Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities

非洲的健康与老龄化：INDEPTH 社区的纵向研究

• 批准号: 8734308
• 负责人: LISA F BERKMAN
• 金额: $ 90.95万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8734308
• 关键词: AIDS/HIV problem; Adult; Africa; Africa South of the Sahara; Age; Aging; Algorithms; Area; Autopsy; Baseline Surveys; Behavioral; Cardiovascular Diseases; Cardiovascular system; Censuses; Characteristics; China; Chronic; Chronic Disease; Clinical; Clinical assessments; Cognitive; Communicable Diseases; Communities; Complex; Country; Data; Data Collection; Demographic Transitions; Disease; Economic Conditions; Economics; Elderly; Elements; Epidemiologic Studies; Epidemiology; Event; Expenditure; Family; Ghana; Goals; HIV; Health; Health Policy; Health Transition; Health system; Household; Incidence; Income; India; Intervention; Labor Forces; Longitudinal Studies; Longitudinal Surveys; Monitor; Mortality Decline; Nature; Nomads; Participant; Personal Satisfaction; Physical Function; Policies; Population; Prevalence; Productivity; Resources; Respondent; Rest; Retirement; Risk; Risk Factors; Sampling; Sister; Site; Social Conditions; Social Environment; Social Policies; Source; South Africa; Staging; Surveys; Tanzania; Time; Validity and Reliability; Visit; Woman; aged; base; cognitive function; cohort; disability; disorder risk; evidence base; experience; field study; follow-up; functional decline; functional outcomes; improved; information gathering; interdisciplinary approach; longitudinal analysis; men; mortality; population based; programs; research study; social; trend

DESCRIPTION (provided by the applicant): Over the last decades, countries in Sub-Saharan Africa (SSA) have experienced a demographic and epidemiological transition with declines in mortality from infectious diseases and increases in the prevalence of non-communicable disease. Many adults in SSA are now surviving with chronic diseases whether they are communicable or non-communicable. While we have data resources to understand the challenges of aging in the context of high income countries, little is understood of the nature of aging in the SSA context. Our project aims to establish longitudinal surveys of health, aging, and well-being allowing estimation of the prevalence and incidence of major chronic conditions in 3 population-based health and demographic surveillance sites (HDSS) at different stages of health transitions (in South Africa, Ghana and Tanzania) in adults age 50 and over (n=12,000). Participants are surveyed in each year 2014 to 2017 with continuous mortality monitoring. Baseline surveys are introduced in one country per year, with South Africa in year 2, Ghana in year 3 and Tanzania in year 4. A 3 year follow up occurs in South Africa in year 5. Through intensive monitoring and follow up, migrants will be maintained in the cohort at very high levels. Our survey is comparable to that of the Health and Retirement Study (HRS) and sister surveys, yet is adapted to capture characteristics specific to SSA. With 4 subprojects on 1.physical and cognitive function, 2.cardiometabolic disorders, 3.HIV, and 4.economic well-being, our goal is to understand the determinants of health in the elderly and in turn find the consequences of health for productivity and well-being. Our specific aims are: 1. To establish three cohorts of 4,000 men and women aged 50 and over based on random stratified samples of the HDSS populations in the INDEPTH sites of Agincourt in South Africa, Navrongo in Ghana and Ifakara in Tanzania (n=12,000). A clinical substudy is conducted in a 10% subsample to look intensively at HIV and CVD. 2. To identify social, economic and biologic predictors of mortality, the incidence of disease (particularly cardiovascular disease and HIV) and changes in physical and cognitive function over three years. 3. To identify the effects of ill health on the economic well-being and productivity of the three cohorts. We aim to identify the ways in which behavioral and biologic risks are embedded in the social and policy context and are driven by social and economic conditions. Health policies, in the broadest sense, will need to rest on a strong evidence base and our study will provide valid and reliable assessments of phenotypic disorders and risk factors.

描述（由申请人提供）：在过去的几十年中，撒哈拉以南非洲（SSA）国家经历了人口和流行病学转变，传染病死亡率下降，非传染性疾病患病率上升。 SSA 的许多成年人现在都患有慢性疾病，无论是传染性的还是非传染性的。虽然我们拥有数据资源来了解高收入国家的老龄化挑战，但对撒哈拉以南非洲地区老龄化的本质了解甚少。我们的项目旨在建立健康、老龄化和福祉的纵向调查，以便估计 3 个基于人口的健康和人口监测点 (HDSS) 在健康转型的不同阶段（在南非）主要慢性病的患病率和发病率、加纳和坦桑尼亚）的 50 岁及以上成年人 (n=12,000)。 2014 年至 2017 年每年对参与者进行调查，并进行持续的死亡率监测。每年在一个国家进行基线调查，南非在第 2 年，加纳在第 3 年，坦桑尼亚在第 4 年。南非在第 5 年进行为期 3 年的跟踪调查。通过密集监测和跟踪，移民将在队列中保持在非常高的水平。我们的调查与健康与退休研究 (HRS) 和姊妹调查的调查相当，但经过调整以捕捉 SSA 的特定特征。我们的 4 个子项目分别涉及 1. 身体和认知功能、2. 心脏代谢紊乱、3. 艾滋病毒和 4. 经济福祉，我们的目标是了解老年人健康的决定因素，进而发现健康对生产力的影响和幸福。我们的具体目标是： 1. 根据南非 Agincourt、加纳 Navrongo 和坦桑尼亚 Ifakara INDEPTH 地点的 HDSS 人群的随机分层样本，建立三个由 4,000 名 50 岁及以上男性和女性组成的队列（n=12,000） ）。在 10% 的子样本中进行临床亚组研究，以深入研究 HIV 和 CVD。 2. 确定三年内死亡率、疾病发病率（特别是心血管疾病和艾滋病毒）以及身体和认知功能变化的社会、经济和生物预测因素。 3. 确定健康状况不佳对三个群体的经济福祉和生产力的影响。我们的目标是确定行为和生物风险嵌入社会和政策背景并受社会和经济条件驱动的方式。从最广泛的意义上来说，卫生政策需要建立在强有力的证据基础上，我们的研究将为表型疾病和危险因素提供有效和可靠的评估。