Long-term Effects of a Natural Disaster on Cognitive Aging, Dementia, Health and Well-being of Older Adults

摘要 该项目将提供严格的科学证据，说明长期以来， 暴露于压力源对认知能力、身体和心理健康以及 印度尼西亚的老年人使用非常丰富的人口代表性纵向 数据收集自大约12，000名老年受访者（> 40岁）之前和之后20年的数据， 2004年印度洋地震海啸灾后重建研究 （星星）。海啸是一场巨大的、无法预料的自然灾害， 沿海社区，而其他类似的，附近的社区没有受到影响，因为 波浪方向、陆地和海底地形。因此，暴露在海啸中， 在我们的研究区域，沿海亚齐和北苏门答腊， 暴露于海啸压力的影响可以给出因果解释。我们将 研究这些影响如何随着个人特定经验的性质而变化。 海啸造成的损失包括被卷入水中、失去家人和经济生计损失。 这项研究将记录老年人在面对压力时的弹性和恢复程度。 海啸及其后果的影响，以及个人在这些过程中发挥的作用， 住户、家庭和社区资源，包括海啸后重建。 特别注意认知和健康的测量和解释。所有老年 受访者将完成用于筛查阿尔茨海默病的评估， 临床验证。至于随机抽取的较年长受访者次样本， 辅以创新的基于神经科学的执行功能措施， 在家中的平板电脑上评估情绪控制。经确认的心脏代谢生物学风险 将收集老年人的同一子样本，以提供独特的丰富，高质量的 为这项研究设计的关键成果的措施。认知与健康之间的联系 将使用同期措施和利用纵向数据对健康 可以追溯到15年前

Abstract This project will provide rigorous scientific evidence on the effects, over the long-term, of exposure to stressors on cognitive performance, physical and psychosocial health and well- being of older adults in Indonesia using extremely rich population-representative longitudinal data collected from about 12,000 older respondents (>40y) before and for 20 years after the 2004 Indian Ocean earthquake and tsunami, the Study of the Tsunami Aftermath and Recovery (STAR). The tsunami was a large and unanticipated natural disaster that devastated some coastal communities while other comparable, nearby communities were untouched because of the wave direction, land and seabed topography. Exposure to the tsunami is, therefore, plausibly exogenous in our study area, coastal Aceh and North Sumatra, so that estimated effects of exposure to the stress of the tsunami can be given a causal interpretation. We will investigate how these effects vary with the nature of individual-specific experiences of the tsunami including being caught up in the water, losing family and loss of economic livelihoods. The research will document the extent of resilience and recovery among older adults in the face of the tsunami and its aftermath, as well as the role played in these processes by individual, household, family and community resources, including post-tsunami reconstruction. Special attention is paid to the measurement and interpretation of cognition and health. All older respondents will complete assessments used to screen for Alzheimer's disease which will be clinically validated. For a randomly selected sub-sample of older respondents, the screeners will be complemented with innovative neuroscience-based measures of executive functioning and emotional control assessed on tablets in the home. Validated cardio-metabolic biological risks will be collected for the same subsample of older adults to provide uniquely rich, high quality measures of key outcomes designed for this research. The links between cognition and health will be described using contemporaneous measures and exploiting longitudinal data on health that reach back 15 years.