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.)