Project

Discipline

multimorbidity; environment; lifestyle; aging; population based ; biobank; non-communicable disease; genomics; inflammation; personalized health; exposome; methylome

Lead
SAPALDIA - Citizen Kohorte und Biobank zum gesunden Altern
Lay summary
SAPALDIA ist die einzige schweizweite Citizen Kohorte mit assoziierter Biobank. Über einen Zeitraum von 25 Jahren wurden die Studienteilnehmer  viermal befragt und untersucht. Sie spendeten wiederholt Bioproben (DNA; Blut, Urin; Stuhl). Diese reichen Langzeitdaten sind unersetzlich für die Forschung zu chronischen Krankheiten und Alterungsprozessen. Zusammen mit Biomarkern fördern sie das Verständnis zu ursächlichen Krankheitsrisiken. SAPALDIA Daten erlauben eine Abschätzung der mit Umwelt und Lebensstil verbundenen Gesundheitstkosten und eine Beurteilung der Qualität mit der Krankheiten behandelt werden. In den nächsten 3 Jahren wird das SAPALDIA Forschungsteam einerseits den Kontakt zu den Studienteilnehmern aufrecht erhalten, um zu erfahren welche Symptome und Krankheiten sie entwichkeln. Desweiteren werden die reichen verfügbaren  Daten für spezifische Forschungsprojekte im Bereich gesundes Altern und Multimorbidität genutzt. Und schliesslich überprüfe zwei Interventionsstudien, was der Einfluss internetbasierten Gesundheitsempfehlungen auf das Verhalten ist und ob eine frühzeitige medikamentöse Behandlung von Erkältungen bei COPD Patienten den Krankheitsverlauf positiv beeinflusst.

Direct link to Lay Summary

Last update: 08.05.2018

Natural persons

Number	Title	Start	Funding scheme

By the end of March 2018, the SAPALDIA team has built a nationally and internationally exceptional resource for studying the origins and consequences of single diseases, multimorbidities, and aging. On 4 occasions (S1 1991; S2 2001; S3 2011; S4 2016-18) over a course of 25 years the study’s participants were characterized in depth during health examinations and interviews. The rich data is connected with a state-of-the-art biobank consisting of high quality blood, DNA (with genome- & methylome-wide data), urine, and stool aliquots. The long-term and longitudinal data from Swiss citizens - the only Swiss-wide biobank still - is irreplaceable for etiological research, particularly in the domain of non-communicable diseases (NCDs) which develop by accumulating molecular damage over years and decades due to a mix of exposures. Many of these risks cannot be studied through interventional or Mendelian Randomization approaches. The general population study’s longitudinal design and data also allow investigating the clinical and economic consequences of chronic environmental and lifestyle risks as a contribution to smarter health system planning. SAPALDIA will maintain, apply, and enrich its information towards generating evidence that supports citizens in “growing older without growing old” and policy makers in promoting healthy aging and providing quality care at adequate costs. Building on its success SAPALDIA will continue working in 3 domains DOMAIN 1 SAPALDIA maintenance: We will preserve the study’s research and public health potential by continuously updating address, geocodes and geo information, life status, and causes of death. We will remain in regular contact with participants in the context of newsletter mailings and follow-up activities, thereby updating also consent information. We have previously set the stage for open data access by building a unique research database with a meta-layer accessible and searchable via a web-application. In the context of S5 follow-up and TwiC we will create a modern software solution and mobile application which integrates with the existing SAPALDIA participant management, address, and research data tools and sets the stage for epidemiological data capturing in the era of personalized health.DOMAIN 2 Analytical maintenance: We aim to understand how physical and psycho-social environments and behavior influence the aging of persons and organism over a period of 25 years. We will interrogate risk causality and mediating biological mechanisms by making use of the rich biomarker information in the context of targeted and agnostic studies, including Mendelian Randomization studies if valid genetic instrumental variables exist. We will investigate how health systems, providers and patients deal with chronic diseases and multimorbidities and how this relates to aging phenotypes, quality of life and well-being. We will systematically assess which components of the 25 year exposome and phenome, quality of care and quality of life are predictive of increased health and social service use to derive estimates for the economic impact of preventive strategiesDOMAIN 3 - S5 Follow-up including implementation of TwiCs :In the context of a pre- and post-intervention questionnaire (yr 1 & yr 3) and monthly reports obtained via a mobile application (yr 2) we will update health, symptom, treatment, and service use information. The follow-up will be combined with 2 interventions. First, all subject receive the link to the Swiss Heart Coach, a web-based and interactive cardiovascular education and coaching program for citizens and patients, developed by the Swiss Heart Foundation. We will evaluate determinants and health benefits of its regular use. Second, in the context of a randomized study we will assess the impact of common colds and the effect of inhaled medication on COPD exacerbation, related symptoms and physical activity.The SAPALDIA cohort data - in its visionary design over 25 years - is immensely useful for the Swiss Personalized Health Initiative and several calls in the Horizon 2018-2020 work program draft (e.g. understanding causative mechanisms in co-morbidities; human microbiome for personalized prediction and prevention of disease; endocrine disruptors - research for better regulation and improved understanding of health effects). We identify gaps and at-risk groups in meeting existing COPD, CVD and diabetes guidelines. We produce data to contribute to guideline improvement and development related to respiratory health and multimorbidity. The added health economic perspective on the rich SAPALDIA data allows for an integrated cost-for-illness and cost-for-disability evaluation of risk patterns.