The events of the past year have highlighted how important medical research is to our daily lives, and to our health. After all, where would we be without the worldwide efforts of medical researchers in developing the Covid-19 vaccine? The Selfridges Group Foundation is a charitable organisation that has been supporting medical research for years, specifically funding research into age-related brain disease, and funding support for those affected by them. One of the projects recently funded by the Foundation uncovers the story of a special group of people who have donated their time and biological material to improve the medical health and social policy for 75 years.
Between the 3rd and the 10th of March 1946, nearly 14,000 newborn babies from across the UK were recruited into a maternity health survey. The Second World War had just ended, rationing was still in effect, and the birth rate was falling to worryingly low levels – especially given the heavy losses of the war, and the need to rebuild the country. A national maternity survey was designed to find out why people in the UK were having fewer children, and what barriers existed to parenthood. The study, led by Dr James Douglas, found that there were a wide range of risks to the life and health of mothers and babies, that only one in five mothers had received pain relief in childbirth, and the cost of having a baby was disproportionately high — what’s more, Douglas found that all of these risks and costs were much higher for the working classes than for other new parents in the UK. The findings of this unprecedented national maternity survey helped to shape policy and law aimed at reducing economic and access inequality to maternity health, and it was also the start of the longest-running birth cohort study in the world — the 1946 cohort.
The significance of this research cannot be underestimated, over the past 75 years, as the Douglas children grew into adults, some with children of their own, they continued to volunteer their time to help improve the quality of health and social care across the UK and all over the world.
The Douglas children — as they came to be known — were a group of 5,362 babies selected from the national maternity survey for continued observation. The group has been followed through infancy, into childhood, adulthood, and now later life — participating in studies as wide ranging as education, mental health, fertility, working life, cardiovascular health, menopause, and now age-related health issues. As Elizabeth, one of the cohort members, recalls ‘I felt I was doing something important, but I didn’t quite know what’. That feeling was sufficiently strong to keep the cohort engaged over the course of a lifetime. The significance of this research cannot be underestimated, over the past 75 years, as the Douglas children grew into adults, some with children of their own, they continued to volunteer their time to help improve the quality of health and social care across the UK and all over the world. The results of the various studies the cohort have participated in have helped to shape understandings of the factors in a child’s education, opportunity, or upbringing that may lead to better quality of life and health in adulthood, and that knowledge has shaped policy in practice across Britain. The surviving members of the 1946 birth cohort celebrate their 75th birthday this month in a Britain that is very different to the one in which they were born – from the post-war period, to the cultural revolution of the 1960s and 70s, the decline of industry and the rise of the digital economy – but their contributions to the medical and social sciences are as important now as they ever have been.
Above: Members of the 1946 cohort receive a birthday card from the National Survey of Health and Development every year. The card they received for their 50th birthday featured photographs of the research team as babies and adults. The researcher who began the study, Dr James Douglas is pictured in the centre.
Age-related brain disease ranks high among public concerns about getting older; the threat of losing one’s memories, faculties, or ability to interact with loved ones is an anxiety for most people in later life. This anxiety is not unfounded; we all know someone who has been affected by dementia, Parkinson’s or Alzheimer’s disease — indeed Alzheimer’s disease affects some 700,000 people in the UK, and 50 million people worldwide. What’s even more concerning is that these diseases are often incurable, and there are very few treatments the medical sciences can offer once symptoms present. But what if the treatments we had at our disposal could be effective, if only we were able to diagnose these diseases at early stages?
The Foundation has recently provided funding to support a landmark study led by Prof Jonathan Schott at UCL to develop blood tests (blood biomarkers, in medical language) that can predict whether a person is likely to develop Alzheimer’s disease.
Studies have shown that up to 40 per cent of age-related brain disease is preventable, which implies that new treatments and approaches are needed to prevent and treat the majority of cases. It is likely that intervening very early – perhaps even before symptoms start – may be the best way to prevent these illnesses from taking hold in the brain. But this requires the tools to diagnose people very early . The Foundation has recently provided funding to support a landmark study led by Prof Jonathan Schott at UCL to develop blood tests (blood biomarkers, in medical language) that can predict whether a person is likely to develop Alzheimer’s disease. Determining the hallmarks of Alzheimer’s disease in the living brain is currently an expensive and sometimes invasive process, involving PET scans or lumbar punctures (where a needle is inserted between vertebrae in the spine to take a sample of spinal fluid). Because of the cost and risk involved, these tests are often only available to a small number of people. Having a simple blood test that could allow doctors to easily identify which people are likely to develop Alzheimer’s disease could vastly improve our ability to diagnose at very early stages and offer treatments that might prevent or reduce the symptoms of these diseases. And a blood test such as this could be widely available to people across the UK, which would vastly improve access to this kind of tool too. Prof Schott and his team were able to add to emerging evidence to suggest that blood tests are able to predict the results of the much more costly brain PET scans. The implications of the Foundation-funded study are so wide-reaching that Dr Schott was able to secure an additional $7m in funding to continue this work from the American Alzheimer’s Association.
Dr Ashvini Keshavan – one of the lead researchers in the study – says the best way to describe the 1946 cohort is to point to the fact that so many of the participants were willing to travel to London and participate in the study – including about one in three opting to undergo a lumbar puncture – even though none of them would directly personally benefit from the results. There is something incredibly moving about the commitments made by the individuals in this cohort over the last 75 years, their willingness to give of themselves over the course of a lifetime in contributing to the common good.