Background

CARE75+ is a cohort study of community-dwelling older people (aged 75 years and over). The aim of CARE75+ is to better understand ageing, what contributes to people remaining fit in later life or becoming frail, and how we might moderate or slow down frailty transitions.

The cohort is currently funded by the Yorkshire & Humber Applied Research Collaboration (ARC)National Institute for Health and Care Research (NIHR).

The cohort was originally established in 2014 within the Primary Care-Based Management of Frailty in Older People’s theme, as part of the Collaboration & Leadership in Applied Health Research & Care (CLAHRC) Yorkshire & Humber. This programme of work resulted in significant changes to practice and developed valuable resources for improving healthcare.

Aims & Objectives

We aim to expand the CARE75+ cohort study (recruitment target of 2500). It will provide a data resource for researchers and a research platform for additional studies (sub-studies), and in the future it will support randomised controlled trials using a Trials within Cohort (TwiCs) methodology. Specific aims in the next few years include:

  • To study longitudinal frailty transitions and health and social care resource use
  • To provide data for the next iteration of the electronic Frailty Index (eFI) using prognostic modelling (see project : Development and national implementation of eFI-2)
  • Identifying research priorities from the perspectives of older people
  • Investigating the feasibility of future trials of interventions to improve health, wellbeing and quality of life outcomes for older people
  • Providing blood samples for the bio-bank at Ethical Tissue, University of Bradford https://www.bradford.ac.uk/ethical-tissue/ for frailty and ageing research
  • Exploring frailty in rural and coastal areas and how to support people living with frailty in black minority and ethnic communities.

What data do we collect?

CARE75+ collects health, social and economic data. The cohort has well-characterised frailty status derived from the electronic Frailty Index to allow the identification and severity grading of frailty and to investigate frailty trajectories (how frailty changes over time and what might influence it).

CARE75+ assessments include detailed information on the demographic, health and social circumstances of participants. An extensive range of measures are collected using validated instruments, including assessments of frailty, cognition, mood, health-related quality of life, comorbidity, medications, resilience, loneliness and self-efficacy. Measures have been chosen to ensure that CARE75+ includes measures for applied epidemiological investigation and randomised trial evaluation of future interventions. For the full list of data outcomes see our data dictionary. Data are collected using a bespoke electronic data capture application, the CARE75+app.

Blood samples are collected from consenting Leeds and Bradford participants at baseline and at 12 month follow-up to provide a resource to investigate associations of a range of organ specific, immunological, endocrine and genetic markers with frailty.

Outputs

Reports and Articles

Turner G, Clegg A, Paynton D, Hodkinson I. Managing frailty properly: a new target for the NHS? Clinical Commissioning monthly . 2014; 1(7): 38-40

Young J, Lyndon H, Bramley D. The work of NHS England in improving outcomes for older people who have frailty.Clinical Commissioning monthly. 2014; 1(7): 34-37

The Yorkshire & Humber Community Ageing Research (CARE) Study highlighted in The Voice – local magazine full of news and information focused on helping the over 50’s in Bradford get the support and advice they need and to get the best out of life.

Peer Review Publications

Nikolova S, Heaven A, Hulme C, West R, Pendleton N, Humphrey S, Cundill B, Clegg A. Social care costs for community-dwelling older people living with frailty Health and Social Care in the Community 2021; https://doi.org/10.1111/hsc.13450

Farrow M, Biglands J, Tanner SF, Clegg A, Brown L, Hensor EMA, O’Connor P, Emery P, Tan AL. The effect of ageing on skeletal muscle as assessed by quantitative MR imaging: an association with frailty and muscle strength. Aging Clinical and Experimental Research 2020. https://doi.org/10.1007/s40520-020-01530-2

Jacob I, Mahmood F, Brown L, Heaven A, Mahmood S, Clegg A. Recruiting older people from the Pakistani community in Community Ageing Research 75+. British Journal of Community Nursing 2020;25(3):110–113 https://doi.org/10.12968/bjcn.2020.25.3.110

