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，美国阿尔茨海默病和相关痴呆(ADRD)的负担预计将翻一番，达到 1390万人，其中妇女在案件中的比例过高。然而，女性的许多强有力的方面 在ADRD的研究中，生活--包括接触基于性别的暴力--几乎没有受到任何关注。 妇女普遍遭受基于性别的暴力，特别是亲密伴侣暴力；几乎 30%的老年女性在一生中经历过IPV。 初步证据表明，IPV与加速生物衰老和降低 认知功能，但样本通常是高度挑选的，样本数量有限，研究缺乏 纵向评估。应激敏化模型还表明，创伤的影响，如IPV， 在某些亚组中可能更大，因为早期生活中的创伤和压力被假设为增加敏感性 与晚年生活中的应激和/或创伤经历有关，但此类模型尚未扩展到神经学 老化的结果，如认知能力下降。然而，包含关于IPV和 纵向认知是有限的，而且往往不具有群体代表性，限制了研究的外部有效性 结果。从因果推断得出的现代可运输性方法可能会提供新的机会来推断 跨人群的研究结果，提高人群层面的外部效度。 这项提案的总体目标是调查IPV对老年人的长期健康后果 顺式性别女性--认知能力下降--使用纵向亚队列数据预测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)。这项工作将会完成 通过三个具体目标：估计(目标1)IPV体验对认知轨迹的影响 中年功能评估(目标2)童年创伤经历是否会改变 IPV对中年认知功能轨迹的体验，并解决(目标3)非 利用在CASTUSE中开发的新的可携带性方法研究NHS2队列的代表性 儿童IPV体验对认知功能轨迹总体效应的推断 使用HRS的中年。这项工作将解决关键的公共卫生问题，这些问题涉及到 在顺性妇女中的IPV，将对生活过程和性别的分析纳入ADRD研究，并将提供 对ADRD研究的方法论贡献，以解决该领域经常出现的样本限制。 此外，该研究金将提供基于性别的暴力、社会关系和 网络、认知功能和因果传递性方法，以及来自 一支杰出的研究团队。这项工作准备在实质性和方法论上为 关于ADRD的文献，可能有助于揭示妇女的生活经历如何影响ADRD风险。