Building Non-Communicable Eye Disease Research Capacity in India

摘要 印度是世界上超过17%的人口和25%的盲人或视障人士的家园 全世界。在印度，失明和视力障碍是导致多年残疾的第四大原因 而且是70岁及以上人群的头号原因，这是印度人口中迅速增长的一部分 不断增长。在印度，90%以上的失明是由于非传染性疾病造成的，其中大部分是 是可以避免的。视力不佳与广泛的后果有关，包括摔倒的风险增加。 痴呆症、抑郁症、残疾、丧失独立性、更长时间和更频繁的住院，以及 死亡率上升。尽管非传染性眼病的负担很大，而且不断增加，特别是 在老年人中，印度缺乏研究专业知识来表征这种流行病并了解其 原因和后果是有效干预和减少人口健康的关键障碍 冲击力。因此，这次培训的重点是建设临床流行病学研究能力， 强调生命过程分析在非传染性眼病研究中的应用 上了年纪的人。鉴于印度人口老龄化和NCED对老年人的不成比例影响 印度人，培训印度视觉研究人员的研究原则和方法是至关重要的，这将使 以有效地满足这一关键需求。此外，我们目前缺乏来自生命历程的知识 了解早年和中年暴露对晚年视力和视力相关的影响的角度 印度的残疾问题。针对印度背景的研究对于确定关键风险因素和残疾至关重要 NCED的后果，并制定有效的有针对性的干预措施。拟议的研究 能力建设方案将利用Aravind眼科护理的特殊机构环境 印度和密歇根大学(UM)的AECS系统，包括NIH资助的密歇根大学克劳德·D。 胡椒老年美国人独立中心和临床与翻译科学奖。UM和 AECS有着悠久的合作和教育交流的历史。根据一项 需求评估调查、博士和硕士级别的培训轨道已设计为满足需求 职业生涯早期和中期渴望从事临床流行病学研究的AECS教员。的目标是 这项计划包括：1)提供全面的研究生水平的培训，指导临床和 对将在NCED和NCED中担任领导角色的AECS受训人员进行流行病学研究 印度的感官衰老研究；2)发展AECS教师的指导和研究教育技能； 以及3)在AECS建立面向广大地区受众的研究培训机会。全 培训活动将在5年授权期结束时过渡到AECS。这两个合作机构 致力于该培训计划的成功及其强大的潜力，以应对日益增长的 NCED和视力残疾在印度迅速老龄化的人口中的流行。

ABSTRACT India is home to over 17% of the world’s population and to 25% of those who are blind or visually impaired worldwide. Blindness and vision impairment are the fourth leading cause of years lived with disability in India and are the number one cause in those age 70 and older, a segment of the Indian population that is rapidly growing. Over 90% of vision loss in India is due to non-communicable disease, the majority of which is avoidable. Poor vision is associated with wide-reaching consequences, including an increased risk of falls, dementia, depression, disability, loss of independence, longer and more frequent hospitalizations, and increased mortality. Despite the large and growing burden of non-communicable eye disease, particularly among older adults, the shortage of research expertise in India to characterize the epidemic and understand its causes and consequences is a critical barrier to intervening effectively and reducing its population health impact. Therefore, the focus of this training program is on building clinical-epidemiological research capacity, with an emphasis on lifecourse analyses applied to the study of non-communicable eye disease (NCED) in older adults. Given the aging of the Indian population and the disproportionate impact of NCED on older Indians, it is critical to train Indian vision researchers in the research principles and methods that will enable them to effectively address this critical need. Moreover, we currently lack knowledge from a lifecourse perspective to understand the effects of early- and mid-life exposures on late-life vision and vision-related disability in India. Research specific to the Indian context is vital to determine key risk factors and disability consequences of NCED, and to develop effective contextualized interventions. The proposed research capacity building program will draw upon the exceptional institutional environments at the Aravind Eye Care System (AECS) in India and at the University of Michigan (UM), including the NIH-funded UM Claude D. Pepper Older Americans Independence Center and Clinical and Translational Science Award. The UM and AECS have a long-standing history of collaboration and educational exchanges. Based on the results of a needs assessment survey, doctoral- and masters-level training tracks have been designed to meet the needs of early- and mid-career AECS faculty who aspire to careers in clinical-epidemiological research. The aims of this program include: 1) to provide comprehensive graduate-level training in the conduct of clinical and epidemiologic research for trainees from AECS who will be equipped to take a leading role in NCED and sensory aging research in India; 2) to develop the mentoring and research education skills of AECS faculty; and 3) to establish research training opportunities at AECS that are offered to a broad regional audience. All training activities will be transitioned to AECS by the end of the 5-year grant period. Both partner institutions are dedicated to the success of this training program and to its strong potential to address the growing epidemic of NCED and visual disability among India’s rapidly aging population.