Mind Your Elders

Mind Your Elders Over the next 2 decades, Canadian scientists will collect and analyze samples from 50,000 people as they age, to figure out how to make the process easier for everyone else. Canada, like every other developed nation, is going gray. Next year, the first baby boomers across Canada will celebrate their 65th birthdays. Seniors are Canada’s fastest-growing age group, and as the years go by, the country’s population will continue to get grayer. By 2015, Canada will for the first time in history have more seniors (65 and older) than youth (under 15). By 2031, one in every four Canadians will be 65 years or older. And thanks to one of the highest life expectancies in the world, by 2065 one in every 10 Canadians will be over 80 years old. Despite the recognition that aging is a multifaceted process involving biological, social, economic, and environmental factors, scientists still see only a blurry picture of how such factors gradually affect an individual life, much less a society. With more information, researchers might be able to improve both the quality and length of life. In November 2001, scientists and policymakers from across the country gathered in Aylmer, Québec to discuss the graying of Canada’s population. “Talking to the research community, we realized we lacked a database of longitudinal research nationally,” says Anne Martin-Matthews, director of the Institute of Aging at the Canadian Institutes of Health Research (CIHR). Despite a relatively small aging research community in Canada, the Institute of Aging jumped in the deep end to sponsor a coast-to-coast longitudinal study called the Canadian Longitudinal Study of Aging (CLSA). The goal of the study is to go beyond traditional questionnaire-based surveys, a staple of longitudinal studies around the globe, and look at the process of aging from “cell to society,” says Parminder Raina, an epidemiologist at McMaster University in Hamilton, Ontario, and lead investigator of the CLSA. Following a successful feasibility study and pilot study completed in December 2008, the CLSA received $23.5 million from CIHR for the study’s first wave of recruitment and data collection. The research platform is unique in both its breadth and depth. Every 3 years for at least 20 years, the project will measure biological, clinical, lifestyle, and social factors in a random sample of 50,000 Canadians aged 45 to 85. Thirty thousand of the 50,000 will also be given extensive physical examinations, including blood and urine samples and body scans every 3 years. “We are putting Canada and population health sciences on the map,” says Raina. By 2065, one in every 10 Canadians will be over 80 years old. To fulfill this mission, the CLSA will require an extensive infrastructure, slated to begin construction in the end of 2010, says Raina. The planned facilities will be funded by a $26 million infrastructure grant from the Canada Foundation for Innovation that has been matched by many provinces. They will include a biobank to store samples for the next 25 to 30 years, a high-throughput lab for biomarker analysis, an extensive IT infrastructure, an epigenetic center, and a statistical analysis center. For the physical examinations, 11 data collection sites will be built across the country, each designed to condense 3 to 4 hours of testing—including full-body bone density scans, electrocardiograms, and neuropsychological testing—into about 90 minutes. In March, the CLSA began the recruitment of the first 13,500 participants with the help of Statistics Canada, the country’s national statistics agency. Data collection will not begin until 2011. “It’s a very ambitious undertaking,” says David Weir, director of the University of Michigan Health and Retirement Study (HRS), who participated in an early CLSA planning meeting. “The sample sizes they’re talking about are really enormous. It will be spectacular if they deliver on that.” The CLSA is unique not only for its size but also for its breadth. A large proportion of Canadians are immigrants from more than 200 different countries, making it one of the most ethnoculturally diverse countries on Earth, so the results will likely be widely applicable, says Martins-Matthews. And thanks to Canada’s universal health care, the CLSA will link to health administration databases, such as hospital databases and public drug plans, to accrue additional data on volunteers, including medication histories. “Canada is the perfect playground for this kind of research,” says Michael Hayden, director of the Centre for Molecular Medicine and Therapeutics at the University of British Columbia and a CLSA working group leader. Hayden joined the CLSA not because of the size of the study but because of its length. “The cohort is a unique opportunity to follow the evolution of markers in the same individual,” says Hayden, who will quantify changes in gene expression and epigenetics over time to pinpoint genetic factors involved in aging. The platform also gives researchers the rare opportunity to study healthy people. “I’m interested in those people who don’t normally come into clinics,” Hayden notes. Though the CLSA is unique in many ways, it will share a number of the challenges of other longitudinal studies: harmonizing data with longitudinal studies around the world, tracking volunteers as they move around the country, storing biological samples over decades, protecting the privacy of volunteers, and adapting to each new wave of data collection. “As hard as you think it is to get going on wave one, wave two is even harder,” warns Weir. But above all, the CLSA may need to be conscious of its pricetag. “I think the budget is underestimated,” says Luigi Ferrucci, director of the Baltimore Longitudinal Study on Aging, an ongoing study since 1958 that has enrolled over 3,000 people from ages 18 to 105. “They don’t realize now how expensive it will be.” The Baltimore study, much smaller in size than the CLSA, costs “many millions of dollars every year,” says Ferrucci. CLSA investigators recognize the challenge. “We have funds right now to set this up…but we have to make sure investments don’t fall off. We need a long-term commitment,” says Hayden. Funding is not taken for granted, says Martin-Matthews. “The hard work is really just beginning,” she agrees. If they find the money, the study will be fantastic, adds Ferrucci. “We need to know what is happening to us [as we age],” he says. “A longitudinal study is our way of looking at our society, in a way that otherwise would not be possible.” CLSA STATS AT A GLANCE Regional data collection centers: 11 Researchers: 160 Expected length: 20+ years Funding (to date): $50 million USD ($24 million from CIHR; $26 million from CFI) Volunteers: 50,000 Age range: 45 to 85

Mind Your Elders

Mind Your Elders

Over the next 2 decades, Canadian scientists will collect and analyze samples from 50,000 people as they age, to figure out how to make the process easier for everyone else.

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Megan Scudellari

Published In

December 2010

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