Thursday, April 21, 2011

Sweet Sixty five!

A landmark British study - and its subjects reached the age of sixty five last month, and I hope it sees many more happy years ahead.  The 1946 British birth cohort study, initiated at a time when there was a great deal of interest in socio-economic planning and reform, is the only one of its kind in the world, in terms of number of years spent and amount of information gathered.

The post war years had an optimism and momentum that lent impetus to this ambitious study that was thought of by the Medical Research Council (MRC) and implemented by a physician, James Douglas, who had been studying effects of air-raid casualties during the war.  The study identified 16,695 babies that were born in the UK in one week of March 1946.  It then looked in more detail at 5000 of these babies and documented social, economic, physical and mental aspects of their lives over time.  The data collected was enormous, the cost and infrastructure considerable, but the study managed to proceed,uninterruptedly, under the leadership of three very different personalities over more than six decades.

Douglas's initial work demonstrated the vast economic gap that existed in society and its effect on health and lifestyle options.  He showed the disparity in medical facilities available for the care of the mother and infant and how these affected their health and survival.  Later on, he addressed the issue of the relative success of the educational system and how children from different socio-economic backgrounds fared in national school exams.  Several of his publications led to changes in parliamentary bills and policy regarding health care and education in Britain.

In 1979, when the project seemed to be stagnating, a social epidemiologist, Wadsworth, who was a part of Douglas's team, took over and steered it in a new direction.  He persuaded the MRC to fund the study to follow important medical parameters (heart, lung and general physical functions) and aspects of people's lifestyle for the next two decades.  He wanted to see if conditions of early life affected people's health and lifestyle when they were adults.  A large amount of data was obtained and several new correlations discovered.  The general impression seems to be that early life experiences do affect one's later choices and also affect one's susceptibility to specific kinds of health problems (though the researchers stress on the fact that one's fate is not ultimately determined by early experiences).

This study, being continued under the leadership of Diana Kuh, now looks to interpreting some of the medical correlations in molecular terms- the genetic variations of the people being studied and epigenetic changes that occur (small modifications of DNA that are induced by environment or stress of some kind and that change patterns of gene expression).

The study is conducted in a highly personalized fashion and several of the subjects, when interviewed, said they were happy to participate.  Obtaining consent in the mid-forties required much less effort (and red tape) than currently, which certainly helped a study of this magnitude.  However the nature and scope of investigations early on was more limited, mainly owing to social reservations about certain issues.  The research has evolved in an interesting way over time and I suspect it sheds light on many more aspects than it was originally intended to.  Other such cohort studies have since been initiated, but it will be many years before one sees whether they succeed in their stated aims.

This study has shown a link between cognition, hormones and aging, something people did not think about much.  The effects of lifestyle, environment (physical and emotional) and social trends on a person's life have been shown very clearly for thousands of people who were born within a few hours or days of each other.  This has made people begin to think about factors influencing life, health and aging.  The study is remarkable  not only in the quality and quantity of data collected but also because the data was not taken just when people were ill or facing difficult times, but periodically through their lives.  It would be wonderful if eventually one could look at alternate or traditional medical systems (several of which emphasize the maintenance of balance and prevention of illness) and incorporate aspects of these in the questionnaires and tests that such people are subjected to.

The MRC has made a small documentary recording to mark this 65th anniversary which can be viewed at

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