78th Newsletter

Health in an Ageing Society

Each year, the Chief Medical Officer for England, Professor Chris Whitty, publishes a report on a topic that he considers important. For 2023, he focused on health in an ageing society. The report gathered lots of information from cohort studies, including NSHD. While we are all living longer, the overall message focused on the factors that lead to later years being spent in better physical and mental health. Important topics were reducing frailty and ill-health and adapting the environment to help those with disabilities lead independent and enjoyable lives.

In the 2022 postal questionnaire we asked about medical conditions which had been recently diagnosed. We found that having more than one long-term condition had become more common between the age of 70 to 76. Long-term conditions are health problems can be managed by drugs, but for which there is no cure, for example high blood pressure, diabetes, arthritis and angina. We also found that NSHD study members are healthier than the general population (on average they have one fewer diagnosis). From the postal questionnaire, 50% of study members had two long-term conditions, and 25% had three or more. The report suggested moving away from having to see several specialists and move towards training more general health professionals who could manage a combination of complex illnesses at the same time.

Despite many negative portrayals of ageing, the report emphasised that many people enter their mid-70s healthy enough to do what is important to them. This matches findings from the 2022 postal questionnaire, showing that only 10% of study members are classed as living with frailty, where people are slower, weaker, or need physical help. In contrast, 86% can still do housework and 94% manage the washing-up!

The report identified differences in the availability of services as more older people move out of urban areas. Many of these areas are often beautiful and welcoming but don’t have the same health care services. More rural settings also tend to have less public transport and fewer services which have been specifically designed for older adults, including housing. People who have moved to new areas in later life often do not have the social support networks, such as friends and families living close by, compared with those who have remained in the same area.

Finally, Professor Whitty called for more research into how we could delay the start of disease and frailty, so that everyone can have a good quality of life. Older age and illness shouldn’t be reasons to exclude people from research studies. We want to study everyone, not just those in good health. That is why we invite everyone to participate regardless of health status. However, we are trying different methods to collect data, including linking to information from GPs and hospitals. This limits the impact on the study members and the need to travel to a clinic location. Together, health professionals and researchers will continue to learn from studies like NSHD for current and future generations.

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COVID-19 Longitudinal Health and Wellbeing National Core Study

During the course of the COVID pandemic, the NSHD joined forces with other British Longitudinal Populations studies to create the Longitudinal Health and Wellbeing National Core Study, led by Prof Nish Chaturvedi. We each sent out similar questionnaires and the data were combined. This meant we could look at the effect of COVID across the country and across different age groups.

The research covered a wide range of topics, all important for understanding the pandemic, how to deal with its effects and to inform policy makers. The following are some of the key findings:

Getting to Grips with Long COVID

One of the important research areas has been Long COVID. Information from the questionnaires and GP records has helped to find out how common Long COVID is, what puts people at risk of it, and what the long-term effects might be. We also found that the way doctors record Long COVID cases can vary a lot. This finding has led to increased training to improve how the NHS tracks and manages these cases.

Mental Health Matters

We also looked at how our mental health before the pandemic affected how we coped with things like lockdowns. We studied the impact of big Government decisions, on our overall well-being. Using data from studies like NSHD, with lots of pre-pandemic data, was vital to understanding the true effects of the pandemic on our mental health.

Disruptions to Healthcare

There were difference on how the pandemic affected different groups of people. We have been looking at why some people were more likely to have issues in accessing healthcare, such as getting hold of medications or hospital appointments being cancelled. This is important for making sure our healthcare system can be better prepared, in case of future crises.

Vaccines: The Bigger Picture

We were interested in understanding how best to roll out vaccinations, ensuring they were safe and effective. The research showed that booster shots were essential to keeping our immunity strong against COVID-19.

Improving Treatment with Data

Lastly, the researchers have shown how quickly and effectively we can use data to monitor new treatments, which helped inform NHS guidelines. This approach could be a game-changer in rapidly understanding how well treatments work.

The COVID work has shown the importance of working with other groups and combining data. Most of the findings would not have been possible if we had worked alone. The COVID findings were written into cabinet reports and given to SAGE (Scientific Advisory Group for Emergencies). SAGE provided the Government with scientific and technical advice to support their decisions during an emergency.

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Home Visit 2023-24

Thank you to everyone to took part in the home visit!!

The home visits are now complete and we have started the process to clean the data, ready for analysis.

We have received a lot of feedback about the 6-day phone call. We appreciate remembering a list of 15 random words after 6-days can be challenging and we are sorry if this caused some distress. The reason for doing the 6 day recall is that the kind of memory tests we use typically test recall after a short delay, usually minutes. However, information learned normally can be forgotten over a longer period of days or weeks. This is called accelerated forgetting.

We also had several comments that study members could not remember the 15 words, but could remember the address or the 3 words given as part of the iPad test. The reason for this could be that three words are easier to remember than 15. In a famous 1956 article, the psychologist George Miller found that we can hold 7 items plus or minus 2 in short term memory. Fifteen words clearly exceeds the 9 outer limit of this. Miller may also have had the answer to why it’s easier to remember an address than random words, since he also argued that information can be more easily remembered as an item if it is ‘chunked”, i.e. where small pieces of a set of information are bound together to create a meaningful whole.

We also received a lot of positive comments and feedback about the nurses. These have been passed on and they were greatly appreciated. The nurses have also enjoyed their time on the study and chatting with all those they met.

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