PERSIAN Design (Main Adult)

The Main (Adult) Cohort aimed to include men and women 35-70 years of age from various geographical regions and ethnicities of Iran. Originally intended to be carried out in 10 geographically distinct areas, the PERSIAN Cohort has now stretched to 18 regions of Iran, chosen based on local disease patterns, exposure to certain risk factors, population stability causes of death, and local commitment and capacity. Enrollment in the PERSIAN Adult Cohort started in 2014 and finished in 2019. Currently, 165,630 individuals have enrolled in this cohort and are being followed up annually.

PERSIAN Adult Cohort Objectives and Outcomes of Interest

The health-oriented and research-oriented objectives of the PERSIAN Adult Cohort are divided into two categories as followed:

Research and Public Health Objectives:

1. To determine incidence/ incidence rates of different non-communicable diseases or outcomes
2. To estimate the risk and protective factors of non-communicable diseases in a representative sample of middle aged Iranian population
3. To determine all-cause mortality rates, as well as specific mortality rates of the leading causes of death
4. To evaluate the relationship between genetic, life style / socioeconomic status and environmental risk factors and the most important non-communicable diseases by case cohort and nested case control designs that will be implemented on the cohort infrastructures
5. To evaluate time trends of lifestyle and environmental factors and the outcomes of interest in the different cohort sites of Iran
6. To assess the relationship between genetic markers and NCDs and comparing them among the different Iranian ethnic groups
7. To evaluate the effectiveness of the most relevant interventions, and to explore the effectiveness of novel interventions, for reducing important non-communicable outcomes through community interventional trials that will be implemented on the population subsets

Health System Research objectives:

1. To design/improve and optimize different Health Information Systems such as a Cancer Registry, Death Registry, Hospital Information System, etc.
2. To improve the quality of health care services
3. To build a population-based research infrastructure for medical universities and to disseminate the concept of “Health System Research” in medical education
4. To enhance national collaborations between medical universities and health research institutes for joint medical and epidemiological research projects
5. To establish the largest biobank in Iran for basic and genetic scientific research and discovery of biomarkers and other biological determinants of disease
6. To establish a practical field for research and training of medical students, residents, and fellows
7. To enhance international collaborations with recognized medical universities and research institutions in order to plan joint projects, and train students and young researchers

Outcomes of Interest

1. Deaths by cause
2. Incidence of major non-communicable diseases including cardiovascular diseases, cancers, and chronic digestive, respiratory, renal, hepatic, and neurological diseases
3. Trends in major risk factors including anthropometric, physiological, life style, and environmental factors

Data Collection

Questionnaires and Physical Examinations

As part of the data gathering for the PERSIAN Cohort, a comprehensive interviewer-administered electronic questionnaire consisting of 3 major sections—General, Medical and Nutrition—has been developed, encompassing many different aspects of an individual’s life, which may have an impact on their health status. In addition to the questionnaires, a physical examination is performed and pulse, blood pressure and anthropometric measurements are also recorded.

Data is gathered at each location using a pre-designed software and pooled into a Central Data Bank. Topics covered in the PERSIAN Cohort questionnaire are as followed: