Prestigious Dhole-Eddlestone Memorial Prize awarded to scientific paper enabling early detection of age-related functional decline

The prestigious Dhole-Eddlestone Memorial Prize has been awarded to an Age and Ageing paper which analyses a major Canadian dataset, the Canadian Longitudinal Study on Aging, to determine normative values for five measures of performance relevant to ageing. The performance charts can, in turn, be used to identify mid- to late-life adults with low physical function relative to their peers of the same age and sex. This prize is given annually to the most deserving medical research relating to the needs of older people, published over the last year in the scientific journal of the British Geriatrics Society (BGS), Age and Ageing.

The Age and Ageing paper, ‘Normative values for grip strength, gait speed, timed up and go, single leg balance, and chair rise derived from the Canadian longitudinal study on ageing’, was published in April 2023. The performance charts developed in this paper were inspired by the World Health Organization’s growth charts for children. The research team identified that the rapid growth experienced by infants and children is analogous to the declines experienced as we age. The performance charts are similar to the child growth charts in the way they benchmark normal performance levels by age and sex. Charts that measure health using key benchmarks are valuable in enabling better targeting of interventions by health professionals.

Retention of physical function and mobility is important for healthy ageing. But even the healthiest people will experience declines in measures such as grip strength and walking speed as they get older. There is a clear benefit to detecting these problems earlier. Older people, and those who care for them, can measure their performance against what is expected for their age and sex, gaining insight to anticipate changes in their care needs. Preventative interventions can change the trajectory of functional decline, preserving mobility and function, and delaying the loss of independence.

The study was led by epidemiologists Alexandra Mayhew and Professor Parminder Raina in the Department of Health Research Methods, Evidence, and Impact at McMaster University and the McMaster Institute for Research on Aging in Ontario, Canada. The research team developed these groundbreaking performance charts to provide an alternative to traditional cut-offs which do not take the expected declines in muscle strength and physical function that occur with normal ageing into consideration. This results in ‘cut-offs’ that over-identify older adults and under-identify younger adults as having low performance. The new performance charts show the distribution of performance in adults aged 45 to 85 years free of mobility impairments for five tests of physical function: grip strength, gait speed, timed up and go, chair rise, and balance.

Dr Alexandra Mayhew and Professor Parminder Raina

The Dhole-Eddlestone Memorial Prize judging panel were particularly impressed by the relevance of the study to the World Health Organization’s ‘Special Issue on Measurements of Healthy Ageing’, recently published in Age and Ageing. As part of the UN Decade of Healthy Ageing, this collection of articles systematically reviewed a vast number of surveys across several countries to identify the best available tools to measure older people’s intrinsic capacity and functional ability. Professionals and experts from over 40 academic institutions highlighted the need for measurement concepts that are clearly defined and address current knowledge gaps. The Dhole-Eddlestone judges viewed the Canadian study as both timely and relevant to furthering the understanding of healthy ageing.

Dr Alexandra Mayhew commented:

Our team is deeply honoured to receive the Dhole-Eddlestone Prize. We would like to thank the participants of the Canadian Longitudinal Study on Aging (CLSA) for generously volunteering their time to the study and the dedicated team of staff and researchers that support the CLSA and have made it one of the leading data platforms for research on ageing. We are grateful to the journal Age and Ageing for providing us with the opportunity to share our work. We hope that the age-specific performance charts we developed will improve the identification of low physical function and mobility in mid-to late-life older adults, allowing for early interventions to preserve mobility and function and improve quality of life.”

Professor Rowan Harwood, Editor-in-Chief of Age and Ageing, commented:

We were thrilled to publish the paper establishing normal values for various physical performance measures widely used when assessing older people. This is painstaking work, from an impressively large Canadian study, beautifully presented. The comparison with growth charts for children is apt. Older people vary one from another, and we need to know if someone’s ability is tracking along what you would expect, or if it is progressively deviating from what people of the same age and sex can do. We see the potential for rapid implementation in clinical practice, for monitoring deterioration or recovery, or for the early detection of emerging problems that might be averted. Congratulations to the whole Canadian Longitudinal Study of Aging team.”

The Dhole-Eddlestone Memorial Prize is funded by a legacy from Dr Manindra Kumar Dhole, a BGS member who died in 1977. The prize is so named to commemorate the anniversary of his marriage with Dr Elizabeth Eddlestone. One cash prize of £1,000 is made each year and announced on 14 January, the anniversary of the date of their marriage. Applications are not accepted. The prize goes to ‘the most deserving published work of medical research appertaining to the needs of aged people’. In practice, the award is made to the paper published in Age and Ageing each year which most impressed the judging panel.