healthy ageing across the life course: findings from the halcyon collaborative research programme

Healthy Ageing across the Life Course: Findings from the HALCyon Collaborative Research Programme

Rachel Cooper on behalf of Diana Kuh and the HALCyon study team

November 2010

GSA’s 63rd Annual Scientific Meeting, New Orleans

HALCyon study team

Diana Kuh, Avan Aihie Sayer, Yoav Ben-Shlomo, Ian Day, Ian Deary, Jane Elliott, Catharine Gale, James Goodwin,Rebecca Hardy, Alison Lennox, Marcus Richards, Thomasvon Zglinicki, Cyrus Cooper, Panos Demakakos, JohnGallacher, Richard Martin, Gita Mishra, Chris Power, PaulShiels, Humphrey Southall, John Starr, Andrew Steptoe,Kate Tilling, Geraldine McNeill, Leone Craig, CarmenMartin-Ruiz, Scott Hofer

Tamuno Alfred, Paula Aucott, Sean Clouston, RachelCooper, Mike Gardner, Emily Murray, Zeinab Mulla, SamParsons, Vicky Tsipouri

plus a Knowledge Transfer Steering Group and 19 national andinternational collaborators

What is HALCyon?

A collaborative research programme: • 9 UK cohorts born early 1900’s to 1958 • 27 investigators, 8 doctoral and post-doctoral

researchers, 19 collaborators• Core project + 8 work packages • Funded from Sept 2008 – March 2012

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

What is being studied?

Indicators of healthy ageing:

• Capability: the capacity to undertake the physical and mental tasks of daily living

• Wellbeing: psychological and social

• Underlying biology: physiology and genetics

8 integrated work packages

9 HALCyon cohorts

Cohort (birth yr/s) Birth Childhood Early Adulthood

Mid Adulthood

Late Adulthood

Lothian (1921)

Hertfordshire Ageing Study (1920-30)

Boyd Orr (1925-37)

Aberdeen (1936)

Hertfordshire Cohort Study (1931-39)

Caerphilly (1920-1934)

ELSA (early 1900s-1952/56)

NSHD (1946)

NCDS (1958)

Analytical strategy

• Systematic review and possibly meta-analysis

• Across HALCyon cohorts – data harmonisation, consistent analysis and investigation of confounding variables

• In depth analysis in relevant specific cohorts to answer particular life course questions

Systematic review

Cross cohort

Indepth

analysis

Physical capability measures in the HALCyon cohorts

Cohort Grip strength

Balance Chair rise

Get up and go

Walking speed

Lothian 1921 Xr X

HAS Xr X X X X

Boyd Orr X X

Aberdeen 1936 x X

HCS Xr X X X X

NSHD Xr Xr Xr X

ELSA Xr Xr Xr Xr

Caerphilly X X

NCDS

Physical capability

1) Are objective measures of PC useful markers of ageing?

2) What are the age and gender differences in PC?

3) Do childhood socioeconomic circumstances influence PC levels in adulthood?

4) How are body size and PC associated?

5) Does the area in which a person lives influence their PC?

6) Do specific genetic variants influence PC?

Overall (I-squared = 89.5%, p < 0.001)

Gale (B) (N=800 (756))

Al Snih (B) (N=2488 (507))

Syddall (B) (N=714 (52))

Takata* (B) (N=642 (94))

Study author/s (sex) (Total N (no. of deaths))

Rantanen (M) (N=6040 (2900))

Cawthon & Ensrud (M)(MrOS) (N=5631 (1070))

Shibata* (F) (N=221 (43))

Klein (B) (N=2612 (194))

Katzmarzyk (B) (N=8148 (269))

Sasaki (B) (N=4821 (2407))

Newman* (B) (N=2292 (286))

Cesari 2008* (B) (N=335 (71))

Shibata* (M) (N=192 (59))

Cawthon & Ensrud (F)(SOF) (N=9700 (5536))

0.97 (0.96, 0.98)

0.99 (0.98, 1.00)

0.96 (0.95, 0.97)

0.95 (0.91, 0.99)

0.97 (0.93, 1.02)

HR (95% CI)

0.97 (0.96, 0.98)

0.96 (0.95, 0.97)

0.99 (0.96, 1.02)

0.95 (0.93, 0.97)

