The NIHR is the most integrated health research system in the world, and the largest national clinical research funder in Europe.
The NIHR supports research studies through our funding programmes, training and support for health researchers, and through providing world-class research facilities. We also support dialogue between the life sciences industry and charities to benefit all, and facilitate the involvement of patients and the public to make research more effective.
The NIHR Clinical Research Network (CRN) supported 162 studies on ageing research, 71 of which were new studies, and recruited 16,235 patients to studies last year (2018/19).
Undernutrition in hospital is very common, affecting approximately 39% patients aged over 65 years. Being malnourished can have an adverse effect on a patient’s health and add to NHS costs. Deconditioning, i.e. loss of physical function during hospital admission, is increasingly recognised to be associated with poor healthcare outcomes and is potentially avoidable. Poor nutrition and deconditioning commonly occur together amongst older people in hospital.
The Southampton Mealtime Assistance and Mobility Programme is a programme of research which started in 2010. Key aspects include:
Read more about this programme of research in this impact case study.
Ageing on its own does not drive healthcare costs. Research supported by the NIHR Guy's and St Thomas' Biomedical Research Centre found that the increasing number of health conditions and age-related impairments along with the proximity to death are more strongly linked to healthcare costs than age alone.
The study showed that in people over 80 years old, costs increased to the mid-90s before declining again. Proximity to death was the strongest predictor of cost, which was higher for people aged 80-84: £10,027 per year versus £7,021 per year for those over 100. Multiple illnesses also had a strong influence, with each additional health complaint progressively increasing costs.
Frailsafe is a simple safety checklist offering the opportunity to improve safety and quality of care for frail older people while in hospital. However, the relatively low completion rate highlights the need to understand how this approach can be better embedded in the complex care that is typical of services provided for older people.
The NIHR Collaboration for Leadership in Applied Health Research and Care Northwest London introduced Frailsafe into 12 NHS hospitals to help health professionals complete key frailty assessments and ultimately improve patient outcomes. Only about 1 in 4 patients had evidence of receiving all the appropriate checks.
Frailsafe could, in theory, support Comprehensive Geriatric Assessment by providing a plan of action at the point of admission. However, it seems that the tool should be considered as part of a complex intervention.
Older patients who do not see the same GP over a period of time are at higher risk of emergency hospital admission compared to those who see the same or a small number of GPs.
Researchers at the Universities of Bristol and Oxford, funded by the NIHR School for Primary Care Research, found that the risk of emergency hospital admission was more than twice as high for patients with the least continuity of care compared to those with high continuity of care.
You can find out more about Ageing studies in your area through the Be Part of Research website.
The NIHR Clinical Research Network (CRN) provides researchers with the practical support they need to make clinical studies happen in the NHS. This support covers every stage of research, from set up to delivery.
We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.
We support the set up and delivery of clinical research in the NHS through our study support service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.
We are committed to raising the profile of ageing research. Maintaining a high profile is key to generating and attracting more ageing research studies, including life-science industry sponsored projects. To date we have done this in a variety of ways, for example:
The Ageing Specialty Group has representation from NHS regions in England, Wales, Scotland and Northern Ireland. Many of our members are nationally and internationally recognised opinion leaders and are experienced Principal Investigators who have participated in advisory boards at national and international levels.
Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for Ageing.
We focus on promoting health, preventing illnesses and improving treatments for older adults. Our mission is to have a beneficial impact on quality of life by ensuring that older people have the opportunity to know about, and participate in relevant clinical research studies, especially those looking at age-related diseases and disabilities.
We support and promote research in the following areas:
These areas are unique to the Ageing Specialty, but in addition, we add value to studies led by other specialties, for example in the areas of dementia, stroke, heart failure and osteoporosis, by working closely with our colleagues from across the Network to deliver high quality ageing research.
Our local teams of research staff are specialists in the recruitment and retention of older adults in a range of health and social care settings, and in engaging families and carers. The ageing research studies that we support are consistently delivered on time and target.
Some examples of studies on the NIHR Clinical Research Network Portfolio are:
The NIHR Clinical Research Network Ageing specialty group works closely with these organisations in integrating clinical research into NHS clinical service provision, and in driving priority setting that encourages research that will have the greatest impact on patients.
We have strong links with national charities such as Age UK, the UK’s largest charity for older people. We work with Age UK to promote the participation of older people in ageing research.
We also work closely with the British Geriatrics Society (BGS), the multi-disciplinary professional membership association consisting of 2,600 specialist clinicians involved in the health and care of older people. A current NIHR study of the acute care of older people in hospital developed by this group is supported by the BGS.
Our members are committed to taking part in national initiatives which help to raise the profile of ageing research.
We contributed to the development of the ageing research agenda for Europe: 'The Future of Ageing Research in Europe: A Road Map'. The road map identifies major themes which need to be prioritised in any future European ageing research to successfully address the needs of an increasing ageing population. Themes include healthy ageing, social and welfare needs, and biogerontology.
Hear all about Mr Brian Marvin’s research journey in the video below, as he talks about his role in a study that aims to find out if the involvement of a geriatrician at the point of discharge from hospital can improve health outcomes.
One example of how our members are helping to embed clinical research in the NHS is by encouraging the NHS organisations we work within to include a statement about research in all outpatients’ letters. Older peoples’ services in Norfolk and Norwich University Hospitals, South London, and Tayside in Scotland have already incorporated the following statement:
"The XXXX Hospital is a teaching hospital and medical students may observe whilst you are being treated. If you would prefer not to have a medical student present, please inform your doctor when you attend. We are also very active in clinical research. Your doctor may therefore approach you now or in the future to discuss possible participation in a research project. In both cases, non-participation in research studies or a preference not to have medical students present will not affect your care in any way."
The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.
NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments. The following BRC undertakes research in ageing:
NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are collaborations between local providers of NHS services and NHS commissioners, universities, other local organisations and the relevant Academic Health Science Network. The primary focus of CLAHRCs is on research targeted at chronic disease and public health interventions. The following CLAHRC undertakes research in ageing:
NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MIC undertakes research in ageing:
All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: email@example.com
Our experts in the NIHR Clinical Research Network (National Specialty Leads) can advise on delivering your aging study in the NHS.
The NIHR Clinical Research Network National Specialty Group for Ageing is currently in the process of appointing a new National Specialty Lead.
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