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

描述(申请人提供)：人口学和社会流行病学方面的大量研究发现，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知的途径是睡眠。最近的研究发现，社会经济因素与睡眠相关，越来越多的证据表明睡眠与健康有关。很少有基于人群的数据可以让研究人员测试社会和经济因素是否在一定程度上通过对睡眠的影响来影响健康，特别是通过客观的睡眠指标。国家社会生活、健康和老龄化项目(NSHAP)是一项基于人口的纵向研究，对美国老年人的健康和社会过程进行了研究。该项目在2005/6年度对3005名年龄在57岁至85岁之间的社区成年人进行了全国概率抽样，获得了广泛的问卷调查和生物测量数据。五年后，这些人将再次接受采访，并通过招募配偶来扩大队列。NSHAP的优势包括详细的婚姻质量和社交网络数据，以及新颖的基于家庭的生物测量收集。在接下来的5年里，由于婚姻的丧失、伴侣健康状况的下降、社交网络中类似的损失以及经济状况的变化，这些因素都会发生变化，其中许多是由于经济衰退。作为NSHAP最初提案中没有的一项子研究的一部分，正在使用三个晚上的手腕动作记录仪收集三分之一的队列及其配偶的睡眠数据。(预计睡眠亚研究样本788)。我们建议使用这一独特的数据资源来开发和测试社会和经济环境以及这些环境的5年变化对特定心理社会和生理领域的影响的模型，通过它们对睡眠的影响。我们假设，社会和经济因素影响健康的部分原因是它们对睡眠行为、质量和数量的影响。我们将研究人口统计因素、社会经济地位和社会关系如何与老年人同时测量的睡眠行为(留出的睡眠时间和就寝时间)和活动测量的睡眠特征(持续时间和几个质量指标)相关，我们还将探索配偶一方的睡眠和健康如何影响另一方的睡眠。我们将研究五年来社会或经济环境的变化如何预测心理社会特征的变化(即孤独、焦虑、抑郁)或预测生理功能指标(认知、炎症标记物、皮质醇压力反应)，以及这些影响可能在多大程度上受到睡眠行为或测量睡眠的数量或质量的调节。

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.