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

描述(申请人提供)：1)研究目标：我们的研究将考察空气质量和生活方式对心血管和认知健康的个人和联合影响 我们将利用国家社会生活、健康和老龄化项目(NSHAP)的数据，评估这些影响是否会受到社会和社区因素的影响，NSHAP是一项具有全国代表性的持续的老年人纵向调查。NSHAP数据包括关于各种人口、健康、社会、心理和生理标记物的特定于参与者的信息，包括居住位置、健康生物标记物、流动性、社会联系、压力、健康状况和认知功能。在2005-2006年和2011年的两次浪潮中，对每个参与者进行了这些因素评估。我们将把NSHAP数据与每日和每月的PM2.5、臭氧、温度暴露联系起来，这些数据将使用经过充分验证的基于地理信息系统和卫星的时空模型进行估计。在这样做的过程中，我们将创建一个渐进的、详细的和全面的记录，记录每个参与者的暴露、健康和福祉。我们将使用这些数据来实现四个目标：(1)检查空气质量、生活方式、情绪、身体和功能健康之间的关系；(2)评估短期空气污染和温度暴露是否与血压和C-反应蛋白升高相关；(3)评估长期空气质量与认知功能受损和压力之间的关系；以及(4)调查社会、邻居和健康因素是否改变了心血管和认知功能对空气污染的反应。2)研究方法：我们将汇编居住在美国各地的3000多名NSHAP参与者的个人特定健康、生活方式和健康数据。我们将把这些数据与社区特征以及使用基于地理信息系统的时空模型估计的每日和每月空气污染物暴露和温度联系起来。我们将使用我们关联的健康、生活方式、邻里关系和暴露数据以及标准和新颖的数据分析方法来测试我们的目标，包括多水平混合模型、核回归机器、中介分析和分层回归技术、控制混杂因素和多重测试调整。将对空气污染和温度措施进行初步分析。3)预期结果：我们将提供新的、全国性的证据，证明空气质量和生活方式导致我国老年人心血管和认知健康不良的风险，老年人是一个庞大且不断增长的人口，他们可能特别容易受到空气污染暴露、极端温度和社会压力的影响。结果将有助于评估对污染和气候变化的敏感性，并确定空气质量损害心血管和认知健康的重要生物学和社会学途径。通过这样做，我们的研究将帮助决策者解决安全边际问题，检查空气污染、气候变化和生活方式对美国老龄化人口的个别和联合影响，并设计干预策略来降低这些风险。

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.