TILDA – The Irish Longitudinal Study on Ageing

Trinity College Dublin

The Irish Longitudinal

StuDy on Ageing

EvidenceBased

Research on Ageing in Ireland

Implications for public policy

InternationalComparative

Analysis

TILDA A Critical Resource for Science and Policy in Ireland

Funding

• Preliminary and Pilot (2 years)

• 10 year study

• Irish Life

• Atlantic Philanthropies

• Government (Health/Office Older People)

Ageing in Ireland

• Proportion of population ≥65 has remained steady at about 11% for the past 40 years

• It is projected that this proportion will rise to 20-25% by 2036 (CSO 2006)

• The greatest increase will be in the oldest old

Age Pyramid for World Population

0 100 200 300 400 500 600 700

0- 4

10-14

20-24

30-34

40-44

50-54

60-64

70-74

80+

Age (

years

)

Population (millions)

2050

2025

2000

Age Pyramid for Irish Population

0 50 100 150 200 250 300 350 400

0- 4

10-14

20-24

30-34

40-44

50-54

60-64

70-74

80-84

90-94

100+

Age (

year

s)

Population (thousands)

2050

2025

2000

Source: US census bureau International database

GenesGenes

NutritionNutrition

Family Networks

Family Networks

Social Participation

Social Participation

EducationEducation

Household Structure

Household Structure

Marital Status

Marital Status

Work and Retirement

Work and Retirement

Income and

assets

Income and

assets

Mental health

Mental health

HealthHealth

Experience Experience of of

AgeingAgeing

Experience Experience of of

AgeingAgeing

Factors Affecting the Experience of Ageing

Factors Influencing the Experience of Ageing

HappinessHappiness

HealthHealth WealthWealth

Quality of Life Quality of Life

income, care, housing,income, care, housing, families, morale, pensions, families, morale, pensions, social networks, social networks, participation work forceparticipation work force

scale and scope ofscale and scope of

contributions madecontributions made

by older people to life by older people to life

in Irelandin Ireland

health statushealth statusmental statusmental status

EnvironmentEnvironment

ExpectationsExpectations ExperienceExperience

social and historicalsocial and historical

TILDA’s Domains

Key Multi-disciplinary QuestionsKey Multi-disciplinary Questions• What changeschanges occur in

physical, psychological and cognitive function over time and across ages?

• What are the physicalphysical, socialsocial and economiceconomic factors that condition these changes?

• What are the adaptive adaptive responsesresponses to change and how do these contribute to successful ageing?

Health

Wealth Happiness

Study DesignStudy Design

• Longitudinal Cohort Study

• Nationally representative sample

• Approximately 8-10,000

• Aged >50 years

• Minimum follow-up 10 years

• Collaboration from institutions across Ireland• Comparable with– ELSA, HRS, SHARE,

Data Collection

SocialSocialFamily situationNature and extent of contactFunctionLevels of care/support, formal/informalFamily transfers – time,assets, income, Social participation/ engagement

TILDA will combine data collection strategies:TILDA will combine data collection strategies:

Face-to-face Interviews- Self reportClinical Assessments- ObjectiveNurse visit/Clinical centreData Linkage

EconomicLabour force participation, retirement – current and retrospectiveFactors influencing the retirement decisionDetailed measures of Income Assets/Wealth, especially housingHuman capital, training (past, present, future) – lifelong learning

  TILDA Milestones

Sep 2006   Start project

Aug 2009   Complete pilot(s)

Sept 2009   Brief Wave 1

July 2010   Clean complete file Wave 1

  2010/11   Analysis Wave 1

Sept 2011   Brief Wave 2

July 2012   Clean complete linked Wave 2 file

  2012/13   Analysis Waves 2/1

Sept 2013   Brief Wave 3

July  2014   Clean complete linked Wave 3 file

  2014/15   Analysis Waves 3/2/1

Sept 2015   Brief Wave 4

July  2016   Clean complete linked Wave 4 file

  2016   Analysis Waves 4/3/2/1

Dec 2016   Completion of 10 year period

Home-Self Report, Objective

PK- Parkinson’s Disease

LocomotionLocomotion

R

HRV

Autonomic Autonomic FunctionFunction

NutritionNutrition

Pulse Wave Velocity

MemoryAttentionConcentrationExecuitive

Senses:Vision, (Acuity, Contrast, Macular pigmment, Retinal Artery, HearingPerception, Tactile

