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Two years ago, the National Institute on Aging launched the GESTALT study, which stands for the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study.

The study takes one of the first large-scale, long-term looks at why aging progresses as it does — and how to help more people take advantage of ways to improve quality of life as they age.

The GESTALT study is looking at biomarkers in blood and tissue that can help scientists understand diseases and signs of aging, such as why muscles shrink, skin wrinkles and memory declines.

It is an offshoot of the long-running Baltimore Longitudinal Study on Aging (BLSA), which has mapped out many of the changes people experience as they get older. Dr. Luigi Ferrucci, scientific director of the National Institute on Aging, leads both the BLSA and the GESTALT study.

The first participants have been part of the study for two years, and he’s recruiting for more generally healthy adults age 20 and older (there is no upper age limit) to participate for 10 years or more so changes can be tracked over time. Study visits last two days every two years and offer substantial compensation.

Researchers are looking at the process of aging on a cellular level, using white blood cells taken in samples from participants. Until recent advances in technology, there wasn’t a way to capture as many cells as are necessary for the study.

Using a process called cytapheresis, blood will be removed through a needle in the vein of one arm and run through a machine that separates out the white blood cells. The blood will be returned through a needle in a vein of the other arm, and white blood cells will be regenerated by the body in a few days.

Surprising early findings

The cells under study have already yielded some surprising information, Ferrucci said.

“What we’ve seen so far is absolutely amazing. We thought we would see a really small biological change. But we’ve found that the body basically reconstructs itself over time,” he said.

There are changes in gene expression, or characteristics, that are “massive and unexpected,” Ferrucci said.

“We are finding that aging is really a series of reconstructions. Changes occur to maintain health. The body adapts to the stress of aging and preserves its ability to function.”

Furthermore, analysis of muscle cells has found that the way they grow and maintain strength “changes dramatically with aging.” The study found muscle gene variants that are protective in some people and that occur only in older age.

To take part in the study

Those interested in the study will first make a short visit to the National Institute on Aging at Baltimore’s Harbor Hospital to make sure they qualify. If they do, they will return to the center for two full days of testing, including an overnight stay.

In addition to cytapheresis, which takes about two hours, those in the study will have skin and muscle biopsies (where very small tissue samples, about the size of grain of rice, will be taken).

The muscle biopsy was something that made people initially wary of participating, Ferucci said, but those already in the study have had no difficulty.

“It’s much easier than they thought. There have been no complications, and one person even ran 10 miles the next day,” he said.

Additionally, participants will have a physical exam, treadmill, strength and balance tests, several MRIs, and cognitive tests. They will have additional blood tests that look at DNA and RNA.

They will return every two years to repeat the tests, although cytapheresis will be done only every four years. In between, they may be contacted by researchers about their ongoing health.

Participants will also be required to wear Fitbits to track physical activity in an objective way rather than self-reporting it.

Healthy adults sought

To participate, adults must weigh at least 110 pounds and have a body mass index below 30. They must agree that their genetic samples can be collected, studied and stored.

They must be able to perform daily self-care without assistance, walk independently for at least 400 meters without assistance, and be able to perform normal activities of daily living without shortness of breath (walking or climbing stairs) or other severe symptoms.

Because researchers are looking for healthy individuals, at least at the outset of the study, there are a number of conditions that will preclude participation. Participants cannot have:

• Any history of drug use
• Genetic diseases such as sickle cell, hemochromatosis (iron overload), cystic fibrosis or Ehlers-Danlos syndrome (connective tissue disorder).
• Autoimmune diseases such as Hashimoto’s thyroiditis, myasthenia gravis or rheumatoid arthritis.
• Cognitive impairment based on mental status screening tests
• A history of cardiovascular disease or cerebrovascular disease, including angina (requiring treatment), myocardial infarction, congestive heart failure, uncontrolled hypertension, pacemaker, stroke or transient ischemic attacks (TIA).
• A history of diabetes (requiring any medical treatment other than diet and exercise)
• Any cancer in the last 10 years, except for locally limited basal cell cancer
• A history of kidney or liver disease
• HIV, Hepatitis B or C, or high blood pressure
• Been certified as legally blind

Participants will be paid $1,600 to $1,700 for the first two-day testing session, and then $2,000 for each two-day testing visit every two years.

To learn more, call (410) 350-3941 or 1-800-225-2572, ext. 3941, or email NiaStudiesRecruitment@mail.nih.gov.