A life course approach to healthy ageing: The HALCyon programme

doi:10.1016/j.puhe.2012.01.025

Public Health

Volume 126, Issue 3, March 2012, Pages 193-195

https://doi.org/10.1016/j.puhe.2012.01.025 Get rights and content

Summary

Introduction

Healthy ageing remains a neglected area in epidemiology, where the traditional focus is on specific diseases. Policy makers and research funders have called for more research on functioning in older people, and on the underlying biological processes of ageing, to promote public health strategies that will reduce the societal and individual costs of an ageing population.

Healthy ageing across the life course (HALCyon) is an interdisciplinary research collaboration that harnesses the power of nine UK cohort studies to discover life course influences on physical and cognitive capability, social and psychological well-being, and underlying biology. Evidence suggests that factors throughout the life course can affect capability and well-being, and the underlying processes of ageing. By assessing the level of robustness and variation of findings in nine cohorts, and placing these within the wider literature, HALCyon provides a more secure evidence base for healthy ageing strategies.

In this symposium, HALCyon co-investigators reported the first wave of findings from five of the eight work packages. For more information, the reader is referred to www.halcyon.ac.uk and published papers.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16

Presentations on the capability and well-being work packages (Kuh, Cooper, Richards and Gale) identified common themes, such as the relationship between capability and well-being, and the extent to which both are affected by lifetime socio-economic position, body size and lifestyle, childhood mental abilities, personality and prior health. The presentation on the biology of ageing work packages (Von Zglinicki) summarized the strategies used for investigating the roles of genetics, cortisol and telomere length on capability and well-being. All presentations demonstrated the three different strands of the analytical approach: (1) systematic reviews and meta-analyses of all available studies; (2) cross-cohort research that focuses on data harmonization of outcomes and potential explanatory factors; and (3) in-depth studies that exploit the special features of a single cohort. The final presentation (Guralnik) discussed how we move from life course research into interventions to benefit healthy ageing.

Section snippets

Capability

Physical capability, the capacity to undertake physical tasks of daily living, can be assessed by objective tests of strength and physical performance, and self-reports of everyday function. The objective measures used in HALCyon are grip strength, chair rises, standing balance and walking speed. HALCyon, in conjunction with the FALCon collaboration (www.nshd.mrc.ac.uk/falcon), first assessed whether these measures are useful markers of ageing and health. The literature examining the

Psychological and social well-being

Maintaining psychological and social well-being in later life is important for ageing, not least because they are linked with survival and may affect physical and cognitive capability. There is a lack of consensus about how well-being should be defined. Using HALCyon cohort data on symptoms of anxiety and depression as measured by the Hospital Anxiety and Depression Scale, it was shown that the psychometric structure of this scale was the same in four HALCyon cohorts.⁷ The relative importance

Biology of ageing

Ageing is different from other biological processes: it cannot be defined on an individual basis, so cause–effect relationships are generally not established; it is not under evolutionary selection, and hence shows great heterogeneity; and modifying factors on ageing differ in different age groups. Von Zglinicki presented progress to date on three areas chosen for HALCyon: genetics; systemic regulation by stress hormones in the hypothalamic–pituitary–adrenal axis (HPA); and cell ageing,

Translation of findings from longitudinal studies to promote healthy ageing

The HALCyon programme supports a Knowledge Transfer Steering Group made up of research users from government departments, charities such as AgeUK, health professionals and researchers themselves. Guralnik, while praising the quality of the rich data, analytical strengths and novel findings of the HALCyon programme, raised the fundamental difficulty of inferring causality from observational studies. However, findings from longitudinal observational studies add important value when translated

Acknowledgements

HALCyon is funded by the New Dynamics of Ageing cross council research programme (RES-353-25-0001). RC is supported by this funding.

References (17)

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Objectively measured physical capability levels and mortality: a systematic review and meta-analysis
BMJ
(2010)
R. Cooper et al.
Objective measures of physical capability and subsequent health: a systematic review
Age Ageing
(2011)
K. Birnie et al.
Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis
PLoS ONE
(2011)
K. Birnie et al.
Socio-economic disadvantage from childhood to adulthood and locomotor function in old age: a lifecourse analysis of the Boyd Orr and Caerphilly prospective studies
J Epidemiol Community Health
(2010)
B.H. Strand et al.
Lifelong socioeconomic position and physical performance in midlife: results from the British 1946 birth cohort
Eur J Epidemiol
(2011)
Dodds R, Denison HJ, Ntani G, Cooper R, Cooper C, Sayer AA, et al. Birth weight and muscle strength: a systematic...
C.R. Gale et al.
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Factors associated with symptoms of anxiety and depression in five cohorts of community-based older people: the HALCyon (Healthy Ageing across the Life Course) Programme
Psychol Med
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There are more references available in the full text version of this article.

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^☆: Save as Summary of HALCyon symposium, World Congress of Epidemiology 7–11 August 2011.

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SymposiumA life course approach to healthy ageing: The HALCyon programme☆

Summary

Introduction

Section snippets

Capability

Psychological and social well-being

Biology of ageing

Translation of findings from longitudinal studies to promote healthy ageing

Acknowledgements

Objectively measured physical capability levels and mortality: a systematic review and meta-analysis

BMJ

Objective measures of physical capability and subsequent health: a systematic review

Age Ageing

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

PLoS ONE

Socio-economic disadvantage from childhood to adulthood and locomotor function in old age: a lifecourse analysis of the Boyd Orr and Caerphilly prospective studies

J Epidemiol Community Health

Lifelong socioeconomic position and physical performance in midlife: results from the British 1946 birth cohort

Eur J Epidemiol

The structure of the Hospital Anxiety and Depression Scale in four cohorts of community-based, healthy older people

Int Psychogeriatr

Factors associated with symptoms of anxiety and depression in five cohorts of community-based older people: the HALCyon (Healthy Ageing across the Life Course) Programme

Psychol Med

Symposium
A life course approach to healthy ageing: The HALCyon programme☆