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This page last changed on 03.02.2015 by kkuk.
Link to EPIC Elderly cohort description
Contact person(s) for the cohort description
Antonia Trichopoulou, Christina Bamia, Philippos Orfanos and Vicky Benetou
Partner
Hellenic Health Foundation (HHF), Partner No 1, National and Kapodistrian University of Athens (UoA), Partner No 2
Institute
Hellenic Health Foundation (HHF) and National and Kapodistrian University of Athens (UoA)
Key personnel for CHANCES
Responsible person: Antonia Trichopoulou
Other Key personnel: Christina Bamia, Philippos Orfanos, Vicky Benetou
Funding
The Hellenic Health Foundation
Definition of the cohort
Target population
Apparently healthy Greeks, men and women, aged 60 years and above.
Recruitment
A total of 28,572 volunteers, 20-86 years old, were recruited from all regions of Greece during 1994-1999. After signing the informed consent form, each EPIC participant underwent a baseline examination, during which an extensive interviewer-administered questionnaire was completed, anthropometry and blood pressure measurements were performed and a blood sample was collected. Information on various sociodemographic variables, medical history, lifestyle and dietary habits was recorded in the questionnaire.
Years of recruitment
1994-1999
Size of the cohort
In total 9,863 elderly individuals from Greece.
Recontacts
Period
1st Follow-up round: 1997-2002.
2nd Follow-up round: 2002-2007.
3rd Follow-up round: 2007-2011.
4rth Follow-up round: 2011-ongoing
Approach
Follow-up questionnaires completed through telephone interviews conducted by trained personnel. Follow-up started approximately 2 years after the date of recruitment. The measurements and information collected during each recontact are the same. The only change refers to nutritional data. Information on changes related to diet started to be recorded during the 2nd recontact and continued thereafter.
Measurements at baseline and recontacts
| Socioeconomic |
Baseline |
Recontact 1 |
Recontact 2 |
| Education |
Yes |
No |
|
| Income |
No |
No |
|
| Marital status |
Yes |
Yes |
|
| Occupation |
Yes |
No |
|
| Employment status |
Yes |
Yes |
|
| History of |
Baseline |
Recontact 1 |
Recontact 2 |
| Diabetes |
Yes |
Yes |
|
| Dyslipidemia |
Yes |
Yes |
|
| Coronary heart disease |
Yes |
Yes |
|
| Stroke |
Yes |
Yes |
|
| Cancer |
Yes |
Yes |
|
| Benign neoplasms |
Yes |
Yes |
|
| Fracture |
Yes |
Yes |
|
| - Which site(s)? |
No |
Yes |
|
| Osteoporosis |
Yes |
Yes |
|
| Family history of |
Baseline |
Recontact 1 |
Recontact 2 |
| Coronary heart disease |
Information available but not ready to be used (not inserted in the database) |
No |
|
| Stroke |
Information available but not ready to be used (not inserted in the database) |
No |
|
| Diabetes |
Information available but not ready to be used (not inserted in the database) |
No |
|
| Cancer |
Information available but not ready to be used (not inserted in the database) |
No |
|
| Lifestyle |
Baseline |
Recontact 1 |
Recontact 2 |
| Current smoking |
Yes |
Yes |
|
| Past smoking |
Yes |
Yes |
|
| Alcohol use |
Yes |
Yes |
|
| Physical activity |
Yes |
Yes |
|
| Nutrition (yes/no) |
Yes |
No |
Yes |
| - Number of food items available (approximately) |
Approximately 200 food items (simple foods and complex recipes) and 15 items of non alcoholic and alcoholic beverages. |
- |
Changes in the frequency of consumption compared to the baseline examination is recorded for 13 food groups and non-alcoholic beverages, as well as, alcohol. |
| - Method(s) of dietary assessment (e.g. 24h-recall, food frequency questionnaire, dietary records) |
Semi-quantitative food frequency questionnaire on the whole study population and a 24h-recall in a random sub-sample of the study population. |
- |
Not a structured method employed. |
| - Supplement use |
Yes |
Yes |
Yes |
| Anthropometry |
Baseline |
Recontact 1 |
Recontact 2 |
| Weight and height |
Yes |
Yes |
|
| - Measured or self-reported |
Measured |
Self-reported |
|
| Unintended weight loss |
|
Yes |
|
| Waist circumference |
Yes |
No |
|
| - Measured or self-reported |
Measured |
|
|
| Hip circumference |
Yes |
No |
|
| Measured or self-reported |
Measured |
|
|
| Blood pressure |
Baseline |
Recontact 1 |
Recontact 2 |
| Measured blood pressure |
Yes |
No |
|
| History of hypertension |
Yes |
Yes |
|
| Blood tests |
Baseline |
Recontact 1 |
Recontact 2 |
| Total cholesterol |
Yes |
No |
|
| HDL cholesterol |
Yes |
No |
|
| Triglycerides |
No |
No |
|
| - Fasting period |
Yes |