0.98 (0.96, 1.00)

0.98 (0.97, 0.98)

0.97 (0.95, 0.99)

0.98 (0.96, 1.00)

1.00 (0.99, 1.01)

0.97 (0.96, 0.98)

0.97 (0.96, 0.98)

0.99 (0.98, 1.00)

0.96 (0.95, 0.97)

0.95 (0.91, 0.99)

0.97 (0.93, 1.02)

HR (95% CI)

0.97 (0.96, 0.98)

0.96 (0.95, 0.97)

0.99 (0.96, 1.02)

0.95 (0.93, 0.97)

0.98 (0.96, 1.00)

0.98 (0.97, 0.98)

0.97 (0.95, 0.99)

0.98 (0.96, 1.00)

1.00 (0.99, 1.01)

0.97 (0.96, 0.98)

1.911 1 1.1

Hazards ratio per 1kg increase in grip strength

Hazards ratios of mortality per 1 kg increase in grip strength

Adjusted for age, sex, body size (or *multiple factors)

BMJ 2010;341:c4467

Age and Ageing 2010 10.1093/ageing/afq117

Physical capability







Differences in grip strength by age and gender

0

10

20

30

40

50

NSHD53

ELSA50-59

ELSA60-69

HCS 60-69

HAS 63-69

HCS 70-73

HAS 70-73

ELSA70-79

LBC2178

LBC2183

ELSA80-89

ELSA90

Age ( years)

Mea

n (

Kg)

Men Women

Cooper et al, in preparation

Physical capability







Father's occupationLothian Birth Cohort 1921

Hertfordshire Ageing Study

Health and Retirement

Caerphilly Study PREHCO project

Boyd Orr

Lothian Birth Cohort 1936

Hertfordshire Cohort Study

ELSA

Aberdeen 1936

Overall (I-squared = 72.3%, p < 0.01)

Study

MF MF MF MMF

M F M

F MF

M F M

F

Sex

79

76

75

7372

71

69

68

66

65

Mean age (y)

-0.26 (-0.47, -0.05)-0.24 (-0.38, -0.10)-0.06 (-0.16, 0.04)-0.01 (-0.14, 0.12)-0.13 (-0.18, -0.09)-0.14 (-0.18, -0.10)-0.06 (-0.09, -0.03)0.05 (-0.03, 0.12)0.01 (-0.05, 0.08)-0.03 (-0.11, 0.05)-0.04 (-0.11, 0.03)-0.12 (-0.26, 0.02)-0.13 (-0.24, -0.02)-0.06 (-0.09, -0.03)-0.04 (-0.11, 0.03)-0.16 (-0.20, -0.12)-0.12 (-0.16, -0.08)-0.04 (-0.15, 0.07)-0.13 (-0.22, -0.04)-0.08 (-0.11, -0.05)

Regression coefficient (95% CI)

Lower SEP=Worse function Better function 0-.4 -.2 .2

Difference in mean walking speed (m/s) comparing lowest with highest SEP

Childhood SEP and walking speed

Adjusted for age

Birnie, Cooper et al, in press

Physical capability







(I-squared = 65.9%, p < 0.01)

CaPs

ABC36

HCS

ABC36

HAS

ELSA

Study

HAS

(I-squared = 69.2%, p < 0.01)

Male

LBC21

ELSA

LBC21

HCS

Boyd Orr

Boyd Orr

Female

(I-squared = 67.5%, p < 0.01)

0.00 (0.00, 0.00)

-0.00 (-0.00, 0.00)

0.01 (0.00, 0.01)

-0.00 (-0.00, 0.00)

0.01 (0.00, 0.01)

0.00 (-0.00, 0.01)

0.01 (0.00, 0.01)

reg.

