Message from our Chief Investigator

Dr Martin McNamara, Chief Investigator, 45 and Up Study

This year, we’ve been reflecting on how much we’ve learnt since the 45 and Up Study began 15 years ago.

Thanks to your incredible contributions, the 45 and Up Study has grown into a world-class research tool that’s filling evidence gaps and advising policymakers on a wide range of health issues – from the greater than previously realised risks posed by tobacco smoking, to how to improve treatment for cancer patients.

Importantly, this year we also gathered information from many of you on the impact of COVID-19 – information that has been critical in assisting the government’s response to the pandemic.

Your commitment has also increased our understanding of what it means to age well, so that we can try to give all Australians the best possible experience of ageing.

Fifteen years of data from a quarter of a million people is a rare and valuable research resource, and we couldn’t have done any of this without you.

Once again, on behalf of the research team, thank you for being part of the 45 and Up Study!


Celebrating 15 years

of the 45 and Up Study

This year marks 15 years since the 45 and Up Study began in 2006.

Back then, no one knew that a quarter of a million people would be willing to take part in a long-term health study. Research on that scale hadn’t been done before in Australia. Still, we put the word out and more than 267,000 people responded, making the 45 and Up Study Australia’s largest study on health and ageing.

Alison Cowle, Program Manager with the 45 and Up Study, was there in those early days, and she says the growth in data has been astounding.

“Since 2006, our community of participants has filled out over half a million health surveys, taken part in 18 smaller studies, and provided real insights into how people use health services such as hospitals and GP clinics. The Study is an incredible resource for health researchers tackling big issues such as mental health, diabetes, cancer and dementia.”

Above all, Alison says it’s your generosity that has stood the test of time. “We’re so grateful to participants for sharing their health data over the past 15 years and helping to build a long-term picture of what it means to age well in Australia,” she says. And with so much data now at researchers’ fingertips, we can’t wait to see what the next 15 years will hold.

Your data in action:

The information you’ve been providing in your 45 and Up Study surveys has powered critical health research.

surveys sent out in the past 12 months

new research projects approved this year

researchers using Study data

Thank you for helping to improve the future health of all Australians!

How you’re coping with the pandemic

The 45 and Up Study has rolled out COVID-19 surveys to over 60,000 participants this year, and your answers are providing fascinating insights into how Australians are coping with the pandemic.

In good news, we found that in 2020, a higher proportion of people rated their quality of life as excellent or very good, compared with surveys from the previous two years. However, one in four said their psychological health was worse because of the pandemic.

Access to healthcare services has also changed, with 40% of people in the 45 and Up Study surveys reporting missed or delayed access to healthcare services, including missed appointments with a dentist (25%), GP (16%) and medical specialist (12%). Participants were largely positive about substantially increased telehealth services, with nearly half responding they had used these services, mostly by telephone.

As for exercise, it appears lockdown has made us less active, with over a quarter of participants spending less time on all forms of physical activity compared with the same time in the previous year. Around the same number also reported spending more time watching TV.

How about vaccination? Four in five of those surveyed in 2020 said they would get the COVID vaccination, with 19% unsure. As Australia continues its COVID vaccination program, another survey currently in the field will provide vital information on attitudes to immunisation.

In all, five surveys are planned in this series. Survey answers will help policymakers understand how the population is impacted by COVID-19 and inform the NSW government’s response to the pandemic.

Healthy ageing devotee

looking forward to getting back on the road

When 45 and Up Study participant Don MacDonald, 76, bought a motorhome a few years ago, he planned to enjoy his retirement on the road. Then came the bushfires, COVID-19 and the March floods. “As a result, the motorhome’s been sitting in the driveway for the last 18 months going nowhere,” he laughs.

Formerly the State Manager of a hardware distribution company, Don joined the 45 and Up Study in 2008 because he wanted to contribute to research and get a better perspective on his own health.

“It’s been very interesting to see how my health has changed over time, and also to see how other people my age are faring.”

Doing regular volunteer work for aged and disabled people in his community has also helped Don stay grateful for his own health. “I deliver meals on wheels and help with easy-care gardening, and a lot of the people we help are younger than me,” he explains. “It makes me appreciate when my own health is good. Sure, I have all the same things most old people get – I have arthritis, and I’m not as fit and healthy as I once was – but all things considered, I’m feeling pretty good.”

Don puts this down to paying more attention to his health and visiting the doctor every six months – a habit he developed after overcoming cancer. “I was diagnosed with thyroid cancer 22 years ago and had my thyroid removed,” he says. “I asked my doctor if I was more likely to die from cancer because I’d had thyroid cancer. He said ‘no, far less likely because now you go and talk to the doctor!’”

With his health on track, and a year of pandemics and natural disasters behind him, Don says he’s now looking forward to life getting a bit more back to normal so he can start up the motorhome and “get back on the road.”

Could big data help tackle dementia?

Over 470,000 Australians are estimated to be living with dementia, and without better prevention and treatment options, that number could more than double in the next 30 years.

In an effort to find answers to this devastating disease, researchers have been using 45 and Up’s long-term health data to dig deeper into the causes of dementia and what we might be able to do to slow its onset.

One such study, conducted by researchers at the Centre for Big Data Research in Health at UNSW, found that smoking and a history of stroke were related to higher rates of dementia. However, staying physically active was related to lower rates of dementia, possibly due to an increase in blood flow that helps maintain brain health.

While there is still no ‘cure’ for dementia, lead researcher Heidi Welberry says there are things we can all do to reduce our risk.

“Leading a physically active lifestyle, stopping smoking and reducing alcohol intake are all likely to help,” she says.

“Improving diet can also be very beneficial, with the Mediterranean diet (high in vegetables, fruits, wholegrains, fish and olive oil but lower in red meat) linked to lower rates of heart disease and cognitive decline. Continuing to engage in cognitively challenging activities and strong social connections are also thought to be important in maintaining overall brain health.”

Over the coming year, the 45 and Up Study will also be taking this research further through a new initiative with the Australian Prevention Partnership Centre that will help understand dementia’s risk factors and find pathways for prevention.

How have you changed?

2021 represents another milestone for the Study, as we have now received the responses to the Study’s third major survey, which follows on five years after the second major survey.

It’s a mammoth task to survey over 260,000 people and to sift through the wealth of information collected. And already this data is providing a fascinating picture of how our participants’ health and lifestyle has changed over the last 15 years. It’s also pretty interesting to see what we’ve all been up to!

The good news is that Study participants appear to be heeding the health messages, with unhealthy habits such as smoking and alcohol consumption on the wane. Only 3% of participants now rate themselves a smoker, compared to 7% 15 years ago. And a third of you are choosing to skip the booze, while those who do indulge are drinking less, with the majority (21%) having only 1-4 drinks per week.

However other challenges such as skin cancer and high blood pressure are becoming more common. 32% of participants have experienced skin cancer (up from 25% at the beginning of the Study) and 8% of participants have endured some other form of cancer (up from 6%).

High blood pressure is another invisible creeper, with 41% of you now reporting high blood pressure (and sorry men, but you’re more likely to be experiencing this hike). As for heart disease – your healthier habits are paying off, as rates of heart disease have steadily dropped since the beginning of the Study from 12% to 9%.

These insights will help guide future decisions about where health services need to be investing more resources, so we thank you for filling out your surveys and adding to this growing snapshot of health and ageing in Australia. To stay updated with our latest research, visit:

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