Context (Bias) (Conflict of Interest) of This Ageing Researcher

1. Leon FlickerProfessor of Geriatric MedicineUWASynthesising SessionA Presentation for the National Symposium on Ageing ResearchSeptember 2003

2. Context (Bias) (Conflict of Interest) of This Ageing Researcher • Male • Medical Practitioner • Non-social (asocial?) scientist

3. Why Do We Do Research? • Curiosity, Investigator driven research • We do research because we are driven to do it – we like finding answers to the questions that interest us. • The wider community helps us by providing us with • 1) Interesting questions • 2) Resources to answer these questions • We, the researchers are in a privileged position, to be able to follow our ideas rather than dwell on our careers. • We should remember that ageing research is comparatively hopelessly under funded (as demonstrated by David Le Couteur). • We do not need more ageing research in just one narrow discipline, we need more of everything, from genes to geography, spanning all major interests of human endeavour.

4. To compete??? • In 16 years as a researcher, despite having collaborated with molecular biologists, statisticians, nurses, allied health people, epidemiologists, psychologists, economists, sociologists, never needed a GAMS number because the ARC does not fund medicos. • In the modern world, if you are competing for scarce research funding and you arbitrarily exclude a skill set you become less competitive. Eg if you want to do dependency, health cost, X, Y, projections wouldn’t they be improved by some quantification of potential loss or gains based on realistic projections of the changing rates of diseases in older people? • In today’s world it is not the discipline that people bring to a research team, it is a skill set useful to answer a question. (pointed out by John Braithwaite) The questions dominates the assembly of the team not vice versa. If you can’t assemble the appropriate team, which now is frequently multidisciplinary, it would be a waste of the taxpayers’ money to fund you. Same for infrastructure

5. BUILDING AUSTRALIA’S AGEING RESEARCH CAPACITY: A FORUM • The speakers will explore the challenge of harnessing resources within a changing national research environment with a view to building a policy-relevant research agenda and fostering stakeholder alliances. • We did not fucus on this – who are the stakeholders of the research besides the researchers themselves and what are their roles?? Pat Reeve did point out that she thought that Australians, possibly older Australians want to have a more directed role in determining this. • Foster stakeholder alliances? How??? There must be mutual benefit, some will actually want specific questions answered, researchers won’t necessarily appreciate being enthused to answer a question brought to their attention and then asked to organise the funding to answer the question, or explore the area……

6. BUILDING AUSTRALIA’S AGEING RESEARCH CAPACITY: A FORUM (2) • The Forum will focus on ideas and opportunities to build the quality, relevance, and scale of research to meet the evidence needs of an ageing Australia. The consultation paper Australian Ageing Research Agenda 2003 will provide background context and information for the session. • Unfortunately , although we did have some criticism of this paper there were few ideas – It was left open as to whether we need a few more big studies, or a lot of little ones. Who will decide this? How do we organise rigorous peer review? (Like democracy the 2nd worse system……..) • If we use the NHMRC or ARC or both how do we ensure equity but still maintain the ability to prioritise?

7. LINKING RESEARCH, POLICY AND PRACTICE • LINKING RESEARCH, POLICY AND PRACTICE • Professor Marmot will provide an International perspective, addressing broad questions relating to appropriate agenda setting and funding structures in multi-disciplinary research fields, the implications for research regarding ageing as a process from birth to death, and the potential use of research to understand the broad social and environmental processes of ageing. Particular emphasis will be given to questions about the mechanisms used in other countries to address these issues.

8. Marmot • Translating research evidence (from health inequalities) into policy – Why? • Practical • Strategic • Moral • Same for Ageing • The advantage of interdisciplinary research is that you don’t have to be at the frontiers – The Frontier is that you are using a separate skill set TOGETHER • You just cannot tell funding bodies that you are doing this. • Nice to be able to compare longitudinal studies done in different countries, increases the variation in exposures and outcomes, and allow evaluation of service system eg the homogenous NHS– My only worry is who has identified the gaps in our current crop of longitudinal studies and could we address the issues by adding to the current ones?

9. PRIORITIES AND CHALLENGES • Speakers will reflect on the priorities and challenges in developing and delivering an Australian Ageing Research Agenda. In particular, speakers will explore the impediments to, and catalysts for, successful development of responsive and policy-relevant ageing research and the necessary mechanisms to facilitate stakeholder engagement. • David le Couteur pointed out that although ageing is indeed a whole of life phenomenon someone at some stage should pay some attention to the research needs of older people. • The evidence for efficacy for health care interventions in older people is severely deficient. • Ageing practitioner researchers are different. • Requires researchers to have a primary focus on ageing

10. PRIORITIES AND CHALLENGES • Hal Kendig • Individual and population ageing • Older people focused • Biopsychosocial approach • What sort of research • What do older people want? • What can produce the maximum impact? • Barriers to use of research • Imposition of Political imperatives • Lack of timelines • Academic publications unavailable • Researchers misunderstand policy processes • Please refer to previous documents

11. THE RESEARCHER PERSPECTIVE • Researchers will explore issues and challenges in developing and delivering an Australian Ageing Research Agenda; in particular, by providing insights into how we might develop a more mutually beneficial collaboration between researchers, policy makers’ and practitioners in building the evidence base for an ageing Australia. • John Braithwaite gave examples from regulatory research - Practice led model which required • Seek out master (and others) practitioners • Get some good ideas • Refine practice • Evaluate (with RCTs) • Dissmeinate • BOTTOM UP NOT TOP DOWN

12. THE RESEARCHER PERSPECTIVE Rhonda Nay How do we research “care” What sort of care? Personal, health care, rehabilitation? They all need addressing. Current care may not be good…….. What about the research about workforce issues in providing this care? What is the research about educational needs? What do we do if the care provided is found to be inadequate.

13. THE RESEARCHER PERSPECTIVE • Tony Broe explained that human ageing • Very serious • Very rapid • Very recent • Poorly understood • Extremely complex • Multifactorial How can ageing research contribute to the general Australian research agenda? Can investigator driven, hypothesis testing ageing research assist aged policy/services?

14. THE RESEARCHER PERSPECTIVE • Peter McDonald • Demography beehive but heading for a coffin • Concern re dismissal of social sciences from the national priorities • Question from the floor (John McNeil) increasing trouble and expense accessing routine databases – making it harder to do any research