Harmonizing health outcomes and determinants across longitudinal studies on aging

说明(由申请人提供)：2001年，国家研究委员会认识到需要对老龄化问题进行多学科研究和纵向研究，强调跨国家研究可以为政策提供比单一国家研究多得多的有用证据。理事会还强调需要统一各国的数据收集并使之标准化。美国国家老龄研究所最近重申，有必要了解国际上老年人在健康和寿命方面的差异。要做到这一点，前提是有可比性的测量和数据。正是出于这一意图，世卫组织关于全球老龄化和成人健康的研究(SAGE)采用了一套方法来提供可比的跨国数据。尽管SAGE侧重于低收入和中等收入国家，但对高收入国家类似研究数据的比较分析可能会提供有益的见解，这将是互惠互利的。建立一个共同的统一数据集是比较分析的基础，其中对事前和事后统一战略给予了极大关注，并证明了来自这种统一数据集的各项指标的有效性，以供进一步深入分析。目前的建议列出了一个议程，以进一步使SAGE对健康、生活质量和幸福感的衡量与其他跨国研究保持一致，例如美国的健康与退休研究(HRS)和欧洲健康与退休研究(SHARE)在11个欧洲国家(第一波研究中，欧盟13个国家在第二轮中)，以及其他国家研究，如英国的英国老龄化纵向研究(ELSA)、印度的纵向老龄化研究(LASI)和中国健康与退休纵向研究(CHARLS)。拟议的研究旨在协调SAGE方法和数据与HRS、SHARE、ELSA、LASI和CHARLS的自我报告健康和福祉，调整在两波调查中自我报告的已知偏差。除了协调自我报告的测量外，它还打算利用健康检查和生物标记物的数据(如果有)创建衍生变量。拟议的研究将为这些调查中的三个主要结果(健康状态、生活质量和幸福感)准备一个综合数据集，并记录不同工具的内部一致性、因素结构、IRT属性、对变化的敏感性和结构以及预测效度。将确定调查中的冗余，并将确定以最可靠和有效的方式衡量结构的一组节俭项目。这些措施预测未来健康结果的能力将在这些调查中进行比较，在这些调查中，可以从多个波(SAGE、HRS、ELSA和SHARE)获得纵向数据。因此，这项研究将为所有这些调查提供一个统一的数据集，并提供一种以强有力的方式衡量这些结果的方法。 与公共卫生的相关性：随着全球人口和流行病学的快速转变，包括在低收入和中等收入国家，迫切需要产生关于老年人口的健康动态、生活质量和福祉的数据，这些数据可以在不同人口和不同时间进行比较。从这些研究中获得的见解将有助于形成当前和未来的卫生和社会政策。可以确定重要的战略，以防止老年群体中健康不良和残疾的负担，并扩大慢性病的保健，以增进福祉和提高生活质量。

DESCRIPTION (provided by applicant): The National Research Council in 2001, recognizing the need for multi-disciplinary research and longitudinal studies on aging, emphasized that cross-national studies can provide substantially more useful evidence for policy than can single country studies. The Council also stressed the need for harmonizing and standardizing data collection across countries. The National Institute on Aging has recently reiterated the need to understand international differences in health and longevity on older adults. A prerequisite for this is comparable measurement and data. It is with this intent that WHO's Study on Global Ageing and Adult Health (SAGE) has been designed using a set of methods to provide comparable cross-national data. Though SAGE is focused on Low and Middle Income (LAMI) countries, comparative analysis of data from similar studies in high income countries is likely to provide useful insights that will be mutually beneficial. The creation of a common harmonized data set where great deal of attention has been paid to ex ante and ex post harmonization strategies and the validity of the indicators from such a harmonized data set has been demonstrated for further in-depth analysis is the foundation for comparative analysis. The current proposal sets out an agenda to further align the measurement of health, quality of life and well-being in SAGE with other cross-national studies such as the Health and Retirement Study (HRS) in the US and the Study of Health And Retirement in Europe (SHARE) in 11 European countries (in its first wave and in 13 countries in the European Union in the second round), and other national studies such as the English Longitudinal Study of Ageing (ELSA) in the UK, the Longitudinal Aging Study in India (LASI) and the China Health and Retirement Longitudinal Study (CHARLS). The proposed study aims to harmonize SAGE methods and data with HRS, SHARE, ELSA, LASI and CHARLS for self-reported health and well- being, adjusting for known biases in self-report across two waves of the surveys. Besides harmonizing measurement of self-reports it also intends to create derived variables using data from health examinations and biomarkers where available. The proposed study will prepare a combined data set for the three main outcomes (health state, quality of life and well-being) across these surveys and record the psychometric properties of the different instruments with regard to their internal consistency, factor structure, IRT properties, sensitivity to change and construct and predictive validity. Redundancies across surveys will be identified and a parsimonious set of items that measure the constructs in the most reliable and valid manner will be identified. The ability of the measures to predict future health outcomes will be compared across these surveys where longitudinal data is available from multiple waves (in SAGE, HRS, ELSA and SHARE). The study will thus provide a harmonized data set across these surveys with a methodology to measure these outcomes in a robust manner. PUBLIC HEALTH RELEVANCE: With the rapid demographic and epidemiological transition occurring globally, including in low and middle income countries, there is an urgent need to generate data with regard to the dynamics of health, quality of life and well-being in the older adult segment of the population that is comparable across populations and over time. Insights obtained from such studies will help shape current and future health and social policy. Important strategies to prevent the burden of ill-health and disability in older age groups, as well as to extend health care for chronic diseases, can be identified to promote well-being and improve quality of life.