MRC National Survey of Health

281 views
251 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
281
On SlideShare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

MRC National Survey of Health

  1. 1. 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
  2. 2. MRC NSHD Review 2005-2008: NSHD has a research and resource function <ul><li>Sept 2005: Review of NSHD </li></ul><ul><li>2005- 2006: Search for new Director. </li></ul><ul><li>Sept 2006: DK appointed. MRC agrees to set up new Unit </li></ul><ul><li>Jan 2007: Mike Wadsworth  Diana Kuh </li></ul><ul><li>May 2007: Submission of 5-year strategic & scientific plans </li></ul><ul><li>Nov 2007: HSPHRB Board approve funding of Unit & clinic data collection </li></ul><ul><li>Jan 2008: MRC Unit for Lifelong Health and Ageing </li></ul>
  3. 3. MRC Unit for Lifelong Health & Ageing <ul><li>Mission: To develop the MRC National Survey of Health & Development into a world class, interdisciplinary life course study of ageing </li></ul>
  4. 4. Maximising the scientific potential of NSHD <ul><li>Scientific discovery of life course influences on normal and healthy ageing </li></ul><ul><li>Physical and cognitive capability – the capacity to undertake the physical and mental tasks of daily living </li></ul><ul><li>Musculoskeletal and cardiovascular function on which capability depends </li></ul><ul><li>New initiatives on which the scientific plans depend </li></ul><ul><ul><li>Enriching the NSHD: clinic data collection 2008-2010 </li></ul></ul><ul><ul><li>Expanding collaborations & capacity building </li></ul></ul><ul><ul><li>More inter-cohort research – secured additional funding </li></ul></ul><ul><ul><li>Facilitate genetic studies of lifelong health and ageing </li></ul></ul><ul><ul><ul><li>New DNA repository 2008  </li></ul></ul></ul><ul><ul><li>Develop e-science capability to facilitate data sharing </li></ul></ul><ul><ul><li>Governance arrangements </li></ul></ul>
  5. 5. Seven interdisciplinary & integrated NSHD scientific programmes <ul><li>Physical capability & musculoskeletal ageing </li></ul><ul><li>Cognitive capability & ageing </li></ul><ul><li>Cardiovascular ageing </li></ul><ul><li>Mental health & wellbeing </li></ul><ul><li>Growth, functional trajectories </li></ul><ul><li>Lifetime lifestyles & social environment </li></ul><ul><li>Nutrition through the life course </li></ul>
  6. 6. 19 follow ups 1948-1977 (2-31 years) <ul><li>Heights & weights at 2,4,6,7,11,15, 26y </li></ul><ul><li>Cognitive development assessed at 8,11,15y & educational achievement </li></ul><ul><li>Diet: Breastfeeding , weaning, 24 hr recall at 2y </li></ul><ul><li>Developmental milestones, physical co-ordination </li></ul><ul><li>Behaviour & temperament </li></ul><ul><li>Mortality, hospital admissions, reported health </li></ul><ul><li>Marital, fertility histories & work histories </li></ul><ul><li>Social & physical environment at all contacts </li></ul><ul><li>Study of offspring children 4 & 8 y </li></ul><ul><li>Dr James Douglas </li></ul><ul><li>Key texts </li></ul><ul><li>Children under five 1958 </li></ul><ul><li>The home and the school 1964 </li></ul><ul><li>All our future 1968 </li></ul>MRC Unit for the Study of Environmental Factors in Mental & PhysicaI Illness established 1962
  7. 7. NSHD follow ups since 1982 focus on life course social & biological risks for adult health & function and age related change <ul><li>Blood pressure, lung function, body size, mental health at 36,43,53y </li></ul><ul><li>Cognitive performance at 43 & 53 years </li></ul><ul><ul><li>Verbal memory, search speed & concentration, general ability </li></ul></ul><ul><li>Physical performance at 53y </li></ul><ul><ul><li>Grip strength, balance, chair rises </li></ul></ul><ul><li>Age at menopause 47-53,57y </li></ul><ul><li>Blood samples at 53 y for DNA & cell lines, HbA1c, lipids </li></ul><ul><li>Mortality & cancer registrations, hospital admissions, health </li></ul><ul><li>Diet, lifestyle, life circumstances </li></ul><ul><li>Professor Mike Wadsworth </li></ul>
