Associated studies

Funded by NHMRC 2022-2026

For adolescent girls, menstrual disorders – irregular, heavy, and/or painful periods (dysmenorrhea)– and non-cyclic pelvic pain are common and burdensome. Evidence is currently limited on the development of menstrual disorders and pelvic pain in adolescence, and the relationship of these conditions with early life factors, in utero exposures, and the mother’s reproductive history and her health behaviours before during and after pregnancy.

The aim of MAPPS is to investigate the role of maternal factors, and of in utero, early life, and childhood exposures, in menstrual disorders and non-cyclic pelvic pain in adolescent girls. The adolescent girls will be recruited via their mothers in the 1973-78 ALSWH cohort. This substudy will generate the evidence needed to advance understanding of the causal pathways that lead to these conditions. The new knowledge will be co-developed as guidance to inform policy and for health professionals to improve risk assessment, prevention, and management of these conditions, as well as information materials for educators, adolescent girls and their families.

For more information on the MAPPS project, please contact A/Professor Leigh Tooth (l.tooth@uq.edu.au)

The Heavy Menstrual Bleeding Decision Aid (HeMBDA) Study is investigating the experiences of women with heavy menstrual bleeding.  We are particularly interested in what helps women to decide between treatments such as long-acting uterine contraceptive devices (such as the Mirena and Kyleena), endometrial ablation and hysterectomy. The study also aims to get feedback from women on tools that could be used to help them decide about treatment options for heavy menstrual bleeding.

For more information visit: https://public-health.uq.edu.au/hembda

Funded by the Medical Research Future Fund

Very little is known about what causes endometriosis and who might be most at risk of developing the disease. A person’s genes, their family history, and their health and experiences during childhood and adolescence might tell us a lot about who is most likely to get endometriosis. We want to find out more about why endometriosis develops, so that women can be diagnosed earlier and have better treatments.

Recruitment for GELLES has finished and analyses are underway.

For more information visit: www.alswh.org.au/gelles or contact Professor Gita Mishra (g.mishra@uq.edu.au)

Funded by NHMRC 2019-2023

The Centre for Research Excellence on Women and Non-Communicable Diseases (CRE WaND) looks to move women’s health beyond reproductive and sexual health to encompass and prioritise prevention and detection of non-communicable diseases (NCDs).

NCDs such as cardiovascular disease (CVD), cancers, respiratory conditions, and diabetes are responsible for two out of three deaths among women. In Australia three quarters of the total burden of disease in women results from five disease groups: CVD and diabetes, cancers, musculoskeletal, respiratory, neurological and mental health conditions. The 2017 National Strategic Framework on Chronic Conditions (NSFCC) warns that NCDs threaten “to overwhelm Australia’s health budget, the capacity of health services, and the health workforce”.

CRE WaND represents a critical window to tackle non-communicable diseases. It combines outstanding data resources with expertise to produce high impact health outcomes, world leading research capacity, and collaborative partnerships.

Bringing together a multidisciplinary team of national and international collaborators including clinicians and researchers who have outstanding expertise in women’s health, epidemiology, advanced biostatistical methods, and health economics and econometrics CRE WaND takes a life course approach to non-communicable disease in women, with a systematic program of investigation to quantify relationships between risk factors, their timing and duration, and their shared links with increased risk of NCDs.

For more information, please visit the CRE website (https://www.wandcre.org.au) or contact CRE wandcre@uq.edu.au

Funded by NHMRC 2019-2021

Estimates of the numbers of people living with dementia in Australia vary widely as they are based on prevalence estimates from other countries applied to the Australian population, or they are extrapolated from small Australian studies that are unlikely to be representative of the national population, particularly in regional areas. Improving Australia’s Dementia Statistics (IADS) is a collaborative project involving researchers in most States, the Australian Institute of Health and Welfare and the Australian Bureau of Statistics (the agencies responsible for national statistics).

IADS will use an approach based on combining data from multiple sources (e.g., hospitals, death certificates and aged care assessments) across multiple jurisdictions, which has been used in other countries, but not yet in Australia for dementia. A series of investigations will be conducted into the quality of dementia data from a range of sources, and for the combined data, including under-counting and under-recognition of dementia, and accuracy of diagnosis of dementia type.

As the main types of dementia, such as Alzheimer’s disease and vascular dementia occur in mainly people aged 80 years or more, the diagnoses and death certification are complicated by multi-morbidity. The consequences of this complexity will be explored in collaboration with statistical agencies in other countries that are facing the same problems of correct attribution of dementia among causes of death and total burden of disease.

IADS will produce protocols and algorithms for the on-going production of high quality data and summary statistics on dementia in Australia that can be maintained by the national health statistical agencies.

