Intimate Partner Violence and Dementia Risk: Applying Lifecourse and Gender Analysis

亲密伴侣暴力和痴呆症风险：应用生命历程和性别分析

• 批准号: 10599392
• 负责人: Audrey Rose Murchland
• 金额: $ 3.96万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-16 至 2024-12-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10599392
• 关键词: Acceleration; Address; Adult; Age; Aging; Alzheimer' s disease related dementia; Anxiety; Attention; Biological Aging; Birth; Cardiovascular Diseases; Characteristics; Cognition; Cognitive; Cognitive deficits; Data; Data Sources; Development; Elderly; Ethnic Origin; Exposure to; Fellowship; Gender; Goals; Health; Health and Retirement Study; Impaired cognition; Life; Life Cycle Stages; Life course epidemiology; Literature; Measurement; Measures; Mental Depression; Mentorship; Methodology; Methods; Modeling; Modernization; Nature; Neurobiology; Neurologic; Nurses' Health Study; Outcome; Participant; Population; Prevention; Public Health; Race; Reporting; Research; Research Personnel; Risk; Sample Size; Sampling; Sexually Transmitted Diseases; Social Network; Socioeconomic Status; Stress; Stress Tests; Subgroup; Training; Trauma; Woman; Women' s Health; Work; career; childhood adversity; chronic pain; cis-female; cisgender; cognitive function; cognitive testing; cohort; dementia risk; ethnic identity; experience; gender-based violence; health inequalities; improved; intimate partner violence; middle age; novel; older women; pediatric trauma; social; social relationships; sociodemographics; socioeconomic diversity; socioeconomics; traumatic stress; violence victimization

PROJECT SUMMARY/ABSTRACT By 2060, the burden of Alzheimer’s disease and related dementias (ADRD) in the U.S. is expected to double to 13.9 million, with women being overrepresented among cases. However, many powerful aspects of women’s lives–including exposure to gender-based violence–have received almost no attention in ADRD research. Women’s exposure to gender-based violence, particularly intimate partner violence (IPV), is pervasive; nearly 30% of older women have experienced IPV in their lifetime. Preliminary evidence suggests that IPV is associated with accelerated biological aging and decreased cognitive functioning, but samples are often highly selected, sample sizes are limited, and studies lack longitudinal assessments. Stress sensitization models also suggest that the impact of trauma, such as IPV, may be larger in some subgroups, since trauma and stress in early life are hypothesized to increase sensitivity to stressful and/or traumatic experiences in later life, but such models have not been extended to neurologic aging outcomes such as cognitive decline. However, data sources that contain robust measures on IPV and longitudinal cognition are limited and often not population representative, limiting the external validity of study results. Modern transportability methods from causal inference may provide novel opportunities to extrapolate study results across populations, improving external validity at the population level. The overall goal of this proposal is to investigate a long-term, aging-related health consequence of IPV among cis-gender women–cognitive decline–an early indicator of ADRD risk using data from longitudinal subcohorts of the Nurses’ Health Study II (NHS2) and the Health and Retirement Study (HRS). This work will be achieved through three specific aims: to estimate (aim 1) the effect of experiences of IPV on trajectories of cognitive functioning in midlife, to evaluate (aim 2) whether experiences of childhood trauma modify the effect of experiences of IPV on trajectories of cognitive functioning in midlife, and to address (aim 3) the non- representative nature of the NHS2 cohort by utilizing novel transportability methods developed in causal inference to estimate the population effect of experiences of IPV on trajectories of cognitive functioning in midlife using HRS. This work will address critical public health questions on the lifecourse consequences of IPV among cis-gender women, bringing analysis of lifecourse and gender into ADRD research, and will provide methodologic contributions to ADRD research to address sample limitations frequent in this field. Further, this fellowship will provide individualized training in gender-based violence, social relationships and networks, cognitive functioning, and methods for causal transportability alongside direct mentorship from an exceptional team of researchers. This work is poised to contribute both substantively and methodologically to the literature on ADRD and may help reveal how lifecourse social experiences of women influence ADRD risk.

项目摘要/摘要 到2060年，美国阿尔茨海默氏病和相关痴呆症（ADRD）的伯恩（ADRD）预计将翻一番 1,390万，妇女在案件中的人数过多。但是，女性的许多有力方面 生活 - 包括基于性别的暴力的生活 - 在ADRD研究中几乎没有受到关注。 妇女对基于性别的暴力，特别是亲密伴侣暴力（IPV）的暴露是无处不在的；几乎 30％的老年妇女在一生中经历了IPV。 初步证据表明，IPV与加速生物衰老有关并改善 认知功能，但通常选择样本，样本量有限，并且缺乏研究 纵向评估。压力敏感性模型还表明创伤的影响，例如IPV 在某些亚组中可能会更大，因为假设早期的创伤和压力以提高灵敏度 在以后的生活中压力很大和/或创伤经历，但是这种模型并未扩展到神经系统 衰老的结果，例如认知能力下降。但是，在IPV和 纵向认知是有限的，通常不是人口代表性的，从而限制了研究的外部有效性 结果。因果推断的现代可运输方法可能提供新的机会来推断 人群之间的研究结果，提高了人口水平的外部有效性。 该提议的总体目标是调查IPV的长期，与老化有关的健康后果 顺式性别妇女认知能力下降 - 使用纵向亚酒精的数据的ADRD风险的早期指标 护士健康研究II（NHS2）和健康与退休研究（HRS）。这项工作将被实现 通过三个具体目标：估计（目标1）IPV经验对认知轨迹的影响 在中年运作，以评估（AIM 2）儿童创伤的经历是否改变了 IPV对中年认知功能轨迹的经验，并解决（AIM 3）非 - NHS2队列的具有代表性的性质，使用在Catal中开发的新型可运输方法 推论以估计IPV经验对认知功能轨迹的人口影响 使用HRS中年。这项工作将解决有关生命之后的关键公共卫生问题 顺式性别妇女中的IPV，将生命力和性别分析的分析带入ADRD研究，并将提供 对ADRD研究的方法论贡献，以解决该领域经常解决样本限制。 此外，该奖学金将在基于性别的暴力，社会关系和 网络，认知功能和因果可运输能力以及直接指导的方法 杰出的研究人员团队。这项工作被中毒以实质性和方法论为 有关ADRD的文献，并可能有助于揭示妇女的生命社会经历如何影响ADRD的风险。