  8. 8. Clinic data collection 60-64 yrs Feasibility study 2006-2007 Main study 2008-2010 <ul><li>Repeat measures of function, body size, & life circumstances </li></ul><ul><li>Cardiac & vascular structure & function </li></ul><ul><li>Musculoskeletal function </li></ul><ul><li>Fasting blood & overnight urine samples ( e nergy metabolism, kidney function, Inflammation, oxidative stress, bone resorption & formation, neuro-endocrine function) </li></ul>Manchester clinical research facility
  9. 9. NSHD clinic data collection Clinical Research Facilities Cardiff
  10. 10. Summary of clinic data collection Postal questionnaire (80% response to date) Pre-assessment questionnaire Pre-assessment questionnaire + Clinic visit + Home visit (>60% in Manchester) (additional 20%) Send out clinic invitation (CRF)
  11. 11. NSHD new clinic data collection: questionnaire-based data and performance tests <ul><li>Household size </li></ul><ul><li>Housing tenure </li></ul><ul><li>Own/partner SEP </li></ul><ul><li>Work status & retirement </li></ul><ul><li>Household income & sources </li></ul><ul><li>Financial hardship </li></ul><ul><li>Marital & fertility histories </li></ul><ul><li>Spare time activities </li></ul><ul><li>Social networks & life events </li></ul><ul><li>Caring for others </li></ul><ul><li>Smoking & drinking habits </li></ul><ul><li>Exercise assessment (EPAC2) </li></ul><ul><li>Edinburgh wellbeing Q </li></ul><ul><li>Neighbourhood satisfaction </li></ul><ul><li>Life satisfaction </li></ul><ul><li>SF36 </li></ul><ul><li>Self reported health problems CVD events, signs & symptoms (incl. Rose angina) </li></ul><ul><li>Bronchitis questionnaire </li></ul><ul><li>Fracture history </li></ul><ul><li>Medication </li></ul><ul><li>Hospital admissions </li></ul><ul><li>Close persons questionnaire </li></ul><ul><li>GHQ28 </li></ul><ul><li>Anthropometry </li></ul><ul><li>ADLs </li></ul><ul><li>Grip strength, chair rises, balance stand, timed get up & go </li></ul><ul><li>Reaction time, word list memory, visual search </li></ul><ul><li>Spirometry </li></ul>
  12. 12. NSHD clinic data collection:cardiac & vascular measures Professor John Deanfield & Dr Denis Pellerin, UCL <ul><li>Cardiac measures include : </li></ul><ul><li>Global LV diastolic function </li></ul><ul><li>Global systolic function </li></ul><ul><li>LV Measurements </li></ul><ul><li>Proximal aorta measurements </li></ul><ul><li>Vascular measures include : </li></ul><ul><li>Carotid-femoral pulse wave velocity (arterial stiffness) </li></ul><ul><li>Radial pulse wave analysis (indirect measure of arterial stiffness) </li></ul><ul><li>Carotid distensibility (local measure of arterial compliance) </li></ul><ul><li>Carotid Intima-Media Thickness (IMT) (local measures of vessel wall) </li></ul>
  13. 13. NSHD clinic data collection: other CVD measures <ul><li>ECG (Professor Peter MacFarlane, Glasgow University) </li></ul><ul><li>Heart rate variability : beat to beat alterations in heart rate - indicator of autonomic regulation of circulatory function (Professor Peter Friberg, Gothenburg University) </li></ul><ul><li>Blood pressure : 4 th repeated measure since 36 years </li></ul><ul><li>Step test (sub-maximal): MRC Epidemiology Unit, Cambridge </li></ul><ul><li>Free living activity (over 5 days) </li></ul>
  14. 14. NSHD clinic data collection: bone measures Professor Judith Adams, Manchester University <ul><li>Bone measures include: </li></ul><ul><li>DXA hip </li></ul><ul><li>total, femoral neck, trochanter, Ward’s </li></ul><ul><li>Lumbar spine (L1-4) </li></ul><ul><li>Whole body & region BMD, fat & lean mass </li></ul><ul><li>vertebral fracture assessment </li></ul><ul><li>Aortic calcification score </li></ul><ul><li>pQCT radius </li></ul><ul><li>4% </li></ul><ul><li>50% </li></ul>
