Impact of Air Pollution, Weather, and Lifestyle on Health in Older Americans

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DESCRIPTION (provided by applicant): 1) Study Objectives: Our study will examine the individual and joint impacts of air quality and lifestyle on cardiovascular and cognitive health in the elderly and will assess whether these impacts are modified by social and neighborhood factors using data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative, on-going, longitudinal survey of the elderly. NSHAP data include participant-specific information on a variety of demographic, health, social, psychological, and physiological markers, including residence location, health biomarkers, mobility, social connectedness, stress, health status, and cognitive function. These factors were assessed for each participant in two waves, in 2005-2006 and in 2011. We will link NSHAP data to daily and monthly PM2.5, ozone, temperature exposures that will be estimated using well- validated GIS- and satellite-based spatio-temporal models. In so doing, we will create a progressive, detailed and comprehensive record of the exposure, health, and well-being of each participant. We will use these data to achieve four aims: to (1) examine the relationship among air quality, lifestyle, emotional, physical, and functional health; (2) assess whether short term air pollution and temperature exposures are associated with increased blood pressure and c-reactive protein; (3) evaluate relationships between long-term air quality and impaired cognitive function and stress, and (4) investigate whether the cardiovascular and cognitive function response to air pollution is modified by social, neighborhood, and health factors. 2) Study Approach: We will compile individual-specific health, lifestyle and health data for over 3,000 NSHAP participants living across the US. We will link these data to neighborhood characteristics and to daily and monthly air pollutant exposures and temperature estimated using GIS-based spatio-temporal models. We will test our aims using our linked health, lifestyle, neighborhood, and exposure data and standard and novel data analysis methods, including multi-level mixed models, kernel regression machine, mediation analyses, and hierarchical regression techniques, controlling for confounders and multiple testing adjustment. Primary analyses will be performed for air pollution and temperature measures. 3) Expected Results: We will provide new, national evidence of air quality- and lifestyle-mediated risks of poor cardiovascular and cognitive health for our nation's elderly, a large and growing population who may be particularly susceptible to air pollution exposures, extreme temperatures, and social stressors. Results will help to assess susceptibility to pollution and climate change and determine important biological and sociological pathways through which air quality damages cardiovascular and cognitive health. In so doing, our study will help decision-makers address margin of safety issues, examine the individual and joint impacts of air pollution, climate change, and lifestyle on an aging US population, and design intervention strategies to reduce these risks.