Click here to see the first published (protocol) paper from HAGIS, published in the British Medical Journal Open. Title: "Pilot study protocol to inform a future longitudinal study of ageing using linked administrative data: Healthy AGeing in Scotland (HAGIS)"
Findings from the HAGIS pilot have highlighted that there are significant differences in bowel screening participation rates between single men and men who live with a partner. In particular, the study has found that 79.5 per cent of men living with a partner had taken a bowel screening test at some point, compared to 57.6 per cent of men who lived alone. See the full story here.
The detailed paper on this topic will be published at the HAGIS pilot report launch on December 8th. Details of the conference can be found here.
HAGIS have been working with several researchers from around Scotland to use the pilot data carry out research on a number of key areas. Those areas include financial literacy, retirement, volunteering, physical activity and more. These pieces of research will contribute to the 2017 Pilot Report to be launched at the 2017 conference.
The HAGIS team have been working hard to prepare the pilot data for analysis.
All 1,057 main interviews were completed in October 2017. Furthermore, of those, 705 participants (67%) also returned the self-completion questionnaires.
The HAGIS pilot survey goes into the field this month! Interviewers from our fieldwork company, Facts International, will be knocking on the doors of randomly selected households in mainland Scotland and asking for permission to interview household members about their outlook on life, their circumstances and their health. This is a first for Scotland.
Scotland will be joining a list of countries that are asking the same questions of their older people. These include the USA, England, Ireland, Mexico, Brazil, India, China and each of the countries in mainland Europe. The data collected from across the world can be compared to answer all kinds of questions that are designed to improve the health and wellbeing of older people.
Which pensioners have the highest standard of living? How much does poor health cause people to retire early? How well are older people networked into their local community? Are older people able to make the right decisions about their finances? These are the kinds of questions that HAGIS will try to answer. We will then be able to compare our answers with those from other countries to see if Scotland is performing well or badly against these important criteria. The next step is to take the answers to the Scottish or UK Governments to ask what policies might be put in place to improve outcomes in Scotland. We work very closely with colleagues in Ireland and England in these projects.
The fieldwork is being co-ordinated by Dr Elaine Douglas at the University of Stirling. She is a graduate in psychology from the University of Stirling and has a PhD in Public Health from University College London. At the moment she is very much focussed on ensuring that we make our target of 1000 completed interviews by March 2017.
Meanwhile Professor David Bell, the economist, is exploring possible funding sources for the first full wave of HAGIS. To be fully comparable with the other countries in the global network, it would be necessary to increase the size of the Scottish sample to at least 6000.
Funding for the pilot project is currently coming from the National Institute on Aging in the United States and from the Nuffield Foundation in London. Early projects to establish the feasibility of HAGIS were funded by the Economic and Social Research Council, the Scottish Institute for Research in Economics and the Centre for Population Change.
Dr Elaine Douglas (Research Fellow/Project Manager of HAGIS at the University of Stirling) and Chloe Fawns-Ritchie (the cognitive testing officer at the Centre for Cognitive Ageing and Cognitive Epidemiology at the University of Edinburgh) attended the British and Irish Longitudinal Studies conference in Belfast. The conference was hosted by the Northern Ireland Cohort Longitudinal Study of Ageing (NICOLA), Northern Ireland’s largest public health study. Researchers from other longitudinal studies including the English Longitudinal Study of Ageing (ELSA) and the Irish Longitudinal Study of Ageing (TILDA) were also in attendance. This was a wonderful opportunity for us to learn how other studies use their data and to see and hear about their research findings.
Dr Douglas highlighted the reasons why ageing research is important for Scotland: our population is ageing at a faster rate than other UK nations. Scotland also has the highest mortality rates and lowest life expectancy in Western Europe. It is key that we learn more about how to keep our population living healthy lives for longer. Fortunately, Scotland has secure, confidential administrative data linkage that enable (with permission) survey responses to be linked to health and social care data. This is a wonderful opportunity to learn more about how people’s work, home and social lives are associated with health outcomes. These findings may inform social, economic and health policy and therefore have the capacity to make a positive impact on our nation’s health and wellbeing.
Chloe presented the work carried out by herself and Professor Ian Deary when developing a short cognitive assessment. For HAGIS, we wanted to include tasks assessing cognitive functions that are important for functioning independently in old age, such as memory for past events and problem solving skills. Performance on these tasks tend to decline with increasing age. We also wanted to include tasks that assess functions that remain relatively stable in ageing, like vocabulary. During my presentation, I gave examples of these tasks so that the audience could see what we will be asking participants to do. Meeting many of the researchers involved in the more established longitudinal studies and learning how they are using their data to understand the relationship between cognitive changes in ageing and health and wellbeing was a particular highlight of the conference. In the future, we would like to identify the associations between cognitive change and health and social outcomes in a Scottish population, and determine whether these differ from those found elsewhere in the British Isles.
