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An ageing cohort is providing insight into both the causes and consequences of cognitive decline, with implications for both health and social policy.
The English Longitudinal Study of Ageing has been tracking more than 10,000 people aged 50 or more since 2002. Unusually, it captures data across a wide range of social, economic and health indicators, an interdisciplinary perspective that allows links to be made between health and wellbeing and social circumstances.
Management of the cohort is coordinated by Professor Andrew Steptoe at UCL in partnership with the Institute of Fiscal Studies and other academic groups. Unusually, data are released as rapidly as possible to other researchers, to encourage their use in evidence-based policy-making.
Among the data collected are measures of cognitive ability. Given that cognitive decline is a well-recognised staging post on the path to dementia, any factors influencing this decline could have later implications for disease. For example, if disease onset could be delayed by five years, some 30,000 fewer people would die from dementia each year.
One factor that could influence the decline of cognitive skills is social isolation. Recently, Professor Steptoe and colleagues have explored the potential impact of both isolation - an objective measure of people's social networks - and loneliness, a subjective assessment of connectedness (which may not necessarily reflect actual degree of isolation).
Notably, the degree of cognitive decline was more closely related with isolation than loneliness. Such studies suggest possible strategies for intervention, for example by promoting social network development in vulnerable populations.
The cognitive data have also provided an unusual opportunity to explore its impact on real-life financial decision-making. This is of particular interest to policy-makers, for example to guide pension policy. One use of ELSA data has been to examine how cognitive performance and numeracy affect savings behaviour around retirement.
Finally, ELSA has been modelled on the US Health and Retirement Survey, enabling international comparisons to be made. As well as revealing that US seniors cognitively outperform their UK peers (despite typically being less healthy), crosscountry comparisons also suggest that cognitive skills in old age are strongly influenced by life course - the elders in industrialised countries are cognitively healthier because of the better living standards they enjoyed when younger.
