There are now almost 500 researchers using data from the 45 and Up Study in their work, in areas ranging from cancer, heart disease, mental health and diabetes, to how people are using the health system.

Here you’ll find a list of all research projects associated with the Study, including those under way, awaiting funding and completed. Published research from finished projects can be found in our Publications section.

Types of research

There are three main types of research projects using 45 and Up Study data:

  • A baseline study analyses only baseline questionnaire data — the responses provided by participants when they first joined 45 and Up
  • A linkage study links the 45 and Up data to health and other records to broaden the information available for research. An example might be the impact of obesity on admissions to hospital
  • A sub-study involves re-contacting a smaller group of 45 and Up participants to provide additional information that relates to one or more specific areas of research. For a list of 45 and Up sub-studies visit the Participant toolkit.

Projects under way

Cancer

Developing indicators of cancer progression and recurrence in NSW using linked NSW Cancer Registry data, Admitted Patients Collection data, Emergency Department data, MBS and PBS Health Insurance data and ABS and RBDMS death data

Project ID: 14008
Study type: Baseline, linkage

2014

Investigators: Prof Sanchia Aranda, Mrs Maria Arcorace, Ms Deborah Baker, Dr Anton Bergheim, Prof David Currow (CI), Dr Stephen Morrell, Prof Jane Young.

Linked administrative data will be used to develop indicators of the fact and timing of cancer progression/recurrence. The accuracy of the indicators will be compared with interview data from a subsample of patients and clinicians.

This study will assist in the development of a methodology for monitoring time to progression/recurrence and from progression/recurrence to death at a population level, in order:

  • To identify the effectiveness of new treatment policies and practices.
  • To determine subgroups of patients at elevated risk of progression/recurrence and early death following progression/recurrence who may need closer follow up surveillance.
  • To assist in policy development for treatment and medical surveillance.

Factors relating to cancer incidence, care and outcomes in the 45 and Up Study

Project ID: 14005
Study type: Baseline, follow-up, linkage

2014

Investigators: Mr Albert Bang, Prof Emily Banks, Mr Sam Egger, Dr Eleonora Feletto, Mr David Goldsbury, Dr Visalini Nair-Shalliker, Prof Dianne O’Connell, Mr Peter Sarich, A/Prof Freddy Sitas, (CI),  A/Prof David Smith, Dr Marianne Weber.

There is a lack of large-scale, prospective data on risk factors for cancer in Australia and the 45 and Up Study provides a unique opportunity to quantify local risk factors for cancer as well as identifying related health outcomes and accounting for cancer-related health services use.

This project aims to quantify factors relating to cancer incidence, care and outcomes in the 45 and Up Study, including cancer mortality, all-cause mortality, and health-sevices use with known and emerging lifestyle, demographic, and health-related cancer risk factors.

Population-level relevance of risk factors for cancer

Project ID: 13006
Study type: Baseline, linkage, follow-up

2014

Investigators: Dr Barbara-Ann Adelstein, Dr Maria Arriaga, Prof Emily Banks, Prof Julie Byles, A/Prof Karen Canfell, Prof Robert Cumming, Prof Graham Giles, Ms Janet Grant, Dr Maarit Laaksonen (CI), Dr Robert MacInnis, A/Prof Dianna Magliano, Prof Paul Mitchell, A/Prof Jonathan Shaw, A/Prof Claire Vajdic.

Cancer attributable to behavioural lifestyle factors is preventable, thus modifications in lifestyle will have a large impact in reducing the cancer burden in Australia and worldwide. It is established that lifestyle interventions are the most cost-effective alternative for preventing cancer. Some lifestyle-related risk factors have been suggested to have a probable role in causing cancer, but more evidence on their strength and population-level relevance based on individual and pooled large-scale studies is necessary to understand the main preventable causes of cancer and direct interventions towards them, in order to set priorities for cancer prevention in each country.

This project aims to provide novel evidence-based data on the fraction of different cancers attributable to lifestyle-related risk factors in Australians. This project will also provide information on whether individuals with certain characteristics are more vulnerable to these risk factors.

The cost effectiveness of managing individuals at high risk of melanoma in a ‘high-risk clinic’ compared with standard care

Project ID:  12018
Study type: Baseline, linkage

2012

Investigators: Dr Anne Cust, Prof Scott Menzies, Prof Graham Mann, Dr Rachael Morton, Ms Caroline Watts (CI).

Cutaneous melanoma is the third most common cancer in NSW. Family history or personal history of melanoma, many moles or atypical moles, and fair skin will place an individual at higher risk of melanoma than the general population. Early detection is a primary factor in survival and the rationale for targeting individuals at high risk of melanoma. The introduction of a specialised clinic at Royal Prince Alfred Hospital in 2006 was a major initiative to improve the care of individuals at high risk of melanoma in NSW. In 2012, the high-risk clinic model will be expanded to three more centres in NSW.

The study is a modelled economic evaluation utilising data of health care costs and outcomes associated with a diagnosis of melanoma, managed in either a high-risk clinic or in the community. The objective is to determine whether it is cost effective to manage individuals considered at high risk of melanoma in a specialised setting (a high-risk clinic) compared with standard care, from a societal and Australian health system perspective.

A population-based examination of cancer in NSW farmers

Project ID: 11025
Study type: Baseline, linkage

2012

Investigators: Prof Bruce Armstrong, Ms Julie Depczynski, Dr Timothy Dobbins, A/Prof Tony Lower (CI).

Australian farmers have significantly elevated rates of death from prostate and lympho-haematopoietic cancers compared with other Australians. It is not known if this is related to higher incidence of these cancers, later presentation, later diagnosis or access to best treatment. The contribution of behavioural, environmental, health service use and other rural factors is also unknown.

This project is a population-based examination of risk factors, incidence, screening, diagnosis, treatment and outcomes of major cancers in NSW farmers. It will look at the comparative incidence, screening rates, stage at presentation, treatment and survival rates of major cancers in Australian farmers with rural non-farmers and urban Australians. It will also explore behavioural, environmental, socioeconomic and other risk factors associated with such differences.

Selective estrogen receptor modules (SERMS) for early breast cancer: utilisation and outcomes in Australian practice

Project ID: 09001
Study type: Baseline, linkage

2011

Investigators: Prof Frances Boyle, Prof Max Bulsara, A/Prof Mary Haines, Asst/Prof Anna Kemp (CI), Prof David Preen, A/Prof Libby Roughead.

Selective estrogen receptor modulators (SERMs) are the cornerstone of post-surgical breast cancer treatment for women with receptor-positive tumours. Little is known, however, about the way SERMs are prescribed and used in Australian clinical practice. This project will examine issues including patient characteristics in relation to initial prescription, switching between SERMs and adherence rates. The study will also determine rates of recurrence of breast cancer and mortality for women using different SERMs in clinical practice.

Diabetes

Appropriateness of access and utilisation of diabetes-related healthcare resources and impact on complications

Project ID: 16006

2016

This study aims to explore the appropriateness of access to and utilisation of diabetes healthcare resources and the impact on complications in people diagnosed with Type 1 or Type 2 diabetes.

The project is being undertaken by the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, under an Australian Diabetes Society Servier Diabetes Research Grant.

The specific aim of this project are:

  1. To examine utilisation of primary care services
  2. Assess individual pathways of diabetes-related care
  3. Compare individual pathways of diabetes- related care according to clinical practice guidelines
  4. Quantify diabetes related complications
  5. Investigate individual pathways of care and the association with diabetes -related complications
  6. Evaluate the appropriateness of diabetes- related care

 

 

 

Physical activity

The social and spatial patterning of physical activity, health outcomes, and related behaviours in New South Wales, Australia: Evidence from the 45 and Up Study

Project ID: 12007
Study type: Baseline

2012

Investigators: Dr Thomas Astell-Burt (CI), Prof Karen Croteau, Prof Gregory Kolt, Dr Xiaoqi Feng.

Using traditional and spatial modelling techniques, the investigators will investigate the spatial patterning of regular physical activity (PA), the declining propensity of regular PA with age, related health problems, and well-known social determinants among residents of NSW aged 45 years and over.

Although it is widely known that regular physical activity (PA) can help to protect our health from a variety of problems, including (but not limited to) certain cancers, cardiovascular diseases, type 2 diabetes, depression and dementia, it is also well established that a substantive proportion of the population do not participate in enough regular PA. This is especially the case as people age, during which many of the aforementioned health problems begin to emerge. This study will aim to find ways to increase levels of regular PA at a population level in order to help prevent or postpone many of these health problems from occurring.

The investigator’s focus on adults over 45 years is borne out of evidence suggesting an increased risk of withdrawal from regular PA with ageing. To shed additional new light on this association, a secondary aim of their study is to examine the extent that the decline in PA across this later stage of the life course varies spatially between different population subgroups (e.g. ethnic and gender groups) and in combination with other health-related behaviours (e.g. smoking and alcohol consumption).

Factors associated with physical activity behaviour, prolonged sitting time and weight status among chronic disease populations in the 45 and Up Study Australia

Project ID: 11011
Study type: Baseline

2011

Investigators: A/Prof Erica James, Dr Natalie Johnson, Prof Ronald Plotnikoff, Ms Camille Short (CI).

Physical activity (PA) and weight management programs have been identified as promising approaches for tertiary prevention because they can help address both the physical and psychological burdens associated with chronic illness. However, little is known about the unique correlates of PA, prolonged sitting time and weight status in chronic disease groups and whether or not they significantly differ between the various chronic disease groups and the non-chronic disease population.

The purpose of this study is to examine the correlates of physical activity, prolonged sitting time and weight status in individuals with chronic disease (cancer, diabetes, heart disease) compared to the non-chronic disease 45 and up study population. Baseline data from the 45 and up study will be the focus of the analysis. Self-reports of PA behaviour, demographics, health behaviours, health status, social support and mental health will be utilised in regression analyses.

GIS mapping the 45 and Up cohort: Physical activity and its relationship to walkability

Project ID: 10010 Part 2
Study type: Baseline

2010

Investigators: A/Prof Hilary Bambrick, Prof Emily Banks, Prof Adrian Bauman, Prof Bin Jalaludin, Ms Sanja Lujic, Mr Darren Mayne (CI), A/Prof Geoff Morgan, Prof Bryan Rodgers

‘Walkability’ describes the capacity of neighbourhood built environments to support walking for utilitarian and recreational purposes of its residents. This project will develop and compare both the objective and subjective walkability of areas within NSW. This will be used to investigate the effects of ‘walkability’ on a range of health outcomes for people 45 and over, including self-reported obesity (BMI estimates), sedentary and sitting time and physical activity behaviour.

Mental health

Maintain Your Brain

Project ID: 16004

2016 Sub Study

Lead Investigator: Prof Henry Brodaty

Maintain Your Brain (MYB) is a randomised controlled trial of multiple online interventions designed to target modifiable risk factors for Alzheimer’s disease and dementia.

Risk factors to be addressed are physical inactivity, cognitive inactivity, depression, overweight and obesity, and poor diet.

Maintain Your Brain aims:

  • In the short term to develop an all new MYB eHealth platform that delivers multimodal, customised and sequential dementia risk factor reduction and lifestyle modific interventions over the internet
  • In the medium term to determine the efficacy of MYB eHealth platform to reduce the rate of cognitive decline in non-demented community dwelling persons aged 55 years
  • In the long term to determine the efficacy of MYB eHealth platform to delay the onset of dementia
  • To examine the cost-effectiveness of the program.

Primary hypothesis: That over 4 years of active intervention, participants engaging with the MYB eHealth platform will have less cognitive decline and less incident all cause dementia than a passive control group.

The causal effects of army service on health

Project ID: 11024
Study type: Baseline

2012

Investigator: Dr Peter Siminski (CI).

This project is a component of a broader research agenda studying the effects of Vietnam-era army service on the life outcomes of veterans. Incorporating data from the 45 and Up Study and other sources, this research will examine the effects of army service on the subsequent health outcomes of Vietnam veterans, focusing particularly on mental illness, physical functioning and alcohol abuse. It is hoped this work will contribute to a greater understanding of the effects of conscription on conscripts’ health, with the potential to stimulate appropriate interventions for the study population. The research will also assess the success of existing veterans’ programs and facilitate a broader understanding of the full human costs of military conflicts.

Exploring associations between health, morbidity and psychological wellbeing in Aboriginal and Torres Strait Islander participants of the 45 and Up Study

Project ID: 11005
Study type: Baseline

2012

Investigators: Prof Emily Banks (CI), Prof Sandra Eades, Dr Grace Joshy, Dr Bridgette McNamara, Prof Beverley Raphael, Dr Anna Williamson.

This two-part project aims to investigate the self-reported health, lifestyle behaviours and general wellbeing of 45 and Up Study participants who identified as Aboriginal and Torres Strait Islander on the baseline survey. These insights will contribute to the understanding of risk profiles and how they differ from non-Aboriginal participants, and of the associations between physical disability and mental health within this cohort.

The first part of the study will describe and compare 45 and Up baseline questionnaire data from Aboriginal and Torres Strait Islander participants to that of non-Aboriginal participants, focusing on sociodemographic, health and lifestyle characteristics.

The second part will investigate high levels of psychological distress among Aboriginal and Torres Strait Islander and non-Aboriginal participants, and its relationship to a range of factors such as socioeconomic status, co-morbidity, disability and lifestyle factors.

Mapping overweight and obesity and psychological distress among the older population in NSW

Project ID: 10010 Part 1
Study type: Baseline

2010

Investigators: A/Prof Hilary Bambrick (CI), Prof Emily Banks, Prof Adrian Bauman, Prof Bin Jalaludin, Ms Sanja Lujic, Mr Darren Mayne, A/Prof Geoff Morgan, Prof Bryan Rodgers

This study aims to determine the geographic distribution of overweight and obese, physical activity and psychological distress from the 45 and Up Study cohort. This information will then be used to establish if there is a relationship between these conditions and socioeconomic and environmental characteristics of regions, as well as individual participant characteristics.

The CREDO Research Project: A randomised controlled trial of a web-based intervention to improve depression, cognitive function and adherence in people with comorbid cardiovascular disease

Project ID: 09009
Study type: Baseline, linkage, sub-study

2009

Investigators: Prof Helen Christensen, A/Prof David Darby, Prof Nick Glozier, Prof Ian Hickie (CI), Prof Paul Maruff, A/Prof Sharon Naismith, Prof Bruce Neal.

It has been shown that there is a relatively strong association between depression and cardiovascular disease. The primary aim of this project is to determine the effects of an evidence based Internet intervention program for depression on depressive symptoms in patients being treated for cardiovascular disease.

The project also aims to determine the immediate and 12-month effects of the same intervention on cognitive function, adherence and treatment for cardiovascular disease. Subsidiary outcomes include reduction in anxiety symptoms, disability and improved employment status, measured at post intervention and at 12 months.

Exploring the relationships between indicators of mental health problems and their correlates in the 45 and Up Study

Project ID: 08008
Study type: Baseline

2008

Investigators: Prof Emily Banks, Dr Soufiane Boufous, Prof Julie Byles, Prof Catherine D’Este, Dr Richard Gibson, Prof Louisa Jorm, Prof Sally Redman, Dr Ian Robinson, Prof Bryan Rodgers, Dr Anna Williamson (CI).

As Australia’s population ages, the need to identify and understand the correlates of mental health problems in middle- to old-aged Australians and the predictors of healthy ageing in relation to mental wellbeing is becoming increasingly urgent. Using baseline questionnaire data, this project will explore the indicators of mental health problems (psychological distress, self-reported anxiety and depression and psychotropic mediation use) and how they correlate to a range of measures including socioeconomic status and physical health in mid-to-late-life Australians.

Cardiovascular health

Epidemiology and cost implications of sudden cardiac death in older adults in NSW Australia

Project ID: 16007

2016

This study will attempt to quantify the size of the burden from sudden cardiac deaths (SCD) in adults.

The project will focus on development of predictors of SCD to develop targeted interventions for patient subgroups with favourable outcomes.

The specific aim of this project are to:

1. Determine the incidence of sudden cardiac death and sudden all-cause death

2. Explore co-existing conditions as potential predictors

3. Identify patient subgroups with favourable cost-effectiveness to whom costly prophylactic interventions could be targeted

 

 

The use of complementary and alternative medicine self-care amongst older Australian adults with cardiovascular conditions

Project ID: 16001

2016 Sub Study

Lead Investigator: Prof Jon Adams

Many patients with cardiovascular conditions try CAM self-care for symptom control, often without informing their health professionals. While there are many risks, challenges and opportunities associated with this ‘covert’ consumption in later life, no research to date has undertaken in-depth examination of this behaviour and associated decision-making, information-seeking, use of information sources, communication and (non)disclosure.

In direct response, this project – drawing upon the 45 and Up Study data set – provides a world-first, in-depth examination of CAM self-care amongst older Australians with cardiovascular conditions. Semi-structured interviews will also be conducted with 20 consenting participants (10 female; 10 male) for each condition (80 in total) to provide in-depth examination of experiences, behaviours and motivations around CAM self-care.

Specifically, through the use of integrated, public health and health services research methods, the project will:

  1. Provide the first insights internationally into the patterning of access, experience, engagement and decision-making regarding CAM selfcare in older adults with cardiovascular disease
  2. Empirically identify the challenges and possibilities of CAM self-care in later life for healthy ageing and living with chronic illness across adults with cardiovascular disease
  3. Develop an innovative critical and co-ordinated public health evidence-base around CAM self-care use for ageing to help inform safe, effective health care and health policy for older Australians
  4. Provide novel analyses, which in turn will take public health in new directions and develop public health practice and policy sensitive to all community activities on chronic illness and ageing.

Novel and established risk factors for cardiovascular and metabolic disease: 45 and Up Study data linkage project

Project ID: 10018
Study type: Baseline, linkage

2010

Investigators: Prof John Attia, Prof Emily Banks, Prof Adrian Bauman, Prof Ian Caterson, Prof John Chalmers, Ms Tien Chey, Prof Don Chisholm, Prof Vicki Flood, A/Prof Tim Gill, Prof Leonard Kritharidis, Ms Isabel Latz, Prof Christopher Levi, Prof Peter MacDonald, Dr Christopher Magee, Ms Suan Peng Ng, Dr Alex Peng, Dr Hidde van der Ploeg, Prof Carol Pollock, Dr Katherine Samaras, Prof Mark Woodward.

Cardiovascular disease remains the highest cause of death for adult Australians. Through linking the data obtained through the 45 and Up Study with other data sources, this study aims to investigate risk factors for cardiovascular disease. The study will investigate a number of established and emerging risk factors for cardiovascular disease including physical activity/inactivity, erectile dysfunction, short sleep duration, diabetes, nutrition and obesity. By examining the relationship between cardiovascular disease and these proposed risk factors the study hopes to provide much needed information about the disease in the Australian context.

Risk factors of cardiovascular disease: gender, age, pregnancy, breastfeeding and exogenous hormone use

Project ID: 10022
Study type: Baseline

2010

Investigators: Dr Christine Chiu, Prof Annemarie Hennessy, Dr Joanne Lind, Ms Samantha Lupton, Dr Angela Makris, Dr Aiden O’Loughlin, Ms Charlene Thornton, Ms Jane Tooher.

This study aims to investigate possible risk factors for cardiovascular disease. In particular the study will investigate risk factors for which there is limited information on their association to cardiovascular disease, including age, gender, exogenous hormone use, high blood pressure during pregnancy and breastfeeding.

The relationship between psychological distress and coronary heart disease outcomes

Project ID: 12013
Study type: Baseline

2012

Investigators:  Dr Alys Havard, Ms Caroline Joyce (CI & PhD Student) with supervisor Dr Kathryn Nicholson Perry, Prof Ian Wilson.

Anxiety and depression are common in people with coronary heart disease, predicting worse outcomes. In the general population depression and anxiety increase the risk of developing coronary heart disease. By using the baseline data from the 45 and Up Study, this project will examine the relationship between a history of anxiety and/or depression and the onset of coronary heart disease.  It will also compare  psychological distress following a cardiac event between those with and without a history of either anxiety or depression.

The Ageing Heart and Brain Study

Project ID: 09020
Study type: Baseline

2009

Investigators: Melina Gattellari (CI), Bin Jalaludin, John Worthington.

This study aims to identify the prevalence and management of stroke risk factors, such as diabetes, hypertension, congestive heart failure, atrial fibrillation, age, smoking and diet. It will also examine the risk factors for the development of Parkinson’s disease, heart disease and stroke, how these risk factors are managed and the impact of these conditions on quality of life and daily living activities. Further, the project aims to determine the outcomes for patients with stroke, heart disease and Parkinson’s disease, such as self-rated quality of life and health status, prevalence of depression and anxiety, and the prevalence and management of risk factors where relevant. Variability in outcomes according to socioeconomic status, age, gender and risk factors will also be ascertained.

Primary care

45 and Up Primary and Community Health Cohort Study

Project ID: 16003

2016

Lead Investigator: A/Prof Elizabeth Comino

The 45 and Up Primary and Community Health Cohort Study aims to explore integration of services between primary, secondary and community health care among a community-dwelling population of older residents over time, and its impact on health service utilisation and health outcomes.

The specific aims of this project are:

  1. To establish the 45 and Up Primary and Community Health Cohort to support research and evaluation of primary care activities and integrated care
  2. To undertake research and evaluation of questions of particular interest to participating organisations in relation to access to integrated care.

The finance and economics of primary health care

Project ID: 13008

Study: Baseline, follow-up, linkage

2013

Investigators: Ms Sheena Arora, Dr Denzil Fiebig, A/Prof Stephen Goodall, Prof Marion Haas, Prof Jane Hall (CI), Dr Milica Kecmanovic, Ms Patricia Kenny, Dr Ian McRae.

This project will investigate the economics of primary care (PC), including the impact of financial incentives, access to PC and the relationship between PC and acute services.

This project involves multiple studies; the first two studies aim to analyse the impact of two different Australian government policies, which both use financial incentives to modifythe practices of General Practitioners (GPs). Study 1 will evaluate an incentive intended to modify the way GPs provide care for people with specified chronic health conditions. Study 2 will evaluate an incentive intended to modify the bulk billing practices of GPs and thereby improve access to GP services.

The influence of socio-economic factors on the pattern of access of primary health care services

Project ID: 12030
Study type: Baseline, linkage

2012

Investigators: Prof Mark Harris

To investigate patterns of preventive care in the 45 and Up Study and SEEF data.

