Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
MRC National Survey of Health and Development: an update Diana Kuh & LHA & data collection teams Director, MRC National Su...
MRC NSHD Review 2005-2008:  NSHD has a research and resource function <ul><li>Sept 2005:  Review of NSHD </li></ul><ul><li...
MRC Unit for Lifelong Health & Ageing   <ul><li>Mission:  To develop the MRC National Survey of Health & Development into ...
Maximising the scientific potential of NSHD <ul><li>Scientific discovery of life course influences on normal and healthy a...
Seven interdisciplinary & integrated NSHD scientific programmes   <ul><li>Physical capability & musculoskeletal ageing  </...
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 developme...
NSHD follow ups since 1982 focus on life course social & biological risks for adult health & function and age related chan...
Clinic data collection 60-64 yrs Feasibility study 2006-2007 Main study 2008-2010 <ul><li>Repeat measures of function, bod...
NSHD clinic data collection  Clinical Research Facilities  Cardiff
Summary of clinic data collection Postal questionnaire  (80% response to date)  Pre-assessment questionnaire   Pre-assessm...
NSHD new clinic data collection:  questionnaire-based data and performance tests  <ul><li>Household size </li></ul><ul><li...
NSHD clinic data collection:cardiac & vascular measures Professor John Deanfield & Dr Denis Pellerin, UCL <ul><li>Cardiac ...
NSHD clinic data collection: other CVD measures <ul><li>ECG   (Professor Peter MacFarlane, Glasgow University) </li></ul><...
NSHD clinic data collection: bone measures Professor Judith Adams, Manchester University <ul><li>Bone measures include: </...
NSHD clinic data collection: challenges  <ul><li>Balance between number of sites and participant travel </li></ul><ul><li>...
WTCRF MRC HNR MRC Epi MRC NSHD Cardiology/ DXA/ hosp lab Participants Postal Clinic or home visit GOS  Heart  hospital Man...
Flow Chart for processing of NSHD blood & urine samples   (Dr Alison Lennox, MRC HNR)
Expanding collaborations & capacity building <ul><li>Key collaborators sharing responsibility for NSHD  programmes & data ...
HALCyon  Healthy Ageing across the Life Course <ul><li>LHA is leading a collaborative programme:  </li></ul><ul><li>9 UK c...
HALCyon cohorts   ELSA/Caerphilly NCDS 1958 NSHD 1946 Herts 1931-39 Aberdeen/Lothian 1936 Boyd Orr 1925-37 Herts 1920-30 L...
FALCon   Function Across the Life Course <ul><li>Funded by Population Health Sciences Research Network </li></ul><ul><li>L...
NSHD E-science initiatives <ul><li>Manage and preserve the ever expanding data resource: </li></ul><ul><ul><li>Existing NS...
LHA/NSHD Organisational Structure Governance structure  Operational structure   Director Steering Committee  Executive Tea...
Acknowledgements <ul><li>My predecessors </li></ul><ul><li>LHA team </li></ul><ul><li>LHA/NSHD Collaborators </li></ul><ul...
Upcoming SlideShare
Loading in …5
×

MRC National Survey of Health

352 views

Published on

  • Be the first to comment

  • Be the first to like this

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>

×