For more information on Improving Australia’s Dementia Statistics, please contact Chief Investigator, Professor Annette Dobson (a.dobson@uq.edu.au)

Funded by Medical Research Future Fund 2018-2020, administered by the Jean Hailes Foundation

This project analyses existing ALSWH databases to:

• Estimate the prevalence and incidence of endometriosis in the Australian population
• Determine the direct cost of the disease (using linked health administrative databases)
• Calculate the costs of lost work productivity in weekly hours in paid work
• Quantify the relationships between endometriosis and future health for precise targeting of interventions
• Describe the current health seeking behaviour of women with endometriosis

For more information on the Endometriosis project, please contact, Professor Gita Mishra (g.mishra@uq.edu.au)

NHMRC funding 2017-2020

Women face a higher risk than men for many age-related chronic diseases including cardiometabolic and respiratory conditions.

Early interventions may have long-term health benefits, but there is a lack of evidence on reproductive risk factors for women in their 40s. Research to date has mainly focused on the risks for older women who have already gone through the dramatic physiological and hormonal changes of the menopause transition. Women in their 40s go through more gradual hormonal and physiological changes, and the links between reproductive factors and risks of poor health faced by women during this period of life remains largely unknown.

The M-PreM Study aims to determine how reproductive characteristics affect women’s chances of having chronic diseases and poor health later in life. The study looks at characteristics like the timing of first period (menarche), period symptoms, pregnancy and pelvic problems. https://alswh.org.au/m-prem/

NHMRC funding 2014-2019

MatCH is a substudy of the ALSWH which invited mothers from the 1973-78 cohort to participate in a survey of every child in their family. MatCH represents an unparalleled opportunity for a family-centred approach to child health outcomes to support a more integrated and targeted approach to the delivery of preventive and primary health care for all Australian families. Professor Gita Mishra leads a team of 10 investigators, from across Australia and overseas, investigating the relationship between the mothers’ health history and the family environment to children’s health outcomes, including health service utilisation. Linkage to administrative databases for early child development and educational outcomes is another feature of this study. https://alswh.org.au/match

The follow-up MatCH survey is under development and will be piloted soon.

NHMRC funding 2012-2015

InterLACE is a collaboration of over 20 existing international longitudinal studies. The project undertakes cross-cohort research by combining data at the individual level from more than 1 million women from these studies to investigate the role of reproductive health across the lifespan on subsequent risk of chronic conditions, including cardiovascular events and type 2 diabetes mellitus. While this poses cross-cohort and cross-cultural research challenges, InterLACE has the capability to address research questions and generate robust evidence that is not possible from any single cohort study. InterLACE also enables a detailed review of methodologies currently used in studies on women’s health that will result in recommendations for study design, menopausal symptom measures, and reporting of results to improve international and cross-cultural comparisons. https://public-health.uq.edu.au/interlace

Tackling multimorbidity in women across the life course: Building the evidence for improved prevention strategies and care pathways

The projects were funded by the NHMRC Investigator grant (APP2009577). Common conditions dataset (CMS), ALSWH databases, and Australian national mortality data will be used to conduct the following projects.

Project 1: What can death records tell us about multimorbidity?

AIMS:

1. Does the prevalence of multimorbidity and the number of causes of death listed on the death record increase with age at death (age effect)?
2. Is the prevalence higher and are more causes listed for women than men (gender effect)? Does the prevalence of multimorbidity and the number of identified causes increase over time (period effect)?

The STrategies for Early Prevention of falls (STEP) consortium is a world first initiative to combine data from cohorts in four countries to examine the prevalence and risk factors of falls in mid-aged adults. STEP uses data from cohort studies in Australia, The Netherlands, Great Britain and Ireland. The cohort studies are: The Australian Longitudinal Study on Women’s Health (ALSWH), The Longitudinal Ageing Study Amsterdam (LASA), The Medical Research Council National Survey of Health and Development (NSHD), and The Irish Longitudinal Study on Ageing (TILDA).

The cohorts were selected based on the following criteria:

1. Representative, population-based sample of adults aged 50-64 years
2. Available data on falls in the previous year at one or more data collection waves
3. Available data on the majority of potential risk factors.

To date, STEP has established the prevalence of falls in middle aged adults across four countries and identified risk factors for falls in adults aged 50-64 years. STEP was established in 2017 and is led by Dr Geeske Peeters (geeske.peeters@gbhi.org), with collaborators A/Prof Leigh Tooth, A/Prof Natasja van Schoor, Professor Rachel Cooper.

Funded by Australian Research Council (ARC) 2018-2020

This project uses data from the 1921-26 and 1946-51 cohorts of the Australian Longitudinal Study on Women’s Health to:

1. Test and contrast empirical models of the outcome oriented ideal of Successful Ageing (as defined by Rowe & Khan) and the functional and life course frame of Healthy Ageing as defined by WHO
2. Compare these empirical models with women’s own perspectives of their ageing gained from prospective qualitative data
3. Provide insights into women’s experience of very old age through interviews with women in their 90s as exemplars of Successful & Healthy Ageing
4. Use the insights derived from the 1921-26 cohort to consider the prospects for Successful and Healthy Ageing in the 1946-51 cohort as these women enter their later years

The study makes optimal use of data from a large cohort of older Australian women, including an elite group who have lived beyond their life expectancy. The information will test the new WHO framework, moving beyond definitions of successful ageing, which apply to only a minority of older people. Detailed modelling to project potential health trajectories for the 1946-51 cohort will show whether these women can be expected to have a similar trajectory as already observed for the 1921-26 cohort.

