1. Faculty of Medicine and Health
  2. Research projects
  3. The Community Ageing Research Study (CARE 75+)

The Community Ageing Research Study (CARE 75+)

  • Start date: 1 January 2014
  • End date: 1 December 2018
  • Partners and collaborators: The CARE cohort is being developed as part of the NIHR CLAHRC Yorkshire and Humber – Primary care-based management of frailty in older people theme. http://clahrc-yh.nihr.ac.uk/our-themes/primary-care-based-management-of-frailty-in-older-people The NIHR CLAHRC Yorkshire and Humber is a partnership between 31 organisations including NHS, Higher Education, Local Authorities, Charities, Industry and the Regional Innovation Hub. A full list is available on our website www.clahrc-yh.nihr.ac.uk.
  • Primary investigator: John Young
  • External co-investigators: Andrew Clegg, Lesley Brown

Description

Objectives and brief methodology

Background

Frailty is a state of vulnerability to poor resolution of homeostasis after a stressor event. Improved management of frailty requires an integrated approach spanning primary care, secondary care and social services. Improved integrated pathways of care should include evidence based interventions where possible. However, there is limited evidence available from clinical trials. One reason for this is that recruitment of older people with frailty in to clinical trials has been disappointing. The Community Ageing Research Study (CARE75+) (ISRCTN16588124) is a longitudinal study providing observational data and a recruitment platform for research with older people with embedded methodology to embed randomised controlled trials

Aim & objectives

National expansion of the CARE75+ cohort study (recruitment target of 2500) for observational research to collect an extensive range of health, social and economic outcome data. CARE75+ will provide a data resource for researchers and a research platform for additional studies (sub-studies), and in the future will support randomised controlled trials using a Trials within Cohort (TwiCs) methodology.

  • To study longitudinal frailty transitions and health and social care resource use
  • To provide data for the next iteration of the eFI using prognostic modelling
  • To identify research priorities from the perspectives of older people with frailty
  • To investigate the feasibility of future trials of interventions to improve health, wellbeing and quality of life outcomes for older people
  • To provide blood samples for basic science research for the CARE75+ bio-bank at Ethical Tissue, University of Bradford for frailty and ageing research 
  • To enable cross-ARC collaboration with  ARC North Thames to harmonise CARE75+ with the DELPHIC cohort
  • To explore frailty in rural and coastal areas and how to support people living with frailty in black minority and ethnic communities

Methods

Potential participants are recruited via their GP practices.  Participants undergo a range of cognitive, physical and psychosocial assessments at baseline, 6, 12, 24 and 48 months. Assessments are face-to-face in the person’s home, with an optional modified follow-up at 6 and 24 months via telephone or the internet.  CARE75+ is recruiting participants from Leeds, Bradford, Newcastle, the West Midlands, Yorkshire and the South-West Peninsula. CARE75+ participants are highly phenotyped, with detailed demographic information collected alongside measures including:

  • Frailty (phenotype model; Cumulative Deficit Model; Clinical Frailty Scale; Edmonton Frail Scale;  electronic Frailty Index (eFI) (developed and validated by this team and available to 99% of UK general practices)
  • Health-related quality of life (SF36 and EQ5D)
  • Cognition (Montreal Cognitive Assessment)
  • Mood (Geriatric Depression Scale)
  • Activities of daily living (Barthel index and Nottingham Extended Activities of Daily Living)
  • Resilience (Brief Resilience Scale)
  • Loneliness (de Jong-Gierveld loneliness scale)
  • Comorbidities

Blood samples are collected at baseline and 12 months as a resource for basic science research.

Impact

CARE75+ study is an innovative trial design with the potential to enhance participation of older people with frailty in to clinical trials and to increase capacity to conduct high quality research with older people with well-defined frailty. To date, CARE75+ has identified participants for 6 sub-studies and published papers on topics including:  pain impact, the agreement between frailty measures, and the agreement between self-reported comorbidities and comorbidities reported on the patient record.

 

Participant criteria

Inclusion criteria 

Community dwelling older people (aged ≥ 75 years)

Exclusion criteria

Care home residents; Bedbound at home; Have terminal cancer; In receipt of the Amber Care Bundle (estimated life expectancy of three months or less); In receipt of palliative care services. Note - attempts will be made to retain participants who move to a care home post consent)

Funding agency

NIHR ARC Yorkshire and Humber

 

Further information

Partners & Collaborators:

The CARE75+ cohort is part of the NIHR ARC YH Older People’s theme

https://www.arc-yh.nihr.ac.uk/what-we-do/older-people

 

Project Period/Timescale:

January 2014 – December 2023

Recruitment at 18/12/2019 n = 1315

 

Further Information:

Andrew Clegg (Principle investigator) 

Lesley Brown (CLAHRC Frailty theme manager)