Building Non-Communicable Eye Disease Research Capacity in India

摘要 印度人口占世界总人口的17%，盲人或视力受损者占25%。 国际吧失明和视力障碍是印度残疾人生活的第四大原因 是70岁及以上人群的头号病因，这部分印度人口正在迅速 增长.在印度，超过90%的视力丧失是由于非传染性疾病，其中大部分是 可以避免的视力不佳会带来广泛的后果，包括福尔斯风险增加， 痴呆、抑郁、残疾、丧失独立性、住院时间更长、更频繁，以及 增加死亡率。尽管非传染性眼病的负担很大且不断增加， 在老年人中，印度缺乏研究专门知识来描述这种流行病并了解其 原因和后果是有效干预和降低其人口健康的关键障碍 冲击因此，该培训方案的重点是建立临床流行病学研究能力， 重点是生命过程分析应用于非传染性眼病（NCED）的研究， 老年人考虑到印度人口的老龄化和NCED对老年人的不成比例的影响， 印度人，至关重要的是要培训印度视觉研究人员的研究原则和方法， 以有效满足这一关键需求。此外，我们目前缺乏生命历程的知识， 了解早期和中期生活暴露对晚年视力和视力相关的影响 残疾在印度针对印度具体情况的研究对于确定关键风险因素和残疾至关重要 NCED的后果，并制定有效的情境化干预措施。拟议研究 能力建设计划将利用Aravind Eye Care的特殊机构环境 系统（AECS）在印度和密歇根大学（UM），包括美国国立卫生研究院资助的UM克劳德D。 胡椒老年美国人独立中心和临床和转化科学奖。um和 AECS有着悠久的合作和教育交流历史。根据一项 根据需求评估调查，设计了博士和硕士培训轨道，以满足需求 早期和中期职业生涯AECS教师谁渴望在临床流行病学研究的职业生涯。的目的 该计划包括：1）提供全面的研究生水平的培训，在临床和 流行病学研究的学员从AECS谁将配备在NCED的主导作用， 在印度的感觉老化研究; 2）发展AECS教师的指导和研究教育技能; 以及3）在AECS建立研究培训机会，提供给广泛的区域受众。所有 培训活动将在5年资助期结束时过渡到AECS。两个伙伴机构 我们致力于这一培训计划的成功，并以其强大的潜力，以解决日益增长的 NCED和视力残疾在印度快速老龄化人口中的流行。

ABSTRACT India is home to over 17% of the world’s population and to 25% of those who are blind or visually impaired worldwide. Blindness and vision impairment are the fourth leading cause of years lived with disability in India and are the number one cause in those age 70 and older, a segment of the Indian population that is rapidly growing. Over 90% of vision loss in India is due to non-communicable disease, the majority of which is avoidable. Poor vision is associated with wide-reaching consequences, including an increased risk of falls, dementia, depression, disability, loss of independence, longer and more frequent hospitalizations, and increased mortality. Despite the large and growing burden of non-communicable eye disease, particularly among older adults, the shortage of research expertise in India to characterize the epidemic and understand its causes and consequences is a critical barrier to intervening effectively and reducing its population health impact. Therefore, the focus of this training program is on building clinical-epidemiological research capacity, with an emphasis on lifecourse analyses applied to the study of non-communicable eye disease (NCED) in older adults. Given the aging of the Indian population and the disproportionate impact of NCED on older Indians, it is critical to train Indian vision researchers in the research principles and methods that will enable them to effectively address this critical need. Moreover, we currently lack knowledge from a lifecourse perspective to understand the effects of early- and mid-life exposures on late-life vision and vision-related disability in India. Research specific to the Indian context is vital to determine key risk factors and disability consequences of NCED, and to develop effective contextualized interventions. The proposed research capacity building program will draw upon the exceptional institutional environments at the Aravind Eye Care System (AECS) in India and at the University of Michigan (UM), including the NIH-funded UM Claude D. Pepper Older Americans Independence Center and Clinical and Translational Science Award. The UM and AECS have a long-standing history of collaboration and educational exchanges. Based on the results of a needs assessment survey, doctoral- and masters-level training tracks have been designed to meet the needs of early- and mid-career AECS faculty who aspire to careers in clinical-epidemiological research. The aims of this program include: 1) to provide comprehensive graduate-level training in the conduct of clinical and epidemiologic research for trainees from AECS who will be equipped to take a leading role in NCED and sensory aging research in India; 2) to develop the mentoring and research education skills of AECS faculty; and 3) to establish research training opportunities at AECS that are offered to a broad regional audience. All training activities will be transitioned to AECS by the end of the 5-year grant period. Both partner institutions are dedicated to the success of this training program and to its strong potential to address the growing epidemic of NCED and visual disability among India’s rapidly aging population.