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Participation bias in longitudinal studies: experience from the Population Study of Women in Gothenburg, Sweden

Journal article
Authors Lauren Lissner
Ingmar Skoog
K Andersson
N Beckman
Valter Sundh
Margda Waern
Dimitri Zylberstein
Calle Bengtsson
Cecilia Björkelund
Published in Scandinavian Journal of Primary Health Care
Volume 21
Pages 242-247
Publication year 2003
Published at Institute of Community Medicine, Dept of Primary Health Care
Institute of Clinical Neurosciences
Institute of Clinical Neurosciences, Section of Psychiatry
Pages 242-247
Language en
Subject categories Public health medicine research areas


Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. OBJECTIVE: To describe a cohort study of women receiving a series of comprehensive health examinations over 32 years. DESIGN: Longitudinal population study based on a randomised sample of the female population from defined age cohorts. SETTING: City of Göteborg, Sweden. SUBJECTS: Subjects were 38, 46, 50, 54 or 60 years old at the start of the study in 1968. Re-examinations were performed in 1974, 1982 and 1992. Non-participants in the most recent examination, initiated in 2000, were offered home visits. MAIN OUTCOME MEASURES: Participation, anthropometric and blood pressure changes. RESULTS: At the end of the 32-year follow-up, 64% of the original participants were alive, and low participation among survivors was a problem. An acceptable participation rate (71% of those alive) was obtained after home visits were offered. Surviving non-participants already had elevated cardiovascular risk factors at onset of the study in 1968, along with lower educational level and lower socioeconomic status. Home visited subjects were similar to non-participants with regard to anthropometry and blood pressure, but did not differ from participants with regard to social indicators. Thirty-two-year longitudinal data demonstrate clear ageing effects for several important variables, which should, however, be considered in the context of documented differences with non-participants at the baseline examination. CONCLUSIONS: Longitudinal studies in elderly populations provide important data on changes during the ageing process. However, participation rates decline for a number of reasons and generalisations should be made with care. Moreover, including home visits in the protocol can both increase participation and reduce participation bias in elderly cohorts. PMID: 14695076 [PubMed - indexed for MEDLINE]

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