Interdisciplinary Research Training in Health and Aging

描述（由申请人提供）：现代老年人慢性疾病负担的增加，部分原因是由于生活方式、环境条件和影响寿命的医疗条件的改善，使生存率和预期寿命得以提高。我们提出了一个公共卫生和老龄化的跨学科培训计划，将我们的学员培养成公共卫生科学和政策的研究人员，以解决老年人慢性疾病的原因和后果，并制定有效的计划和政策。来自10多个公共卫生和医学学科，在博士/博士后指导和老龄化研究方面有杰出记录的教师（n=19）将参加。我们将培养16名博士和博士后，他们将获得将公共卫生科学和政策应用于老龄化和慢性病问题所需的技能和知识。这将通过核心课程、跨学科月度研讨会、实践实习以及在跨学科研究和培训方面经验丰富的教师的共同指导来完成。了解老年人健康和功能变化的轨迹显然需要纵向视角，既能捕捉到累积性暴露，也能捕捉到变化性暴露。这意味着使用方法和统计模型，允许建模时间相关的协变量和同时竞争的结果。老年人群的研究在方法和概念上具有特殊的挑战，这些挑战在标准的公共卫生计划中没有得到解决。我们的老年人慢性疾病培训计划将解决以下问题：风险因素、暴露和疾病。危险因素对慢性疾病的影响可能是时间依赖性的（早期或中年vs.晚年），这是由于生物学随年龄、选择性生存或其他随时间和年龄变化的辅助因素而发生的变化。2)。老年人慢性病的初级预防。有证据表明，可以通过改变主要危险因素来预防老年人群中的疾病。3)。4.预防疾病进展；老年人的研究方法包括招募，保留的实际问题和更多的理论问题，如测量脆弱性，认知和功能状态和残疾的方法。5)。老龄化模型包括纵向分析技术，缺失数据，时间依赖分析。6)。转化为公共卫生实践和政策。这一培训方案的基础是认识到了解、预防和管理老年人慢性病的后果是复杂的，需要采取多层次的办法，将临床、生物和社会心理因素与卫生保健和卫生政策结合起来。

DESCRIPTION (provided by applicant): Modern increases in the burden of chronic disease at older ages are partly a consequence of increased survival and life expectancy made possible by improvements in lifestyle, environmental conditions and medical treatments that influence longevity. We propose an interdisciplinary training program in public health and aging that will prepare our trainees as researchers in public health science and policy to address the causes and consequences of chronic disease in older people and to develop effective programs and policies. Faculty (n=19) from 10+ disciplines in public health and in medicine with outstanding records in doctoral/postdoctoral mentoring and aging research will participate. We will train 16 doctoral and postdoctoral students who will gain the skills and knowledge needed to apply public health science and policy to the problems of aging and chronic disease. This will be accomplished by core coursework, interdisciplinary monthly seminars, practice internships, and co-mentoring by faculty highly experienced in interdisciplinary research and training. Understanding the trajectories of change in health and function among older adults clearly requires longitudinal perspectives that can capture both cumulative and changing exposures. This implies use of methodological and statistical models that permit modeling of time-dependent covariates and simultaneous competing outcomes. Research in older populations has special methodological and conceptual challenges that are not addressed in standard public health programs. Our training program in chronic disease in older adults will address the following issues: 1.) Risk factors, exposures and disease. The effects of risk factors on chronic disease may be time-dependent (early life or mid life vs. late life) due to changes in biology with age, selective survival, or other cofactors that vary over time and with aging. 2.) Primary prevention of chronic disease in older adults. The evidence that disease can be prevented in older populations by altering primary risk factors. 3.) Prevention of disease progression: 4.) Methods of research in aging adults including practical issues of recruitment, retention and more theoretical issues such as methods to measure frailty, cognitive and functional status and disability. 5.) Models in aging including longitudinal analytic techniques, missing data, time-dependent analyses. 6.) Translation into public health practice and policy. This training program is based on the realization that understanding, preventing and managing the consequences of chronic disease in older people is complex and requires a multi-level approach that integrates clinical, biological and psychosocial factors with health care and health policy.