SES and Age-Related Disability in a Biracial Community

描述(由申请人提供) 这项应用是流行病学研究的继续，该研究调查了社会经济劣势和社区条件对老年黑人和白人残疾的影响。拟议的项目是在一项以人口为基础的纵向研究的背景下进行的，研究对象是居住在芝加哥一个地理上界定的城市混血社区的65岁及以上的人。在最初的资助期间，调查人员成功地收集了年度残疾结果数据，并使用自我报告工具和对研究区域的系统社区调查收集了有关社区情况的详细信息。这一延续的第一个总体目标是确定与老年人残疾有关的邻里条件的相对贡献和具体性质。第二个总体目标是确定邻里条件导致残疾增加的生物学机制，特别是通过唾液皮质醇的下丘脑-垂体-肾上腺(HPA)轴的过度活动，以及通过从血液样本中获得的白细胞介素6(IL-6)和C反应蛋白(CRP)的炎症过程。为了实现这些目标，研究人员建议继续每年收集残疾结果数据，并从7000多名参与者那里获取血液样本和唾液皮质醇。这些数据将与关于个人特征、健康状况和邻里因素的丰富现有数据集相结合，以检验与总体目标相关的一系列具体假设。 残疾是与年龄有关的慢性病的一种常见和高度普遍的后果，也是老年人整体健康的关键指标。预防残疾对于改善老年人的生活和降低医疗费用至关重要。拟议的工作将有助于更好地了解与残疾增加相关的特定社区条件，为更有效的政策奠定基础，以防止未来几代老年人的残疾。

DESCRIPTION (provided by applicant) This application is a continuation of an epidemiologic study that investigates the effect of socio-economic disadvantage and neighborhood conditions on disability in older blacks and whites. The proposed project takes place in the context of a population-based, longitudinal study of persons aged 65 years and over who live in a geographically defined, urban, biracial community area in Chicago. During the initial funding period, the investigators have successfully collected yearly disability outcome data, and detailed information on neighborhood conditions using self-report instruments and a systematic neighborhood survey of the study area. The first overall goal of this continuation is to determine the relative contribution and specific nature of the neighborhood conditions that are associated with disability in older adults. The second overall goal is to determine the biological mechanisms through which neighborhood conditions lead to increased disability, focusing specifically on hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis, via salivary cortisol, and inflammatory processes, via interleukin-6 (IL-6) and C-reactive protein (CRP), obtained from blood samples. To accomplish these goals, the investigators propose to continue yearly collection of disability outcome data and obtain blood samples and salivary cortisol from over 7,000 participants. These data will be integrated with a rich set of existing data on personal characteristics, health conditions, and neighborhood factors to test a series of specific hypotheses related to the overall goals. Disability is a common and highly prevalent consequence of age-related chronic diseases, and a critical indicator of overall health among older people. Prevention of disability is essential to improve the lives of older people and reduce health care costs. The proposed work will contribute to a better understanding of the specific neighborhood conditions that are associated with increased disability, laying the foundation for more effective policies to prevent disability in future generations of older adults.