Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities

描述（由申请人提供）：在过去几十年中，撒哈拉以南非洲国家经历了人口和流行病学转型，传染病死亡率下降，非传染性疾病患病率上升。SSA的许多成年人现在都患有慢性疾病，无论是传染性疾病还是非传染性疾病。虽然我们有数据资源来了解高收入国家背景下的老龄化挑战，但对SSA背景下的老龄化性质了解甚少。我们的项目旨在建立健康、老龄化和福祉的纵向调查，以便在3个以人口为基础的健康和人口监测站点（HDSS）（南非、加纳和坦桑尼亚）对50岁及以上成年人（n=12,000）处于健康转型不同阶段的主要慢性病的患病率和发病率进行估计。2014年至2017年每年对参与者进行调查，并持续监测死亡率。每年在一个国家进行基线调查，南非在第2年，加纳在第3年，坦桑尼亚在第4年。南非在第5年进行了为期3年的随访。通过密切监测和后续行动，移徙者将保持在非常高的水平。我们的调查与健康与退休研究（HRS）及其姊妹调查相当，但进行了调整，以捕捉特定于SSA的特征。1上有4个子项目。生理与认知功能；2.心脏代谢紊乱；艾滋病毒，4。经济福祉，我们的目标是了解老年人健康的决定因素，进而发现健康对生产力和福祉的影响。我们的具体目标是：1。在南非阿金库尔、加纳纳夫隆戈和坦桑尼亚伊法卡拉的INDEPTH站点的HDSS人群随机分层样本的基础上，建立3组4000名年龄在50岁及以上的男性和女性队列（n=12,000）。临床亚研究在10%的亚样本中进行，以深入研究HIV和CVD。2. 查明三年内死亡率、疾病发病率（特别是心血管疾病和艾滋病毒）以及身体和认知功能变化的社会、经济和生物学预测因素。3. 确定健康状况不佳对三个队列的经济福利和生产力的影响。我们的目标是确定行为和生物风险嵌入社会和政策背景的方式，并由社会和经济条件驱动。从最广泛的意义上讲，卫生政策将需要建立在强有力的证据基础上，我们的研究将提供对表现型疾病和风险因素的有效和可靠的评估。

DESCRIPTION (provided by the applicant): Over the last decades, countries in Sub-Saharan Africa (SSA) have experienced a demographic and epidemiological transition with declines in mortality from infectious diseases and increases in the prevalence of non-communicable disease. Many adults in SSA are now surviving with chronic diseases whether they are communicable or non-communicable. While we have data resources to understand the challenges of aging in the context of high income countries, little is understood of the nature of aging in the SSA context. Our project aims to establish longitudinal surveys of health, aging, and well-being allowing estimation of the prevalence and incidence of major chronic conditions in 3 population-based health and demographic surveillance sites (HDSS) at different stages of health transitions (in South Africa, Ghana and Tanzania) in adults age 50 and over (n=12,000). Participants are surveyed in each year 2014 to 2017 with continuous mortality monitoring. Baseline surveys are introduced in one country per year, with South Africa in year 2, Ghana in year 3 and Tanzania in year 4. A 3 year follow up occurs in South Africa in year 5. Through intensive monitoring and follow up, migrants will be maintained in the cohort at very high levels. Our survey is comparable to that of the Health and Retirement Study (HRS) and sister surveys, yet is adapted to capture characteristics specific to SSA. With 4 subprojects on 1.physical and cognitive function, 2.cardiometabolic disorders, 3.HIV, and 4.economic well-being, our goal is to understand the determinants of health in the elderly and in turn find the consequences of health for productivity and well-being. Our specific aims are: 1. To establish three cohorts of 4,000 men and women aged 50 and over based on random stratified samples of the HDSS populations in the INDEPTH sites of Agincourt in South Africa, Navrongo in Ghana and Ifakara in Tanzania (n=12,000). A clinical substudy is conducted in a 10% subsample to look intensively at HIV and CVD. 2. To identify social, economic and biologic predictors of mortality, the incidence of disease (particularly cardiovascular disease and HIV) and changes in physical and cognitive function over three years. 3. To identify the effects of ill health on the economic well-being and productivity of the three cohorts. We aim to identify the ways in which behavioral and biologic risks are embedded in the social and policy context and are driven by social and economic conditions. Health policies, in the broadest sense, will need to rest on a strong evidence base and our study will provide valid and reliable assessments of phenotypic disorders and risk factors.