None listed
Conditions
Brief summary
Provision of mental health services to people with mental illness is associated with high health care costs and characterised by a complex presentation of people with severe mental illness such as schizophrenia, bipolar disorder and severe major depression. To improve health and services for this population, a more holistic approach, one that considers a patient’s physical and nutritional status, mental health and cognition, is needed. Indeed, recent evidence suggests that people with severe mental illness are at higher risk for frailty, a condition caused by the decline in reserve and function across multiple physiologic systems. To date, programs targeting directly frailty directly have demonstrated improvement in outcomes such as increased physical and cognitive functioning, decreased hospitalisation rates and improved quality of life (1). In people with mental illness, frailty has mostly been explored in those with late-life depression and anxiety, which has led to the development of multimodal interventions targeting lifestyle factors and multidisciplinary care. To date, frailty has been minimally investigated in those with severe mental illness. Through cross-disciplinary collaborations, our team of skilled early career and clinical researchers, with track record investigating frailty and health outcomes in people with severe mental illness, will enable a rapid translation of the study outcomes into health care policy and clinical practice. By accessing longitudinal data of the UK Biobank, a large-scale biomedical database and research resource, containing in-depth health information from half a million participants, the proposed research is uniquely placed to expand our understanding of frailty in people with severe mental illness. This novel information will inform the development of interventions tailored to the unique needs of this cohort. The UK Biobank protocol is available online: https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/about-us (1) Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146-56.
Interventions
Participants include all 502,412 subjects assessed at the baseline phase of the UK Biobank study. Baseline assessment occurred from 13 March 2006 to 1 October 2010.
For time-to-event analyses, we will obtain data on all-cause mortality from Data-Field 40000 of the UK Biobank study: https://biobank.ctsu.ox.ac.uk/crystal/field.cgi?id=40000. Data on the deaths of UK Biobank participants comes from NHS Digital for participants in England & Wales and from the NHS Central Register, part of the Natio
Participants include all 502,412 subjects assessed at the baseline phase of the UK Biobank study. Baseline assessment occurred from 13 March 2006 to 1 October 2010. For time-to-event analyses, we will obtain data on all-cause mortality from Data-Field 40000 of the UK Biobank study: https://biobank.ctsu.ox.ac.uk/crystal/field.cgi?id=40000. Data on the deaths of UK Biobank participants comes from NHS Digital for participants in England & Wales and from the NHS Central Register, part of the National Records of Scotland, for participants in Scotland (see https://biobank.ctsu.ox.ac.uk/crystal/ukb/docs/DeathLinkage.pdf). In the time-to-event analysis of all-cause mortality, we will left-censor three subjects who have a date of death before study entry. We will right censor at 12 November 2021, which is the last date of death in the dataset. We will derive information on mental and behavioural disorders, subjects' Hospital Frailty Risk Score, and subjects' Charlson Comorbidity Index Score, from record-level inpatient data on ICD-10 Diagnosis codes (ICD-9 or ICD-10) relating to the inpatient episode of care for England, Wales and Scotland. Data on diagnoses occurring during hospital inpatient admissions in England come from the Data Access Request Service, managed by NHS Digital. The dataset is called Hospital Episode Statistics Admitted Patient Care (see page 3 of https://biobank.ctsu.ox.ac.uk/crystal/ukb/docs/DeathLinkage.pdf). Data on diagnoses occurring during hospital inpatient admissions in Wales comes from the Secure Anonymised Information Linkage Databank at the University of Swansea, managed by NHS Wales Informatics Service's Information Services Division. The dataset is called Patient Episode Database for Wales Admitted Patient Care (see https://biobank.ctsu.ox.ac.uk/crystal/refer.cgi?id=138483). Data on diagnoses occurring during hospital inpatient stays in Scotland come from the electronic Data Research and Innovation Service, managed by Information Services Division Scotland part of NHS National Services Scotland. This dataset is called General Acute Inpatient and Day Case - Scottish Morbidity Record (see https://biobank.ctsu.ox.ac.uk/crystal/refer.cgi?id=138483). We will not left-censor any of these conditions, but will right-censor them at 1 October 2010, the last date of assessment for any UK Biobank participant in the baseline assessment period. The UK Biobank study has a protocol available for viewing online at https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/about-us We will observe in participants mental and behavioural disorders, frailty (using three measures) and comorbidity (using one measure) and mortality. This study involves no active participation for participants, as all data comes from previous UK Biobank assessments or hospital episode or death register records linked to UK Biobank. After baseline observation from 13 March 2006 to 1 October 2010, there will only be follow-up data on all-cause mortality as deaths occur.
Sponsors
The University of Queensland
Eligibility
Sex/Gender
All
Age
37 Years to 73 Years
Healthy volunteers
Yes
Inclusion criteria
Participants in the UK Biobank study, as this is a secondary data analysis of that dataset. The UK Biobank Study Protocol is available at https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/about-us
Exclusion criteria
None.
Outcome results
None listed