Stress Mental Disorders Accelerated Aging and Dementia a 35 year Cohort Study - Covid Supplement

大量研究表明，抑郁症状或障碍与认知和精神障碍之间存在联系 功能结果。焦虑症状和障碍、睡眠不佳和有压力的生活事件是常见的 与抑郁症相关，但对它们与认知和功能衰退的关系知之甚少，如 就像在阿尔茨海默病(AD)中发生的那样。这些与压力相关的暴露也与 发病率和残疾，但将它们与不良的健康结果联系起来的机制尚不清楚。横截面 研究表明，这些暴露可能通过加速细胞衰老而导致这些结果，通过测量 端粒缩短。具有良好应激相关病史的队列中的前瞻性研究 为了研究这种可能性，需要暴露和反复测量细胞老化。我们建议 使用巴尔的摩流行病集水区(ECA)已经收集的数据分析这些问题 跟踪研究队列，增加了另一波数据收集。巴尔的摩ECA的研究开始收集 1981年抑郁症和焦虑症的结构化诊断性访谈数据 东巴尔的摩居民，并在另外三次浪潮中做到了这一点，最近一次是在2004年(第四次浪潮)。此外 对于焦虑、抑郁症状和障碍的测量，多样化的(35%非裔美国人)ECA 队列完成了对睡眠不佳、生活应激源、创伤暴露、认知和 功能障碍。2004年，当所有参与者都是40岁的时候，他们献血和口腔 样本。所有的非洲经委会受试者现在都是≥50岁(估计平均值为68岁，范围52-96)。我们会找到并采访 据估计，来自第四波的601名参与者，重复着结构化的心理诊断面谈评估 精神障碍，以及通过自我报告和手腕测量生活应激源、创伤暴露和睡眠不佳 动作记录仪。参与者将完成神经心理测试和功能测量，并将再次捐赠 血液和口腔样本。这将使我们能够确定35年的压力历史之间的联系- 相关的暴露，从中年到晚年，伴随着认知和功能的下降，判定为轻度认知 损伤和痴呆症诊断，包括可能的和可能的AD，以及细胞老化的生物标志物： 2004年至2016年端粒缩短，p16INK4a水平升高。我们还将确定这些是否 暴露与我们根据新发现选择的ECA中的基因的表观遗传修饰有关 我们将在巴尔的摩的现有数据中进行全基因组关联和甲基化分析 老龄化纵向研究(BLSA)和INCHIANTI队列。我们将检查这些基因的甲基化是否 非洲经委会的候选部位和炎症测量(2004年和2016年以血液衡量)，居中 ECA队列中的假设性预测性关联。结果将澄清压力相关因素之间的联系 中老年的暴露和衰老相关的结果，促进了对这些联系机制的了解 对疾病和残疾的暴露，并为预防这些结果的途径提供线索。

Numerous studies demonstrate links between depressive symptoms or disorders and poor cognitive and functional outcomes. Anxiety symptoms and disorders, poor sleep, and stressful life events are common and correlated with depression, but little is known about their association with cognitive and functional decline, such as occurs in Alzheimer’s disease (AD). These stress-related exposures are also associated with medical morbidity and disability, but the mechanisms linking them to poor health outcomes are unclear. Cross-sectional studies suggest that these exposures might lead to these outcomes by hastening cellular aging, measured by shortening of telomeres. Prospective studies in cohorts with well-characterized histories of stress-related exposures and repeated measures of cellular aging are needed to investigate this possibility. We propose to analyze these issues using data already collected in the Baltimore Epidemiologic Catchment Area (ECA) Followup Study cohort, adding another wave of data collection. The Baltimore ECA Study began collecting structured diagnostic interview data on depressive and anxiety disorders in 1981 in a representative sample of East Baltimore residents, and did so over three additional waves, most recently in 2004 (Wave 4). In addition to measures of anxiety and depressive symptoms and disorders, the diverse (35% African American) ECA cohort has completed repeated measures of poor sleep, life stressors, trauma exposure, cognition, and functional impairment. In 2004, when all participants were aged ≥40 years, they donated blood and buccal samples. All ECA subjects are now aged ≥50 (estimated mean = 68, range 52-96). We will locate and interview an estimated 601 participants from Wave 4, repeating structured diagnostic interview assessment of mental disorders, and measuring life stressors, trauma exposure, and poor sleep by both self-report and wrist actigraphy. Participants will complete neuropsychological tests and functional measures, and will again donate blood and buccal samples. This will enable us to determine the association of 35-year histories of stress- related exposures, from mid to later life, with cognitive and functional decline, adjudicated mild cognitive impairment and dementia diagnoses, including probable and possible AD, and biomarkers of cellular aging: shortening of telomeres and increases in p16ink4a levels from 2004 to 2016. We will also determine if these exposures are associated with epigenetic modification of genes in the ECA that we select based on novel genome-wide association and methylation analyses we will conduct in existing data from the Baltimore Longitudinal Study of Aging (BLSA) and the InCHIANTI cohorts. We will examine whether methylation of these candidate sites, and measures of inflammation (measured in blood in 2004 and 2016) in the ECA, mediate hypothesized predictive associations in the ECA cohort. Results will clarify the link between stress-related exposures from mid to later life and aging-related outcomes, advance knowledge of mechanisms linking these exposures to disease and disability, and provide clues to avenues for preventing these outcomes.