- Using nationally representative longitudinal study in England (English Longitudinal Study of Ageing ELSA) to determine neighbourhood characteristics associated with good/poor cognitive ageing
- To use contemporary methods to identify the full range of healthy and poor cognitive trajectories
- Understand the effect of ‘Area’ on cognitive ageing across England
- Define and Map ‘Area’ characteristics of good/poor cognitive ageing in England
- To develop risk prediction models for these categories of cognitive ageing that incorporate information on geographical and individual characteristics and their interaction
Cognitive function in later life is a key issue as populations’ age. Negative trends in cognitive ageing reflect poor health and dementia, but there is the possibility of opportunities to avoid/delay these outcomes. There are a number of preventable risk factors identified for cognitive decline and dementia, but we have a limited understanding of the effects of geographical location. The goal of this work is to specify the relationship between geographical location and healthy and poor cognitive ageing, to analyse personal and geographical level interactions predicting trends in cognitive ageing, and thus allowing other work packages to direct their activities.
To realize these aims we will use The English Longitudinal Study of Aging (ELSA) which is a panel study of people living in England who were aged 50 or over at baseline and have previously responded to the Health Survey for England (a nationally representative cross-sectional household survey). Participants (n=11,392 at the first wave) are followed every two years with up to 7 waves data available. The multidisciplinary focus of data collection in ELSA gives coverage at each wave of: cognitive functioning (both self-report and direct measures of performance); physical health, including cardiovascular diseases and chronic conditions, pain, age related symptoms, and subjective health reports; physical function; mental health; a range of wellbeing measures; economics (income, financial assets, pensions and housing); social networks and social, civic and cultural participation. The ELSA data permits linkage to geographical location and environment information, providing study a unique opportunity to deliver the objectives of this work package. Individuals are mapped according to Census information as Middle Layer Super Output Areas (MSOA) in England and Wales (maximum person size 7500 minimum 5000) of which there are 7193 constrained by the 2003 local authority boundaries used in 2001 Census. This provides geographical location and associated environmental data such as Indices of Multiple Deprivation, Area Inequality and Rurality. . ELSA also includes questions on participant’s perception of their area of residence, providing comparison with objective Census data. For this we will use both traditional approaches to causal modelling – linear and logistic models, path analysis, structural equation modelling – and will apply recent developments in advanced statistics for longitudinal analysis and complex modelling (such as a latent variable extension of the standard growth model).