News and Events
Study finds new cardiovascular predictor of mortality in older people
December 6th, 2016:
Research from the Irish Longitudinal Study on Ageing (TILDA) shows for the first time that the speed of heart rate change in response to standing up predicts mortality in older people.
When we stand up our heart rate speeds up then settles. The rate at which this happens in older people has been shown for the first time to predict mortality four years later according to new research from TILDA published in Circulation Research, a leading journal of the American Heart Association.
The team at Trinity College Dublin in collaboration with researchers from Harvard University’s Center for Population and Development Studies found that the speed of heart rate recovery in the initial 20 seconds after a person stands predicts the likelihood of dying over four years in older people.
The research team went a step further by dividing participants into groups based on their speed of heart rate recovery. Those in the slowest heart rate recovery group were 7 times more likely to die over the four year period compared with those in the fastest heart rate group. They remained 2.3 times more likely to die even when the researchers took account of other known risk factors for mortality and for heart rate such as age, diabetes, lung disease, socio-economic status, smoking, dietary factors, and body mass index.
The research involved 4475 TILDA respondents aged 50 years and over who completed a detailed cardiovascular health assessment at the TILDA health centre at Trinity in 2011 and were followed up four years later. Participants in the study rested in a lying position for 10 minutes during which time their heart rate and blood pressure were monitored. Participants were then asked to rise from the lying position to a standing position [Figure 1].
This simple maneuver represents a major cardiovascular challenge causing the heart to beat faster as it tries to compensate for the drop in blood pressure that occurs when a person stands up after lying down. The heart beat then returns towards its baseline or normal rate and it is the speed of this recovery to baseline that is the key factor. The faster it returns to normal, the better.
Commenting on the findings, the author of the report and Senior Research Fellow with TILDA, Dr Cathal McCrory, remarked that: “Our study shows that the speed of heart rate recovery in response to standing is an important marker of health and vitality that could be assessed quite readily in a clinical setting such as a hospital. It represents a new and potentially important biomarker of cardiovascular ageing that is useful for screening purposes.”
Also commenting on the findings, Principal Investigator of TILDA, and Director of the Falls and Syncope Unit at St James Hospital, Dublin, Professor Rose Anne Kenny commented: “Changing from lying or sitting to standing postures is a repeated activity throughout the day and poses a challenge to the cardiac system to maintain steady blood pressure and heart rate and thus lower stress on the system. We are excited by the potential to help people improve their heart rate recovery, possibly by simple strategies such as individualised exercise and to use these heart rate measures as a means of monitoring how well our interventions are working.”
Figure 1: Heart Rate and Blood Pressure Response to Standing among 4475 Participants in the Irish Longitudinal Study on Ageing (TILDA)
Legend: Figure 1 shows the average heart rate and blood pressure response to standing among 4475 participants who completed the active stand in The Irish Longitudinal Study on Ageing (TILDA). The vertical axis represents values of heart rate in beats per minute (bpm) and values of systolic and diastolic blood pressure in millimeters of mercury (mmHg). Resting values of heart rate and blood pressure were measured 60 seconds prior to standing. Heart rate rises rapidly in the initial 10 seconds after standing to combat the drop in blood pressure that occurs when a person stands from a lying position. The speed of heart rate recovery (i.e. decline in heart rate) between 10 and 20 seconds after standing predicts an individual’s risk of mortality over a four-year period.
The Irish Longitudinal study on Ageing was funded by the Department of Health, the Atlantic Philanthropies and Irish Life. Dr Cathal McCrory was funded by a Health Research Board (HRB) Interdisciplinary Capacity Enhancement Award (grant number: ICE/2011/7)
The paper is available here
For media queries contact:
Dr Cathal McCrory, Senior Research Fellow, TILDA, Trinity College Dublin, at firstname.lastname@example.org
Yolanda Kennedy, Press Officer for the Faculty of Health Science, Trinity College Dublin, at email@example.com
Changes in entitlement to medical cards results in changes in number of GP visits for over 50s
October 27th, 2016:
A new report launched today by The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin, details the impact that changes to an older person’s entitlement to a medical card has on their use of health services, such as GP visits, flu vaccines, medications and hospital care. The report authors found that changes in people’s entitlement to medical cards are associated with changes in their use of GP services and level ofmedications dispensed.
Using data from two waves of TILDA in 2010 and 2012 they found that in the over 50s:
- Gaining a full medical or GP visit card is associated with 1.3 extra GP visits per annum. Compared to the level of GP visiting for this group in 2010, which was 3 visits, this represents an increase of approximately 43 per cent.
- For those who lose a full medical or GP visit card, the number of GP visits falls by 1.2 visits per annum. This is equivalent to a fall of approximately 29 per cent from the 2010 level which was 4 annual visits.
