The voice of older people in longitudinal studies

UKCRC centre of Excellence for Public Health (NI)

Dr Michael Quinn

Why understanding ageing is important

• By 2031, one in three of us will be over 60 years.– The fastest growing population are >80years.– 1.3 million people in the UK are now >85

• Life expectancy increasing but the trajectory of healthy life expectancy is different, with worse morbidity among the poor and isolated elderly.

• The contribution of older people to society and economic activity will be increasingly important.

Are the voices speaking for older people in our community representative?

How representative are older people in public consultations?

• The voice of ‘older people’ in lobbying groups and public agencies may not reflect the diversity of the older population!

• Qualitative research has demonstrated that ‘self selection’ occurs amongst those involved in forums related to developing services for older people*.

*Barnes, M. The same old process? Older people, participation and deliberation.Ageing & Society 25, 2005, 245-259

How do we hear the many voices of our ageing population?

• Longitudinal studies offer insight into the impact of ageing both on individuals and on the society in which they live.

• Studies must be representative of their population.

• We must listen for those who find it hardest to be heard!

The Northern Ireland Longitudinal Study of Ageing (NILDA).

• An opportunity to hear the voices of older people in our community and to learn from their experiences.

• Shed light on the causes of causes with dividend of smarter policies.

• A lasting legacy of research infra-structure i.e. • The Framingham Study• The Rotterdam Study • The Whitehall Studies

• Longitudinal studies are the ONLY WAY to separate causes and effects and understand dynamic relationships.

• To produce intellectual capital and policy relevant knowledge.

Why do people drop-out of longitudinal studies?

• The older people are the more likely they are to drop out.

• Lower socio-economic status.

• Cognitively impaired.• Educational status.• Childless.• Still at work.• Less socially active.

Thinker A, Quality in Ageing, Vol 9, issue 4, Dec 2008

• Reasons for drop-out:• Too time consuming -

contact is too frequent • Questionnaires - difficult,

intrusive, humiliating• Medical Exams - tiring,

dislike of blood samples and cognitive tests

Methods used by other studies to reduce drop-out!

• Information: newsletters, personal response to queries, meetings, results feedback, study website

• Incentives: Primarily medical investigation.• Fringe benefits: fridge magnets, pens, money, calendars• Contact: newsletters, information meetings, birthday cards,

reminder telephone calls, media coverage.• Efforts to reduce attrition: homes visits, transport to

medicals, tracing lost participants, completing questionnaires online and a study website.

What can NILDA learn from industry!!

A Brave New World ?