For more information on Beyond successful ageing: Longevity and healthy ageing among Australian women, please contact Chief Investigator, Professor Julie Byles (julie.byles@newcastle.edu.au)

CREWH21 was funded by the National Health and Medical Research Council of Australia and ran from 2010 to 2015. The objectives of CREWH21 were to examine how changes in the health system impact on women’s health and how changes in other aspects of women’s lives impact on their health and health care needs. It aimed to provide new insights into the epidemiology of common conditions and a strong evidence base for policy and economic analyses. CREWH21 research combined data from the ALSWH with administrative health services data using the rapidly developing record linkage capabilities of the NCRIS funded Population Health Research Network. CREWH21 focussed on four priority health issues of national importance and particular relevance to women (reproductive health, mental health, cardiovascular conditions and musculoskeletal problems).

Investigators

• Annette Dobson (Director)
• Gita Mishra (Co-Director)
• Wendy Brown
• Christina Lee
• Nancy Pachana
• Julie Byles
• Deborah Loxton
• Jayne Lucke
• Leigh Tooth
• David Sibbritt

Research Fellows

• Dr Paul Gardiner – May 2013-December 2015
• Dr Gerrie-Cor Gast – September 2011-January 2014
• Dr Xenia Dolja-Gore – October 2014-October 2015
• Dr Melissa Harris – January 2015–October 2015
• Dr Danielle Herbert – April 2011-December 2012
• Dr Alexis Hure – May 2011–January 2013
• Dr Caroline Jackson – February 2012-February 2015
• Dr Mark Jones – January 2012-February 2015
• Dr Geeske Peeters – May 2011-August 2015
• Dr Ingrid Rowlands – July 2014-October 2016

Maintaining health and independent living are high priorities for Australia’s rapidly expanding older population. This project capitalized on two existing large-scale studies, the Australian Longitudinal Study on Women’s Health involving over 12,000 older women selected from every part of Australia, and the Health in Men Study involving over 12,000 older men from Perth, Western Australia, to increase our scientific understanding of strategies for maintaining the health and wellbeing of older people living in the community. ALSWH and HIMS have been following older Australians in order to determine what contributes to older people’s health and quality of life. The Men, Women and Aging project combined data from these two studies to address the following questions:

• What health-related, personal, lifestyle and social factors predict survival and healthy non- disabled life in men and women aged 70-90 years?
• Do changes in lifestyle in older age (e.g., smoking cessation) affect length and quality of life?
• Who makes greatest use of health services, and who least, and how does this relate to health outcomes?
• How are health and lifestyle factors related to social connectedness and independent living in older age?
• What health and lifestyle factors predict positive mental health in older age?
• How are older men’s and women’s lifestyles and health status different, and how are they the same?
• Should health promotion programs in old age target men and women separately, or not?

Men, Women and Ageing was funded through the Ageing Well, Ageing Productively initiative of the National Health and Medical Research Council and the Australian Research Council, and ran from 2006 to 2010.

Using health outcome data from pooled Longitudinal Studies of Ageing to develop statistical and microsimulation models to determine how to best compress morbidity and optimize healthy and productive ageing (DYNOPTA)

DYNOPTA drew together data from nine Australian Longitudinal Studies of Ageing (LSAs), including 53,484 participants, to identify factors capable of preventing disease, reducing ill-health, and promoting engaged and successful ageing for Australians.

The focus was upon conditions that significantly contribute to the burden of disease including cognitive decline and dementia, sensory impairment, impairment in mobility and common mental disorders such as depression. Although individual studies contain rich data on particular topics, there are only a small number of individuals in each study with specific medical conditions, or combinations of different conditions, especially at the older ages. Pooling data from nine studies overcomes this problem. This innovative and interdisciplinary study also involved development of the first Australian dynamic micro-simulation model of the health and social outcomes of the baby boomer and older cohorts. The simulation allowed for evaluation of the impact of modifying risk factors, and costs associated with different trajectories of health and ageing. DYNOPTA takes an interdisciplinary life course approach, incorporating interdependencies among demographic, behavioural, social, economic and health factors. The multidisciplinary team and collaborative pooling of existing studies added value and built upon experience, as recommended in the Prime Minister’s Science, Engineering and Innovation Council 2003 report. The outcomes aimed to direct health and social policy to promote health behaviour, and social and medical interventions to compress morbidity and optimize healthy ageing in Australian society over the next 40 years.

DYNOPTA was funded through the Ageing Well, Ageing Productively initiative of the National Health and Medical Research Council and the Australian Research Council. Further information about the project can be found at http://dynopta.anu.edu.au/index.php