The Swedish National Study on Aging and Care in Nordanstig (SNAC-N)


Cohort 1:

Baseline: 2001 – 2004
Follow-up 1: 2005 – 2006
Follow-up 2: 2007 – 2011
Follow-up 3: 2011 – 2012
Follow-up 4: 2013 – 2015
Follow-up 5: 2016 – 2018

Cohort 2:

Baseline: 2006 – 2012
Follow-up 1: 2011 – 2012
Follow-up 2: 2013 – 2015
Follow-up 3: 2016 – 2018

Cohort 3:

Baseline: 2013 – 2015
Follow-up 1: 2016 – 2018

SNAC-N – Care System Study – Surveys:
2001 – ongoing

Sample size

Cohort 1:

Baseline: 766 participants
Follow-up 1: 206 participants
Follow-up 2: 415 participants
Follow-up 3: 170 participants
Follow-up 4: 266 participants

Cohort 2:

Baseline: 265 participants
Follow-up 1: 68 participants
Follow-up 2: 185 participants

Cohort 3: 273

SNAC-N – Care System Study:

Total Number of Participants: 1.504 (No Limit)

Number of Participants with Biological Samples : 800

Sample population


Sample residence


Survey mode

Information was collected through an examination; a social interview and the assessment of physical functioning (performed by a nurse); a clinical examination, including geriatric, neurological and psychiatric assessment (performed by a physician); a cognitive assessment (performed by a psychologist).

The self-administered questionnaire included information about social network, leisure activities, nutritional assessment, health related life quality (Short Form 12 Health Survey), Neugarten Life Satisfaction Index, well-being assessed by PANAS, and health perception using the Ware┬┤s Health Perceptions Questionnaire. Information including demographic data, living arrangement, education and current and past occupational history, current and past socioeconomic status, life habits including alcohol consumption and smoking, physical functioning with information collected on ADL, IADL, use of medical and social facilities, and formal and informal care received and provided was collected in the social interview. The clinical examination form included family and past clinical history, current and past use of drugs.

Physical measures such as motility and strength, sensory functions, observational tests concerning hand strength, walking speed and balance were assessed in the social interview by a nurse. A geriatric examination which included information on general status, measuring heart function with an ECG, lung function, blood pressure measurements and symptoms including pain, was completed as part of the clinical examination.

A neurological examination was also completed at the clinical examinitation which included testing episodic and semantic memory, language, abstract thinking, praxis, visuospatial ability, gnosis and frontal lobe tests, dementia severity according to the Clinical Dementia Rating scale, a psychiatric examination which included the Comprehensive Psychopathological Rating Scale and the Neuropsychiatric Inventory, and diagnostic conclusions according to standardized criteria.

A psychological test battery was used to assess five major cognitive domains: episodic memory, mental tempo, executive functioning, spatial function and semantic memory.

Blood samples were also collected.

SNAC-N Care System Study

Data were collected each year in the spring. All contacts between older persons and the care system in the involved area were recorded. It concerned the operations of long-term care services system including volume and character of services provided in the relation to disability and other factors influencing needs.

Data collected cover the person’s functional ability in terms of ability to perform personal (PADL) and instrumental activities of daily living (IADL), cognitive functioning using the Berger scale, special health complaints or needs (persistent pain, dizziness, ulcers, anxiety, in need of constant monitoring), living circumstances and conditions in terms of adaptation of housing to functional problems, access to informal care or privately organized or paid care, and details concerning public health care and services according to the Social Services Act and/or the Health and Medical Services Act. Additional information concerning the use of hospital care and out-patient care can be obtained through the county council administrative registers. Municipality registers provide data on personal income and co-payment for care services.

Longitudinal or cross-section study


Data sources

Biomarkers, lifestyle, and medical history over the life course, physical status and mental health status.

Cognitive measures
Physical measures
Biosamples (Blood)

SNAC-N – Care System Study:
Cognitive measures
Administrative databases (Health databases)

Main topics

Influence of life-time environmental and biological factors on aging process, identification of preventive strategies


SNAC-N is a longitudinal study on the influence of life-time environmental and biological factors on medical, psychological, and social health in late adulthood.

The objective of this study is to increase the understanding of the aging process and to identify possible preventive strategies to improve the health and the care of older adults.

Scientific domain

Social Science, Medicine, Psychology

Age studies subcategories
Cohort study (60+)

Karolinska Institutet

Department of Neurobiology, Care Sciences and Society (NVS)


Anders Wimo
Professor, PI of SNAC-N
Aging Research Center (ARC) Department of Neurobiology, Care Sciences and Society (NVS)
Karolinska Institutet
Tel: +46 70 5795383



Lagergren M, Fratiglioni L, Hallberg IR et al., A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004 Apr;16(2):158-68.