Biodemography of Health, Social Factors & Life Challenge

描述（由申请人提供）：我们提出了一套分析，检查生物测量和健康变化的前因、相关关系和后果。具体来说，我们将研究三个问题。1)哪些个体和环境因素有助于我们对下游健康和生存的理解？我们将重点讨论健康与压力经历、社会经济地位、社会心理脆弱性和情感幸福之间的联系。2)哪些因素可以预测生物指标的变化？我们将研究人口统计学和社会心理因素以及环境暴露，以确定先前的经历如何与生物标志物的变化相关联。我们将重点关注社会经济地位（SES），情绪健康，慢性和急性压力源的影响。我们将检查所有生物标志物的变化；一项特别创新的分析将检验压力体验和端粒磨损之间的联系。3)生物指标的变化能预测健康结局和生存吗？我们将使用生命历程框架来探索生物指标的变化以及先前经历和暴露的轨迹如何与随后的健康、身体和认知功能以及生存相关联。特别令人感兴趣的是几个备受瞩目的生物指标（端粒长度、5-HTTLPR基因型和炎症标志物）、可能改变这些关联的因素（创伤、护理、睡眠质量、慢性疼痛和乐观）的新数据，以及基因与环境的相互作用。我们要求为两项数据收集活动提供资金，以丰富以前收集的数据：2010年进行第二轮家庭功能评估；以及冷冻生物标本的选择分析。具体来说，我们将：1)获得访谈者在家中收集的健康和功能指标。2006年生物标志物研究的家庭方案包括握力、定时行走、椅子站立、血压和肺活量。我们建议通过补充计划于2010年进行的纵向调查，为2006年研究的幸存者收集这些数据。这些评估结果将被添加到公共使用数据集中。2)我们将对第1轮冷冻血液标本进行检测（5-HTTLPR、同型半胱氨酸、叶酸、ICAM-1、e-选择素和高灵敏度c反应蛋白），将第1轮数据“回填”到第2轮标准。这些检测结果将被添加到公开发布的数据中。这项工作建立在20年的健康和社会心理数据、两轮生物标志物收集和一个具有已建立的富有成效合作记录的跨学科研究小组的基础之上。公共卫生相关性：拟议的数据收集和分析将帮助研究人员了解环境因素（如个人的社会经济地位以及他们面临的生活挑战的类型和程度）如何以及为什么会影响老年人的健康和生存。中心重点是了解不同生物机制的作用，包括心血管和代谢功能、免疫反应和遗传影响，这些机制是社会环境与下游健康之间联系的基础。这些发现对确定人群健康的最强预测因子和扩大临床医生对心血管疾病传统危险因素的关注具有重要意义。

DESCRIPTION (provided by applicant): We propose a set of analyses that examine the antecedents, correlates, and consequences of change in biological measures and health. Specifically, we will examine three questions. 1) What individual and environmental factors contribute to our understanding of downstream health and survival? We will focus on links between health and stressful experience, SES, psychosocial vulnerability and emotional well- being. 2) What factors predict change in bioindicators? We will examine demographic and psychosocial factors along with environmental exposures to determine how prior experience is associated with change in biomarkers. We will focus on the effects of socioeconomic status (SES), emotional well-being, and chronic and acute stressors. We will examine change across the full array of biomarkers; a particularly innovative analysis will examine the connection between stressful experience and telomere attrition. 3) Do changes in bioindicators predict health outcomes and survival? We will use a life course framework to explore how change in bioindicators and trajectories of prior experience and exposures are associated with subsequent health, physical and cognitive function, and survival. Of particular interest are several high-profile bioindicators (telomere length, 5-HTTLPR genotype, and inflammatory markers), new data on factors that may modify these associations (trauma, caregiving, sleep quality, chronic pain, and optimism), and gene-environment interactions. We request funding for two data collection activities in order to enrich previously-collected data: A second round of in-home functional assessments in 2010; and selected assays of frozen biospecimens. Specifically, we will: 1) Obtain interviewer-measured markers of health and function collected in the home. The household protocol of the 2006 biomarker study included measures of grip strength, timed walks, chair stands, blood pressure, and lung capacity. We propose to collect these data for the survivors of the 2006 study by supplementing the longitudinal survey planned for 2010. These assessments will be added to the public use data set. 2) We will perform assays (5-HTTLPR, homocysteine, folate, ICAM-1, e-selectin, and high sensitivity C-reactive protein) of frozen round 1 blood specimens to "backfill" the round 1 data to the round 2 standard. The results of these assays will be added to the publicly released data. The work builds on a foundation of two decades of health and psychosocial data, two rounds of biomarker collection, and an interdisciplinary research team with an established record of productive collaboration. PUBLIC HEALTH RELEVANCE: The proposed data collection and analysis will help researchers understand how and why environmental factors - such as individuals' socioeconomic status and the type and extent of life challenges that they face - influence health and survival at the older ages. A central focus is to understand the role of different biological mechanisms, including cardiovascular and metabolic function, immune response, and genetic influences, that underlie the linkages between the social environment and downstream health. The findings have implications for identifying the strongest predictors of population health and for expanding clinicians' focus beyond conventional risk factors of cardiovascular disease.