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MRC National Survey of Health and Development: an update Diana Kuh & LHA & data collection teams Director, MRC N PowerPoint Presentation
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MRC National Survey of Health and Development: an update Diana Kuh & LHA & data collection teams Director, MRC National Survey of Health and Development MRC Unit for Lifelong Health and Ageing Longview, Oxford, October 2 nd 2008.

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slide1

MRC National Survey of Health and Development: an update

Diana Kuh & LHA & data collection teams

Director, MRC National Survey of Health and Development

MRC Unit for Lifelong Health and Ageing

Longview, Oxford, October 2nd 2008

mrc nshd review 2005 2008 nshd has a research and resource function
MRC NSHD Review 2005-2008: NSHD has a research and resource function

Sept 2005: Review of NSHD

2005- 2006: Search for new Director.

Sept 2006: DK appointed. MRC agrees to set up new Unit

Jan 2007: Mike Wadsworth  Diana Kuh

May 2007: Submission of 5-year strategic & scientific plans

Nov 2007: HSPHRB Board approve funding of Unit & clinic data collection

Jan 2008: MRC Unit for Lifelong Health and Ageing

mrc unit for lifelong health ageing
MRC Unit for Lifelong Health & Ageing

Mission: To develop the MRC National Survey of Health & Development into a world class, interdisciplinary life course study of ageing

maximising the scientific potential of nshd
Maximising the scientific potential of NSHD

Scientific discovery of life course influences on normal and healthy ageing

  • Physical and cognitive capability – the capacity to undertake the physical and mental tasks of daily living
  • Musculoskeletal and cardiovascular function on which capability depends

New initiatives on which the scientific plans depend

    • Enriching the NSHD: clinic data collection 2008-2010
    • Expanding collaborations & capacity building
    • More inter-cohort research – secured additional funding
    • Facilitate genetic studies of lifelong health and ageing
      • New DNA repository 2008 
    • Develop e-science capability to facilitate data sharing
    • Governance arrangements
seven interdisciplinary integrated nshd scientific programmes
Seven interdisciplinary & integrated NSHD scientific programmes
  • Physical capability & musculoskeletal ageing
  • Cognitive capability & ageing
  • Cardiovascular ageing
  • Mental health & wellbeing
  • Growth, functional trajectories
  • Lifetime lifestyles & social environment
  • Nutrition through the life course
19 follow ups 1948 1977 2 31 years
Heights & weights at 2,4,6,7,11,15, 26y

Cognitive development assessed at 8,11,15y & educational achievement

Diet: Breastfeeding , weaning, 24 hr recall at 2y

Developmental milestones, physical co-ordination

Behaviour & temperament

Mortality, hospital admissions, reported health

Marital, fertility histories & work histories

Social & physical environment at all contacts

Study of offspring children 4 & 8 y

Dr James Douglas

Key texts

Children under five 1958

The home and the school 1964

All our future 1968

19 follow ups 1948-1977 (2-31 years)

MRC Unit for the Study of EnvironmentalFactors in Mental & PhysicaI Illness established 1962

slide7
Blood pressure, lung function, body size, mental health at 36,43,53y

Cognitive performance at 43 & 53 years

Verbal memory, search speed & concentration, general ability

Physical performance at 53y

Grip strength, balance, chair rises

Age at menopause 47-53,57y

Blood samples at 53 y for DNA & cell lines, HbA1c, lipids

Mortality & cancer registrations, hospital admissions, health

Diet, lifestyle, life circumstances

Professor Mike Wadsworth

NSHD follow ups since 1982focus on life course social & biological risks for adult health & function and age related change
clinic data collection 60 64 yrs feasibility study 2006 2007 main study 2008 2010
Clinic data collection 60-64 yrsFeasibility study 2006-2007Main study 2008-2010

Repeat measures of function, body size, & life circumstances

Cardiac & vascular structure & function

Musculoskeletal function

Fasting blood & overnight urine samples (energy metabolism, kidney function, Inflammation, oxidative stress, bone resorption & formation, neuro-endocrine function)

Manchester clinical research facility

summary of clinic data collection
Summary of clinic data collection

Postal questionnaire

(80% response to date)

Send out clinic invitation (CRF)

Pre-assessment questionnaire Pre-assessment questionnaire

+ Clinic visit + Home visit

(>60% in Manchester) (additional 20%)

nshd new clinic data collection questionnaire based data and performance tests
Household size

Housing tenure

Own/partner SEP

Work status & retirement

Household income & sources

Financial hardship

Marital & fertility histories

Spare time activities

Social networks & life events

Caring for others

Smoking & drinking habits

Exercise assessment (EPAC2)

Edinburgh wellbeing Q

Neighbourhood satisfaction

Life satisfaction

SF36

Self reported health problems CVD events, signs & symptoms (incl. Rose angina)