Regional level modelling of patient catchment areas – defining and analysing variation in primary health care need, utilisation and cost

Project ID: 12003
Study type: Baseline, linkage

2012

Investigators: Dr Danielle Butler, Dr Federico Girosi (CI), Prof Louisa Jorm, Mr Paul Konings, Dr Ian McRae.

This study aims to investigate geographic patterns of primary healthcare in order to provide more effective means of resource allocation and to improve health equity and overall health outcomes.

Investigators will develop patient catchment areas to examine the geography of care-seeking behaviour. The variation in healthcare need, utilisation and costs will be measured across these catchment areas. Disentangling the complex relation between these three measures and geographies will allow investigators to develop models for prioritising resource allocation. This study intends to provide valuable information for service delivery organisations regarding how best to target their services based on population need.

Use of primary care, health events, health services use and costs in the 45 and Up Study

Project ID: 11023
Study type: Baseline, linkage

2011

Investigators:  Ms Catrina Bines, A/Prof Fiona Blyth, Mrs Danushka Fox, Mr Tim Harrold, Dr Alys Havard, Prof Louisa Jorm (CI), Dr Maina Kariuki, Ms Sanja Lujic, Dr Kris Rogers, Prof James Warren.

The project will analyse linked data from the 45 and Up Study to establish the relationships between use of primary care (Medicare-funded services) and subsequent health service use, health outcomes and health service cost. It will examine the contributions of person-, geographic- and service-level factors to these relationships.

By identifying the relationships between the use of primary care services, hospital admissions for potentially preventable hospitalisation (PPH) diagnoses, and subsequent health and health care outcomes, this project will validate the use of PPH as a measure of quality and affordability of primary care. The investigators will explore these relationships for individual PPH conditions, including new candidate conditions that are not included in current standard PPH indicator sets, and identify confounding and mediating factors. With these findings, the project will identify refinements to the PPH indicator to improve its utility as a performance measure.

Using health services

Understanding the health needs of men and women in the midlife period

Project ID: 16005

2016

Lead Investigator: Jane Estoesta

Family Planning NSW is exploring the current gaps in health service provision for men and women in the midlife period of 45 to 64 years.

This study aims to inform the development of an integrated multidisciplinary midlife clinic model offering specialised care and health and wellbeing programs for men and women in this age group.

The specific aim of this project are to :

  1. Assess the demographic, socioeconomic characteristic’s  and health issues of men and women 45-64 years
  2. Review the MBS and PBS  items being utilised by this age group
  3. Determine whether people of this age group seek medical care

 

Exploring the relationship between social care, primary & secondary health service use and adverse health outcomes

Project ID: 15007

2016

Lead Investigator: Peter Lewis

The purpose of this project is to facilitate early identification of, and intervention with, people whose health trajectory indicates impending unplanned hospital admission, ED attendance, residential aged care admission, significant change in health state or death, and to contribute to evaluation of any intervention aimed at preventing the downward trajectory.

The objectives are:

  1. To describe health, residential and community services use by NSW residents, aged 45 years and over, and factors associated with that service use
  2. To compare health, residential and community services use, demographic characteristics and factors associated with that service use across NSW Local Health Districts
  3. To identify patterns of health, residential and community service use, along with other covariates, that indicate increased likelihood of an adverse health outcome (emergency hospital admission; ED attendance; residential aged care admission; significant change in health state; death)
  4. To contribute to the evaluation of any intervention aimed at preventing unplanned hospital admission, ED attendance, residential aged care admission, significant change in health state, or death.

Men’s Perspectives on Falls and Preventing Falls

Project ID: 15002

Study type: Sub-study

2015

Lead Investigator: Prof Lindy Clemson

Falls are a significant and growing public health concern among older people, affecting both men and women. Older women are at greater risk of falls than older men and experience more fall-related injury, while older men have higher fall-related mortality.

Fall prevention programs, such as Stepping On, which challenge older people to realistically appraise their risk of falling and gain knowledge about and incorporate safe practices into their everyday lives, have been shown to be effective in both reducing falls and the negative consequences of falls.

However, women are much more likely than men to engage in fall prevention programs, and so, to gain the benefits of participating in these programs .Little research has been done to date which specifically considers men’s perspectives on falls and preventing falls, their awareness of fall prevention programs, or their perceptions of, and/or experiences with programs such as Stepping On.

This project is looking at the experiences of men who have had a recent fall, what they did as a result of having the fall and what they think about preventing falls. This information will assist program developers and coordinators to adjust and adapt fall prevention programs to better meet the needs and interests of older men and thereby improve the accessibility and acceptability of these programs. Invited participants are asked to complete a telephone interview with the researchers, lasting approximately 30-60 minutes.

Fall-related and other health service use in Stepping On participants and other older adults

Project ID: 14011
Study type: Baseline, follow-up, linkage

Investigators: Ms Therese Carroll, Prof Lindy Clemson, Dr Lara Harvey, Prof Stephen Lord, Dr Serigne Lo, Dr Serene Paul, Prof Cathie Sherrington (CI), Dr Anne Tiedermann.

2014

Falls affect 30% of older adults. Information about long term health service use in older fallers can contribute to health service planning. This study investigates whether there is any detectable impact of the Stepping On fall prevention program on total and fall-related health service use.

Health service utilisation before and after a diagnosis of cancer: a data linkage study using the 45 and Up Study cohort

Project ID: 14009
Study type: Baseline, linkage

2014

Investigators:, Prof Sanchia Aranda, Ms Deborah Baker, Ms Nicola Creighton, Prof David Currow, Ms Kalinda Griffiths, Ms Mikaela Jorgensen, Dr Kris Rogers, Mr Matthew Soeberg, Ms Megan Varlow, Mr Richard Walton, Prof Jane Young (CI).

This study aims to quantify health service use in a cohort of people with cancer in NSW, before and after their cancer diagnosis, with the potential to inform future initiatives to streamline care pathways and improve cancer care services outside of hospital settings.

A key reason for undertaking this research is to contribute evidence for implementing change in health systems to improve patient and the  potential to contribute information about an important knowledge gap on health service utilisation before and after a cancer diagnosis in NSW, particularly the role of primary care in early detection and follow-up of cancer.

Mapping the outcome of calls to healthdirect in Australia

Project ID: 14001
Study type: Baseline, linkage

2014

Investigators: Ms Mary Byrne, Dr Amy Gibson, Prof Louisa Jorm (CI), A/Prof Anthony Lawler, Mr Carlo Leonessa, Ms Maureen Robinson, Dr Danielle Tran, Mr David Washington.

Healthdirect Australia contracts the provision of a 24 hour/7 day nurse triage service (healthdirect Australia), which handles approximately 1,000,000 calls per year. Approximately 80,000 are transferred on to the After Hours General Practitioner Helpline (AGPH) for further assessment and advice. It is thus crucial for the wellbeing of the Australian community that Healthdirect Australia’s services are appropriate, safe, effective and efficient.

This project will link healthdirect Australia operational call data with routinely collected hospital and emergency department data and the 45 and Up Study baseline questionnaire, and use these to explore the outcomes of calls to the healthdirect Australia telephone triage service.

Using patient experiences of adverse events to improve health services

Project ID: 12012
Study type: Sub-study, linkage

2014

Investigators: Prof Rick Iedema, Dr Patrick Kelly, Prof Elizabeth Manias, Dr Jennifer Smith-Merry, Prof Merrilyn Walton (CI).

Evidence of the patient experience is fundamental to creating effective health policy and service responses yet this is missing from our knowledge of adverse events.  Adverse events (AE) are actions occurring during health care which cause harm to patients. Despite considerable investment in efforts to reduce AEs, there are no recent, large scale studies of AEs in Australian State or Territory hospital patients. We therefore lack basic descriptive information about patient experiences and have no reliable baseline estimates that could be used to assess the impact of efforts to reduce AEs.

This project aims to understand AEs from the patient experiences. Through this study patients’ experiences, frequency and characteristics of AEs will be determined and patient characteristic’s will be compared between patients who experience AEs and those who do not. This project will also explore current services and policy structures designed to deal with adverse events.

Effects of reducing prescription drug co-payments among Indigenous Australians

Project ID: 13009
Study: Baseline, linkage

2014

Investigators: Dr Margaret Kelaher (CI), Dr Amal Trivedi.

There are profound disparities in mortality and morbidity impacting Aboriginal and Torres Strait Islander populations with chronic illness, highlighting the need to identify effective policy interventions, both in Australia and in other countries that can ameliorate racial and ethnic health disparities.

This project aims to produce empirical evidence on the impact of lowering medication out-of-pocket costs (co-payments) on the use of medications and acute hospital care among Indigenous Australians.

Hospitalisations by oldest old people and those who have had stroke

Project ID: 12025
Study type: Baseline, linkage

2013

Investigators: Prof Julie Byles (CI), Ms Catherine Chojenta, Dr Lynn Francis, Ms Isobel Hubbard, A/Prof Lynne Parkinson, Dr Jennifer Stewart-Williams Dr Andrew Searles, Prof Hal Kendig.

This study has four key aims:

  • Build platforms, methods and capacities for using linked data to examine ways in which the use and impacts of health and aged care services change as people grow older.
  • Undertake analyses of health care use associated with major chronic illnesses (such as stroke, arthritis and diabetes) and health risk behaviours; and the modifying effects of age, gender, other sociodemographic factors, and area of residence.
  • Undertake analyses to identify major drivers of health service use and factors associated with different levels and patterns of use among particular population subgroups according to age, gender, sociodemographic resources, and geographical location.
  • Develop and apply techniques for post roll out evaluation of recent health and policy innovations.

Impact on prescriber behaviour and patient health outcomes of national QUM programs – Antithrombotic Agents

Project ID: 12021
Study type: Baseline, linkage

2012

Investigators:  Dr Magnolia Carona-Morrel, Ms Eimir Hurley, Associate Prof Rachael Moorin, Associate Prof David Preen, Dr Yeqin Zuo.

NPS delivers several national QUM and Quality Use of Diagnostic tests programs per year. NPS routinely evaluates the effect of its programs on health professional knowledge and attitudes (through survey) and prescribing and referral practice (through analysing PBS and MBS data), but has not previously assessed association of its programs with health outcomes. Within the limitations of observational and ecological studies, access to the 45 and Up Study linked datasets will enable NPS to examine the association between selected programs and (gross) measures of health outcome (hospitalisation and death). Project outputs will inform NPS program development and therefore medicines advice to prescribers.

The project seeks to estimate the NPS program ‘Antiplatelet and anticoagulant therapy in stroke prevention (2009)’ impact on selected health outcomes (hospitalisation and death) using linked 45 and Up Study survey, MBS, PBS, hospitalisations and death data.

Waiting times for elective surgery and the demand for private care

Project ID: 12005
Study type: Baseline, linkage

2012

Investigators:  Dr Meliyanni Johar, A/Prof Glenn Jones, Prof Michael Keane, Prof Elizabeth Savage (CI), Dr Olena Stavrunova.

Reducing public hospital waiting times is a central issue in the Australian healthcare debate. Subsidies to private health insurance and increased expenditures to shorten waiting times both aim to ease pressure on the public hospital system. However, there is no empirical evidence to support the relative fairness or effectiveness of alternative policies.

