FALCon project: Measurment and modelling of [Function Across the Life Course]

The MRC Unit for Lifelong health and Ageing (LHA) was part of a cross-unit collaboration (2008-2012) with the MRC Biostatistics Unit (Cambridge University) and MRC CAiTE Centre (University of Bristol), MRC Epidemiology Resource Centre (University of Southampton), MRC Social and Public Health Sciences Unit (Glasgow University), on the measurement and modelling of Function Across the Life Course.

Background
Many measures of physiological, cognitive and physical function (e.g., blood pressure, IQ, grip strength) reach a peak (a high functional level) early in life, remain relatively stable, and then decline during older age. Repeated measures of function can thus act as a dynamic tool to study the biological imprint of physical and social exposures. Such measures of function are important because they affect our immediate health and quality of life; and also because they are predictors of future health, likelihood of disease, and of mortality. As an example, research has shown that acquiring a high peak bone mass (a marker of bone health, fracture risk and osteoporosis) early in life reduces the inevitable decline that occurs from our late 20’s. The level of peak bone mass achieved thus serves as the “bone bank for the remainder of life”. Signs of impaired function may act as intermediate markers of underlying disease processes or accelerated ageing, and importantly, indicate a need for early intervention.

Epidemiological studies are increasingly including measures of function as well as disease status, but there are no guiding principles on which to base the choice and timing of measures. It is also clear that in order to understand how measures of function change with age and affect health over the entire life course we need repeated measures from large numbers of individuals from birth to death - to date, no single study has such information. Currently, the best description of life course functional trajectories will come from the pooling of data from cohorts spanning the whole age range. Harmonisation of measures of function across cohorts would facilitate this comparison, while development of the statistical methods for combining trajectories is also necessary.

The objectives were:
(1) To provide recommendations for cohort studies on the measurement of physical, cognitive and cardiovascular function

(2) To develop statistical models for the synthesis of function across cohorts in order to model the whole life course trajectory

Investigators: 
Dr Rebecca Hardy (PI)
Professor Diana Kuh
Dr Andrew Wills (LHA then University of Bristol)

External collaborators: 
Dr Eleni Bakra (MRC Biostatistics Unit, Cambridge)
Dr Fiona Matthews, MRC Biostatistics Unit, Cambridge;
Professor Debbie Lawlor, MRC CAiTE Centre, University of Bristol;
Professor Avan Aihie Sayer, MRC Epidemiology Resource Centre;
Ms Michaela Benzeval, MRC Social and Public Health Sciences Unit

Other contributors:
Dr Rachel Cooper (LHA),
Dr Graciela Muniz-Terrera (MRC Biostatistic Unit then LHA)

Publications

Wills et al. PLoS Med 2011

Life Course Trajectories of Systolic Blood Pressure Using Longitudinal Data from Eight UK Cohorts

Wills et al. Epidemiology 2012

Population Heterogeneity in Trajectories of Midlife Blood Pressure

Cooper et al. BMJ 2010

Objectively measured physical capability levels and mortality: a systematic review and meta-analysis

Cooper et al. Age and Ageing 2011

Objective measures of physical capability and subsequent health: a systematic review

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