Anxiety, Stressful Life Events, and Physical Health in Older Adults

描述(由申请人提供)：建议项目的总体目标是了解焦虑、应激性生活事件(SLE)和晚年身体健康之间的联系。关于老年人焦虑的研究很少，尽管焦虑症在这个年龄段比情感障碍更普遍。在成年人中，焦虑与疾病、残疾、过度使用医疗保健和糟糕的生活质量有关。人们对焦虑对老年人身体健康的影响知之甚少。这项拟议的研究旨在(1)了解焦虑、系统性红斑狼疮和晚年身体疾病之间的暂时联系；(2)测试焦虑和系统性红斑狼疮是否会增加老年人的死亡风险；以及(3)了解这些过程背后的遗传和环境影响。这项研究将从大规模双胞胎人口登记中抽取分开抚养和一起抚养的双胞胎样本。关于焦虑、系统性红斑狼疮和身体健康的自我报告数据是在20年期间8次通过问卷调查收集的；与国家登记处的联系将进一步提供关于住院记录和死亡率的数据。时间关联性将使用潜在差异分数(LDS)结构方程模型进行检验。与常用的交叉滞后或增长曲线模型相比，LDS模型允许我们评估焦虑和SLE的增加(相对于平均水平)是否预测较晚的身体疾病发病，反之亦然。在对潜在的协变量进行调整后，将通过生存分析来计算因焦虑和应激性生活事件而导致的死亡风险。将在表型和基因水平上进行分析，以评估焦虑和系统性红斑狼疮对疾病和死亡率的影响 部分遗传影响。该项目直接涉及国家 老龄与健康人2010年倡议：了解晚年焦虑及其对 发病率和死亡率是加强对这两种疾病并存的预防、诊断和干预的必要手段 条件。预防、诊断和干预工作反过来可以延长活跃的生命和健康 老年人的预期，并减少由于过度使用服务而不必要的成本， 药物和后半生的损害。

DESCRIPTION (provided by applicant): The broad objective of the proposed project is to understand the association of anxiety, stressful life events (SLE), and physical health in late life. Little research has been conducted on anxiety in older adults, although anxiety disorders are more prevalent than affective disorders in this age group. Among adults, anxiety is associated with high prevalence of illness, disability, excessive health care usage and poor quality of life. Less is known about the impact of anxiety on the physical health of older adults. The proposed research aims at (1) understanding the temporal association of anxiety, SLE, and physical illness in late life; (2) testing whether anxiety and SLE increase the risk of death in older adults; and (3) understanding genetic and environmental influences underlying these processes. The study will draw from a sample of reared-apart and reared-together twins from a large scale population twin registry. Self-report data on anxiety, SLE and physical health were collected through questionnaires at 8 occasions over a 20-year period; linkage to national registries will further provide data on hospitalization records and mortality. Temporal association will be examined with latent difference score (LDS) structural equation models. Compared to the commonly used cross-lagged or growth curve models, LDS models allow us to evaluate whether increases in (versus mean levels of) anxiety and SLE are predictive of later onset of physical illness, and vice versa. Calculation of mortality risk due to anxiety and stressful life events after adjusting for potential covariates will be performed with survival analysis. Analyses will be performed at both phenotypic and genotypic levels to estimate the effects of anxiety and SLE on illness and mortality after partialling genetic influences. This project directly addresses the research priorities stated by the National Institute on Aging and the Healthy People 2010 initiative: understanding late-life anxiety and its impact on morbidity and mortality are necessarily to improve prevention, diagnosis and intervention of these comorbid conditions. Prevention, diagnosis and intervention efforts can in turn prolong active life and health expectancies in older adults, and reduce unnecessarily costs due to excessive service utilization, medications and impairment in the later half of life.