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Open Access Study protocol

Rationale, design and methods for a community-based study of clustering and cumulative effects of chronic disease processes and their effects on ageing: the Busselton healthy ageing study

Alan James113*, Michael Hunter128, Leon Straker2, John Beilby143, Romola Bucks4, Tim Davis5, Robert H Eikelboom6, David Hillman17, Jennie Hui1438, Joe Hung13, Matthew Knuiman8, David A Mackey9, Robert U Newton10, Lyle J Palmer11, AW Bill Musk12138 and the Busselton Healthy Ageing Study (BHAS) Investigator Group

Author Affiliations

1 Department of Pulmonary Physiology and Sleep Medicine/West Australian Sleep Disorders Institute, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia

2 School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, Australia

3 Pathwest, The University of Western Australia, Crawley, Perth, Australia

4 School of Psychology, The University of Western Australia, Crawley, Perth, Australia

5 Fremantle Hospital; School of Medicine and Health, The University of Western Australia, Crawley, Perth, Australia

6 Ear Science Institute Australia, Ear Sciences Centre; School of Surgery, The University of Western Australia, Crawley, Perth, Australia

7 School of Anatomy and Surgery, The University of Western Australia, Crawley, Perth, Australia

8 School of Population Health, The University of Western Australia, Crawley, Perth, Australia

9 Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Perth, Australia

10 Health and Wellness Institute, Edith Cowan University, Joondalup, Perth, Australia

11 Ontario Institute for Cancer Research and Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Canada

12 Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia

13 School of Medicine and Pharmacology, The University of Western Australia, Crawley, Perth, WA, Australia

14 School of Pathology and Laboratory, The University of Western Australia, Crawley, Perth, WA, Australia

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BMC Public Health 2013, 13:936  doi:10.1186/1471-2458-13-936

Published: 8 October 2013

Abstract

Background

The global trend of increased life expectancy and increased prevalence of chronic and degenerative diseases will impact on health systems. To identify effective intervention and prevention strategies, greater understanding of the risk factors for and cumulative effects of chronic disease processes and their effects on function and quality of life is needed.

The Busselton Healthy Ageing Study aims to enhance understanding of ageing by relating the clustering and interactions of common chronic conditions in adults to function. Longitudinal (3–5 yearly) follow-up is planned.

Methods/design

Phase I (recruitment) is a cross-sectional community-based prospective cohort study involving up to 4,000 'Baby Boomers’ (born from 1946 to 1964) living in the Busselton Shire, Western Australia. The study protocol involves a detailed, self-administered health and risk factor questionnaire and a range of physical assessments including body composition and bone density measurements, cardiovascular profiling (blood pressure, ECG and brachial pulse wave velocity), retinal photography, tonometry, auto-refraction, spirometry and bronchodilator responsiveness, skin allergy prick tests, sleep apnoea screening, tympanometry and audiometry, grip strength, mobility, balance and leg extensor strength. Cognitive function and reserve, semantic memory, and pre-morbid intelligence are assessed. Participants provide a fasting blood sample for assessment of lipids, blood glucose, C-reactive protein and renal and liver function, and RNA, DNA and serum are stored. Clinically relevant results are provided to all participants. The prevalence of risk factors, symptoms and diagnosed illness will be calculated and the burden of illness will be estimated based on the observed relationships and clustering of symptoms and illness within individuals. Risk factors for combinations of illness will be compared with those for single illnesses and the relation of combinations of illness and symptoms to cognitive and physical function will be estimated.

Discussion

This study will enable a thorough characterization of multiple disease processes and their risk factors within a community-based sample of individuals to determine their singular, interactive and cumulative effects on ageing. The project will provide novel cross-sectional data and establish a cohort that will be used for longitudinal analyses of the genetic, lifestyle and environmental factors that determine whether an individual ages well or with impairment.

Keywords:
Busselton; Healthy ageing; Clusters of illness; Cross-sectional; Prevalence; Multi-morbidity