Effects of Public Health Interventions on Aged Adults in Village Social Networks

洪都拉斯农村地区不断变化的社会网络互动和痴呆症 摘要 社会联系可以降低痴呆症的风险。但要确定任何此类事件的范围和方向， 因果关系很难。发展中国家社交网络与痴呆症的关系 设置也非常不完全理解。在这里，我们将利用12个国家中约2，011人的罕见数据， 洪都拉斯的村庄，他们是正在进行的纵向研究的一部分，以评估社会 网络相互作用与老年痴呆症在这个农村人口，使用交叉， 分段的、纵向的和巧合的实验方法。我们用一种 经验证的痴呆症评估工具适用于该农村人群（PhotoTest）。目标1： 将首先量化社交网络位置与痴呆症之间的关联。一个主要假设 患有痴呆症的老年人将在村级社交网络中被社会边缘化， 即使考虑到相关的混杂因素。接下来，在目标2中，我们将评估 年长村民的社交网络在两年的时间间隔内与他们随后的 痴呆状态，利用我们数据的重要性。一个主要的假设是， 社会网络程度和中心性将与更高的后续痴呆风险相关。最后， 在目标3中，我们将评估外源性诱导的变化（由潜在的随机 这项试验向每个村庄随机选择的成员提供公共卫生信息， 在老年村民的网络中， 痴呆状态在这里，由于老年人的网络连接发生了变化， 压力，在从第一波到第三波的两年时间里，我们假设， 随后确定的痴呆症将受到不利影响。一个主要假设是， 老年人的社会边缘化会增加他们患痴呆症的风险， 对于那些没有经历过这种社会网络冲击的老年人来说。

Changing Social Network Interactions and Dementia in Rural Honduras Villages Abstract Social connections may reduce dementia risk. But determining the extent and direction of any such causal effect is difficult. The relationship between social networks and dementia in developing world settings is also very incompletely understood. Here, we will exploit rare data about 2,011 people in 12 villages in Honduras who are part of an ongoing longitudinal study in order to evaluate how social network interactions are associated with dementia in this rural elderly population, using cross- sectional, longitudinal, and coincidentally experimental approaches. We assess dementia using a validated dementia assessment tool suitable for use in this rural population (PhotoTest). In Aim 1, we will first quantify the association between social network position and dementia. A primary hypothesis is that older adults with dementia will be socially marginalized within village-level social networks, even after accounting for pertinent confounders. Next, in Aim 2, we will assess how changes in the social networks of older villagers across a two-year interval are associated with their subsequent dementia status, exploiting the longitudinality of our data. A primary hypothesis is that a decline in social network degree and centrality will be associated with higher subsequent dementia risk. Finally, in Aim 3, we will assess how exogenously induced changes (induced by an underlying randomized trial that offered public health information to randomly chosen members of each village with monthly visits over a two-year period) in the networks of older villagers are associated with their subsequent dementia status. Here, since the network connections of the elderly change, under experimental pressure, over the two-year period from Wave 1 to Wave 3, we hypothesize that measures of dementia ascertained subsequently will be adversely affected. A primary hypothesis is that exogenously caused social marginalization of older adults will increase their dementia risk, compared to the elderly not experiencing such shocks to their social network.