Interdisciplinary Research Training in Health and Aging

描述(申请人提供)：老年人慢性病负担的现代增加部分是由于生活方式、环境条件和影响寿命的医疗治疗的改善而导致的生存和预期寿命增加的结果。我们提出了一个关于公共卫生和老龄化的跨学科培训计划，该计划将使我们的受训人员成为公共卫生科学和政策方面的研究人员，以解决老年人慢性病的原因和后果，并制定有效的计划和政策。来自公共卫生和医学的10多个学科的19名教师将参加，他们在博士/博士后指导和老龄化研究方面有出色的记录。我们将培养16名博士后和博士后，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、跨学科每月研讨会、实习和由在跨学科研究和培训方面经验丰富的教师共同指导来实现。要了解老年人健康和功能变化的轨迹，显然需要能够捕捉累积和变化暴露的纵向视角。这意味着使用方法和统计模型，允许对依赖时间的协变量和同时竞争的结果进行建模。在老年人群中的研究有特殊的方法和概念上的挑战，而标准的公共卫生计划没有解决这些挑战。我们的老年人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相关的(早年或中年与晚年)，原因是生物学随年龄、选择性生存或其他随时间和年龄变化的辅助因素而变化。2.)老年人慢性病的初级预防。通过改变主要危险因素可以在老年人口中预防疾病的证据。3.)预防疾病进展：4.)对老年人的研究方法包括招募、保留等实际问题，以及更多的理论问题，如衡量脆弱程度、认知和功能状态以及残疾的方法。5.)老龄化模型包括纵向分析技术、缺失数据、时间相关分析。6.)转化为公共卫生实践和政策。这一培训方案的基础是认识到，了解、预防和管理老年人慢性病的后果是复杂的，需要采取多层次的方法，将临床、生物和心理社会因素与卫生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.