Life and living in advanced age: a cohort study in New Zealand--e Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: study protocol

Abstract

Background: The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand.

Methods/design: A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples.

Discussion: A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.

Figure 1

The main areas of interview and physical assessment. CVD – cardiovascular disease, QOL – quality of life, SF-12 – Medical Outcomes Study Short Form Health Survey (12 item), BORG – Borg Rating of Perceived Exertion Scale, GDS-15 – Geriatric Depression Scale (15 item), 3MS – Modified Mini Mental State Examination, NEADL - Nottingham Extended Activities of Daily Living Scale, MRADL - Manchester Respiratory Activities of Daily Living Scale, SPPB – Short Physical Performance Battery, NRS – Numerical Rating Scale, AUDIT – Alcohol Use Disorders Identification Test, SCREEN II - Seniors in the Community: Risk Evaluation for Eating and Nutrition (Version II), PASE – Physical Activity Scale for the Elderly, PANT - Practitioner Assessment of Network Type.

Figure 2

Timeline from inception to the end of current funding (Wave 3).