A Long Look at Longevity

Duke University has launched the MURDOCK Study, an ambitious effort to track the long-term health of 50,000 North Carolinians and gain insight into aging, nutrition, Alzheimer’s, and other health issues over their life span.

KANNAPOLIS — David Livengood hopes to improve the world’s health. Finding out how many chair squats can be done in 60 seconds is just part of the process.

“It’s something I can donate,” Livengood says as he repeatedly sits down and then stands up. "I don’t have money but I can give my information to help other people.”

The chair squats are just one of a battery of fitness evaluations Livengood will perform today, under the direction of Leah Bouk. She’s coordinating the clinical trials for the MURDOCK Study, which is one of the largest health studies ever conducted. Livengood, a 44-year-old Kannapolis sales representative, wants to be a participant in the study, which is based at the North Carolina Research Campus in Kannapolis. The evaluation is the first requirement for joining the study.

“There are only a couple of projects like this that bring together the large number of people we are collecting as well as the amount of data we are collecting from each person,” says Bouk, Clinical Trials Project Leader with the MURDOCK Study. She’s checking her stopwatch and recording the time it takes for Livengood to walk a specific distance, which is another test in the initial evaluation. Besides the tests, and a blood and urine sample, he’ll be required to check in with researchers and provide personal and health information every year.

“We collect samples for DNA, RNA, metabalomics and proteomics,” adds Bouk. “What’s exciting is that any information we collect is going to have an impact on the future of medicine.”

MURDOCK is short for Measurement to Understand the Reclassification of Disease of Carbarrus/Kannapolis. Duke University launched the study in 2007 with a $35 million gift from David Murdock, founder of the research campus, which is part of the reason the study is based in Kannapolis.

The MURDOCK study tracks the health changes over several years among a large segment of the population throughout Kannapolis, Cabarrus County and parts of Rowan, Mecklenburg and Stanly counties. More than 11,500 people have signed up to be monitored in the study. The eventual goal is to follow 50,000 people. Researchers say the study area provides a good blend of people living in rural and urban areas.

Researchers say they are collecting so much information from so many people because the only way to identify, treat, and defeat some of the leading diseases is to learn how those diseases start.

“Most diseases — and I mean the chronic things that afflict us such as heart disease, diabetes, high blood pressure and arthritis — all develop over many years,” says Dr. Kristin Newby, Principal Investigator with the MURDOCK Study. Newby is also a cardiology professor with Duke University School of Medicine. “It’s not as if you one day wake up with something that you didn’t have the day before. But the only way to understand the transitions from being healthy to having an illness is to follow a person over a long period of time.”

The initial health evaluation and blood tests will provide a baseline or starting point for researchers to follow participants. Additional data on the subject’s health will be collected every year after that to add to the database. Usually the additional data will simply be responses to questions, including how a subject is feeling and what is happening in their life. On occasion, additional clinical evaluations or blood and urine tests may be needed.

Multiple research projects will utilize data from the MURDOCK Study, including the research into Multiple Sclerosis taking place in Dr. Simon Gregory’s lab. In the United States, 400,000 people are diagnosed with MS, known to researchers as a genetic disease. Researchers want to understand the risk factors and triggers for the disease as well as any signatures that would indicate the disease is developing.

“I don’t believe in one mechanism causing a disease,” says Dr. Simon Gregory, Director of the Genomics Core at David H. Murdock Research Institute. His lab is one of several at the Institute using data from the MURDOCK Study. “I think there are many triggers for a disease and to understand them you have to use a lot of approaches. The MURDOCK Study and the bio specimens that are being collected will allow us to approach a very complex problem with very different perspectives.”

“If we could find a blood signature that is specific to MS that would be very helpful for clinicians for diagnosis as well as prognosis,” adds Dr. Sabrina Cote, a post-doctoral fellow at the DHMRI who is helping with the MS project. “With a blood signature doctors could better understand if a treatment regimen is helping or is causing problems. They could also know if a new medication is needed before another attack that could cause permanent damage.”

The findings from the MURDOCK Study should also help foster the promise of precision medicine, which would allow doctors to use a person’s genetic, clinical, social, and environmental characteristics to tailor prevention and treatment plans. The concept of precision medicine is especially useful in geriatrics and the care of older patients.

“The extraordinary part of this study is that we have data that is unique in the lifespan perspective,” says Dr. Miriam Morey, the principal investigator in the MURDOCK Study and a professor in the Division of Geriatrics at Duke Aging Center. “I can go into the literature and there is data on people who are 70, 80 and 90 years old, but there isn’t much about people who are 30 and 40 years old. Now, we’ll be able to look across lifespan and see what factors are most important, and when are changes happening in people’s lives that influence how they age.”

Dr. Morey adds that scientists already know it is never too late to change your behavior and improve your health as you age. With the information from the MURDOCK Study, she hopes to see how lifestyle changes made by people old and young influenced their health and functioning going forward.

“The large sample of patients will allow us to look at multiple events and multiple things that are happening over time that could be associated with change. This becomes so important as the population ages because it used to be that people who reached 65 didn’t live much longer. But now it’s a 30 year life after that and people need to decide how they are going to live it, because much of that is in a person’s own hands. Their health is based on their behavior.”

The MURDOCK Study is known as a longitudinal study, which means it is long lasting and designed to study and measure a population over a long period of time. And because they are rare and produce a large amount of data, the conclusions reached through longitudinal studies can have a long lasting effect. That is the case with what has become known as The Framingham Study. It was conducted in England in 1948 and revolutionized the understanding of cardiovascular disease. In fact, many of the therapies that doctor’s employ today are based on the groundbreaking study that is now more than 50 years old. Doctors with the MURDOCK study hope their work has the same effect.

“I think this could have a tremendous impact on our understanding of disease because of the breadth of what we’re doing, the ability to look across all common diseases and to follow people from health to disease,” says Dr. Newby. “And if you add to that the technology we are using and the molecular backdrop to our research, I hope in 50 years people will say the MURDOCK study really changed the course of how we treat people with common diseases.”

Dr. Newby pauses for a moment, looks out the window and smiles. And then she adds, “I know that’s a lofty goal and it sounds a bit arrogant to say but that’s what we’re in the game for — to change how we treat people.”

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