The project’s first aim is to develop an empirical model of expected waiting times and to estimate the impact of waiting times on insurance purchase and hospital choice. It will also for the first time provide evidence of the impact of waiting on subsequent health outcomes. The model will be used to evaluate the effectiveness of alternative policies attempting to improve access to public hospital care, a key factor in the National Priority of promoting and maintaining good health. Additionally, investigators intend to quantify the importance of achieving reductions in waiting time in terms of future health system utilisation and health expenditures.

Evaluation of osteoporosis management: treatment effectiveness, policy utilisation and impacts on fracture incidence

Project ID:  11002
Study type: Baseline, linkage

2012

Investigators: Dr Fiona Blyth, Dr Jian Sheng Chen (CI), Prof Judy Simpson.

Osteoporosis is still under-treated in Australia although PBS-listed anti-resorptive drugs for its treatment have been available for more than 10 years. This highlights the need for identification of barriers to the treatments and assessment of the effectiveness of anti-resorptive drugs in clinical practice in the general population. This project aims to evaluate osteoporosis management in Australia. It seeks to assess the effectiveness of anti-resorptive drugs in clinical practice, to identify barriers to the treatments, and to examine adverse drug reaction incidence in a ‘real world’ setting.

The aims are:

  • To evaluate the effectiveness of anti-resorptive drug therapies for primary and secondary prevention of fractures
  • To evaluate the impact of anti-resorptive medication and mortality
  • To determine to what extent the current osteoporosis management is ensuring patients with osteoporosis are appropriately treated
  • To examine adverse drug reaction incidence in a ‘real world’ setting with various anti-resorptive therapies.

High risk prescribing in older people

Project ID: 11006
Study type: Baseline, linkage

2011

Investigators: Prof Emily Banks (CI), A/Prof Fiona Blyth, Prof David Le Couteur, Dr Danijela Gnjidic, A/Prof Sarah Hilmer, Dr Grace Joshy, A/Prof Sallie-Anne Pearson, Prof Andrew McLachlan, Prof Rosalie Viney.

The objective of this project is to determine the prevalence, risk factors, clinical consequences and costs of high-risk prescribing in older people. As older people are the most likely to be prescribed medications, yet are also the most likely to be harmed by their medications, this study will provide an important evidence base for the quality use of medications in Australia. The study population for this project will include all participants aged upwards of 45 years, but with a main focus on participants aged 60 years and older, allowing for the examination of age-related trends in high-risk prescribing across a broad age range.

Risk management and funding structures: an econometric panel data analysis of health insurance in Australia

Project ID: 10028
Study type: Baseline, linkage

2011

Investigators: Dr Thomas Buchmueller, Prof Denise Doiron, Prof Randall Ellis, Prof Denzil Fiebig, A/Prof Glenn Jones, Dr Meliyanni Johar, Prof Elizabeth Savage (CI).

The overall goal of this project is to provide a detailed analysis of the equity and efficiency of current health insurance subsidies. In order to reach this stage a number of procedures will be undertaken. Researchers will first estimate models of total individual health expenditure risk by using a unique dataset, which links 45 and Up survey data with a panel of detailed records on medical services, pharmaceuticals and hospital admissions. A system of separate risk equations for medical, pharmaceutical and hospital expenditures will then be devised in order to investigate substitution across programs. The research team will also determine the extent of deviations between current health care subsidies and predicted risk-related subsidies and identify how they are distributed across the population. This will allow them to simulate the impacts on resource allocation of alternative subsidies.

Risk characteristics, hospital admissions, and outcomes of patients with chronic diseases in NSW, 2005-2009

Project ID: 09021
Study Type: Baseline, linkage

2010

Investigators: Mr Geoff Barnden, Mr Peter Brandt, Mr Zoran Bolevich, Dr Yiqun Chen, Mr Bennett Durham, Dr Richard Matthews (CI), Mrs Helen Moore, Mr Allan Went.

A Chronic Disease Management Program that aims to reduce avoidable hospital admissions and to improve outcomes has been established by the NSW Department of Health. The program specifically targets five chronic conditions including diabetes, congestive heart failure (CHF), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and hypertension.

For an effective program implementation, patients who are at the highest risk and who can benefit most from participation in the program should be identified and enrolled. Previous studies have assumed that patients identified at high risk on the basis of their previous admissions would continue to be at high risk of admission in the absence of the intervention. Evidence has proved this assumption may not be true and that identification of high risk patients should consider factors other than or in addition to hospital admissions.

Through the use of data linkage this study aims to:

  • Investigate factors associated with hospital admissions (planned/ unplanned) and re-admissions of older patients diagnosed with the five chronic diseases in NSW
  • Investigate the influence of healthcare utilisation on disease outcomes, taking into account the patients’ risk characteristics.

The health needs and service use of older men

Project ID: 10027
Study type: Baseline

2010

Investigators: Prof Julie Byles, Prof Lindy Clemson, Prof Hal Kendig, Dr Mary Lam, A/Prof Lynette Mackenzie (CI).

This cross-sectional study will focus primarily on the health, functioning and service use of men aged over 70 years. Older men within the 45 and Up baseline cohort who live alone will be compared with those who live with others to identify their specific health risks and geographical factors, and to compare the health and social functioning of these two groups. The project also aims to determine the necessity of investigating the health needs of older men in a longitudinal study, given that older men have generally been overlooked as a group by health researchers.

Validation of Aboriginal identification algorithms in the APDC and ABS Mortality Data using the 45 and Up Study

Project ID: 10026
Study type: Baseline, linkage

2010

Investigators:  Prof Emily Banks, Dr Tim Churches, Prof Sandra Eades, A/Prof Mary Haines, Prof Louisa Jorm (CI), Prof Alastair Leyland, Ms Sanja Lujic, Ms Deborah Randall.

The objective of this study is to investigate the factors that predict ‘correct’ Aboriginal identification in hospital inpatient and mortality data and develop a set of candidate algorithms for improving Aboriginal identification for use with these data. Self-identified Aboriginal status in the 45 and Up Study baseline dataset will serve as a ‘gold standard’ to inform these procedures. The comparative validity, i.e. the sensitivity, specificity, positive and negative predictive values, of these algorithms will then be examined by the study team. The extent to which estimated Aboriginal rates and rate ratios for hospital separations, hospital outcomes and mortality vary according to the algorithm will also undergo analysis.

Obesity, overweight and hospitalisation: Identifying targets for interventions to prevent adverse health outcomes

Project ID: 10016
Study type: Baseline, linkage

2010

Investigators: Prof Emily Banks (CI), Prof Adrian Bauman, Prof James Butler, Ms Debra Fernando, Prof Louisa Jorm, Dr Vicki Wade.

The health effects of obesity are far-reaching and could potentially undermine recent gains in life expectancy and work done to reduce the life expectancy gap between indigenous and non-indigenous Australians.

This project aims to identify targets for interventions to reduce hospitalisation, and hence certain adverse health outcomes, relating to obesity and overweight. It will provide reliable evidence on how obesity and overweight impact on the risk and costs of hospitalisation in Australia and how this impact varies with ageing, socioeconomic disadvantage, co-morbidity, physical activity and a range of other factors.

Prescription opioid use for chronic non-cancer pain

Project ID: 10005
Study type: Baseline, linkage

2010

Investigators: A/Prof Fiona Blyth (CI), Prof Louisa Jorm, Asst/Prof Anna Kemp, Prof Andrew McLachlan, Dr Kris Rogers.

Prescription opioid medications are widely used in cancer pain and acute non-cancer pain management, so it is important to understand the factors relating to opioid use. This study will investigate: the relationship between the uses of prescribed opioid medication by those experiencing chronic non-cancer pain and a wide range of demographic, lifestyle, health and social factors; and the usage patterns of long-term opioid therapy by such patients.

Validation of self-report of surgery in the 45 and Up Study

Project ID: 09016
Study type: Baseline, linkage

2009

Investigators: Louisa Jorm (CI).

This project will investigate the agreement between self-report of surgical procedures and the recording of these procedures in routine administrative hospital morbidity data by linking the 45 and Up Study baseline questionnaire to the NSW Admitted Patient Data Collection. This research will also identify the procedure and patient factors that are associated with accurate self-reporting.

Validation of recording of comorbidity in the Admitted Patient Data Collection (APDC)

Project ID: 09015
Study type: Baseline, linkage

2009

Investigators: Diane Watson (CI).

This project is led by Dr Diane Watson, an associate researcher with the Manitoba Centre for Health Policy and recently visiting Research Fellow at the Sax Institute. The study uses self-reported information from the 45 and Up Study baseline questionnaire to explore the sensitivity and specificity of the recording of comorbidities in APDC data, and the factors (person- and hospital-related) that influence this.

Joint replacement study

Project ID: 09014
Study type: Baseline, linkage

2009

Investigators: A/Prof Fiona Blyth (CI), Prof Louisa Jorm, Dr Kris Rogers.

This project is investigating the characteristics of cohort members who have had hip or knee replacements. It involves an analysis of MBS and PBS data to investigate trajectories of service and medication use in people who have had these procedures, as well as an examination of self-reported physical functioning after joint replacement surgery.

Project ID: 08013
Study type: Baseline, linkage

2008

Investigator: Louisa Jorm (CI).

This project sought to describe the characteristics of 45 and Up Study participants who are high users of hospital services, including demographic, lifestyle, health, social and other factors.

Small numbers of individuals who are high users of health services make a major contribution to the costs of health care, in both the public and private sectors. Knowing more about the characteristics of these individuals, the health problems that they have, and their patterns of service use, will better inform policy interventions to improve the health of these individuals, and reduce or optimise their service use.

Health, lifestyle factors and ageing

Blood donation and healthy ageing behaviours in a large scale NSW sample

Project ID: 13012
Study type: Baseline, follow-up

2014

Investigators: Ms Carley Gemelli, Ms Jane Hayman, Dr Daniel Waller (CI).

The 45 and Up Study data provides potential new insight into the health behaviours of a population of blood donors and non-blood donors in the NSW community allowing the Australian Red Cross Blood Service to tailor and target communications based on a better understanding of donors.

This project aims to determine the importance of lifestyle factors in affecting donation behaviour, and suitability of blood for donation. The project will also explore and compare blood donor and non-blood donor characteristics and their effect on donation behaviour.

The Life Histories and Health (LHH) Project – Socioeconomic determinants and health inequalities over the life course: Australian and English comparisons

Project ID: 08007
Study type: Baseline, sub-study

2012

Investigators: Prof Julie Byles, Prof Hal Kendig (CI), Dr Gita Mishra, Dr Kate O’Loughlin, Prof James Nazroo.

The rise of chronic diseases like cancer, diabetes and cardiovascular disease are combining with the rapid ageing of the population to create a major health challenge for the coming decades. Understanding health risks and protective factors over the life course of the baby boom cohort will inform public health programs to prevent and respond to chronic disease and other major health challenges.

This study’s first aim is to determine opportunities for intervention from early to later life to prevent chronic diseases, depression and selected cancers. The researchers will also investigate socioeconomic and behavioural factors as risks and protections in the development of chronic disease, and endeavour to identify major health differentials in the life course of men, women and other social groups in the cohort. Finally, health histories and outcomes for the baby boom cohorts in Australia and the UK will be compared.

How do health and lifestyle factors relate to self-rated memory?

Project ID: 10021
Study type: Baseline

2010

Investigators: Dr Jim Basilakis, Prof Phillipa Hay, Prof Louisa Jorm, Ms Sabrina Kohler, Prof Anthony Maeder, Mr Robert Joshua May, A/Prof Gerald Muench, Dr Syed Ziaur Rahman (CI).

