The English Longitudinal Study of Ageing: Update for HSE User Group http://www.ifs.org.uk/elsa The English Longitudinal Study of Ageing: Update for HSE User Group Carli Lessof National Centre for Social Research

Key Facts about ELSA A study of people aged 50 and over and their younger partners Multi-disciplinary - to understand the relationship between people’s health and their economic and social circumstances Longitudinal - interviews conducted every two years to understand change over time Comparative - international comparison with HRS (US), SHARE (Europe) and others Applied research which is policy relevant; aims are long-term

Research Team and Funders International Centre for Health and Society, UCL Institute for Fiscal Studies National Centre for Social Research Dept of Public Health and Primary Care, University of Cambridge Department of Psychiatry, University of Cambridge Funders National Institute on Aging Consortium of UK Government departments

The ELSA Team MANAGEMENT GROUP OTHER INVESTIGATORS RESEARCH GROUP Lisa Calderwood Maria Casanova Laura Conway Edlira Gjonça Martin Hyde Mary Janevic Saffron Karlsen Meena Kumari Michelle Lee Anne McMunn Zoë Oldfield Keeley Ribas Rebecca Taylor James Banks Richard Blundell Bob Erens Roger Jowell Carli Lessof Michael Marmot (PI) James Nazroo Orazio Attanasio David Blane Richard Disney Paul Higgs Felicia Huppert Costas Meghir David Melzer Susan Purdon Nick Steel

Sample Design Sample is representative of population aged 50 and over, living in private households in England Drawn from Health Survey for England (HSE) Three years of HSE used - 1998, 1999 & 2001 Annual cross-section of approximately 16,000 adults Core content, supplemented by varying modules Health measures provide ‘pre-baseline’ information Household response - HSE (74% to 76%) Individual adult response - HSE (67% to 70%)

HSE Content for ELSA Baseline General health Use of health services MRC respiratory questionnaire, chest pain, CVD Physical activity Eating habits, smoking, drinking Height and weight (collected in interview) Waist and hip, demi-span (by nurse) Parental history GHQ12 Blood pressure; blood sample Prescribed drugs; vitamins; nicotine replacements

Eligibility for the Study Core sample members born on or before 29th Feb 1952 In household sector in England at baseline (ELSA W1) Younger partners cohabiting with core sample at HSE New partners who joined household since HSE Some data about other household and family members No interviews in institutions or outside England at baseline Report focuses on core sample members

ELSA development - the first five years 1998, 99, 01 HSE fieldwork, interview and nurse visit Wave 1 2001 Development 2002 Fieldwork March 2002-March 2003 2003 Analysis and reporting 2004 Data deposit Wave 2 2003 Development 2004 Fieldwork (including nurse visit) 2005 Analysis, reporting and data deposit Initially we intend to conduct interviews every two years (twice in the first five-year cycle), giving us a long enough period to estimate healthy life expectancy and its predictors, and allowing us to collect a large amount of data about transitions without overburdening panelists. The five year cycle, together with the initial HSE interview, would look like

Interview Content and Structure Household demographics Individual demographics Health Social participation Work and pensions Income and assets Housing Cognitive function Psychosocial health Expectations Final questions (including consents) Timed walk Self-completion

Interview Content and Structure Household demographics Answered once per household Individual demographics ] Health ] Answered by all Social participation ] Can be conducted concurrently Work and pensions ] Income and assets Answered once per financial unit Housing Answered once per household Cognitive function ] Psychosocial health ] Answered by all Expectations ] Should be answered in private Final questions ] Timed walk Answered by 60+, floating block Self-completion Can be left behind or switched Interview length versus attrition Flexible interviewing Validated measures and new questions Unfolding brackets Randomisation

Response Issued sample of ~11,600 households; ~18,800 individuals Achieved sample of ~7,900 households; ~12,100 individuals ~11,400 interviews with core sample members ~640 interviews with partners under 50 and ~70 with new partners Response among core sample members Household response 70% 96% responding within households Overall individual response rate of 67% Individual response rate for new partners 68% Individual response rate for younger partners 63% Core interviews - including ~200 partial and ~160 proxy responses Sample refreshment at W3 Following rules

