000, 2530 persons aged 40 to 44 years participated in our project. In 2001 we interviewed 2551 people aged 60-64. This latter group represents about 25% of those in this age group living in the ACT and Queanbeyan.
It takes three years to interview all participants, and the first wave of interviews was completed early in 2002. Wave 2 of this project commenced in 2003 and we have now completed interviewing our 20+ and 40+ age groups for a second time. We have been very pleased with the response rate, re-interviewing 90% of our youngest age group and 93% of the 40+ age group. In April 2005 we commenced re-interviewing our 60+ participants.
We have been able to send interviewers to most of the participants who have moved to other parts of Australia while those now living overseas were asked to complete an interview by mail or email. In this latter case we were unable to obtain cognitive and physical testing data. We are very happy about our response rate at Wave 2. Our participants have, on the overall, been very pleased to see us again and have been co-operative and accommodating in finding time to meet with our interviewers.
In 2006 CMHR was awarded an NHMRC Project grant to undertake Wave 3. Associate Professor Kaarin Anstey is the Chief Investigator of this stage of the PATH project.
Wave 3 commenced in May 2007 and our participants, many of whom are now in thier thirties are being interviewed for the third time. Over twenty participants have continued thier involvenment with PATH and are being interveiwed in Wave 3.
As for Wave 2, PATH interviewers will catch up with most of our participants living in Australia. Overseas participants will again be asked to compete questionairres by post or email.
New research directions for Wave 3 of the PATH Project will improve the benefit of the study to providing excellent research data for use in the development of government policy and clinical practice. The additional aims of Wave 3 focus on the impact of personal, social and lifestyle transitions on mental health as experienced by different age groups. These trasnitions inlcude pregnancy, changes in family structure, relationship formation and separation, changes in work enviroment and retirement. This wave will enable us to identify patterns of resilience and effective coping strategies among individuals with negative life events, social adn economic adverstiy and previous ill-health, as well as people with risk factors for the development of mental disorders.
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Some comments from an interviewer and two participants:
An interviewer:
As a professional social researcher for over 25 years, it is very satisfying for me to be part of such a rigorous and valuable study. In this long-term study, it is possible for respondents to develop a rapport with their interviewers while maintaining a high degree of confidentiality. There are occasional surprises, as when a young man said: "You know, you saved my life". He assumed that I knew that he was suicidal. But I do not access the answers that people put in to the computer. That comes at a later stage in the research. In his case, the questions at Wave 1 made him realize that there was help available for his depression. He saw a GP (for the first time) and was prescribed treatment. Four years later, he was a happy man.
Even with physical health, the results can be rewarding. When I routinely took another man's blood pressure, he said: "That's better, isn't it.” He remembered that his earlier BP had been very high, and assumed that I knew that. He had visited a GP (for the first time) and been given some alarming news. It was "change your lifestyle or else". He credited me with saving his life.
A 40+ participant:
I thought it would be an excellent project to participate in because Alzheimer's disease is so prevalent that any research which can help to solve the problems of the disease can only be welcome. The actual survey is not difficult and takes two and one half hours every four years which is not onerous. It has the immediate benefit of showing participants some indicators as to their current state of health, and the survey is already revealing some unsuspected conclusions regarding for example, the connection between lung capacity and memory, something that had previously not been suspected.
A 60+ participant:
I enjoyed participating in the PATH Through Life Project and I found it very interesting. The little exercises and questions we are asked to complete are interesting and certainly test the mind. I find it a personal challenge to do the best I can at these tests.
On the other side I am proud to participate in an ongoing project of this sort and I believe it will help to understand the mental and physical health of generations to come. It is good to feel involved and connected to this project by way of the annual Xmas card and newsletters.
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Additional Studies in 60 plus Group
As well as our main Path interview we have undertaken some additional sub-studies. These are:
1. Study of the Brain using Structural Magnetic Resonance Imaging (MRI)
This study involves participants having a brain MRI scan and providing a blood sample. In Wave 1, 478 participants from our 60+ age group were randomly selected to take part in this sub-study. This is being undertaken in collaboration with Professor Perminder Sachdev and colleagues from the Neuropsychiatric Institute, University of New South Wales.
