Lifetime lifestyles and social environment
What is the role of lifetime
lifestyle and social environment on health-related quality of life
and survival?
Research programme:
Life course lifestyles and social environment in relation to
health, health related quality of life, and survival in later
life
Programme leader: Dr
Gita Mishra
External collaborators:
- Dr Alison Lennox, MRC Human Nutrition
Research
- Professor Ulf Ekelund, MRC
Epidemiology Unit
- Professor Annette Dobson, University
of Queensland, Australia;
- Professor Julie Byles, University of
Newcastle, Australia
Diet and breast cancer
investigators:
- Professor Isabel dos Santos Silva,
London School of Hygiene and Tropical Medicine
- Professor Ian Jacobs, University
College London
Life course approach to
urinary incontinence investigators:
- Professor Linda Cardozo, King’s
College London
- Dr Tim Croudace, University of
Cambridge
The way people live their lives, from the food they eat to the
environment they live in, affects their health and wellbeing.
Policy makers are interested in these lifestyle factors as they can
be modified to improve health.
The overall aim of this programme is to investigate the role of
lifetime lifestyles and the social environment on disease
incidence, health problems and multimorbidity (having more than one
disease or health problem), and their joint effects on health
related quality of life and survival. Most of these data are
categorical, so we shall adopt methods for discrete longitudinal
data such as latent class mixture models, generalised estimating
equations, and hierarchical joint models.
Objectives
- To describe the longitudinal profiles of
lifestyle risk factors, such as dietary patterns, social class,
physical activity levels, smoking status, alcohol use, maintenance
of body weight, and medication and health service use, identifying
periods of continuity and change
- To determine how early life factors, such as
childhood cognition, parental behaviours and social conditions,
shape longitudinal profiles of lifestyle risk factors, and whether
educational and social mobility or other changes in life
circumstances (such as retirement) trigger lifestyle changes
- To describe patterns of multimorbidity in
cohort members and their parents
- To investigate the effects of lifelong
lifestyle on health related quality of life, health symptoms,
cancer incidence, multimorbidity and survival
- To investigate the genetic and lifetime
environmental factors associated with new objective measures of
physical activity
- To investigate how these new measures of
physical activity and the transition to retirement relate to
cardiovascular and musculoskeletal function
Sample research finding
An approach to modelling the effects
of lifetime socioeconomic circumstances
There is growing evidence that the duration of
time spent in unfavourable circumstances across life is related to
an increased risk of chronic disease and premature mortality.
Analyses that only consider the association of a cumulative score
derived, for example, from summing binary indicators of social
class at different ages with a later outcome may produce misleading
results as they do not consider the full range of potential life
course models that may be operating.
We described a model-fit approach to
disentangle the different life course hypotheses, given the
assumption of no measurement errors and provided the study has
sufficient power.(1) We recommended comparing a set of
nested models – each corresponding to the accumulation, critical
period and effect modification hypotheses – to an all-inclusive
(saturated) model. Our approach has highlighted that researchers
should not adopt an a priori hypothesis without testing to see if
other life course models fit the data equally well.
(1) 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 2008:November 21st. [Epub ahead of print]