Wednesday, April 16, 2025
Health research is developing rapidly, with more diverse study populations and more advanced measurement methods. It makes research questions more complex. At the same time, it offers new opportunities and insights to better understand and solve health issues. Prof. dr. Arfan Ikram focuses on the development and application of new analytical methods to address these challenges. “I want to further develop how we not only generate knowledge, but also effectively disseminate and apply it.”
Ikram is professor of Epidemiology at Erasmus MC, Chairman of ZonMw and member of the NWO board and principal investigator of the Rotterdam Study. He was also recently appointed Medical Delta professor, with an appointment at LUMC.
What does the appointment as Medical Delta professor mean to you?
“I see this appointment as a wonderful milestone, for several reasons. First of all, because the philosophy of Medical Delta, in which transdisciplinary collaboration is central, really appeals to me. I know several other Medical Delta professors and have seen how they fulfil their role. That fits in well with how I like to collaborate and connect with other institutions.
In addition, I consider it an honour to now be officially affiliated with the Department of Clinical Epidemiology at the LUMC. Epidemiology is a relatively young field, but the department in Leiden plays a leading role in its development. It feels very special to be part of it now.”
Did you expect this appointment?
“With a number of colleagues who are already Medical Delta professors, I saw the impact it had on them and how it strengthened their field. It was something I thought: if it happened to me, I could have the same experience. The recognition for my way of doing research and the content of my work means a lot to me. I see it as a signal that I am on the right track. At the same time, it is also an encouragement to further expand my work and to intensify collaboration even more.”
Can you briefly explain what your expertise is?
“I am an epidemiologist. Many people immediately think of infectious diseases, but these days that is only a small part of the entire field. Epidemiology has two important aspects. The first is the application: studying the occurrence and prevention of diseases in the population. In my case, it is mainly about dementia, Alzheimer's disease and more broadly: healthy brain aging. Prevention and chronic diseases are key words.
The second aspect of my field of work is methodology. Here, it is not so much about what you research, but how you do it. It is crucial that research is well designed and executed, so that the results are reliable and relevant. Methodology helps to prevent distortion and to really get answers to research questions. I not only apply that methodological knowledge, I also develop and improve it, specifically for brain research.
A large part of my research takes place within the Rotterdam Study, a long-term population study. Within this study, I shape the dementia research. In addition, my role has become broader and I am also responsible for the epidemiological basis of the entire study. This means that I oversee the scientific quality and methodological approach of the various sub-studies. This role as guardian of the epidemiological standard is now my main responsibility.”
What do you expect to contribute to the Rotterdam Study as a Medical Delta professor?
“The Rotterdam Study has been running for a long time and has yielded many valuable insights. At the same time, it is not a unique study; other similar studies are also underway in Leiden and even in Rotterdam itself. At a national level, I am working on better connecting different cohorts and other research initiatives. The broader infrastructure also plays a role in this, such as the Health Campus The Hague and the ‘Rotterdam Gezond’-program. As a Medical Delta professor, I see opportunities to more easily link these initiatives.
The different perspectives complement each other perfectly and provide a more complete picture of health and disease. As Medical Delta professor, I want to strengthen that collaboration and contribute to an even broader scientific impact.
Collaboration within Medical Delta helps to make more efficient use of existing knowledge and infrastructure. Instead of reinventing the wheel every time, we can learn from each other and share solutions. Moreover, collaboration offers an opportunity for scaling up. By bundling data and insights, a more impressive and powerful research network is created.
What is also nice is that many studies are complementary. For example, the Leiden studies focus on clinical populations, while the Rotterdam Study focuses on the general population outside the hospital walls. These different perspectives complement each other perfectly and provide a more complete picture of health and disease. As Medical Delta professor, I want to strengthen this collaboration and contribute to an even broader scientific impact.”
The healthcare system is under increasing pressure. What does this mean according to you? What transition should we undergo as a society and how can your research contribute to this?
“Technological developments, such as artificial intelligence, can help us work more efficiently. But a fundamental change in mindset is also needed. Everyone understands that prevention is essential. Yet, as a society, we are not able to give this structural substance. There is no lack of knowledge; we know very well what works. But in the field, choices are regularly made that are detrimental to prevention. Prevention is not free of costs. If we are really concerned about the pressure on healthcare, we must also be prepared to make compromises somewhere. Why are we not able to do that?
