Behavioral epidemiology of healthy aging

健康老龄化的行为流行病学

• 批准号: 8736491
• 负责人: Alan B Zonderman
• 金额: $ 168.76万
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8736491
• 关键词: Accounting; Adult; African American; Age; Age of Onset; Alcohol or Other Drugs use; All-Trans-Retinol; American; Antioxidants; Ascorbic Acid; Behavior; Behavioral; Beta Carotene; Biological; Body Weight; Bread; Cardiovascular Diseases; Carotenoids; Cerebrovascular Disorders; Clinical; Clinical Trials; Cocaine; Cocaine Users; Cognitive; Communities; Data; Data Quality; Dementia; Diet; Dietary Potassium; Dietary intake; Discipline; Dose; Drug usage; Economic Conditions; Economics; Emotional; Environmental Risk Factor; Epidemiology; Esters; Ethnic Origin; Event; Food; Food Industry; Genetic; Genetic Markers; Goals; Guidelines; Health; Health Professional; Health Status; Hour; Hypertension; Individual; Individual Differences; Intake; Intervention; Life; Link; Logistic Regressions; Logistics; Longevity; Longitudinal Studies; Lutein; Measures; Mental Health; Modeling; Morbidity - disease rate; National Health and Nutrition Examination Survey; Neighborhoods; Neurotic Disorders; Opiates; Outcome; Participant; Patient Self-Report; Patients; Performance; Personality; Personality Development; Personality Traits; Personality inventories; Population Group; Population Heterogeneity; Potassium; Poverty; Proteins; Psychological Factors; Questionnaires; Readability; Recommendation; Research; Research Personnel; Resources; Risk; Risk Factors; Sampling; Serum; Societies; Socioeconomic Status; Sodium; Source; Structure; Surveys; Telephone; Testing; Time; Vitamin E; Weight; Weight Gain; Woman; Yeasts; aged; body-mind; depressive symptoms; design; dietary control; emotional distress; experience; follow-up; health disparity; healthy aging; indexing; interest; literacy; low socioeconomic status; meetings; men; middle age; mortality; named group; physical conditioning; psychologic; racial and ethnic; response; social; socioeconomics; success; tool; trend; zeaxanthin

We examined the relationship of elevated depressive symptoms with antioxidant status in cross-sectional data from the National Health and Nutrition Examination Surveys 2005-6 on US adults aged 20-85 years. Depressive symptoms were measured using the Patient Health Questionnaire with a score cut-off point of 10 to define 'elevated depressive symptoms'. Serum antioxidant status was measured by serum levels of carotenoids, retinol (free and retinyl esters), vitamin C and vitamin E. The main analyses consisted of multiple logistic and zero-inflated Poisson regression models, taking into account sampling design complexity. The final sample consisted of 1798 US adults with complete data. A higher total serum carotenoid level was associated with a lower likelihood of elevated depressive symptoms with a reduction in the odds by 37 % overall with each sd increase in exposure, and by 34 % among women (P< 0.05). A dose-response relationship was observed when total serum carotenoids were expressed as quartiles (Q4 (1.62-10.1 mumol/l) v. Q1 (0.06-0.86 mumol/l): OR 0.41; 95 % CI 0.23, 0.76, P< 0.001; P for trend = 0.035), though no significant associations were found with the other antioxidant levels. Among carotenoids, beta-carotene (men and women combined) and lutein+zeaxanthins (women only, after control for dietary lutein+zeaxanthin intake and supplement use) had an independent inverse association with elevated depressive symptoms among US adults. None of the other serum antioxidants had a significant association with depressive symptoms, independently of total carotenoids and other covariates. In conclusion, total carotenoids (mainly beta-carotene and lutein+zeaxanthins) in serum were associated with reduced levels of depressive symptoms among community-dwelling US adults. The sodium intake of participants of the Healthy Aging in Neighborhoods of Diversity across the Life Span study who were in three of the special population groups identified by the Dietary Guidelines for Americans, 2010 (those with hypertension, African Americans, and those >51 years) was analyzed to determine if they met sodium recommendations. The sample included 2152 African American and white subjects, aged 30-64 years. Major dietary sources of sodium for each group were determined from two 24-hour dietary recalls, and dietary intakes were compared with sodium recommendations. Dietary potassium was also evaluated. The intakes of the groups studied exceeded 1500 mg sodium while their potassium intakes were lower than the Adequate Intake of 4700 mg. The major contributors of sodium included "cold cuts, sausage, and franks," "protein foods," and yeast breads. Excessive sodium intake characterized the diet of an urban, socioeconomically diverse population who are hypertensive or at risk for having hypertension. These findings have implications for health professionals and the food industry. Reciprocal relations between weight and psychological factors suggest that there are deep connections between mind and body. Personality traits are linked to weight gain; weight gain may likewise be associated with personality change. Using data from two diverse longitudinal samples (N = 1,919) collected at two time points an average of 10 years apart, we showed that significant weight gain is associated with increases in both impulsiveness and deliberation: In both samples, middle-aged adults who gained 10% or more of their baseline body weight by follow-up increased in their tendency to give in to temptation, yet were more thoughtful about the consequences of their actions. The present research moves beyond life events to implicate health status in adult personality development. The findings also suggest that interventions focusing on the emotional component of impulse control may be more effective because even people who become more thoughtful about the consequences of their actions may have limited success at inhibiting their behavior. We examined the data quality and replicability of the Revised NEO Personality Inventory (NEO-PI-R) factor structure in a sample that varied in ethnicity, socioeconomic status, and literacy. Participants (N = 546), drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, were African American (58%) and white (42%) urban dwellers living above (49%) and below (51%) 125% of the federal poverty line. The NEO-PI-R, administered via telephone, was evaluated for data quality (percent valid, acquiescence, internal consistency), congruence with the normative factor structure, and readability. All indices of data quality and factor congruence were excellent in the full sample. Literacy was the most consistent predictor of data quality. A slightly worse structure was found for the Openness to Experience and Extraversion factors among lower socioeconomic status African American and white participants. The overall index of factor congruence, however, supports replication of the normative structure well beyond chance levels even among those with lower literacy. Despite the challenges of low literacy, the present findings indicate that personality traits can be assessed reliably in socioeconomically diverse populations that include those living in poverty. Illicit substances increase risk of morbidity and mortality and have significant consequences for society. Personality traits are associated with drug use; we test whether these associations vary by socioeconomic status. Participants (N=412) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study completed the Revised NEO Personality Inventory and self-reported use of opiates and cocaine. 50% of participants were living below 125% of the federal poverty line. Mean-level personality differences across never, former, and current opiate/cocaine users were compared. Logistic regressions compared never versus current users and interactions between personality traits and poverty status tested whether these associations varied by socioeconomic status. High Neuroticism and low Agreeableness increased risk of drug use. The association between low Conscientiousness and drug use was moderated by poverty, such that low Conscientiousness was a stronger risk factor for illicit substance use among those with relatively higher SES. For every standard deviation decrease in Conscientiousness, there was a greater than 2-fold increase in risk of illicit substance use (OR=2.15, 95% CI=1.45-3.17). Conscientiousness was unrelated to drug use among participants living below 125% of the federal poverty line. Under favorable economic conditions, the tendency to be organized, disciplined, and deliberate is protective against drug use. These tendencies, however, matter less when financial resources are scarce. In contrast, those prone to emotional distress and antagonism are at greater risk for current drug use, regardless of their economic situation.

