New News From the Adult Changes in Thought Study: A Long-Standing Living Laboratory of Aging Funded for Five More Years
Background/Aims: Delivery system-based research in enumerated populations provides a unique opportunity to study complex chronic diseases as they develop. Studies of disorders that affect people late in life can be particularly valuable. The Adult Changes in Thought (ACT) study was recently awarded five more years of funding. This makes ACT one of the longest continually funded studies and establishes it as a preeminent living laboratory for aging research.
Methods: Originally a joint project between Group Health and the University of Washington, the ACT study recruited a cohort of randomly selected Group Health enrollees over age 65 without dementia from 1994 to 1996. Initially 2,581 persons were recruited, but in response to cohort shrinkage over time, we developed expansion and ongoing replacement strategies to maintain a currently active cohort of approximately 2,000 living persons who are followed every 2 years. The original outcomes of interest in ACT were Alzheimer’s disease and related dementias based on standardized diagnostic methods supplemented by neuropathologic outcomes. This funding cycle we’ve added a new outcome “resilience” to specifically study persons who defy expectations by avoiding cognitive decline and frailty well into late life.
Results: ACT has enrolled over 5,000 subjects to date and includes over 1,000 cases of incident dementia (over 70% Alzheimer’s disease) and over 600 autopsy cases, of which about half have extensive frozen tissues from a rapid autopsy protocol. The laboratory now includes a biobank with a vast array of genomic information along with a population-based neuropathology biobank that is unique worldwide. The new funding cycle will include state-of-the-art measures of physical activity (e.g. accelerometers, inclinometers) to determine how physical activity and sedentary time affect outcomes, especially resilience, and also include unique neuropathologic markers (synaptosomes and histelide) to better understand brain aging. ACT has always supported other investigations, and we are well equipped to support HCSRN scientists who wish to use our living learning laboratory of aging.
Conclusion: The long-running ACT study in the new funding cycle will focus on the science of aging and multimorbidity, understanding resiliency and robust aging, and sharing data from our extensive data repository for other studies of interest.
Larson EB, Aiello Bowles EJ, Walker RL, Anderson ML, White D, Richmire K, Lee WW, Balch SL, LaCroix AZ, Rosenberg D, Dublin S, Crane PK. New news from the Adult Changes in Thought study: a long-standing living laboratory of aging funded for five more years. J Patient Cent Res Rev. 2016;3:170-1.