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Epidemiology, Demography and Biometry Program National Institute on Aging, National Institutes of Health, USA

Richard Havlik, M.D., M.P.H. Associate Director

Learning Objectives:
• To become familiar with the epidemiology programs of the National Institute on Aging (NIA) • To understand the investigations being conducted by the Epidemiology, Demography, and Biometry (EDBP) Program, part of the Intramural Research Program, (NIA) • To be aware of data resources available for the study of the epidemiology of aging and age-associated diseases

Performance Objectives:
• Monitor appropriately and update knowledge regularly concerning epidemiology programs at the NIA • Become more knowledgeable about the epidemiology of aging and age-associated diseases by accessing information from the EDB Program, NIA • Begin to access data sets available at the National Archive of Computerized Data on Aging and use for relevant epidemiologic analyses

National Institute  on Aging

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18 16


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31,559,000 25,704,000 12,397,000 6,459,050

8 6 4 2 0

1900 10









2000 10 20 30 Projected

Epidemiology, Demography, and Biometry (EDB) Program Primary Mission:
To conduct research on aging and ageassociated diseases and conditions using population-based epidemiologic and biometric methods

EDP Program Part 1
Epidemiology, and Demography Office • Chronic Diseases • Aging Processes • Environmental, Social, and Behavioral Factors Neuroepidemiology of Aging Office • Dementing Processes • Risk Factors for Dementia • Other Neuropsychiatric Diseases

EDB Program Part 2
Geriatric Epidemiology Office • Gerontological Issues • Biomedical and Comorbidity Factors • Genetic and Metabolic Factors Biometry Office • Methods • Statistics • Data Management

Utility of EDB Program Studies
• Elucidate the etiology of diseases by combining epidemiologic data with information from other disciplines. • Evaluate the consistency of epidemiologic data with etiologic hypotheses developed either clinically • or experimentally. developing and Provide the basis for evaluating preventive new procedures and public health practices.

Key Guiding Research Principles
Studies should: • Be platforms for hypothesis –driven research • Be population based to minimize bias and maximize relevance • Be longitudinal in nature to minimize cross-sectional biases • Address a wide range of psychosocial and biomedical issues, including the incorporation of emerging biological and genetic opportunities • Attempt to secure data from earlier in life to assess long-term influences • Take advantage of racial diversity and unique populations for investigation

EDB Program Targets
Behavior\ Environment

AgeAssociated Diseases & Conditions Cognitive Physical Function Function & & Disability Dementi a Genetics

EDB Program: Targets of Studies

Physical Cognitive Diseases & Genetics/ Behavior/ Function &Function & Conditions Poly- EnvironDisability Dementia morphisms ment
 X  X  X  X X X X X   X  X  X     X   

X EPESE  HAAS X WHAS VSMA X HEALTH ABC ACT  AGES - Hawaii (Diabetes) AGES - Reykjavik (Iceland) 

X = Primary Focus

 = Secondary

EDB Program: Major Studies








EPESE HAAS WHAS VSMA HEALTH ABC ACT AGES - Hawaii (Diabetes) AGES - Reykjavik (Iceland)

Established Populations for Epidemiologic Studies of the Elderly (EPESE)
East Boston, 1982-83 Senior Health Project (N=3809)
Epidemiology, Demography, and Biometry Program (EDBP) National Institute on Aging (NIA)

Iowa 1982 85+ Rural Health Study (N=3673) New Haven 1982 Yale Health and Aging Project (N=2812) North Carolina 1986-87 Piedmont Health Survey of the Elderly (N=4163)

EPESE Study Design
Sample: Total or random samples of community populations of men and women age 65 and over Number of Participants at Baseline: 14,450 Follow-up: In-home interview 3-year intervals,brief telephone contact intervening years. Blood work and performance measures. (Original sites 1982-83 to 1989) (Duke 1986-87 to 1993) Surveillance with Medicare and

Women’s Health and Aging Study
Focus: Causes and Course of Disability
• Screened 5000 for 1002 Disabled Older Women in Community • Assessment of Baseline Disease-Disability Associations • Follow-up for Course and Outcome over 5 years

Honolulu-Asia Aging Study
• A Study of Dementia in Honolulu Heart Program Participants • 3734 Japanese-American Men Aged 70-90 years • 25 Years of Prospective Data Available, Focused on Cardiovascular Disease and Other Risk Factors • Completed Dementia Re-examinations at 3, 5 and 7 Years; On-going Examination Cycle • Coordinate Methods with Studies in Japan, Seattle

Health, Aging and Body Composition (Health ABC)
Design: Clinical research study 3,075 persons age 70-79 Comparable numbers of women and men Comparable numbers of whites and African-Americans Free of ADL disability Free of functional limitation Outcome: New onset of functional limitation Decline in performance, strength and endurance Follow-up: even years with yearly examinations S

Country-to-Country Activities
Collaboration with: • MRI Study in 10 European Communities (study of Cardiovascular Determinants of Dementia-CASCADE) • Honolulu-Asia Aging Study (dementia in JapaneseAmerican men) and with similar studies in Seattle, Washington and Hiroshima, Japan (Ni-Hon-Sea Study) • Aging project of the Veneto Region (PROVA Study) using protocols similar to those of EDB Program • Italian Longitudinal Study on Aging (ILSA) has cohort under observation since 1991

Planned Collaboration with the Iceland Heart Association Reykjavik Study Scientific strategy: Characterize study participants with detailed phenotypes for: Neurologic diseases (cognition, Alzheimer’s and Parkinson’s), atherosclerotic status, diabetes and hyperglycemia, obesity and body composition, and Collect DNA and other biologic specimens for molecular markers osteoporosis Add unique risk factors to the database: birthweight, childhood weight, and dietary factors Test relevant candidate genes for genetic susceptibility, gene-environment and gene-gene interaction

National Archive of Computerized Data on Aging (NACDA)
• Mission is to advance research on aging by helping researchers gain access to archived data sets. • Located at the University of Michigan and is a project of the Inter-university Consortium for Political and Social Research (ICPSR) • For further information: http://www.icpsr.