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

描述（由申请人提供）： 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 并将利用国家社会生活、健康和老龄化项目（NSHAP）的数据来评估这些影响是否会受到社会和邻里因素的影响，该项目是一项全国性的、持续的、针对老年人的纵向调查。 NSHAP 数据包括有关各种人口统计、健康、社会、心理和生理标记的参与者特定信息，包括居住地点、健康生物标记、流动性、社会联系、压力、健康状况和认知功能。这些因素在 2005-2006 年和 2011 年分两轮对每个参与者进行了评估。我们将 NSHAP 数据与每日和每月的 PM2.5、臭氧、温度暴露联系起来，这些暴露将使用经过充分验证的 GIS 和卫星时空模型进行估计。在此过程中，我们将为每位参与者的接触情况、健康状况和福祉创建渐进、详细和全面的记录。我们将利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反应蛋白升高有关； （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）研究心血管和认知功能对空气污染的反应是否会受到社会、邻里和健康因素的影响。 2) 研究方法：我们将为居住在美国各地的 3,000 多名 NSHAP 参与者编制个人特定的健康、生活方式和健康数据。我们将这些数据与邻里特征以及使用基于 GIS 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。我们将使用关联的健康、生活方式、邻里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，包括多级混合模型、核回归机、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测量进行初步分析。 3) 预期结果：我们将提供新的全国证据，证明空气质量和生活方式介导的我国老年人心血管和认知健康状况不佳的风险，这些老年人口数量庞大且不断增长，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。在此过程中，我们的研究将帮助决策者解决安全边际问题，研究空气污染、气候变化和生活方式对美国人口老龄化的个体和联合影响，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.