LifeLines: A new focus on Healthy Ageing

This article is published on behalf of Netherlands Foreign Investment Agency (NFIA) (Read more articles by NFIA here).

For a number of years, the Northern Netherlands region has focused on Healthy Ageing, which means becoming old in a healthier way. In developed countries, life expectancy is increasing – about two years every decade. It is expected that 50% of the baby girls born today will reach the age of 100 years or more. The reasons for increasing life expectancy are better hygiene and living conditions, better health care and better nutrition. For example, nutrition plays a very important role in prevention. Good nutrition increases the condition and as a result people are less susceptible to illness, also it helps patients to recuperate quicker.

In the Northern region, the University Medical Center Groningen is the nucleus in health research. UMCG houses the European Research Institute for the Biology of Ageing (ERIBA) and has set up the LifeLines cohort and biobank.

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LifeLines: world’s largest population-based studies

LifeLines is one of the world’s largest population-based studies comprising 165,000 individuals covering three generations. It offers a unique data resource to researchers worldwide. Its cohort study and biobank link information on biomedical measurements, environmental exposures, (epi)genetics, nutritional, psychological and social factors, as well as data on health care use. The infrastructure enables the performance of both large-scale as well as detailed epidemiological studies to gene-environmental factors in a broad range of multifactorial diseases. Only this multidimensional and multidisciplinary approach will deliver the depth of insight required to understand the origins and course of age-related (chronic) diseases.

LifeLines forms a pivotal base for important breakthroughs in the screening, prevention, diagnosis, and treatment of (chronic) diseases. Not just data, but a whole infrastructure is available for researchers, from both public and private institutions. Besides the large scale high quality data in many domains, LifeLines provides state of the art high performance computer power, a team of methodological experts, an (inter)national network of biobank researchers and a fully automated storage and retrieval system to deliver a selection from the millions stored biosamples overnight. In short, LifeLines’ infrastructure, cohort, knowledge and know-how is at the disposal of researchers to answer their specific research questions or setup their own collection. This saves researchers valuable time, while being ensured of high quality, ready-to-use data and samples. In this role, LifeLines facilitates the creation of research communities by matching researchers who are working with similar data and have joint research interests.

Cohort dimensions               

A random sample of the population aged 25-50 years was invited to participate in LifeLines. Each participant was asked to invite his parents, partner, parents-in-law and children to join the study. The result is a unique three-generation (family) population design, with large benefits:

  • Vast statistical advantages: multiple-­level information, separation of non-­genetic and genetic familial transmission and increased
  • Unique possibilities to study social characteristics: socio-economic mobility, partner preferences, in and between­ generation similarities.

This design enables the prospective investigation of the effect of time-varying exposures, like health behavior and environmental factors on the development of chronic disease, as well as interactions between genetic and environmental risk factors in disease development.

Data collection

All participants receive a number of questionnaires and a medical examination at one of the ten LifeLines research locations. The questionnaires cover items like demographics, family composition, work and educational level, health & history of disease, lifestyle and diet, day time spending, living environment, quality of life, health perception, personality, stress and social issues. Participants are followed for at least thirty years and are invited every five years for a medical examination at a local LifeLines research location. Annually, the participants receive follow-up questionnaires. Follow-up on morbidity and mortality will be based on general practitioners, hospital and pharmacy records.

Sample processing

Blood samples and 24-hour urine are collected for long-term storage and for laboratory measurements. Conditioned and monitored transport of blood and urine samples to the highly automated LifeLines laboratory guarantees complete traceability. Samples are analyzed on the day of collection. Routine chemistry and hematology is processed in parallel within 12h after collection. DNA is extracted from white blood cells using automation of an isolation method that has shown stability and quality of the isolated DNA for decades. Uniquely 2D barcoded labware are used for storage at -80 °C. It is a completely automated sample storage with a capacity of 8+ million aliquots. Sample quality is maximized with its sample handling process. Storage of the samples at high quality standards at different time points (every 5 year) facilitates the researchers to go back in time to investigate traces of diseases or events in the carefully processed and registered bio-materials at LifeLines.

Data storage

LifeLines has developed a dedicated high-quality IT system to conduct the study. After checking the data on inconsistencies through an accurate procedure (notably the answers from the paper questionnaires), data are pseudonymized and transferred to the high performance computer center of the University of Groningen for secure storage without identifiable information. At these systems the phenotype data from questionnaires, medical examinations and laboratory assessments are mapped on a common data model and linked with imputed whole genome data and with external data sources. The available data-items are displayed in an interactive real-time catalogue on the LifeLines website. Finally, datasets for individual researchers are created as data views.

Participant involvement

All results of the medical examinations are provided to the LifeLines participants and her/his general practitioner. Potential health consequences are evaluated by a team of physicians. If indicated, participants and their general practitioner receive dedicated advice.

Extensive networks

As a center of expertise in biobanking, LifeLines takes part in a number of strategic alliances, national and international biobank networks and research collaborations. Through these networks LifeLines established itself as one of the world leaders in the science of biobanking, as well as contribute to the advancement of public-private partnerships.

LifeLines biobanking expert center

In collaboration with clinical biobanks and the international biobank network, LifeLines has established a “Biobanking expert center” for practical and scientific support of researchers and organizations. The center guards and supports participation in (inter)national research collaborations and biobanking networks and concomitant enrichment of the LifeLines data collection and economic value creation. Moreover, with the extensive hands-on experience the center can advise on the establishment, operation and enhancement of a professional biobank. LifeLines is permanently aiming to improve biobanking worldwide by researching its own data and establishing professional guidelines, policies and protocols for large study populations. LifeLines has developed expertise in ethics and privacy rules, the organization of collecting and storing large quantities of biomaterials and data and the guaranteed quality of the data warehouse.

For more information on the LifeLines Project/Health Aging or investing in the Netherlands, contact the Netherlands Foreign Investment Agency: Ms Suzanne Sweerman, Executive Director, South East Asia, at Tel: +65 6739 1135, Email: / Ms Adeline Tan, Senior Project Manager at Tel: +65 6739 1137, Email: or visit

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