The TRIL Clinic has assessed more than 600 older adults with an average age of 73. Two thirds had a history of falls. They came to the Clinic through referrals from GPs or public health workers or were referred by other departments in St James’s Hospital. A large proportion of the cohort self-referred. In 2010, the Clinic added a longitudinal component to its clinical research and re-assessed the original patient cohort enabling researchers to characterise and identify causative markets of physical, cognitive and social decline in older people.
Medical
• Full medical and medications history
• Falls history
• Gait analysis
• Heart function
• Blood tests
• Physical examination
• Hearing and vision
Social
• Personal profile and daily life
• Social networks
• Personality and psychological well being
• Cognitive Function
• Motor, memory and Perception Lapses
• Alertness
• Executive Function
Data from the in-depth clinical assessments are stored in a growing database that researchers can mine to identify trends and discover correlations between health conditions and symptoms. As Dr Mimi Fan (former Clinical Director of the first phase of TRIL) notes: ‘The beauty of TRIL is that we’re not focusing on a specific area, we’re taking a multidisciplinary, holistic look at the person. Because we're collecting so many different parameters, across disciplines, we can mine the data to find new correlations that lead to new insights and research directions.’
The data from these assessments have been analysed by the multi-disciplinary research team in St James’s Hospital and partner universities. This analysis has yielded important insights which have been published and presented worldwide. The data have also informed the design of technologies and protocols. For example:
• The standard time allowed by the amber light pelican crossings is insufficient for older people over 80 years of age to cross the road on time, due to their slower walking speed.
• A dramatic reduction in gait stability and speed can be observed when older people are dual tasking. This suggests for instance, that using a mobile phone when walking will significantly increase an older person’s risk of falling.