The purpose of this study is to examine relationships between certain brain characteristics and health measures such as blood pressure, depression and memory problems. The MRI brain scans are being done at National Capital Diagnostic Imaging in Deakin, ACT, under the direction of Dr Jeremy Price and Ms Julie Ralphs. Blood samples are being collected by Capital Pathology in Deakin, ACT. Those who took part in this study at Wave 1 were invited to have another MRI at Wave 2 and 376 participants again took part. Repeating MRIs after four years will enable PATH researchers to measure brain changes over time.
At Wave 2 the MRI study was expanded to include the 40+ age group, and 431 people from this age group participated.
Above: Team members from the Neuropsychiatric Institute, University of NSW.
Front Row: Xiaohua Chen, Ora Lux, Angie Russell, Anne Poljak.
Back Row: Lora Ng, George Smythe, Carlton Chu, Perminder Sachdev, Wei Wen.
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The MRI team has completed volumetric tracings of various brain structures including the amygdala, the hippocampus, the entorhinal cortex, the corpus callosum, the prefrontal cortex, the caudate putamen, and the anterior cingulate gyrus. The majority of this time-consuming work was done by Jerome Maller and Chantal Meslin. These tracings give us the size of these specific brain structures, many of which are thought to be associated with memory storage and retention. The team has also completed ratings of atrophy and white matter lesions in the MRI brain scans in this study. Team members at the University of NSW have used automated methods to measure brain volume and to undertake the biochemical analysis of blood samples.
Above: 3D image of the hippocampus (green) and the amygdala (red).
We have also been working in collaboration with NICTA to develop computer programs for automating volumetric measurements of the brain. Data analysis is well underway and a number of papers have been published. Analysis of the blood samples provided by this group allowed comparison between specific blood chemical levels and certain brain characteristics. The data gathered from the analysis of brain MRIs undertaken at Wave 1 has provided invaluable baseline data for comparison at later waves.
Some of these findings are described in Results from the brain MRI study.
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2. The Health and Memory Study
For this sub-study participants in the 60+ age group were selected on the basis of the physical and memory test results in the first interview. These people are then invited to have a more detailed physical and neurocognitive assessment from a medical doctor. Participants of this study were also asked to have a brain MRI at Wave 1. The aim of this study is to examine relationships between health and memory and to look at memory change over time. 117 people took part in this sub-study at Wwave 1. The sub-study was undertaken again with the 60+ age group at Wave 2 and 138 people participated.
Above: Dr Mary Vett and Dr Chantle Meslin undertake clinical interviews of participants in the Health and Memory sub-study.
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Links
More details about MRI scans can be found at www.howstuffworks.com/mri.htm
Research Outcomes
Analysis of PATH data
Completion of Wave 1 of the PATH project resulted in a large data-set which, to be utilised fully, requires many researchers to analyse the data. Within CMHR we currently have seven PhD students analysing parts of the PATH data for their PhD dissertations as well as seven academic staff and several research assistants. To enable further analysis, a number of other research organisations have been allowed access to the PATH data for analysis. Before sharing this data with other organisations a Data Sharing Agreement is signed and only de-identified data is released.
Professor Simon Easteal from the John Curtin School of Medical Research, ANU, is responsible for the genetic analysis using the DNA extracted from the cheek swabs provided at Wave 1. The National Centre for Epidemiology and Population Health (NCEPH) have a group of nine researchers concentrating on data related to job stress and health. A group led by Professor Perminder Sachdev at the Neuropsychiatric Institute, University of NSW are focusing on analysis of MRI and blood data. We also have an agreement with two researchers at Pennsylvania State University, Department of Human Development and Family studies to analyse the PATH data. We have 67 papers published in scientific journals and more are currently being written. See Path Publications for a full list of those papers published or in press. A number of researchers have presented their results at conferences around the around Australia and internationally.
