TCD has embarked on a major study of ageing in Ireland, which will involve 10,000 people over the next decade, reports Dick Ahlstrom.
A comprehensive new study of older people and how they live may change the nature of growing old in Ireland. It will inform policy- makers and society generally, but it also has the potential to deliver improved medical care.
The first Irish longitudinal study on ageing, named Tilda, will involve up to 10,000 people who will be assessed over at least a 10-year period, explains the head of geriatric medicine at Trinity College Dublin, and principal investigator of Tilda, Prof RoseAnne Kenny. "Our mantra is we want Ireland to be the most successful place in the world to grow old," she says.
Trinity will run Tilda but she points out it is an inter-institutional collaboration involving University Colleges Dublin and Cork, the Royal College of Surgeons in Ireland, NUI Galway, Dundalk Institute of Technology and the Economic and Social Research Institute.
Irish Life has donated €4 million in support of Tilda and Atlantic Philanthropies has also contributed by supporting a new clinical centre for ageing at St James's Hospital, Dublin.
Longitudinal studies follow a given group of individuals over long periods of time. Most western countries have ongoing longitudinal studies on ageing, but this will be Ireland's first.
"They try to understand how older people are ageing within that society so you can inform public policy," she explains. "Ireland to date hasn't had a longitudinal study on ageing. The advantage of coming in late, however, is we already have answers to problems experienced elsewhere."
The Irish study will also benefit because of characteristics unique to this island. "Ireland has a homogenous gene pool in people over 50 and this will allow us to look at the genetic process of ageing. Another advantage is our geography, it is a pretty small place."
The study will include a range of ages, but all participants will be 50 or older. Reaching the target 10,000 subjects will be a challenge because subjects will be chosen at random from a larger pool of 30,000 potential participants.
The Irish study will build on longitudinal studies elsewhere to produce a far more comprehensive study of ageing. It will include a startling range of subjects, not just health- related but also those with a social dimension, including how the person interacts with neighbours and friends and their degree of social connection.
"We have an Ageing Consortium in Trinity which has 40 different disciplines involved," Prof Kenny says. This includes medical clinicians and basic scientists but also arts and humanities, the English department, bioengineers and geographers, and all of these are likely to become involved in Tilda.
Typically, these studies involve talking to the subjects at their homes, but Tilda will add more to the mix. "We plan not only to visit them at home and take a detailed social and economic picture but also bring them to centres where we can look in a detailed way at physical aspects such as their gait and balance."
The Tilda team will use a "magic carpet" packed full of electronics that will automatically measure gait, foot lift and walking characteristics. Bone density will be measured and blood tests will give insights into stress levels and indications of inflammation, indicative of conditions such as arthritis.
All of these details will remain strictly confidential, Prof Kenny stressed, but will flow into a pool of knowledge that will provide invaluable insights into what it is like to grow older in Ireland. "An investigator from the National Institutes of Health in the US says this study has the potential to be far more powerful than any existing longitudinal study worldwide."
A pilot programme starts in the Dundalk area next month so that Tilda's selection and sampling methods can be assessed, she says. The study gets underway fully from September, with first data expected in just six months including an assessment of needs and health condition of Ireland's over-50s.
"This is going to inform policy on these individuals as consumers but also on their economic contribution to society," Prof Kenny says, noting that 40 per cent of over-65s are providing more than 40 hours of childcare a week in many western countries.