There are countless examples. Think of the sale of unhealthy food in supermarkets or the fact that approximately one in six Dutch people still smoke. We have known for decades that smoking is harmful, but as a society we have still not solved the problem. Of course, you can point to individual choices, but the role of the government and the influence of stakeholders, such as the tobacco lobby, is also significant.
We already know a lot about prevention in the case of dementia. The most effective measures correspond to the advice for a healthy heart: more exercise, healthy eating, no smoking. If we as a society really work on this, we can possibly prevent a quarter of all dementia cases. The knowledge about this is there and widely known, but the implementation is lacking. That is why I am convinced that we need to focus on this in the coming years. We need to bring academics into contact with those who have the expertise to implement that knowledge. Universities of applied sciences and secondary vocational education (‘mbo’s’), for example. This kind of collaboration makes the difference. It is possible, but it is difficult. We need to be prepared to take on that challenge.”
What is it like to work with someone from a completely different discipline?
“I am still relatively inexperienced in this area, but what strikes me time and again is that practice-oriented organisations have a completely different way of thinking. In recent years, I have come into contact with universities of applied sciences more often. There I see work that makes me think: an academic would have approached this very differently.
An example of this is something that happened two years ago, in the context of the dissemination of knowledge from the Rotterdam Study. We wanted to make known the valuable insights we had gathered in thirty years of research.
When I shared this with someone who is very practice-oriented, I immediately got the reaction: You can't do it like that?
Our first approach was typically academic: all researchers made a list of the most important findings, and we proudly placed this summary on our website. There were truly groundbreaking results among them, published in leading scientific journals. But when I shared this with someone who is very practice-oriented, I immediately got the reaction: You can't do it like that? Nobody reads this!
That person suggested something completely different: organize a knowledge festival. We did that. In a farm, with information stands, we told exactly the same story, but in a way that was much more accessible and interactive. It was a great success. This is for me a striking example of the difference between theoretical and conceptual thinking versus purposeful and practice-oriented thinking.”
With the new program, Medical Delta focuses more on practical needs. What is the importance of practical situations for your research?
“I am actively involved in this, especially because I am becoming increasingly aware of the challenges surrounding implementation. Applying research results in practice is much more complex than is often thought, it is a fully-fledged field of research in itself. Implementation and applied research require a targeted approach and I am increasingly realizing how essential that is.
Within the Medical Delta setting, I will come into contact with this even more intensively. Not only through universities, but also through universities of applied sciences, where practice-oriented research comes into its own.”
How do you involve practice partners in your research?
“In prevention, especially primary prevention, various practice partners play a crucial role. Think of general practitioners, practice assistants and care providers in the neighbourhood, but also policy makers at local level, such as districts and municipalities. In addition, we work together with higher professional education and intermediate vocational education institutions, because they combine practice-oriented research and education.
I am currently working within the national consortium BIRD NL (Influencable Risk Factors Prevention Dementia). This partnership includes University Medical Centers, alpha and beta faculties of universities, knowledge institutes such as Pharos, but also organisations such as the Brain Foundation and Alzheimer Nederland. It is a diverse group of researchers and professionals, which ensures a different, broader dynamic in the research.
Why is this broad collaboration important?
“In research, we speak of a knowledge cycle with three phases. Knowledge development, gathering new insights by collecting, analysing and publishing data. This is the part that academics are strong in. Knowledge dissemination, spreading knowledge to the right target groups, such as policymakers and the general public. This goes beyond publishing in scientific journals and requires targeted communication. Academics are often less strong in this. And knowledge implementation, actually applying the knowledge in practice. For example: we know that 30 minutes of exercise per day reduces the risk of dementia. But how do we ensure that people not only acquire this knowledge, but are also motivated to act on it?
How do we ensure that people not only acquire this knowledge, but are also motivated to act on it?Practical professionals often have a much better sense of this last phase. I realise that my expertise lies mainly in the first phase and that I can still learn a lot about the second and third phases. That is why I am entering this collaboration with a learning attitude: I want to further develop how we not only generate knowledge, but also effectively disseminate and apply it.”
Which other researcher or practice partner has really surprised you and why?
“There are so many people I could name. What strikes me most is the change in mindset that is needed in society and that also had to take place within academia. In prevention, for example, we are increasingly realizing that this requires a national approach and collaboration. I am now really seeing that change in mindset happening.
A good example is the national consortium of cohort studies (NCC) that we have set up. We have managed to break down barriers between programs and disciplines, making collaboration more easy and knowledge better shared. This shows that when we dare to look beyond the boundaries of our own disciplines and institutions, we can make great strides forward.”