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Recent Research Outcomes
Suicide
Kate Fairweather-Schmidt, a PhD student at CMHR, has been investigating predictors of suicidal thoughts and actions and has already had two papers published on this subject. Kate's research has found suicidal ideation (thoughts) highest in the youngest age group, and that males with chronic illness were more prone to suicidal thoughts. Underemployed participants in the oldest age group were seven times more likely to have suicidal thoughts than those working full time. In the twelve months prior to interview, 8.2% of participants interviewed had experienced suicidal thoughts. Childhood adverstiy and negative emotional reactions were also associated with suicidal thoughts, while believing yourself to be in control of your life was associated with fewer suicidal thoughts. Contrary to clinical and popular views, these results show that non mental health variables such as employment, physical helth, social factors and personality are equally important as symptoms of psychological distress.
Following on from this work Kate has looked at differences between those who just have thoughts of suicide ad those who attempt suicide (0.8% of PATH participants). Those who had thought about suicide and went on to make a suicide attempt were more likel to b unemployed (particulatly the 40-44 year age group), to have poorer physical health and to have more relationship difficulties compared to those who had thought about but not attempted suicide. Contraty to expectaiton, this study found that ideators and attempters experienc similar levels of depression and anxiety.
Smoking following trauma
Further analysis has been undertaken on the data supplied by participants affected by the 2003 Canberra bushfires. Dr Ruth Parslow found that experience of this disaster triggered increased tobacco use in the youngest age group regardless of whether this experience resulted in Post Traumatic Stress symptoms. She concludes that public health information provided to communities and health care providers should note that increase in this preventable health risk may occur as a result of individuals experiencing trauma.
Childhood adversity and adult personality
Dr Setphen Rosenman has found that childhood domestic activity has substantial associations with clinically important aspects of personality. High levels of childhood adversity increase the risk of high neuroticism (anxious personality traits) and negative thoughts. However, maternal depression is "pre-eminent among adversities predicting later disadvantageous traits." The effects of childhood adversity continue throughout the lifespan in both men and women. The results of this study emphasise the importance of childhood domestic adversity, in particular, maternal psychological il-health, as a target for preventative intervention for psychological difficulties at all ages.
Genetic analysis of the PATH data
Androgen receptor gene
Previous research has reported associations between adverse childhood experiences (including parental divorce), early menache and early sexual activity, possibly due to a polymorphism (a variation) of the androgen receptor gene predisposing fathers to behaviours that include family abandonment and their daughters to early menache and sexual activity, and less stable relationships. Professor Tony Jorm analysed PATH data to test this hypothesis and found that those women who reported adverse childhood experiences within their family aslo experienced an earlier menache and earlier sexual activity. However, the androgen receptor gene polymorphism was unrelated to adverse fathering behaviour or to marital breakdown.
Serotonin neurotransmitter gene
Currently two PhD students are analysing the genetic datra from the PATH project. Philip Chipman is investigating the association between variations in two genees involved in the functionin of the neurotransmitter, serotonin, and vulnerability to anxiety and deprssion. Serotonin levels tend to be low in people who are depressed adn many antidepressive drugs work by increasing the level of available serotonin. Phil is also explroing any interactions between these genes, anxiety and depression, environmental risk factors sucha s childhood adversity, or recetn life stresses and personality traits.
Karen Mather is also working on DNA from the PATH project, relating to genes and ageing.
Apolipoprotein E (APOE) gene
It is known that having a certain allele (varient) E4 of the gene APOE increases the likelihood of developing Alzheimer's disease in later life. It is possible that having this varient also has an effect in cognitive functioning earlier in life. Using PATH data it was found that, although cognitive performance declined with age, there was no effect of the E4 allele at any age. These results suggest that decline in cognitive performance with age must not be due to preclinical Alzheimer's disease.
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Results from the Brain MRI Study
Hippocampal and amygdalar volumes and handedness
Associate Professor Kaarin Anstey and coleagues have investigated the assocaiton between hippocampal and amygdala volumes, as determined by manual tracing, and right or left handedness. (The hippocampus is important for converting short term memory to more permanent memory while the amygdala plays an important role in emotions). They found that, after adjusting for intracranial volume, women had larger hippocampi than men. Hippocampal volume was found to be larger in left-handed women than right-handed women while there was no difference in men. The results of this study are clinically significant in conditions where reduction in hippocampal volume is used as a clinical indicator such as temporal lobe epilepsy, schizophrenia and Alzheimer's disease. They raise the possibility that some of the individual differences in prevalence and disease progression may be explained by gender and handedness. It is possible that a large hippocampus reflects greater brain reserve in women, and particularly left-handed women, a group who have a lower incidence of dementia.
