Brendan J. Whelan

Cohort Profile: The Irish Longitudinal Study on Ageing

Ireland shares with other developed countries the prospect of rapid and sustained population ageing. The age distribution of the Irish population is undergoing a dramatic change at present and this trend is predicted to continue into the future. People are living longer, and older persons represent a larger proportion of the population. In Ireland, the proportion of the population aged 565 years has remained steady at 11% for the past 40 years. However, it is projected that this proportion will rise to 14% by 2021 and to 19% by 2031. The greatest increase will be in the oldest old, aged 480 years, which is expected to more than treble by 2036. This change in the demographic profile of the Irish population poses a major public health challenge. Unlike the situation in the USA, the UK and many other developed countries, there have been no large population-based cohort studies in Ireland to inform research on healthy ageing. Whereas a number of studies have provided population-based data on the health status of older people living in Ireland, many questions remain unanswered. The Irish Longitudinal Study on Ageing (TILDA) is a large prospective cohort study of ageing, which includes an assessment of the social, economic and health circumstances of community-resident older people living in Ireland. The study has been harmonized with leading international research so as to ensure adoption of best practice and comparability of results. The Irish government, The Atlantic Philanthropies and Irish Life plc have provided funding for the study. Ethical approval has been obtained from the Trinity College Dublin Research Ethics Committee. Who is in the sample?

Design and Methodology of The Irish Longitudinal Study on Ageing

To provide comprehensive data on older people in Ireland and new insights into the causal processes underlying the aging transformation.

The end of the line? The Visual Analogue Scale and Verbal Numerical Rating Scale as pain assessment tools in the emergency department

Objectives To compare the Visual Analogue Scale (VAS) and the Verbal Numerical Rating Scale (VNRS), in the assessment of acute pain in the emergency department (ED). Furthermore, to determine the influence of demographics on this agreement and practical limitations of the scales. Setting St Vincents University Hospital, Dublin; a 479-bed teaching hospital; annual ED census 36 000 adult patients. Methods A prospective observational study was conducted on ED patients with acute pain as a component of their presenting complaint. Eligible patients scored their pain on both VAS and VNRS within 1 hour of arrival. They rescored their pain every 30 minutes for 2 hours using both scales. The primary outcome measure was agreement between VAS and VNRS. Secondary outcomes were ease of pain scale use and effect of patient demographics on pain scores. Agreement between scores was evaluated using the Bland-Altman method. Results 123 patients were included (median age 35; 43.9% male). There was a strong correlation between VAS and VNRS (rs=0.93). However, there was not perfect agreement between the two scales. Patient age (older age, p<0.005, t=−4.448), gender (female sex, p<0.005, t=4.903) and educational level attained (third level education, p<0.005, t=5.575) had a statistically significant influence on the agreement between VAS and VNRS. There was a preference for VNRS in those patients who expressed a preference for one pain scale over the other. Conclusions VAS and VNRS are not interchangeable in assessing an individual patients pain over time in the ED setting. VNRS has practical advantages over VAS in this setting.

The differential impact of subjective and objective aspects of social engagement on cardiovascular risk factors

BackgroundThis article provides new insights into the impact of social engagement on CVD risk factors in older adults. We hypothesized that objective (social participation, social ties and marital status) and subjective (emotional support) aspects of social engagement are independently associated with objective measures of cardiovascular risk.MethodsData from the English Longitudinal Study on Ageing (ELSA) were analyzed. The effects of social participation, social ties, marital status, and emotional support on hypertension, obesity, high sensitivity C-reactive protein, and fibrinogen were estimated by logistic regression controlling for age, sex, education, physical function, depression, cardiovascular disease, other chronic diseases, physical activity, and smoking.ResultsSocial participation is a consistent predictor of low risk for four risk factors, even after controlling for a wide range of covariates. Being married is associated with lower risk for hypertension. Social ties and emotional support are not significantly associated with any of the cardiovascular risk factors.ConclusionOur analysis suggests that participation in social activities has a stronger association with CV risk factors than marital status, social ties or emotional support. Different forms of social engagement may therefore have different implications for the biological risk factors involved.

The effect of business risk on manufacturing investment ☆: Sectoral survey evidence from Ireland

Abstract This paper analyses the results of a special sample survey on risk and investment carried out using the European Union investment survey sampling frame for Ireland. The paper looks at decision-making by large manufacturing firms located in Ireland to see whether their investment decisions can be understood within the various models of risk that economists use. Equilibrium and disequilibrium models are examined to see what best explains the behaviour revealed by the firms’ responses. The paper develops a categorisation of the main theoretical channels of influence from risk to investment. In the light of this theory, the survey replies of Irish firms are used to assess the importance of the different channels of influence.

How Well-Informed Are Pension Scheme Members on Their Future Pension Benefits? Evidence from Ireland

One part of the policy response in many countries to increasing pension coverage will be greater private provision on the part of individuals. This requires that individuals are well informed about pensions. In this article, we assess levels of knowledge of pensions using a representative sample of older Irish adults. We find that two-thirds of individuals enrolled in pension schemes do not know what amount will be paid out on retirement and/or whether the payments will be in the form of lump sums, monthly payments, or both. One policy implication is the need for increased information to be directed at certain groups, in particular, women and less educated people. More fundamentally, the results suggest that the mandatory elements in pension systems should be extended.