LiLACS NZ - our community

Principal Investigator

Professor Ngaire Kerse

Academic staff

• Dr Marama Muru Lanning: Senior Māori Academic
• Dr Anna Rolleston: Senior Māori Academic
• Ruth Teh: Post-Doctoral Research Fellow
• Karen Hayman: Research Fellow

Professional staff

• Rangimārie Mules, Project Manager
• Ruth Speck, Adminstrative Assistant

Data specialists

• Simon Moyes, Senior Data Analyst
• Dale-Cormack Pearson, Data Quality

After extensive consultation and regional meetings with local tribal leaders and older people, seven local organisations were subcontracted by the University of Auckland to contact, recruit and enrol participants and to conduct the interviews and physical assessments. They comprised three Primary Health Organisations (PHOs; organisations that manage data and distribute funds for groups of general practitioners), and four rūnanga (iwi authority). Four organisations enrolled both Māori and non-Māori participants; two, working under a joint subcontract, enrolled only Māori and one enrolled only non-Māori.

Rotorua

• Rotorua Area Primary Health Services
• Te Rūnanga o Ngāti Pikiao Trust
• Korowai Aroha Health Centre

Tauranga

• Research Centre Western Bay of Plenty
  
• Ngā Mataapuna Oranga Kaupapa Māori Primary Health Organisation

Whakatāne

• Whakatāne area

Opotiki

• Te Rūnanga o Ngāti Irapuaia . Subcontract to Te Kaha area for local coordination and recruitment.

LiLACS NZ is the world’s first longitudinal study of an indigenous population aged 80 plus years old.

Tihei (wa) Mauri Ora!
Behold the breath of life!

With questions of how health and wellbeing is experienced for older Māori currently ageing in New Zealand society, how culture relates to health and wellbeing, and how Māori and New Zealand society may respond this research explores new information on a section of the Māori population, New Zealand society and indigenous groups that has not been included in research to date.

Te Rōpū Kaitiaki o Ngā Tikanga Māori
Protectors of Principles of Conduct in Māori Research

For the LiLACS NZ project, Māori philosophy meant that in the tradition of whānaungataunga (kinship relationships), Te Rōpū Kaitiaki o Ngā Tikanga Māori (subsequently termed Rōpū), drawn from diverse tribes across New Zealand was established to ensure that Māori people, and Māori language and culture would be respected. The Rōpū actively inform the research team on all matters pertaining to Māori; specifically: customs to approach potential Māori participants taking into account the history of the tribes and tribal relations; important families and leaders of mana, mystery and authority with whom to communicate; use of te reo Māori me ngā tikanga (Māori language and culture) construction of questionnaire items about Māori cultural practices; wording and translation of all questionnaire items; and on-going interactions with participants and community groups. Importantly, the Rōpū brings extensive knowledge and wisdom of Māori society and spirituality to LiLACS NZ.

The members of Te Rōpū Kaitiaki are as follows:  

• Dr Mere Kepa
  
• Mrs Leiana Reynolds
• Dr Waiora Port
• Mrs Betty McPherson
• Mr Hone Kameta
• Mrs Florence Kameta
• Late Mrs Paea Smith

• Marama Muru-Lanning, James Henare Research Centre, Faculty of Arts, University of Auckland
• Anna Rolleston, PhD, CSANZ, Senior Research Fellow, University of Auckland
• Ruth Teh, Department of General Practice and Primary Health Care
• Karen Hayman, Department of General Practice and Primary Health Care, University of Auckland
• Simon Moyes, Department of General Practice and Primary Health Care, University of Auckland
• Janine Wiles, Social and Community Health, University of Auckland
• Carol Wham, School of Food and Nutrition, Massey University
• Martin Connolly, Freemason’s professor of Geriatric Medicine, School of Medicine, University of Auckland
• Merryn Gott, Professor of Health Sciences, School of Nursing, University of Auckland
• Valerie Wright-St Clair, Occupational Therapy, AUT University
• Avinesh Pillai, Department of Statistics, University of Auckland
• Thomas Lumley, Department of Statistics, University of Auckland
• Santosh Jatrana, Deakin University, Melbourne, Australia
• Oliver Menzies, Auckland District Health Board, Auckland  
• Joanna Broad, Freemason’s Department of Geriatric Medicine, School of Medicine, University of Auckland
• Sally Keeling, Older People’s Health, University of Otago, Christchurch Campus
• Tim Wilkinson, Older People’s Health, University of Otago, Christchurch Campus
• Robert Doughty, Department of Cardiology, University of Auckland

Introduction

LiLACS NZ is much more than a simple research project. It also contributes to research development by hosting, contributing or encouraging other research projects.

