Effects of Public Health Interventions on Aged Adults in Village Social Networks

洪都拉斯农村地区社会网络互动的变化与痴呆症 摘要 社会关系可能会降低患痴呆症的风险。但确定任何此类事件的程度和方向 因果关系是很难的。社会网络与发展中国家痴呆症的关系 对设置的理解也很不全面。在这里，我们将利用12年2011人的罕见数据 洪都拉斯的村庄是正在进行的纵向研究的一部分，目的是评估社会 在这个农村老年人口中，网络互动与痴呆症有关，使用交叉- 分段的、纵向的、巧合的实验方法。我们评估痴呆症使用 经过验证的适合农村人口使用的痴呆症评估工具(PhotoTest)。在目标1中，我们 将首先量化社交网络地位和痴呆症之间的联系。一个基本假设 患有痴呆症的老年人将在村级社会网络中被社会边缘化， 即使在考虑了相关的混杂因素之后。接下来，在目标2中，我们将评估 年长村民在两年内的社交网络与他们随后的 痴呆症状态，利用我们数据的经度。一个主要的假设是， 社交网络的程度和中心性将与更高的后续痴呆症风险相关。最后， 在目标3中，我们将评估外源性诱导的变化(由潜在的随机 向每个村庄随机选择的成员提供公共卫生信息的试验，每月 两年内的访问)在年长村民的网络中与他们随后的 痴呆症状态。在这里，由于老年人的网络连接发生了变化，在实验下 压力，在从第一波到第三波的两年时间里，我们假设测量 随后确诊的痴呆症将受到不利影响。一个主要的假设是 与之相比，外源性导致的老年人的社会边缘化会增加他们患痴呆症的风险 对于没有经历过这样的社交网络冲击的老年人。

Changing Social Network Interactions and Dementia in Rural Honduras Villages Abstract Social connections may reduce dementia risk. But determining the extent and direction of any such causal effect is difficult. The relationship between social networks and dementia in developing world settings is also very incompletely understood. Here, we will exploit rare data about 2,011 people in 12 villages in Honduras who are part of an ongoing longitudinal study in order to evaluate how social network interactions are associated with dementia in this rural elderly population, using cross- sectional, longitudinal, and coincidentally experimental approaches. We assess dementia using a validated dementia assessment tool suitable for use in this rural population (PhotoTest). In Aim 1, we will first quantify the association between social network position and dementia. A primary hypothesis is that older adults with dementia will be socially marginalized within village-level social networks, even after accounting for pertinent confounders. Next, in Aim 2, we will assess how changes in the social networks of older villagers across a two-year interval are associated with their subsequent dementia status, exploiting the longitudinality of our data. A primary hypothesis is that a decline in social network degree and centrality will be associated with higher subsequent dementia risk. Finally, in Aim 3, we will assess how exogenously induced changes (induced by an underlying randomized trial that offered public health information to randomly chosen members of each village with monthly visits over a two-year period) in the networks of older villagers are associated with their subsequent dementia status. Here, since the network connections of the elderly change, under experimental pressure, over the two-year period from Wave 1 to Wave 3, we hypothesize that measures of dementia ascertained subsequently will be adversely affected. A primary hypothesis is that exogenously caused social marginalization of older adults will increase their dementia risk, compared to the elderly not experiencing such shocks to their social network.