White Matter Hyperintensities (WHMs) and Health
Over the last year, a number of researchers have been examining ‘white matter hyperintensities' (WMHs). These are very small areas in the white matter of the brain that show up as bright white patches on MRI scans. These are regions of the brain that have been damaged, possibly by tiny strokes or reduced blood flow to the region.
Professor Perminder Sachdev, Dr Wei Wen and colleagues has examined the impact of WMHs on specific areas of physical health and cognitive functioning. They found that WMHs are common, although mild in this age group, with women having slightly more lesions than men. WMHs were found to be significantly positively associated with poorer reported physical health and disability, as well as with the tests of motor performance and reaction time. These results suggest that people in their early 60's may suffer physical impairment as a result of the these white matter lesions. More research into both risk and protective factors involved in the formation of WMHs could lead to the development of effective prevention strategies.
WHM and depression
Furthering the work in this area, Tony Jorm and others have looked at the relationship between the total amount of WMHs and levels of depression. Previous studies have found an association between WMHs and depression in elderly groups. Analysis of the younger PATH sample also showed this association. However, this association disappeared when physical disability and smoking were taken into account. One interpretation of this is that WMHs cause physical disability, which in turn causes depression. Wave 2 MRI data will allow the causal relationship to be explored more fully.
Effects of homocysteine
HIgh levels of homocysteine have been shown to increase the risk of cascular disesae and some studies have shown an association between high homocysteine levels and poor cognitive performance. Analysis of PATH data found a positive association between teh amount of WMHs adn the level of homocysteine in the blood for men only. HIgher levels of homocysteine were associated with poorer cognitive performance, but this is probably not a direct relationship but rather mediated through WHMs as an intervening variable. These associations have been found in a younger, healthier sample than previous studies and suggest that homocysteine is having a deleterious effect on the brain before it actually contributes to increased strokes, brain atrophy and Alzheimer's disease.
Homocysteine and folate
Further study has explored the relationship between low folic acid and vitamin B12 and high homocysteine levels as possible predictors of depression. This association has been found previously in some studies. Low folic acid and high homocysteine, but not low vitamin B12 predicted depressive symptoms. These results suggest that folic acid could play a role in the alleviation of depressive symptoms and that levels of homocysteine should also be considered in the treatment of depression. CMHR, in collaboration with beyondblue: the national depression initiative are currently undertaking a randomised control trial looking at, in part, the role of folate in preventing depression in the elderly. See Beyond Ageing Project
Hormone Replacement Therapy (HRT) and cognition
There is some evidence to suggest that HRT may protect the brain from neurological change and the development of dementia. Lee-Fay Low, a recently completed PhD student at CMHR, has examined the volume of a number of brain structures using data from the MRI sub-study. She found no dfference between those who were using HRT, those who had previously used HRT and those who had never used HRT. Continuing this work Lee-Fay looked at the association between HRT and cognitive performance but again found no difference.
Lung function, cognitive impairment and brain atrophy
Examining data from the 60-64 plus age group, Perminder Sachdev found that decreased lung function was related to poorer cognitive function and increased brain atrophy. The results of this study have practical implications. Smoking is known to reduce lung function and increase the risk of vascular disease and stopping smoking at any age is known to improve lung function. The fact that the brain effects seen here are apparent in the early 60s age group suggests that preventative intervention should occur early in life and be life long.
Alcohol, brain atrophy and WMHs
Kaarin Anstey found that there was a positive association between highter weekly alcohol consumption and brain atrophy. In women, the detrimental effects of alcohol on the brain appear to occur at lower levels of consumption. However alcohol consumption was not associated with WMHs, or hippocampal, amygdale or corpus callosum volumes. Longitudinal follow up of these participants will allow for examination of how alcohol consumption affects further brain atrophy and whether alcohol-related atrophy affects brain reserve in relation to demetia risk.
