Insight 46

The Medical Research Council National Survey of Health and Development (NSHD; also known as the British 1946 Birth Cohort) is one of the oldest continuously running birth cohorts. The cohort comprises 5362 individuals born in England, Scotland, and Wales in one week in March 1946.

Data has been collected on the individuals at 26 time points, as well as through smaller sub-group collections. As of January 2020, approximately 2,600 study members remain in active follow-up. This cohort is particularly interesting and unique because health and life circumstances, and cognitive and physical measurements have been collected on this group since their childhood, allowing scientists to identify social and biological factors that affect lifelong health, ageing, and the development of chronic disease.

Insight 46 is a neuroimaging sub-study of the NSHD. Beginning in 2015, 502 NSHD members were recruited to take part in a clinic visit to London at two time points (Phases 1 and 2). The study was expanded in 2021 to increase the sample size and to bring some participants to London for a third time point (Phase 3). The picture below is a depiction of the types of data collected during the multi-day clinic visits, and more detailed information about the research can be found in the extensive Insight 46 publication list.

If you are a member of the NSHD or if you are interested in learning more about the 1946 British birth cohort life course data, please click here to visit the webpage for the NSHD.

Insight 46 Phases 1& 2

Between 2015 and 2018, 502 NSHD study members who attended a clinic at ages 60-64 were randomly recruited to participate in a Neuroimaging sub-study, also referred to as Insight 46. For the first phase of the study, participants underwent a day of testing in London at a baseline time point. Tests included tests of memory, thinking, movement, eyesight, sense of smell, and hearing. Data were also collected on height and weight, personal and family history of neurological disorders, and recently taken medication. At the end of the day, participants completed a one-hour brain scan in the integrated Magnetic Resonance Imaging and Positron Emission Tomography (PET/MR) scanner that is housed at University College London Hospital. The scans allow for an assessment not only of brain structure and function, but also for the accumulation of ß-amyloid, one of the key proteins implicated in Alzheimer’s disease.

For the second phase of the study, the 502 participants were invited to return to London to repeat the tests that were administered at the baseline time point. Participants were also given the option to undergo an additional half-day of testing, which included a lumbar puncture, cardiovascular assessments, and functional near-infrared spectroscopy. The second phase of the study began in 2018 and was completed in 2021. Of the 502 phase 1 study members who were invited to a phase 2 research visit, 413 were willing to return for a clinic visit in London and 29 participated in a remote research assessment due to COVID-19 restrictions.

Insight 46 Phase 3

The third phase of the study began in August 2021. For this phase of the study, we are aiming to recruit 250 participants who participated in phases 1 and 2 of the study (the TAU group) and 500 NSHD members who have not yet taken part in Insight 46 (the AMYLOID group). The research visits for these two groups will be identical, with the exception that the tau group will undergo a tau PET and the amyloid group will undergo an amyloid PET.  

What happens during an Insight 46 phase 3 clinic visit?

The following video explains what an NSHD study member can expect when taking part in an Insight 46 phase 3 clinic visit in London.

What do we hope to find out?

The specific aims of the sub-study are firstly to identify the brain changes that accompany healthy ageing; and secondly to see if brain changes can be detected that in due course might help predict who is at risk of developing dementia, and Alzheimer’s disease in particular. This in turn will we hope inform the design of clinical trials aimed at preventing the onset of dementia.

Participant Information Books

Separate participant information books were created to inform the participants at the recruitment stages of each phase of Insight 46. Click on the links below to open and view a PDF copy of the information books. 

Phase 1:

Phase 2: 

Phase 3: