TILDA and the HRB

Professor Rose Anne Kenny

Trinity College Mercers Institute St James Hospital

The Irish LongituDinal study on Ageing

TILDA

Trinity College Dublin, The University of Dublin

Trinity EngAGE Centre for Research in Ageing

International Impact (2009-2013)

• Geriatrics & Gerontology: % of Papers in Top 1% - InternationalSource/s: InCites/Web of Science/Scopus

Trinity College Dublin, The University of Dublin

InnoLife Consortium- Health and Ageing European Institute of Technology KIC

EIT Budget €2.7B (2015-2020)

TCDImperialOxfordCambridgeNewcastleKarlinski

ResearchPolicy

Practice

www.tilda.iewww.tilda.ie

New knowledgePopulation research

Clinical trialsPolicy needsPolicy impact

Training

www.tilda.iewww.tilda.ie

8,504Participants

50+

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Every 2 years

For 10 years

2010, 2012, 2014, 2016.....www.tilda.iewww.tilda.ie

Creating Infrastructure

Biobanking,

Population sample,

Multidisciplinary- HUB

Training Education –community

Soft ware

2010, 2012, 2014, 2016. refresh.... www.tilda.iewww.tilda.ie

Health Wealth

Happiness

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GenesGenesGenesGenes

NutritionNutritionNutritionNutrition

Family Family networksnetworksFamily Family

networksnetworks

Social Social participationparticipation

Social Social participationparticipation

EducationEducationEducationEducation

Household Household StructureStructure

Household Household StructureStructure

Marital Marital StatusStatus

Marital Marital StatusStatus

Work &Work &RetirementRetirement

Work &Work &RetirementRetirement

Income Income & assets& assetsIncome Income & assets& assets

HealthHealthHealthHealth

Experience Experience of Ageingof Ageing

Experience Experience of Ageingof Ageing

Mental Mental healthhealth

Mental Mental healthhealth

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TILDA Data

Wave 1 Wave 2

Health 2593 2757

Social 898 1725

Economic 867 978

2014•HRA: Inequalities in Access to GP Care in Ireland: An Analysis using Longitudinal Data €329,988 (€150,424 to TILDA) •HRA: Hypotension, vasoreactivity and white matter intensities in the ageing brain: The Irish Longitudinal Study on Ageing (TILDA) - €330,000•HPF Research Training Fellowships for Healthcare Professionals (2014) - €244,206

2013•HRA: Targeted actions to identify novel inflammatory and immunological factors associated with predisposition to AMD in the TILDA population cohort (2013) [Overall budget  €329,987]

2012•HRB ICE: Interdisciplinary Capacity Enhancement (ICE) Awards 2012- Effecting change in cardiovascular health in older Irish Adults (2012) - €589,327•HRA: Project SADD: Socioeconomic position, anxiety, depression and diabetes in the ageing population in Ireland (2012)- €331,000

2011•HRB ICE: Interdisciplinary Capacity Enhancement (ICE) Awards 2011-  Building research and implementation capacity in the Irish Longitudinal Study on Ageing (TILDA): health inequalities, mental health and opportunities to influence health and social care policies - €794,681• HRA: Frailty and Cognitive impairment in the older population (2011) - €297,750

HRB PhD Scholars programme

6 Ph.D. Scholars (2008-2010)

15 Ph.D. Scholars 2010-

TILDA Core – 10 Ph.D 2009- 2013 4 Ph.D. present

The Active Stand

Heart Rate Recovery and Mortality6

78

910

11

12

13

14

HR

Diffe

ren

ce fro

m B

ase

line

(B

PM

)

10 20 30 40 50 60 70 80 90 100 110

Recovery Time (secs)

Alive (4yr follow-up) Deceased (4yr follow-up)

Slow Heart Rate Recovery and Mortality

(Finucane C et al Circulation 2015)

Orthostatic cardiovascular responses to standing

SBP DBP

Poorer People Have A Higher Resting Heart Rate

Social Networks are Beneficial for Health

J Geront Series B 2014

Hypertension prevalence over 50 years (TILDA wave 1)

.

Awareness in hypertensives

Blood pressure controlled to SBP<140 mmHg and DBP<90mmHg

52%52%Treatment in hypertensives BP control in the treated

On antihypertensive medication (ATC codes CO2, CO3, CO7, CO8, CO9)

59%59%

Awareness defined as a self-report of ever having a doctor’s diagnosis of hypertension

55%55%

64% 64% of those aged 50yrs and older were hypertensive

Statin use in groups at high risk of CVD (50-64 years, W1)

Statin use for secondary prevention (those with existing CVD) is lower than expected given the strength of evidence for the use of statins in this group

– known CVD 68.8% using statins– multiple CVD events 78.6% using statins

.

Statin use in groups at high risk of CVD (50-64 years, W1)

Statin use for secondary prevention (those with existing CVD) is lower than expected given the strength of evidence for the use of statins in this group

– known CVD 68.8% using statins– multiple CVD events 78.6% using statins

Statin use for primary prevention in those at high risk of CVD is also low

– Known diabetics 57.4% using statins– High or very high absolute risk group 19.0% using statins

.

Childhood Adversity Increases Risk of Psychiatric Disorders in Later Life

Risk of Disease Increases as the Number of Adverse Childhood Events Increases

Project SADD: Socioeconomic position, anxiety, depression and diabetes in the ageing population

−Diabetes affects 8.3% of adults aged 50+ in Ireland, rising to 12% in those aged 75+

−primary level or no education are 60% more likely to have diagnosed diabetes

−Cross-sectionally, diabetes is not independently associated with depression or anxiety

−those with diagnosed diabetes at Wave 1 reported a Major Depressive Disorder (11.9% vs. 7.4%) or Generalized Anxiety Disorder (12.8% vs. 7.5%) after a two year follow-up