- Gaining a full medical card was associated with a significant increase in the numbers of medications taken regularly.
- Getting a medical card was not, however, associated with any significant changes in the probability of a flu vaccine, the number of emergency department visits, outpatient visits or inpatient nights.
- 12.6 per cent of the over 50s who did not have a full medical or GP visit card in 2010, gained one by 2012.
- For those with a full medical or GP visit card in 2010, just 3.5 per cent had lost their full medical or GP visit card by 2012.
- 24% of community-living Irish people aged 65 years and older are frail, 45% are pre-frail.
- 57% of Public Health Nursing service users aged 65 years and older are frail.
- Less than one third of frail older people access the Public Health Nursing service.
- Frail older people’s healthcare entitlement, living arrangements, disability and severity of frailty are all important determinants for accessing the Public Health Nursing service.
- The prevalence of frailty in those aged 65 years and older varied from 17% to 29% across Community Healthcare Organisation.
- When TILDA revealed two thirds of older people have high blood pressure – often unknown to the individual despite the risk it poses to their heart and brain health – TILDA, with funding from the HRB, rolled out a nationwide programme to community health nurses to encourage more frequent blood pressure monitoring.
- TILDA measurements on walking speeds revealed that one in three older adults cannot cross the street in the time allotted at signalised crossings. TILDA researchers are now working with local authorities to assess signal timing settings and are providing evidence for public safety campaigns with the Road Safety Authority.
- Atrial fibrillation (Afib) is a common cause of stroke, heart failure and dementia. TILDA found that the prevalence of Afib was 2.3% in the population, rising to 20% in men aged over 80 years. Of those with an arrhythmia, one third were unaware of the arrhythmia and one third were incorrectly treated. The Irish Heart Foundation translated these findings into a national awareness campaign and now, the National Screening Programme Guidelines use this TILDA data.
- In addition to the original funding from the Department of Health, Atlantic Philanthropies and Irish Life of over €28 million, since 2006, TILDA has also raised additional grant funding for research projects of €4.6 million;
- TILDA has 34 staff including 14 post-doctoral researchers and 8 students and has trained 28 PhDs and post-doctoral fellows, 140 field workers and 25 research nurses;
- The TILDA team have authored 108 papers in peer reviewed publications as well as 23 reports, topic reports and research briefs;
- More than 1100 people have access to anonymised TILDA data for their own research projects, both nationally and internationally;
- TILDA is engaged in more than 45 national research collaborations and more than 25 international collaborations;
- TILDA has reached over 10,000 social media learners through their free online course, Strategies for Successful Ageing, which will run again for Positive Ageing Week, this September 26th 2016;
- The TILDA study is harmonised to 13 other international longitudinal studies on ageing which allows cross country comparisons of key indicators of health, wealth and happiness.
The researchers found that in 2012, 39% of the over 50s had a full medical or GP visit card and no private health insurance (PHI); 18% had dual cover, i.e. a full medical or GP visit card and PHI; 33% had PHI only; and 10% had neither a full medical/GP visit card nor PHI ‘no cover’.
In summer 2015, however, free GP care for all children aged under 6 years of age, and all adults aged 70+ years was introduced. In May 2016, the new Government announced a commitment to an extension of free GP care to all those under 18 years of age.
Dr Anne Nolan, one of the authors of the report, commented: “These findings have important implications for the Irish healthcare system as free GP care is extended to all under 6s and over 70s and as we move towards universal healthcare. In the context of extensions in free GP care, it is crucial to understand current patterns of healthcare utilisation, not only for highlighting the extent to which the current system leads to financial barriers to accessing healthcare services, but also for forecasting the likely demand implications of reform proposals so that policymakers can cost the proposals and plan effectively.”
Dr Nolan continued: “One of the key questions is whether the increase in the use of GP services and medications that we observe upon receipt of a full medical/GP visit card reflects an increase in beneficial care and/or whether those who lose a full medical/GP visit card are foregoing necessary care. This would require more detailed research on diagnoses, length of consultation, health outcomes etc.”
Professor Rose Anne Kenny, Principal Investigator of TILDA noted “Data from TILDA provide a unique opportunity to explore how changes in access to healthcare services impact on the use of healthcare in Ireland. As further waves of TILDA data become available, the impact of public healthcare entitlements on health outcomes can be investigated”.
The full report is available here.
