Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study
BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4904 (Published 23 December 2009) Cite this as: BMJ 2009;339:b4904
- Joanna Collerton, principal clinical research fellow1,
- Karen Davies, research nurse manager1,
- Carol Jagger, professor of epidemiology12,
- Andrew Kingston, research assistant (medical statistics)1,
- John Bond, professor of social gerontology and health services research13,
- Martin P Eccles, William Leech professor of primary care research13,
- Louise A Robinson, professor of primary care and ageing13,
- Carmen Martin-Ruiz, senior research associate1,
- Thomas von Zglinicki, professor of cellular gerontology1,
- Oliver F W James, senior research fellow1,
- Thomas B L Kirkwood, director1
- 1Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL
- 2Department of Health Sciences, University of Leicester, Leicester
- 3Institute of Health and Society, Newcastle University, Newcastle upon Tyne
- Correspondence to: J Collerton j.c.collerton{at}ncl.ac.uk
- Accepted 9 October 2009
Abstract
Objectives The Newcastle 85+ Study aims to systematically study the clinical, biological, and psychosocial attributes of an unselected cohort of 85 year olds and to examine subsequent health trajectories as the cohort ages; health at baseline is reported.
Design Cross sectional analysis of baseline data from a cohort study.
Setting Newcastle upon Tyne and North Tyneside primary care trusts, United Kingdom.
Participants 1042 people born in 1921 and registered with the participating general practices.
Main outcome measures Detailed health assessment and review of general practice records (disease, medication, and use of general practice services); participants could decline elements of the protocol.
Results Of the 1453 eligible people, 851 (58.6%) were recruited to health assessment plus record review, 188 (12.9%) to record review only, and 3 (0.2%) to health assessment only. Data from record review are reported on a maximum of 1030 and from health assessment on a maximum of 853; individual denominators differ owing to withdrawal and missing values. Of the health assessment sample (n=853), 62.1% (n=530) were women and 10.4% (n=89) were in institutional care. The most prevalent diseases were hypertension (57.5%, 592/1030) and osteoarthritis (51.8%, 534/1030). Moderate or severe cognitive impairment was present in 11.7% (96/824) of participants, severe or profound urinary incontinence in 21.3% (173/813), hearing impairment in 59.6% (505/848), and visual impairment in 37.2% (309/831). Health assessment identified participants with possible disease but without a previous diagnosis in their medical record for hypertension (25.1%, 206/821), ischaemic heart disease (12.6%, 99/788), depression (6.9%, 53/772), dementia (6.7%, 56/840), and atrial fibrillation (3.8%, 30/788). Undiagnosed diabetes mellitus and thyroid disease were rare (1%, 7/717 and 6/762, respectively). A median of 3 (interquartile range 1-8) activities of daily living were undertaken with difficulty. Overall, 77.6% (646/832) of participants rated their health compared with others of the same age as good, very good, or excellent. High contact rates in the previous year with general practitioners (93.8%, 960/1024) were recorded. Women had significantly higher disease counts (medians: women 5, men 4; P=0.033) and disability scores (medians: women 4, men 2; P=0.0006) than men, but were less likely to have attended outpatient clinics in the previous three months (women 29% (150/524), men 37% (118/320), odds ratio 0.7, 95% confidence interval 0.5 to 0.9).
Conclusions This large cohort of 85 year olds showed good levels of both self rated health and functional ability despite significant levels of disease and impairment. Hypertension, ischaemic heart disease, atrial fibrillation, depression, and dementia may be underdiagnosed. Notable differences were found between the sexes: women outnumbered men and had more disease and disability.
Footnotes
We thank the participants for their time and personal information; the research nurses (Brenda Balderson, Sally Barker, Julie Burrows, June Edwards, Julie Ferguson, Gill Hedley, Joan Hughes, Judith Hunt, Julie Kimber, and Victoria Raynor); the blood sample processing technicians (Sam Jameson, Claire Kolenda, Craig Parker, and Anna Tang); the data manager (Pauline Potts); the study secretary (Lucy Farfort); Newcastle and North Tyneside primary care trusts and local general practices; Newcastle and North Tyneside 1 research ethics committee; Rudi Westendorp and Jacobijn Gussekloo (Leiden University Medical Centre, the Netherlands) for sharing their experiences of the Leiden 85+ Study; and Wendy den Elzen (Leiden University Medical Centre PhD student) for assistance with preparation of the blood datasets.
Contributors: JC participated in the design and execution of the study; data collection; data preparation, analysis, and interpretation; and the development and writing of the paper. KD participated in the study design, data collection, and data preparation. CJ participated in the study design, the development and writing of the paper, and supervised the analysis. AK participated in the analysis and interpretation of data and writing of the paper. JB participated in the design and conduct of the study, analysis, and writing of the paper. MPE participated in the design and conduct of the study, analysis, and writing of the paper. LAR participated in recruitment, data collection, and writing the paper. CM-R participated in the study set-up and blood collection and blood tests. TvZ participated in the study design and data collection. OFWJ participated in the study design, data interpretation, and development and writing of the paper. TBLK conceived the study, secured funding, and oversaw all aspects as principal investigator. He participated in the design and execution of the study; data management and analysis; and the development and writing of the paper. JC and TBLK are the guarantors. All authors saw and approved the final manuscript, had full access to all of the data (including statistical reports and tables) in the study, and can take responsibility for the integrity of the data and the accuracy of the data analysis. In addition to the authors the following contributed to the Newcastle 85+ Study as members of the management team or Academic Stakeholders Group: Ashley Adamson, Fraser Birrell, John Burn, Patrick Chinnery, Mike Clarke, Daniel Collerton, Paul Corris, Chris Day, Andrew Fisher, Gary Ford, Roger Francis, Tim Goodship, John Isaacs, Bernard Keavney, Roseanne Kenny, John Mathers, Janet McComb, Ian McKeith, Simon Pearce, Robert Pickard, Brian Saxby, Therese Small, Jimmy Steele, Angus Walls, and Keith Wesnes.
Funding: The baseline phase of the Newcastle 85+ Study was supported by a combined grant from the Medical Research Council and Biotechnology and Biological Sciences Research Council (grant No G0500997) and a grant from the Newcastle Healthcare Charity. The funders had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the paper; and in the decision to submit the paper for publication.
Competing interests: None declared.
Ethical approval: This study was approved by the Newcastle and North Tyneside 1 research ethics committee.
Data sharing: No additional data are available.
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