Achieved Sample Size - All Sample Types Numbers % Age Men Women Total Men Women Total Under 50 104 472 576 2 7 5 50-54 920 1156 2076 17 17 17 55-59 1030 1171 2201 19 17 18 60-64 813 883 1696 15 13 14 65-69 806 912 1718 15 13 14 70-74 680 797 1477 13 12 12 75-79 498 596 1094 9 9 9 80+ 485 777 1262 9 11 10 Total 5336 6764 12100 100 100 100

Response and Weighting High response to elements within survey Housing 99.7% Income and assets 99.0% Self-completion 92.0% Consents c.80% Imputation for missing values in economic variables Weighting to take account of household non-response Post-stratified to the relevant population using Census 2001 Applied at individual level

Health, wealth and lifestyles of the older population in England: the 2002 English Longitudinal Survey http//www.ifs.org.uk/elsa/report.htm

Retired (%), by age and private pension type: men with private pensions

Prevalence of measured mobility limitation - % unable or <0 Prevalence of measured mobility limitation - % unable or <0.4 metres / second on gait speed test

Men - poor walking performance by occupational social class

Prevalence of mobility impairment by years of education in women Gait speed test - % unable or <0.4m/s

Numerical ability by age and education - women

Conclusions Old age is not a problem Variability in the picture Striking socioeconomic gradients in every aspect of ageing The challenge for longitudinal analyses is to determine the predictors of being on a successful trajectory The payoff to individuals and society of moving the population to healthier, more productive ageing is enormous

Panel Maintenance Build panel identity Optimise future contact Web site, thank you letters, magnets, cards and findings Optimise future contact Identifying deaths using administrative records Maintaining addresses Tracing and mover strategies Stable addresses and self-nominated proxies Maximise response Pilot panel to provide early feedback Interviewer continuity Incentive payments Survey burden and salience

Survey Content at Wave 2 Core modules will remain Repeat cross-sectional questions Dependent interviewing where prior data is available (Temporary) removal of some questions Some additions to main questionnaire Loneliness, life satisfaction Quality of care Date of onset of new conditions Job change and retirement House moves Extra consumption questions Identifying change Questions to identify new events Repeat cross-sectional questions Dependent interviewing for key survey estimates where prior data is available Reduces burden and time Benefits and risks (e.g. consistent household grids, suppressing change) Proactive dependent interviewing e.g. household grid, avoiding seam effects for transitions Reactive dependent interviewing e.g. checking lost events, weird assets, avoiding inconsistent data

Major Changes at Wave 2 Nurse visit Moves into institution sample members only blood pressure; blood samples; saliva sample height & weight; waist & hip; lung function physical performance measures Moves into institution Exit interview Change to following rules outside of England partners to be followed for at least one wave after splits

Plans for ELSA Data Initial deposit of flat file Link to HSE data record per person some derived variables some imputations weights basic documentation Link to HSE data HSE serial HSE 98, 99, 01 Common data set Preparation for longitudinal data Additional documentation

ELSA development - the next six years? 2006 W3 fieldwork- refreshment, retrospective 2007 Off-year mail out 2008 W4 fieldwork (including nurse visit) 2009 Off-year mail out 2010 W5 fieldwork - refreshment 2011 Off-year mail out Initially we intend to conduct interviews every two years (twice in the first five-year cycle), giving us a long enough period to estimate healthy life expectancy and its predictors, and allowing us to collect a large amount of data about transitions without overburdening panelists. The five year cycle, together with the initial HSE interview, would look like

ELSA development - the next six years? Analysis Reporting Data Initially we intend to conduct interviews every two years (twice in the first five-year cycle), giving us a long enough period to estimate healthy life expectancy and its predictors, and allowing us to collect a large amount of data about transitions without overburdening panelists. The five year cycle, together with the initial HSE interview, would look like

The English Longitudinal Study of Ageing: Update for HSE User Group http://www.ifs.org.uk/elsa The English Longitudinal Study of Ageing: Update for HSE User Group Carli Lessof National Centre for Social Research