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PATH Publications
Anstey K.J., Windsor T., Jorm A.F., Christensen H., & Rodgers,
B. (2004) The association of pulmonary function with
cognitive performance in early, middle and late adulthood. Gerontology,
50:230-234.
Anstey K, Dear K, Christensen H, Jorm A (2005) Biomarkers,
health, lifestyle and demographic correlates of reaction time performance
in early, middle and late adulthood. Quarterly Journal of Experimental
Psychology, 58A (1), 5-21.
Anstey, K. J., Maller, J. J., Reglade-Meslin, C., Christensen, H., Jorm,
A.F., Wen, W. & Sachdev, P. (2004) Hippocampal
and Amygdalar Volumes in Relation to Handedness in Adults Aged 60 to
64. Aging Neurorepor, 15, 2825-2820.
Anstey KJ, Windsor TD, Rodgers B, Jorm AF, Christensen H. (2005)
Lower cognitive test scores observed in alcohol abstainers are associated
with demographic, personality, and biological factors: the PATH Through
Life Project. Addiction 100,1291-1301.
Anstey KJ, Butterworth P, Jorm AF, Christensen H, Rodgers B & Windsor
TS (2004) A population survey found an associations
between self-reports of traumatic brain injury and increased psychiatric
symptoms. Journal of Clinical Epidemiology, 57, 1202-1209.
Anstey K, Dear K, Christensen H, Jorm A (2005) Biomarkers,
health, lifestyle and demographic correlates of reaction time performance
in early, middle and late adulthood. Quarterly Journal of Experimental
Psychology, 58A (1), 5-21.
Butterworth, P., Anstey, K., Jorm, A.F., & Rodgers, B. (2004).
Results from a community survey demonstrated cohort differences in the
lifetime prevalence of self-reported head injury. Journal of
Clinical Epidemiology, 57 (7), 742-748.
Caldwell, T.M., Rodgers, B., Jorm, A.F., Christensen, H., Jacomb, P.A.,
Korten, A.E. & Lynskey, M.T. (2002). Patterns
of association between alcohol consumption and symptoms of depression
and anxiety in young adults. Addiction, 97, 583-594.
Christensen H, Dear KBG, Anstey KJ, Parslow RA, Sachdev P, Jorm AF (2005)
Within occasion Intra-individual variability and
pre-clinical diagnostic status: Is intra-individual variability an indicator
of Mild Cognitive Impairment. Neuropsychology, 19 (3); 309-317.
D'Souza, R.M., Stradzins, L., Lim, L., Broom, D., & Rodgers, B.
(2003). Work and health in a contemporary society:
Demands, control and insecurity. Journal of Epidemiology and
Community Health, 57, 849-854.
D’Souza RM, Strazdins L, Clements MS, Broom DH, Parslow R, Rodgers
B. (2005) The health effects of jobs: status, working
conditions or both? New Zealand Journal of Public Health.29:222-228.
Jacomb P, Maxwell K, Christensen H, Rodgers B, Jorm A. (2003) Computer-assisted
self-interviewing (CASI) in a large community survey: Some methodological
issues. Australasian Epidemiologist, 10, 34-37.
Jorm, A.F., Korten, A.E., Rodgers, B., Jacomb, P.A. & Christensen,
H. (2002). Sexual orientation and mental health:
Results from a community survey of young and middle-aged adults.
British Journal of Psychiatry, 180, 423-427.
Jorm, A.F., Dear, K.B.G., Rodgers, B. & Christensen, H. (2003).
Interaction between mother’s and father’s affection as a
risk factor for anxiety and depression symptoms: Evidence for increased
risk in adults who rate their father as having been more affectionate
than their mother. Social Psychiatry and Psychiatric Epidemiology,
38, 173-179.
Jorm, A.F., Korten, A.E., Christensen, H., Jacomb, P.A., Rodgers, B.
& Parslow, R.A. (2003). Association of obesity
with anxiety, depression and emotional well-being: A community survey.
Australian and New Zealand Journal of Public Health. 27, 434-440.
Jorm, A.F., Dear, K.B.G., Rodgers, B. & Christensen, H. (2003).
