Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities

描述（由申请方提供）：在过去几十年中，撒哈拉以南非洲（SSA）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。撒哈拉以南非洲的许多成年人现在都患有慢性病，无论是传染性的还是非传染性的。虽然我们有数据资源来了解高收入国家老龄化的挑战，但对SSA背景下老龄化的性质了解甚少。我们的项目旨在建立健康，老龄化和福祉的纵向调查，以估计主要慢性病的患病率和发病率在3个基于人口的健康和人口监测点（HDSS）在不同阶段的健康转变（在南非，加纳和坦桑尼亚）在50岁及以上的成年人（n = 12，000）。参与者在2014年至2017年每年接受调查，并持续监测死亡率。每年在一个国家进行基线调查，第二年是南非，第三年是加纳，第四年是坦桑尼亚。第5年在南非进行3年随访。通过密集的监测和后续行动，移徙者将在队列中保持很高的水平。我们的调查是可比的健康和退休研究（HRS）和姐妹调查，但适应捕捉特定于SSA的特征。通过4个子项目，1.身体和认知功能，2.心脏代谢障碍，3.艾滋病毒和4.经济福祉，我们的目标是了解老年人健康的决定因素，并反过来发现健康对生产力和福祉的影响。我们的具体目标是：1.根据南非Agincourt、加纳Navrongo和坦桑尼亚Ifakara的INDEPTH研究中心HDSS人群的随机分层样本，建立3个队列，每组4，000名50岁及以上的男性和女性（n = 12，000）。在10%的子样本中进行了一项临床子研究，以深入研究HIV和CVD。2.确定三年内死亡率、疾病（特别是心血管疾病和艾滋病毒）发病率以及身体和认知功能变化的社会、经济和生物预测因素。3.确定健康状况不佳对三个组群的经济福祉和生产力的影响。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，卫生政策需要建立在强有力的证据基础上，我们的研究将提供对表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.