Stress, Coping, Health, & Optimal Aging

描述(申请人提供)：压力和应对过程影响生物标记物，如实验室环境中的血压、胆固醇组分和皮质醇，以及现场环境中自我报告的健康状况。然而，建立压力与疾病之间的联系一直非常困难(Cohen等人，2007年)，部分原因是许多关于压力的流行病学研究只对生活事件进行单一的衡量，充其量只能是对长期健康的微弱预测。在标准化的老龄化研究中，我们已经收集了20多年的压力和应对数据，这提供了一个独特的机会来研究长期的压力模式(例如，慢性和间歇性与低水平)如何影响生物标记物的变化、心血管疾病的发展和死亡率，以及长期的心理健康轨迹。我们的理论模型提出，个人可以通过明智地管理压力，包括评估和应对过程，降低对疾病的易感性，促进最佳衰老。标准老龄化研究(NAS)是一个大型小组研究，在20世纪60年代研究开始时，对2280名年龄在21岁到80岁之间的男性进行了研究。1985年，我们开始研究生活事件，1989年开始收集生活事件、烦恼和应对措施，并与三年一度的生物医学考试相结合。2001年，我们通过日记研究添加了日常压力源，并纳入了NAS的妻子。2008年，我们将皮质醇添加到日常日记研究中。NAS中拟议的额外数据收集将使我们能够利用纵向突发设计来检查慢性应激、日常应激、个性和生物标记物之间的相互作用，如皮质醇昼夜节律和老年男性和女性的α淀粉酶。我们还将研究皮质醇活性随时间的变化，这被认为是调节衰老速度的关键因素。第一个具体目标将是使用生长混合模型来模拟从中年到晚年的压力和应对过程的变化模式。其次，我们将研究这些不同的模式对生物标记物(例如血压、胆固醇组分)的变化以及心血管疾病和死亡率的影响。使用耦合分析，我们假设麻烦将更好地预测更近的生物标志物的变化，而生活事件模式将更好地预测长期健康结果。相反，积极的应对会促进保持良好的心理健康和高密度脂蛋白水平。第三个具体目标将研究慢性压力、个性、性别和年龄对皮质醇反应性的影响。

DESCRIPTION (provided by applicant): Stress and coping processes affect biomarkers such as blood pressure, cholesterol fractions, and cortisol in laboratory settings, and self-reported health in field settings. However, establishing the stress-illness link has been very difficult (Cohen et al., 2007), in part because many epidemiological studies of stress have single measures of life events which, at best, are only weak predictors of long-term health. At the Normative Aging Study, we have been collecting stress and coping data for 20+ years, which provides a unique opportunity to examine how patterns of stress over the long term (e.g., chronic vs. intermittent vs. low) affect changes in biomarkers, the development of cardiovascular disease, and mortality, as well as long-term mental health trajectories. Our theoretical model proposes that individuals can decrease vulnerability to disease and promote optimal aging through judicious management of stress, including appraisal and coping processes. The Normative Aging Study (NAS) is a large panel study of 2,280 men aged 21 to 80 at study onset in the 1960s. In 1985, we began studying life events, and in 1989 began collecting, life events, hassles and coping measures in conjunction with the triennial biomedical exams. In 2001, we added daily stressors using diary studies, and included NAS wives. In 2008 we added cortisol to the daily diary studies. The proposed additional data collection in the NAS will allow us to utilize a longitudinal burst design to examine the interplay among chronic stress, daily stress, personality, and biomarkers such as cortisol diurnal rhythms and alpha amylase in older men and women. We will also examine change in cortisol reactivity over time, thought to be a key factor modulating the rate of aging. The first specific aim will be to model patterns of change in stress and coping processes from middle-age to late life, using growth mixture models. Second, we will examine the impact of these different patterns on changes in biomarkers (e.g., blood pressure, cholesterol fractions), as well as the development of cardiovascular disease and mortality. Using coupling analyses, we hypothesize that hassles will better predict change in the more proximal biomarkers, while life event patterns will be better predictors of long-term health outcomes. In contrast, positive coping will promote the maintenance of good mental health as well as HDL levels. The third specific aim will examine the impact of chronic stress, personality, gender, and aging on cortisol reactivity.