Aging in Puerto Rico: Longitudinal Follow-Up of the PREHCO Study

项目概要/摘要 在过去的十年里，波多黎各经历了人口迅速老龄化，金融崩溃，大规模向外 年轻人的移民，然后是飓风玛丽亚现在是建立在唯一的人口基础上的理想时机- 基于波多黎各老年人的队列，在这些主要研究之前， 事件访问了波多黎各各地的家庭，以确定第一个全岛60岁以上成年人的样本 波多黎各老年人：健康状况（PREHCO）研究。一系列广泛的措施， 健康和衰老，包括认知和身体功能的家庭测试，在基线时收集 (2002 2003年）和四年后（2006/2007）。我们建议收集两波与衰老有关的新数据， 对大约1，000名PREHCO幸存者进行抽样调查。本项目将：a）扩展 PREHCO随访至基线后16 - 20年; B）检查主要老化的生命过程预测因子 结果，即认知障碍、残疾和死亡率; c）收集飓风相关压力源的数据 d）添加毛发皮质醇作为慢性下丘脑-垂体-肾上腺（HPA）轴的标志物 激活;以及e）增加与健康和退休研究一致的认知和代理线人措施 （HRS）。我们的项目将实现以下具体目标：目标1。审视纵向生命历程 认知健康、皮质醇水平、心理健康、残疾和死亡率的生物心理社会预测因素16-20 基线后的几年。目标二。检查压力源之间的横截面关联， 因素，感知压力，皮质醇和健康，以及两年后健康的变化。目标3。增加 PREHCO在跨文化比较中的实用性。波多黎各是美国的重要组成部分， 在美国人口老龄化研究中被忽略了。PREHCO参与者现在年龄超过76岁， 考虑到这一年龄组的死亡率不断上升，我们建议收集两个新的随访时间点， PREHCO的数据代表了一个时间有限的机会，可以增加我们对衰老，压力和 健康在一个研究不足和潜在的弱势群体。

PROJECT SUMMARY/ABSTRACT In the past decade, Puerto Rico has experienced rapid population aging, financial collapse, mass outward migration of younger people, and then Hurricane Maria. Now is an ideal time to build on the only population- based cohort of older adults in Puerto Rico, unique in having data on health and function prior to these major events. Households across Puerto Rico were visited to identify the first island-wide sample of adults age 60+ years for the Puerto Rican Elderly: Health Conditions (PREHCO) study. A wide range of measures relevant to health and aging, including in-home testing of cognitive and physical function, was collected at baseline (2002/2003) and four years later (2006/2007). We propose to gather two new waves of data related to aging, stress and health in a sample of approximately 1,000 PREHCO survivors. The current project will a) extend PREHCO follow-up to between 16 and 20 years after baseline; b) examine life course predictors of major aging outcomes, namely cognitive impairment, disability, and mortality; c) collect data on hurricane-related stressors and mental health; d) add hair cortisol as a marker of chronic hypothalamic pituitary adrenal (HPA) axis activation; and e) add cognitive and proxy informant measures that align with the Health and Retirement Study (HRS). Our project will enable the following specific aims: Aim 1. Examine longitudinal life course biopsychosocial predictors of cognitive health, cortisol levels, mental health, disability, and mortality 16-20 years after baseline. Aim 2. Examine cross-sectional associations between stressors, resilience-enhancing factors, perceived stress, cortisol, and health, as well as changes in health two years later. Aim 3. Increase utility of PREHCO for cross-cultural comparisons. Puerto Rico is an important part of the U.S. that has largely been omitted from U.S. population-based studies of aging. PREHCO participants are now age 76+ years and given accelerating mortality rates for this age group, our proposal to gather two new time points of follow-up data for PREHCO represents a time-limited opportunity to add to our knowledge about aging, stress, and health in an understudied and potentially vulnerable population.