Pathogenesis of physical disability in Aging women

描述(由申请人提供)：老年人的残疾是一种与衰老相关的频繁的、不利的健康后果。以人群为基础和临床 研究表明，老年人的残疾与 慢性疾病，既有单独的，也有组合的，并由一系列 个人层面的因素。然而，越来越多的证据表明 提示慢性疾病以外的致病因素可能起着重要作用 在残疾的发展或进展中的作用，以及 与老年人的死亡率有关。这项研究建议评估 三个潜在致残者在残疾发病机制中的作用： 炎症，激素，微量营养素缺乏，单独的，组合的，和 与现有疾病、损伤和虚弱有关。我们建议 通过分析已经收集的数据来评估这些问题 妇女健康与老龄化研究(WHAS)I及其附属研究 一项研究采集了血液，分析了许多指标，并储存了血浆和 血清。WHAS I和II提供了1/3最残障和2/3‘S残障最少的数据 分别是居住在社区的残疾老年妇女。年长的女性 比老年男性更有可能生活在残疾或依赖他人的生活中，而且 因此需要长期护理。这项研究建议回答以下问题 研究的目标是使用合并的数据集，这些数据集涵盖了 老年妇女：a)建立人口标准和人口变化率 致病生物介体；b)确定这些生物标记物 解释残疾状况；c)纵向评估独立和 致病生物介体对残疾的交互作用 在疾病之上，以及脆弱作为这些的修饰者的潜在作用 关系；d)制定筛查诺模图，用于临床鉴定 那些严重残疾风险较高的人，并评估 有意义地延缓这种进展所需的干预措施；以及e)产生 基于WHAS结果的专著，描述了致病途径的证据 残疾及其危险因素。 这项拟议的研究是组成互动的三项研究之一 研究项目拨款，旨在进行下一代分析 妇女健康与老龄化研究。这3个项目将探索一系列 老年人残疾的生物、社会和环境风险因素 女人。预计这三个级别的评价将单独和共同进行，以 提供对有效预防机会的实质性新理解 以及老年妇女残疾的治疗。

DESCRIPTION (provided by applicant): Disability in older adults is a frequent, adverse health outcome associated with aging. Population-based and clinical research indicates that disability in older adults is strongly associated with chronic diseases, both singly and in combination, and modified by a host of factors at the individual level. However, there is increasing evidence to suggest that pathogenic factors beyond chronic diseases may play significant roles in the development or progression of disability, as well as being associated with mortality in older adults. This study proposes to evaluate the role of three potential contributors to the pathogenesis of disability: inflammation, hormones, micronutrient deficiencies, singly, in combination, and in relation to existing diseases, impairments and frailty. We propose to evaluate these questions through analysis of already-collected data in the Women's Health and Aging Study (WHAS) I and its ancillary studies, the WHAS II and a study that collected blood, analyzed many measures and stored plasma and serum. WHAS I and II provide data on the 1/3 most disabled and the 2/3's least disabled older women living in the community, respectively. Older women are substantially more likely than older men to live disabled or dependent, and to require long-term care due to this. This study proposes to answer the following research aims using merged data sets that span the full spectrum of function in older women: a) to establish population norms and rates of change for pathogenic biomediators; b) to determine the degree to which these biomarkers explain disability status; c) to evaluate longitudinally the independent and interactive contributions of pathogenic biomediators to disability, over and above that of disease, and the potential role of frailty as a modifier of these relationships; d) to develop screening nomograms for clinical identification of those at high risk of severe disability and assess potential impact of interventions needed to meaningfully delay such progression; and e) produce a Monograph based on WHAS results that describes evidence for a causal pathway to disability and its risk factors. This proposed research is one of three studies that comprise an Interactive Research Project Grant designed to conduct next-generation analyses of the Women's Health and Aging Studies. These 3 projects will explore a range of biological, social and environmental risk factors for disability in older women. These 3 levels of evaluation are anticipated, singly and together, to provide substantive new understanding of opportunities for effective prevention and treatment of disability in older women.