Anxiety, depression, LonelinessFalls, FOF, QOL

Blood:GenesInflammation

GaitBalance

NeurocardiovascularNeurocardiovascularLocomotionLocomotion

PolicyPolicy

ConvenienceConvenienceSmall StudiesSmall Studies

TILDATILDA

Hypothesis Hypothesis Generating Generating and Testingand TestingTranslational Translational ResearchResearch

POLICYPOLICY

TRILCENTRE.ORG TRILCENTRE.ORG INTEL, IDAINTEL, IDA(30millionX3yrs)

Corridor

Home and community

Clinic FallsCognitionSocial Connection

FrailtyFrailtyIsolationIsolation

TILDA OutcomesTILDA will enable us to…– Raise and heighten awarenessawareness ageing issues;– Identify and understand trendstrends in ageing;– generalizabilitygeneralizability of findings from smaller studies;– Develop informed policiesinformed policies ; improved advocacy – Make Ireland a hotbed for ageing researchageing research and

innovation in technology, services, & other domains;– Validate Validate measures used globally around ageing; – Inform an emerging market of care servicescare services; – Potentially lead to start-upsstart-ups and spin-off venturesspin-off ventures, e.g.

in pharma, biotech, assistive tech, service delivery, etc.

OpportunitiesOpportunities

Extension of the Extension of the Survey to Survey to Northern IrelandNorthern Ireland

– Scientific value of observing in one island – Different government, social

care, health system

–One islandOne island 2 2 systemssystems

Policy Context - Ireland’s unique featuresPolicy Context - Ireland’s unique features DemographyDemography

• Population is young – ageing will occur later than in the rest of Europe

• Ireland has one of the lowest old-age dependency rates in the OECD

• Will still be one of the lowest in 2025

• But by 2050 will rise to the EU-15 average

• Relatively high age of retirement for men

Ageing in Ireland - unique featuresAgeing in Ireland - unique features PensionsPensions

• Low cost, low level flat rate State pension• Ireland has lowest net replacement rate in the

OECD• Occupational pension coverage low – 52% of the

workforce. Policy strongly focussed on raising this

• Bulk of the population reliant on State pension – this is low but has improved relative to average earnings

• National Pension Reserve Fund introduced in 2001 – will pay out from 2025

Ageing in Ireland - unique featuresAgeing in Ireland - unique features Poverty and Living StandardsPoverty and Living Standards

• Picture regarding poverty in old age is very dependent on the period selected and the data source used

• According to EUROSTAT definitons, Ireland has one of highest rates of poverty among the over 65s in the EU

• But this is based on a headcount measure – picture more favourable if “poverty gap” measure is used

• This is due to marked bunching of households at the exact State pension level

• Link TILDA work with extensive national and international research on poverty measurement conducted in the ESRI over last 20 years

PROPORTION OF PERSONS 65+ AT RISK OF POVERTY (BASED ON EUROSTAT DATA)

0 10 20 30 40 50

NL

LU

SE

DE

FR

IT

AT

FI

DK

BE

UK

EL

P T

ES

IE

Other unique featuresOther unique features

• Very high level of owner occupation, rising strongly with age

• In recent years, very high immigration – this has short run and long run effects

• Low divorce rate

• Relatively large number of individuals living in rural settings

• Falling celibacy rate

Huge Challenges for our Society and for Public Policy

• How to maintain the living standards and quality of life of our population?– Pensions, Housing

• How to provide appropriate services and facilities?– Healthcare, Social Care, Social Contact

• How to ensure effectiveness and financial sustainability?– Level and mix of Public Expenditure, Role of the

Public and Private sectors

1. Pension Issues1. Pension Issues• Key focus of policy – how to improve coverage• Limited effectivness so far – why? • TILDA will provide new and detailed information

on much more than coverage:– Pension type (DB,DC etc)– Pension Quality (amount, indexation etc)– Distribution by sector, occupation, gender– Knowledge about pensions

• Allow analysis of which groups and what factors influence pension take up

• Unique new data on pension alternatives – housing, investments, businesses

2. The Retirement Decison2. The Retirement Decison

• Increasing retirement age key objective for all countries

• It will:– improve pension funding levels– improve living standards in old age– reduce labour shortages– Increase social participation

• The longitudinal dimension of TILDA will allow analysis of the retirement decision and determination of what could make staying at work more attractive

3. Formal and Informal Care3. Formal and Informal Care

• Policy Issue – how to ensure a high level of complementarity between formal and informal care

• TILDA will provide in-depth information on:– The family situation and on the nature and extent of

contact– Care needs as measured by ADLs, IADLs – Levels of care/support, both formal (state and

private) and informal (family and voluntary)– Intra family transfers – assets, income, time

• Social participation/ engagement