Project

Discipline

Public Health ; Cardiovascular diseases ; Cardiovascular risk factors ; Mental disorders; Genetics; Epidemiology

Lead
CoLaus|PsyCoLaus est une étude de cohorte prospective dans la population de Lausanne conçue pour investiguer les mécanismes qui sous-tendent la fréquente co-apparition des maladies cardiovasculaires (MCV), des facteurs de risque cardiovasculaires (FRCV) et des troubles psychiatriques.
Lay summary
Objectifs: Réévaluer ce large échantillon communautaire qui a déjà été investigué une première fois sur le plan somatique, psychiatrique et génétique entre 2003 et 2008 et lors de deux évaluations de suivi entre 2009 et 2017. La récolte d’informations du troisième suivi (prévu pour 2018-2020) sera cruciale pour répondre à trois questions principales: Est-ce que les troubles psychiatriques augmentent la vulnérabilité aux MCV et FRCV? Est-ce que les MCV, les FRCV ou leur traitement augmentent le risque de développer des troubles psychiatriques? Est-ce que les MCV, les FRCV et les troubles psychiatriques ont des facteurs pathogéniques en commun? Les résultats des trois premières investigations ont été publiés dans plus de 390 articles dans des revues scientifiques. Tous les sujets de l’échantillon de base (n=6734 sujets âgés de 35 à 75 ans au départ) seront invités à participer au troisième examen de suivi physique et psychiatrique. En plus des évaluations déjà effectuées qui seront répétées, le troisième suivi permettra de récolter de l’information sur les manifestations psychopathologiques apparues depuis le deuxième suivi, d’ajouter des mesures sur le taux de variabilité de la fréquence cardiaque et un questionnaire sur les dépenses des participants en matière de santé. Contexte scientifique et social : Des connaissances plus avancées sur les liens entre ces troubles permettront le développement de stratégies de prévention et de traitement plus spécifiques et efficaces.

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Last update: 28.03.2018

Natural persons

Active participation

Number	Title	Start	Funding scheme

Background: Despite scientific progress in the last years, the mechanisms underlying the frequent co-occurrence of cardio-vascular diseases (CVD) or risk factors (CVRF) and mental disorders still need to be elucidated. Aims: to re-assess a large population-based sample, which already underwent a comprehensive physical, biochemical, psychiatric and genetic (GWAS) baseline investigation as well as two physical and psychiatric follow-up evaluations, in order to continue to prospectively assess the complex associations between CVD, CVRF and mental disorders. The collection of additional follow-up information will be crucial to address these questions:Research questions: 1) Do mental disorders increase vulnerability to CVRF, CVD and cognitive impairment? 2) Do CVRF and CVD promote the development of mental disorders or cognitive impairment? 3) Do CVRF/CVD and mental disorders share common pathogenetic processes?Methods: We propose to perform a comprehensive third follow-up (FU3) assessment of CVRF and CVD as well as a psychiatric evaluation in all willing subjects of the original CoLaus sample aged 35 to 75 years at recruitment, which took place between 2003 and 2006. At baseline, the first (FU1 2009-13) and the second follow-up (FU2 ongoing since 2015), participants were invited to undergo both an extensive somatic and psychiatric evaluation. Among the 6734 participants recruited at baseline 75.2% took part at FU1 and still 72.5% at FU2, whereas 6.3% of the original sample died. The proportion of subjects with at least one physical and one psychiatric evaluation is 73.8%. The results of the baseline and FU1 evaluations have already led to the publication of more than 354 peer-reviewed papers. The FU3 is planned for 2018 to 2020. Similar to FU2, the physical FU3 (expected sample size: 4200 subjects) will include the collection of information on the incidence of CVRF or CVD since FU2 and on the course of CVRF diagnosed at previous assessments. In the case of a new CVD event or death, detailed information will be elicited from medical records or from the Swiss National Death Registry. The psychiatric FU3 (expected sample size: 3300 subjects) will include the collection of information on psychopathological manifestations since FU2 and a screen for cognitive impairment (subjects = 65 years). In addition to the measures of the previous evaluations, which will be repeated, the FU3 will allow us to add a measure of heart rate variability and the collection of stools for microbiota profiling. Moreover, health economic data on all participants will be elicited through questionnaires and the participants' summary accounts of health expenditures from their health insurer.Main expected outcome: CoLaus/PsyCoLaus provides a unique opportunity to prospective study the interplay between CVRF/CVD and mental disorders. The proposed FU3 will allow us to 1) better disentangle the temporal relationship between CVRF/CVD and mental disorders and their associations with biological, clinical, behavioral and environmental factors by gaining information from a third data point, 2) collect more data on outcomes such as CVD events or deaths, which were still relatively rare at FU2, in order to increase the statistical power to test our hypotheses regarding these outcomes, 3) prospectively assess the associations between measures introduced in FU2 and mental outcome variables at FU3, 4) add complementary measures, and 5) extend the recruitment to a cohort of the participants' offspring in the age range of 15 to 35 years in order to study the interplay between cardio-metabolic risk factors and mental disorders in early adulthood.Potential relevance: 1. Increased knowledge of the links between CVRF/CVD and mental disorders will result in the development of more specific and efficient strategies of prevention and treatment of both psychiatric disorders and CVD/CVRF. 2. A deeper understanding of the course of mental disorders and CVD/CVRF and their determinants will increase prognostic accuracy and provide an important empirical basis for nosology. 3. The collection of data on service utilization health expenditures will provide important information for the development of health policy addressing prevention and care in aging populations.