After a dementia diagnosis, the focus is often only on the person’s symptoms rather than parameters which might be causally linked or even predictive of the risk of the disease. Self-rated memory may be a clinical rating device for cognitive functioning and mild senile dementia. Limited population-based information exists about the patterns of self-rated memory and its potential risk and protective factors. Information about these factors could assist in identifying and targeting prevention and early intervention strategies.

Baseline data from the 45 and Up Study will be used to examine the relationships between self-rated memory and a range of potential risk and protective factors. In particular this project will investigate:

  • Associations between self-rated memory and health conditions.
  • Associations between self-rated memory and lifestyle factors.
  • Associations between self-rated memory and social determinants of health.
  • Associations between self-rated memory and medication use.

Retirement transition: a longitudinal P-E fit approach within a “life expectancy” time framework

Project ID: 08003
Study type: Baseline, sub-study

2009

Investigators: A/Prof Barbara Griffin (CI), Prof Beryl Hesketh (CI).

The Retirement Transition project was a sub-study which re-contacted a sub-group of the 45 and Up Study participants. The project sought to understand how retirement impacts on the wellbeing of Australian baby boomers, through the exploration of the importance of a person’s own predicted life expectancy as a predictor of retirement timing, financial decisions and how the individual will adjust to retirement. The study’s aim was to identify the needs and values of retirees and the resources required to meet these, hoping to contribute to new strategies designed to promote successful ageing in an evolving economic and social context with increased life expectancy.

Economic impacts of disease on older workers: costs to government and individuals and opportunities for intervention

Project ID: 06006
Study type: Baseline

2007

Investigators: Dr Arul Earnest, Prof Simon Kelly, Dr Megan Passey, A/Prof Richard Percival, Dr Sabrina Pit, Prof Deborah Schofield (CI).

The aim of this project is to determine the economic impacts of disease on older workers, aged 45 to 65 years. Investigators will build a microsimulation model to estimate the relationship between a range of health conditions and early retirement. This study will: determine whether increased longevity has also resulted in better health in persons of older working age; identify those conditions which have the greatest economic impact in relation to early retirement; and estimate the impact of reduced illness in the older working population. The investigators will model the labour force participation and retirement of older workers and its relationship to illness, model the costs to individuals of early retirement related to illness and model the costs to the Australian government of early retirement related to illness.

Carers and labour force participation

Project ID: 10004
Study type: Baseline

2010

Investigators: Prof Julie Byles, Dr Emily Callander, Prof Deborah Schofield (CI), Dr Rupendra Shrestha.

A report by the Australian Institute of Health and Welfare projected a 27% increase in the number of carers between 1998 and 2013. This may have a large impact on labour force supply as people may be forced to take premature retirement to provide care to family and friends.

The study’s objective is to demonstrate that people caring for family members are likely to have a lower probability of being in the labour force and caring for family members is likely to impact on their income. The study will analyse the association between caring and being out of the labour force among persons aged 45–64 years, analyse how this association varies by carers’ own health status and estimate the impact of staying out of the labour force to provide care on a carers’ income.

Identifying predisposing factors for, and the consequences of, common and emerging infectious diseases in a large prospective cohort study of adults

Project ID: 11013
Study type: Baseline, linkage

2011

Investigators: Prof Emily Banks, Prof John Kaldor, Dr Bette Liu (CI).

This project will link all 45 and Up Study data to the Notifiable Diseases Database, Admitted Patient Data Collection, Register of Births Deaths and Marriages and ABS, Medicare, PBS and Cancer registrations to determine risk factors for the development of important infectious diseases and to determine what impact specific infections have on long-term health in adults.

The investigators intend to establish risk factors that contribute to the development of several infectious diseases commonly notified in the NSW adult population, such as viral hepatitis, influenza and Ross River virus. A number of sociodemographic and behavioural factors, including weight status, smoking and drinking behaviour and ethnicity, will be observed to determine whether they predispose adults to the selected diseases. Research into the impact of specific infections on long-term health in adults will also be undertaken, involving the exploration of modifiable factors that may affect the progression of the infection into longer-term consequences. This work has the potential to contribute to a better understanding of the pathogenesis and prevention of many infectious diseases and their long-term sequelae.

Social determinants of health

Socioeconomic status, depression and risk of stroke: analysis of 750,000 participants from two prospective cohort studies

Project ID: 13010
Study type: Baseline, linkage

2014

Investigators: Dr Caroline Jackson (CI), Prof Gita Mishra, Prof Cathie Sudlow.

There are important gaps in our understanding of how depression and socioeconomic status (SES) affect stroke risk. Preliminary studies suggest that age and gender differences may exist, but the evidence is limited. It is also unclear whether depression is simply a risk marker for disease, rather than an independent risk factor for stroke. Furthermore, the mechanisms by which SES and depression might influence stroke risk remains unclear and under-investigated.

This project aims to determine the association between depression, SES and stroke, investigate whether the effect of depression and SES differs by age and gender, and the extent to which conventional stroke risk factors mediate associations with stroke.

Health inequalities among middle-aged and older Australian citizens

Project ID: 11003
Study type: Baseline

2011

Investigators: A/Prof Sharon Friel (CI), Dr Rosemary Korda, Ms Isabel Latz, Dr Vasoontara Yiengprugsawan.

Existing research has shown that an individuals’ position in society and the associated differences in access to resources such as employment, education and housing is associated with the social distribution in health outcomes. Various demographic and socio-economic factors have been studied in the context of health status, with results generally indicating poorer health outcomes with lower social status.

The overall aim of this project is to provide new evidence on the associations between material, socio-cultural, psychosocial and behavioural factors and a number of major physical and mental health outcomes in a large Australian cohort of middle-aged and older citizens. The results of this project will provide new insight into the relative influence of social and health inequalities, highlighting key entry points for public policy.

Social Capital and Social Support Analysis of the 45 and Up Study Data for the SEEF project

Project ID: 10012
Study type: Baseline

2010

Investigators: Prof Adrian Bauman, Prof Dorothy Broome, Dr Anne Grunseit, Prof Don Nutbeam, Dr Philayrath Phongsavan (CI), Prof Sally Redman.

Social networks are considered an important factor in healthy ageing. It is argued that positive connections to people can sustain well-being and quality of life and contribute to independent living. This study, in conducting a follow-up survey of 100,000 participants, will profile the distributions of social interactions by demographic characteristics and examine its relationship with health practices and health status.

Measuring Socioeconomic Status (SES) – an empirical study

Project ID: 10008
Study type: Baseline

2010

Investigators: Prof Adrian Bauman, A/Prof Jack Chen (CI), Prof Bin Jalaludin, Dr Lixin Ou.

In past health studies socioeconomic status is often based on three measures — education, prestige of occupation and family income. However these three measures have been criticised as inadequate. This project will test whether further indicators — such as home ownership and family wealth — should be routinely included additional measures. Investigators will compare the predictive and constructive validity of the conventional Principle Component method of deriving approximate Socioeconomic Status with a Social Economic Position score (SEP based on one-factor confirmatory factor analysis) and a Socioeconomic Status class membership (based on latent class analysis). Using the results gleaned from these investigations, either a SEP score or SES class membership will be derived for each respondent in the 45 and up baseline data. Investigators hope that such a score or SES class membership can be used in both baseline and follow-up analyses.

The SEEF Project: Understanding the impact of social, economic and geographic disadvantage on the health of Australians in mid to later life: What are the opportunities for prevention?

Project ID: 06001
Study type: Baseline, sub-study

2007

Investigators: Ms Sandra Bailey, Dr Hilary Bambrick, Prof Emily Banks, Prof Adrian Bauman (CI), Dr John Beard, Prof Dorothy Broom, Prof Julie Byles, Prof Judith Clark, Prof Mark Harris, Prof Bin Jalaludin, Prof Louisa Jorm, Prof Tony McMichael, Prof Don Nutbeam, Prof Sally Redman, Dr Bryan Rodgers, Prof Deborah Schofield.

As the Australian population ages, there is an urgent need to understand how people can remain healthy and independent for as long as possible.

This research will examine the ways in which social, economic and environmental factors contribute to the health of Australians in mid to later life. The participants will be selected as a 100,000 person sub-sample of the 45 and Up Study, allowing an in-depth investigation into the ways in which these factors affect each other and their importance in different sub-groups within the population. Information gained from this project will outline the most necessary areas in which programs and policies should be directed to aid in improving the health of disadvantaged Australians.

Exploring the social, economic and environmental determinants of health among Aboriginal and Torres Strait Islander participants and non-Aboriginal participants of the ‘45 and Up’ and ‘SEEF-A’ Study

Project ID: 06001H
Study type: Baseline, linkage

Investigators: Prof Emily Banks, Prof Adrian Bauman, Prof Sandra Eades (CI), Dr Lina Gubhaju, Ms Rona Macniven, Dr Bridgette McNamara.

2013

This project investigates the socio-demographic characteristics, environmental factors, lifestyle behaviours and the physical and mental well-being of middle-aged and older Aboriginal and Torres Strait Islander people from New South Wales.

Other

Using ’45 and Up ‘ dataset to develop statistical methodologies for survey nonresponse in the 45 and Up Study

Project ID: 16002

2016

Lead Investigator: Dr Joanna Wang

This project focuses on the non-response issues in the 45 and Up Study, the largest longitudinal study of population aging in the Southern Hemisphere.

By using the linked baseline questionnaire data and the follow-up resurvey data, this project aims to develop and apply statistical methods and strategies that can be adopted for identifying, quantifying and assessing the impact of non-response bias that can potentially exist in the 45 and Up study.

The linked data will be used for identifying important characteristics that are significantly related to non-response at follow-up surveys and future statistical analyses to assess the impact of non-response on measures of associations between various factors and outcomes of interest.

 

Investigation of urinary, prostatic and sexual health using linked data

Project ID: 10014B
Study type: Baseline, linkage

2012

Investigators: Prof Emily Banks (CI), Dr Mark Clements, Dr Mithilesh Dronavalli, Dr Terry Dwyer, Elsamual Elhebir, Prof Jeff Hughes, Dr Grace Joshy, Dr Rosemary Korda, Dr David Smith.

Lower urinary tract symptoms (LUTS) are extremely common and are responsible for considerable morbidity and health care costs. In men, international studies indicate the prevalence of benign prostatic hyperplasia, a term often used synonymously with LUTS, is approximately 35% for men aged 60 and over and surgical treatment for LUTS is extremely common. In women, incontinence is a common and significant health problem, with 8% of those in the 45 and Up Study reporting being troubled by leaking urine on a daily basis. Surgery for incontinence is also common. However, this area remains under researched and little reliable data exist on factors associated with LUTS, sexual health and related surgical procedures. Furthermore, although various prescription medications are known to exacerbate prostatic and urinary symptoms, direct evidence using linked prescription data and clinical outcomes is limited. This project will use questionnaire data from the 45 and Up Study linked to data on medications, hospitalisation and other health services use to identify potentially modifiable factors associated with LUTS, and the health and health services sequelae of LUTS.

Risk factors of benign prostatic hyperplasia (BPH) in the 45 and Up Study

Project ID: 10014
Study type: Baseline

2010

Investigators: Prof Emily Banks (CI), Dr Mark Clements, Prof Terry Dwyer, Dr Rosemary Korda, Ms Isabel Latz, Dr Alex Peng, Dr David Smith.

