Research programme: Enhancing NSHD
Programme leader: Professor Diana Kuh
The MRC National Survey of Health and Development (NSHD) is the oldest of the British birth cohorts, and is unique in having data across life on the health and social circumstances of a representative sample (N=5,362) of those born in England, Wales and Scotland in March 1946. Enhancing NSHD has been the core programme of the MRC Unit for Lifelong Health and Ageing at UCL (LHA), combining research and a resource function.
The resource function has been to curate, enrich and share the NSHD resource, on which all Unit programmes and research collaborations depend. In the last five years; we have completed the 24th follow-up, with a high response rate; developed data sharing policies and web-based data sharing tools; raised the international and national profile of the study through the NSHD 70th birthday events; and enhanced NSHD through new biomarker and genetic data.
The research function is to foster integrative research across the Unit programmes and with external collaborators, and to build capacity in life course epidemiology, life course methods, and ageing research. Ongoing studies include: the lifetime determinants of kidney function, thyroid function, and healthy ageing; the long-term health effects of exposure to air pollution; dietary studies; menopausal studies, and genetic studies. Much of this work involves comparative research across cohorts. For example, LHA has led the Healthy Ageing across the Life Course (HALCyon) research programme which brought together an interdisciplinary group of researchers to study life course determinants of three aspects of healthy ageing across nine UK cohort studies: physical and cognitive capability, social and psychological wellbeing and underlying biology, including aspects of physiology and genetics. More details can be found on www.halcyon.ac.uk.
The two main research themes have been:
(1) healthy ageing and the management of health and health care needs as the cohort grows older, and how these are influenced by earlier life experiences;
(2) the biology of ageing, linking epidemiology and mechanistic science in this cohort study. The latter includes planned metabolomic and epigenomic projects, and research collaborations on lifetime determinants and consequences of the ageing lung and endocrine function. We also plan to extend HALCyon cross cohort research activities, data harmonisation and data sharing through international collaborations and through our role in the new ESRC/MRC Cohort Resource Facility. The Cohort Resource Facility is funded by the ESRC and the MRC from October 2012 with the purpose of maximising the use, value and impact of data collected across a portfolio of key UK longitudinal studies.
This programme also co-ordinated and managed the 2014-16 data collection.
Kuh D., Wong A., Shah I., Moore A., Popham M., Curran P., Davis D., Sharma N., Richards M., Stafford M., Hardy R. and Cooper R. The MRC National Survey of Health and Development reaches age 70: maintaining participation at older ages in a birth cohort study. Eur J Epidemiol. 2016; 31(11): 1135–1147.
Mishra G and Kuh D. How do health symptoms during midlife relate to menopausal transition? A British prospective cohort study. BMJ 2012;344:e402.
This paper was the first to combine factor analysis and latent class analysis to study how longitudinal symptom profiles related to timing of menopause. The paper found that women had different symptom profiles and only some profiles were related to timing of the menopause. As expected, there was evidence of timing of hot flushes and night sweats in relation to the menopause: some women experienced the peak severity prior to menopause, while for other women symptoms became more bothersome afterwards. A third of women experienced only mild or no symptoms of hot flushes and night sweats through their menopausal transition. While two thirds of women reported psychological symptoms during the same period, for only one in ten were these reports clearly related to menopause timing; other life events were generally more important. These findings help women and their health professionals know what to expect during the menopausal transition, so that an approach to symptom management can be tailored to individual needs.
Kuh D, Pierce M, Adams J, Deanfield J, Ekelund U, Friberg P, Ghosh AK, Harwood N, Hughes A, MacFarlane P, Pellerin D, Stephen AM, Wong A, Richards M, Hardy R on behalf of the NSHD scientific and clinic data collection teams. Updating the cohort profile for the MRC National Survey of Health and Development: a new clinic-based data collection for ageing research. International Journal of Epidemiology 2011 Feb;40(1):e1-9.
This paper presents the research protocol for the recent clinic data collection and was the first updated cohort profile published by the International Journal of Epidemiology.
Ong, KK, Elks, CE, Wills, AK, Wong, A, Wareham, NJ, Loos, RJF, Kuh, D, Hardy, R. Timing of associations between polymorphism in LIN28B and BMI across the life course. Journal of Clinical Endocrinology and Metabolism 2011 Jan;96(1):E125-9.
This study extended the original paper that identified LIN28B as a key genetic determinant of pubertal timing to provide evidence that earlier pubertal timing, which is a known marker of increased adult metabolic disease risk, results in a prolonged elevation in BMI during early to mid-adult life in women.
Repapi E et al. with multiple co-authors. Genome-wide association study identifies five new loci associated with lung function. Nature Genetics 2010 Jan;42(1):36-44.
This was one of the first opportunities to use the NSHD as a replication study, after the DNA repository was established, helping to establish five new genetic markers of lung function. Subsequently there were two further papers (Soler Artigas et al. Nature Genetics 2011;43:1082-90; Soler Artigas et al. American Journal of Respiratory and Critical Care Medicine 2011;84:786-95) extending these findings to 16 new genetic markers suggesting novel mechanistic pathways, investigating the joint effects of five genetic variants on lung function, and examining the effects of these genetic markers on chronic obstructive pulmonary disease.
Mishra G, Nitsch D, Black S, De Stavola B, Kuh D, Hardy R. A Structured approach to modelling the effects of binary exposure variables over the life course. International Journal of Epidemiology 2009 Apr;38(2):528-37.
This paper showed how to model the effects of a binary exposure variable over the life course, and demonstrated how to distinguish a sensitive period model from an accumulation model when studying the effects of lifetime socioeconomic position on adult health.