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Active Research
Applicant: Professor Sheena Ramsay, Clinical Senior Lecturer & Hon Consultant in Public Health, Newcastle University Sheena.Ramsay@newcastle.ac.uk
1. Research Theme: Social engagement and cardiovascular disease in older age –
To examine the association between social engagement and development of cardiovascular disease in older age, particularly heart failure.
To examine the possible pathways underlying associations between social engagement and cardiovascular diseases such as heart failure.
2. Social determinants of frailty and disability –
To examine the associations, cross-sectionally and longitudinally, between social factors (social class, deprivation, social engagement) and age-related conditions such as disability and frailty.
3. Denture use in older ages and its influence on nutrition and age-related outcomes such as disability and frailty.
4. Understanding the influence of markers of oral health in older age on malnutrition, sarcopenia and disability.
These investigations will be undertaken cross-sectionally, and longitudinally to investigate decline in oral health and its influence on adverse health outcomes in older age.
Applicant: Dr Barbara Jefferis, Associate Professor UCL. B.jefferis@ucl.ac.uk
Title: Understanding the importance of physical activity and sedentary behaviours for healthy ageing.
Aim: Physical activity and sedentary behaviour are modifiable behaviours which can potentially contribute to multiple facets of healthy ageing. Given the growing older adult populations and the low levels of physical activity and high levels of sedentary behaviour in this age group, there is much potential for benefit if we understand which aspects of physical activity are important for different age-related conditions. This includes understanding if only proximal physical activity is important or if changes in later life are important and if there is an interplay between sedentary time and physical activity. Age related outcomes to be studied include important physical conditions such as disability, physical function and frailty as well as wellbeing including quality of life and mental health.
Objectives:
How are physical activity and sedentary behaviour associated cross-sectionally and longitudinally with physical age-related conditions including disability, physical function and frailty.
How are physical activity and sedentary behaviour associated cross sectionally and longitudinally with healthy ageing related to wellbeing (quality of life and mental health).
These investigations will investigate changes in pattern, level and intensity of physical activity and sedentary behaviour, as well as their interplay and their influence on adverse health outcomes in older age.
Applicant: Dr Ayesha Ahmed, PhD Student at UCL- MRC Doctoral Training Programme Ayesha.Ahmed_18@ucl.ac.uk
Title: Primary prevention of stroke in older populations in the UK
Aim: To explore if primary prevention of stroke and its subtypes should target the same risk factors across the adult life-course. Stroke is a leading cause of adult disability and death in the UK, with burden rising sharply with age. The European Stroke Action Plan 2018-2030 emphasizes primary prevention of stroke by both risk factor modification and improved stroke risk assessment.
Objectives:
1. To assess the impact of traditional health factors - the 7 metrics of cardiovascular health as defined by the American Heart Association
2. To assess the impact of non-conventional factors like markers of inflammation, NTproBNP and psychosocial influences.
3. To investigate if current risk prediction tools – most of which have been derived from middle aged populations, can be used to reliably predict stroke as a specific endpoint in older age.
4. To determine if improvements can made by incorporating newer non-conventional predictors.
Applicant: John Mitchell MRC Doctoral Training Programme, UCL John.mitchell.12@ucl.ac.uk
Title: Life-course trajectories of sporting, recreational and non-recreational physical activity participation, and their supporting role for cognitive health.
Physical activity is frequently cited as a ‘polypill’ with far-reaching benefits for lifelong health. However, one aspect of physical activity less well understood is it’s role in supporting lifelong cognition and moderating the risk of dementia in later-life. Early evidence is positive, suggesting healthy levels of physical activity in later-life, of both high and low intensity, might buffer our risks of cognitive decline and dementia. The evidence to date opens new avenues for research and includes the following questions which will be addressed using the British Regional Heart Study:
Is lifelong physical activity associated with mid-life and later-life cognition, or is later life a ‘critical period’ for attaining the maximum direct benefits of physical activity on cognition and dementia risk?
Which aspects of our movement patterns is most associated with cognition, with a specific focus on the role of sporting engagement?
As the global disease burden of cognitive decline and dementia rise, understanding the precise role which modifiable risk factors play is vital. Given the immediate and near-universal access to physical activity, the implications of this research are highly relevant and globally applicable.
Applicant: Dr Artaza Gilani, Academic Clinical Fellow in General Practice, NIHR ACF programme. artaza.gilani@ucl.ac.uk
Title: Understanding the association between postural change in blood pressure and health outcomes
Aim: To explore the relationship between postural hypotension and cardiovascular disease in the BRHS. Exaggerated postural change in blood pressure, in particular, postural hypotension, is found in 1 in 5 community dwelling older adults. Its association with falls and fractures is well-known but there is emerging evidence that it may also increase cardiovascular morbidity and mortality. The association is especially strong in middle-aged adults but exaggerated postural change in blood pressure is more often found in older adults.
