The 2019 QUEX PhD candidates are working on the following projects. Please note, these positions have been filled.

17. The role of assets and deficits in adverse outcomes for older people

UQ academic lead

Associate Professor Ruth Hubbard, Associate Professor in Geriatric Medicine, Faculty of Medicine

Exeter academic lead

Dr Iain Lang, Senior Lecturer in Public Health, University of Exeter Medical School

Project description

Frailty is distinctive health state related to growing older in which multiple systems within the body gradually decline in function. Recognising and assessing frailty as a way of identifying and supporting older adults at risk of decline has assumed growing importance in recent years in clinical practice.

But although frailty is a good predictor of adverse outcomes such as institutionalisation and mortality there is substantial variation in these outcomes even when frailty is taken into account: for example, 5% of people with the highest levels of frailty live for at least five years, and women survive with much higher levels of frailty than men. One promising angle of investigation to explain this relates to the importance of assets – which includes not only socioeconomic assets (such as income) but behavioural ones (such as alcohol consumption) and environmental ones (such as living in a supportive neighbourhood).

Project aim

The aim of this project is to establish the importance of assets as a means of (a) explaining differences in frailty-related outcomes and (b) identifying potentially modifiable factors that can be used to support frail older people and improve their health. The work of this PhD will be an important foundation for the development and testing of an instrument with potential applicability in community, acute, and long-term-care settings.

The project will involve:

  1. A systematic review of literature on frailty and assets, in which the student will synthesize the relatively diffuse literature on factors that ameliorate the consequences of frailty. This will help focus the subsequent stages of the project.
  2. Analysis of the relationship between assets, frailty, and outcomes using two large well-established panel studies, the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS).
  3. Development a Health Asset Profile that matches the Frailty Index used to measure frailty and measure how incorporation of the Health Asset Index improves the predictive validity of the Frailty Index
  4. Work with clinicians to co-design an instrument that incorporates both a Frailty Index and a Health Asset Profile and is implementable in practice and test the feasibility of its use in acute-care settings.