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Ageing Trajectories of Health: Longitudinal Opportunities and Synergies

Ageing Trajectories of Health: Longitudinal Opportunities and Synergies

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Studies 36
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The objective of the ATHLOS Project is to achieve a better understanding of ageing by identifying patterns of healthy ageing pathways or trajectories, the determinants of those patterns, the critical points in time when changes in trajectories are produced, and to propose timely clinical and public health interventions to optimize healthy ageing. Moreover, a new definition of 'old age' based on many characteristics rather than just the classical chronological definition of age has been used for calculating projections in each specific population and guide policy recommendations. To do so, the Consortium has created a harmonised dataset with over 400,000 individuals collated from existing longitudinal studies of ageing and including information on physical and mental health, biomarkers, life style habits, social environment and participation, among others.

ATHLOS is a five-year project funded by the European Union's Horizon 2020 Research and Innovation Programme under grant agreement number 635316.

The Consortium is coordinated by Dr Josep Maria Haro (Parc Sanitari Sant Joan de Déu) and consists of 14 partners from 11 European countries.

WORK-PACKAGES

WP1: Creation of harmonised dataset: A single harmonised dataset has been generated to include 18 prospective studies. In order to create a common data set for analysis, the first task was to map variables across all the datasets: a core set of variables were identified in each survey and they were categorised in different domains and response options remapped to account for differences within surveys. The original questions, design of each survey and characteristics of the sample were provided as metadata. Additional variables, including health-related outcomes and their determinants, were created and added to the harmonised dataset.

WP2: Development of analytical methods: A single scale of healthy ageing was created using an Item Response Theory approach. Several statistical models (based on Mixed Models with Repeated Measures, Generalised Estimating Equations, Structural Equation Modelling, Growth curve Mixture Modelling) were used (considering the single scale of health and other health-related outcomes as indicators of healthy ageing) to quantify trajectories of healthy ageing and their determinants. Finally, a microsimulation model was developed to predict trends in healthy ageing under alternative scenarios of determinants, interventions and health policy.

WP3: Describing patterns of trajectories, determinants and inequalities of healthy ageing: Health trajectories and determinants of healthy ageing were assessed. The models created in the previous stage were employed to identify biological, lifestyle, medical and social determinants of healthy ageing across the life span and to identify variations in ageing trajectories associated to socio-demographic factors such as socioeconomic position and gender. Statistical methods such as Growth curve Mixture Modelling approach were used to identify groups of people that share a trajectory pattern and to explore variations in trajectories across groups at different stages of demographic transition. Age-Period-Cohort analysis was employed to analyse if subsequent cohorts of older adults are ageing in a healthier manner.

WP4: Characteristics-based approach to defining old age: A reconceptualization of ‘old age’ was developed using projections of the proportion of older adults in a given population over time, exploring also the added value of health status in the new definition and the policy implications of different definitions of ageing.

WP5: Knowledge translation: This WP involves activities that use the research outcomes obtained from the previous WPs to conduct a series of applications to effectively improve the health of European citizens, providing more effective health services and strengthening the health care system. The microsimulation model developed in WP2 was used to: generate the economic and social consequences of policy value decisions on how best to allocate resources for interventions to modify ageing trajectories across the population (this exercise will enable policy-makers to be aware of the consequences of inevitable policy trade-offs); explore alternative healthy ageing scenarios in Europe and internationally, and to discuss their implications for policy, and; identify population-level or clinical interventions that can directly alter ageing trajectories towards those that optimise healthy ageing.

WP6: Dissemination: This WP responds to the crucial need, from the initial deployment phase onward, to provide extensive visibility to the project in order to capitalise on the knowledge generated and advance the interests of concerned parties (public and private healthcare providers, technological companies, academia, pharmaceutical companies, public authorities, patients and caregivers). The dissemination activities have been intensively informed by the research conclusions and supporting evidence arising from the ATHLOS research, including especially the findings and policy recommendations arising from the project.

WP7: Coordination and management: This WP is devoted to: - Making optimal use of resources by running agile structures and procedures linking together the project components. - Participating in the project’s meetings. - Ensuring quality assurance by means of proper internal reporting and follow-up tools. - Mitigating technical and managerial pitfalls. - Communicating with the EC’s relevant contact points. - Ensuring that all requirements regarding the reporting to EC are met.

