Transcript Document

TILDA – The Irish Longitudinal
Study on Ageing
Trinity College Dublin
TILDA
A Critical Resource for Science and Policy in Ireland
The Irish Longitudinal
StuDy on Ageing
Evidence
Based
Research on Ageing in
Ireland
Implications for
public policy
International
Comparative
Analysis
Funding
• Preliminary and Pilot (2 years)
• 10 year study
• Irish Life
• Atlantic Philanthropies
• Government (Health/Office Older People)
Ageing in Ireland
• Proportion of population ≥65 has remained
steady at about 11% for the past 40 years
• It is projected that this proportion will rise
to 20-25% by 2036 (CSO 2006)
• The greatest increase will be in the oldest
old
Age Pyramid for World Population
80+
2050
70-74
Age (years)
60-64
2025
50-54
2000
40-44
30-34
20-24
10-14
0- 4
0
100
200
300
400
Population (mil ions)
500
600
700
Age Pyramid for Irish Population
100+
90-94
2050
80-84
Age (years)
70-74
2025
60-64
2000
50-54
40-44
30-34
20-24
10-14
0- 4
0
50
100
150
200
250
300
350
400
Population (thousands)
Source: US census bureau International database
Factors Affecting the Experience of
Ageing
Genes
Health
Nutrition
Family
Networks
Mental
health
Income
and
assets
Experience
of
Ageing
Work and
Retirement
Social
Participation
Education
Marital
Status
Household
Structure
TILDA’s Domains
Environment
income, care, housing,
families, morale, pensions,
Factors Influencing the Experience
of Ageing
social networks,
Quality of Life
participation work force
social and historical
health status
mental status
Expectations
Happiness
Health
Wealth
Experience
scale and scope of
contributions made
by older people to life
in Ireland
Key Multi-disciplinary Questions
• What changes occur in
physical, psychological
and cognitive function
over time and across
ages?
• What are the physical,
social and economic
factors that condition
these changes?
• What are the adaptive
responses to change
and how do these
contribute to successful
ageing?
Health
Wealth
Happiness
Study Design
•
•
•
•
•
•
•
Longitudinal Cohort Study
Nationally representative sample
Approximately 8-10,000
Aged >50 years
Minimum follow-up 10 years
Collaboration from institutions across Ireland
Comparable with– ELSA, HRS, SHARE,
Data Collection
TILDA will combine data collection strategies:
Face-to-face Interviews- Self report
Clinical Assessments- Objective
Nurse visit/Clinical centre
Social
Data Linkage
Family situation
Nature and extent of contact
Function
Levels of care/support, formal/informal
Family transfers – time,assets, income,
Social participation/ engagement
Economic
Labour force participation, retirement – current and retrospective
Factors influencing the retirement decision
Detailed measures of Income
Assets/Wealth, especially housing
Human capital, training (past, present, future) – lifelong learning
TILDA Milestones
Sep
2006
Start project
Aug
2009
Complete pilot(s)
Sept
2009
Brief Wave 1
July
2010
Clean complete file Wave 1
2010/11
Analysis Wave 1
Sept
2011
Brief Wave 2
July
2012
Clean complete linked Wave 2 file
2012/13
Analysis Waves 2/1
Sept
2013
Brief Wave 3
July
2014
Clean complete linked Wave 3 file
2014/15
Analysis Waves 3/2/1
Sept
2015
Brief Wave 4
July
2016
Clean complete linked Wave 4 file
2016
Analysis Waves 4/3/2/1
2016
Completion of 10 year period
Dec
Home-Self Report, Objective
Pulse Wave Velocity
Autonomic Function
Blood:
Genes
Inflammation
Locomotion
Gait
Balance
PK- Parkinson’s Disease
Anxiety, depression, Loneliness
Falls, FOF, QOL
HRV
Nutrition
Memory
Attention
Concentration
ExecuitiveR
Senses:
Vision, (Acuity,
Contrast, Macular
pigmment, Retinal
Artery, Hearing
Perception,
Tactile
Neurocardiovascular
Locomotion
Policy
POLICY
TILDA
Convenience
Small Studies
Hypothesis
Generating
and Testing
Translational
Research
TRILCENTRE.ORG
INTEL, IDA
(30millionX3yrs)
Clinic
Corridor
Falls
Cognition
Social Connection
Frailty
Isolation
Home and
community
TILDA Outcomes
TILDA will enable us to…
– Raise and heighten awareness ageing issues;
– Identify and understand trends in ageing;
– generalizability of findings from smaller studies;
– Develop informed policies ; improved advocacy
– Make Ireland a hotbed for ageing research and
innovation in technology, services, & other domains;
– Validate measures used globally around ageing;
– Inform an emerging market of care services;
– Potentially lead to start-ups and spin-off ventures,
e.g. in pharma, biotech, assistive tech, service
delivery, etc.
