Risk and Resilience Factors in Memory Aging Among Older Cancer Survivors: A Cross Country Comparison of the US and England

老年癌症幸存者记忆老化的风险和弹性因素：美国和英国的跨国比较

• 批准号: 10589206
• 负责人: Ashly C Westrick
• 金额: $ 11.24万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589206
• 关键词: Acceleration; Accounting; Acute; Address; Age; Aging; Alzheimer' s disease related dementia; Cancer Patient; Cancer Survivor; Cancer Survivorship; Clinic; Cognitive; Complex; Comprehensive Health Care; Country; Data; Data Analyses; Diabetes Mellitus; Diagnosis; Diagnostic; Economics; Education; Elderly; England; Environment; Equity; General Population; Goals; Government; Health; Health and Retirement Study; Healthcare Systems; Hypertension; Income; Individual; Inequality; Intervention; Interview; Knowledge; Leadership; Longitudinal Studies; Malignant Neoplasms; Measurement; Memory; Memory Loss; Mental Depression; Mental Health; Mentorship; Neighborhoods; Obesity; Older Population; Persons; Phase; Physical activity; Policies; Politics; Population; Positioning Attribute; Process; Proxy; Research; Research Personnel; Risk; Risk Factors; Role; Sampling; Short-Term Memory; Social support; Socioeconomic Factors; Survivors; Symptoms; Training; United Kingdom; United States; Variant; cancer diagnosis; cancer epidemiology; cardiovascular health; career; cohort; comorbidity; dementia risk; experience; health care availability; health difference; healthy aging; high risk population; human old age (65+); individual variation; long term memory; modifiable risk; multilevel analysis; neighborhood disadvantage; older women; population based; prevent; recruit; resilience; resilience factor; safety net; sex; social; social determinants; social epidemiology; social vulnerability; socioeconomic disparity; socioeconomics; survivorship

Memory loss is a hallmark symptom of Alzheimer’s disease and related dementias (ADRD). By identifying its early stages, interventions could be developed to prevent or slow ADRD progression. While previous research has examined memory aging among the general population, the long-term memory aging of older cancer survivors is under-studied. This is a critical evidence gap, as >26 million people in the United States (US) and >5 million people in the United Kingdom (UK) will be cancer survivors by 2040, and >70% of cancer survivors will be over age 65. The US and UK have different health care systems, government social safety net policies, and magnitudes of income inequality. Hence, older cancer survivors are aging in different social, political, and economic environments across these two high-income countries. A cross-national comparison of the US and UK is an opportunity to identify drivers of both individual-level variation and population-level differences in the memory aging of older cancer survivors. Understanding the long-term memory aging of older cancer survivors in a cross-national framework will enhance our knowledge of what factors matter most for the memory aging of older cancer survivors and could be targets for interventions. This K99/R00 proposal leverages longitudinal pre- and post-cancer diagnosis data from two nationally representative cohorts, the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), to investigate long-term memory trajectories of N=2,500 older cancer survivors from 2002 to 2018. The specific aims are to: (1) identify and compare memory trajectories of cancer survivors in the HRS and ELSA, overall and by age and sex (K99 phase); (2) identify and compare individual, neighborhood, and macro-level socioeconomic inequalities in memory aging of cancer survivors in the HRS and ELSA (R00 phase); and, (3) identify the roles of modifiable risk and resilience factors (hypertension, diabetes, obesity, depression, physical activity, social support) across countries, as these may be intervention targets to promote healthy memory aging among older cancer survivors (R00 phase). The training plan will build on the applicant’s prior training in social and cancer epidemiology to include: (1) ADRD research among cancer survivors; (2) the measurement and analysis of multi-level socioeconomic exposures; (3) and complex longitudinal data analyses in a cross-national framework. This integrated training will prepare the applicant for a successful independent research career focused on the social determinants of healthy aging among older cancer survivors. The applicant is supported by a cohesive and interdisciplinary mentorship team, including HRS and ELSA leadership. Identifying country-level differences in risk and resilience for cancer-related memory aging is important for informing population-level interventions and will support the exploration of policy- relevant determinants in future research. The proposed research will unite the fields of cancer survivorship and ADRD research by using a cross-national, population-based approach to identify high-risk groups of older cancer survivors for accelerated memory decline, as well as identify modifiable risk factors as intervention targets.

记忆力丧失是阿尔茨海默病和相关痴呆症(ADRD)的一个显著症状。通过确定其 在早期阶段，可以制定干预措施来预防或减缓ADRD的进展。虽然之前的研究 已经研究了普通人群中的记忆老化，老年癌症的长期记忆老化 对幸存者的研究还不够深入。这是一个关键的证据差距，因为美国和美国有2600万人 到2040年，英国将有500万人成为癌症幸存者，70%的癌症幸存者 年龄将超过65岁。美国和英国有不同的医疗体系，政府的社会保障网络政策， 以及收入不平等的程度。因此，老年癌症幸存者在不同的社会、政治和 这两个高收入国家的经济环境。美国和英国的跨国比较 是一个机会来确定个人水平差异和人口水平差异的驱动因素 老年癌症幸存者的记忆老化。了解老年癌症幸存者的长期记忆老化 在一个跨国家的框架内，将增强我们对什么因素对记忆老化最重要的知识 老年癌症幸存者，可能成为干预的目标。此K99/R00方案利用纵向预 和癌症后诊断数据，来自两个具有全国代表性的队列，美国健康和退休研究 (HRS)和英语老龄化纵向研究(ELSA)，以研究老年人的长期记忆轨迹 N=2500名老年癌症幸存者，从2002年到2018年。具体目的是：(1)识别和比较记忆 HRS和ELSA中癌症幸存者的轨迹，总体和按年龄和性别(K99阶段)；(2)确定和 比较个人、邻居和宏观层面的社会经济不平等在癌症记忆老化中的作用 HRS和ELSA中的幸存者(R00阶段)；以及，(3)确定可改变的风险和复原力因素的作用 (高血压、糖尿病、肥胖、抑郁、体力活动、社会支持)，因为这些可能 BE干预目标是促进老年癌症幸存者(R00期)的健康记忆老化。培训 该计划将以申请人先前在社会和癌症流行病学方面的培训为基础，包括：(1)ADRD研究 癌症幸存者；(2)多层次社会经济暴露的测量和分析；(3)和 跨国框架下复杂的纵向数据分析。这一综合培训将为 申请成功从事健康老龄化的社会决定因素的独立研究 在老年癌症幸存者中。申请者得到了一个有凝聚力的跨学科指导团队的支持， 包括HRS和ELSA领导层。确定国家一级癌症相关风险和复原力的差异 记忆老化对于为人口层面的干预提供信息非常重要，并将支持政策的探索- 未来研究中的相关决定因素。这项拟议的研究将联合癌症存活率和癌症研究领域 ADRD研究使用跨国家、基于人群的方法来识别老年癌症的高危人群 对于记忆力加速衰退的幸存者，以及确定可修改的危险因素作为干预目标。