Cohort difference in sexual orientation: results
from a large age-stratified population sample. Gerontology. 49,
392-395.
Jorm, A.F., Anstey, K.J., Christensen, H. & Rodgers, B.(2004) Gender
differences in cognitive abilities: The mediating role of health state
and health habits. Intelligence. 32, 7-23.
Jorm, A.F., Christensen, H., Rodgers, B., Jacomb, P.A. & Easteal,
S. (2004). Association of adverse childhood experiences,
age of menarche and adult reproductive behavior: Does the androgen receptor
gene play a role? American Journal of Medical Genetics (Neuropsychiatric
Genetics)125B: 105-111.
Jorm, A.F. & Christensen, H. (2004). Religiosity
and personality: Evidence for non-linear associations. Personality
and Individual Differences 36: 1433-1441.
Jorm, A.F., Anstey, K.J., Christensen, H., de Plater, G., Kumar, R.,
Wen, W. & Sachdev, P. (2005). MRI hyperintensities
and depressive symptoms in a community sample of 60-64 year old individuals.
American Journal of Psychiatry. 162:699-704.
Jorm, A.F., Butterworth, P., Anstey, K.J., Christensen, H., Easteal,
S., Maller, J., Mather, K.A., Turakulov, R.I., Wen, W. & Sachdev,
P. (2004). Memory complaints in a community sample
aged 60-64 years: Associations with cognitive functioning, psychiatric
symptoms, medical conditions, APOE genotype, hippocampus and amygdala
volumes, and white-matter hyperintensities. Psychological Medicine.
34: 1495-1506.
Jorm, A.F, Rodgers, B., Christensen, H. (2004) Use
of medications to enhance memory in a large community sample of 60-64
year olds. International Psychogeriatrics. 16:2, 209-217.
Kumar, R., Dear, K.B.G., Christensen, H., Ilschner, S., Jorm, A.F.,
Meslin, C., Rosenman, S.J. & Sachdev, P.S. (2005). Prevalence
of mild cognitive impairment (MCI) in 60 to 64 year old community-dwelling
individuals: The Personality and Total Health (PATH) Through Life 60+
Study. Dementia and Geriatric Cognitive Disorders. 19:67-74.
Low L-F, Anstey KJ, Jorm AF, Rodgers B, Christensen H. (2005)Reproductive
period and cognitive function in a representative sample of naturally
postmenopausal women aged 60-64. Climacteric 8, 380-389.
Low L-F, Anstey KJ, Maller J, Kumar R, Wen W, Lux O, Salonikas C, Naidoo
D, Sachdev P. (2006) Hormone replacement therapy,
brain volumes and white matter in postmenopausal women aged 60-64.
Neuroreport 17: 101-104.
Low L-F, Anstey KJ, Jorm AJ, Christensen H, Rodgers B (2006) Hormone
replacement therapy and cognition in an Australian representative sample
aged 60-64 years. Maturitas. 54, 86-94
Maller JJ, Réglade-Meslin C, Anstey KJ & Sachdev P (2006)
Sex and symmetry differences in hippocampal volumetrics:
Before and beyond the opening of the crus of the fornix. Hippocampus
16:80-90.
Parslow, R., Jorm, A, Christensen, H., Rodgers, B., Jacomb, P. (2002).
Factors associated with young adults' obtaining general
practitioner services. Australian Health Review, 25, 109-118.
Parslow RA, Jorm AF. (2003) The impact of pet ownership on health and
health service use: Results from a community sample of Australians aged
40 to 44. Anthrozoos, 16 (1), 43-56.
Parslow RA, Jorm AF. (2003) Pet ownership and risk
factors for cardiovascular disease: another look. Medical Journal
of Australia. 179, 466-468.
Parslow RA, Jorm AF, Butterworth P, Jacomb PA, Rodgers B.(2004) An
examination of seasonality experienced by Australians living a continental
temperate climate zone. J Affective Disorders, 80, 181-190.
Parslow R, Jorm A, Christensen H, Rodgers B. (2004) Use
of medical services after participation in a community-based epidemiological
health survey. Social Psychiatry and Psychiatric Epidemiology.
