Early Life Conditions, Work, Psychological Wellbeing, Cognition and Dementia Risk

不断增长的预期寿命正在推动老年人口规模的迅速增长，预计将导致痴呆症病例急剧增加，从目前的全球约4700万人，到2050年可能超过1.4亿人。在这个项目中，我们建议通过利用来自33个国家的HRS系列调查的新的协调数据来促进我们对老年认知能力下降、阿尔茨海默病和阿尔茨海默病相关痴呆的保护性和风险因素的理解。我们在柳叶刀委员会最近提出的模型的基础上提出了一个新的风险因素生命过程模型，该模型在历史、制度和物理环境的背景下，将阿尔茨海默病和阿尔茨海默病相关痴呆的风险与早年和中年因素联系起来。 这项建议旨在探讨心理健康和阿尔茨海默病和阿尔茨海默病相关痴呆的风险是如何在晚年演变的，以及生活中的重大变化如何影响这些变化，例如退休和家庭环境的变化(例如配偶的死亡或重大健康事件)。在此过程中，我们特别强调早期生活条件的作用，它既是观察到的认知和心理健康的决定因素，也是解释晚年重大生活变化影响的调节因素。 我们将分析来自31个国家的丰富和可比较的数据，利用这样一个事实，即西方世界的一些主要老龄化研究(健康和退休研究，HRS；英语老龄化纵向研究，ELSA；欧洲健康、老龄化和退休调查，SHARE)最近已经包括(或即将包括)生活史模块，获得关于儿童健康、家庭环境、教育和居住流动性的信息。除了这些自我报告外，我们还将利用被调查者目前和当时的背景和机构信息(例如商业周期的状况或婴儿死亡率)。背景信息将有助于确定受访者童年和成年期间的环境和事件对以后生活的认知功能和阿尔茨海默病和阿尔茨海默病相关痴呆的风险以及心理健康的因果影响。

Rising life expectancy is contributing to rapid increases in the size of the older population and is expected to lead to a sharp rise in dementia cases, from about 47 million people worldwide today, to potentially more than 140 million in 2050. In this project, we propose to advance our understanding of protective and risk factors for late-life cognitive decline and Alzheimer's disease and Alzheimer’s disease-related dementias by taking advantage of new harmonized data from the HRS family of surveys across 33 countries. We propose a novel life-course model of risk factors, building on the recently proposed model by the Lancet commission, which links the risk of Alzheimer's disease and Alzheimer’s disease-related dementia to early and mid-life factors, within the context of historical, institutional, and physical environments. This proposal seeks to explore how psychological well-being and the risk of Alzheimer's disease and Alzheimer’s disease-related dementias evolve later in life and how these are affected by major life changes, such as retirement, and changes in family circumstances (for instance death or major health events of a spouse). In doing so, we place special emphasis on the role of early life conditions, both as determinants of observed cognition and psychological wellbeing and as moderating factors in the explanation of the effects of major life changes later in life. We will be analyzing rich and comparable data from 31 countries, by taking advantage of the fact that a number of the main aging studies in the Western world (Health and Retirement Study, HRS; English Longitudinal Study of Aging, ELSA; Survey of Health, Ageing and Retirement in Europe, SHARE) have recently included (or are about to include) life history modules eliciting information about childhood health, family circumstances, education, and residential mobility. In addition to these self-reports we will make use of contextual and institutional information, both at present and at the time of a respondent’s childhood (such as the state of the business cycle or infant mortality). The contextual information will help in identifying causal effects of circumstances and events during a respondent’s childhood and adult life on later life cognitive function and risk of Alzheimer's disease and Alzheimer’s disease-related dementias, and psychological well-being.