Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community

在这次续期申请中，我们将在过去项目期成功的基础上，进一步研究 生物，社会和经济条件，塑造健康的老龄化人口的南非。我们 非洲的健康与老龄化：INDEPTH社区的纵向研究（HAALSI） 完成了最初的3年赠款期，建立了一个以社区为基础的队列，并提供了基线数据 国际人口统计学评价网络中5，059名年龄≥40岁的男女 发展中国家人口及其健康协会（INDEPTH），南非阿金库尔。的 基线调查的回应率为86%。我们使用已经到位的基础设施和工具进行跟踪- 对HAALSI队列进行随访监测，我们预计数据收集的随访损失非常小 继续前进。我们建议每隔三年进行两次跟进数据收集， 对三波数据收集和六年随访的发病率，死亡率， 生物、行为和环境风险因素，以及身体和认知功能。拟议 HAALSI计划包括五个项目：项目1：阿尔茨海默病和相关痴呆症和认知 项目2：南非老龄人群的心脏代谢疾病;项目3：艾滋病毒和艾滋病毒 促进健康老龄化的干预措施;项目4：改善健康老龄化的公共政策;项目5： 多重谋杀。这些项目将得到四个核心的支持：领导和行政（核心A）、外地 (Core B）、数据管理和分析（核心C）、生物标志物和生物库（核心D）。这一切成功都 项目和核心将由来自美国和南非的调查人员领导。所有项目将共享一个 共同的住户和参与者调查和评估，并有目标， 项目，以创建一个协同和动态的计划。HAALSI项目所使用的研究设计非常精细， 调整以捕捉南非特有的特征，并与其他HRS姐妹研究保持一致， 印度、中国、巴西、英国、欧洲和美国，提供了一个独特的机会， 比较慢性病的生物、社会和经济决定因素及其对 功能和健康结果的老龄化人口。这种跨国统一比较将使 科学家确定新的风险因素，并了解已知风险因素在全球范围内的影响。我们 这项研究将为目前关于高度工业化的西方国家是否存在“标准”风险因素的争论提供信息。 在非西方国家，低收入国家的健康结果也有同样的影响。我们的研究表明， 确定和检查慢性健康状况的新的和确定的危险因素的分布 并进行后续研究，以发现所确定的生物学、社会学和 环境风险因素。我们在这个应用程序中建立了一套强大的实验目标，重点是 评估旨在减少健康风险的公共政策，这与美国的健康直接相关。

In this renewal application, we will build on the successes of the past project period to further examine the biological, social, and economic conditions that shape health in the aging population of South Africa. Our program, Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI) completed its initial 3-year grant period with the establishment of a community-based cohort with baseline data for 5,059 men and women ≥40 years of age in the International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH) community of Agincourt, South Africa. The response rate to the baseline survey was 86%. We use the infrastructure and tools already in place for follow- up surveillance of the HAALSI cohort, and we anticipate very minimal loss to follow-up for data collection moving forward. We propose to conduct two waves of follow-up data collection at three-year intervals, allowing the longitudinal analysis of three waves of data collection and six years of follow-up for morbidity, mortality, biological, behavioral, and environmental risk factors, and physical and cognitive function. The proposed HAALSI Program includes five projects: Project 1: Alzheimer’s Disease and Related Dementias and Cognitive Impairment; Project 2: Cardiometabolic Disease in an Aging South African Cohort; Project 3: HIV and HIV Interventions to Promote Healthy Aging; Project 4: Public Policies to Improve Healthy Aging; and Project 5: Multimorbidity. The projects will be supported by four cores: Leadership and Administration (Core A), Field (Core B), Data Management and Analysis (Core C), Biomarkers and Biobanking (Core D). Each of these projects and cores will be led by investigators from both the U.S. and South Africa. All projects will share a common household and participant survey and assessment and have aims that are tightly integrated across projects to create a synergistic and dynamic program. The study design used by the HAALSI Program is finely tuned to capture characteristics specific to South Africa as well as harmonize with other HRS sister studies in India, China, Brazil, the UK, Europe, and the U.S., providing a unique opportunity to conduct cross-country comparisons of the biological, social, and economic determinants of chronic diseases and their effects on functional and health outcomes in aging populations. Such cross-country harmonized comparisons will enable scientists to identify new risk factors and understand the impact of known risk factors on a global scale. Our study will inform the current debate about whether “standard” risk factors in highly industrialized Western countries have the same effects on health outcomes in non-Western, low income countries. Our study sets out to identify and examine the distribution of both novel and established risk factors for chronic health conditions and conduct a follow-up study to discover the predictive value of the identified biological, social, and environmental risk factors. We have built a strong set of experimental aims into this application focusing on the evaluation of public policies aimed at reducing health risks, which has direct relevance to health in the U.S.