Content and Objectives

In this (cohort) study, 205,414 people between the ages of 20 and 69 recruited from all over Germany in the years 2014-2019 will be medically examined and questioned about their lifestyle habits (e.g. physical activity, smoking, diet, occupation). In addition, blood samples and other biomaterial will be taken from all study participants and stored in a central biosample bank for later research projects. After 5 years, all participants are again invited to the study centres for an examination and a second interview. In the course of the 10 to 20-year follow-up, some participants will naturally develop certain diseases that can then be linked to the data collected. The study therefore offers unique potential for a variety of scientific investigations. It will provide valuable insights into how genetic factors, environmental conditions, social environment and lifestyle interact in the development of diseases. The findings will be used to derive strategies for better prevention and treatment of the most common diseases. The third funding phase began on 1 May 2023 and will last until 30 April 2028. The donor conference consisting of the federal government and the 13 federal states with study centres sees a continuation of the NAKO Health Study as a goal.

The project also allows differentiated analyses of the health of people with a migration background. The NAKO Health Study contains two larger subpopulations: a so-called "Aussiedler cohort" with n=1,700 people with a Russian migration background and a subgroup with n=1,400 people with a Turkish migration background. This enables cooperation with BiB research area 2 "Migration and Mobility", for example, which deals with the well-being and subjective health of migrants, among other things. Furthermore, research questions on the spatial mobility of the NAKO population can be answered as part of the relocation history.

The sub-project "Mortality Follow-Up of the NAKO Health Study" at the BIB pursues three objectives: (1) a regular rolling vital status survey of all study participants; (2) for deceased subjects, the collection and validation of the cause(s) of death via the information in the death certificate and other clinical and other documentation, whereby increasingly available socio-demographic and employment-related characteristics can be linked to these cases (including the German Classification of Occupations of 2010); (3) the conceptual preparation of a non-responder mortality follow-up (subject to funding approval), whereby a statistical twin (same year of birth, same year of invitation, same gender, same study centre) is drawn from the pool of selected but not recruited addresses for each recruited and investigated case. By comparing the active cases with their statistical twins, sample bias can be recorded and the findings from the active cases can be extrapolated to the total German population.

Outstanding features of the Mortality Follow-Up include the very extensive validation procedures for cause of death information from various data sources, the support of multi-causal cause of death analyses and the direct linkability with other study parameters such as biomarkers, imaging data and other physical health parameters. The mortality follow-up research team is thus setting new standards that are also unique in international comparison.