Aston academic improves physical and psychological health of older adults

Aston academic improves physical and psychological health of older adults in the BAFTA-nominated TV show Old People’s Home for Four Year Old’s

Why is this research needed?

The functional decline and frailty associated with ageing is a significant cause of morbidity and mortality in the UK. With an estimated 17.4% of the worldwide population classed as 'frail', and a further 49.3% as ‘pre-frail’, significant efforts are needed to tackle this preventable problem. 

Although not present in the entire older population, it is still a significant concern due to the increased risk of adverse health changes, disability and poorer clinical outcomes.

Interventions such as exercise can help to prevent or even reverse frailty, however research is needed to discover the best possible approaches as there is no current consensus.

Old People’s Home for Four Year Old’s (OPHF4YO) is a television programme that uses intergenerational interaction as a remedy for frailty to improve older people’s health and wellbeing. The concept for the show was developed by CPL Productions; however, the production company lacked sufficient knowledge in designing and assessing the required interventions. The company needed substantial assistance in embedding a research-based approach to the programme before broadcasting.

The research team

Dr James Brown is Director of the Aston Research Centre for Healthy Aging (ARCHA). He is Trustee and Communications Officer for the British Society for Research on Ageing (BSRA), the world's oldest ageing research society.

Due to his research expertise in both frailty and biogerontology, CPL productions recruited Brown to design the interventions and develop a range of frailty-related tests to evaluate the impact of the intergenerational activities for Channel 4’s OPHF4YO.

Brown worked with Dr Sri Bellary, Reader in Metabolic Medicine at Aston and Clinical Director for Diabetes and Endocrinology at the Heart of England Foundation NHS Trust. Their prior research on frailty was the basis for Brown going on to be featured in the programme as an expert.

The research process

Aston University research, led by Brown, focused on the ageing process and how frailty can be measured, prevented and treated in older adults. During the project, Brown was part of a multi-disciplinary team consisting of clinicians with knowledge of intergenerational activities as well as an early years expert. Together they developed activities for the intergenerational study to assess the effects of such activities on frailty in older adults.

Following use of various activities including arts and crafts, a maze, reminiscence and dance, the team measured data over 12 weeks to analyse changes in hand grip strength, gait speed and balance in the older adults. Through these tests, they saw improvements in the physical and cognitive performance of adults, with examples of outstanding improvement in quality of life for both groups.

Brown’s research in this project has generated new knowledge in the biology of ageing and how metabolism and physical activity are linked to markers of ageing and frailty. It was identified that a biological marker of frailty was influenced by an exercise hormone in healthy individuals. Additionally, fats in the blood associated with diet and exercise can predict ageing. His research also demonstrated how older adults can be better handled following discharge from the NHS.

Alongside OPHF4YO, Brown has been involved in two other collaborative research studies to identify and treat frailty in older adults.  SPRINTT was an EU clinical trial of physical activity in frailty whilst FOCUS was an EU study to develop and trial tools to identify and treat frailty. Showing great expertise in the assessment of physical and cognitive function and frailty in older adults.

Impact

Improved wellbeing in older adults

The intergenerational interventions developed by Brown improved the mood, physical and cognitive function in the older adults. Major improvements in balance, walking speed, grip strength and mood were seen along with improvements in overall cognitive function and episodic memory. These improvements were maintained 6 months later.

Improved wellbeing in children

From parent diaries it was clear that many of the children in OPHF4YO had gained improved confidence and independence. Their use of language had developed as well as an improved imagination, maturity, empathy and concentration.

Production Company

As a result of Brown’s underpinning research, OPHF4YO was successfully launched on Channel 4. Series 1 of the programme was effective and reached over 2.5 million viewers per episode as well as being accorded for multiple awards and a BAFTA nomination.

Due to this success, a second series was commissioned which featured Dr Brown on screen. Series 2 averaged 1.8 million viewers over five episodes and was ranked 4th among documentaries on Channel 4 in 2018, and 6th among human interest documentaries on all commercial channels during its broadcast.

CPL Productions’ reputation has benefitted, culminating in their recent nomination as the best Independent Production Company at the Broadcast Awards in 2019. CPL has received multiple awards and nominations across both series.

Increased public understanding

The programme has had significant media coverage and has inspired individuals, organizations and policymakers to consider intergenerational programmes to improve quality of life for older individuals.

The Secretary of State for Health, Rt Hon. Matt Hancock MP has called for “intergenerational care to become routine”.

OPHF4YO has also had both national and international impact and stimulated immense interest in intergenerational activities. This has led to an increase in the number of institutions using the practice.

Inspired further intergenerational developments and research

United for All Ages (UfAA), who are delivering a £12m intergenerational development program stated that “intergenerational activities have exploded due to the two series of OPHF4YO”.

The UKs first four generation holiday – the ‘Great Grandparent Getaway’ was developed by Parkdean using Dr Brown’s research expertise. The group were also inspired by OPHF4YO and undertook their own research into multigenerational holidaying. In this, 2,000 grandparents and great-grandparents were asked about experiences with their grandchildren and it was found that 50% saw improvements in their mental health after spending short periods of time together.

Why is this research relevant today?

For many people, the latter years of life are spent in frailty. This age-related state of vulnerability significantly increases the risks of falls, disability and hospitalisation. This poses further difficulties to the individuals, their families, healthcare systems and the wider society.

Frailty is therefore a huge burden on society, both for individuals and for the healthcare and social care systems. Interventions to prevent and decrease frailty are valuable. These interventions are necessary to improving quality of life in older age and reducing the burdens frailty poses on society.