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Investigators Contacts
  • (Coordinator) Dr. Josep Maria Haro
    Parc Sanitari Sant Joan de Déu
  • Prof. Martin Bobak
    University College London
  • Prof. Martin Prince
    King's College London
  • Dr. Matthew Prina
    King's College London
  • Prof José Luis Ayuso-Mateos
    Universidad Autónoma de Madrid
  • Dr Matilde Leonardi
    Fondazione IRCCS Istituto Neurologico Carlo Besta
  • Dr. Jerome Edmond Bickenbach
    Swiss Paraplegic Research
  • Dr. Sergei Scherbov
    Internationales Institut Fuer Angewandte Systemanalyse
  • Dr. Warren Sanderson
  • Prof Fernando Rodríguez Artalejo
    Universidad Autonoma de Madrid
  • Prof Beata Tobiasz-Adamczyk
    Jagiellonian University
  • Prof. Andrezj Pajak
    Uniwersytet Jagiellonski
  • Prof. Demosthenes Panagiotakos
    Harokopio University in Athens
  • Seppo Koskinen
    Institute of Health and Welfare
  • Ilona Koupil
    Karolinska Institutet
  • Mr. Holger Arndt
    SPRING TECHNO GMBH & CO KG
  • Ms. Ilenia Gheno
    AGE Platform
  • Dr. Abdonas Tamosiunas
    Institute of Cardiology of Kaunas University of Medicine
  • Dr. Ruzena Kubinova
    National Institute of Public Health
  • (Project Manager) Dr. Ellen Vorstenbosch
    Parc Sanitari Sant Joan de Déu
  • Dr. Albert Sanchez-Niubo
    Parc Sanitari Sant Joan de Déu

Individual Studies

Acronym Name Study design Participants Countries
KLoSA The Korean Longitudinal Study of Ageing Cohort 10,254 South Korea
SAGE WHO Study on Global Ageing and Adult Health Cohort 63,437 South Africa , Ghana , China , India , Russian , Mexico
UBCoS The Uppsala Birth Cohort Multigenerational Study Other 61,613 Sweden
LASI The Longitudinal Aging Study in India Cohort 1,683 India
MHAS The Mexican Health and Aging Study Cohort 15,146 Mexico
ELSA English Longitudinal Study of Ageing Cohort 12.099 United Kingdom
ATTICA The ATTICA Study Cohort 3,042 Greece
CHARLS The China Health and Retirement Longitudinal Study Cohort 17,708 China
HRS Health and Retirement Survey Cohort 37,317 United States of America
ENRICA Seniors-ENRICA Cohort 2,614 Spain
HAPIEE The Health, Alcohol and Psychosocial factors in Eastern Europe Study Cohort 36,106 Russian , Poland , Czech Republic , Lithuania
SHARE The Survey of Health, Ageing and Retirement in Europe Cohort 30,816 Austria , Belgium , Czech Republic , Denmark , Estonia , France , Greece , Hungary , Ireland , Israel , Italy , Netherlands , Poland , Portugal , Slovenia , Spain , Sweden , Switzerland , Germany , Luxembourg , Croatia
COURAGE in Europe Collaborative Research on Ageing in Europe Cohort 10,800 Finland , Poland , Spain
ALSA Australian Longitudinal Study of Aging Cohort 2,087 Australia
10/66 The 10/66 Dementia Research Group Population-Based Cohort Study Cohort 15,901 Cuba , India , China , Dominican Republic , Venezuela , Peru , Mexico , Puerto Rico
TILDA The Irish Longitudinal Study of Ageing Cohort 8,500 Ireland
Health2000 Health 2000 Cohort 22,261 Finland
JSTAR Japanese Study of Aging and Retirement Cohort 7,268 Japan

Harmonization Studies

Acronym Name
1066-HS 10-66 Harmonised Study
ALSA-HS ALSA Harmonised Study
ATTICA-HS ATTICA Harmonised Study
CHARLS-HS CHARLS Harmonised Study
COURAGE-HS COURAGE Harmonised Study
ELSA-HS ELSA Harmonised Study
ENRICA-HS ENRICA Harmonised Study
HAPIEE-HS HAPIEE Harmonised Study
HEALTH2000-HS HEALTH2000-2011 Harmonised Study
HRS-HS HRS Harmonised Study
JSTAR-HS JSTAR Harmonisation Study
KLOSA-HS KLOSA Harmonisation Study
LASI-HS LASI Harmonisation Study
MHAS-HS MHAS Harmonisation Study
SAGE-HS SAGE Harmonisation Study
SHARE-HS SHARE Harmonisation Study
TILDA-HS TILDA Harmonisation Study
UBCOS-HS UBCOS Harmonisation Study