Overview of NSHD data
Developmental data were collected from the mother, from birth to age 15, over 11 sweeps. These data include childhood anthropometry, developmental milestones, mental development, cognition, health including infections, and socioeconomic circumstances.
For the 8 sweeps between ages 6 to 15 years, additional data were collected by:
- the school teacher administering educational attainment, IQ and other tests of intellectual ability, and qualitative assessment of school conduct
- the school doctor including illnesses and infectious diseases and heart rate measurement.
From age 16 to 31 years, there were a further 8 questionnaire sweeps capturing repeat data on socioeconomic status, lifestyle behaviours, and mental and cognitive health, now completed by the study member.
A further seven whole cohort sweeps have been performed from age 32, with two clinical sub-studies from age 70 (Insight 46 and Myofit 46). Biomedical measures were included at age 36, 43, 53, 60-64 (a detailed clinic visit), 69 and 75 years. Blood pressure, heart rate, lung function and medications have been captured at all these time points, and blood sampling and grip strength performed at ages 53, 60-64 and 69. Analysis of blood biomarkers, DNA for genetic and epigenetic studies have been conducted at ages 53, 60-64 and 69.
Summary of NSHD data collected
Time point (ages) | ||||||||||
1946 (birth) | 1947-50
(1-4 yrs) |
1951-61
(5-15 yrs) |
1962-77
(16-31 yrs) |
1978-2003
(32-57 yrs) |
2006-10
(60-64 yrs) |
2014-16
(68-70 yrs) |
2020-21
(74-75 yrs) |
|||
Number of data collections | 1 | 2 | 8 | 8 | 3 | 1 | 2 | 1 | ||
Measures ascertained through record linkage or questionnaires |
Social factors
|
Socioeconomic position | ✓ | ✓ | ✓ | ✓ | ✓ | – | – | ✓ |
Social function
(contacts, support, participation) |
– | – | – | – | ✓ | ✓ | ✓ | ✓ | ||
Occupation
|
– | – | – | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Educational Qualifications | – | – | ✓ | ✓ | – | – | – | – | ||
Psychological measures | Behaviour and mental health | – | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
Physical and health measures
|
Childhood development and adversity | – | ✓ | ✓ | – | – | – | – | – | |
Illness, infection, vaccination, and hospitalisation | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Life events e.g. adult adversity, chronic social conditions | – | – | – | – | ✓ | ✓ | ✓ | ✓ | ||
Smoking status
|
– | – | – | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Functional limitations | – | – | – | – | ✓ | ✓ | ✓ | – | ||
Exercise and physical health, sleep patterns
|
– | – | ✓ | – | ✓ | ✓ | ✓ | ✓ | ||
Diet diaries or diet data, alcohol intake, drugs, medications
|
– | ✓ | – | – | ✓ | ✓ | ✓ | ✓ | ||
Survival and morbidity | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Key measures avaliable in NSHD
Measure | Ages | Notes | |
Growth and physical function | |||
Anthropometry | Height, weight, bioimpedance | At every sweep
|
Self-reported at age 20, 26, 31, otherwise measured.
Weight only at birth Plus waist circumference from 36 and hip circumference from 43 |
Strength | Grip strength | All whole-cohort sweeps from age 53; wave 2 Insight 46 | Measured using electronic handgrip dynamometer |
Aerobic capacity | Exercise test
|
Age 60-64 and 69. | At age 60-64, cardio-respiratory fitness was measured as heart rate response to an incremental step test. |
Balance | Chair rises, standing balance. Postural sway and gait analysis via Datagait device | Ages 53, 60-64 and 69. | |
Bone density and body composition | DXA (whole body, lumbar spine and hip) | Age 60-64 | Lean and fat mass, body fat distribution, bone mineral density, aortic calcification |
Cognition | fNIRS + Stroop test, trail-making, month backwards, maximal finger tapping, letter search, word recall, gambling task, emotion recognition task, visual acuity, speech in babble test
Brain MRI |
Ages 8, 11, 15, 26, then all whole-cohort sweeps from age 43; enhanced testing in Insight 46 | For whole cohort: verbal and nonverbal ability tests up to age 26; neuropsychological tests of memory and processing speed at all sweeps since 43, plus, intermittently, executive function, praxis, verbal ability and cognitive state. For Insight 46, additional tests of memory, executive function, visuospatial function, and cognitive state |
Mental Health | Range of questionnaires including repeat GHQ-28.