Benign prostatic hyperplasia (BPH) is a common condition among men from middle-age onwards. Left untreated BPH can lead to urinary tract infection, urinary bladder stones or obstructive uropathy (renal failure). This project will involve analysis of 45 and Up Study baseline questionnaire data to examine the relationships between demographic, lifestyle and health factors and outcome measures for BPH, such as the International Prostate Symptom Score, or a diagnosis of benign prostate hyperplasia.

CKD45 Study – A Community CKD (chronic kidney disease) cohort from the 45 and Up Study

Project ID: 12033
Study type: Baseline, linkage

2012

Investigators: Prof Alan Cass (CI), Dr Celine Foote, A/Prof Meg Jardine.

Chronic kidney disease (CKD) is associated with cardiovascular morbidity, decreased quality of life, premature mortality and increased health service utilisation. One critical area of nephrology where information is lacking is the management of CKD patients who are not referred to nephrologist care, a group who are largely managed in primary health care settings.

This study will provide crucial information pertaining to a community-dwelling, older adult CKD cohort, particularly high-risk groups who may have differential access to care. This cohort will provide an understanding of the prevalence, risk factors and management of CKD in a community setting. The study findings will be used to formulate interventions to slow progression, decrease the personal and societal burden of CKD and aim to narrow the gap between evidence and clinical practice.

Cancer

Sexual wellbeing and quality of life after prostate cancer: a comparative study of heterosexual and non-heterosexual men

Project ID: 13005
Study type: Sub-study

2013

Investigators: Mr Alan Brotherton, Prof Suzanne Chambers, Prof Ian Davis, Prof Gary Dowsett, A/Prof David Latini, A/Prof Janette Perz, Prof Jane Ussher (CI), A/Prof Scott Williams.

This study will examine the psychological burden of changes to sexual wellbeing, sexual identity and intimate relationships in heterosexual and non-heterosexual men with prostate cancer. While previous research has focused on heterosexual men, this study seeks to undertake a comparative analysis of the impact of prostate cancer on the sexual wellbeing of both heterosexual and non-heterosexual men. This comparative study marks a crucial and timely examination of the commonalities and differences in the impact of prostate cancer on men’s sexual wellbeing, and will productively inform specific and tailored health care provision and support.

Development of a risk score predicting colorectal cancer among Australian men and women in later life

Project ID:  12002
Study type: Baseline, linkage

2013

Investigators: Prof Emily Banks, Dr Grace Joshy, Prof Kerin O’Dea, Prof David Roder (CI), Dr Annika Steffen.

Colorectal cancer (CRC) substantially contributes to the burden of cancer in Western countries and is thought to be largely preventable through modification of diet and lifestyle. The identification of high-risk individuals who would most likely benefit from lifestyle modification, and/or a proven screening or surveillance strategy, could allow intervention resources to be focused and substantially reduce the burden of CRC.

A model summarising the effect of dietary and lifestyle factors on an individual’s risk of CRC would be a valuable tool for clinical practice and for planning medical research. A number of modifiable risk and protective factors have already been consistently and convincingly identified in epidemiologic studies, including physical activity, BMI status, smoking history, alcohol intake and the consumption of red and processed meat and dietary fibre. However, there has been little prior research in the development of quantitative models for summarising the effect of multiple risk factors and estimating an individual’s absolute risk of CRC. The aim of the present research is to develop a simple, practical and informative risk score using easily accessible sociodemographic, dietary and lifestyle data, for predicting absolute risk of CRC among older adults in the 45 and Up Study.

Evaluation of data mining methods for exploring factors associated with prostate cancer

Project ID: 11008
Study type: Baseline

2011

Investigators: Ms Shima Ghassem Pour (CI & PhD student), Prof Louisa Jorm, Prof Anthony Maeder.

Due to the chronic nature of prostate cancer it is difficult to understand the journey of patients who are at an advanced stage. The project aims were to find an information solution that can integrate multiple information elements and relate these to prostate cancer aetiology, risk and progression.

Outcomes resulting from this research:

Ghassempour S, Girosi F, Maeder A. Clustering multivariate time series using Hidden Markov Models. Int J Environ Res Public Health [Internet] 2014;11(3):2741-63. doi: 10.3390/ijerph110302741

Pour SG, Maeder A, Jorm L. “Constructing a Synthetic Longitudinal Health Dataset for Data Mining.” The Fourth International Conference on Advances in Databases, Knowledge and Data Applications; IARIA. 29 Feb–5 Mar 2010. Saint Gilles, Reunion Island.

Pour SG, Maeder A,  Jorm L. “Validating Synthetic Health Datasets for Longitudinal Clustering”. In Proc. Health Informatics and Knowledge Management 2013 (HIKM 2013) Adelaide, Australia. CRPIT, 142. Gray, K. and Koronios, A. Eds., ACS. 15-20

Ghassem Pour S, McLeod P, Verma B, Maeder A. “Comparing data mining with ensemble classification of breast cancer masses in digital mammograms”. In S Khanna, A Sattar & D Hansen (eds.) Proceedings of the Second Australian Workshop on Artificial Intelligence in Health (AIH 2012), CEUR-WS, Sun SITE Central Europe operated under the umbrella of RWTH Aachen University, Aachen, Germany.

Referral pathways in colorectal cancer: general practitioners’ patterns of referral and factors that influence referral

Project ID: 09022
Study type: Baseline, linkage

2009

Investigators: Prof Michael Barton, Prof Justin Beilby, Dr Lisa Crossland, Mr David Goldsbury, Prof Mark Harris (CI), Prof Dianne O’Connell, Mr Shane Pascoe, Prof Allan Spigelman, Prof Craig Veitch.

The project aims were to increase our understanding of the pattern and factors influencing the referral of colorectal cancer (CRC) patients to cancer care specialists after diagnosis in general practices. CRC is used as a model for cancer treatment referral because of the variations in practice and outcomes.

Outcomes resulting from this research:

Goldsbury D, Harris M, Pascoe S, Olver I, Barton M et al. Socio-demographic and other patient characteristics associated with time between colonoscopy and surgery, and choice of treatment centre for colorectal cancer: a retrospective cohort study. BMJ Open [Internet] 2012 May 26;2(3):e001070. doi:10.1136/ bmjopen-2012-001070

Goldsbury D, Harris M, Pascoe S, Barton M, Olver I et al. The varying role of the GP in the pathway between colonoscopy and surgery for colorectal cancer: a restrospective cohort study. BMJ open [Internet] 2013 Mar 6;3(3). doi:10.1136/bmjopen-2012-002325

Investigation of the costs of treatment of non-melanoma skin cancer

Project ID: 09024
Study type: Baseline, linkage

2009

Investigators: Prof Marion Haas, Prof Jane Hall (CI), Ms Patricia Kenny.

The project investigated the feasibility of measuring the cost of non-melanoma skin cancer (NMSC) using administrative data alone or in conjunction with survey day from the 45 and Up Study. It was part of work requested by the Cancer Institute NSW as part of the Costing and Economic Evaluation Program (CHEEP).

Outcomes resulting from this research:

Kenny P, Haas M, Hall J. Costs of Non-Melanoma Skin Cancer. May 2010. A report by the Centre for Health Economics Research and Evaluation for CHEEP (Costing Health Economic Evaluation Project). May 2010.

Diabetes

Breastfeeding and subsequent risk of diabetes

Project ID: 09019
Study type: Baseline

2009

Investigators:  Prof Emily Banks, Dr Bette Liu (CI) Prof Louisa Jorm.

The main aim of this project was to examine the effect of breastfeeding on a woman’s subsequent risk of developing diabetes.

Diabetes is a significant cause of morbidity and mortality in Australia with more than one million Australians affected.(5)  The reduction in risk of diabetes with breastfeeding reported from studies conducted in predominantly US populations is substantial (10-20%).(3)  Given the high incidence of diabetes in Australia, the association between duration of breastfeeding and diabetes has important public health implications.  This project analysed data from the 45 and Up Study to examine the association between breastfeeding and diabetes in Australian women and determine if this differs according to factors including body mass index, parity, ethnicity.

Outcomes resulting from this research:

Liu B, Jorm L, Banks E. Parity, breastfeeding and the subsequent risk of maternal type 2 diabetes. Diabetes Care 2010 Jun;33(6):1239–41. doi: 10.2337/dc10-0347

Diabetes-related risk factors among Vietnam-born residents in NSW

Project ID: 09006
Study type: Baseline

2009

Investigators: Dr Hilary Bambrick, Prof Maree Johnson, Prof Louisa Jorm (CI), Dr Duong Tran.

People from culturally and linguistically diverse backgrounds comprise a significant proportion of the Australian population, with Vietnam-born people accounting for 3.6% of those who were born overseas in the 2006 Census. Vietnam-born women have rates of gestational diabetes that are 2-3 times those of Australian-born women, however there is little research conducted with a focus on diabetes and its risk factors in the Vietnamese-speaking community.

The aims of this study were to contribute to a better understanding of cultural and health status of Vietnam-born residents in NSW in terms of how they are acculturating in Australia; the patterns of their behavioural risk factors; distribution of their illnesses, disorders or problems; and the relationship between these outcomes.

Outcomes resulting from this research:

Tran DT, Jorm L, Johnson M, Bambrick H, Lujic S. Effects of Acculturation on Lifestyle and Health Status Among Older Vietnam-Born Australians. Asia Pac J Public Health [Internet] 2013 doi:10.1177/1010539513491419

Tran DT, Jorm LR, Johnson M, Bambrick H, Lujic S. Prevalence and Risk Factors of Type 2 Diabetes in Older Vietnam-Born Australians. J Community Health [Internet] 2013 doi:10.1007/s10900-013-9745-2

Investigating best practice primary care for older Australians with diabetes using data linkage

Project ID: 08006
Study type: Baseline, linkage, sub-study

2008

Investigators: A/Prof Elizabeth Comino (CI), Dr Jeff Flack, Prof Marion Haas, Prof Mark F Harris, Prof Bin Jalaludin, Prof Louisa Jorm, Dr Mohammed Mohsin, A/Prof Gawaine Powell Davies.

In Australia most people access healthcare through community-based primary care such as general practice (GP), pharmacy and allied health.

This study aims to explore the processes of primary care for older people with diabetes. Specifically, it will investigate the relationship between best practice primary care and health outcomes including quality of life and hospitalisation. This research will enable a better understanding of the role of best practice primary health care for participants living with diabetes in Australia and how this care can be improved.

Population-based study of factors associated with type 2 diabetes

Project ID: 08010
Study type: Baseline

2008

Investigators: A/Prof Hilary Jane Bambrick, Prof Annemarie Hennessy, Prof Louisa Jorm (CI), Ms Sanja Lujic, Dr Seyed Morteza Shamshirgaran.

The aim of this study was to examine factors associated with type 2 diabetes in the 45 and Up Study cohort, including country of birth, duration of residence, ancestry and aboriginality, other demographic and socioeconomic factors, medical and family history and behavioural and lifestyle factors.

Outcomes resulting from this research:

Shamshirgaran SM, Jorm L, Bambrick H, Hennessy A. Independent roles of country of birth and socioeconomic status in the occurrence of type 2 diabetes. BMC Public Health [Internet] 2013;13(1):1223. doi:10.1186/1471-2458-13-1223

Research contributed to Dr Seyed Morteza Shamshirgaran’s PhD thesis: Type 2 diabetes in migrant groups: population-based study of lifestyle factors, complications and hospital use.

