last updated 23 June 2009
Overview and aims
The Personality and Total Health (PATH) Through Life Project is a 20-year longitudinal cohort study of 7,485 young (aged 20 – 24 at baseline), midlife (aged 40 – 44 at baseline) and older (aged 60 – 64 at baseline) adults randomly sampled from the Electoral Rolls of the Australian Capital Territory and the nearby city of Queanbeyan. The original aims of the project were:
- to delineate the course of depression, anxiety, substance use and cognitive ability with increasing age across the adult life span;
- to identify environmental and genetic risk and protective factors influencing individual differences in the course of these characteristics; and
- to investigate interrelationships over time between the three domains of depression and anxiety, substance use, and, cognitive ability and dementia.
These broad aims relate to clinical outcomes that constitute the major burden of disease within the Australian community, and continue to provide the core direction for the project. Additional aims incorporated into the third wave of data collection (currently underway) focus on the mental-health related impact of various personal, social and lifestyle transitions and events experienced by the different age cohorts. These include:
- (in)fertility and pregnancy,
- changes in family structure, relationship formation and separation,
- menopause, and
- retirement
Unique Contribution of PATH
Several design features of the PATH project contribute to its unique standing among population-based longitudinal cohort studies. These include:
- Obtaining measures of genetic, biological (including MRI), psychosocial and lifestyle risk and protective factors for mental health and well-being
- Use of a narrow age cohort design with longitudinal follow-ups as an optimal means of separating age and cohort effects
- Assessment of participants across the full adult lifespan, permitting investigation of developmentally significant, but under-studied periods such as midlife
- Recruitment and follow-up of a ‘young-old’ population, providing important pre-clinical data for studying the development of age-related changes in memory and cognition
The PATH interview
PATH interviews are conducted by trained interviewers, usually in participant’s homes. To provide a high level of confidentiality, the participant completes most of the interview (e.g., self-reported health, substance use, personality and psychosocial measures) themselves using a computer with a touch-sensitive screen. However a number of physical (e.g., FEV, grip strength) and cognitive tests (e,g., memory, reaction time) are administered by the interviewer. Cheek swabs were collected at the baseline interview for the extraction of DNA for genetic analysis.
Each Wave of the PATH Project and the associated sub-studies have been approved by the Australian National University’s Human Research Ethics Committee.
Sub-studies of the PATH Project
1. Study of the Brain using Structural Magnetic Resonance Imaging (MRI)
Randomly selected sub-samples of our midlife (431 participants) and older (478 participants) cohorts have undertaken MRI scans and provided blood samples. The data from this sub-study allows us to examine physical changes to the brain in later life and how they relate to other changes in cognition and mental health. Analysis of the brain includes measurement of the volume of brain structures (eg corpus callosum, hippocampus, amygdala, entorhinal cortex) and assessment of ‘white matter hyperintensities’ (small areas of dead or damaged brain tissue). The MRI sub study is being undertaken in collaboration with Professor Perminder Sachdev and colleagues from the Neuropsychiatric Institute, University of New South Wales.
2. The Health and Memory Study
For this sub-study, sub-groups of participants in the oldest age group (117 at baseline and 138 at the first follow-up) were selected on the basis of the physical and memory test results obtained in the baseline interview. Participants were then invited to take part in a more detailed physical and neurocognitive assessment administered by a medical practitioner. Participants were also asked to have a brain MRI at Wave 1. The Health and Memory sub-study provides a more fine-grained analysis of cognitive capacity and examination of relationships between changes in physical health and cognitive performance over time.
3. The Midlife Cardiovascular Study
In Wave 3 we are inviting those 40+ participants who took part in the Study of the Brain using Structural Magnetic Resonance Imaging (MRI) at the previous assessment to undergo a cardiovascular examination and to again have a brain MRI. Dr Walter Abhayaratna, a cardiologist at the Canberra Hospital and a researcher at the ANU Medical School is conducting this sub-study, which aims to evaluate the interrelationships between blood pressure, aortic stiffness, cardiovascular risk factors and conditions, and cognitive function in midlife.
Contact:
For any general queries regarding the PATH Through Life Project please contact Trish Jacomb on 02 61258408 or trish.jacomb@anu.edu.au
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