Social relationships, economic shocks, sleep and wellbeing among older adults

描述（由申请人提供）：人口统计学和社会流行病学方面的大量研究发现，影响老年人健康的两个最重要的环境决定因素是社会经济地位和社会关系。将这些上游因素与健康结果联系起来的一个相对未被探索的途径是睡眠。最近的研究发现，社会经济因素与睡眠有关，越来越多的证据表明睡眠与健康有关。很少有以人口为基础的数据可以让研究人员测试社会和经济因素是否部分通过对睡眠的影响来影响健康，特别是对睡眠的客观测量。国家社会生活、健康和老龄化项目（NSHAP）是一项以人口为基础的美国老年人健康和社会过程的纵向研究，在2005/6年度从全国范围内的3005名57-85岁的社区居民中获得了广泛的问卷调查和生物测量数据。五年后，同样的人再次接受面试，并且通过招募配偶扩大了这个群体。NSHAP的优势之一是详细的婚姻质量和社会网络数据，以及新颖的基于家庭的生物测量收集。在5年的随访期间，由于婚姻损失、伴侣健康状况下降、社交网络中类似的损失以及经济环境的变化（其中许多是由于经济衰退），将会发生变化。作为最初NSHAP提案之外的一项子研究的一部分，研究人员正在使用三个晚上的手腕活动记录仪收集三分之一的研究对象及其配偶的睡眠数据。（预测睡眠子研究样本788）。我们建议利用这一独特的数据资源来开发和测试社会和经济环境的影响模型，以及这些环境对特定社会心理和生理领域的5年变化，通过它们对睡眠的影响。我们假设社会和经济因素在一定程度上通过影响睡眠行为、质量和数量来影响健康。我们将研究老年人的人口因素、社会经济地位和社会关系如何与同时测量的睡眠行为（留出的睡眠和就寝时间）和活动记录仪测量的睡眠特征（持续时间和一些质量测量）相关，我们将探索配偶一方的睡眠和健康如何影响另一方的睡眠。我们将研究社会或经济环境的5年变化如何预测心理社会特征（即孤独、焦虑、抑郁）的变化或预测生理功能指标（认知、炎症标志物、皮质醇应激反应）的变化，以及这些影响在多大程度上可能由睡眠行为或测量睡眠的数量或质量介导。

DESCRIPTION (provided by applicant): A wealth of research in demography and social epidemiology has found that two of the most important environmental determinants of health for the elderly are socioeconomic status and social relationships. One relatively unexplored pathway linking these upstream factors with health outcomes is sleep. Recent studies have found that socioeconomic factors are correlated with sleep, and there is mounting evidence that connects sleep and health. Few population- based data are available that would allow researchers to test whether social and economic factors affect health in part through their impact on sleep, particularly with objective measures of sleep. The National Social Life, Health and Aging Project (NSHAP), a population-based, longitudinal study of health and social processes among older adults in the U.S., obtained extensive questionnaire and biomeasure data from a national probability sample of 3,005 community- dwelling adults ages 57-85 in 2005/6. The same individuals are being reinterviewed five years later, and the cohort expanded by recruiting spouses. Among the strengths of NSHAP are detailed marital quality and social network data, and novel home-based biomeasure collection. During the 5-year follow-up interval there will have been changes due to marital loss, declines in partner health, similar losses in the social network, and changed economic circumstances, many due to the recession. As part of a substudy that was not in the original NSHAP proposal, sleep data are being collected on one-third of the cohort and their spouses using three nights of wrist actigraphy. (projected sleep substudy sample 788). We propose using this unique data resource to develop and test models of the effects of social and economic circumstances and 5- year changes in these circumstances on specific psychosocial and physiologic domains, through their impact on sleep. We hypothesize that social and economic factors influence health in part through their effects on sleep behavior, quality and quantity. We will examine how demographic factors, socioeconomic status, and social relationships relate to concurrently measured sleep behavior (time set aside for sleep and bedtime) and actigraph-measured sleep characteristics (duration and several measures of quality) in older adults, and we will explore how the sleep and health of one spouse influence the other spouse's sleep. We will examine how 5-year changes in social or economic circumstances predict changes in psychosocial characteristics (i.e., loneliness, anxiety, depression) or predict indicators of physiological function (cognition, inflammatory markers, cortisol stress response) and the extent to which those effects may be mediated by sleep behavior or the quantity or quality of measured sleep.