We can’t prevent what we don’t measure: the missing pathways to chronic disease
A new review published in the International Journal of Population Data Science (IJPDS) suggests that our understanding of how chronic diseases develop over a lifetime remains surprisingly incomplete, leaving important gaps in our ability to prevent conditions before they take hold.
Chronic diseases, including heart disease, lung disease and dementia, affect millions of people worldwide. They cut lives short, reduce quality of life and cost health systems billions. Yet these conditions do not suddenly appear when symptoms develop. Unhealthy changes in the body often begin many years earlier, meaning that tracking health throughout life could help identify opportunities for early prevention.
To understand how well these early changes are being measured, researchers reviewed long-term studies that tracked indicators linked to major chronic diseases across the life course. After screening 3,770 research papers, they identified 36 studies. The review was undertaken to inform future health measurements for Generation Victoria, (GenV), a major Australian study following more than 120,000 children and parents.
The review found that some aspects of health have been measured far more consistently than others. Blood pressure, a key predictor of heart disease, showed the strongest coverage, with studies tracking it from age five to 105 years. Blood sugar and some measures of bone, muscle function and strength were also well represented.
In contrast, important gaps remain elsewhere. Studies of cognition used many different assessment methods, making results difficult to compare. Measures of lung and kidney health covered only certain stages of life, leaving gaps between childhood, adulthood and older age. None of the studies tracked hearing or vision over long periods.
These gaps matter because isolated snapshots cannot show how health changes across an entire lifetime. Researchers may observe what happens at one age but miss how changes accumulate and interact over time. A more complete picture could improve understanding of when chronic diseases begin to develop and when preventive interventions are likely to have the greatest impact.
Long-term population studies are uniquely placed to provide this evidence. Unlike routine healthcare, which often investigates people only after symptoms appear, longitudinal studies can collect health measures before disease develops, offering valuable insights into the earliest stages of chronic illness.
The authors suggest that new technologies could make it easier for studies such as GenV to collect a wider range of health measures. They also argue that long-term population studies could coordinate the information they collect, building a clearer picture of health across the life course without requiring any single study to measure everything or follow every person from childhood to old age.
Dr Katie McBain said “We have detailed information about some pathways to chronic disease, but major gaps remain. By working together, long-term population studies could fill these gaps and build a more complete picture of how chronic disease develops across the life-course. This could help us see where prevention might have the greatest impact.”
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Dr Katie McBain, Murdoch Children’s Research Institute