Mark Speechley, PhD

Dr.M Speechley Professor
P: 519.661.2111 ext: 86266
F: 519.661.3766
E-mail: speechly@uwo.ca

I am an epidemiologist who works primarily as a methodologist, applying the principles of epidemiology and biostatistics to conditions associated with human aging including neurodegenerative and musculoskeletal disorders. These include falling in older adults, stroke rehabilitation, frailty, Parkinson’s Disease, dementia, and levels of physical activity. In the area of supporting trainees, I have supervised 14 PhD and 32 MSc graduates, mostly in Epidemiology and Biostatistics.

In the area of measurement, with colleagues and graduate students I have developed original scales to measure i) purposive and habitual physical activity (‘Phone-FITT’, Gill et al., J Aging Physical Act 2008;16(3):292-315), ii) willingness to join a disease-specific (joint replacement) patient registry, (Terry et al, Health Policy 2008;85(3):293-304), iii) pre-radiographic symptoms of early osteoarthritis (‘QUICKS’, Clark et al., Phys Ther, 2014;94(1):111-20), and iv) fibromyalgia prevalence (‘LFESSQ’, White et al., J Rheumatol 1999;26(4)880-4). I also i) helped validate an existing frailty scale in older surgical candidates (Dasgupta et al., Arch Gerontol Geriatr 2009;48(1)78-83, ii) evaluated the addition of experiential questions to a disease-specific quality of life scale for people living with Parkinson’s Disease (Gofton et al., J Palliat Care;2015;31(4):213-20, iii) critically evaluated the methodological history of the Alzheimer’s Disease Assessment Scale – Cognitive Subscale (Kueper et al., J Alzheimers Dis 2018;63(2):423-444) and iv) participated in a measurement consensus exercise for shared measures of mobility and cognition (Montero-Odasso et al., J Gerontol A Biol Sci Med Sci 2019;74(6):897-909. In a sample of people living in the community after receiving a psychiatric diagnosis, I applied a pooled index approach to produce a single outcome variable by combining four outcome measures (Speechley et al., Health Serv Outcomes Res Methodol 2009 9(2):133-143.) The pooled index is guaranteed to have a smaller pooled standard deviation than the source variables, increasing the signal/noise ratio, and also prevents the alpha inflation problem posed by separate hypothesis tests on multiple outcome variables.

In the area of research design, I have helped design and analyze both observational (prospective cohort) and experimental (random control trial, including partial factorial) studies. Analysis of cohort studies includes the first prospective community-based study of falls in older adults (Tinetti et al., N Engl J Med 1988;319(26):1701-1707). Design of cohort studies includes the Gait and Brain Study (e.g. Montero-Odasso et al., J Gerontol A Biol Sci Med Sci 2014;69(11):1415-21) including the analysis of gait and cognitive trajectories (Montero-Odasso et al., J Am Geriatr Soc. 2018;66(9):1676-1683). I was the epidemiologist for the London site of the HEIRS study, which at the time it began was the largest (n = 100,000) genetic screening study ever conducted and to my knowledge the largest (n = 16,000) health study ever done in London Ontario (Adams et al., N Engl J Med. 2005;352:1769-78). Design/analysis of Phase II trials includes donepezil in mild Alzheimer’s (Montero-Odasso et al., J Alzheimers Dis 2015;43(1):193-9 and phlebotomy in non-alcoholic fatty liver disease (Beaton et al., Aliment Pharmacol Ther 2013;37(7):720-9. Phase III trials include evaluations of peer support in osteoporosis (Kloseck et al., Clinical Interventions in Aging 2017;12(823-233), mindfulness interventions for late-life treatment-resistant depression, and for PTSD in first responders (work currently underway); and donepezil in mild Alzheimer’s (Montero-Odasso et al., Eur J Neurol. 2019;26(4):651-659). I played a key role in the partial factorial design of the SYNERGIC trial (Montero-Odasso et al., BMC Geriatr. 2018;18(1):93) that is influencing the design of a soon-to-be launched Canadian study to postpone the onset of dementia through lifestyle modifications.

In the area of knowledge translation, in addition to falls prevention (Speechley M, J Safety Res. 2011 Dec;42(6):453-9) I have authored original scripts based on qualitative research findings to advocate for improved care of older adults living with dementia at home (“Advocating For Hilda”), or in long-term care (“All Behaviour Has Meaning”) and for people living with brain injuries (“It’s No Big Deal”). All three scripts have been presented live, and captured on video, to audiences of caregivers and staff members.

Appointments

Research Cluster Membership

Research Interests

  • Falls Prevention & Injury Epidemiology
  • Rehabilitation & Musculoskeletal Epidemiology
  • Applied methodology (measurement, scale and index development and evaluation)

Education

  • BA Honours Sociology
  • MA Sociology
  • PhD Epidemiology & Biostatistics

Publications (selected)