Multidimensional pathways to healthy aging among Filipino women

描述（由申请人提供）：本跨学科研究旨在确定生物学、社会、经济和环境对成年中后期过渡时期妇女健康和功能结果轨迹的影响。它旨在确定影响(1)身体健康，包括身体成分的成年早期经历和暴露；血压、炎症和免疫应答的生物标志物、葡萄糖代谢失调和血脂异常；（二）身体功能和残疾；(3)认知;(4)幸福感的社会心理方面，包括人际关系质量和抑郁。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。自1983年以来，CLHNS对女性进行了多次调查。再加上拟议的两轮调查，这些数据将涵盖30年的成年人生活，样本量约为1875人。参与者居住在菲律宾宿务大都会，其环境变化的特点是快速城市化、社会变革和经济发展，为研究这些变化如何随着时间的推移影响健康和功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岁以下。初步分析将确定发展的顺序以及发病率和残疾风险共同发生的模式。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、住房密度等组成部分；以财富、收入和教育程度为代表的社会经济地位；家庭结构和关系，重点是祖父母的角色；与体力和时间需求相关的工作多维度以及与地位和自主性相关的工作角色；还有饮食质量和身体活动。之所以选择这些风险，是因为它们具有实质性的重要性，具有很强的政策意义，并且可以从CLHNS获得特别详细、高质量的纵向数据。这项研究有一个重要的优势，即在与衰老有关的疾病和残疾发展之前收集了基线数据，并将能够确定因果关系。

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.