  15. 15. NSHD clinic data collection: challenges <ul><li>Balance between number of sites and participant travel </li></ul><ul><li>Complexity </li></ul><ul><li>Integration of nurses, echotechnicians, bone technicians </li></ul><ul><li>Clinically relevant results: duty of care </li></ul><ul><li>Increased regulatory environment </li></ul><ul><ul><li>Raised awareness of security issues by participants </li></ul></ul><ul><ul><li>Secure transfer of clinical and other data </li></ul></ul><ul><li>Volume of data for checking, co-ordinating with core reading labs & merging into NSHD data base </li></ul><ul><li>Strategies for maximising the scientific investment </li></ul>
  16. 16. WTCRF MRC HNR MRC Epi MRC NSHD Cardiology/ DXA/ hosp lab Participants Postal Clinic or home visit GOS Heart hospital Manchester CRF, Imaging Science GP practice ECG Glasgow
  17. 17. Flow Chart for processing of NSHD blood & urine samples (Dr Alison Lennox, MRC HNR)
  18. 18. Expanding collaborations & capacity building <ul><li>Key collaborators sharing responsibility for NSHD programmes & data collection </li></ul><ul><li>Externally funded initiatives with collaborators </li></ul><ul><ul><li>NSHD based </li></ul></ul><ul><ul><li>Inter-cohort comparative research </li></ul></ul><ul><ul><li>Genetic studies of lifelong health & ageing </li></ul></ul><ul><li>Funding of 3 NIA life course fellowships </li></ul><ul><li>Shared fellowships & studentships </li></ul>
  19. 19. HALCyon Healthy Ageing across the Life Course <ul><li>LHA is leading a collaborative programme: </li></ul><ul><li>9 UK cohorts born 1921 to 1958 </li></ul><ul><li>23 investigators, 19 collaborators </li></ul><ul><li>8 projects </li></ul><ul><li>Aim is to improve the lives of older people by understanding how healthy ageing is influenced by factors operating across the whole of life. </li></ul><ul><li>Indicators of healthy ageing being studied include: </li></ul><ul><li>the ability to undertake the physical and cognitive tasks of daily living; </li></ul><ul><li>social and psychological wellbeing; </li></ul><ul><li>genetic and other biological ageing processes. </li></ul>
  20. 20. HALCyon cohorts ELSA/Caerphilly NCDS 1958 NSHD 1946 Herts 1931-39 Aberdeen/Lothian 1936 Boyd Orr 1925-37 Herts 1920-30 Lothian 1921 Late A Mid A Early A Child Birth Cohort & birth yr
  21. 21. FALCon Function Across the Life Course <ul><li>Funded by Population Health Sciences Research Network </li></ul><ul><li>LHA are leading this project which uses data from cohorts based at MRC Units and Centres. </li></ul><ul><li>The aims are: </li></ul><ul><li>to develop statistical methods to allow pooling of data from several cohorts </li></ul><ul><li>to apply the methodology to model physical, cognitive and cardiovascular trajectories across the whole of life </li></ul><ul><li>to recommend appropriate measures of function at different ages and their timing. </li></ul>
  22. 22. NSHD E-science initiatives <ul><li>Manage and preserve the ever expanding data resource: </li></ul><ul><ul><li>Existing NSHD data collected over 60 years (15,000 variables) </li></ul></ul><ul><ul><li>New clinic and genetic data </li></ul></ul><ul><ul><li>Data from other cohorts for comparative research. </li></ul></ul><ul><li>Facilitate data discovery and use </li></ul><ul><li>Maintain data security and study reputation. </li></ul><ul><li>The new LHA Web Data Access system will: </li></ul><ul><li>Integrate the various sources of data, metadata and semantic classifications </li></ul><ul><li>Manage data requests and analysis </li></ul><ul><li>Act as an exemplar for the MRC Data Preservation and Sharing Initiative. </li></ul>
  23. 23. 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
  24. 24. Acknowledgements <ul><li>My predecessors </li></ul><ul><li>LHA team </li></ul><ul><li>LHA/NSHD Collaborators </li></ul><ul><li>Lifelong study participants </li></ul><ul><li>Thank you for listening! </li></ul>

×