Social support from the closest person and sleep quality in later life: Evidence from a British birth cohort study

ObjectivesThe life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated this for Addenbrooke’s Cognitive Examination third edition (ACE-III), used in clinical settings to screen for cognitive impairment and dementia.DesignLongitudinal birth cohort study.SettingResidential addresses in England, Wales and Scotland.Participants1762 community-dwelling men and women of European heritage, enrolled since birth in the Medical Research Council (MRC) National Survey of Health and Development (the British 1946 birth cohort).Primary outcomeACE-III.ResultsPath modelling estimated direct and indirect associations between apolipoprotein E (APOE) status, father’s social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association betweenAPOEε4 and the ACE-III score (β=−0.04 [–0.08 to –0.002], p=0.04), but not betweenAPOEε4 and childhood cognition (β=0.03 [–0.006 to 0.069], p=0.10) or the NART (β=0.0005 [–0.03 to 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (β=0.20 [0.14 to 0.26], p<0.001) and the NART (β=0.35 [0.29 to 0.41], p<0.001); educational attainment and occupational complexity were modestly and independently associated with the ACE-III (β=0.08 [0.03 to 0.14], p=0.002 and β=0.05 [0.01 to 0.10], p=0.02, respectively).ConclusionsThe ACE-III in the general population shows a pattern of life course antecedents that is similar to neuropsychological measures of cognitive function, and may be used to represent normal cognitive ageing as well as a screen for cognitive impairment and dementia.

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Clustering & trajectories of multimorbidity across the lifecourse: a 70 year birth cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckz186.228 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A R Khanolkar ◽

P Patalay

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Age Of Onset ◽

Later Life ◽

Birth Cohort Study ◽

Physical And Mental Health ◽

Cross Sectional ◽

Public Health Challenge ◽

Associated Risk Factors ◽

Multiple Conditions

Abstract Background Multimorbidity (≥2 chronic diseases) is increasingly prevalent in ageing populations and presents a public health challenge in successful disease management. Most evidence for multimorbidity at different ages comes from cross-sectional data, hindering understanding the extent and types of multimorbidity across the lifecourse, how they develop and associated risk factors. The aim of this study is to investigate the clustering and patterning of multimorbidity over the lifecourse using one of the longest running national birth cohort studies. Methods This ongoing study is based on the National Survey of Health & Development (NSHD), a birth cohort study following 5,362 individuals born in 1946 with detailed sociodemographic and clinical data collected from 22 waves across the lifecourse till date. This study will investigate the trajectories and clustering of 24 diseases (physical and mental health) and potential differences by sex and socioeconomic status using mixed-effects linear spline modelling. Results Preliminary analyses indicate that as expected, the rates of many conditions increase with age (e.g. 13% obese at age 43 to 31% at age 69), increasing the likelihood of individuals suffering from multiple conditions with age. At age 63, 73% with diabetes had hypertension, increasing to 85% with hypertension at age 69. We will estimate longitudinal trajectories of multimorbidity for individuals and whether the age of onset and rate of accumulation vary by sex, life-period and SES. Given the longitudinal nature of the data, we will investigate the extent to which multimorbidity earlier in the lifecourse predicts the rate of further multimorbidity later in the lifecourse. Conclusions Understanding patterning and trajectories of multimorbidity over the lifecourse and associated inequalities will better inform health care provision planning including appropriate window periods for intervention, specifically for the disadvantaged at higher risk of high multimorbidity. Key messages This is the first study to investigate trajectories of multimorbidity with data from birth to old age. Understanding how early life factors predict later life multimorbidity will better inform healthcare planning.

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Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study

Journal of Bone and Mineral Research ◽

10.1002/jbmr.2798 ◽

2016 ◽

Vol 31 (6) ◽

pp. 1167-1176 ◽

Cited By ~ 21

Author(s):

Kate A Ward ◽

Ann Prentice ◽

Diana L Kuh ◽

Judith E Adams ◽

Gina L Ambrosini

Keyword(s):

Cohort Study ◽

Life Course ◽

Birth Cohort ◽

Dietary Patterns ◽

Bone Health ◽

Later Life ◽

Birth Cohort Study

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Associations between birth weight and body composition in later life: Preliminary findings from a British birth cohort study

Journal of Epidemiology & Community Health ◽

10.1136/jech.2011.143586.69 ◽

2011 ◽

Vol 65 (Suppl 2) ◽

pp. A31-A31

Author(s):

D. Bann ◽

R. Cooper ◽

A. Wills ◽

J. Adams ◽

D. Kuh

Keyword(s):

Body Composition ◽

Cohort Study ◽

Birth Weight ◽

Birth Cohort ◽

Later Life ◽

Birth Cohort Study

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Associations Between Factors Across Life and One-Legged Balance Performance in Mid and Later Life: Evidence From a British Birth Cohort Study

Frontiers in Sports and Active Living ◽

10.3389/fspor.2020.00028 ◽

2020 ◽

Vol 2 ◽

Author(s):

Joanna M. Blodgett ◽

Rachel Cooper ◽

Daniel H. J. Davis ◽

Diana Kuh ◽

Rebecca Hardy

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Later Life ◽

Birth Cohort Study ◽

Balance Performance

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Variations of health check attendance in later life: results from a British birth cohort study

BMC Public Health ◽

10.1186/s12889-019-7875-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rebecca Wilson ◽

Diana Kuh ◽

Mai Stafford

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Social Factors ◽

Service Use ◽

Later Life ◽

Life Course Perspective ◽

Health Check ◽

Birth Cohort Study ◽

Men And Women ◽

Health Checks

Abstract Background Older adults are advised to attend a number of preventive health checks to preserve health and identify risk factors for disease. Previous research has identified a number of health and social factors, labelled as predisposing, enabling and need factors, using Andersen’s Behavioural Model of Health Service Use, that are associated with health care utilisation. We aimed to assess associations between factors from childhood and adulthood, and health check attendance in later life in a British birth cohort study. Methods For 2370 study members from the MRC National Survey of Health and Development (NSHD), health check attendance was assessed at age 68. Study members were asked if they: attended blood pressure and cholesterol checks, had their eyes tested, received the influenza vaccine, attended colon cancer screening and dental checks. Health and social factors from childhood and adulthood were used in binomial regression models to test associations with health check attendance in men and women. Results Health check attendance was high; 41% reported attending all six health checks within the recommended time frame. In multivariable models, being a non-smoker and having more health conditions in adulthood were associated with greater health check attendance in men and women. In women, childhood socioeconomic advantage, being more physically active in midlife and previously attending screening procedures, and in men, greater self-organisation in adolescence and being married were associated with attending more health checks in later life, following adjustments for childhood and adulthood factors. Conclusions A number of predisposing, enabling and need factors from childhood and adulthood were found to be associated with health check attendance at age 68, demonstrating the relevance of applying a life course perspective to Andersen’s model in investigating health check attendance in later life. Health related factors were found to be stronger correlates of health check attendance than socioeconomic factors.

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