Topic Report: The impact of frailty on public health nurse service utilisation. Finding from The Irish longitudinal Study on Ageing (TILDA)
26 September 2016
A new report by The Irish Longitudinal Study on Ageing on older frail people’s use of public health nursing services in Ireland was launched today by Dr Lorna Roe of TILDA and the Centre for Health Policy and Management, Trinity College Dublin at the annual general meeting of the Institute of Community Health Nursing. The report examines the demographic and healthcare entitlements of older frail Irish people utilising Public Health Nursing services. The study was commissioned by the Institute of Community Health Nursing (ICHN).
Key Findings include:
Commenting on the study, the lead author, Dr Lorna Roe said “These findings raise questions about the role of the Public Health Nurse in the care of older people in particular regarding the objective identification of frail older people in practice and access and entitlement to Public Health Nurse services for an increasingly older population. Further research is warranted to examine differing intensities of PHN delivery to older people with varying levels of frailty.”
The full report is available here
Dr Lorna Roe was previously funded as a scholar on the Health Research Board structured PhD Scholars Programme in Health Services Research.
Uncovering the secrets of successful ageing - TILDA explores decade of research to understand a generation
From heart conditions to caring for grandchildren and from undiagnosed diabetes to the power of positive thought, the Irish Longitudinal Study on Ageing (TILDA) has spent a decade understanding Ireland’s older generation. Trinity College Dublin will celebrate that milestone with 600 of the 8500 participants at a special event today, at which researchers and participants will consider the critical impact this research continues to have on the lives of older people.
Such is the breadth and depth of the subjects TILDA’s research covers that policy makers, NGOs and others have used the findings as the evidence base for 52 policy and strategy documents covering: transport; health; jobs; pensions; carers; residential and home care; health and road safety public awareness campaigns; capacity planning for services; medical care and practice; IT; health insurance; dementia prevention; volunteering; taxation and the economy.
The TILDA research team and principal investigator, Professor of Medical Gerontology at Trinity, Rose Anne Kenny, will give examples of how this research is changing policy and practice for older adults.For example:
Professor Kenny continued: “The TILDA team wish to pay tribute to TILDA participants who have helped us to unmask the important and often silent contribution that older adults make to Irish society. The participants have contributed to a rich legacy which will ensure a better quality of life for future generations by helping us to understand the process of ageing. This understanding is coupled with important information to help governments to make efficient policy decisions to optimise health and economic success as populations age.”
Established in 2006, TILDA was designed to provide an evidence base for understanding ageing in Ireland and beyond. 8500 participants are interviewed at home every two years and take part in an in-depth health assessment every four years. Researchers gather detailed information about their health, wealth and social structures and are able to track changes in people’s physical and emotional wellbeing over time. The research is helping them pinpoint the lifestyle choices, behaviours and strategies that prove to be the most successful for a positive ageing experience.
The study was initially funded by a philanthropic gift from Irish Life and from Atlantic Philanthropies in addition to funding from the Department of Health.
Using publicly archived TILDA datasets
Delivered by TILDA in conjunction with the Irish Social Science Data Archive (ISSDA) and Gateway to Global Aging.
Date: 9th September 2016
Venue: Trinity College Dublin
10am - 1pm: Introduction to publicly available TILDA datasets.
- Overview of TILDA.
- Accessing and using TILDA data, available through ISSDA.
- Accessing and using the digital library and harmonised TILDA dataset,
- through the Gateway to Global Aging.
Room: Maxwell Theatre (90 spaces)
2pm - 4pm: Hands-on workshop using the harmonised TILDA dataset to do cross-country comparisons.
Room: Áras an Phiarsaigh PC Lab 0.12 (20 spaces)
For more information:
Professor Rose Anne Kenny presents on “How a longitudinal study can change the research landscape” at the Biomedical and Life Sciences Innovation Showcase.
Tuesday, May 17th 2016: The showcase was co-hosted by Trinity College Dublin and the Royal College of Surgeons in Ireland to promote the next wave of Biomedical and Life Sciences research being undertaken within both institutions and profile examples of and opportunities for Knowledge Transfer and Industry collaboration.
Professor Rose Anne Kenny's talk:
TILDA 2016 Scientific Advisory Board Meeting
Wednesday, May 13th 2016: The TILDA research team and affiliated researchers presented to members of the TILDA Scientific Advisory Board and other guests during the one-day event held at Trinity College Dublin. Presentations included the Global Brain Health Institute; Technological Assessments in Longitudinal Studies; Chrono-Biological Markers of Ageing; Knowledge Exchange Seminars on Hypertension; The Relationship Between Kidney Disease and Ageing; Sexual Activity and Relationship Quality in Older Age; and Housing and Older Adults in Ireland.
