Cohort profile: Oxford Pain, Activity and Lifestyle (OPAL) study, a prospective cohort study of older adults in England

PURPOSE: The ‘Oxford Pain, Activity and Lifestyle’ (OPAL) cohort is a longitudinal, prospective cohort study of adults, aged 65 years and older, living in the community which is investigating the determinants of health in later life. Our focus was on musculoskeletal pain and mobility, but the cohort is designed with flexibility to include new elements over time. This paper describes the study design, data collection, and baseline characteristics of participants. We also compared the OPAL baseline characteristics with nationally representative data sources. PARTICIPANTS: We randomly selected eligible participants from two stratified age bands (65-74 and 75 and over years). In total, 5,409 individuals (42.1% of eligible participants) from 35 general practices in England agreed to participate between 2016 and 2018. The majority of participants (n=5,367) also consented for research team to access their UK NHS Digital and primary health care records. FINDINGS TO DATE: Mean participant age was 74.9 years (range 65-100); 51.5% (n=2,784/5,409) were women. 94.9% of participants were white, and 28.8% lived alone. Over 83.0% reported pain in at least one body area in the previous six weeks. Pain was more prevalent in women (86.0%). One third of participants reported having one or more falls in the last year. Most participants were confident in their ability to walk outside. Characteristics of OPAL cohort participants were broadly similar to the general population of the same age. FUTURE PLANS: Postal follow-up of the cohort is being undertaken at annual intervals, with data collection ongoing. Linkage to NHS hospital admission data is planned. This English prospective cohort offers a large and rich resource for research on the longitudinal associations between demographic, clinical, and social factors and health trajectories and outcomes in community-dwelling older people.