Focus on NAKO results

Here you will find key results and highlights of the German National Cohort (NAKO) — find out about the progress and findings that will improve the health of many people.

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Study results by subject area

Discover the results of the German National Cohort (NAKO) in various topics and find out more about the most important widespread diseases and health issues.

Anxiety and stress

The coronavirus pandemic and its protective measures have had an impact on the general and mental health of the population in Germany. There has been a significant increase in depressive symptoms, anxiety and stress.

Extensive data set with Germany-wide environmental factors

For the first time, a large population-based data set with high-quality environmental indicators is now available for Germany. This opens up new possibilities for innovative research and the derivation of policy-relevant information. The expansion of the database includes indicators such as light pollution, mobility and biodiversity as well as socio-economic factors such as the unemployment rate and geographical disadvantage.

Insufficient physical activity in the home office

The majority of people surveyed reported a significant decrease in physical activity and an increasingly sedentary lifestyle during the pandemic, especially among those who switched to working from home.

Hand gripping strength and physical fitness

Hand grip strength and its maintenance in old age are an important indicator of health and physical performance, particularly in older people. Adults around the age of 40 had the highest hand grip strength. Up to this age, the hand grip strength of adults increased and then fell with age.

Insufficient physical activity associated with higher healthcare costs

Insufficient physical activity was associated with higher costs for the healthcare system. A positive effect on costs was shown by free-time sport, while a high level of physical activity at work was associated with higher costs.

Obesity as a risk factor

Overweight in adolescence can increase the likelihood of developing multiple sclerosis.

Loneliness

32 per cent of NAKO participants described themselves as lonely during the pandemic – 26 per cent of men and 37 per cent of women. Older people were less affected than young people. One in two people felt lonelier during the first lockdown than before.

Road traffic noise

Researchers used imaging data from MRI examinations of over 11,000 participants in the NAKO and combined this with road traffic noise data in Germany. The results of the analysis suggest that exposure to traffic noise may be associated with a higher proportion of adipose tissue in the body, which could also increase the risk of associated diseases.

Traffic noise

Two thirds of over 86,000 participants did not feel disturbed by traffic noise. One in ten reported strong/very strong disturbance, with the highest numbers in Berlin-Mitte and Leipzig. The strongest associations with noise disturbance were observed for factors relating to the individual living situation, such as the position of the bedroom facing the main road compared to the garden/courtyard.

Ageing processes

People are known to age at different speeds. The study, based on MRI data from the UK Biobank and the NAKO, was able to show how differently body composition affects health risks. Women often have higher levels of subcutaneous adipose tissue and intramuscular fat, while men have more visceral fat and muscle volume. The method could help to better identify high-risk individuals in order to improve personalised prevention measures.

Health risks for people on low incomes

In order to remain mentally fit for as long as possible in old age, it is important to understand which risk factors could affect cognitive performance at an early age. The study showed that cognitive performance was lower in people with an income below the poverty line compared to people with an income above the poverty line.

Childhood trauma and diseases in adulthood

Traumatic experiences in childhood were associated with a higher risk of physical and mental illness in adulthood.This risk of diseases was found to be particularly high in younger people.

Birth order

The risk of type 1 diabetes was highest in only one child and decreased with higher birth order.

Chronic back pain

The analysis of MRI data from around 30,000 participants in the NAKO health study showed that a higher proportion of adipose tissue in the back muscles was associated with chronic back pain. The study clearly shows how helpful it could be to take the composition of the muscles into account when assessing the risk of chronic back pain.

Movement in the daily rhythm

The analysis of the information from around 61,000 participants suggests that physical activity in the afternoon and evening has a greater benefit for metabolic health than activity in the morning, while nocturnal activity is not recommended.

SARS-CoV-2 infections

As part of the IMMUNEBRIDGE project, data and biosamples from nine population- and hospital-based studies were analysed to provide estimates of protection against SARS-CoV-2 infections and severe COVID-19 infections between June and November 2022. The researchers found relevant protection gaps in the oldest age group and in people with comorbidities.

Education and cognitive functions

Cognitive skills were lower in older participants. Higher education was associated with better cognitive function.

Social inequality as a risk of illness

A low level of education and a low income increased the risk of cardiovascular disease in women more than in men. The study underlines the importance of gender-specific prevention strategies.

Biodiversity

The presence of diverse birdlife in the neighbourhood was associated with positive psychological well-being.

Effects of high blood pressure

Younger age at hypertension diagnosis was associated with a higher risk of associated cardiovascular disease.

Measuring the body

Participants from the southern study centres were generally smaller than those from the northern study centres. The participants from the study centres in Neubrandenburg, Augsburg, Saarbrücken and Essen had the highest body mass index (BMI) values.

Post-COVID

The risk of post-COVID symptoms was lower after an Omikron infection and after a fourth vaccination, and if you have already recovered well from an infection.