Pathogenesis of physical disability in Aging women

描述（由申请人提供）：老年人的残疾是一种常见的， 与衰老相关的不良健康结果。基于人群和临床 研究表明，老年人的残疾与 慢性疾病，无论是单一的和组合，并修改了主机 个人层面的因素。然而，越来越多的证据表明， 提示慢性病以外的致病因素可能起重要作用 在残疾的发展或进展中的作用，以及 与老年人的死亡率有关。本研究旨在评估 三个潜在因素在残疾发病机制中的作用： 炎症，激素，微量营养素缺乏，单独，组合，和 与现有的疾病、损伤和虚弱有关。我们建议 通过分析已经收集的数据来评估这些问题， 妇女健康和老龄化研究（WHAS）I及其辅助研究，WHAS II 一项研究收集了血液，分析了许多措施，储存了血浆， 血清的第一和第二次世界卫生行动计划提供了三分之一最残疾和三分之二最不残疾的数据 残疾老年妇女生活在社区，分别。老年妇女 比老年男子更有可能残疾或依赖他人生活， 因此需要长期护理。本研究拟回答以下问题 研究的目的是使用跨越功能全谱的合并数据集， （a）确定老年妇女的人口标准和变化率， 致病性生物标志物; B）确定这些生物标志物 解释残疾状况; c）纵向评估独立和 致病生物介质对残疾的相互作用， 以上的疾病，和脆弱的潜在作用，作为一个修改这些 d）制定筛选列线图，用于临床识别 严重残疾高危人群，并评估 干预措施需要有意义地延迟这种进展;和e）产生一个 基于WHAS结果的各论，描述了因果途径的证据， 残疾及其危险因素。 这项研究是三项研究之一，包括一个互动 研究项目补助金旨在进行下一代分析的 妇女健康与老龄化研究。这三个项目将探索一系列 老年人残疾的生物、社会和环境风险因素 妇女预计这3个级别的评估，单独和一起， 对有效预防的机会有实质性的新认识 和老年妇女的残疾治疗。

DESCRIPTION (provided by applicant): Disability in older adults is a frequent, adverse health outcome associated with aging. Population-based and clinical research indicates that disability in older adults is strongly associated with chronic diseases, both singly and in combination, and modified by a host of factors at the individual level. However, there is increasing evidence to suggest that pathogenic factors beyond chronic diseases may play significant roles in the development or progression of disability, as well as being associated with mortality in older adults. This study proposes to evaluate the role of three potential contributors to the pathogenesis of disability: inflammation, hormones, micronutrient deficiencies, singly, in combination, and in relation to existing diseases, impairments and frailty. We propose to evaluate these questions through analysis of already-collected data in the Women's Health and Aging Study (WHAS) I and its ancillary studies, the WHAS II and a study that collected blood, analyzed many measures and stored plasma and serum. WHAS I and II provide data on the 1/3 most disabled and the 2/3's least disabled older women living in the community, respectively. Older women are substantially more likely than older men to live disabled or dependent, and to require long-term care due to this. This study proposes to answer the following research aims using merged data sets that span the full spectrum of function in older women: a) to establish population norms and rates of change for pathogenic biomediators; b) to determine the degree to which these biomarkers explain disability status; c) to evaluate longitudinally the independent and interactive contributions of pathogenic biomediators to disability, over and above that of disease, and the potential role of frailty as a modifier of these relationships; d) to develop screening nomograms for clinical identification of those at high risk of severe disability and assess potential impact of interventions needed to meaningfully delay such progression; and e) produce a Monograph based on WHAS results that describes evidence for a causal pathway to disability and its risk factors. This proposed research is one of three studies that comprise an Interactive Research Project Grant designed to conduct next-generation analyses of the Women's Health and Aging Studies. These 3 projects will explore a range of biological, social and environmental risk factors for disability in older women. These 3 levels of evaluation are anticipated, singly and together, to provide substantive new understanding of opportunities for effective prevention and treatment of disability in older women.