Main interview

This world class research programme comes from the University of Auckland’s School of Population Health. After a successful feasibility study, all Māori aged 80 to 90 years and all non-Māori aged 85 years within the Bay of Plenty and Lakes District Health Board areas (excluding the Taupo area) were identified and invited to participate in a detailed interview and physical assessment, and to give a blood sample. Those who agreed to participate (421 Māori and 516 non-Māori) constituted the two inception cohorts of LiLACS NZ, and began being interviewed in 2010. In the five years since that time there have been annual follow-up interviews making six data collection waves in total.

Additional Studies

• Nutrition Study
  

• Kaiāwhina Study
  • The Kaiāwhina study aims to investigate the carers of LiLACS NZ participants, describing the carers, their relationship to participants and the amount and type of care they give. For informal carers, the impact this caring has on their lives is investigated, including their health, quality of life and employment

• End of Life Study
  • End of Life study focuses on understanding the health of LiLACS NZ participants in the last months of their life and what decisions they made. Satisfaction with the health care and other practices that occurred at the time of death will be elicited from other people involved; the family or whānau member, i.e. the study participant. Carers were asked questions about how the they and the participant perceived the care the participant received at the end of their life.

TULIP consortium

The TULIP consortium is a collaboration of investigators involved in longitudinal cohort studies of advanced age (80+) who voluntarily cooperate to maximise the utility and use of data and increase understanding of international comparisons.

The aim of the consortium is to improve health and wellbeing for older people, particularly those aged 80+, through high quality research.

The consortium also includes the following studies:

• Newcastle 85+ Study
• Laiden 85-Plus Study
• TOOTH Study, Japan

Matters of the Mind

The Matters of the Mind Study aims to understand the ageing brain of LiLACS NZ participants. We hope to answer what proportion of Maori and non-Maori of advanced age are affected by frailty of the brain.

Te Pākeketanga

Te Pākeketanga is a mixed-methods research project. The researchers gathered stories from the whanau and families of 52 Maori and non-Maori LiLACS NZ participants to understand their end-of-life circumstances and needs, and the informal and formal care they received. Participants shared their stories to help us understand what support caregivers require to meet the needs and wishes of both the older person, and their caregivers. As a result we also know more about bereavement experiences of whanau and families. The findings will allow policy-makers, support services, and health-care providers to understand how they can best support people in older age, within their communities. The interview phase is now finished and we are analysing the data. We will begin sharing the findings in 2016.

Managing Health Study

In the Managing Health study, we are interviewing Māori and non-Māori LiLACS NZ participants along with general practices to understand the ways that people experience and manage health and illnesses in advanced age. LiLACS NZ identified that 95% of participants live with multimorbidities, and this study offers a unique opportunity to listen to participants to understand how older people themselves perceive and cope with multiple illnesses. So far twenty LiLACS NZ participants in the wider BoP area (with an average age of about 90) have generously welcomed our researchers into their homes where most are still living independently. Discussions have covered how participants manage their health, what helps them manage well, what they perceive primary care practitioners are doing well for them and what they could do better, and what they think contributes to ageing well. We have also been fortunate in being able to spend time talking with a number of GPs as well as holding focus groups in general practices. These discussions with general practitioners and general practice groups (including GPs, practice managers, nurses, and receptionists) have provided us with insight about caring for people in advanced age and the opportunities and challenges that primary care teams experience in working with this age group. We anticipate the findings will contribute to knowledge about health and well-being in advanced age, and particularly help to support primary care and related services.

Students

PhD students

• Casey Mace: Physical activity outcomes and measures for those in advanced age
  
• Karen Cardwell: The contribution of pharmacists to the management of multimorbidity
• Karen Hayman: Understanding resilience in advanced age
• Kristina Zawaly: Dementia in advanced age
• Marama McDonald: Prevalence and aetiology of anaemia in older Maori and non-Maori
• Rosemary Gibson: Sleep of Maori and non-Maori of advanced age
• Thomas Puvill: To identify determinants of quality of life and health status in two culture in New Zealand
  
• Adine Nachum: Meaningful activities in advanced age
  

Masters students

• Angela Rapson: Neighbourhood and wellbeing
• Briar Bennett: Investigation of protein intakes of Maori in advanced age
• Chavindi Uduwaka: Socio-economic and living environment factors in relation to nutrition risk and nutrient intake in advanced age
• Fiona Baggett: Dietary protein intake may reduce hospitalisations due to infection in Maori of advanced age
• Jacqueline Beaten: Predictors of cessation of driving
• Kristy Redwood: Validation of the nutrition screening tool ‘seniors in the community: risk evaluation for eating and nutrition, Version II among octogenarians
• Katrina Allen: Pain and analgesics

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