Implications of Lifecourse Epidemiology for Research on Determinants of Adult Disease.
Implications of Lifecourse Epidemiology for Research on Determinants of Adult Disease.
复制标题
生命性流行病学对成人疾病决定因素的研究的影响。
DOI：
10.1007/bf03391613
复制
发表时间：
2010-11
影响因子：
5.5
通讯作者：
Glymour, M Maria
中科院分区：
文献类型：
--
作者：
Liu, Sze;Jones, Richard N;Glymour, M Maria
许多通常与衰老相关的疾病现在被认为与早年的社会和生理因素有关。了解生命早期接触风险因素的时间如何影响晚年健康可能会阐明导致成人健康不平等的机制，并确定有效干预措施的可能点。认识到慢性疾病在整个生命过程中的发展也对成人疾病危险因素的研究具有重要意义。我们回顾了描述危险因素暴露时间与疾病发展如何相关的替代概念模型。我们以教育与成人认知能力下降和痴呆之间的关系为例，提出对生命历程模型进行一些扩展，以提高其与成人慢性病研究的相关性。我们讨论了每个生命历程概念模型对衰老和慢性疾病研究的研究设计、分析和解释的重要影响。我们总结了生命历程框架所隐含的几个研究考虑因素，包括：分析功能变化而不是损伤发生的优点；幸存者偏见的普遍挑战；控制早期生活条件可能造成的混淆的重要性；以及成年人对治疗的反应可能存在的异质性。
Many diseases commonly associated with aging are now thought to have social and physiologic antecedents in early life. Understanding how the timing of exposure to early life risk factors influences later-life health may illuminate mechanisms driving adult health inequalities and identify possible points for effective interventions. Recognizing chronic diseases as developing across the lifecourse also has implications for the conduct of research on adult risk factors for disease. We review alternative conceptual models that describe how the timing of risk factor exposure relates to the development of disease. We propose some expansions of lifecourse models to improve their relevance for research on adult chronic disease, using the relationship between education and adult cognitive decline and dementia as an example. We discuss the important implications each of the lifecourse conceptual models has on study design, analysis, and interpretation of research on aging and chronic diseases. We summarize several research considerations implied by the lifecourse framework, including: advantages of analyzing change in function rather than onset of impairment; the pervasive challenge of survivor bias; the importance of controlling for possible confounding by early life conditions; and the likely heterogeneity in responses of adults to treatment.