David Bell and Elaine Douglas went to the launch of the seventh wave of the English Longitudinal Survey of Ageing’s on October 13th. HAGIS is yet to have its first full wave, so we are well behind England! Even so, ELSA is a youngster compared with the Health and Retirement Study (HRS) which began back in 1992 and has surveyed a group of Americans aged 50+ every two years since then.
The launch report focussed mainly on employment, retirement and health. These are also vital issues for Scotland – particularly with the new tax and welfare powers coming to the Scottish Parliament. The ELSA results showed that the poor and the wealthy are likely to retire early, with middle income earners waiting longer before they retire. If repeated in Scotland, this would have important implications for Scotland’s income tax receipts.
The report also showed how income and wealth are associated with the length of time people can expect to live free of disability or serious illness. At age 50, the wealthiest 33% of England’s population can expect to spend more than 76% of the rest of their life free from illness and over 90% of the rest of their life free from disability. In contrast, the poorest 33% will be 58% free from illness and 85% free from disability over the rest of their life.
These are fairly dry statistics. But Scotland will soon control a £2.7bn budget for welfare benefits. Most of this money will be used to support disabled people. So it is important that we know the equivalent figures for Scotland. One obvious way to do this is to increase the number of older people in the HAGIS sample. The seventh wave of ELSA surveyed 9700 people aged 50+.
Many of the other longitudinal surveys of ageing attended the ELSA launch. These included the Republic of Ireland, Northern Ireland, Brazil, India and Korea. We heard about their future plans and research. For example, some great work in the Republic of Ireland has traced how changes in blood pressure affect older people’s susceptibility to falls.
The principal investigator of the European longitudinal survey of ageing (SHARE) was also at the meeting. SHARE is a massive undertaking that now covers 28 European countries (and Israel). It was interesting to learn from him that SHARE has been chosen to lead the first survey of Syrian migrants in Germany. The applications of these surveys are many and varied!
Given the importance of the US National Institute of Aging in funding these studies, it was not surprising that a number of Americans researchers also travelled to London. They were very interested in HAGIS and particularly impressed by its potential for linking data from the survey to administrative data – particularly health and social care.
This linkage is very important both because it means that researchers don’t have to rely on people’s recollection of what has happened to them. It is also much cheaper to consult health records than to carry out a health assessment which would require a nurse visit.
This has a really worthwhile meeting: it helped us to publicise HAGIS and to understand where it sits in the international network of longitudinal studies. Soon, we should be able to share the results from the HAGIS pilot with our international research colleagues!
The HAGIS project received ethical approval from Stirling Management School on the 23rd of October 2015.
Ageing and Cognitive Decline: Longitudinal Perspectives- was successfully held on Friday 24th July at the Royal Society of Edinburgh. The first half of the session was chaired by Professor Emma Reynish. Emma firstly introduced Professor Ian Deary, from the University of Edinburgh, who started the day by talking about his research on the Lothian Birth Cohorts. More specifically, he discussed the possible factors which contribute to greater cognitive decline in older age. Ian also outlined the cognitive domains which will be assessed in the pilot of HAGIS.
Next, Professor Ken Langa, from the University of Michigan, presented some interesting findings from the Health and Retirement Study (HRS) and the Ageing, Demography And Memory Study (ADAMS) - a supplement to the HRS. In particular, Ken highlighted the prevalence of dementia and cognitive impairment in the US and the likely future increase in the actual number of people experiencing cognitive impairment as a result of an increasing elderly population. Another key message that Ken delivered was the high societal cost of care for cognitively impaired patients, 49% of which, accrues to informal care givers.
The second half of the day was chaired by Professor Marion McMurdo. Marion began by introducing Professor Robert Wright, from the University of Strathclyde, who talked about financial literacy and its relationship with ageing and cognition. Robert outlined the meaning and measures of financial literacy and presented some research from the British Election Study (BES) which suggested that some financial concepts are poorly understood by the British population. Furthermore, Robert explored the importance of understanding the relationship between cognition and financial literacy, and pointed to some preliminary results from The Irish Longitudinal Ageing (TILDA) study, which suggest cognitive ability, in several different domains, significantly predicts financial literacy.
Lastly, Professor David Bell, Principal Investigator for HAGIS, closed the day by talking about the benefits of data linkage to ageing research. David presented some findings from a recent project with the Scottish Government which linked patient’s health and social care records from 5 local authorities in Scotland. Additionally, David updated the audience on the current progress of HAGIS and the future of the project.
Overall, the presentations each pointed to the important role that HAGIS will play in helping to understand the ageing process in Scotland, especially in the presence of the ageing population facing us today. Thanks to all who attended, we hope to see you again soon!
Presentation slides from the event:-