No |
|
| ApoA1 |
No |
No |
|
| ApoB |
No |
No |
|
| Glucose |
No |
No |
|
| - Fasting period |
No |
No |
|
| Glucose tolerance test |
No |
No |
|
| HbA1c |
No |
No |
|
| GGT |
No |
No |
|
| CRP |
No |
No |
|
| 25-Hydroxy-Vitamin D |
No |
No |
|
| Other tests (specify) |
No |
No |
|
| Availability of frozen sera for further analysis |
Yes |
No
|
|
- Storage temperature (°C) of sera
|
-196 |
|
|
| Availability of frozen plasma for further analysis |
Yes |
No
|
|
- Storage temperature (°C) of plasma
|
-196 |
|
|
| Genetics |
Baseline |
Recontact 1 |
Recontact 2 |
| Genotypic data |
No |
No |
|
| GWAS (specify) |
No |
No |
|
| Other high-throughput array data (specify) |
No |
No |
|
| Availability of DNA for further genotyping |
Yes |
No |
|
| Plated DNA |
No |
|
|
| Otherwise stored DNA |
Buffy coat |
|
|
| Other measurements |
Baseline |
Recontact 1 |
Recontact 2 |
| Perceived health |
Yes |
No |
|
| Cognitive decline/dementia |
No |
Yes (one question). The Mini-Mental State Examination (MMSE) was administered in a sub-sample of the population aged 60 years and above (approximately 816 participants) |
|
| Depression |
Yes, one question referring to depression at the baseline questionnaire. |
Yes (one question). The Geriatric Depression Scale was administered in a sub-sample of the population aged 60 years and above (approximately 816 participants). |
|
| Grip Strength |
No |
No |
|
| Lung function |
No |
No |
|
| Audiometry |
No |
No |
|
| Measurement of bone density (DEXA) |
No |
No |
|
| Quality of life instruments (such as SF-12, EUROQoL) |
No |
No |
|
| Limitations in ADL/IADL (i.e. Activities of daily living/Instrumental activities of daily living) |
No |
No |
|
| Multimorbidity instruments (such as CIRS-G) |
No |
No |
|
| Frailty scales |
No |
No |
|
| Reproductive history (for women) |
Yes |
Yes |
|
| Menstruation and menopausal status |
Yes |
Yes |
|
| Fertility problems |
Yes |
No |
|
| Pregnancies |
Yes |
Yes |
|
| Breast feeding |
Yes |
No |
|
| Hysterectomy and ovariectomy |
Yes |
Yes |
|
| History of oral contraceptive use |
Yes |
Yes |
|
| History of menopausal hormones use |
Yes |
Yes |
|
| Current use of exogenous hormones |
Yes |
Yes |
|
| Use of drugs |
Yes |
Yes |
|
| Availability of classification of drugs, specify (e.g. Anatomical Therapeutic Chemical(ATC) classification system) |
Yes, ATC code |
Yes, ATC code |
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Future recontacts
4rth Follow-up round: 2011- is ongoing.
Other follow-up
Follow-up period
Active follow-up is conducted continuously from 1997 and onwards.
Sources of data
1) Death certificates from national and regional death registries.
2) Hospital Discharge records from hospitalized patients.
3) Medical records of hospitalized patients
Follow-up procedure
All medical conditions diagnosed by a doctor are reported during a telephone interview conducted by trained personnel and recorded in the follow-up questionnaire. The self-reported endpoints of interest (e.g cancer and cardiovascular disease) are further ascertained and verified through active follow-up methods, meaning visits to the hospitals for the acquisition of medical records, pathology reports or hospital discharge records. Deaths and causes of death are verified through the contact with regional and national death registries.
End-points covered through the follow-up
- All deaths: Yes
- Specification of the cause: Yes (immediate, intermediate and underlying causes of death are availabale)
- Non-fatal cancers: Yes
- Non-fatal acute coronary events: Yes
- Non-fatal stroke: Yes
- Non-fatal diabetes: Yes
- Fractures: Yes
- Cognitive impairment/dementia: Yes
- Nursing home admission: No
ICD-version used for classification of diseases in the data
ICD-10 is used for the classification of the causes of death and ICD-O-2 for the classification of non-fatal cancers.
References
Bamia C, Halkjær J, Lagiou P et al. Weight change in later life and risk of death amongst the elderly: the European Prospective Investigation into Cancer and Nutrition-Elderly Network on Ageing and Health study. J Intern Med 2010 Jan 28. [Epub ahead of print]
Riboli E, Hunt KJ, Slimani N et al. European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 2002 Dec;5(6B):1113-24
Trichopoulou A, Bamia C, Norat T et al. Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study. Eur J Epidemiol 2007;22(12):871-81
Trichopoulou A, Orfanos P, Norat T et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 2005 Apr 30;330(7498):991
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