Background

The CARE75+ is a longitudinal cohort study of community-dwelling older adults (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. The study is also a research recruitment platform enabling older people to participate in research studies relevant to older age. The study has oversight from a bespoke Patient and Public Involvement Group.

The cohort was established in 2014 and it is funded by the Yorkshire & Humber Applied Research Collaboration (ARC), National Institute for Health and Care Research (NIHR).

Aims & Objectives

The aim is to study longitudinal frailty transitions and health and social care resource use. The cohort will provide a data resource for researchers and a research platform for additional studies (sub-studies). Specific objectives include:

  • Provide data for the next iteration of the electronic Frailty Index (eFI) using prognostic modelling
  • Identify research priorities from the perspectives of older people
  • Investigate the feasibility of future trials of interventions to improve health, wellbeing, and quality of life outcomes for older people
  • Explore frailty in rural and coastal areas
  • Explore how to support people living with frailty in black minority and ethnic communities.

What data do we collect?

CARE75+ has collected data at different time-points using different methods (pathways):

CARE75+ Original pathway:

Data collected at baseline, 6, 12, 18, 24 and 48 months. Data collected in-person with remote options at 6 months.

CARE75+ REMOTE pathway:

All data is collected remotely via methods including telephone; video-conference (e.g., Zoom, Teams); postal questionnaire; or web-form submission.

CARE75+2 pathway:

Baseline, 1 year and 2 years include full assessment in-person. A modified assessment is conducted at 6, 18, 30 and 36 months using remote methods.

The cohort uses the electronic Frailty Index (eFI) for the identification and severity grading of frailty and to investigate frailty trajectories (how frailty changes over time and what might influence it). CARE75+ collects data on medication, health conditions and frailty from the participant’s General Practice electronic patient record.

For a list of the outcome measures that the CARE75+ collects, please refer to the published protocols and the data dictionaries.

Blood samples were collected from consenting Leeds and Bradford participants at baseline and at 12-month follow-ups. The samples provide a resource for potential investigations into the associations of organ specific, immunological, endocrine and genetic markers with frailty. Blood samples are currently stored at Ethical Tissue at the University of Bradford.

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.