Biodemography of Health, Social Factors and Life Challenge

描述（由申请人提供）：我们提出了一套分析，检查生物措施和健康变化的前因，相关因素和后果。具体来说，我们将研究三个问题。1)哪些个人和环境因素有助于我们对下游健康和生存的理解？我们将关注健康与压力体验、社会经济地位、心理社会脆弱性和情感幸福之间的联系。2)哪些因素可以预测生物指示剂的变化？我们将研究人口统计学和社会心理因素沿着环境暴露，以确定既往经验如何与生物标志物的变化相关。我们将专注于社会经济地位（SES），情绪健康以及慢性和急性压力的影响。我们将研究整个生物标志物阵列的变化;一个特别创新的分析将研究压力体验和端粒磨损之间的联系。3)生物指标的变化能预测健康结果和生存率吗？我们将使用生命历程框架来探索生物指标的变化以及先前经历和暴露的轨迹如何与随后的健康，身体和认知功能以及生存相关。特别令人感兴趣的是几个备受瞩目的生物指标（端粒长度，5-HTTLPR基因型和炎症标志物），关于可能改变这些关联的因素（创伤，睡眠质量，慢性疼痛和乐观）的新数据，以及基因-环境相互作用。我们请求为两项数据收集活动提供资金，以丰富以前收集的数据：2010年进行第二轮家庭功能评估;对冷冻生物标本进行选定的分析。具体而言，我们将：1）获得在家中收集的访谈测量的健康和功能标志物。2006年生物标志物研究的家庭方案包括测量握力、定时行走、椅子站立、血压和肺活量。我们建议通过补充计划于2010年进行的纵向调查来收集2006年研究的幸存者的这些数据。这些评估将被添加到公共使用数据集。2)我们将对冷冻第1轮血液标本进行检测（5-HTTLPR、高半胱氨酸、叶酸、ICAM-1、e-选择素和高敏C反应蛋白），以将第1轮数据“回填”到第2轮标准。这些试验的结果将添加到公开发布的数据中。这项工作建立在20年的健康和社会心理数据，两轮生物标志物收集以及一个具有生产合作记录的跨学科研究团队的基础上。公共卫生相关性：拟议的数据收集和分析将帮助研究人员了解环境因素-例如个人的社会经济地位以及他们面临的生活挑战的类型和程度-如何以及为什么影响老年人的健康和生存。中心重点是了解不同的生物机制的作用，包括心血管和代谢功能，免疫反应和遗传影响，这些机制是社会环境和下游健康之间联系的基础。这些发现对于确定人群健康的最强预测因子以及将临床医生的关注范围扩大到心血管疾病的传统危险因素之外具有重要意义。

DESCRIPTION (provided by applicant): We propose a set of analyses that examine the antecedents, correlates, and consequences of change in biological measures and health. Specifically, we will examine three questions. 1) What individual and environmental factors contribute to our understanding of downstream health and survival? We will focus on links between health and stressful experience, SES, psychosocial vulnerability and emotional well- being. 2) What factors predict change in bioindicators? We will examine demographic and psychosocial factors along with environmental exposures to determine how prior experience is associated with change in biomarkers. We will focus on the effects of socioeconomic status (SES), emotional well-being, and chronic and acute stressors. We will examine change across the full array of biomarkers; a particularly innovative analysis will examine the connection between stressful experience and telomere attrition. 3) Do changes in bioindicators predict health outcomes and survival? We will use a life course framework to explore how change in bioindicators and trajectories of prior experience and exposures are associated with subsequent health, physical and cognitive function, and survival. Of particular interest are several high-profile bioindicators (telomere length, 5-HTTLPR genotype, and inflammatory markers), new data on factors that may modify these associations (trauma, caregiving, sleep quality, chronic pain, and optimism), and gene-environment interactions. We request funding for two data collection activities in order to enrich previously-collected data: A second round of in-home functional assessments in 2010; and selected assays of frozen biospecimens. Specifically, we will: 1) Obtain interviewer-measured markers of health and function collected in the home. The household protocol of the 2006 biomarker study included measures of grip strength, timed walks, chair stands, blood pressure, and lung capacity. We propose to collect these data for the survivors of the 2006 study by supplementing the longitudinal survey planned for 2010. These assessments will be added to the public use data set. 2) We will perform assays (5-HTTLPR, homocysteine, folate, ICAM-1, e-selectin, and high sensitivity C-reactive protein) of frozen round 1 blood specimens to "backfill" the round 1 data to the round 2 standard. The results of these assays will be added to the publicly released data. The work builds on a foundation of two decades of health and psychosocial data, two rounds of biomarker collection, and an interdisciplinary research team with an established record of productive collaboration. PUBLIC HEALTH RELEVANCE: The proposed data collection and analysis will help researchers understand how and why environmental factors - such as individuals' socioeconomic status and the type and extent of life challenges that they face - influence health and survival at the older ages. A central focus is to understand the role of different biological mechanisms, including cardiovascular and metabolic function, immune response, and genetic influences, that underlie the linkages between the social environment and downstream health. The findings have implications for identifying the strongest predictors of population health and for expanding clinicians' focus beyond conventional risk factors of cardiovascular disease.