Cardiovascular and Cerebrovascular Risk Factors for Mobility Limitation in the Jackson Heart Study

杰克逊心脏研究中导致活动受限的心脑血管危险因素

• 批准号: 10576340
• 负责人: Michelle Christina Odden
• 金额: $ 39万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576340
• 关键词: Affect; African American population; Age; Aging; Ancillary Study; Biology; Blood Pressure; Brain; Cardiac health; Cardiovascular Diseases; Cardiovascular system; Categories; Cerebrovascular Disorders; Clinical; Cognitive; Cohort Studies; Communities; Data; Dementia; Development; Disparity; Disparity population; Elderly; Ethnic Origin; Event; Exposure to; Gait speed; Goals; Health; Heart failure; Human; Human Activities; Hypertension; Impaired cognition; Inflammation; Intervention; Jackson Heart Study; Kidney; Kidney Diseases; Knowledge; Life; Link; Measures; Mediating; Mediation; Mediator; Methods; Microvascular Dysfunction; Mississippi; Myocardial Infarction; Obesity; Outcome Study; Participant; Pathway interactions; Patient Self-Report; Persons; Physical Performance; Physical activity; Population; Prevalence; Prevention strategy; Race; Research; Resources; Risk Factors; Schedule; Seminal; Smoking; Socioeconomic Status; Stroke; Testing; Underrepresented Populations; Vascular Diseases; Walking; White Matter Hyperintensity; Work; brain health; brain magnetic resonance imaging; cardiovascular health; case finding; cerebrovascular; cognitive testing; critical period; dementia risk; depressive symptoms; design; disability; fasting glucose; high risk population; human old age (65+); middle age; novel; preservation; prevent; psychosocial; racial health disparity; sex; vulnerable community

ABSTRACT Walking is a core activity of human life. Mobility limitation, or difficulty or inability to walk, can limit a person's ability to work, live independently, and participate in the community. Heart and brain health are two of the strongest modifiable pathways to mobility limitation. African Americans have a disproportionate burden of cardiovascular disease (CVD), cerebrovascular disease (CBVD), cognitive impairment, and mobility limitation, but the majority of research on the relationship between these conditions has been conducted in predominantly white populations. The biology and optimal prevention strategies for mobility limitation may differ by race/ethnicity, highlighting a critical need for research in underrepresented populations. The proposed research will add validated measures of mobility, disability, and physical performance to the Jackson Heart Study (JHS), a cohort study of African Americans, designed to investigate causes of CVD in a high-risk population. JHS participants have undergone three exams (Exam 1, 2000-2004, Exam 2, 2005-2008, Exam 3, 2009-2013); Exam 4 is scheduled on the 3,500 remaining participants (mean age = 65 years) beginning in 2020. The exam will include extensive CVD measures, socioeconomic status, psychosocial health, cognitive testing, and brain MRI. We propose an ancillary study to add established measures of mobility limitation: gait speed <0.6 m/s, and self-reported difficulty/inability to walk a quarter of a mile or climb 10 stairs. We will leverage the nearly 20 years of data on CVD/CBVD risk factors and newly collected data on subclinical vascular disease and brain health to better understand the timing of exposure to risk factors and mediating pathways to mobility limitation in African Americans. We hypothesize that exposure to high blood pressure, high fasting glucose, and adiposity in midlife will have stronger associations with mobility limitation in older adults than exposure to these risk factors in late life. We will use novel statistical mediation methods to quantify the extent to which potential mediators explain the relationship between CVD/CBVD risk factors and mobility limitation, while allowing us to test for potential interactions by these mediators. This research will support our long-term goal to enhance functional health among African Americans, in order to preserve independence and participation in the community. Understanding the link between heart and brain health and mobility limitation is critical to reduce racial disparities in health. Moreover, the addition of the functional measures will help expand JHS into a contemporary study cardiovascular health and aging in African Americans.

抽象的 步行是人类生活的核心活动。流动性限制，或难以行走，可能会限制一个人的 能够工作，独立生活和参与社区的能力。心脏和大脑健康是其中两个 移动限制的最强修改途径。非裔美国人的负担不成比例 心血管疾病（CVD），脑血管疾病（CBVD），认知障碍和活动限制， 但是，关于这些条件之间关系的大多数研究主要是在 白人人群。生物学和最佳预防限制策略可能会有所不同 种族/种族，强调了对人群不足的研究的迫切需求。拟议的研究 将在杰克逊心脏研究（JHS）中添加验证的移动性，残疾和身体表现的衡量标准， 一项对非裔美国人的队列研究，旨在调查高危人群中CVD的原因。 JHS 参与者接受了三项考试（考试1，2000-2004，考试2，2005-2008，考试3，2009-2013）; 考试4计划于2020年开始剩下的3500名参与者（平均年龄= 65岁）。考试 将包括广泛的CVD措施，社会经济地位，社会心理健康，认知测试和大脑 MRI。我们提出了一项辅助研究，以添加既定的迁移率措施：步态速度<0.6 m/s， 并自我报告的困难/无能为力，步行四分之一英里或爬10个楼梯。我们将利用近20个 关于CVD/CBVD风险因素以及亚临床血管疾病和大脑的新收集的数据的多年数据 健康以更好地了解暴露于风险因素的时机并介导通往行动限制的途径 在非裔美国人。我们假设暴露于高血压，高空腹葡萄糖和 中年的肥胖将与老年人的流动性限制更牢固，而不是暴露这些 后期的危险因素。我们将使用新颖的统计调解方法来量化潜力的程度 调解员解释了CVD/CBVD风险因素与流动性限制之间的关系，同时使我们能够 测试这些介体的潜在相互作用。这项研究将支持我们的长期目标来增强 非裔美国人的功能健康，以维护独立性并参与 社区。了解心脏与大脑健康与流动性限制之间的联系对于减少 健康方面的种族差异。此外，增加功能措施将有助于将JHS扩展到 非洲裔美国人的当代研究心血管健康和衰老。