The determinants of ageing well

Australia’s largest longitudinal research project on ageing, the 45 and Up study, reaches a five-year milestone and launches the next wave

Professor Sally Redman, CEO Sax Institute (at lectern), and 45 and Up Study participants L-R Saul Moss, Jan King, Gaetano Di Benedetto at Clovelly Surf Life Saving Club

By Natasha Egan

Participants of Australia’s largest longitudinal study on ageing are again being called upon to report on their health, lifestyles and medical histories to determine how well they are ageing five years on from the initial survey. 

Researchers and participants gathered at Clovelly Surf Life Saving Club in Sydney’s east on Friday to discuss findings in the five years so far (see end of story) and launch the next phase.

The 45 and Up Study, managed by the Sax Institute, involves 267,000 people from New South Wales, now aged from 50 to over 100 years old.

The collaborative eight-partner project reaches about one in 10 New South Wales residents in the target age group with over half residing in rural and regional areas.

Professor Bruce Armstrong, a senior advisor to the Sax Institute and professor of public health at the University of Sydney said: “The study creates a rich resource of information to study the health of people and understand what determines good health and an extended life.”

The primary objective is to help determine more accurately and more fully what the determinants of healthy ageing are, he said. 

“Healthy ageing is ensuring people can live with a good quality of life, which might also lengthen life,” Prof Armstrong told Australian Ageing Agenda.

The study collects information about all things that determine health, including mental health, and indicators of chronic disease. 

Participants also consent to having their survey results linked to other routinely collected records, which means researchers can see such things as why a participant went to hospital, if they were in an aged care facility and in the case of death, when it happened and what from.

The study also deliberately targets over 140,000 people living in rural and regional areas. 

This is to ensure the study is relevant to all people in NSW and provides equally rich information, Prof Armstrong said.

Researchers are encouraged to tap into the 45 and Up data, over 400 researchers are currently doing so, and there has already been significant findings, Prof Armstrong said.

Asking people how much time they spent sitting and standing has allowed researchers to make an “enormously important finding”, Prof Armstrong said.

“We have been able to show that the more time a person spends standing, the less their risk of death.”

This outcome is independent of how much other exercise a person does, which is also beneficial, he said. 

It’s an important new finding, which opens up a way to help a lot of people and it that can be immediately operational, Prof Armstrong said.

“You can do a lot of that sitting down work standing up. People are now having standing meetings. I now have a standing desk. My day is not spent slumped in a chair.” 

Another important finding is based on a sub-study within the main study, Prof Armstrong said. 

It focused on older people and their home environment to see what hazards there are in the home that can cause injury.

This data is now being used by government and other stakeholders to try and make it safer for people living in their homes, he said.While it is too early to describe exactly who is and who isn’t ageing well in Australia, Professor Armstrong said they hope that’s a question they can answer in about five years from now.

The first 40,000 follow-up surveys have just been sent out to participants with the remainder going out over the next three years.

The follow-up survey includes a question on what transport people usually use. Investigators want to know if there are any health differences for car users and people who use public transport, Prof Armstrong said. 

“You have to ask the right questions and then you can follow on and see what the relationship is beyond that,” Prof Armstrong said.

Cancer Council New South Wales is the major partner the 45 and Up Study, which is managed by the Sax Institute. The other partners are the National Heart Foundation of Australia (NSW Division), NSW Health, beyondblue, Ageing, Disability and Home Care, Department of Family and Community Services NSW, the Australian Red Cross Blood Service, and UnitingCare Ageing.

A snapshot of our ageing population – key 45 and Up participant statistics 

  • 71% of participants eat recommended amounts of fruit each day but only 32% eat enough vegetables 
  • 32% of participants are in the healthy weight range for their height 
  • 33% drink alcohol less than once a week 
  • 56% have never smoked and 37% have quit 
  • 52% rate their health as excellent or very good and 11% say it is fair or poor 
  • 5% are caring full-time for someone else 
  • 40% have reported some hearing loss and 43% report excellent eyesight 
  • 44% say their memory is excellent or very good 
  • 25% take multivitamin supplements 
  • 49% have had a bowel cancer screen 
  • 88% of women have had a mammogram 
  • 71% of men have had a PSA test 
  • 11% say their mother was diagnosed with Alzheimer’s disease 
  • 30% say their father was diagnosed with heart disease 
  • 8% say they have a sibling diagnosed with diabetes 
  • 90% need no help with daily tasks but only 32% report no health limitations preventing them from vigorous physical activity 

Participants range in age from 50 to over 100 years old; 46% are male and 54% are female

Source: The Sax Institute

Tags: 45-and-up, 5-year-milestone, bruce-armstrong, research, sax-institute,

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