HALCyon project
Investigator
Diana Kuh, MRC Unit for Lifelong Health and Ageing
Team
Professor Diana Kuh (Principal Investigator), MRC Unit for Lifelong Health and Ageing (LHA)
Professor Avan Aihie Sayer, MRC Epidemiology Resource Centre, University of Southampton
Professor Yoav Ben-Shlomo, University of Bristol
Professor Ian Day, University of Bristol
Professor Ian Deary, University of Edinburgh
Dr Jane Elliott, Institute of Education
Dr Catharine Gale, MRC Epidemiology Resource Centre, University of Southampton
Dr James Goodwin, AgeUK
Dr Rebecca Hardy, LHA
Dr Alison Lennox, MRC Human Nutrition Research
Dr Marcus Richards, LHA
Professor Thomas von Zglinicki, Institute for Ageing and Health, Newcastle University
Other investigators
Professor Cyrus Cooper, MRC Epidemiology Resource Centre, University of Southampton
Dr John Gallacher, Cardiff University
Professor Richard Martin, University of Bristol
Dr Gita Mishra, LHA
Professor Chris Power, Institute of Child Health, University College London
Dr Paul Shiels, University of Glasgow
Dr Humphrey Southall, University of Portsmouth
Professor John Starr, University of Edinburgh
Professor Andrew Steptoe, University College London
Dr Panos Demakakos, University College London
Dr Kate Tilling, University of Bristol
Professor Lawrence Whalley, University of Aberdeen
Dr Geraldine McNeill, University of Aberdeen
Dr Leone Craig, University of Aberdeen
Dr Carmen Martin-Ruiz, Institute for Ageing and Health, Newcastle University
Researchers
Ms Paula Aucott, University of Portsmouth
Dr Rachel Cooper, LHA
Dr Emily Murray, LHA/NIA
Dr Zeinab Mulla, LHA
Dr Mike Gardner, University of Bristol
Ms Tamuno Alfred, University of Bristol
Ms Sam Parsons, Institute of Education
Partners
James Goodwin, Age UK
Howard Bergman, McGill University
George Davey Smith, University of Bristol
Dorly Deeg, Free University of Amsterdam
Glen Elder, University of North Carolina
David Gems, University College London
Jack Guralnik, National Institute on Aging
Scott Hofer, Oregon State University
Felicia Huppert, University of Cambridge
Tom Kirkwood, Institute for Ageing and Health, Newcastle University
Debbie Lawlor, University of Bristol
Stafford Lightman, University of Bristol
Bill MacNee, University of Edinburgh
Fiona Matthews, MRC Biostatistics Unit, University of Cambridge
David Melzer, Peninsula Medical School
Linda Partridge, University College London
Johannes Siegrist, University of Dusseldorf
Nick Tyler, University College London
Frans van der Ouderaa, Netherlands Consortium for Healthy Ageing
Aims and objectives
The overall objective of this collaborative research programme (CP) was the scientific discovery of lifetime determinants of healthy ageing.
The four main aims were to
investigate how individual ageing is subject to different influences over the life course
understand, through qualitative research, the dynamic ways in which the meanings and experiences of ageing are changing and diversifying
encourage and support the development of innovative multidisciplinary research groups and methods
provide a sound evidence base for policy and practice so that research contributes to the wellbeing and quality of life of older people
Design
The first two aims were achieved by bringing nine UK cohort studies together for the first time for comparative research. These cohorts include 30,000 men and women born from 1918 to 1958, currently aged 50 years and older many of whom have been followed-up since early life.
Using the wealth of existing data supplemented by new data and biological measures, we studied three domains of healthy ageing:
Physical and cognitive capability
Psychological and social wellbeing
Biomarkers of ageing (telomere length, genetic variation, hypothalamic-pituitary-adrenal (HPA) axis).
Eight integrated work packages (WPs) investigated inter-relationships between indicators of capability, wellbeing and biological ageing; how these indicators and inter-relationships change with age; and common lifetime determinants such as early development, lifetime health, personality, nutrition and other lifestyle characteristics.
Seven of the WPs used a range of innovative quantitative methods. The other WP took a complementary qualitative approach by interviewing a sample of cohort members from three of the studies to find out how they themselves understood their life history, the experiences that shaped them, and their response to ageing. These insights were compared with the findings from the quantitative studies.
The last two aims were achieved through a core project which had three components: methodology, knowledge transfer and programme management.
This fostered the interaction of four groups:
Primary cohort investigators
Cross-linking methodologists
Specialists in biological, psychological and social ageing
Non-academic partners with expertise in disseminating and using research outcomes, led by Help the Aged
Policy implications
This research delivered high impact findings that provided new insights into ageing throughout life and influenced the delivery of health and social care, health promotion and the formulation of policy which affects older people.
New data from this collaborative research programme (CP) provided a life course framework for ageing in its biological, social and psychological dimensions. The framework reflected the diversity of the older population and embedded their subjective experiences within cutting edge epidemiological and biomedical evidence.
This research had implications for all older people, from the youngest and fittest in later life, whose priority is maintaining capabilities, to the oldest, frailest and their carers, for whom management of incapacity is a major concern. All these stake-holders benefitted in terms of their person-centred care, their involvement in the choice and mode of delivery of that care, and support in long-term limiting conditions, all key objectives of the NSF for older people.
There were four main types of users of the research findings from our CP:
Policymakers responsible for regulating health services and formulating public health promotion, including healthy ageing programmes.
Health and social service practitioners who provide services to individuals.
Academic investigators, including those studying younger cohorts.
Older and future older members of society and their families, including study participants.
Representatives of these four user groups agreed to participate in a Knowledge Transfer (KT) Steering Group that ran for the duration of the CP.
Membership included older people themselves and representatives from Child Poverty Action Group, International Longevity Centre-UK, British Nutrition Foundation, British Geriatrics Society, Alzheimer’s Society, Royal College of General Practice, US Alliance for Aging Research and the Department of Health and other governmental organisations.
The KT Steering Group, chaired by Dr James Goodwin of Help the Aged, was responsible for translating knowledge gained from the research into strategies for dissemination, intervention and policy change in order to improve the lives of older people.
Operationally, it was based on an interactional model that aimed to maximise knowledge transfer and policy impact by fostering relationships between the researchers and the research users at all stages of the research process - from conceptualisation through to dissemination and utilisation.
The KT Steering Group will met six-monthly to receive progress reports, lay summaries and presentations from the scientists based on programme milestones and outputs, and to drive knowledge transfer activities. The group highlighted where our research activities were relevant for particular policy debates and constructed an impact profile to optimise the mechanisms for launching or planning interventions and initiatives, including avenues and tools for dissemination. These included the six-monthly CP workshops that benefitted research users, and workshops or conferences for policymakers, practitioners and older people themselves.
New findings were delivered into the public domain via press and media activities and were brought to the attention of government as appropriate.
The interdisciplinary research team included two consultant geriatricians as well as five others who were medically qualified. These investigators had an interest in incorporating biomarkers and performance tests into the assessment of older patients. The questions addressed by researchers were not always those asked by policy makers, practitioners or end-users, and translational research was essential to link policy and practice if recommendations were to be relevant to user groups.
Our interdisciplinary life course approach, use of mixed methods and findings on the lifetime biological social determinants of capability and wellbeing in ageing were valuable to other researchers on ageing. We collaborated with investigators on other UK and international birth cohorts to ensure that subsequent studies of ageing in these cohorts benefitted from, and further developed, the lessons learned through this NDA programme.
In summary, knowledge transfer and policy impact are of high importance to the research programme and our model was designed to maximise their delivery throughout the life of the project.