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.

项目总结/摘要 到2060年，美国阿尔茨海默病和相关痴呆症（ADRD）的负担预计将增加一倍， 13.9妇女在这些案件中所占比例过高。然而，妇女的许多强大方面 生命--包括暴露于基于性别的暴力--在ADRD研究中几乎没有受到关注。 妇女遭受基于性别的暴力，特别是亲密伴侣暴力的情况很普遍; 30%的老年女性在一生中经历过IPV。 初步证据表明，IPV与加速生物老化有关， 认知功能，但样本往往是高度选择，样本量有限，研究缺乏 纵向评估。应激致敏模型还表明，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 压力和/或创伤的经验，在以后的生活中，但这样的模型还没有扩展到神经系统 老化的结果，如认知能力下降。然而，包含IPV和 纵向认知是有限的，往往不具有人口代表性，限制了研究的外部效度 结果从因果推理的现代可运输性方法可能提供新的机会来推断 研究结果跨人群，提高外部效度在人口水平。 这项提案的总体目标是调查IPV对老年人健康的长期影响。 顺性别女性-认知能力下降-使用纵向亚队列数据的ADRD风险的早期指标 护士健康研究II（NHS 2）和健康与退休研究（HRS）。这项工作将实现 通过三个具体目标：估计（目标1）IPV的经验对认知轨迹的影响 评估（目标2）童年创伤的经历是否会改变 IPV在中年认知功能轨迹上的经验，并解决（目标3）非 通过利用因果关系中开发的新型可移植性方法， 推断估计IPV经验对认知功能轨迹的人群影响， 使用HRS的中年人。这项工作将解决关键的公共卫生问题的生命过程的后果， 在顺性别妇女中进行IPV，将生命过程和性别分析纳入ADRD研究，并将提供 ADRD研究的方法学贡献，以解决该领域经常出现的样本限制。 此外，该研究金还将提供关于基于性别的暴力、社会关系和 网络，认知功能，以及因果可移植性的方法，以及来自一个 优秀的研究团队。这项工作准备在实质上和方法上都有助于 有关ADRD的文献，可能有助于揭示女性一生的社会经历如何影响ADRD风险。