The Sri Lanka Healthy Minds Study

描述(由申请者提供)：该申请为斯里兰卡健康心灵研究(SLHMS)奠定了基础，这是杜克大学和鲁哈纳大学医学院的一个新的合作研究项目，旨在描述斯里兰卡老年抑郁症和认知障碍的流行病学。SLHMS将是一项基于人群的研究，其中将使用生命周期观点来检查个人、照顾者和其他家庭层面的因素，以更好地了解抑郁风险及其对认知障碍的影响。我们目前提议的一个重要目标是在鲁胡纳大学建立流行病学研究方面的持续研究能力和技术专长，以促进可持续发展和卫生保健系统以及其他长期合作项目。虽然斯里兰卡是亚洲老龄化最迅速的国家之一，但缺乏关于斯里兰卡老年人最常见的神经精神疾病的流行病学数据，我们的研究计划计划解决这一差距。最近的一项估计是，60岁以上的人中有28%的人患有抑郁症，这一点尤其令人担忧，因为这种情况与大多数其他健康问题的预后显著恶化有关，包括认知障碍及其相关残疾。总体目标是描述抑郁症和认知障碍的流行病学，并确定可改变的心理社会因素，这些因素可用于未来的健康促进努力和医疗保健资源分配。这项建议的具体目的是：(1)用定性的方法检查斯里兰卡当地老年人对抑郁症和认知衰退的了解，以及对成功老龄化和对精神疾病的态度等概念；(2)验证抑郁症的测量方法和将用于家庭调查的其他结构；(3)试点家庭调查，以确定可行性并为R01提交产生初步数据，以及(4)发展鲁哈纳大学的研究能力，这将导致长期的研究合作。我们的长期研究目标是前瞻性地检查照顾者和其他家庭成员在老年家庭成员的抑郁和认知障碍状态中所扮演的角色。最终，我们希望我们的发现将提供具体的证据，以指导具有成本效益的、以社区为基础的干预措施，以预防或改善斯里兰卡老年人抑郁和认知障碍的影响。 与公共卫生相关：斯里兰卡这样的发展中国家人口迅速老龄化，不仅对卫生保健系统，而且对传统的护理系统也构成了重大挑战。必须确定文化上突出的风险和保护因素，以防止该人群最常见的神经精神问题，即抑郁和认知障碍。拟议的研究旨在阐明这些因素，然后将其作为促进健康的干预措施和政策的基石。

DESCRIPTION (provided by applicant): This application lays the foundation for the Sri Lanka Healthy Minds Study (SLHMS), a new collaborative research project between Duke University and the Faculty of Medicine at the University of Ruhuna that aims to describe the epidemiology of depression and cognitive impairment among elderly Sri Lankans. The SLHMS will be a population based study where individual, caregiver, and other family level factors will be examined using a lifecourse perspective to better understand depression risk and its influence on cognitive impairment. An important goal of our current proposal is to build sustained research capacity and technical expertise in epidemiological research at the University of Ruhuna in order to facilitate the SLHMS as well as other long term collaborative projects. While Sri Lanka is one of Asia's most rapidly aging countries, there is a lack of epidemiological data on the most common neuropsychiatric conditions among the elderly in Sri Lanka and it is this gap that our research program plans to address. A recent estimate of 28% depression among those over 60 is especially troubling, as the condition is associated with significantly worse prognosis of most other health problems, including cognitive impairment and its associated disability. The overarching goal is to both describe the epidemiology of depression and cognitive impairment and to identify modifiable psychosocial factors, which can be utilized in future health promoting efforts as well as healthcare resource allocation. The specific aims of this proposal are to: (1) use qualitative methods to examine local understanding of depression and cognitive decline among elderly in Sri Lanka, concepts such as successful aging and attitudes towards mental illness; (2) validate measures of depression and other constructs to be used in a household survey; (3) pilot a household survey to establish feasibility and generate preliminary data for R01 submission, and (4) develop the research capacities at the University of Ruhuna which will lead to long term research collaborations. Our long term research goal is to examine prospectively the role of the caregiver and other family members in relation to the depression and cognitive impairment status of the elderly family member. Ultimately, we hope that our findings will provide concrete evidence to guide cost-effective, community based interventions to prevent, or ameliorate the impact of, depression and cognitive impairment among Sri Lankan elderly. PUBLIC HEALTH RELEVANCE: The quickly aging population of a developing country like Sri Lanka poses significant challenges to not just the health care system but the traditional systems of caregiving as well. It is imperative to identify the culturally salient risk and protective factors against the most common neuropsychiatric problems of this population, namely depression and cognitive impairment. The proposed study aims to elucidate these factors, which can then serve as building blocks for health promoting interventions and policies.