5 Recommendations for research
The Public Health Advisory Committee (PHAC) recommends that the following research questions should be addressed. It notes that 'effectiveness' in this context relates not only to the size of the effect, but also to cost effectiveness and duration of effect. It also takes into account any harmful or negative side effects.
All the research should aim to identify differences in effectiveness among groups, based on characteristics such as socioeconomic status, age, gender and ethnicity.
5.1 What is the prevalence of risk and protective factors in mid‑life for the development of dementia, disability and frailty, and what are the longitudinal relationships between them? Are dose–response relationships evident and how strong are these? Which factors are independent and which mediate others?
5.2 What are the most effective and cost‑effective population‑level measures to help people in mid‑life maintain or adopt healthy behaviours and build up resilience to dementia, disability and frailty? What are the best methods for evaluating their effect? How do these measures affect health inequalities?
5.3 What are the most effective and cost‑effective mid‑life services and interventions in the long term for reducing behavioural risk, leading to healthier ageing and preventing or delaying the development of dementia, disability and frailty in later life? How can these be delivered in a consistent and sustainable manner? How can multiple interventions be effectively packaged to maximise efficiency? What are the barriers and facilitators to the uptake of services and interventions, and to the development and maintenance of healthy behaviours of people in mid‑life? What are the effects on health inequalities?
5.4 How strong are the associations between hearing and visual loss, and sleep patterns and positive and negative health outcomes, in particular the development of dementia, disability and frailty? What are the most effective and cost‑effective interventions to protect hearing and vision and improve sleep and what is their effect on the development of dementia, disability and frailty?
5.5 How effective and cost‑effective is the NHS Health Check programme? What are the patterns of uptake in relation to the demographics of the population and their degree of behavioural risk? What is the programme's effect on the development of dementia, disability and frailty? How feasible is extending the NHS Health Check programme to a younger age range?
More detail identified during development of this guideline is provided in gaps in the evidence.