Mental health

Physical Activity and Depression in Men Living in Rural and Remote Areas of NSW

Project ID: 09005
Study type: Baseline

2009

Investigators: A/Prof Hilary Bambrick, Dr Emma George (CI), Prof Louisa Jorm (Supervisor), Prof Gregory Kolt, Ms Sanja Lujic.

The aims of this project were to analyse the baseline questionnaire data to explore the relationship between physical activity levels and self-reported doctor-diagnosed depression and depressive symptoms in men aged 65 and over living in rural and remote areas of NSW.

Depression is one of the most common mental health conditions worldwide, with findings indicating that one in six Australian men will suffer from depression at any given time. The risk of depression and suicide in older Australian men, aged 65 and older, is equally as high, with factors such as physical illness, decreased mobility due to chronic pain and isolation being major causes. Findings of this project will contribute to an improved understanding of the burden of mental illnesses, including depression, in New South Wales; and inform later investigation of the relationship between physical activity and mental health.

Outcomes resulting from this research:

George E, Kolt G, Jorm L, Lujic S. Physical activity and psychological distress in older men: Findings from the New South Wales 45 and Up Study. J Aging Phys Act 2012 Jul;20(3):300-16

Physical activity

Physical activity and health: Studies of older adults and middle-aged men

Project ID: 10006
Study type: Baseline

2010

Investigators: Dr Mitch Duncan, Prof Louisa Jorm, Prof Gregory Kolt (CI), Prof Kerry Mummery, Dr Richard Rosenkranz, Lisa Yorston.

The aims of this project were to examine the relationship between the amount and intensity of physical activity undertaken by those over 65 years of age, and their perceived limitations in functional activity. In relation to middle-aged men, the aim of the study was to examine the relationship between the amount and intensity of physical activity and volume of seated activity and a range of health and non-health variables including medical conditions, perceived health and quality of life status, dietary behaviours, education, employment, rurality and socioeconomic status.

Outcomes resulting from this research:

George E, Rosenkranz R, Kolt G. Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study. Int J Behav Nutr Phys Activity [Internet] 2013 Feb 8;10:20. doi:10.1186/1479-5868-10-20

Rosenkranz RR, Duncan MJ, Rosenkranz SK, Kolt GS. Active lifestyles related to excellent self-rated health and quality of life: cross sectional findings from 194,545 participants in The 45 and Up Study. BMC Public Health [Internet] 2013;13(1):1071. doi: 10.1186/1471-2458-13-1071

Yorston L, Kolt G, Rosenkranz R. Physical Activity and Physical Function in Older Adults: The 45 and Up Study. J Am Geriatr Soc 2012;60(4):719–25. doi:10.1111/j.1532-5415.2012.03906.x

Physical Activity and Depression in Men Living in Rural and Remote Areas of NSW

Project ID: 09005
Study type: Baseline

2009

Investigators: A/Prof Hilary Bambrick, Dr Emma George (CI), Prof Louisa Jorm (Supervisor), Prof Gregory Kolt, Ms Sanja Lujic.

The aims of this project were to analyse the baseline questionnaire data to explore the relationship between physical activity levels and self-reported doctor-diagnosed depression and depressive symptoms in men aged 65 and over living in rural and remote areas of NSW.

Depression is one of the most common mental health conditions worldwide, with findings indicating that one in six Australian men will suffer from depression at any given time. The risk of depression and suicide in older Australian men, aged 65 and older, is equally as high, with factors such as physical illness, decreased mobility due to chronic pain and isolation being major causes. Findings of this project will contribute to an improved understanding of the burden of mental illnesses, including depression, in New South Wales; and inform later investigation of the relationship between physical activity and mental health.

Outcomes resulting from this research:

George E, Kolt G, Jorm L, Lujic S. Physical activity and psychological distress in older men: Findings from the New South Wales 45 and Up Study. J Aging Phys Act 2012 Jul;20(3):300-16

Cardiovascular health

Cross sectional descriptive analysis of the baseline 45 and Up data set to inform the cardiovascular research network (CVRN)

Project ID: 10003
Study type: Baseline

2010

Investigators: Prof Emily Banks, Prof Adrian Bauman (CI), Prof John Chalmers.

The aims of this study were to analyse cardiovascular disease and diabetes by socio-demographic factors in the baseline 45 and Up dataset; to examine the sub types of cardiovascular disease, diabetes or renal disease that are available in the 45 and Up data set; and to examine the risk for people who have already with reported heart disease, hypertension, diabetes, stroke, and renal disease. The risk factor profile sought were those risk factors that could be identified through the baseline dataset, including profiling by physical activity level, obesity, smoking status and some nutritional patterning.

Outcomes resulting from this research:

The project produced an important report on baseline prevalence rates of cardiovascular and related risk factors. The investigators of this project also provided valuable feedback to the 45 and Up Study, relating to methodology, which resulted in beneficial updates to the 45 and Up Study’s baseline data.

An evaluation of the contribution of cardiovascular risk factors to psychological distress and disability in the 45 and Up Study

Project ID: 08016
Study type: Baseline

2008

Investigators: Ms Joanne Atkins, Prof Nick Glozier, Prof Ian Hickie (CI), A/Prof Sharon Naismith, Dr Matthew Paradise.

The aims of this project were to determine which single or combined cardiovascular risk factors predict psychological distress/depression, and to determine the major associations of physical health and psychological distress with measures of disability among participants in the 45 and Up Study of working age (<65 years). It also hoped to provide understanding of key factors predicting disability and quality of life in the NSW population.

Outcomes resulting from this research:

Paradise MB, Glozier NS, Naismith SL, Davenport TA, Hickie, IB. Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study. BMC Psychiatry 2011 July 1;11:108. doi:10.1186/1471-244X-11-108

Paradise MB, Naismith SL, Davenport TA, Hickie IB, Glozier NS. The impact of gender on early ill-health retirement in people with heart disease and depression. Aust N Z J Psychiatry 2012;46(3):249–56. doi: 10.1177/0004867411427807

Health, lifestyle factors and ageing

Sleep duration, obesity and health in middle aged and older Australian adults

Project ID: 09003
2009

Investigators: A/Prof Peter Caputi, Prof Donald Iverson, Dr Christopher Magee (CI).

The primary objective of this project was to examine the relationships between sleep duration, obesity and other health indicators in a large sample of Australian adults aged 45 years and over.

Outcomes resulting from this research:

Magee CA, Holliday EG, Attia J, Kritharides L, Banks E. Investigation of the relationship between sleep duration, all-cause mortality and pre-existing disease. Sleep Medicine [Internet] 2013 March 18. doi: 10.1016/j.sleep.2013.02.002

Magee C, Kritharides L, Attia J, McElduff P, Banks E. Short and long sleep duration are associated with prevalent cardiovascular disease in Australian adults. J Sleep Res 2012 Aug;21(4):441–7. doi: 10.1111/j.1365-2869.2011.00993.x

Magee C, Caputi P, Iverson D. Relationships between self-rated health, quality of life and sleep duration in middle aged and elderly Australians. Sleep Med 2011 Apr;12(4):346–50. doi: 10.1016/j.sleep.2010.09.013

Magee C, Caputi P, Iverson D. Is Sleep Duration Associated With Obesity in Older Australian Adults? J Aging Health 2010 Dec;22(8):1235–55. doi: 10.1177/0898264310372780

Magee C, Iverson D, Caputi S. Short sleep mediates the association between long work hours and increased body mass index. J Behav Med 2011 Apr;34(2):83–91. doi: 10.1007/s10865-010-9287-3

Magee C, Iverson D, Caputi S. Sleep duration and obesity in middle-aged Australian adults. Obesity 2010;18(2):420–1. doi: 10.1038/oby.2009.373

Holliday EG, Magee C, Kritharides L, Banks E, Attia J. Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PLoS One [Internet] 2013. doi: 10.1371/journal.pone.0082305

Magee C, Iverson D, Caputi S. Factors associated with short and long sleep. Prev Med 2009 Dec;49(6):461–7. doi: 10.1016/j.ypmed.2009.10.006

The following paper cited three papers by Magee regarding the synthesis of data on the relationship between sleep loss, obesity and diabetes:

Pannain S, Beccuti G, van Cauter E. Chapter 10: The Connection Between Sleep Loss, Obesity, and Type 2 Diabetes in P.J. Shiromani et al. (eds.) Sleep Loss and Obesity: Intersecting Epidemics. Springer Science+Business Media, 2012;133–68 doi: 10.1007/978-1-4614-3492-4_10

Lifestyle influences on autoimmune and inflammatory diseases

Project ID: 11009
Study type: Baseline

2011

Investigators: Prof Gregory Kolt, A/Prof Richard Rosenkranz (CI), Asst/Prof Sara Rosenkranz.

This project aimed to investigate the association between lifestyle factors and autoimmune and inflammatory diseases such as rheumatoid arthritis, osteoporosis, asthma and hay fever.

Outcomes resulting from this research:

Rosenkranz R, Rosenkranz S, Neessen K. Dietary factors associated with lifetime asthma or hayfever diagnosis in Australian middle-aged and older adults: a cross-sectional study. Nutr J [Internet] 2012 Oct 12;11(1):84. doi:10.1186/1475-2891-11-84

Fruit and vegetable intakes among men and women in NSW: who is going for 2 and 5?

Project ID: 09023
Study type: Baseline

2009

Investigators: Prof Emily Banks, Prof Julie Byles (CI), Dr Paul Kowal, Ms Melinda Soriano.

Diet and nutrition are common risk factors contributing to the rising rates of chronic conditions. This study aimed to examine the level of intake of fruit and vegetables among people aged 45 and over in NSW. These data will be analysed against key sociodemographic factors such as age, sex, income and education, other dietary behaviours (e.g. eating meat, fruit juice, eggs, milk, cereals), and other risk factors for chronic conditions and health conditions such as BMI, physical activity, smoking and alcohol intake.

Outcomes resulting from this research:

Charlton K, Kowal P, Soriano MM, Williams S, Banks E, Vo K, et al. Fruit and vegetable intake and body mass index in a large sample of middle-aged Australian men and women. Nutrients [Internet] 2014;6(6):2305-19. doi: 10.3390/nu6062305

Relationship between demographic and lifestyle factors and asthma and hay fever in an older Australian population

Project ID: 08009
Study type: Baseline

2008

Investigators: Dr Neil Misso (CI), Dr Hassan Vally (CI).

This project explored associations between demographic and lifestyle factors with asthma and hay fever in the older Australian population.

Sun exposure and its correlates in the NSW 45 and Up cohort study

Project ID: 07004
Study type: Baseline

2007

Investigators: Prof Bruce Armstrong (CI), Dr Anne Kricker.

The aim of this project was to analyse data collected via the 45 and Up Study baseline questionnaire to systematically determine the strongest predictors of skin cancer and sun exposure. Data is being used to assess the extent to which the current methods of measuring sun exposure ask for sufficient information about all relevant behaviours.

Social determinants of health

Exploring the relationships between tobacco, alcohol use and socioeconomic status and mental health in the 45 and Up Study sample

Project ID: 12023
Study type: Baseline

2012

Investigators: Prof Amanda Baker, Dr Billie Bonevski (CI), Mrs Ashleigh Guillaumier, A/Prof Patrick McElduff, A/Prof Chris Paul, Ms Laura Twyman.

