Project 3: Preservation of Musculoskeletal Health and Functioning in Early Old Age

Swan-Aging U19的首要目标是确定中年因素对成功老龄化的影响，特别关注更年期过渡(MT)期间的变化以及健康指标的中年变化对老年早期功能和健康的影响。在生命过程中的这一时期，年龄为66-75岁，是改变社会角色和过渡到老年的关键时期，这时健康以及身体和认知功能开始积累不利的变化。天鹅老龄化的一个主要目标是评估中年健康和MT的种族/民族差异是否解释了早年健康和功能方面的种族/民族差异。第三个目标是将天鹅老龄化的研究结果翻译给女性和医疗保健提供者。项目3侧重于MT特征以及MT相关和通常与中年衰老有关的健康指标变化在保持肌肉骨骼健康和身体功能方面的作用。项目3还将研究身体功能和认知功能之间的接口，因为成功的衰老和保持独立性需要在老年时对这两个功能领域进行相对保存。项目3的具体目标是：1)确定和量化MT特征和中年健康指标的轨迹对维持瘦体重和肌肉力量、最大限度地减少骨量损失和脂肪质量增加以及维持早年身体功能的影响；2)确定和量化MT特征和中年健康指标的轨迹对避免早年跌倒和骨折的影响；3)确定和量化早年肌肉骨骼健康和身体功能的种族/民族差异在多大程度上可归因于MT特征和中年健康指标的种族/民族差异；以及4)将天鹅老化肌肉骨骼的研究成果翻译给妇女和医疗保健提供者。为了实现这些目标，拟议的天鹅老龄化访问(队列中值年龄将为71岁)将包括测量骨密度、身体成分、肌肉力量和身体功能，并确定(与裁决)临时跌倒和骨折。结合多个项目，我们将描述肌肉骨骼健康和功能轨迹的心血管先兆(项目2)；认知功能轨迹(项目1)与跌倒之间的关系；以及身体功能轨迹与残疾的发展和轻度认知障碍的发病(项目1)之间的关系。估计MT相关因素和中年因素对老年早期肌肉骨骼健康和功能的影响程度，将为未来研究中预防和干预的关键目标提供信息。确定可改变的中年因素并量化其对维持老年早期肌肉骨骼健康和功能的影响，以及了解身体和认知功能的交集，是制定和测试有针对性的筛查战略和早期干预措施以优化老年人的独立性和生活质量所需的关键第一步。

The overarching goal of the SWAN-Aging U19 is to determine the impact of midlife factors on successful aging, with a specific focus on the effects of changes during the menopause transition (MT) and midlife changes in health indicators on functioning and health in early old age. This period in the life course, ages 66-75 years, is a pivotal time of changing social roles and transitioning into old age, when adverse changes in health as well as physical and cognitive functioning begin to accumulate. A major goal of SWAN-Aging is to assess whether racial/ethnic differences in midlife health and the MT explain racial/ethnic disparities in health and functioning in early old age. The third goal is to translate SWAN-Aging findings to women and health care providers. Project 3 focuses on the role of MT characteristics and MT-related and usual midlife-aging-related changes in health indicators on preservation of musculoskeletal health and physical functioning. Project 3 will also examine the interface between physical and cognitive function, because successful aging and maintenance of independence require relative preservation of both of these functional domains into old age. The specific aims of Project 3 are to: 1) determine and quantify the impact of MT characteristics and trajectories of midlife health indicators on maintaining lean mass and muscle strength, minimizing loss of bone mass and increases in fat mass, and preserving physical functioning in early old age; 2) determine and quantify the impact of MT characteristics and trajectories of midlife health indicators on avoidance of falls and fractures in early old age; 3) determine and quantify the extent to which racial/ethnic disparities in musculoskeletal health and physical functioning in early old age are attributable to racial/ethnic differences in MT characteristics and midlife health indicators; and 4) translate SWAN-Aging musculoskeletal findings to women and health care providers. To achieve these aims, the proposed SWAN-Aging visit (when cohort median age will be 71 years) will include measurement of bone mineral density, body composition, muscle strength, and physical functioning, and ascertainment (with adjudication) of interim falls and fractures. Integrating across Projects, we will describe cardiovascular antecedents (Project 2) of trajectories of musculoskeletal health and functioning; the relationship between cognitive function trajectories (Project 1) and falls; and the relation between physical functioning trajectories and the development of disability and the onset of mild cognitive impairment (Project 1). Estimation of the size of the effects of MT-related and midlife factors on musculoskeletal health and functioning in early old age will inform key targets for prevention and intervention in future studies. Identifying modifiable midlife factors and quantifying their impact on preservation of musculoskeletal health and functioning in early old age as well as understanding the intersection of physical and cognitive function are critical first steps needed for developing and testing targeted screening strategies and early interventions to optimize independence and quality of life in older adults.