Pictured above (from back, left to right): Prof. James Nazroo, Prof. Lisa Berkman, Prof. Aartjan Beekman, Prof. Charles Normand, Prof. Jim Smith, Prof. Robert Wright, Prof. Yaohui Zhao, Prof. Brendan Wheelan, Prof. Rose Anne Kenny, Prof. John Henretta, Prof. David Weir, Prof. Robert Clarke, Dr Christine McGarrigle, Prof. Stacy Tessler Lindau, Prof. Finbarr Martin, Prof. Alan Barrett, Prof. Carol Brayne, and Prof. Ian Young.
Lecture by Professor James P. Smith "Irish immigrants and their progeny around the world"
Thursday, 12th May 2016: We were delighted to have Professor James Smith join us in celebrating 10 years of TILDA.
Lecture on Irish Immigrants to the US Marks 10 Years of TILDA
Hollywood movies often portrayed the Irish as a poor and uneducated race of people. Yet like so many other Hollywood storylines, this image is just a myth. In fact Irish migrants to the US during the first half of the 20th century were on average as well educated as other European immigrants to the US, according to Professor James Smith, who delivered the lecture ‘Irish Immigrants and their Progeny around the World’ in Trinity College Dublin to mark the 10th anniversary of TILDA (The Irish Longitudinal Study on Ageing).
In addition to comparing whether Irish migrants to the US were more or less educated than the Irish who stayed at home, Professor Smith, the son of an Irish mother who emigrated to the US, examined how the children and grandchildren of Irish migrants to the US did in terms of their education. Did they receive more education in the US than they would have received if the original migrants had stayed at home in Ireland? The answer is no.
Professor Smith, Distinguished Chair in Labor Markets and Demographic Studies at US-based policy-research institute RAND, visited Trinity to help celebrate the 10th anniversary of TILDA. He has served from the start of TILDA as chair of the International Scientific Advisory Board and has played a pivotal role in helping TILDA be a success.
Professor Paul Browne, Head of School of Medicine, welcoming Professor James Smith said: “We are grateful to Professor Smith for being incredibly generous with his time and expertise, and in particular for his mentorship of younger researchers at TILDA and being an inspiration.
Full press release available here
You’re Only As Old As You Feel!
Our attitudes to ageing can have a direct effect on our health
Dublin Wednesday January 27, 2016: Negative attitudes to ageing affect both physical and cognitive health in later years, new research reveals. The study from TILDA, at Trinity College Dublin, further reveals that participants with positive attitudes towards ageing had improved cognitive ability.
The research, led by Dr Deirdre Robertson, formerly of TILDA, now based at Columbia University, investigated whether long-term exposure to negative attitudes towards ageing affects long-term changes in physical health as well.
Older adults with negative attitudes towards ageing had slower walking speed and worse cognitive abilities two years later, compared to older adults with more positive attitudes towards ageing.
This was true even after participants’ medications, mood, their life circumstances and other health changes that had occurred over the same two-year period were accounted for.
- Furthermore, negative attitudes towards ageing seemed to affect how different health conditions interacted. Frail older adults are at risk of multiple health problems including worse cognition. In the TILDA sample frail participants with negative attitudes towards ageing had worse cognition compared to participants who were not frail. However frail participants with positive attitudes towards ageing had the same level of cognitive ability as their non-frail peers.
Speaking about the findings, Dr Robertson, commented: “The way we think about, talk about and write about ageing may have direct effects on health. Everyone will grow older and if negative attitudes towards ageing are carried throughout life they can have a detrimental, measurable effect on mental, physical and cognitive health.”
Principal Investigator of TILDA, Professor Rose Anne Kenny, added: “Researchers and policy makers can work together to develop and implement societal-wide interventions to target attitudes and perhaps, ultimately, find novel ways of maintaining health in later life.”
Data from TILDA provides a unique opportunity to study attitudes towards ageing as it tracks health changes over time in a nationally representative sample of community-dwelling older adults. These latest findings have important implications for media, policymakers, practitioners and society more generally. Societal attitudes towards ageing are predominantly negative. Everyone will grow older and if these attitudes persist they will continue to diminish quality of life.
The full research brief, summarising the three published papers is available here
For media queries:
Helen Hanley, firstname.lastname@example.org, +353 1 896 355, +353 87 855 4540
The Trinity EngAGE Massive Open Online Course (MOOC) – entitled Strategies for Successful Ageing – is now open for registration. This free five-week course begins on February 8th and presents world-leading research in ageing as well as offering strategies to support health and well-being. Lead educator is Professor Rose Anne Kenny, Director of Mercer's Institute for Successful Ageing and Founder of The Irish Longitudinal Study on Ageing (TILDA). She is joined by Trinity EngAGE Principal Investigators including: Professors Davis Coakley, Brian Lawlor, Ian Robertson, Virpi Timonen, Fiona Newell, Sabina Brennan, Richard Layte and Dr David Thomas.