A Follow-up Study for Causes of Cancer in Black Women

黑人妇女健康研究（BWHS）始于1995年，目的是研究癌症的危险因素 非裔美国人（AA）女性的发病率和生存率。59，000名AA女性，年龄21-69岁（中位年龄， 38)来自美国17个州的人通过填写健康问卷登记。从那时起，关于健康的数据， 行为，以及许多其他因素已经通过两年一次的邮寄和网络问卷收集， 约85%的潜在人年随访成功。癌症是通过自我报告确定的，癌症 登记处，国家死亡指数，以及与医疗保险数据的联系。该研究发表了250多篇 关于癌症和非恶性疾病的手稿。随着年龄的增长（平均年龄 现在63，范围45-93），研究条件变得重要，如阿尔茨海默病（AD）和相关疾病 痴呆症，特别影响老龄化人群，在AA中比在白色个体中更常见。 我们建议在BWHS中研究AD。我们通过他们的社会安全号码将BWHS参与者与 2013年的医疗保险数据，并使用算法来识别AD病例。我们确定了98个病例，其中只有12个 在该年内，曾被家人或自己举报。我们建议在 我们现在已经将BWHS参与者（2007-2016）与整个10年的医疗保险数据联系起来， 产量约800箱。社会心理压力与认知能力下降有关， 在AA中普遍存在的是种族歧视的经历。我们建议前瞻性评估 BWHS参与者在BWHS上报告的日常和体制性种族主义的感知经历 在10年的医疗保险数据中确定的与随后的AD事件相关的问卷调查。我们也 他们建议测试一种以合理成本跟踪大规模人群认知功能的潜在方法。 我们将通过智能手机应用程序进行测试，BWHS参与者将在他们的智能手机上安装认知测试 手机.我们建议招募来自美国各地的200名BWHS参与者，他们同意安装一个名为 DANA在他们的智能手机上，并完成认知测试（20分钟）后立即安装和 半年后。这项研究将提供有关老年AA妇女是否愿意和能够 如果这个目标被证明是可行的，那么在未来， 为此目的招收大量的BWHS参与者。

The Black Women's Health Study (BWHS) began in 1995 with the goal of studying risk factors for cancer incidence and survival in African American (AA) women. 59,000 AA women ages 21-69 years (median age, 38) from 17 states across the U.S. enrolled by completing health questionnaires. Since then, data on health, behaviors, and numerous other factors have been collected through biennial mailed and web questionnaires, with follow-up successful for ~85% of potential person-years. Cancers are identified through self-report, cancer registries, the National Death Index, and linkage with Medicare data. The study has published over 250 manuscripts to date on cancer and on nonmalignant illnesses as well. With the aging of the cohort (median age now 63, range 45-93), it becomes important to study conditions, such as Alzheimer's Disease (AD) and related dementias, that particularly affect aging populations and occur more commonly in AAs than white individuals. We propose to study AD in the BWHS. We linked BWHS participants through their social security numbers to Medicare data in 2013 and used an algorithm to identify AD cases. We identified 98 cases, of which only 12 had been self-reported or reported by family members for that year. We propose to identify AD cases in the entire 10 years of Medicare data to which we have now linked BWHS participants (2007-2016), which should yield ~800 cases. Psychosocial stressors have been linked to poorer cognition, and an important such stressor that occurs commonly among AAs is experiences of perceived racism. We propose to prospectively assess perceived experiences of everyday and institutional racism reported by BWHS participants on BWHS questionnaires in relation to subsequent incident AD identified in the 10 years of Medicare data. We also propose to test a potential method for tracking the cognitive function of large populations at reasonable cost. We will do so through a smart phone app with cognitive tests that BWHS participants will install on their smart phones. We propose to enroll 200 BWHS participants from across the U.S. who agree to install an app called DANA on their smart phones and to complete the cognitive tests (20 minutes) immediately after installation and 6 months later. This study will provide informative data on whether older AA women are willing and able to be tracked for cognition through an app. If this goal turns out to be feasible, it will then be possible in the future to enroll a large number of BWHS participants for this purpose.