In March 1946, around 5,300 babies born within the same week in England, Wales and Scotland were recruited to take part in what has become the longest-running health study ever conducted.
They would be followed throughout their lifetimes, contributing to vital health findings that have shaped medical policy and treatment. Today, the National Survey of Health and Development (NSHD) is the world’s longest-running study of its kind – and around 2,500 of the volunteers, now all 80, are still taking part.
“These are basically the most studied people on Earth and they have contributed to the longest continuous study of human health in a population that has ever been done, so we’re hugely grateful to them for their commitment to research,” says Professor Jonathan Schott, professor of neurology at University College London, which manages the study. “They have contributed so much throughout their lives and influenced research and practice.”
The study, funded by the Medical Research Council, was initially intended to investigate why the birth rate had fallen in the 1930s and 1940s, looking at the impact of childbirth and the effectiveness of maternity services. A key finding was that only one fifth of mothers had received pain relief during childbirth, which led to a law change allowing midwives to give pain relief without a doctor present.
Decades of research, spanning from childbirth to ageing, has been conducted on thousands of people (Photo: Mary Hinkley/UCL Digital Media, ISD-LTMS)Since then, the survey continued, with participants regularly having developmental data taken, including measurements of the body, as well as tests for cognition, memory and health markers such as heart rate, balance and lung function. Decades of research showed that how we are brought up as children, including whether or not we are breastfed, our diets and the schools we go to, can have a lasting and profound effect on health and wellbeing, and how socioeconomic factors are fundamentally linked to health.
“Being part of the survey has always made me feel special – I remember being called out of class when I was eight to do an intelligence test by someone from the survey and I felt very important,” says Jacqueline Randall, a great-grandmother and former security escort at GCHQ who lives in Cheltenham with her husband. “After that I got more used to having tests done by nurses at home, such as blood tests and seeing how long I could stand on one leg for.”
Being part of the NSHD significantly impacted some participants’ lives. John Oliver initially failed the 11 plus but thanks to cognitive tests he’d previously had as part of the survey, the decision was overturned and he was able to get a grammar school education after all.
“I remember being sent to the headmistress’s office at school and being told that Surrey Council had awarded me a grammar school place after the people who ran the survey intervened,” recalls John, who now lives in Winchester with his wife, and has a daughter and a grandson. “At the time the 11 plus was seen as the be-all-and-end-all, so I’d been very disappointed to not get into a grammar school. It was a big surprise to be told I could go to one after all.”
John eventually went on to run and share in a large construction company, where he remained until retiring. “I got into the training scheme of one of the biggest construction companies in the country. I would never have had the opportunity to be picked for the scheme had I not gone to grammar school.”
Others discovered health issues early as a result of the tests they had.
As a child, the tests Jacqueline had as part of the survey found she had astigmatism, and she’s needed glasses since. Other tests discovered that she had flat feet, so she started to do certain exercises to help this from an early age.
At the age of eight, Randall was taking part in intelligence testsBut the most significant finding came from tests around eight years ago, which discovered that she had a heart arrhythmia (irregular heartbeat), which had led to heart failure.
“I wasn’t experiencing symptoms at the time so I wouldn’t have known about it otherwise,” says Jacqueline. She consequently had heart investigations done privately and had a pacemaker implanted a year ago. “In the last five years, I had more symptoms, including dizzy spells, fatigue and breathlessness and it’s helped with them to an extent,” she says.
Sheila Lee, a retired picture editor from London who has two children and three grandchildren, discovered she had high cholesterol when she was 65 purely due to the tests. “I consequently gave up cheese, limited the amount of red meat I eat and started taking statins,” she explains.
In 2015, a sub-study, Insight46 (part-funded by the charity Alzheimer’s Research UK ) started, aiming to discover how different factors can influence brain health. It involved around 500 of the NSHD participants having regular brain scans and memory and cognitive tests, and found that high blood pressure, exercise and head injuries in midlife are all thought to affect brain health and the risk of developing dementia, meaning that midlife is an especially important stage for people to take steps to protect their future brain health.
“It’s really special to be part of the Insight46 study because I’m conscious of the ageing process and this is making a big contribution to that – we have become a unique and valuable resource when it comes to research,” says Sheila. “I can tell that I’m getting worse at remembering words and I’m forgetting how to do things, and I find the tests for Insight46 harder each time.”
“So many of our friends have got dementia so it’s a very pertinent thing for people of my age,” adds participant Donald Malcolm, a retired company director who lives with his wife in Clackmannanshire, Scotland, and has two children and four grandchildren.
The study made Donald more aware of the importance of exercise when it comes to brain health. “As a result, I’ve devoted about 10 years towards helping to set up a community sports hub, which is about making sport accessible for everyone and bringing people together, as socialising and exercise are things that help,” he says.
The community sports hub Donald Malcolm set up promotes exercise for brain health.Having a detailed array of information about what a large group of individuals have been exposed to throughout their lives, and about their genetics, has been key to the Insight46 study, says Professor Schott, who is leading the research and is chief medical officer at Alzheimer’s Research UK. “It started when the participants were 69, when very few people are likely to have dementia. We used brain scans to look for amyloid protein – a core feature of Alzheimer’s – and found about 20 per cent of them had a build-up of it, so we could look back to try to find the possible causes for this.”
One of the key findings was how important exercise is in maintaining brain health. “Doing even a small amount of regular exercise throughout your life seems to be the most beneficial thing for exercise and brain health, and it’s never too late to start,” he says. Further funding from America means the study will continue for another five years.
Other key research, in which around 500 NSHD participants were involved, was the MyoFit46 heart study. This started in 2020 and found that wearing a “smart vest” with electrodes in was a more effective way to collect readings about heart health than a conventional electrocardiogram and investigated the factors that shaped heart health in older age, such as blood pressure and scarring.
And new research projects involving the members of the NSHD are ongoing. John is currently involved in a sleep study, meaning that he’s had a sleep mat under his mattress for the last 18 months, which collects information including heart rate and movements.
“It’s a privilege to be part of research and help other people – looking back now, you realise how important being in this study has been,” adds Donald. “Everyone likes to think they are leaving behind a legacy, and this one is a particularly good one to leave.”
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