Opportunities
Extension of the
Survey to
Northern Ireland
– Scientific value of observing in
one island
– Different government, social
care, health system
–One island 2
systems
Policy Context - Ireland’s unique features
Demography
• Population is young – ageing will occur
later than in the rest of Europe
• Ireland has one of the lowest old-age
dependency rates in the OECD
• Will still be one of the lowest in 2025
• But by 2050 will rise to the EU-15 average
• Relatively high age of retirement for men
Ageing in Ireland - unique features
Pensions
• Low cost, low level flat rate State pension
• Ireland has lowest net replacement rate in the
OECD
• Occupational pension coverage low – 52% of the
workforce. Policy strongly focussed on raising
this
• Bulk of the population reliant on State pension –
this is low but has improved relative to average
earnings
• National Pension Reserve Fund introduced in
2001 – will pay out from 2025
Ageing in Ireland - unique features
Poverty and Living Standards
• Picture regarding poverty in old age is very dependent
on the period selected and the data source used
• According to EUROSTAT definitons, Ireland has one of
highest rates of poverty among the over 65s in the EU
• But this is based on a headcount measure – picture
more favourable if “poverty gap” measure is used
• This is due to marked bunching of households at the
exact State pension level
• Link TILDA work with extensive national and
international research on poverty measurement
conducted in the ESRI over last 20 years
PROPORTION OF PERSONS 65+ AT RISK OF
POVERTY (BASED ON EUROSTAT DATA)
IE
ES
PT
EL
UK
BE
DK
FI
AT
IT
FR
DE
SE
LU
NL
0
10
20
30
40
50
Other unique features
• Very high level of owner occupation, rising
strongly with age
• In recent years, very high immigration –
this has short run and long run effects
• Low divorce rate
• Relatively large number of individuals
living in rural settings
• Falling celibacy rate
Huge Challenges for our Society
and for Public Policy
• How to maintain the living standards and
quality of life of our population?
– Pensions, Housing
• How to provide appropriate services and
facilities?
– Healthcare, Social Care, Social Contact
• How to ensure effectiveness and financial
sustainability?
– Level and mix of Public Expenditure, Role of the
Public and Private sectors
1. Pension Issues
• Key focus of policy – how to improve coverage
• Limited effectivness so far – why?
• TILDA will provide new and detailed information
on much more than coverage:
–
–
–
–
Pension type (DB,DC etc)
Pension Quality (amount, indexation etc)
Distribution by sector, occupation, gender
Knowledge about pensions
• Allow analysis of which groups and what factors
influence pension take up
• Unique new data on pension alternatives –
housing, investments, businesses
2. The Retirement Decison
• Increasing retirement age key objective for
all countries
• It will:
– improve pension funding levels
– improve living standards in old age
– reduce labour shortages
– Increase social participation
• The longitudinal dimension of TILDA will allow
analysis of the retirement decision and
determination of what could make staying at
work more attractive
3. Formal and Informal Care
• Policy Issue – how to ensure a high level of
complementarity between formal and informal
care
• TILDA will provide in-depth information on:
– The family situation and on the nature and extent of
contact
– Care needs as measured by ADLs, IADLs
– Levels of care/support, both formal (state and
private) and informal (family and voluntary)
– Intra family transfers – assets, income, time
• Social participation/ engagement