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.

You can use our search tool to display only studies meeting certain criteria, for example studies about cancer, or baseline studies only. Scroll down to browse the full list of all projects under way and completed.

Projects Underway Projects Completed

Projects under way

Physical Activity

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

Project ID: 10010Part2

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.

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.

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).

Using Health Services

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.

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.

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.

Using patient experiences of adverse events to improve health services

2014

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

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.

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.

Risk factors for admission to residential aged care 

Project ID: 13007

Study Type: Baseline, Linkage

2013

Investigators: A/Prof Fiona Blyth, Prof Julie Byles (CI), Ms Catherine Chojenta.

The aim of this project is to examine the risk factors for admission to residential aged care in a large representative sample of New South Wales men and women.

Risk factors to be considered will include demographics, physical health, mental health, social support and health behaviours.

The research outcomes will include an improved understanding of those people who are at greater risk of admission to residential aged care. An understanding of these risk factors will assist in improved projecting of numbers of people who will require residential aged care in the future and also a more accurate profile of the people more typically likely to enter residential aged care, so that services can be catered to their specific needs.

Population-based risk factors and use of health services for fracture

Project ID: 10017

Study Type: Baseline, Linkage

2010

Investigators: Prof Emily Banks (CI), Dr Mark Clements, Dr Rosemary Korda, Dr Jeffrey Lai, Prof Robyn Lucas.

Fracture is an important, under-researched and increasing health problem. Fractures occur frequently among older populations and are a significant source of morbidity and mortality worldwide. A range of demographic and lifestyle factors have been shown to be important risk factors for fracture. This study will investigate these and other general factors in relation to fracture risk including sun exposure and pharmaceutical agents (including hormonal contraceptives).

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.

Effects of reducing prescription drug co-payments among Indigenous Australians

Project ID: 13009study

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

Project ID: 14011

Study Type: Baseline, Follow-up, Linkage

2014

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.

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.

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.

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.

Primary Care

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.

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.

The finance and economics of primary health care

Project ID: 13008

Study Type: 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.

Other

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.

The Influence of Season on Participant Responses to 45 and Up Study Survey Questions About Health and Wellbeing

Project ID: 10011

Study Type: Baseline

2010

Investigators: Dr Hilary Bambrick, Prof Emily Banks, Dr Charmian Bennett (CI), Prof Anthony J McMichael.

Weather and climate have diverse, and often dramatic, influences on health and wellbeing. This project aims to describe and quantify the variation in participant responses associated with the season in which the 45 and Up Study survey was answered. This information will help assess whether seasonality is an important predicator of survey responses to questions on health and wellbeing, and which variables, if any, are most strongly affected.

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.

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.

Cancer

Understanding the risk factors for cancer in the 45 & Up Study Cohort

Project ID: 07005

Study Type: Baseline

2009

Investigators: Dr Emily Banks, Dr Karen Canfell, A/Prof Dianne O’Connell, A/Prof Freddy Sitas (CI), Mr David Smith, Dr Marianne Weber.

Significant structural changes to the Australian population are predicted for the near future such that the number of people aged over 65 will increase by around 50% in the next 10-15 years. In terms of health, these changes will carry a significant increase in the social and financial burden to the Australian public and the issue of ‘healthy aging’ will be a prominent concern. Cancer risk generally increases with age, with almost one third of all cancers diagnosed in NSW occurring in individuals over 75 years. Thus, the focus on older individuals in the 45 and Up Study cohort is particularly suited to examining potential risk factors for cancer.

This projects aims to use the first (and subsequent) baseline surveys of the 45 and Up Study for cross-sectional analysis of variables pertinent to risk factors for cancer. The proposed cross-sectional analysis will underpin cancer research using the cohort in the future by providing baseline descriptive data and informing hypothesis generation, protocol development, sample size calculations, grant applications, and future study and analysis directions.

Skin Health Study – Infectious and lifestyle determinants of non-melanoma skin cancer

Project ID: 09011

Study Type: Baseline, Sub Study

2009

Investigators: Prof Bruce Armstrong, Porf Emily Banks, Dr Anne Kricker, Dr Michael Pawlita, A/Prof Freddy Sitas (CI), Dr Tim Waterboer, Dr Marianne Weber.

Australia has the world’s highest reported incidence rates of the keratinocyte skin cancers basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). They are also Australia’s most expensive cancers in terms of diagnosis and treatment. This study aims to quantify the contributions of amount and pattern of sun exposure to the risk of keratinocyte cancers. The study will also explore other risk factors for the cancers including smoking and alcohol consumption, other lifestyle factors and the human papilloma virus infections (HPV).