A substantial body of research has shown that smoking rates are significantly higher in disadvantaged groups compared with the general population, for example, compared with a population prevalence of 15% in Australia, smoking rates are 62-91.9% among individuals with a mental illness, and 25.9% among individuals in the lowest quintile of disadvantage.

The aim of this project was to explore the relationships between smoking, alcohol use, socioeconomic status and mental health (depression and anxiety in particular) in the 45 and Up Study population to help model the associations between these factors, and guide the development of tailored smoking cessation interventions in low socioeconomic status group with mental health issues.

Outcomes resulting from this research:

Bonevski B, Regan T, Paul C, Baker AL, Bisquera A. Associations between alcohol, smoking, socioeconomic status and comorbidities: Evidence from the 45 and Up Study. Drug Alcohol Rev [Internet] 2013. doi:10.1111/dar.12104

Exploring the relationships between exposure to second-hand smoke, co-morbidities, housing status and socioeconomic status in the 45 and Up Study sample

Project ID: 12022
Study type: Baseline

2012

Investigators: Dr Billie Bonevski (CI), Ms Anne Jones, A/Prof Patrick McElduff, A/Prof Chris Paul, Dr Allison Salmon.

Numerous complaints from residents in multi-unit housing about their exposure to second-hand tobacco smoke from neighbours are reported to Action on Smoking on Health (ASH) and Cancer Council NSW. Complaints are often from people who feel trapped because they have to keep doors and windows closed to stop tobacco smoke from infiltrating their homes.

There has been very little Australian data regarding the extent of second-hand smoke in various housing types and the link between second-hand smoke and socioeconomic status. A substantial amount of research evidence has drawn direct links between exposure to second-hand smoke and harm to health for both adults and children. Given smoking rates are much higher among groups of lower economic status who are more likely to be from areas of high-density living, the research project’s aim was to examine the relationships between these factors.

Outcomes resulting from this research:

Findings have been utilised by ASH Australia for advocacy to achieve health policy and legislative change in smoke-free policies for multi-unit housing. This has contributed to changes in NSW legislation with a by-law being introduced restricting smoking in common areas of multi-unit housing.

Bonevski B, Paul C, Jones A, Bisquera A, Regan T. Smoky homes: Gender, socioeconomic and housing disparities in second hand tobacco smoke (SHS) exposure in a large population-based Australian cohort. Prev Med [Internet] 2013 doi:10.1016/j.ypmed.2013.12.024

Maintaining independence

Project ID: 09017
Study type: Baseline, linkage

2009

Investigators: Prof Julie Byles, Ms Nicole Mealing (CI).

This project aim was to explore the factors that enhance the likelihood that older people will “age in place”, and stay living independently for as long as possible. These factors being financial resources; good relationships with family and friends; supportive home and neighbourhood environments; physical and mental health status; availability of informal support; and access to support services. The project involved linking data from the 45 and Up Study baseline questionnaire with records from the NSW Home and Community Care Program Minimum Dataset (HACC MDS) and NSW Admitted Patient Data Collection (APDC). Analyses explored who uses HACC services in NSW and why, and the relationships between use of HACC and hospital inpatient services.

The HAIL Project: Housing and Independent Living

Project ID: 9013
Study type: Baseline, sub-study

2009

Investigators: Prof Julie Byles, A/Prof Lynette Mackenzie, A/Prof Lynne Parkinson, Prof Sally Redman, Dr Anna Williamson.

This study examined the home and neighbourhood environments of a sample of community dwelling older people, to determine the extent to which these environments can be considered to be “supportive” according to internationally accepted measures; identified those people who are least likely to be currently living in supportive environments; and then contrast these findings against people’s expectations of their increasing needs as they age and of how these needs are to be met.

Outcomes resulting from this research:

Byles J, Gallienne L, Blyth F, Banks E. Relationship of age and gender to the prevalence and correlates of psychological distress in later life. Int Psychogeriatr 2012 Jun;24(6):1009–18. doi: 10.1017/S1041610211002602

Byles J, Mackenzie L, Parkinson L, Leigh L, Redman S, Curryer C. Supporting housing and neighbourhoods for healthy ageing: Findings from the Housing and Independent Living Study (HAIL). Australasian Journal on Ageing [Internet] 2012 Oct 25. doi:10.1111/j.1741-6612.2012.00646.x

Byles JE, Leigh L, Vo K, Forder P, Curryer C. Life space and mental health: a study of older community-dwelling persons in Australia. Aging & Mental Health [Internet] 2014:1-9. doi: 10.1080/13607863.2014.917607

Mackenzie L, Curryer C, Byles JE. Narratives of home and place: findings from the Housing and Independent Living Study. Ageing and Society [Internet] 2014:1-29. doi: 10.1017/s0144686x14000476

Health behaviour clusters

Project ID: 09010
Study type: Baseline

2009

Investigators: A/Prof Barbara Griffin, Prof Mike Jones, Dr Kerry Sherman.

Typically large groups of people are studied by dividing them into subgroups based on demographic variables such as age, race, gender and income. This segmentation neglects the rich diversity of psychosocial factors that are known to underlie health-related intentions and behaviours. This study, by segmenting the 45 and Up baseline data, investigated whether people can be grouped by the health-related behaviours in which they engage and whether there are differential outcomes for members of different subgroups.

Outcomes resulting from this research:

Griffin B, Sherman KA, Jones M, Bayl-Smith P. The clustering of health behaviours in older Australians and its association with physical and psychological status, and sociodemographic indicators. Ann Behav Med [Internet] 2014;48(2). doi: 10.1007/s12160-014-9589-8

Other

Patterns of complementary medicine use in patients with osteoarthritis

Project ID: 11004
Study type: Baseline

2011

Investigators: A/Prof Fiona Blyth, A/Prof Marlene Fransen, Prof Louisa Jorm (Supervisor), Ms Sanja Lujic, Dr Lynette March, Mr Sean Williams (CI).

The aim of this project was to undertake a descriptive analysis of the usage patterns of glucosamine, omega 3 and fish-oil in a population with osteoarthritis.

Outcomes resulting from this research:

It was found that glucosamine use was more common than previously reported in people being treated for osteoarthritis (45%). In a population treated for osteoarthritis, glucosamine use was found to be more prevalent in those with higher income, higher levels of education, being female, increased exercise levels, less physical limitation, and good self-rated health and quality of life.

Mr Sean Williams, an MBBS (Honours) student at the University of Western Sydney, was awarded First Class Honours and the University Medal for this research. Mr Williams presented his research findings at the 45 and Up Study Collaborators’ Meeting 2011, and the Australian Rheumatology Association NSW Meeting 2011.

The profile and prevalence of use of glucosamine and fish oil among older Australians

Project ID: 10013
Study type: Baseline

2010

Investigators: A/Prof Jon Adams (CI), A/Prof Alex Broom, Dr Chi-Wai Lui, Prof David Sibbritt, Dr Jon Wardle.

The use of complementary and alternative medicine — including dietary or nutritional supplements — has attained mainstream status in contemporary western society. Unfortunately there has been little empirical investigation examining the profile and prevalence of the use of such dietary and nutritional supplements for older adults. The aim of this project was to determine, the profile of users of glucosamine and fish oil or omega-3 fatty acids and the prevalence of use in 45 and Up Study participants based on demographic, health status, and health behaviour variables.

Outcomes resulting from this research:

Sibbritt D, Adams J, Lui C-W, Broom A, Wardle J. Who Uses Glucosamine and Why? A Study of 266,848 Australians Aged 45 Years and Older. PLoS ONE [Internet] 2012 7(7):e41540. doi:10.1371/journal.pone.0041540

Adams J, Sibbritt D, Lui C-W, Broom A, Wardle J. Omega-3 fatty acid supplement use in the 45 and Up Study Cohort. BMJ Open [Internet] 2013;3:1–8. doi:10.1136/bmjopen-2012-002292

Randomised pilot study for collection of biospecimens and biodata from 1,000 participants in the 45 and Up Study (Link-Up Project)

Project ID: 08020
Study type: Sub-study

2009

Investigators: Prof Emily Banks (CI), Prof Louisa Jorm, A/Prof Sonia Wutzke.

The project aim was to collect detailed physical measures and biospecimens from approximately 1,000 45 and Up Study participants through dedicated clinics and existing pathology services to:

Provide overall information on the feasibility, acceptability and cost of collecting biospecimens and biodata from 45 and Up Study participants.

Establish likely response rates for collection of biospecimens and biodata from 45 and Up Study participants, overall and according to a range of factors, including data collection model, fasting versus non-fasting status, distance of residence from the collection site, age, sex, socioeconomic status, functional capacity and lifestyle.

The other aim of the project was to validate self-reported measures of height and weight against measured height and weight and provide measured data on height and weight to calibrate self-reported height and weight for the rest of the 45 and Up Study.

Outcomes resulting from this research:

Banks E, Herbert N, Rogers K, Mather T, Jorm L. Randomised trial investigating the relationship of response rate for blood sample donation to site of biospecimen collection, fasting status and reminder letter: The 45 and Up Study. BMC Med Res Methodol [Internet] 2012 Sep 24;12:147. doi:10.1186/1471-2288-12-147

The relationship between oral health, diet and systemic health outcomes in the 45 and Up Study Cohort

Project ID: 07011
Study type: Baseline

2007

Investigators: Dr Manish Arora (CI), Dr Bradley Christian, Assoc Prof Wendell Evans, Dr Pathik Mehta, Dr Shanti Sivaneswaran.

The Australian population continues to age. These expected changes in the Australian population pose a myriad of challenges in understanding the determinants of aging related health conditions. Oral health is an integral part of our overall health. Poor oral health status has been linked to a number of systemic diseases.

The aims of this study was to address the issues surrounding oral health with a primary focus on the interrelationship between tooth loss and diseases affecting the whole body.

Outcomes resulting from this research:

Arora M, Schwarz E, Sivaneswaran S, Banks E. Cigarette Smoking and Tooth Loss in a Cohort of Older Australians: the 45 and Up Study. J Am Dent Assoc 2010 Oct;141(10):1242–49

Physical Activity and Depression in Men Living in Rural and Remote Areas of NSW

Project ID: 09005
Study type: Baseline

2009

Investigators: A/Prof Hilary Bambrick, Dr Emma George (CI), Prof Louisa Jorm (Supervisor), Prof Gregory Kolt, Ms Sanja Lujic.

The aims of this project were to analyse the baseline questionnaire data to explore the relationship between physical activity levels and self-reported doctor-diagnosed depression and depressive symptoms in men aged 65 and over living in rural and remote areas of NSW.

Depression is one of the most common mental health conditions worldwide, with findings indicating that one in six Australian men will suffer from depression at any given time.  The risk of depression and suicide in older Australian men, aged 65 and older, is equally as high, with factors such as physical illness, decreased mobility due to chronic pain and isolation being major causes.  Findings of this project will contribute to an improved understanding of the burden of mental illnesses, including depression, in New South Wales; and inform later investigation of the relationship between physical activity and mental health.

Outcomes resulting from this research:

George E, Kolt G, Jorm L, Lujic S. Physical activity and psychological distress in older men: Findings from the New South Wales 45 and Up Study. J Aging Phys Act 2012 Jul;20(3):300-16