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Institute of Epidemiology & Health Care

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Research

By combining existing 35 years of data on environmental exposures (social, behavioural, cardiometabolic, inflammatory) and chronic disease with repeat assessment of cognitive and motor function (6 measures from 1997 to 2023) Whitehall II is uniquely positioned internationally to disability and dementia.

Impact of Research

Whitehall II study publications have been used as evidence in several public health guidelines and policies.

Current Research on Ageing

Professional woman with laptop

Ageing is not characterised by universal decline. Rather, variations in the speed of ageing result in people of the same age becoming increasingly dissimilar in terms of cognitive capability, mental and physical health and functioning over time. 

Understanding the causes of this age-related individual heterogeneity and its distribution by social group is the core focus of our current work. 

In addition to providing insights into individual and social differences in the development of frailty, disability, dependence, and dementia, our work enables the determination of optimal time windows and targets for interventions that maximize the potential for healthy-ageing and independent living. 

Our recent research highlights are:

Generalizability of Whitehall II findings

As Whitehall II is an occupational cohort study, prevalence of risk factors and incidence of disease are lower than the general population. Nevertheless, the associations between causal risk factors and disease in Whitehall II are similar to those in the population-based British Regional Heart Study (Batty et al,  Epidemiology 2014).

Whitehall II has contributed to >100 research consortia papers and the results have been consistent with summary estimates from other studies. Thus, the causal risk factor-health outcome associations observed in Whitehall II are very likely to be generalizable, applicable to the UK and other developed countries. 

See for example how Whitehall II results compare to other studies in the graph below, which shows the inverse association between socioeconomic status and mortality in Whitehall II and 45 other cohort studies from Europe, the US and Asia (Stringhini et al. Lancet 2017)

Lancet Studies
Cognitive Ageing and Dementia

The unique feature of the Whitehall II cognitive data is assessment starting at age 45, allowing us to study the social, behavioural and biological determinants of heterogeneity in cognitive decline, starting in midlife and dementia.

Cardiometabolic Health

Whitehall II has collected an unrivalled set of multiple repeat measures over 30 years of follow-up, complementing our cardiovascular morbidity and mortality follow-up. For example, blood pressure and body mass index have been measured on 7 occasions and oral glucose tolerance on 4 occasions. Our longitudinal studies of diabetes development have attracted much attention. 

The causes and consequences of aortic stiffening is a novel focus of our cardiometabolic research, which is also relevant to those interested in interventions to reduce vascular ageing. Whitehall II has now collected three measures of carotid-femoral pulse wave velocity.

Physical Functioning and Mental Health

A major aim of our research is to identify midlife risk factors and protective factors for old-age functional limitations and depression. In addition to social circumstances, lifestyle and chronic diseases, we examine the role of biological factors, such as low-grade inflammation, in predicting functioning and mental well-being at older ages.

Socioeconomic and occupational stressors

Biological, environmental and lifestyle factors explaining differences in health between people from different socioeconomic circumstances have been a key research area for Whitehall II since the beginning of the study. Our findings have had a strong impact on health policy nationally and internationally. To understand the health effects of workplace factors, such as work stress, we have combined data from Whitehall II to those from other cohort studies.