Interdisciplinary Research Training in Health and Aging

描述（由申请人提供）：现代老年人慢性病负担的增加部分是由于生活方式、环境条件和影响寿命的医学治疗的改善使生存和预期寿命增加。我们提出了一个跨学科的培训计划，在公共卫生和老龄化，将准备我们的学员作为研究人员在公共卫生科学和政策，以解决老年人慢性疾病的原因和后果，并制定有效的计划和政策。教师（n=19）从10+学科在公共卫生和医学博士/博士后指导和老龄化研究的优秀记录将参加。我们将培养16名博士和博士后学生，他们将获得将公共卫生科学和政策应用于老龄化和慢性病问题所需的技能和知识。这将通过核心课程，跨学科的每月研讨会，实践实习，以及在跨学科研究和培训方面经验丰富的教师的共同指导来完成。了解老年人健康和功能变化的轨迹显然需要纵向的观点，可以捕捉累积和不断变化的暴露。这意味着使用方法和统计模型，允许建模的时间依赖性协变量和同时竞争的结果。在老年人群的研究有特殊的方法和概念的挑战，没有在标准的公共卫生计划解决。我们的老年慢性病培训计划将解决以下问题：1。风险因素、暴露和疾病。风险因素对慢性病的影响可能是时间依赖性的（早期或中年与晚期），这是由于生物学随年龄的变化，选择性生存或其他随时间和衰老而变化的辅助因素。2.）老年人慢性病的一级预防。有证据表明，老年人可以通过改变主要危险因素来预防疾病。3.）第三章预防疾病进展：4.）老年人的研究方法，包括招聘，保留和更多的理论问题，如方法来衡量脆弱，认知和功能状态和残疾的实际问题。5.）老龄化模型包括纵向分析技术，缺失数据，时间依赖分析。6.）转化为公共卫生实践和政策。这一培训方案是基于认识到，了解，预防和管理老年人慢性病的后果是复杂的，需要一个多层次的方法，将临床，生物和心理社会因素与保健和卫生政策相结合。

DESCRIPTION (provided by applicant): Modern increases in the burden of chronic disease at older ages are partly a consequence of increased survival and life expectancy made possible by improvements in lifestyle, environmental conditions and medical treatments that influence longevity. We propose an interdisciplinary training program in public health and aging that will prepare our trainees as researchers in public health science and policy to address the causes and consequences of chronic disease in older people and to develop effective programs and policies. Faculty (n=19) from 10+ disciplines in public health and in medicine with outstanding records in doctoral/postdoctoral mentoring and aging research will participate. We will train 16 doctoral and postdoctoral students who will gain the skills and knowledge needed to apply public health science and policy to the problems of aging and chronic disease. This will be accomplished by core coursework, interdisciplinary monthly seminars, practice internships, and co-mentoring by faculty highly experienced in interdisciplinary research and training. Understanding the trajectories of change in health and function among older adults clearly requires longitudinal perspectives that can capture both cumulative and changing exposures. This implies use of methodological and statistical models that permit modeling of time-dependent covariates and simultaneous competing outcomes. Research in older populations has special methodological and conceptual challenges that are not addressed in standard public health programs. Our training program in chronic disease in older adults will address the following issues: 1.) Risk factors, exposures and disease. The effects of risk factors on chronic disease may be time-dependent (early life or mid life vs. late life) due to changes in biology with age, selective survival, or other cofactors that vary over time and with aging. 2.) Primary prevention of chronic disease in older adults. The evidence that disease can be prevented in older populations by altering primary risk factors. 3.) Prevention of disease progression: 4.) Methods of research in aging adults including practical issues of recruitment, retention and more theoretical issues such as methods to measure frailty, cognitive and functional status and disability. 5.) Models in aging including longitudinal analytic techniques, missing data, time-dependent analyses. 6.) Translation into public health practice and policy. This training program is based on the realization that understanding, preventing and managing the consequences of chronic disease in older people is complex and requires a multi-level approach that integrates clinical, biological and psychosocial factors with health care and health policy.