Research Projects - Aging
Healthy aging and associated health risk factors are a central focus of PHRI research. PHRI is part of the international Longevity Consortium, which looks at factors and trends across populations to provide insight into healthy aging.
The Honolulu Heart Program
The Honolulu Heart Program (HHP) was initially funded in 1965 through a contract from the NIH National Heart, Lung, and Blood Institute as a prospective study of environmental and biological causes of cardiovascular disease among Japanese American men living in Hawaii. The original study involved a cohort of 8,006 men born between 1900 and 1919. The HHP, in concert with a similar study conducted in European-ancestry Americans in Framingham, Massachusetts, has been seminal in generating a body of knowledge which, when translated into public health strategies, has resulted in nearly a 90% reduction in age-specific rates of fatal stroke, and similar dramatic fall in fatal myocardial infarction – in less than a half century. The ongoing research and examination of the HHP cohort has led to hundreds of studies, publications, and presentations, as well as considerable international recognition.
The HHP has been the basis of a long and successful research collaboration between PHRI and the Kuakini Medical Center, continuing to this day. It is the longest study of its kind with original participants, now ranging in age from 87 to 106, and the focus has shifted to healthcare issues of aging. A wealth of information has been gathered from throughout the lives of the study’s participants on diet, lifestyle, physical activity, and genetics, information that is crucial to understanding what helps people achieve a healthy old age.
The Honolulu Asia Aging Study
One of the projects utilizing the HHP cohort is the Honolulu Asia Aging Study (HAAS). PHRI Investigators have utilized the unique HHP population to study diseases associated with aging such as Alzheimer’s disease, vascular dementia, and Parkinson’s disease. One of the most extraordinary aspects of the HAAS project is research on brain structure at death, based largely on microscopic studies of different types of disease lesions in more than 30 brain regions, linking these to clinically recognized declines in function during the final years of life, and to a variety of exposures and personal characteristics decades earlier.
The HAAS project operates at the leading edge of research on Alzheimer’s disease, Parkinson’s disease, and the allied diseases that erode health, functioning, and personal identity in the final years of life. The autopsy represents the ultimate HHP/HAAS examination – the final contribution and definitive measure provided by our participants, generating maximum knowledge return on the investments of the men, their families, and the PHRI researchers. Through these contributions, and the intensive work of PHRI scientists, we are making real progress toward improving the longevity and health of our children, grandchildren, and future generations.
Pacific Genetic Epidemiologic Study on Aging
PHRI, in collaboration with the University of Hawaii, Kuakini Medical Center, Queen's Medical Center, and Stanford University, developed a network of experts in genetics, epidemiology, geriatrics, and biostatistics to plan and carryout comprehensive genetic epidemiologic studies in longevity and aging utilizing candidate gene/genetic association analysis designs. This study also developed new performance-based tests of functional ability in using the offspring of the Honolulu Heart Program cohort.
Defining the Healthy Aging Phenotype
The Hawaii Lifespan Study uses innovative approaches for secondary data analysis and novel genetic analyses that focus on functional characteristics of healthy aging over our entire lifespan. We are identifying biological and behavioral factors that enable people to survive to exceptional ages in good health.
Thus far, we have completed three years of our four year project and have operationalized three phenotypes of longevity (healthy survival, unhealthy survival, and non-survival). “Healthy” was defined as an absence of six-major age-related diseases, high physical function, high cognitive function, and no evidence of dementia. We have also tested the ability of environmental risk factors to predict the aging phenotypes and identified several strong predictors. These risk factors, as a group, if avoided in mid-life, can confer up to a four-fold increased odds of living 90+ years. Finally, we discovered a gene variant that is associated with a three-fold increased odds ratio for exceptional human longevity.