Questions about the Fifth Health Check (5HC)

1. How is the fifth health check different from previous health checks?

The aim of this phase of EPIC-Norfolk (5HC) is to investigate measures to understand how health changes as individuals age, and further clarify the factors that influence the ageing process and risk of disease. We will be looking at cognitive function (covering a range of mental abilities not just memory), the levels and patterns of physical activity undertaken by participants and relating this to change in function and body composition as we age. There is evidence that lifestyle factors (such as diet, smoking and exercise) are associated with the risk of a number of the common conditions linked to ageing e.g. diabetes, heart disease and dementia. The EPIC-Norfolk study has collected over twenty years of lifestyle, biological and genetic information and is well placed to identify not only factors associated with decline but also those associated with the maintenance of health and functional ability in older age.

2. Why do we have to come to Norwich, is there a clinic near me?

Previously, EPIC staff either came to your local GP practice, or set up a special clinic in your local area. Due to the complex equipment we are now using, we are unable to set up in different clinics around the county. We now have an established central location in Norwich with a fully equipped clinic and a team of researchers. If you would like to attend a health check appointment but transport is a problem, then please telephone the clinic on 01603-776812 and we may be able to provide a taxi or minibus pickup.

3. Are there any possible risks associated with the DEXA body compositional scan, undertaken as part of the Fifth Health Check?

The DEXA scanner is an x-ray procedure. The x-ray exposure from this equipment is very small indeed, amounting to approximately 8 hours natural exposure to background radiation. For reference, a single chest X-ray amounts to about 3 day's background radiation. However, if there is a possibility that you may be pregnant, we will be unable to carry out the DEXA measurement. Please telephone the unit on 01603 776812 for advice if you suspect that you may be pregnant before your appointment. We also need to be informed if you have received any exposure to X-rays in the 4 weeks leading up to your appointment, in particular an x-ray where you may have been asked to swallow barium, or a nuclear scan where a contrast media was used to highlight certain organs.

4. Will I go into a tunnel for this scan?

No, you will not be required to go into a tunnel. The scan requires you to lie on a bed and an arm passes over the top of you. It will be carried out in a bright, airy room and the operator will remain with you throughout.

5. What tests are being carried out as part of the Fifth Health Check?

Please see Fifth Health Check page

Click here (EPIC Norfolk Fifth Health Check) available from the EPIC Home page for further information on the tests included in this phase.

6. My partner or friend is a participant but was not approached when I was. Why?

We approach participants based on the GP surgery where they are registered. It may be that your partner belongs to a different surgery to yourself, or as we send out approaches in alphabetical order, they may have a different surname to yourself. If you have received an invitation to the Fifth Health Check and you would like to come on the same day as another EPIC participant living at the same address (or nearby), please call us on our freephone number and we will send an invitation pack to that person and can then arrange an appointment at the same time. You can also write this on your participation form and we will note it at our end.

7. What if the set clinic times do not suit me?

That should not be a problem. You will be sent a participation form where there will be space to indicate the best times for an appointment to suit you. The clinic opening hours are distributed to accommodate most requests and you will be able to discuss your preferences with the study team when they telephone to make your appointment.

8. What do I need to do on the day of my appointment?

Please eat and drink as normal. Hot and cold drinks will also be offered during your appointment.

If you usually wear a hearing aid or contact lenses please wear them as normal on the day.

If you usually wear spectacles please ensure that you bring these with you on the day (including thoses used for computer use).

Please also bring a list of your medications (the docket for repeat prescriptions would be very useful). Medications are either those prescribed by your GP, or supplements you may have bought over the counter at the chemist or a health food store. Details of the brand of medication, the dose, and the frequency that you take it would be most useful.

It would be helpful if ladies are able to wear their hair loose, or are able to remove any hair ornaments to aid the accuracy of the height measurement without disturbing your hair.

To carry out a DEXA scan we must ensure that you are free from all metal as this affects the results obtained, so if you are able to wear or bring suitable clothing which is free from metal it would be very helpful. However, please don't worry if you are unable to find anything suitable at home as we have garments that you are able to change into at the unit. Ladies - please don't forget that most bra fasteners and underwiring are metal, therefore you will be asked to remove these prior to the scan.

9. Where is the EPIC Clinic in Norwich situated?

The Clinic is based at the Norwich Community Hospital (formerly the West Norwich Hospital). Entry to the site is via entrance A - signposted main car park. The unit is a green porta cabin with a brick front in the main car park.

10. Is there any parking at the clinic?

There is parking available on-site. You will be sent a car-parking voucher to display in your windscreen with your appointment pack. You will also be asked to provide the clinic with your car registration number when booking your appointment and this ensures that you can park free of charge for the duration of your health check.

11. Does the clinic have disabled access?

Yes. We do have a ramp outside the clinic, but please do call the clinic to discuss your individual needs if you have any concerns. In particular, if you have very limited mobility which may affect your ability to transfer from one room to another.

12. What should I expect at the health appointment check?

There may be other participants within the unit at the same time as you but you will be taken through the entire appointment by the same researcher. The appointment structure can vary according to the participant and researcher, but each element will be explained fully before proceeding.

13. Will I have to use a computer for any of the tests at the health check?

Yes, some of the tasks performed at the appointment will be displayed on a computer. Each of the tasks will be thoroughly explained and demonstrated by the researcher before starting and you don't have to know anything at all about computers to be able to complete these tasks. As a computer is used, it may be beneficial to bring with you the glasses that you would normally wear when viewing a computer screen should these be different from the glasses you wear for reading or distance.

14. What results are available after I've had a health check?

Your results are not available on the day of your appointment as they are not released until all quality control checks have been carried out. Approximately six weeks after your appointment you will be sent a copy of your body composition (DEXA results). This copy will show your regional fat distribution, fat mass and overall fat percentage, and your average blood pressure result calculated from the two measurements taken at your appointment. You will also receive a copy of your physical activity results (step count) relating to the seven days you were wearing an activity monitor. The report we send directly to you will not contain your bone mineral density results (BMD) as these, along with your blood pressure results, will be sent directly to your GP.

15. Why can't the participants be notified of the bone density (BMD) results from the DEXA scan?

The DEXA scan carried out during your EPIC health check is a total body DEXA scan and this result alone is not routinely used to diagnose low bone density (osteoporosis) in an individual. We provide the result to your GP as they have access to additional health-related information contained in your medical records and can assess whether there is a clinical justification to refer you for a clinical diagnostic scan of the spine and hip.

16. Why can't I have the results of all of the tests carried out at the health check?

In addition to the explanation above regarding bone density results, many of the tests we carry out are research tools only and are not considered as clinical diagnostic tests. We are not able to provide the results of these particular tests because they do not currently have a defined medical meaning e.g. cognition and memory test results.

17. Why doesn't EPIC carry out a hearing test as part of the Fifth Health Check?

We acknowledge that this would be a useful test, but unfortunately the conditions within the clinic are unsuitable at the present time to guarantee accurate testing. In addition to this, we have to decide on a research strategy at each phase of the study and hearing is not included in this phase. However, it may well be included in future phases.