Framework and baseline examination of the German National Cohort (NAKO)

Abstract

The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors for the development of cardiovascular diseases, cancer, diabetes, neurodegenerative and psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases in a random sample of the general population. Between 2014 and 2019, a total of 205,415 men and women aged 19–74 years were recruited and examined in 18 study centres in Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires and a wide range of biomedical examinations. Biomaterials were collected from all participants including serum, EDTA plasma, buffy coats, RNA and erythrocytes, urine, saliva, nasal swabs and stool. In 56,971 participants, an intensified examination programme was implemented. Whole-body 3T magnetic resonance imaging was performed in 30,861 participants on dedicated scanners. NAKO collects follow-up information on incident diseases through a combination of active follow-up using self-report via written questionnaires at 2–3 year intervals and passive follow-up via record linkages. All study participants are invited for re-examinations at the study centres in 4–5 year intervals. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. NAKO is a major resource for population-based epidemiology to identify new and tailored strategies for early detection, prediction, prevention and treatment of major diseases for the next 30 years.

Grip strength values and cut-off points based on over 200,000 adults of the German National Cohort - a comparison to the EWGSOP2 cut-off points

“…For this purpose, a different study was used, but this study had a much smaller sample size. Furthermore, the generalizability of the NAKO data could be limited due to the low response proportion [ 36 ] especially for younger people [ 34 ].…”

Investigating people’s attitudes towards participating in longitudinal health research: an intersectionality-informed perspective

“…They were eligible to participate in the study provided that they had been invited to participate in NAKO and either accepted or declined this invitation. NAKO had invited a random sample of German residents aged 19–74 to participate [ 57 ]. The study centres were responsible for recruitment from their databases according to the sampling criteria laid out above.…”

“…During the NAKO baseline examinations running from 2014 to 2019, a random sample of the general population consisting of 205,415 women and men aged 19–74 years was examined in 18 regional study centres across Germany. Assessments included a wide range of medical examinations, the collection of various biomaterials, an extensive interview and self-completion questionnaires (see [ 57 ] for a comprehensive description). Potential NAKO participants were randomly drawn from regional registries of residents and were recruited according to a standard recruitment protocol (see [ 46 ] for details) that included an invitation letter, followed by up to three reminder letters, each separated by waiting periods of 14 days.…”

Towards a European “Cohort Moonshot”: revisiting the long-term strategy to support health research of tomorrow

“…Today's major advancements in epidemiology and clinical research originate from large population or patient-based cohort studies. Countries who had the vision of implementing mega cohorts early, such as the UK Biobank (UK, 500,000 participants) [1], the All of Us Research Program (USA, up to 1 million participants), Constances (France, 200,000 participants) [2], or the German National Cohort NAKO (Germany, 205,000 participants) [3] are now collecting the fruits of their massive investments with breakthrough scientific achievements.…”