Is mental disorder a preventable cause of age-related disease? The Dunedin Study.

精神障碍是与年龄相关的疾病的可预防原因吗？

• 批准号: 7774364
• 负责人: TERRIE E MOFFITT
• 金额: $ 50.09万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7774364
• 关键词: Adolescence; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol dependence; American; Anxiety; Anxiety Disorders; Atherosclerosis; Attention; Behavior; Behavioral Medicine; Biological; Biological Markers; Birth; Books; C-reactive protein; Carbohydrates; Cardiovascular Diseases; Carmine; Cause of Death; Cell division; Cerebrovascular Disorders; Child; Chromosomes; Chronic; Chronic Schizophrenia; Clinical; DNA Sequence; Data; Data Collection; Dementia; Development; Diabetes Mellitus; Diagnosis; Disease; Dyslipidemias; Elderly; Epidemiologic Studies; Expectancy; Family history of; Fibrinogen; Finches; Fostering; Gender; General Population; Goals; Half-Life; Health; Health Status; Heart Diseases; Hypertension; Immune System Diseases; Immunology; Impaired cognition; Impairment; Individual; Inflammation; Inflammatory; Insulin Resistance; Interleukin-6; Knowledge; Learning; Length; Life; Life Cycle Stages; Life Expectancy; Life Experience; Longitudinal Studies; Major Depressive Disorder; Malignant Neoplasms; Marijuana Dependence; Measurement; Measures; Memory; Mental Depression; Mental Health; Mental Tests; Mental disorders; Metabolic syndrome; Methods; Mind; Molecular; Morbidity - disease rate; NIH Program Announcements; Neuropsychological Tests; Neuropsychology; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Onset of illness; Outcome; Outcome Measure; Outcome Study; Parents; Pathogenesis; Pathway interactions; Patients; Physiological; Policy Maker; Population; Premature aging syndrome; Prevention; Primary Prevention; Prognostic Marker; Publications; Recording of previous events; Recurrence; Research; Risk; Risk Factors; Role; Schedule; Schizophrenia; Science; Series; Services; Severities; Sex Characteristics; Short-Term Memory; Signal Transduction; Stroke; Substance Addiction; Syndrome; System; Telomere Shortening; Testing; Thinking; Time; Trust; Variant; Woman; Women' s Health; Work; Writing; age related; anti social; base; body system; cohort; design; disability; emerging adult; executive function; falls; fitness; follow-up; frailty; grandparent; immune function; improved; indexing; inflammatory marker; innovation; interest; lipid metabolism; meetings; member; men; middle age; mortality; neuropsychological; novel; older men; older women; perceptual organization; physical conditioning; prevent; processing speed; prognostic; programs; prospective; protein structure; public health relevance; recurrent depression; senescence; sex; skills; social; telomere

