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Longest-running cohort study in the UK celebrates turning 70

29 Feb 2016

The latest findings from the MRC National Survey for Health and Development (NSHD), a cohort study which turns 70 this week, have shown reason to celebrate – a rise in wellbeing throughout the seventh decade of life.

The MRC NSHD in March 1946, with the recruitment of thousands of newly born babies, and is the oldest and longest-running birth cohort in the UK. Over 3,000 study members turn 70 this month and together they are some of the most closely medically observed people in the world.

In a cohort study, researchers follow a group of people over time and this long-term assessment helps them make important links between genetics, environment, lifestyle and health.

The MRC invests taxpayers’ money in some of the best medical research in the world across every area of health and has been funding the study since 1962. In the UK, a staggering 1 in 30 people (3.5% of the population) are part of a cohort, and the MRC funds 23 of the 41 UK-based cohorts.

To celebrate, the NSHD is hosting two birthday parties for its study members, in London on Tuesday 1 March and in Manchester on Thursday 3 March. Eight hundred guests are expected to attend the events, with some study members even bringing a parent - who originally signed them up for the cohort when they were born.

Meanwhile, some of the latest findings from the NSHD have shown a rise in wellbeing throughout the seventh decade of life. Using the Warwick-Edinburgh Mental Wellbeing Scale, participants - when aged 60 to 64 - were asked to rank a 14-item scale with five response categories.

The questions covered a range of aspects of mental wellbeing including feeling cheerful, confident, optimistic, useful and relaxed.

The new findings show that when the same individuals were asked the same questions at age 69, overall there was an improvement in all 14 items that make up the wellbeing scale compared to their responses in their early sixties. This is in spite of most study members reporting at least one common chronic disease such as arthritis or cancer.

Researchers at the MRC Unit for Lifelong Health and Ageing (LHA) at University College London now plan to study what experiences and circumstances are linked to this increase.

Dr Mai Stafford, Programme Leader at the MRC LHA, said: “What we’ve found is that, on average, levels of wellbeing increased during people’s sixties. We found that 1 in 5 experienced a substantial increase in wellbeing in later life, although we also found a smaller group who experienced a substantial decline.

“The benefit of using a cohort study like NSHD is that we can look at how individuals change over time. We hope this will allow us to pinpoint which common experiences may be linked to an improvement in wellbeing in later life.”

The findings from this unique cohort have had a major contribution to healthcare, education and social policy for more than 50 years. Thanks to the study, more information than ever is being discovered about what can maintain physical and cognitive function as we age, and what can contribute to the risk of heart disease, cancer, dementia, type 2 diabetes; and much of this has already entered common knowledge1.

Professor Diana Kuh, who leads the MRC NSHD at the MRC LHA, said: “NSHD study members have been helping us for seven decades of their lives and we are grateful for their time and commitment to the study. Their contribution to our knowledge about human development and ageing is enormously valuable for science and policy. Thank you all – and happy birthday!”

The study is now at a crucial stage, following study members as they get older and providing vital information for those delivering healthcare to older people. Modern science will learn even more than before about healthy and unhealthy ageing, and this knowledge is very likely to lead to new possibilities for prevention.

Past findings from the NSHD

The finding, in 2014, that more rapid rises in systolic blood pressure during midlife (even if not crossing into hypertension) were related to poorer cardiac structure (published in the European Heart Journal in 2014) has implications for treatment guidelines as it suggests that identification and treatment of people with rapidly increasing SBP, even if they are not reaching the criteria for hypertension, may be beneficial in preventing subsequent cardiovascular disease.

The findings (published in The Lancet Diabetes & Endocrinology in 2014) suggesting that those who lost weight at any age during adulthood, even if weight was regained later, had better cardiovascular risk profiles than those who remained overweight or obese supports public health strategies that help individuals to lose weight at all ages.

In 2014, the finding that better performance in tests of physical capability (i.e. grip strength, chair rising and standing balance) in midlife was linked to higher survival rates over 13 years of follow-up was published in the British Medical Journal. This highlighted the value of these simple objective physical tests in helping to identify those people who from at least as early as midlife onwards may require more support than others to achieve a long and healthy life.

Subsequent work (under review) examining changes in objective measures of physical capability between ages 53 and 60-64 has highlighted that age-related decline may not be entirely inevitable and is potentially modifiable. This work has also suggested that there may be a need to monitor physical capability from at least as early as midlife onwards as opportunities to help some high risk groups may already have been missed if no action is taken until later in life.

A 2009 report on adult life chances in relation to childhood mental health using NSHD was cited by the government in support of a case for early intervention to build mental capacity and resilience.

The study’s findings of the continuing effect of early life growth and development on health outcomes in adulthood add to the arguments for early intervention of the kind provided by the national SureStart programme.

The 1999 paper comparing children’s diet in 1950 with that in the 1990s (‘Food and nutrient intake of a national sample of four-year-old children in 1950: comparison with the 1990s’, Public Health Nutrition) had an impact because of its evidence that the quality and nutrient value of infant and childhood diet had declined between 1950 and 1990.

The study’s finding (published in All our Future in 1968) of the extent and inequity of the ‘waste of talent’ – in terms of high ability children who did not continue into further or higher education – added to arguments for improving opportunities for, and expectations of, children from poorer families

The Home and the School (1964) had a great impact, probably because it provided the first hard evidence that parents and preschool circumstances had a significant impact on ability and attainment at age eight, and so showed that preschool development and experience formed the bedrock on which primary schooling was built

Press reports that followed the publication of Maternity in Great Britain (1948), which were concerned with the ‘Need for Better Care and Lower Costs’ (The Times), are likely to have influenced the arguments for improvements in the care of mothers and babies

In addition, the NSHD is a member of the Dementias Platform UK, £53 million collaboration between universities and industry established by the MRC in 2014, to transform the best dementia research into the best treatments as quickly as possible. It combines the power of multiple population studies to compare healthy people with people at all stages of dementia.

The NSHD is featured in a new book about cohort studies called ‘The Life Project’ by Helen Pearson, which will be published by Allen Lane on Thursday 3 March 2016.

Find out more about the study in our series of blogs: a birthday message from the cohort leaders, reflections of a cohort member, and an entry by Helen Pearson on how the cohort inspired her book: The Life Project.

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