Life course epidemiology, ageing research, and maturing cohort studies: a dynamic combination for understanding healthy ageing

Author(s):  
Diana Kuh ◽  
Marcus Richards ◽  
Rachel Cooper ◽  
Rebecca Hardy ◽  
Yoav Ben-Shlomo
2014 ◽  
Vol 73 (2) ◽  
pp. 237-248 ◽  
Author(s):  
Diana Kuh ◽  
Sathya Karunananthan ◽  
Howard Bergman ◽  
Rachel Cooper

Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.


2021 ◽  
pp. 095269512199539
Author(s):  
Penny Tinkler ◽  
Resto Cruz ◽  
Laura Fenton

Birth cohort studies can be used not only to generate population-level quantitative data, but also to recompose persons. The crux is how we understand data and persons. Recomposition entails scavenging for various (including unrecognised) data. It foregrounds the perspective and subjectivity of survey participants, but without forgetting the partiality and incompleteness of the accounts that it may generate. Although interested in the singularity of individuals, it attends to the historical and relational embeddedness of personhood. It examines the multiple and complex temporalities that suffuse people’s lives, hence departing from linear notions of the life course. It implies involvement, as well as reflexivity, on the part of researchers. It embraces the heterogeneity and transformations over time of scientific archives and the interpretive possibilities, as well as incompleteness, of birth cohort studies data. Interested in the unfolding of lives over time, it also shines light on meaningful biographical moments.


Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jean-Pierre Michel ◽  
Fiona Ecarnot

In today’s tormented world, it appears useful to take advantage of communication channels to promote life-course immunization and affirm its major role in healthy ageing. Instead of developing the argument of chronological age, we demonstrate the life-course principle here based on the P4 medicine concept. Are vaccines “preventive, personalized, predictive, and participatory?” Based on detailed analysis of research findings, we successively demonstrate the seminal role of vaccines on preventable infectious diseases, post-sepsis functional decline, non-communicable diseases (cardio-neuro-vascular, respiratory, and renal diseases), community protection, antimicrobial resistance, and perhaps even old-age dementia. Healthy ageing and the promotion of immunization are closely dependent on health literacy and provision of information by skilled health-care professionals. However, personal autonomy and individual freedom are influenced by psycho-cognitive hurdles (cultural approaches, beliefs, emotions, and behaviours), the opinions of the public/family/friends, and the increasing role of social media, which challenges scientific evidence. A similar phenomenon exists when dealing with the issue of healthy ageing, whose success depends greatly on life-course immunization.


2018 ◽  
Vol 10 (3) ◽  
pp. 299-305 ◽  
Author(s):  
S. Santos ◽  
D. Zugna ◽  
C. Pizzi ◽  
L. Richiardi

AbstractIn epidemiologic analytical studies, the primary goal is to obtain a valid and precise estimate of the effect of the exposure of interest on a given outcome in the population under study. A crucial source of violation of the internal validity of a study involves bias arising from confounding, which is always a challenge in observational research, including life course epidemiology. The increasingly popular approach of meta-analyzing individual participant data from several observational studies also brings up to discussion the problem of confounding when combining data from different populations. In this study, we review and discuss the most common sources of confounding in life course epidemiology: (i) confounding by indication, (ii) impact of baseline selection on confounding, (iii) time-varying confounding and (iv) mediator–outcome confounding. We also discuss the issue of addressing confounding in the context of an individual participant data meta-analysis.


Author(s):  
Rebecca Hardy ◽  
Graciela Muniz-Terrera ◽  
Scott Hofer

Author(s):  
Gita D. Mishra ◽  
Diana Kuh ◽  
Yoav Ben-Shlomo

2018 ◽  
Vol 72 (6) ◽  
pp. 507-512
Author(s):  
Anne Gosselin ◽  
Annabel Desgrées du Loû ◽  
Eva Lelièvre

BackgroundLife course epidemiology is now an established field in social epidemiology; in sociodemography, the quantitative analysis of biographies recently experienced significant trend from event history analysis to sequence analysis. The purpose of this article is to introduce and adapt this methodology to a social epidemiology question, taking the example of the impact of HIV diagnosis on Sub-Saharan migrants’ residential trajectories in the Paris region.MethodsThe sample consists of 640 migrants born in Sub-Saharan Africa receiving HIV care. They were interviewed in healthcare facilities in the Paris region within the PARCOURS project, conducted from 2012 to 2013, using life event history calendars, which recorded year by year their health, family and residential histories. We introduce a two-step methodological approach consisting of (1) sequence analysis by optimal matching to build a typology of migrants’ residential pathways before and after diagnosis, and (2) a Cox model of the probability to experience changes in the residential situation.ResultsThe seven-clusters typology shows that for a majority, the HIV diagnosis did not entail changes in residential situation. However 30% of the migrants experienced a change in their residential situation at time of diagnosis. The Cox model analysis reveals that this residential change was in fact moving in with one’s partner (HR 2.99, P<0.000) rather than network rejection.ConclusionThis original combination of sequence analysis and Cox models is a powerful process that could be applied to other themes and constitutes a new approach in the life course epidemiology toolbox.Trial registration numberNCT02566148.


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