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.

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.

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.

Population-level relevance of risk factors for cancer

Project ID: 13006

Study Type: Baseline, Follow-up, Linkage

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.

Physical and psychosocial outcomes in adult cancer survivors

Project ID: 10020

Study Type: Baseline, Linkage

2012

Investigators: Prof David Goldstein, Prof Andrew Lloyd, Dr Efty Stavrou (CI), A/Prof Claire Vajdic, Dr Kate Webber.

In Australia, the number of new cancer cases is expected to increase with the ageing population. Due to improvements in cancer detection and modes of treatment, cancer survivorship numbers are increasing. Healthcare needs of this population therefore warrant systematic investigation.

The overall objective of the program is to evaluate the impact of selected cancer diagnoses on the lifestyle behaviours, comorbidity and other health outcomes of adult survivors up to 10 years post-diagnosis. This project will assist to determine physical and psychosocial needs for cancer survivors beyond their critical cancer care. Specifically, investigators will examine the long-term health service needs, lifestyle behaviours and functional outcomes of cancer survival sub-groups and how these differ to those without a history of cancer. The project will investigate any disparity in health burden among cancer survivors, including survivors from Australian and non-Australian ancestry. The associated financial costs to the community and the out-of-pocket expenses to the individual for the provision of ongoing health services not related to critical cancer care will be studied. This work aims to make a substantial contribution to understanding the long-term health and lifestyle behaviours of cancer patients and provide evidence to support healthcare planning for individual patients and health systems in the future.

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.

Health care utilisation and risk factors for cancer of unknown primary (CUP)

Project ID: 10023

Study Type: Baseline, Linkage

2014

Investigators: Dr Timothy Dobbins, Mr Lawrence Er, Ms Nicola Meagher, A/Prof Sallie-Anne Pearson, A/Prof Claire Vajdic (CI), Prof Robyn Ward.

This project aims to examine the patterns of health care utilisation including hospitalisations, emergency department visits, and Medicare and Pharmaceutical Benefits Scheme use prior to and after a cancer of unknown primary (CUP) diagnosis — both overall and by subtype, and in relation to survival. The investigators will study the risk factors for incident CUP using a nested case-control study design.

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.

Economic analysis of the social costs of skin cancer in NSW

Project ID: 12024

Study Type: Baseline, Linkage

2012

Investigators: Dr Joshua Brynes, Ms Melanie Crane (CI), Prof Christopher Doran, Mr James Kite, A/Prof Andrew Seales, A/Prof Anthony Shakeshaft.

Few economic evaluations have been conducted in Australia to measure the magnitude of the impact of skin cancer. There are large gaps in understanding the wider costs of skin cancer, particularly the impact of non-melanoma skin cancers. There is also little known about the indirect costs incurred by society, such as costs beyond the health sector.

This study is an economic cost analysis study which will investigate the societal costs of skin cancer in NSW. The study will also include a cost effectiveness analysis of the Cancer Institute’s skin cancer prevention activities in NSW.

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.

Cause of death in men with prostate cancer

Project ID: 11010

Study Type: Baseline, Linkage

2011

Investigators: Mr Sam Egger, Mr David Goldsbury, Prof Dianne O’Connell, Dr David Smith (CI).

Prostate cancer is the most commonly registered cancer in Australia and too little is understood about the complex associations between screening for prostate cancer and death from the disease to generate cohesive health messages. PSA testing is commonly performed in Australia with little evidence of its effectiveness, but clear evidence of harms associated with treatment. Likewise, there is little information on the relative importance of various treatment options at different stages of disease and whether screening or treatment confers lower risk of death.

This project aims to answer questions regarding prostate cancer outcomes. This project will evaluate the hypothesis that “men die with prostate cancer rather than of prostate cancer”, determine whether the risk of death from suicide or heart disease is raised in men after prostate cancer diagnosis, investigate the relationship between statin use and death from prostate cancer and explore differences in cause of death in men according to screening status.

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.

Health, Lifestyle Factors And Ageing

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.

Sleep and health outcomes

Project ID: 14010

Study Type: Baseline, Follow-up

2014

Investigators: A/Prof Peter Caputi, Jeong Kyu Lee, Dr Christopher Magee (CI).

Sleep duration has been linked with a range of health outcomes, including obesity, cardiovascular disease, and depression. The aim of this project is to examine the longitudinal effects of different sleep patterns on these outcomes.

