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BIOL0027 > A Life Course Approach to the Study of Ageing > Flashcards

A Life Course Approach to the Study of Ageing Flashcards

1
Q

What are the 2 key current population trends?

A

Fertility rates - decreased in 1960s then plateaued

Life expectancy - increasing

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2
Q

What are the defining characteristics of population ageing?

A

Increased absolute number of old people

Increased proportion of old people in population - age structure change

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3
Q

Define epidemiology

A

Study of distribution and determinants of health-related states/events

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4
Q

What is life-course epidemiology?

A

Long-term effects of whole-life physical/social hazard exposures

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5
Q

How can an early-life exposure affect late life disease development?

A

Indirectly - via chains of pathways

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6
Q

What is the foetal origins of adult disease hypothesis and how did it originate?

A

Barker linked birthweight (marker of foetal growth) to various health outcomes
Undernutrition during critical developmental periods in utero has long-term effects on chronic disease risk - by affecting structure/function of organs, tissues, systems

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7
Q

Name 3 life course studies

A

National Survey of Health and Development
Hertfordshire Cohort Study
Caerphilly Study

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8
Q

What is the Hertfordshire Cohort study?

A

All births in county in 1930s
Traced individuals in later life
Linked old age health to birth measurements
Lacking mid-life data - may be unknown mid-like exposures affecting later disease risk

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9
Q

What is the Caerphilly study?

A

Started measuring in mid-adulthood

Relied on recall of earlier life exposures - to link to later life diseases

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10
Q

What is the National Survey of Health and Development?

A

Studies effect of lifetime exposures

On pregnancy/birth, childhood development, education, adult health and function

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11
Q

What is Kuh et al.’s definition of healthy ageing?

A

Survival to old age
Delayed chronic disease onset
Optimal functioning for max. life of time

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12
Q

Which lifetime influences were found to increase adult premature mortality in the NSHD?

A

Lower childhood and adult socioeconomic position
Lower childhood cognitive ability
Over/underweight in childhood and adulthood
Adult severe psychiatric disorder

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13
Q

What is the practical aim of life-course epidemiology?

A

Identify at-risk individuals early

Identify targets and timings for interventions to prevent disease - enable optimal functioning for max. length of time

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14
Q

What are the benefits of studying function?

A

More dynamic than disease/mortality endpoints
Can study variation in population
Can identify high-risk and low-risk subgroups
Can study processes from early life - before disease

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15
Q

What is the hypothetical model of function over the life-course?

A

Increase in early life
Plateau in early-mid adulthood
Decline in later life

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16
Q

Which features of the hypothetical model of function over the life-course can vary between individuals to give different trajectories?

A

Rate of development
Level of peak
Timing of decline onset
Rate of decline

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17
Q

Which features of the hypothetical model of function over the life-course are early life exposures more likely to affect?

A

Rate of development

Level of peak

18
Q

Which features of the hypothetical model of function over the life-course are adult life exposures more likely to affect?

A

Decline

19
Q

Why are there no datasets with repeat measures of function in the same people across their life-course?

A

Earlier medical technology restricted ease of measurements

20
Q

What are the 2 types of data used to measure function across the life-course?

A

Cross-sectional - covering wide age range

Combining data from different cohorts - with overlapping age groups

21
Q

What are the limitations of measuring function over the life-course?

A

Cannot distinguish the effects of age from period and cohort effects - may distort age-related changes
Measurements may need to change to be age-specific - e.g. cognitive tests for children/adults
Equipment used to measure function changes due to improved medical technology - increased accuracy

22
Q

Does grip strength follow the hypothetical model of function?

A

Yes

23
Q

Does blood pressure follow the hypothetical model of function?

A

No

24
Q

How does mean systolic blood pressure change across the life-course in the general population?

A

Starts to increase in mid-life

25
Q

How does mean systolic blood pressure change across the life-course in Whitehall civil servants and what does this suggest?

A

Steady across mid-life
Starts to increase in late-life
Mean population trajectory may be unhealthy

26
Q

Define physical capability

A

Capacity to perform physical tasks of daily living

27
Q

What are the ways of assessing physical capability?

A

Early assessments

Performance-based assessments

28
Q

What are early assessments of physical capability?

A

Self-reports of functional limitations and abilities

29
Q

What are the limitations of early assessments of physical capability?

A

Validity and reproducibility - does not consider cognitive inabilities that may affect functional performance
How to measure change over time

30
Q

Which clinical tests are used to performance-based assessments of physical capability?

A

Walking speed
Chair rise
Standing balance
Grip strength

31
Q

Which aspects of healthy ageing are measures of physical capability linked to?

A

Increased survival rates
Delayed disease/disability onset
Increased mental wellbeing

32
Q

Which physical capability in younger populations is linked to mid-life mortality?

A

Adolescent muscle strength

33
Q

Which factors across the lifetime are associated with physical capability?

A 
Genes
Growth and body size
Lifestyle and socioeconomic circumstances
Cognitive capability
Chronic disease
34
Q

How is prenatal growth linked to grip strength and what does this suggest?

A

Higher birthweight linked to increased grip strength, lean mass, muscle fibres
Foetal growth critical for muscle fibre development

35
Q

How is childhood growth linked to chair rise performance and why?

A

Weight gain in childhood - better midlife chair rise performance
Weight gain in adolescence - poorer midlife chair rise performance
As gain lean mass in childhood - fat mass in adolescence

36
Q

How is childhood socioeconomic position linked to physical capability?

A

Lower childhood paternal socioeconomic class - poorer physical functions in later life
Regardless of later life environment

37
Q

How is childhood cognition linked to balance?

A

Higher childhood cognition - increased balance in mid-life
Effect weakens with age - cognition affects peak of balance - in decline early life factors have smaller impact - later life factors take over

38
Q

How is a disadvantaged childhood linked to adult respiratory function trajectories?

A

More negative effect on lung function in smokers than non-smokers
Upbringing and adult smoking both affect trajectories

39
Q

What is left ventricular mass index (LVMI) a predictor of?

A

Cardiovascular disease

40
Q

Why might mid-life be a sensitive period for cardiovascular disease?

A

Faster increase in systolic blood pressure in midlife linked to increased LVMI in late-life

BIOL0027 (20 decks)

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