DESCRIPTION (provided by applicant): We propose to test the novel hypothesis that a persistent history of psychiatric disorder might accelerate individuals' risk of progression toward age-related disease. Specifically, the hypothesis is that people who suffer chronic or recurrent psychiatric disorders during early adulthood will, already by age 38, show cognitive decline and abnormal status on sub-clinical biomarkers that are known to be prognostic early warning signs for late-life diseases, frailty and disability. Rather than focus on psychiatric disorders as an outcome, we study psychiatric disorders as a potentially preventable `exposure' that may accelerate aging. METHOD: We will test this hypothesis in the context of the Dunedin Study, a longitudinal study from birth to age 38 of a representative birth cohort of men and women (N=1037). A unique design feature is that baseline physical health and baseline neuropsychological assessments were carried out from birth to age 13, prior to the onset of most psychiatric disorders. To our knowledge, no other study of the health consequences of psychiatric disorder has these prospective baseline data, which are essential to test whether health and neuropsychological functions have deteriorated in individuals with persistent psychiatric disorder. Cohort members' psychiatric histories of recurrent Depression, recurrent Anxiety, chronic Schizophrenia-syndrome, persistent Alcohol Dependence, and persistent Cannabis Dependence will be defined using data from repeated assessments across 20 intervening years in this longitudinal study. Here we propose to assess the cohort again at age 38, for new data collection. We will assess sensitive outcome measures of sub-clinical health status that are known predictors of age-related diseases in later life: neuropsychological tests of memory and executive functions, the metabolic syndrome, immunological biomarkers, and shortened telomere length. These markers were chosen because they show meaningful variation among people in their late 30's and are known early warning signs for dementia, cardiovascular disease and diabetes. INNOVATION AND SIGNIFICANCE: Life expectancy is growing longer and longer. Policy makers and citizens are concerned that our extra years of life should be healthy, productive, and enjoyable, not extra years of disease and disability. The hope of preventing age-related diseases and of increasing health expectancy requires research to identify candidate risk targets that can be treated successfully, in early- to-middle adulthood. If the hypothesis that psychiatric disorder accelerates the sub-clinical progression toward age-related disease were shown to be true by our proposed research, this would imply that age- related disease could be reduced by successfully treating psychiatric disorders early in life. PUBLIC HEALTH RELEVANCE: As life expectancy grows longer and longer, policy makers and citizens are concerned that our extra years should be healthy, productive, and enjoyable, not extra years of disease and disability. The hope of preventing age-related diseases requires research to identify candidate risk targets that can be treated successfully, in early-to-middle adulthood, before the onset of age-related disease. If the hypothesis that psychiatric disorder accelerates the sub-clinical progression toward age-related disease were shown to be true by our proposed research, this would imply that age-related diseases could be reduced by successfully treating psychiatric disorders early in life.

描述（由申请人提供）：我们建议测试新的假设，即精神疾病的持续病史可能会加速个人向年龄相关疾病进展的风险。具体来说，该假设是，在成年早期患有慢性或复发性精神疾病的人，到38岁时，已经表现出认知能力下降和亚临床生物标志物的异常状态，这些生物标志物被认为是晚年疾病，虚弱和残疾的预后预警信号。而不是集中在精神疾病作为一个结果，我们研究精神疾病作为一个潜在的可预防的“暴露”，可能会加速老化。实验方法：我们将在达尼丁研究的背景下检验这一假设，达尼丁研究是一项对男性和女性的代表性出生队列（N=1037）进行的从出生到38岁的纵向研究。一个独特的设计特点是，基线身体健康和基线神经心理学评估进行了从出生到13岁，在大多数精神疾病发作之前。据我们所知，没有其他研究精神障碍的健康后果有这些前瞻性的基线数据，这是必不可少的测试是否健康和神经心理功能恶化的个人与持续的精神障碍。队列成员的复发性抑郁症、复发性焦虑症、慢性精神分裂症综合征、持续性酒精依赖和持续性大麻依赖的精神病史将使用本纵向研究中20年间重复评估的数据进行定义。在这里，我们建议在38岁时再次评估队列，以收集新的数据。我们将评估亚临床健康状态的敏感结果指标，这些指标是晚年年龄相关疾病的已知预测因子：记忆和执行功能的神经心理学测试，代谢综合征，免疫学生物标志物和缩短的端粒长度。之所以选择这些标志物，是因为它们在30多岁的人群中显示出有意义的变化，并且是痴呆症，心血管疾病和糖尿病的早期预警信号。创新和意义：预期寿命越来越长。政策制定者和公民关心的是，我们额外的生命应该是健康的，富有成效的，愉快的，而不是疾病和残疾的额外岁月。预防与年龄有关的疾病和增加健康预期的希望需要研究确定可以在成年早期至中期成功治疗的候选风险目标。如果我们提出的研究证明精神障碍加速向年龄相关疾病的亚临床进展的假设是正确的，这将意味着年龄相关疾病可以通过在生命早期成功治疗精神障碍来减少。公共卫生关系：随着预期寿命越来越长，政策制定者和公民都关心我们的额外岁月应该是健康的，富有成效的，愉快的，而不是疾病和残疾的额外岁月。预防与年龄有关的疾病的希望需要进行研究，以确定可以在年龄相关疾病发作之前在成年早期至中期成功治疗的候选风险目标。如果我们提出的研究证明精神疾病加速年龄相关疾病的亚临床进展这一假设是正确的，那么这将意味着可以通过在生命早期成功治疗精神疾病来减少年龄相关疾病。