SummaryThe City Eye Study is a nine year longitudinal prospective epidemiological study.During the first three year phase the study recruited 1029 volunteers, aged between 54 and 65 years, primarily from companies and organisations working in or around the City of London.The analysis of the first cohort data shows a significant association between nuclear lens opacities and moderate to heavy cigarette smoking. The Relative Risk for nuclear lens opacity and cigarette smoking ranges from 1.0 for past light-smokers through 2.6 for past heavy-smokers, to 2.9 for present heavy smokers.

Objectives Cognitive screening via telehealth is increasingly employed, particularly during the COVID‐19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26‐point telephone adaptation of the Mini‐Mental State Examination (tMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a telephone adaptation of the urban version of the Kimberley Indigenous Cognitive Assessment short‐form (tKICA screen). Methods A sub‐sample (n = 20) of participants (aged 55–69 years; 11 women) who had completed an in‐person cognitive assessment (MMSE and KICA screen) within the past 6 months as part of the Koori Growing Old Well Study completed telephone‐based cognitive testing without an assistant. Results There was moderate correlation and reasonable agreement between MMSE versions (rs = 0.33; p = 0.2), although the limits of agreement were unacceptably wide (−4.1 and 4.8 points difference). Poorer performance was seen on the tMMSE for Season (p = 0.02) and Phrase (p = 0.02) items, and better performance for three‐word Recall (p = 0.03). KICA‐screen versions were poorly correlated (rs = 0.20; p = 0.4) with telephone scoring a mean of 2.17 points below the face‐to‐face score, greater bias observed at the lower end of the performance and worse scores for Season (p = 0.02) and Recall (p = 0.001) items. Age and education were not associated with telephone screening performance. Hearing impairment was associated with poorer performance on the tKICA screen (p = 0.04) but not the tMMSE (p = 0.6). Conclusions Results indicate that telephone administration of the MMSE and/or KICA screen is not equivalent to in‐person testing for older Aboriginal people, and further revision and evaluation are required.

Background Rates of dementia and cognitive impairment in Australian Aboriginal and Torres Strait Islander populations are 3‐5 times higher than in the overall population. In addition, under‐detection of these conditions has been consistently confirmed, particularly in primary care. A national co‐design project called the Let’s CHAT (Community Health Approach To) Dementia aims to optimise detection rates and management of dementia and cognitive impairment in Indigenous primary care contexts. This will occur through the co‐development of a model of care, and outcome measures include data profiling the dementia risk of older Indigenous persons and current management of patients with confirmed or suspected cognitive impairment or dementia Method Six‐monthly medical record audits of patients aged 50 and over recording: basic demographic information, presence of dementia risk factors, current care practices in relation to dementia and co‐morbid conditions of ageing. Result Audits were conducted on patients (n=1675) in 12 primary health services across Australia. The mean age of patients was 60.3 (8.3). The top ten risk factors documented overall were: hypertension (50.9%), polypharmacy (46.7%), current smoking (43%), diabetes (42.9%), dyslipidaemia (41.1%), obesity (35%), depression (30%), mental health concerns (25.9%) cardiovascular disease (25.6.%) and low physical activity (19.1%), but there was some inter‐service variation in risk factor profiles. Documented evidence of health service assessment for, and investigation of, cognitive impairment was limited. Use and type of diagnostic tools varied widely between services (e.g. MMSE used with 0.6%‐45.9% of sample, KICA (culturally appropriate cognitive assessment tool) used with 0.0%‐5.0% of sample). Diagnoses of dementia and cognitive impairment (combined = 3.8%) are well below known prevalence rates in these populations (∼20%), although there is variation from service to service (range = 0.8% ‐8.9%). Conclusion The audit data confirm low rates of detection and low levels of assessment activity for cognitive impairment and dementia in Indigenous primary care contexts, while the population displays a high risk for developing these conditions. These findings underscore the need for more focus on detection activities in primary health care, as well as reinforcing the importance of preventive health care strategies.