0.00 (-0.00, 0.00)

0.00 (0.00, 0.00)

0.00 (-0.00, 0.01)

coeff. (95% CI)

0.01 (0.00, 0.01)

0.00 (-0.00, 0.01)

0.00 (0.00, 0.00)

0.00 (-0.00, 0.00)

0.00 (0.00, 0.01)

0.00 (0.00, 0.01)

0.00 (0.00, 0.00)

-0.00 (-0.00, 0.00)

0.01 (0.00, 0.01)

-0.00 (-0.00, 0.00)

0.01 (0.00, 0.01)

0.00 (-0.00, 0.01)

0.01 (0.00, 0.01)

0.00 (-0.00, 0.00)

0.00 (0.00, 0.00)

0.00 (-0.00, 0.01)

0.01 (0.00, 0.01)

0.00 (-0.00, 0.01)

0.00 (0.00, 0.00)

0.00 (-0.00, 0.00)

0.00 (0.00, 0.01)

0.00 (0.00, 0.01)

poorer function better function 0-.04 -.02 0 .02 .04

Height

(I-squared = 47.4%, p = 0.03)

CaPs

(I-squared = 14.5%, p = 0.32)

HAS

ABC36ELSA

HAS

(I-squared = 53.7%, p = 0.06)

HCS

FemaleLBC21

ABC36

Boyd Orr

ELSA

Boyd Orr

Study

LBC21Male

HCS

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.00)

-0.01 (-0.01, -0.00)-0.01 (-0.01, -0.01)

-0.01 (-0.02, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.00)

-0.02 (-0.03, -0.01)

-0.01 (-0.02, -0.00)

-0.01 (-0.01, -0.00)

coeff. (95% CI)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

reg.

-0.02 (-0.03, -0.00)

-0.01 (-0.01, -0.00)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.00)

-0.01 (-0.01, -0.00)-0.01 (-0.01, -0.01)

-0.01 (-0.02, -0.01)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.00)

-0.02 (-0.03, -0.01)

-0.01 (-0.02, -0.00)

-0.01 (-0.01, -0.00)

-0.01 (-0.01, -0.01)

-0.01 (-0.01, -0.01)

-0.02 (-0.03, -0.00)

-0.01 (-0.01, -0.00)

poorer function better function 0-.04 -.02 0 .02 .04

Current BMI

Current BMI, height and walking speed (m/s)

Hardy et al, in preparation

Body size across life and physical capability

Age

Physical capability







Data on area from across life in NSHD

Birth 4 8 11 15 26 43 53 60+

Geocoded all Years

N=2634

Mid-life

N=2,955

Young adulthood

N=3,543

Childhood

N=4,698

Physical capability 53 years

N=2440

Murray et al, in preparation

1950 1972 1999

Mean differences in balance time (log seconds) at age 53y by tertiles of area % unemployment at ages 26y and 53y in NSHD

% unemployment

1972 :

Low: 0.0 – 1.7,

Med: 1.8 - 2.4,

High: 2.4 – 6.8

1999:

Low: 0.0 – 3.6,

Med: 3.7 – 5.1,

High: 5.2 – 11.2

Low(ref)

High Tertile

Medium Tertile High

Tertile

Low(ref)

Medium Tertile

-0.40

-0.30

-0.20

-0.10

0.00

0.10

0.20

ln(

tim

e)

1972 1999

Murray et al, in preparationhttp://www.seniorsworldchronicle.com/2007_10_07_archive.html

Physical capability







Association between TERT SNP rs401681 and poor balance

Alfred et al, under review

What we’ve learnt

• Compiling and harmonising data from multiple cohorts is challenging and takes a long time but….

• Results provide empirical evidence that is often more robust than that from an individual study

• Inter-cohort work should be used to complement more in-depth work conducted within individual studies

Physical capability levels:• predict survival and subsequent morbidity• differ by gender and decline with age across UK cohorts• are influenced by childhood socioeconomic

circumstances• vary by body size and neighbourhood characteristics

Other ongoing and future work

• Cognitive capability

• Inter-relationships between cognitive and physical capability

• Lifetime nutrition and capability

• Social and psychological wellbeing

• Qualitative study- Comparisons between cohorts onthe meaning & experience of ageing

• HPA axis and cortisol levels

• Telomere length- repeat measures on large sample sizes- interlab comparisons

www.halcyon.ac.uk

Acknowledgements

The HALCyon study team

Diana Kuh, Tamuno Alfred, Kate Birnie, Rebecca Hardyand Emily Murray

New Dynamics of Ageing and UK Medical Research Council

Contact: [email protected]

healthy ageing across the life course: findings from the halcyon collaborative research programme

Documents

hertfordshire ageing

halcyon study teamnovember

indicators of healthy

c4467 age

body size

gender differences

person lives

relevant specific cohorts