Multidimensional pathways to healthy aging among Filipino women

描述(由申请人提供)：这项跨学科研究旨在确定生物学、社会、经济和环境对女性从成年中期到成年后期的健康和功能结果轨迹的影响。它试图确定影响(1)身体健康，包括身体成分、血压、炎症和免疫反应的生物标记物和接种疫苗的免疫反应、葡萄糖代谢失调和血脂异常的成年早期经历和暴露；(2)身体功能和残疾；(3)认知；以及(4)幸福的心理社会方面，包括关系质量和抑郁。数据来自正在进行的以社区为基础的宿务纵向健康和营养调查(CLHNS)。自1983年以来，CLHNS对女性进行了多轮调查。随着拟议的两轮额外调查，数据将跨越30年的成年生活时期，样本量约为1875。参与者生活在菲律宾宿务大都会的不断变化的环境中，其特点是快速城市化、社会变化和经济发展，这为研究这些变化如何随着时间的推移影响健康和机能能力提供了理想的环境。目前，54%的女性年龄在50-60岁之间，18%的女性年龄在60岁。初步分析将确定发病和残疾风险并存的发展顺序和模式。随后的多层次纵向分析将模拟自然环境的时变影响，包括城市化及其卫生、空气质量、拥挤、住房密度；财富、收入和教育所代表的社会经济地位；家庭结构和注重祖父母角色的关系；与物质和时间需求有关的多方面工作、与地位和自主性有关的工作作用；以及饮食质量和身体活动。之所以选择这些暴露，是因为它们具有实质性的重要性，具有很强的政策意义，而且可以从CLHNS获得特别详细、高质量的纵向数据。这项研究具有重要的优势，即在与衰老相关的疾病和残疾发展之前收集基线数据，并将能够确定因果关系。 与公共卫生相关：老龄化研究在低收入和中等收入国家尤为重要，在这些国家，急剧变化的社会、环境、人口和发病率模式导致越来越多的老年人存活到老年，更多的残疾影响到他们的保健需求和生活质量。这项拟议的研究将确定随着时间的推移积累起来的多种环境和生活方式因素，这些因素会影响与老龄化相关的慢性病、残疾和心理健康。它将提供必要的证据，为可能帮助妇女保持健康和功能能力、提高其生活质量和降低医疗费用的护理做法提供信息。

DESCRIPTION (provided by applicant): This interdisciplinary study aims to identify biological, social, economic, and environmental influences on trajectories of health and functional outcomes in women in the transitional years from middle to later adulthood. It seeks to identify early adulthood experiences and exposures that affect (1) physical health, including body composition; blood pressure, biomarkers of inflammation and immune response to vaccination, dysregulation of glucose metabolism, and dyslipidemia; (2) physical functioning and disability; (3) cognition; and (4) psychosocial aspects of well-being including quality of relationships and depression. Data come from the ongoing, community-based Cebu Longitudinal Health and Nutrition Survey (CLHNS). The CLHNS has followed women through multiple survey rounds since 1983. With the proposed two additional survey rounds, the data will span a 30-year period of adult life, with a sample size of about 1875. Participants live in Metro Cebu, Philippines, in a changing environment characterized by rapid urbanization, social change, and economic development, providing an ideal setting in which to study how such changes influence health and functional capacity over time. At present 54% of women are 50-60 and 18% are >60 years old. Initial analysis will identify the sequence of development and patterns of co-occurrence of morbidity and disability risk. Subsequent multilevel longitudinal analysis will model the time-varying effects of the physical environment, including urbanization and its components of sanitation, air quality, crowding, housing density; socioeconomic status represented by wealth, income and education; family structure and relations with a focus on grandparenting roles; multiple dimensions of work related to its physical and time demands as well as work roles related to status and autonomy; as well as diet quality and physical activity. These exposures were selected because of their substantive importance, strong policy significance, and availability of especially detailed, high quality longitudinal data from the CLHNS. The study has the important advantage of having baseline data collected prior to the development of aging-related disease and disability, and will be able to identify causal associations. PUBLIC HEALTH RELEVANCE: The study of aging is particularly important in low- and middle-income countries, where dramatically changing social, environmental, demographic and morbidity patterns are resulting in an increased number of elderly surviving to older ages with more disabilities affecting their health care needs and quality of life. The proposed research will identify multiple environmental and lifestyle factors that accumulate over time to influence aging- related chronic diseases, disability and psychological health. It will provide the evidence needed to will inform care practices that may help women to maintain health and functional capacity, and improve their quality of life and reduce health care costs.