This project developed computer models to estimate the value for money of interventions for cardiovascular diseases and dementia, and the impact these interventions on healthcare demand.
April 2014 - March 2017
Personalising preventive health interventions
Research Team: Professor David Melzer, Professor Carol Brayne, Dr Louise Lafortune, Dr Kate Walters, Dr Alessandro Ble, Dr Joao Delgado & Dr Kirsty Bowman
Who's involved: University of Exeter, University of Cambridge & University College London
September 2013 - March 2017
In this project SPHR researchers aimed to improve evidence on cardiovascular risk factors in later life to help people age well. Some scientists have claimed heart disease risk factors are not predictive in later life: for example there has been substantial publicity about how being overweight or obese in old age may even be beneficial.
To carry out this project researchers used very large databases of electronic medical records and data from study volunteers.
The research team found the idea that obesity in old age resulted in better health outcomes to be misleading as this is only true when compared to smokers and individuals with diseases causing weight loss.
Researchers found this statement to be driven in part by the BMI formula, which ignores weight gain in the stomach area, and does not consider muscle loss seen in later life. Research findings also highlighted a link between obesity and dementia.
Overall, for ageing well, researchers found having a normal BMI and waist circumference is associated with substantially better outcomes compared to older groups who are overweight.
This project was the first to look at long term trends in blood pressure towards the end of life. The findings have major potential implications for blood pressure management as researchers found individuals have a greater chance of developing high blood pressure in later life if they have substantial falls in pressures for approximately 15 years before death.
Research currently states cardiovascular disease risk factors are not predicable in later life, however the research team found 60 to 69 year olds who have good cardiovascular health are likely to be healthier for 10 years longer than those with poor cardiovascular health.
Unfortunately less than 3% of the general older population in England have ideal cardiovascular health, which showcases the extent ageing outcomes need to be improved in the older population.
Bowman K, Delgado J, Henley WE, Masoli JA, Kos K, Brayne C, Thokala P, Lafortune L, Kuchel GA, Ble A, Melzer D. Obesity in Older People With and Without Conditions Associated With Weight Loss: Follow-up of 955,000 Primary Care Patients. J Gerontol A Biol Sci Med Sci. 2017 Feb;72(2):203-209
Delgado J, Masoli JA, Bowman K, Strain WD, Kuchel GA, Walters K, Lafortune L, Brayne C, Melzer D, Ble A;. Outcomes of Treated Hypertension at Age 80 and Older: Cohort Analysis of 79,376 Individuals. J Am Geriatr Soc. 2016 Dec 30.
Atkins JL, Pilling LC, Ble A, Dutta A, Harries LW, Murray A, Brayne C, Robine JM, Kuchel GA, Ferrucci L, Melzer D. Longer-Lived Parents and Cardiovascular Outcomes: 8-Year Follow-Up In 186,000 U.K. Biobank Participants. J Am Coll Cardiol. 2016 Aug 23;68(8):874-5.
Bowman K, Atkins, JL, Delgado, J, Kos, K, Kuchel, GA, Ble, A, Ferrucci, L, Melzer D. Central adiposity and the overweight risk paradox in aging: follow-up of 130,473 UK Biobank participants. AJCN. May 31, 2017.
Ble A, Hughes PM, Delgado J, Masoli JA, Bowman K, Zirk-Sadowski J, Mujica Mota RE, Henley WE, Melzer D. Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study. J Gerontol A Biol Sci Med Sci. 2016 May 4.
Ble A, Masoli JA, Barry HE, Winder RE, Tavakoly B, Henley WE, Kuchel GA, Valderas JM, Melzer D, Richards SH. Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12. BMC Geriatr. 2015 Nov 5;15:146.
Delgado J, Bowman K, Ble A, Masoli J, Han Y, Henley W, Welsh S, Kuchel GA, Ferrucci L, Melzer D. Blood Pressure Trajectories in the 20 Years Before Death. JAMA Intern Med. 2018 Jan 1;178(1):93-99.
SPHR Public Health Evidence Briefing: Do statins work in older people