Aging in Puerto Rico: Longitudinal Follow-Up of the PREHCO Study

在过去的十年里，波多黎各经历了人口迅速老龄化、金融崩溃、大规模外逃 年轻人的迁徙，然后是飓风玛丽亚。现在是建立在唯一以人口为基础的 波多黎各老年人队列，在这些重大事件之前拥有独一无二的健康和功能数据 事件。走访了波多黎各各地的家庭，以确定全岛60岁以上成年人的第一个样本 波多黎各老年人年：健康状况(PREHCO)研究。一系列与以下方面相关的措施 健康和老龄化，包括认知和身体功能的家庭测试，都是在基线上收集的 (2002/2003；N=4,291)和四年后(2006/2007；N=3,891)。我们建议收集两波新的数据 对大约1,000名前HCO幸存者的样本进行了与衰老、压力和健康有关的调查。当前项目 A)是否会在基线后16至20年内延长HEC前的随访时间；b)检查生命进程预测因素 主要老龄化后果，即认知障碍、残疾和死亡率；c)收集与飓风有关的数据 应激源和心理健康；d)添加头发皮质醇作为慢性下丘脑-垂体-肾上腺的标志 (HPA)轴激活；以及e)增加认知和代理线人措施，以与健康和 退休研究(HRS)。我们的项目将实现以下具体目标：目标1.检查纵向生活 认知健康、皮质醇水平、精神健康、残疾和死亡率的病程生物-心理-社会预测因子16- 基线后20年。目标2.检查应激源之间的横向关联，增强韧性 因素，感知压力，皮质醇，和健康，以及两年后健康的变化。目标3.提高效用 进行跨文化比较。波多黎各是美国的重要组成部分，在很大程度上 在美国基于人口的老龄化研究中被省略了。PREHCO参与者现在76岁以上，并给予 这个年龄段的死亡率不断上升，我们建议收集两个新的随访数据时间点 PREHCO代表着一个时间有限的机会，可以增加我们对老龄化、压力和健康的了解 未得到充分研究和潜在的弱势群体。

In the past decade, Puerto Rico has experienced rapid population aging, financial collapse, mass outward migration of younger people, and then Hurricane Maria. Now is an ideal time to build on the only population-based cohort of older adults in Puerto Rico, unique in having data on health and function prior to these major events. Households across Puerto Rico were visited to identify the first island-wide sample of adults age 60+ years for the Puerto Rican Elderly: Health Conditions (PREHCO) study. A wide range of measures relevant to health and aging, including in-home testing of cognitive and physical function, was collected at baseline (2002/2003; N=4,291) and four years later (2006/2007; N=3,891). We propose to gather two new waves of data related to aging, stress and health in a sample of approximately 1,000 PREHCO survivors. The current project will a) extend PREHCO follow-up to between 16 and 20 years after baseline; b) examine life course predictors of major aging outcomes, namely cognitive impairment, disability, and mortality; c) collect data on hurricane-related stressors and mental health; d) add hair cortisol as a marker of chronic hypothalamic pituitary adrenal (HPA) axis activation; and e) add cognitive and proxy informant measures that align with the Health and Retirement Study (HRS). Our project will enable the following specific aims: Aim 1. Examine longitudinal life course biopsychosocial predictors of cognitive health, cortisol levels, mental health, disability, and mortality 16- 20 years after baseline. Aim 2. Examine cross-sectional associations between stressors, resilience-enhancing factors, perceived stress, cortisol, and health, as well as changes in health two years later. Aim 3. Increase utility of PREHCO for cross-cultural comparisons. Puerto Rico is an important part of the U.S. that has largely been omitted from U.S. population-based studies of aging. PREHCO participants are now age 76+ years and given accelerating mortality rates for this age group, our proposal to gather two new time points of follow-up data for PREHCO represents a time-limited opportunity to add to our knowledge about aging, stress, and health in an understudied and potentially vulnerable population.