This study will be important in clarifying the influence of sleep patterns on health outcomes such as obesity and CVD. The findings will provide an innovative insight into these associations, and the first large-scale research in an Australian context, while having the potential to inform relevant public health interventions and policy.

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.

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.

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.

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.

Social Determinants Of Health

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.

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.

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.

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.

Mental Health

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.

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

Project ID: 10010Part1

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.

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.

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.

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.

Cardiovascular Health

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.

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.

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.

Peripheral arterial disease in the 45 and Up Study

Project ID: 13011

Study Type: Baseline, Linkage

2014

Investigators: Dr Sally Inglis (CI)

The principal aim of this research is to examine the epidemiology, outcomes and management of peripheral arterial disease (PAD) in the 45 and Up Study.

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.

Diabetes

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.

Completed Projects

Cancer

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.

Other

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

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

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

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

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.

Using Health Services

Understanding the factors relating to health insurance status

Project ID: 08004

Study Type: Baseline

2008

Investigators: Prof Emily Banks, Prof Louisa Jorm (CI), Ms Rosemary Korda, Ms Sanja Lujic.

Health insurance status varies widely in the population and has a substantial impact on access to health services. It is important to understand the factors relating to health insurance status in order to quantify an important source of health inequality and to better predict use and costs of services.

This project analysed data from the 45 and Up Study to examine the relationship between health insurance status and a wide range of demographic, lifestyle, health, social and other factors.

Outcomes resulting from this research:

Banks E, Jorm L, Lujic S, Rogers K. Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort. Aust New Zealand Health Policy 2009 July 28;6:17. doi: 10.1186/1743-8462-6-17

Project ID: 08013 Study type: Baseline, linkage

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.

The 45 and Up Study: exploring met and unmet need for homecare in NSW

Project ID: 07013

Study Type: Baseline

2007

Investigators: A/Prof Hilary Bambrick, Prof Julie Byles, Prof Louisa Jorm (CI), Prof Hal Kendig, Dr Lynne Parkinson, Dr Robert Pedlow.

This research projects aims were to provide detailed information not previously available, about who uses Home and Community Care (HACC) Services in NSW and why, and about the relationships between use of HACC and hospital inpatient services. It explored older people’s capacities to remain in the community, their use of HACC and hospital services,  and the factors (personal, environmental and service related) that influence these.

Outcomes resulting from this research:

The project findings provide information on older people in need who do not make use of HACC services and information from the project regarding met and unmet needs for care informs the planning of HACC services.

Jorm L, Walter S, Lujic S, Byles J and Kendig H. Home and community care services: a major opportunity for preventive health care? BMC Geriatr 2010 May 22;10:26. doi: 10.1186/1471-2318-10-26Kendig H, Mealing N, Carr R, Lujic S, Byles J, Jorm L.

Assessing patterns of Home and Community Care service use and client profiles in Australia: a cluster analysis approach using linked data. Health Soc Care Community 2012;20(4):375–87. doi:10.1111/j.1365-2524.2011.01040.x

Report: Byles J, Jorm L, Kendig H, Lujic S, Mealing N, Walter S. The 45 and Up Study: Exploring the health of Home and Community Care clients in New South Wales. December 2009. Report to Ageing, Disability and Home Care, Family and Community Services.

Chronic disease management plans: Who receives them and do they make a difference to use of health care services and health outcomes?

Project ID: 09012

Study Type: Baseline, Linkage

2009

Investigators: Prof Kirsty Douglas, Late Prof Marjan Kljakovic, Dr Rosemary Korda (CI), Ms Laurann Yen.

The aim of this project was to study participants with heart disease, diabetes or asthma to determine if health outcomes or health services are impacted by chronic disease management plans; compare patterns of healthcare and health outcomes between those people who do have a current GP management plan and those who do not; and to develop policy and systems interventions to improve outcomes for people with chronic illness.

Outcomes resulting from this research:

Douglas K, Yen L, Korda R, Kljakovic M, Glasgow N. Chronic disease management items in general practice: A population-based study of variation in claims by claimant characteristics. Med J Aust 2011 Aug 15;195(4):198–202.

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

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

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.

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

Health, Lifestyle Factors And Ageing

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.

Outcomes resulting from this research:

Griffin B, Loh V, Hesketh B. A mental model of factors influencing subjective life expectancy. Social Sciences and Medicine [Internet] 2013 February;82:79–86. doi: 10.1016/j.socscimed.2013.01.026

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.

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

Project ID: 090032009

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

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.

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

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

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

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

Diabetes

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.

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

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