|
Ages 13 and 15, all sweeps from age 36; some clinical record-based information | Teacher ratings of emotional and conduct problems in adolescence; semi-structured clinical instrument at age 36, an interview-based custom version of this at age 43, self-report GHQ-28 at ages 53, 60-64 and 69; annual Ryff scales for women in midlife; relevant service use 15-43 years including schizophrenia ascertainment |
Cardiovascular | |||
Blood pressure | Sitting blood pressure
Supine to standing blood pressure response |
Sitting blood pressure at every whole-cohort sweep from age 36 | |
Heart rate | 6, 7, 11 and every whole-cohort sweep from age 36 | ||
Cardiac and macrovascular | Includes ECGi, 3T CMR contrast stress perfusion and brain MRI, carotid IMT, pulse wave velocity, pulse wave analysis; also echocardiography at 60-64 & at 75+ | All measures except ECGi, CMR and brain MRI were performed at age 60-64 | |
ECG/HRV | Repeat ECG/HRV | Age 60-64 | |
NT proBNP, troponin | Plasma | Age 60-64 | |
Microvascular | Maximal vasodilation in response to heating, retinal OCT, GlycoCheck, | Measured by Doppler fluximetry, OCT and GlycoCheck | |
Drug levels | Assessed by questionnaire or nurse and by metabolomics | Questionnaire or nurse from age 31 onwards
Metabolomics performed at age 60-64 |
Panel of 500 commonly used medications from ultra high-performance liquid chromatography / tandem mass spectrometry (Metabolon) |
Metabolic | |||
Glucose, insulin and HbA1c | Serum | Ages 53, 60-64 and 69 | HbA1c at all time points, insulin and glucose 60-64 |
NMR metabolomics | Serum | Age 60-64, 69 | |
Ultra high-performance liquid chromatography / tandem mass spectrometry metabolomics | Serum | Age 60-64 | |
Actigraphy | 7 day physical activity and sleep monitoring via actiwatch | Age 60-64 and 69 | At age 60-64, assessment of free-living physical activity over 5 days was measured by combined heart rate and movement sensor (Actiheart) with individual calibration |
Liver and thyroid function tests | Serum | Age 60-64 | |
Lipid profile | Serum | Ages 53, 60-64 and 69 | |
Sex hormones | Plasma | Ages 53 and 60-64 | Testosterone, SHBG, DHEAS, androstenedione |
Respiratory | Repeat spirometry | Ages 43, 53, 60-64 and 69 | Spirometry, FEV1/FVC plus MRC respiratory disease questions from age 20 and PEFR at 36 |
Renal | POC creatinine testing to be conducted prior to CMR + gadolinium | Age 60-64
Insight 46 |
Cystatin C, eGFR, urinary albumin and creatinine. Stored overnight urine. For Insight 46, dried urine spots and spot urine. |
Biological ageing | |||
Telomere length | DNA | Ages 53 and 60-64 | |
Epigenetics | DNA | Ages 53 and 60-64 | Blood and buccal (women only at 53) |
IGF1, IGF2, IGFBP3 | Plasma | Ages 53 and 60-64 | Also IGF1 receptor and IGFBP1-7 from Metabolon (age 60-64) |
Inflammatory markers | Serum | Age 60-64 | Metabolomics profile, white cell count at both 60-64 and 69 |
Cortisol | Age 60-64 | Salivary measures at 4 time points throughout the day, urinary cortisol | |
Other blood and urine measures | Biosample collection.
|
Ages 53, 60-64 and 69 | Stored serum, plasma and whole blood |
Genetics | Ages 53 and 60-64 | Illumina DrugDev array, NeuroX2 chip. Includes ApoE status. Long read sequencing | |
Wearables | Wrist worn activity monitors and computer/app | Age 76 | Cognitron, active/passive physical activity over 1 year. |
Bold indicates novel measures collected 2019-2024.
Linked data
The NSHD was the first study (in 1991) to have participants flagged on the NHS Central Register for mortality and cancer registrations. The cohort are now routinely linked to Hospital Episodes Statistics (using a mixed model of consent and Section 251). Through external funding and collaborations, additional address-level geo-coding has been conducted to obtain air pollution estimates.
We also have linked NHS COVID-19 data as part of the UK LLC collaboration
Linkages with routine data.
Years | Linkage details |
Birth – Present | Cancer registration, mortality, hospital episode statistics: inpatients, outpatients, A&E, emergency care dataset. |
1950, 1972, 1999 | Area deprivation (Am J. Epi. 2013, 178(3):441–450) |
1989, 1999, 2006-10 | NO2, SO2 and black smoke (BS) air pollution exposure estimates (Eur Respir J. 2015 Jan; 45(1): 38–50.) |