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Historic Kaiser Permanente Data to Aid in Long-Term Study to Determine Extent of Ethnic Disparities in Brain Health and Dementia

New $13 million study funded by National Institute on Aging will revisit patients who were first screened as long as 50 years ago

July 13, 2016



man at doctor office talking to female doctor

OAKLAND, Calif. — A new five-year, $13 million Kaiser Permanente study will revisit physical exams undertaken from the 1960s through the 1980s to evaluate how risk factors in early and mid-life have affected brain health and dementia risk among a large, ethnically diverse cohort of seniors.

The Kaiser Permanente Northern California Division of Research will partner with the University of California Davis Alzheimer’s Disease Center to undertake state-of-the-art brain imaging and cognitive testing of study participants, with funding from the National Institute on Aging.

“This study is like time travel, allowing us to look at risk and protective factors for cognitive decline throughout one’s life,” said Rachel Whitmer, PhD, principal investigator of the new study and research scientist with the Kaiser Permanente Northern California Division of Research. “We’ll be able to analyze how factors such as midlife vascular health, psychosocial conditions, and early-life growth indicators have influenced brain health and dementia risk among current members of Kaiser Permanente.”

In particular, researchers aim to explore how early-life conditions may play a role in racial and ethnic differences in dementia rates and risk factors for cognitive decline, an area that has not been well studied.

An old black and white photo where two nurses greet a man with a clipboard while another man looks on

A longshoreman is greeted by staff of the Kaiser Permanente multiphasic health screening program in 1961.

The older data will be pulled from the world-renowned multiphasic exam, which Kaiser Permanente Northern California began using in the early 1950s. The exam involved screening individuals for certain chronic illnesses early and identifying them early in their course. In the 1960s, medical professionals began administering the battery of tests to members in an automated, efficient routine. The results were analyzed in bulk by computer, which allowed doctors to spot trends in community health and work to address public health risks.

Later this year, the KHANDLE study (Kaiser Healthy Aging and Diverse Life Experience) will begin enrolling a total of 1,800 white, black, Asian and Latino Kaiser Permanente members, equally divided among the four ethnicities, who participated in the multiphasic exam. All study participants must be over age 65 and not have a current diagnosis of dementia.

To evaluate brain health and Alzheimer’s and dementia risk, Kaiser Permanente researchers will conduct comprehensive medical and cognitive evaluations of study participants, and the UC Davis Alzheimer’s Disease Center researchers will provide magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.

“The bulk of what is known about early-life risk factors for dementia and brain pathology is from studies of highly educated whites,” said Dan Mungas, PhD, professor of neurology at UC Davis. “This study will fill a much needed gap in understanding dementia and brain aging in a group that is representative of the aging U.S. population.”

This new study is part of Whitmer’s ongoing body of research at Kaiser Permanente to better understand the risk and protective factors for dementia. Whitmer has used the multiphasic data, paired with comprehensive data from Kaiser Permanente’s electronic health record, to identify midlife dementia risk factors such as smoking, hypertension, depression, cholesterol, obesity and others.

Whitmer noted that the funding will allow Kaiser Permanente to establish a long-term study that is similar in scope to the now nearly 60-year-old Framingham Heart Study in Massachusetts, which has redefined what is known about early-life risk factors for dementia and heart disease.

About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 550-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit www.dor.kaiser.org or follow us @KPDOR.

About the UC Davis Alzheimer’s Disease Center
The UC Davis Alzheimer’s Disease Center is one of only 27 research centers designated by the National Institutes of Health’s National Institute on Aging. The center’s goal is to translate research advances into improved diagnosis and treatment for patients while focusing on the long-term goal of finding a way to prevent or cure Alzheimer’s disease. Also funded by the state of California, the center allows researchers to study the effects of the disease on a uniquely diverse population. For more information, visit www.ucdmc.ucdavis.edu/alzheimers.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10.6 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.