Associate Feature: The Challenges of Ageing

Across Scotland, people are living for longer. While clearly this is to be celebrated, increasing life expectancy is not without its challenges. In particular, much of the increase in life expectancy in recent years has been that, on average, we live longer in poor health. In the UK, life expectancy has grown faster than healthy life expectancy, with men now expected to spend 16 years of life in poor health, and women 19 years.
The Advanced Care Research Centre (ACRC) is a new multi-disciplinary research programme which aims to narrow the gap, and to support the independence, dignity and quality of life for people in later life.

The challenges
The challenges posed by ageing populations are broad. Increasing numbers of people are living with multiple health conditions (known as multimorbidity), and experience long-term physical and mental frailty that needs managing. Multimorbidity rapidly increases with age, with the majority of over-75s having at least three major chronic conditions. Multimorbidity is strongly associated with reduced quality of life and physical and mental function, which drives the need for support from family or health and social care services in later life.  
Looking back from death, it is often straightforward to see when someone’s physical and mental function and care needs changed. However, our ability to predict future needs is poor, and our care systems are not optimally set up to minimise future ill-health or mitigate the effect of functional decline on quality of life and independence.
The challenges posed by an ageing population are broad, and can only be addressed by people from different areas of society working together.  
How does the ACRC intend to meet the challenge?
The aim of the ACRC is to transform care for people in later life using personalised and predictive care enabled by data science, artificial intelligence (AI) and assistive technologies and robotics. We want to embed this in systems of health and social care which are highly responsive to the wishes, priorities and needs of individual people in later life.  
Our core principle is that the person in later life is at the heart of everything we do.

What are we already doing?
The ACRC has been up and running since early 2021, and involves over 30 academics from the Universities of Edinburgh, Newcastle and UCL. Funded with an initial grant from Legal & General, we are soon to move into offices in the Edinburgh Bioquarter. New researchers and other staff have been brought on board, bringing a wealth of experience from a range of disciplines (from medicine, through engineering and informatics, to social sciences and architecture). We also have 11 PhD students becoming the first cohort of our Academy for Leadership and Training in Advanced Care to develop the next generation of leaders in this field, who will be both excellent in their core disciplines and skilled in collaborating across disciplines and sectors.

The work of the ACRC covers a variety of
different areas:
We are developing new technologies of care, offering practical, user-driven technology which can be used to monitor aspects of health and wellbeing such as physiological monitoring and collect data about falls to predict potential future occurrences.
We will improve and make better use of data, including developing methods to turn free text health and social care records into data that is ready for systematic analysis. We will use existing and enhanced data to explore and understand how later life trajectories of frailty and wellbeing interrelate, and how they are influenced by external factors such as housing and wealth. We will develop and validate risk prediction tools for mortality, hospitalisation and others for use in health and care delivery, helping ensure that the delivery of the right care to the right person in the most cost-effective way.
We are using social science research to understand the ‘person in context’. This includes how people plan for and manage the challenges posed by changes in physical and mental function in the context of social support, personal and financial circumstances, community and statutory resources.
Using all the information collected from this work, we will support and evaluate the development of new models of integrated care.

Launch
On Wednesday 3rd November, at 9:30am, we are holding our online launch, with speakers from the ACRC and beyond. There will be satellite seminars on a variety of topics. We would welcome anyone with an interest to attend. Register by visiting our website: www.edin.care.
Bruce Guthrie is a Professor of General Practice within the University of Edinburgh, and is Director of the ACRC.

This article is sponsored by the University of Edinburgh.