Objectives:
1. To investigate the mechanisms by which postural change in blood pressure may increase cardiovascular risk
2. To examine the association of postural change in blood pressure and cardiovascular outcomes, including stroke, myocardial infarction and heart failure, in older adults.
Applicant: Qiaoye (Jessie) Wang, Phd Student UCL qiaoye.wang.21@ucl.ac.uk
Title: Lifestyle, diet, fatty acids, and their associations with risk of cardiometabolic multimorbidity
Aim: Cardiometabolic multimorbidity (CMM) is a common pattern of multimorbidity, defined as the co-existence of two or more cardiometabolic diseases, including myocardial infarction, stroke, and type 2 diabetes. The prevalence of CMM increases with age, and with population aging worldwide, CMM is becoming an increasing global health concern. Each additional cardiometabolic condition present would increase healthcare costs, complicate medical treatment, impair quality of life, and double the risk of death. Although there is substantial evidence that modifiable risk factors are associated with the risk of individual cardiometabolic diseases, the relationships between lifestyle risk factors, especially dietary factors, and CMM remain less studied.
Objectives:
- To explore association of lifestyle factors (summarized by AHA Life’s Simple 7) with risk of CMM.
- To explore associations of diet quality, dietary patterns, dietary components, and nutrients (particularly omega-3 and omega-6 fatty acids) with risk of CMM.
- To explore additional risk factors of CMM (e.g., HDL and triglycerides).
- To investigate how fatty acids (particularly omega-3 and omega-6 fatty acids) impact the progression of CMM, specifically, from healthy to the first cardiometabolic disease, and subsequently to CMM.
Applicant: Eftychia Kotronia, PhD Student Newcastle University
Title: Poor oral health and age-related health outcomes in older people
Aim: To investigate the associations of poor oral health (objectively and subjectively assessed measures) with age-related health outcomes in older people in the UK and USA.
Objectives:
1. What is the association of oral health and disability and physical function?
2. What is the association between oral health and body composition and sarcopenia?
3. Is poor oral health associated with inflammatory, haemostatic and cardiac markers?
4. Is poor oral health associated with various dietary components?
5. Is there an association between oral health measures and all- and specific-cause mortality?
6. What is the association of poor oral health with the incidence of disability? Do nutrition and inflammation mediate this relationship?
Applicant: Dr Doug McKechnie, Academic Clinical Fellow in General Practice, NIHR ACF programme douglas.mckechnie.11@ucl.ac.uk
Title: Inflammation, natriuretic peptides and heart failure risk
Aim: To explore the previously-reported associations between inflammation and heart failure risk, including the role of NT-proBNP and thereby the activity of the natriuretic peptide system. Upon completion, planning to move towards investigating the links between frailty phenotypes and heart failure.
Objectives:
1. To determine the relationship between inflammatory markers, NT-proBNP and heart failure risk
2. To assess the relationship between inflammatory markers and NT-proBNP
Funded Projects
The British Regional Heart Study: a resource for studying the causes, pathways and prevention of cardiovascular disease and disability among older British men (BHF Programme Grant, 2019-2024)
Despite the recent decline in cardiovascular disease (CVD) mortality, CVD remains a major cause of morbidity and mortality at older ages (>70 years) and is responsible for a huge burden of disability, frailty and functional and cognitive decline. The British Regional Heart Study (BRHS) is one of very few longitudinal studies with detailed information on individual health-related behaviours, social factors and biological risk markers in both middle and later life, with detailed participant examinations at 40-59, 60-79, 72-91 and 79-98 years and with continuing follow-up for CVD morbidity and mortality. The aim of this programme grant application is to (i) maintain and improve intensive follow-up of the cohort members for CVD mortality, morbidity and disability (crucial for maximizing the value of the 60-79, 72-91 and 79- 98 year examinations), with enhanced clinical outcome data through NHS Digital linkage to optimise the BRHS data resource (ii) facilitate the use of BRHS data for collaboration and (iii) establish the BRHS as a national research resource for the studying of cardiovascular health and related morbidity in older adults. This rich scientific study resource will facilitate future research on the development of novel CVD preventive strategies and for improving the cardiovascular health of older adults.
Project Grants:
Identifying oral health markers of malnutrition and sarcopenia in older people in the community (Dunhill Medical Trust 2018-2021)
Sarcopenia (loss of muscle mass), a major cause of disability, is closely related to malnutrition (under-nutrition). Oral health, through its influence on malnutrition, has been implicated in sarcopenia. However, the influence of poor oral health, including tooth loss, periodontal (gum) disease and dry mouth (xerostomia) on sarcopenia has not been studied comprehensively and prospectively. In a study of older British people, we will collect prospective data on sarcopenia, malnutrition and oral health. With these data we will quantify the contribution of oral health to developing sarcopenia, and investigate the role of malnutrition in linking oral health to sarcopenia. We will also ascertain which simple (self-reported) validated oral health markers, could improve early identification of those at high-risk of sarcopenia. Our goal is to provide evidence for the potentially key role of oral health in the prevention and management of malnutrition and sarcopenia.