Nikolova S, Hulme C, West R, Pendleton N, Heaven A, Bower P, Humphrey S, Farrin A, Cundill B, Hawkins R, Clegg A. Normative Estimates and Agreement Between 2 Measures of Health-Related Quality of Life in Older People With Frailty: Findings From the Community Ageing Research 75+ Cohort. Patient-Reported Outcomes 2020:23(8)1056-1062. https://doi.org/10.1016/j.jval.2020.04.1830

Brown L, Mossabir R, Harrison N, Brundle C, Smith J, Clegg A. Life in lockdown: A telephone survey to investigate the impact of COVID-19 lockdown measures on the lives of older people (≥ 75years). Age Ageing 2020; afaa255, https://doi.org/10.1093/ageing/afaa255

Munyombwe T, West RM, Pendleton N, Clegg A. Mapping between the Electronic Frailty Index and a Research Standard Frailty Index: Findings from the Community Ageing Research 75+ (CARE 75+) Cohort Study. Advances in Geriatric Medicine and Research 2020;2(4):e200023. https://doi.org/10.20900/agmr20200023

Coventry PA, McMillan D, Clegg, A, Brown L, van der Feltz-Cornelis C, Gilbody S, Ali S. Frailty and depression predict instrumental activities of daily living in older adults: A population-based longitudinal study using the CARE75+ cohort. PLOS one, 2020;15(12), p.e0243972. https://doi.org/10.1371/journal.pone.0243972

Hale M, Santorelli G, Brundle C, Clegg A. A cross-sectional study assessing agreement between self-reported and general practice recorded health conditions among community dwelling older adults. Age and Ageing 2019;49(1):135-140. https://doi.org/10.1093/ageing/afz124

Brown L, Young J, Teale E, Santorelli G, Clegg A. A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study. Advances in Geriatric Medicine and Research 2019;1:e190002 https://doi.org/10.20900/agmr20190002

Brundle C, Heaven A, Brown L, Teale E, Young J, West R, Clegg A. Convergent validity of the electronic frailty index. Age Ageing 2019;48(1):152-156. https://doi.org/10.1093/ageing/afy162

Clegg A, Bates C, Young J, Ryan R, Nichols L, Teale EA, Mohammed MA, Parry J, Marshall T. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing 2016;45(3):353-360.

Heaven A, Brown L, Foster M, Clegg A. Keeping it credible in cohort multiple Randomised Controlled Trials: the Community Ageing Research 75+(CARE 75+) study model of patient and public involvement and engagement. Research Involvement and Engagement 2016;2(1):30.

Brown L, Young J, Clegg A. Heaven A. Pain in older people with frailty. Reviews in Clinical Gerontology 2015;25(03):159-171.

Clegg A, Rogers L, Young J. Diagnostic test accuracy of simple instruments for identifying frailty in community dwelling older people. Age Ageing 2015;44(1):148-152. https://doi.org/10.1093/ageing/afu157

Turner G, Clegg A. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing 2014;43(6):744-747.

Clegg A, Barber S, Young J, Iliffe S, Forster A. (HOPE) trial: a pilot randomised controlled trial of a home-based exercise intervention for older people with frailty. Age Ageing 2014;43(5):687-695.

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. The Lancet 2013;(9868):752-762.

Clegg A, Barber S, Young J, Forster A, Iliffe S. Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review. Reviews in Clinical Gerontology 2012;22:68-78.

Clegg A, Young J. The Frailty Syndrome. Clinical Medicine 2011;11(1):72-75.

Timescales

January 2014 – March 2026

Funding agency

National Institute for Health and Care Research (NIHR)

Further information

For further information please visit the CARE75+ website: https://www.bradfordresearch.nhs.uk/care75/, or contact Professor Andrew Clegg – Chief Investigator or  Lesley Brown – Project Manager  Telephone: 01274 383906

This summary presents independent research funded by the National Institute for Health and Care Research, Yorkshire and Humber Applied Research Collaborations NIHR200166. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health and Care Research or the Department of Health and Social Care.