Article Text


Using cohorts to study lifecourse epidemiology
O2-2.2 Measurement and modelling of functional trajectories across the life course
  1. R Hardy1,
  2. F Matthews2,
  3. D Kuh1,
  4. D Lawlor3,
  5. A A Sayer4,
  6. M Benzeval5
  1. 1MRC Unit for Lifelong Health and Ageing, London, UK
  2. 2MRC Biostatistics Unit, Cambridge, UK
  3. 3MRC Centre for Causal Analyses in Translational Epidemiology, Bristol, UK
  4. 4MRC Lifecourse Epidemiology Unit, Southampton, UK
  5. 5MRC|CSO Social and Public Health Sciences Unit, Glasgow, UK


Introduction Epidemiological studies are increasingly including measures of function as well as disease status but there are no guiding principles on which to base the choice of measures. The overall aim of this project is to develop recommendations for the measurement of function and the modelling of functional trajectories within and across cohort studies. Continuous and normally distributed measures of biological function, repeated over time, provide dynamic tools for studying the biological imprint of physical and social exposures. Signs of impaired function may act as intermediate markers of underlying disease processes, failure to reach developmental potential, or accelerated ageing, and offer opportunities for early intervention. There is currently no single study which has repeated measures of function from birth to old age. The best description of life course functional trajectories currently will come from the pooling of data from cohorts spanning the whole age range. Harmonisation of measures of function is required to facilitate this, while development of the statistical methods for combining trajectories is necessary.

Methods and Results We illustrate progress towards the ultimate objective of modelling the life course trajectories of cardiovascular, physical and cognitive function using data from multiple cohorts, and investigating risk factors influencing their shape. Using blood pressure as an example, we present results from the modelling of the longitudinal trajectories in multiple UK cohorts of different ages. We discuss issues relating to the comparability of measures both within and between studies, and the development of statistical methods for the synthesis of trajectories across cohorts.

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