The 45 and Up Study Group

Information for researchers

E-News Current Edition

Welcome to the 5th issue of The 45 and Up e-News, a bulletin for members of the 45 and Up Study Research Network, researchers, policy makers and others with a professional interest in Australia’s largest cohort study.

Recruitment gathers momentum

Since December 2007 recruitment has been accelerated, with around 100,000 recruitment packs being mailed each month to randomly sampled individuals identified through Medicare Australia’s enrolment database.  There is a steady response rate of between 17,000 and 18,000 people per mailing. 

At the current pace of recruitment, processing of participants is a major task, so there will continually be a proportion of new participants ‘queuing’ at the processing stage. At the time of going to press approximately 90,000 people have been recruited into the Study and have given informed consent for follow-up and linkage.

At the current pace of recruitment, it is expected that the target of 250,000 participants will be reached within the coming year.   

The MBF Foundation

As announced in the last newsletter, the MBF Foundation agreed to fund a three-year Policy in Action Roundtable to ensure the Study is put to early use for research that will directly inform the provision of health services and programs for older people. The Roundtable will:

• Foster high-quality research using the 45 and Up Study that is relevant to policy and practice, and to the community
• Develop ideas for policy-relevant research projects using the 45 and Up Study that will:
  - inform a three year program of work (the MBF Foundation Policy in Action Program); or
  - be progressed through other mechanisms, including commissioned research and   competitive grant funding applications
• Facilitate the translation of research findings from the 45 and Up Study into policy actions
• Enhance mutual learning and collaboration among policymakers and researchers

The first meeting of the MBF Policy in Action Roundtable was held in December 2007. This meeting was attended by senior personnel from federal and state government as well as Study funding partners. A list of ideas for policy-relevant research using the 45 and Up Study was agreed, including:

• Factors relating to health insurance status
• Obesity and hospitalisation, including costs (linked to nutrition and physical activity)
• Linkage of 45 and Up data with aged care datasets, e.g., Home and Community Care Program, Community Aged Care Packages
• Primary care and pathways to diagnosis (mental health and cancer as case studies)
• Maintaining independence, including the impact of social connectedness
• Risk factors for high health resource utilisation

Study’s website upgraded

In February 2008 the 45 and Up Study’s website was upgraded and expanded.  As well as having a new look and more features, the site also now has a dedicated section for researchers. Visit the Information for Researchers section to find out more about: 

• applying to use the Study resource
• information for inclusion in grant applications
• help analysing the data from the Study

and more about the Study resource generally.    

45 and Up Study data now part of the CHeReL master linkage key

Data from 45 and Up Study participants are now part of the master linkage key for the NSW Centre for Health Record Linkage (CHeReL), meaning that events such as hospital admissions, deaths and cancer registrations will be automatically linked to their questionnaire records over the coming years. The CHeReL does not hold specific health information- rather it retains a “key” to link health events to individuals over time that can be used by researchers and data custodians to construct linked datasets. The 45 and Up Study is the only large scale study that we know of that has been incorporated into a population level data linkage service.

Data from the first 34,106 Study participants have been incorporated into the master linkage key. Meta-data on this linkage show that from mid-2000 to mid-2006 there were: 77,280 hospital admissions; 3,315 cancer registrations; 651 births and 246 deaths among these early recruits to the cohort.

Linkages conducted through CHeReL promise to provide a very rich source of data for researchers using the 45 and Up Study. We would encourage anyone interested in using these data to submit an application to the Study team. For more information about applying to use linked data click here.

Projects using 45 and Up Study data

To date, 25 research proposals have received approval to use data from the Study. Details of the projects are included in the 45 and Up Study website.

Eight projects are in progress using de-identified questionnaire data from the Study. The broad range of projects includes:

• Sun exposure and its correlates
• The relationship between oral health, diet and systemic health outcomes
• The correlates of poor memory, mental health and wellbeing in ageing: are they different in the old-old (aged > 80 years)?
• Understanding risk factors for cancer
• Understanding the factors relating to health insurance status
• Determining aged care trajectories in NSW
• Understanding the impact of social, economic and geographic disadvantage on the health of Australians in mid to later life
• Economic impacts of disease on older workers: costs to government and individuals and opportunities for intervention

For more information on research underway, click here.

Spotlight on research project underway

Socio-demographic and lifestyle factors linked to tooth loss: findings from the 45 and Up Study

By Manish Arora and Anthony Blinkhorn, Population Oral Health Unit, Faculty of Dentistry, University of Sydney

Tooth loss remains an important public health issue in Australia. Losing teeth not only impairs our ability to chew food, but has a wider impact on the quality of life and has also been linked to a number of systemic conditions including heart disease and cancer. Using 45 and Up Study data, we examined various factors that may be linked to tooth loss in approximately 36,000 adults living in New South Wales. We found that those in the poorest sections of the community, having lower levels of education and incomes, were more likely to suffer complete tooth loss. Those with a university education were only half as likely to lose all their teeth, than those who left before completing their school certificate.

We also found that a number of lifestyle factors were linked to the risk of losing teeth. Those who were active smokers at the time of the survey or had ever smoked cigarettes in the past, were more likely to lose all their teeth than those who never smoked. Participants in this survey who reported being exposed to second-hand cigarette smoke were also more likely to lose all their teeth. Interestingly, this link was also seen in persons who had never smoked themselves. While the adverse effects of active smoking on oral health are well-known, there is little data on the association between passive tobacco smoke and tooth loss.

We are hopeful that, as the 45 and Up Study progresses, we will be able to learn more on this issue and identify other risk factors for tooth loss and other oral health conditions. The Study’s unique data will help researchers and clinicians improve the dental health of adults living in Australia, and the size of the sample means that the results would have world-wide significance.

Communications activities

Alongside the recruitment process, we are also undertaking marketing and media activity, both to encourage people to volunteer for the Study, and to ensure that those already participating in the Study remain involved with it.   Individuals wishing to volunteer are asked to call the Study helpline on 1300 45 11 45 or complete an online volunteer registration form.

In February 2008 a newsletter was mailed to current participants, featuring: background information about the Study; one or two facts emerging from it; details of an upcoming sub-study; privacy and confidentiality measures; an interview with a participant; and information about the Study Partners.

A new Communications Manager commenced with the Study in December 2007 and several marketing and public relations activities have been instigated. The Study’s Scientific Director, Associate Professor Emily Banks, has been interviewed for a diverse range of print and broadcast media, including the Sydney Morning Herald, the Daily Telegraph, and ABC Statewide radio.

Collaborators’ Meeting

The fifth annual 45 and Up Study Collaborators’ Meeting will be held on Thursday 30^th October 2008, from 10.30am to 3.00pm at the Australian Technology Park Conference Centre, Eveleigh (adjacent to Redfern Train Station), Sydney. This is a chance for researchers, supporters and other interested parties to receive a comprehensive update on study progress and to engage with others to maximise the use of data from the study for policy-relevant research.

Professor Elio Riboli Chair in Cancer Epidemiology and Prevention at Imperial College, London and a Principal Investigator of the European Prospective Investigation into Cancer and Nutrition,will be the keynote speaker.  

To view a copy of the report from last year’s Collaborators’ Meeting click here.

Collaborators and other interested people are welcome to attend the 2008 Collaborators’ Meeting. Further details of the program will be posted on the website (in latest news and events) as they become available.  

Further Information

To find out more about any of the above email Dr Sonia Wutzke, Director, Research Assets at the Sax Institute.