Based in the northern Netherlands, Lifelines is building a unique long-term research cohort that also offers market parties untapped opportunities.
How can we age more healthily? Why do some people stay healthy and others become ill in life? An important part of the questions can only be answered with scientific research. And that is exactly why Lifelines exists: to enable scientific research into healthier aging. This is done by collecting data and bodily materials from 167,000 people in the Northern Netherlands and making them available to researchers and policy makers.
Lifelines is a non-profit organization with a simple but ambitious mission: to enable us to age more healthily. The organization does this by collecting data and bodily material from some 167,000 residents of the Northern Netherlands since 2006 and making it available to researchers and policy makers with care and under conditions. "Ultimately, we want to make an impact in the form of more healthy life years for the population," says director Debbie van Baarle. "That's the higher goal."
In doing so, Lifelines aims to build a bridge between public and private. "We have a public mission and entrepreneurial energy. In that field of tension lies precisely our strength: we bring science and society together, build partnerships and ensure that knowledge/science finds its way into practice faster."
What makes Lifelines unique
The Netherlands has more cohorts and biobanks - think of the Rotterdam and Maastricht studies or aging cohorts in Leiden - but Lifelines stands out because of its scale and duration. "We serve a large region as well as follow participants longitudinally," says Van Baarle. "Every five years they come to a Lifelines site for a comprehensive health examination." The fourth round of research is now underway. About half of the approximately 70 staff members are busy collecting (questionnaires, cognition tests, blood sampling and biobank management), the other half providing data and samples. "We don't analyze ourselves," the director emphasizes. "However, we do ensure that researchers can get maximum value from the data, for example with data links, support for additional questionnaires or the implementation of additional measurements."
The power of Lifelines becomes apparent when long-term data can be linked to current questions. For example, researchers found a relationship between BMI and the density of fast food chains in the neighborhood. That's information that local policymakers can do something with: from licensing policy to health interventions.
During the corona pandemic, the social value proved even more direct. Van Baarle: "We already had fifteen years of data and added up-to-date questionnaires. These showed that lower socioeconomic groups were hit especially hard by closures, in part because they started moving less. Such insights helped reopen gyms earlier."
A long-term cohort requires continued attention to representativeness. "It is not easy to keep people involved for twenty years," says Van Baarle. "Certain groups drop out faster: less mobile people, or people with a lower socioeconomic status. That's exactly who you want to retain." That's why Lifelines works with personal follow-up: letters, phone calls, and increasingly targeted communication. Lifelines is also developing an app that allows participants to get more feedback, from results to personal tips. That can be an important motivation to continue participating: people want to know how their health is doing and what they can do about it.
Lifelines is financed by shareholders UMCG and RUG and with large subsidies, currently mainly from the Ministry of Health, Welfare and Sport. But relying on public money alone is risky. Moreover, the contribution from VWS is decreasing while internal costs are increasing. So new sources are needed. The goal is a healthy balance: public funding where needed, complemented by partnerships that strengthen independence as well as social value. "Researchers already pay a contribution for data or samples; we are also exploring partnerships with biotech and pharma, for example, but always within clear social frameworks," says Van Baarle. "We apply the test: does it contribute to more healthy years of life, and does knowledge flow back into our database? If the answer is 'no' or 'gray', we basically don't do it. Separately, we are also working on a set of standard boundary conditions so that this is clear to the market."
That is exactly where NOM comes in. "We have been a big fan of Lifelines from the start, but our involvement has recently become even more concrete," explains project manager Gerard Lenstra. This is reflected, among other things, in the appointment of a "dealmaker": someone who will explore collaborations with industrial and other external partners. "Lifelines is a great activity with which we as the Northern Netherlands are truly distinctive. With a stronger line towards the market, we can only further strengthen that foundation, both to make even better use of the database and to create an additional financial source for Lifelines with this."
According to Lenstra, the dealmaker, who will be paid by NOM at least for a year, can ensure that a concrete need in the industry (pharma and food first and foremost) is filled without jeopardizing Lifelines' position. "These market parties are the missing link in the chain between fundamental research and the individual citizen. We can thus further strengthen the impact of Lifelines. Naturally, this will all continue to be done according to transparent and responsible agreements we have with the participants. What's more, I am also a participant myself and would only welcome it, even out of self-interest, if the results were to have an even greater impact in the future."
The future is measuring more often and smarter. Wearables and 'swallowables' offer enormous opportunities for continuous monitoring. A first step has already been taken with a large exercise study together with the Radboud UMC in Nijmegen, in which participants wear a small exercise meter on their upper leg for a week. "That provides a week's worth of continuous data instead of a completed questionnaire," Van Baarle said.
Although the focus is on the northern Netherlands, Lifelines regularly collaborates with parties elsewhere in the country. National coordination and harmonization between cohorts is high on the agenda. Crucially, the network continues to work, with RIVM and GGDs for public health, with academic groups for science, and with companies for translation into applications. "Research publications are step one; real impact requires translation to practice and policy," says Van Baarle.
To the outside world, Lifelines has a clear message: "We seek cooperation and explore new markets. I invite organizations that can create value with our unique combination of scale, duration and depth - from preventive care to data-driven policy - to get in touch. Lifelines is here to bring science and society closer together."
Participation in Lifelines is not financially rewarded; participants receive their results and an actual health check. This reciprocity - measuring, giving back, improving - makes the program what it is: an engine for healthier aging.