Bronchitis questionnaire

Fracture history

Medication

Hospital admissions

Close persons questionnaire

GHQ28

Anthropometry

ADLs

Grip strength, chair rises, balance stand, timed get up & go

Reaction time, word list memory, visual search

Spirometry

NSHD new clinic data collection: questionnaire-based data and performance tests
slide12
NSHD clinic data collection:cardiac & vascular measuresProfessor John Deanfield & Dr Denis Pellerin, UCL

Cardiac measures include:

Global LV diastolic function

Global systolic function

LV Measurements

Proximal aorta measurements

Vascular measures include:

Carotid-femoral pulse wave velocity (arterial stiffness)

Radial pulse wave analysis (indirect measure of arterial stiffness)

Carotid distensibility (local measure of arterial compliance)

Carotid Intima-Media Thickness (IMT) (local measures of vessel wall)

nshd clinic data collection other cvd measures
NSHD clinic data collection: other CVD measures

ECG (Professor Peter MacFarlane, Glasgow University)

Heart rate variability: beat to beat alterations in heart rate - indicator of autonomic regulation of circulatory function (Professor Peter Friberg, Gothenburg University)

Blood pressure: 4th repeated measure since 36 years

Step test (sub-maximal): MRC Epidemiology Unit, Cambridge

Free living activity (over 5 days)

nshd clinic data collection bone measures professor judith adams manchester university
NSHD clinic data collection: bone measuresProfessor Judith Adams, Manchester University

Bone measures include:

  • DXA hip
  • total, femoral neck, trochanter, Ward’s
  • Lumbar spine (L1-4)
  • Whole body & region BMD, fat & lean mass
  • vertebral fracture assessment
  • Aortic calcification score
  • pQCT radius
  • 4%
  • 50%
nshd clinic data collection challenges
NSHD clinic data collection: challenges
  • Balance between number of sites and participant travel
  • Complexity
  • Integration of nurses, echotechnicians, bone technicians
  • Clinically relevant results: duty of care
  • Increased regulatory environment
    • Raised awareness of security issues by participants
    • Secure transfer of clinical and other data
  • Volume of data for checking, co-ordinating with core reading labs & merging into NSHD data base
  • Strategies for maximising the scientific investment
slide16

Cardiology/

DXA/

hosp lab

ECG

Glasgow

WTCRF

GP

practice

Manchester

CRF,

Imaging

Science

Clinic

or home

visit

MRC HNR

MRC Epi

Participants

Postal

MRC NSHD

GOS

Heart

hospital

expanding collaborations capacity building

Key collaborators sharing responsibility for NSHD programmes & data collection

Externally funded initiatives with collaborators

NSHD based

Inter-cohort comparative research

Genetic studies of lifelong health & ageing

Funding of 3 NIA life course fellowships

Shared fellowships & studentships

Expanding collaborations & capacity building
halcyon healthy ageing across the life course
HALCyon Healthy Ageing across the Life Course

LHA is leading a collaborative programme:

  • 9 UK cohorts born 1921 to 1958
  • 23 investigators, 19 collaborators
  • 8 projects

Aim is to improve the lives of older people by understanding how healthy ageing is influenced by factors operating across the whole of life.

Indicators of healthy ageing being studied include:

  • the ability to undertake the physical and cognitive tasks of daily living;
  • social and psychological wellbeing;
  • genetic and other biological ageing processes.
falcon function across the life course
FALConFunction Across the Life Course

Funded by Population Health Sciences Research Network

LHA are leading this project which uses data from cohorts based at MRC Units and Centres.

The aims are:

  • to develop statistical methods to allow pooling of data from several cohorts
  • to apply the methodology to model physical, cognitive and cardiovascular trajectories across the whole of life
  • to recommend appropriate measures of function at different ages and their timing.
nshd e science initiatives
NSHD E-science initiatives
  • Manage and preserve the ever expanding data resource:
    • Existing NSHD data collected over 60 years (15,000 variables)
    • New clinic and genetic data
    • Data from other cohorts for comparative research.
  • Facilitate data discovery and use
  • Maintain data security and study reputation.

The new LHA Web Data Access system will:

  • Integrate the various sources of data, metadata and semantic classifications
  • Manage data requests and analysis
  • Act as an exemplar for the MRC Data Preservation and Sharing Initiative.
lha nshd organisational structure
LHA/NSHD Organisational Structure

Governance structure Operational structure

Director

Steering Committee Executive Team

Risk management Cardiac/Vascular & Bone/Muscle

Sub-Committee Project Management Groups

UCL Genetics Advisory Group

Samples Access Advisory Group

acknowledgements
Acknowledgements
  • My predecessors
  • LHA team
  • LHA/NSHD Collaborators
  • Lifelong study participants

Thank you for listening!