How Do Our Decisions to Smoke and Drink in Midlife Affect Our Cognitive Performance in Later Life? Findings from the 1946 British Birth Cohort

Background: There is a not a clear understanding of the potential time-period windows for lifestyle interventions. This study examined how smoking and harmful drinking across early midlife affect cognitive performance in later life. Methods: Data is from Medical Research Council National Survey of Health and Development (NSHD). Cognitive abilities were measured at age 60-64. Information about alcohol consumption was collected via food diaries at multiple time points across life (ages 36, 43, 53 and 60-64). Information about smoking was collected via interviews and questionnaires at ages 20, 25, 31, 36, 43, 53 and 60- 64. Multivariable logistic regression was used, adjusting for gender, childhood cognition at age 8, education and socioeconomic status. Findings: Drinking in moderation across midlife appears to be protective against poor memory in later life (OR=0.86, 95% CI (0.63-1.16)). In contrast, harmful drinking at 43 and 53 years was associated with higher odds of poor memory (OR=1.36, 95% CI (0.79-2.33)), (OR=1.26, 95% CI (0.65-2.43)). Drinking heavily, particularly at age 43, was also associated with higher odds of slow search speed at the same age (OR=1.66, 95% CI (1.01-2.76)). An increase in the number of smoking pack-years was associated with low memory (OR=2.17, 95% CI (1.33-3.54)) and slow search speed (OR=1.65, 95% CI (1.03-2.64)). Interpretation: These results may be suggesting that intervention may be more beneficial in the decades preceding clinical the manifestation of neuropathological burden

UCL qualitative health research symposium 2015: enriching qualitative inquiry in health

The field of health research appears increasingly open to qualitative approaches. We celebrate the rise in qualitative and mixed methods publications and the marked presence of qualitative researchers in academic centres of health research. However, we note enduring tensions between the conceptual and methodological approaches of qualitative research and those of a quantitative paradigm, generally more familiar to health practitioners, policymakers and often other researchers. In some instances, qualitatively-oriented investigations continue to conflict with the expectations within health research to provide concrete and timely findings and recommendations. These concerns foreground questions to be explored around the applicability, value, contribution, legitimacy and limitations of qualitative inquiry within the prevailing research culture. In recognition of these questions, we curated a day long symposium around abstracts submitted in response to an open, internationally disseminated call, framed to create a productive space for the critical examination of the current state of qualitative health research, and the exploration of ways to enable its enrichment. We organised the papers, posters, keynote address and panel discussion into three themes. The first, Problematising the research landscape, reflects on particular issues arising when we 'do' qualitative research. The second, Re-approaching familiar frameworks, explores the application of epistemological traditions of the social sciences to understand health, and to consider what underpins how we frame and treat such topics. The third, Imagination at work-enriching the potential, attends to the prospects of bringing new approaches into research, sometimes borrowed from other fields. The symposium facilitated engagement with current research and reflections on connecting methodological advances with theoretical traditions amidst challenges of carrying out applied health research. A perceived need exists for qualitative researchers to concertedly promote and enrich our contributions without homogenising or obscuring what our approach has to offer. This could be achieved through the continued development of a common platform for qualitative research that facilitates collaborations and fosters interdisciplinary education and training. This symposium represents critical steps towards these aims, to be further developed through the convening of future events