Stress, Coping, Health, & Optimal Aging

描述（由申请人提供）：压力和应对过程影响生物标志物，如实验室环境中的血压、胆固醇分数和皮质醇，以及现场环境中自我报告的健康状况。然而，建立压力与疾病之间的联系是非常困难的（Cohen et al., 2007），部分原因是许多关于压力的流行病学研究都是对生活事件的单一测量，而这些研究充其量只是对长期健康状况的微弱预测。在规范老龄化研究中，我们已经收集了20多年的压力和应对数据，这提供了一个独特的机会来研究长期压力模式（例如，慢性、间歇性和低压力）如何影响生物标志物的变化、心血管疾病的发展、死亡率以及长期的心理健康轨迹。我们的理论模型表明，个体可以通过明智地管理压力，包括评估和应对过程，降低对疾病的脆弱性，促进最佳衰老。规范老龄化研究（NAS）是一项大型小组研究，在20世纪60年代开始研究时，对2280名年龄在21至80岁之间的男性进行了研究。1985年，我们开始研究生活事件，并于1989年开始收集生活事件、烦恼和应对措施，同时进行三年一次的生物医学检查。2001年，我们通过日记研究加入了每日压力源，包括NAS妻子。2008年，我们在日常日记研究中加入了皮质醇。NAS中提出的额外数据收集将允许我们利用纵向突发设计来检查老年男性和女性的慢性压力，日常压力，个性和生物标志物（如皮质醇日节律和α淀粉酶）之间的相互作用。我们还将研究皮质醇反应随时间的变化，这被认为是调节衰老速度的关键因素。第一个具体目标将是使用生长混合模型来模拟从中年到晚年压力和应对过程的变化模式。其次，我们将研究这些不同模式对生物标志物（如血压、胆固醇含量）变化的影响，以及心血管疾病和死亡率的发展。通过耦合分析，我们假设争吵可以更好地预测更近的生物标志物的变化，而生活事件模式可以更好地预测长期健康结果。相反，积极应对有助于保持良好的心理健康和高密度脂蛋白水平。第三个具体目标是研究慢性压力、个性、性别和年龄对皮质醇反应的影响。

DESCRIPTION (provided by applicant): Stress and coping processes affect biomarkers such as blood pressure, cholesterol fractions, and cortisol in laboratory settings, and self-reported health in field settings. However, establishing the stress-illness link has been very difficult (Cohen et al., 2007), in part because many epidemiological studies of stress have single measures of life events which, at best, are only weak predictors of long-term health. At the Normative Aging Study, we have been collecting stress and coping data for 20+ years, which provides a unique opportunity to examine how patterns of stress over the long term (e.g., chronic vs. intermittent vs. low) affect changes in biomarkers, the development of cardiovascular disease, and mortality, as well as long-term mental health trajectories. Our theoretical model proposes that individuals can decrease vulnerability to disease and promote optimal aging through judicious management of stress, including appraisal and coping processes. The Normative Aging Study (NAS) is a large panel study of 2,280 men aged 21 to 80 at study onset in the 1960s. In 1985, we began studying life events, and in 1989 began collecting, life events, hassles and coping measures in conjunction with the triennial biomedical exams. In 2001, we added daily stressors using diary studies, and included NAS wives. In 2008 we added cortisol to the daily diary studies. The proposed additional data collection in the NAS will allow us to utilize a longitudinal burst design to examine the interplay among chronic stress, daily stress, personality, and biomarkers such as cortisol diurnal rhythms and alpha amylase in older men and women. We will also examine change in cortisol reactivity over time, thought to be a key factor modulating the rate of aging. The first specific aim will be to model patterns of change in stress and coping processes from middle-age to late life, using growth mixture models. Second, we will examine the impact of these different patterns on changes in biomarkers (e.g., blood pressure, cholesterol fractions), as well as the development of cardiovascular disease and mortality. Using coupling analyses, we hypothesize that hassles will better predict change in the more proximal biomarkers, while life event patterns will be better predictors of long-term health outcomes. In contrast, positive coping will promote the maintenance of good mental health as well as HDL levels. The third specific aim will examine the impact of chronic stress, personality, gender, and aging on cortisol reactivity. PUBLIC HEALTH RELEVANCE: The older population of Americans, age 65+, is expected to almost double by 2040. As older adults are by far the largest consumers of medical services, this threatens an economic and public health care crisis in the near future. Understanding the psychosocial factors that promote optimal aging may help to attenuate these costs.