Mid-life Aging & Urinary Incontinence in a Multi-Ethnic

中年老龄化

• 批准号: 7008664
• 负责人: L ELAINE WAETJEN
• 金额: $ 14.42万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-02-15 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7008664
• 关键词: aging; blood chemistry; clinical research; epidemiology; female; hormone regulation /control mechanism; human data; human middle age (35-64); longitudinal human study; menopause; racial /ethnic difference; sex hormones; urinary incontinence; women' s health

DESCRIPTION (provided by applicant): Urinary Incontinence is a common, debilitating and costly problem in middle-aged and older women. The prevalence of this condition appears to increase in women between 45-55 years old, an age range that coincides with the menopausal transition. Yet little is known about how the physiological changes associated with mid-life and ovarian aging affect incontinence. This study addresses the first two goals of the NIA RFA Aging through the Lifespan; our interdisciplinary team will examine longitudinally how life- course pathways and differences in risk factors affect urinary incontinence. OBJECTIVE: Our specific aims are: 1) to examine how the incidence and changes in prevalence of incontinence by type (stress, urge, mixed) vary over the stages of the menopausal transition; 2) to identify mid-life physical and psychosocial factors in the development, progression and regression of incontinence by type over 10 years, 3) to explore associations between incontinence and the hormonal changes of the menopausal transition; and 4) to examine the role of race/ethnicity in these specific aims. METHODS: The Study of Women's Health Across the Nation (SWAN) is a longitudinal cohort of 3300 Caucasian, African-American, Chinese, Japanese and Hispanic women who are being followed to characterize the menopausal transition. Our study proposes to use 10 years of questionnaire data with physical and hormonal measures in SWAN to investigate the development and determinants of change in incontinence symptoms across the menopausal transition and into the postmenopausal period. This proposal will primarily involve multivariable regression analysis of ordinal outcomes with mixed models in which random effects are used to model the unmeasured systematic subject-specific sources of variability. RATIONALE: Longitudinal studies that investigate causal sequences and factors associated with the development, progression and regression of incontinence are now needed to improve knowledge about the etiology of incontinence as women age. This investigation will provide this important and novel information that would be otherwise difficult to obtain. With this information we hope to help clinicians advise and treat incontinent mid-life and aging women and to inform incontinence prevention strategies by identifying modifiable risk factors for incontinence and factors associated with improving incontinence.

描述（由申请人提供）：尿失禁是中老年女性常见的、使人衰弱且代价高昂的问题。这种疾病的患病率在 45-55 岁之间的女性中似乎有所增加，这个年龄范围恰逢更年期过渡。然而，人们对中年和卵巢衰老相关的生理变化如何影响尿失禁知之甚少。这项研究解决了 NIA RFA 整个生命周期衰老的前两个目标；我们的跨学科团队将纵向研究生命历程路径和危险因素的差异如何影响尿失禁。目的：我们的具体目标是：1）研究不同类型（压力性、急迫性、混合性）失禁的发生率和患病率变化在绝经过渡阶段的变化情况； 2) 确定 10 年来不同类型失禁发生、进展和消退的中年身体和心理社会因素，3) 探索失禁与绝经过渡期荷尔蒙变化之间的关联； 4) 研究种族/族裔在这些具体目标中的作用。方法：全国妇女健康研究 (SWAN) 是一项由 3300 名白人、非裔美国人、中国人、日本人和西班牙裔妇女组成的纵向队列研究，对她们进行追踪以了解更年期过渡的特征。我们的研究建议使用 10 年的问卷数据以及 SWAN 中的身体和激素测量数据来调查绝经过渡期间和绝经后时期失禁症状变化的发展和决定因素。该提案将主要涉及使用混合模型对顺序结果进行多变量回归分析，其中随机效应用于对未测量的系统性特定主题变异源进行建模。理由：现在需要进行纵向研究来调查与失禁的发生、进展和消退相关的因果序列和因素，以提高对随着女性年龄增长而出现的失禁病因的认识。这项调查将提供这些重要且新颖的信息，否则这些信息将很难获得。有了这些信息，我们希望帮助临床医生为中年和老年女性失禁提供建议和治疗，并通过识别失禁的可改变风险因素和与改善失禁相关的因素，为失禁预防策略提供信息。