|Title:||Quality of life in the last years of life: qualitative and quantitative research with the Cambridge City over-75s Cohort.|
|Principal research question:||The fastest growing section of the population is the "oldest old" and this study aims to gain a fuller understanding of what it means to live so long and die so old.|
|Background:||Funded by the BUPA Foundation, this study aims to gain a fuller understanding of what it means to live into extreme old age and to die when so old. The research is taking account of personal experiences, attitudes and preferences using qualitative methods, and quantifying patterns of health, cognition, social networks and service support at the end of life, building on 20 years’ quantitative data.
The study is being undertaken in collaboration with the Cambridge City over-75s Cohort, and is led by Dr Jane Fleming and Prof Carol Brayne of the Department of Public Health and Primary Care. The current focus on very old age, particularly concerning quality of life and care towards the end of life, falls within the NIHR funded CLAHRC programme’s Old Age and End of Life Care Theme.
|Methodology description:||This study consists of three linked projects within the framework of an on-going longitudinal observational study, the Cambridge City over-75s Cohort.
Project 1: A follow-up survey of participants in this population-based study of ageing (Year 21, n=44 aged ≥95) and their relatives or other close carers has added to a rare collection of over 20 year’s data on cognition, function, health, social networks and service use of the very old. In addition to structured survey data collection, topic guided interviews provided important qualitative information on attitudes and preferences concerning living to be so old and end-of-life care, a rich resource for on-going analyses.
Project 2: Interviews with deceased participants’ close informants continue to complete trajectory tracking of any functional and cognitive changes, final illness and perceptions of support needed and provided for older people and their carers at the very end of life.
Project 3: New analyses of the existing datasets are examining an important sub-sample of very old people in their last year of life, using interview data for participants who were last surveyed less than a year before dying aged ≥85 (n=321, including n=161 aged ≥90 at death). The focus is on characterising this sample, representative of a rising section of the population, in terms of their health and well-being, cognitive and physical function, formal services and informal support networks, and their place of care and death.
|Outcome measure description:||This cohort provides a unique opportunity to explore quality of life and supportive end-of-life care in advanced old age by combining prospective and retrospective methods using both first-hand and proxy accounts. The research has important policy and resource-use implications.|
|Start date:||1st January 2006|
|End date:||31st December 2010|
|Contact person:||Jane Fleming|
|Contact Details:||Cambridgeshire and Peterborough Collaboration for
Leadership in Applied Health Research and Care
Institute of Public Health, Robinson Way
Telephone: 01223 330341
Fax: 01223 330330
|Collaborative:||Unit Team Members: Dr Morag Farquhar, Dr Stephen Barclay, Prof Ann Louise Kinmonth
Other Collaborators: Prof Carol Brayne
|Funding Organisation:||The BUPA Foundation|
|Funding Organisation:||NIHR - CLAHRC|
|References and Publications|
Fleming J, Zhao E, O'Connor DW, Pollitt PA, Brayne C.
Cohort profile: the Cambridge City over-75s Cohort (CC75C)
Int J Epidemiol. 2007 Feb;36(1):40-6.
To view the publication click here
Zhao J, Barclay S, Farquhar M, Kinmonth AL, Brayne C and Fleming J for the Cambridge City over-75s Cohort (CC75C) study collaboration
The “oldest old” in the last year of life: population-based findings from CC75C study participants aged at least 85 at death
J Am Geriatr Soc. 2010 Jan;58(1):1-11.
To view the abstract click here
Fleming J, Zhao J, Farquhar M, Brayne C, Barclay S and the Cambridge City over-75s Cohort (CC75C) study collaboration
Place of death for the “oldest old”: ≥85-year-olds in the CC75C population-based cohort
British Journal of General Practice 2010 (April); e171-179, DOI: 10.3399/bjgp10X483959.
To view the publication click here