39: 311-317.
Parslow, R.A., Jorm, A.F., Christensen, H., Jacomb, P.A. & Rodgers,
B. (2004). Gender differences in factors affecting
use of health services: An analysis of a community study of middle-aged
and older Australians. Social Science and Medicine, 59, 2121-2129..
Parslow RA, Jorm AF, Christensen H, Rodgers B, Strazdins L, D'Souza
RM (2004) The associations between work stress and
mental health: A comparison of organizationally employed and self-employed
workers. Work and Stress.18:3, 231-244.
Parslow, Jorm, Christensen, Broom, Srtrazdins, D'Souza. (2004) The
impact of employee level and work stress on mental health and GP service
use: an analysis of a sample of Australian government employees.
Biomed Central-Public Health. 4:41.
Parslow RA, Jorm AF.(2004) Use of prescription medications
and complementary and alternative medicines to treat depressive and
anxiety symptoms: results from a community sample. Journal of
Affective Disorders. 82: 77-84.
Parslow RA, Jorm AF, Christensen H, Rodgers B, Jacomb P (2005). Pet
ownership and health in older adults: Findings from a survey of 2551
community-based Australians aged 60 to 64. Gerontology 51:40-47.
Parslow R, Sachdev P, Salonikis C, Lux O, Jorm AF, Naidoo D (2005).
Associations between plasma antioxidants and hypertension
in a community-based sample of 415 Australians Aged 60-64. Journal
of Human Hypertension.19:219-226
Parslow RA, Jorm AF, Christensen H. (2005) Associations
of pre-trauma attributes and trauma exposure with screening positive
for PTSD: analysis of a community-based study of 2085 young adults.
Psychological Medicine. Oct 28;:1-9
Parslow RA, Jorm AF (2006)A: Tobacco use after experiencing
a major natural disaster. Analysis of a longitudinal study of 2063 young
adults. Addiction 101, 1044-1050.
Parslow RA, Jorm AF, Christensen H, Mackinnon A. (2006) A
new instrument to measure engagement in life: factor analysis and associations
with sociodemographic, occupational and cognitive variables.
Gerontology (Behavioral Sciences) 52: 188-198.
Prichard Z, Easteal S. 2006. Characterization of
simple sequence repeat variants linked to candidate genes for behavioral
phenotypes. Hum Mutat 27(1):120.
Rodgers B, Windsor TD, Anstey KA, Dear K, Jorm AF, Christensen H. (2005)
Non-linear relationships between cognitive function
and alcohol consumption in young, middle aged and older adults: the
PATH Through Life Project. Addiction.100, 1280-1290.
Rosenman, S.J. & Rodgers, B. (2004). Childhood
adversity in an Australian population. Social Psychiatry and
Psychiatric Epidemiology. Sep;39(9): 695-702.
Rosenman S and Rodgers B. (2006). Childhood adversity
and adult personality. Aust & NZ J Psychiatry 40: 482-490.
Sachdev, P.S., Wen, W., Christensen, H. & Jorm, A.F. (2005). White
matter hyperintensities are related to physical disability and poor
motor function. Journal of Neurology, Neurosurgery and Psychiatry.
76:362-7.
Sachdev, P.S., Parslow, R.A., Lux, O., Salonikas, C., Wen, W., Naidoo,
D., Christensen, H. & Jorm, A.F. (2005). Relationship
of homocysteine, folic acid and vitamin B12 with depression in a middle-aged
community sample. Psychological Medicine. 35:529-538.
Sachdev P, Parslow R, Salonikas C, Lux O, Wen W, Kumar R, Naidoo D,
Christensen H Jorm A. (2004) Homocysteine and the
brain in mid-adult life: evidence for an increased risk of leukoaraiosis
in men. Archives of Neurology. 61: 1369-1376.
Sachdev PS, Anstey KJ, Parslow RA, Wen W, Maller J, Kumar R, Christensen
H, Jorm AJ. (2006) Pulmonary function, cognitive
impairment and brain atrophy in a middle-aged community sample.
Dementia and Geriatric Cognitive Disorders. 21: 300-308.
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