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Objective: to develop and validate a prediction model for incident locomotor disability after 7 years in older adults.Setting: prospective British cohort studies: British Women's Heart and Health Study (BWHHS) for development and the English Longitudinal Study of Ageing (ELSA) for validation.Subjects: community-dwelling older adults.Methods: multivariable logistic regression models after selection of predictors with backward elimination. Model performance was assessed using metrics of discrimination and calibration. Models were internally and externally validated.Results: locomotor disability was reported in BWHHS by 861 of 1,786 (48%) women after 7 years. Age, a history of arthritis and low physical activity levels were the most important predictors of locomotor disability. Models using routine measures as predictors had satisfactory calibration and discrimination (c-index 0.73). Addition of 31 blood markers did not increase the predictive performance. External validation in ELSA showed reduced discrimination (c-index 0.65) and an underestimation of disability risks. A web-based calculator for locomotor disability is available (http://www.sealedenvelope.com/trials/bwhhsmodel/).Conclusions: we developed and externally validated a prediction model for incident locomotor disability in older adults based on routine measures available to general practitioners, patients and public health workers, and showed an adequate discrimination. Addition of blood markers from major biological pathways did not improve the performance of the model. Further replication in additional data sets may lead to further enhancement of the current model. [ABSTRACT FROM PUBLISHER]

Background: the evaluation of the determinants of change over time in health-related quality of life (HR-QoL) in older people is limited. This study aims to identify patterns of change in HR-QoL over 7 years and their determinants using data from the British Women's Heart and Health Study, a representative sample of older women (n = 4286).Methods: longitudinal latent class analysis was used to identify subpopulations of women with similar HR-QoL trajectories from 1999–2000 to 2007. HR-QoL was measured using the EQ-5D. Multivariate multinomial logistic regression was used to model the association of identified trajectories with baseline predictors after multiple imputation of missing data.Results: four distinct EQ-5D trajectories were suggested: high (19% of women), high decline (22%), intermediate (42%) and low decline (16%). Prevalent arthritis (OR = 13.4; 95% CI: 8.8, 20.5), diabetes (OR = 4.6; 95% CI: 1.5, 14.2) and obesity (OR = 3.9; 95% CI: 2.5, 6.0) were the strongest predicting health conditions of adverse changes in HR-QoL and physical activity the strongest predicting lifestyle factor (OR = 2.8; 95% CI: 2.0, 3.9).Conclusions: findings suggest that older women without obesity or pre-existing health conditions who undertake more physical activity are more likely to experience high HR-QoL, reinforcing the importance of these factors for healthy ageing. [ABSTRACT FROM PUBLISHER]

Longitudinal studies of loneliness among older people are comparatively rare. At 8 years after the initial survey in 1999–2000, we followed up on the 999 people aged 65+ years who were living in the community in the United Kingdom. We found that 583 participants were still alive, and 287 (58%) participated in the follow-up survey. The overall prevalence of loneliness at both time points was very similar, with 9% reporting severe loneliness; 30% reporting that they were sometimes lonely, and 61% reporting that they were never lonely. We developed a 12-category typology to describe changes in loneliness across the follow-up period and report that 60% of participants had a stable loneliness rating, with 40–50% rating themselves as never lonely, and 20–25% rating themselves as persistently lonely; 25% demonstrated decreased loneliness, and approximately 15% demonstrated worse loneliness. Changes in loneliness were linked with changes in marital status, living arrangements, social networks, and physical health. Importantly improvements in physical health and improved social relationships were linked to reduced levels of loneliness. This result suggests that strategies to combat loneliness are not confined to the arena of social interventions such as befriending services, which aim to build and support social embeddedness, but may also result from the treatment of chronic and long-term health conditions. [ABSTRACT FROM AUTHOR]