我们根据 2005-6 年美国 20-85 岁成年人的国家健康和营养检查调查的横断面数据，研究了抑郁症状加重与抗氧化状态之间的关系。使用患者健康问卷测量抑郁症状，分数截止点为 10，以定义“抑郁症状加重”。血清抗氧化状态通过类胡萝卜素、视黄醇（游离和视黄酯）、维生素 C 和维生素 E 的血清水平来测量。主要分析包括多重逻辑回归和零膨胀泊松回归模型，同时考虑到抽样设计的复杂性。最终样本由 1798 名美国成年人组成，数据完整。血清总类胡萝卜素水平较高，抑郁症状升高的可能性较低，暴露量每增加 sd，总体几率就会降低 37%，女性则降低 34%（P<0.05）。当血清总类胡萝卜素以四分位数表示时，观察到剂量-反应关系（Q4 (1.62-10.1 mumol/l) vs. Q1 (0.06-0.86 mumol/l)：OR 0.41；95 % CI 0.23、0.76，P < 0.001 ; 趋势 P = 0.035），但未发现与其他显着相关性抗氧化剂水平。在类胡萝卜素中，β-胡萝卜素（男性和女性合计）和叶黄素+玉米黄质（仅限女性，在控制膳食叶黄素+玉米黄质摄入量和补充剂使用后）与美国成年人抑郁症状升高呈独立负相关。独立于总类胡萝卜素和其他协变量，其他血清抗氧化剂均与抑郁症状没有显着相关性。总之，血清中的总类胡萝卜素（主要是 β-胡萝卜素和叶黄素+玉米黄质）与社区居住的美国成年人抑郁症状水平的降低有关。 2010 年《美国人膳食指南》确定的三个特殊人群（高血压患者、非洲裔美国人和 51 岁以上人群）中的“终身多样性社区健康老龄化”研究参与者的钠摄入量进行分析以确定它们是否符合钠建议。样本包括 2152 名非裔美国人和白人受试者，年龄在 30-64 岁之间。通过两次 24 小时饮食回顾确定每组的主要膳食钠来源，并将膳食摄入量与钠建议进行比较。还评估了膳食钾。研究组的钠摄入量超过 1500 毫克，而钾摄入量低于 4700 毫克的充足摄入量。钠的主要来源包括“冷盘、香肠和香肠”、“蛋白质食品”和酵母面包。钠摄入过多是患有高血压或有高血压风险的城市、社会经济多样化人群的饮食特征。这些发现对卫生专业人员和食品行业具有重要意义。 体重和心理因素之间的相互关系表明，心灵和身体之间存在着深刻的联系。性格特征与体重增加有关；体重增加同样可能与性格改变有关。使用在平均相隔 10 年的两个时间点收集的两个不同纵向样本 (N = 1,919) 的数据，我们发现体重显着增加与冲动和深思熟虑的增加相关：在这两个样本中，体重增加的中年成年人通过随访，他们屈服于诱惑的倾向增加了基线体重的 10% 或更多，但他们对自己行为的后果更加深思熟虑。目前的研究超越了生活事件，将健康状况与成人人格发展联系起来。研究结果还表明，专注于冲动控制的情绪成分的干预措施可能更有效，因为即使人们对自己行为的后果更加深思熟虑，在抑制自己的行为方面也可能取得有限的成功。 我们在不同种族、社会经济地位和识字率的样本中检查了修订版 NEO 人格量表 (NEO-PI-R) 因子结构的数据质量和可复制性。参与者（N = 546）来自“一生中多元化社区的健康老龄化”（HANDLS）研究，其中包括非洲裔美国人（58%）和白人（42%），生活水平高于（49%）和低于（51%）的城市居民。 %) 联邦贫困线的 125%。 NEO-PI-R 通过电话管理，评估数据质量（有效百分比、默认、内部一致性）、与规范因素结构的一致性以及可读性。在整个样本中，所有数据质量和因子一致性指标都非常出色。识字率是数据质量最一致的预测指标。在社会经济地位较低的非裔美国人和白人参与者中，发现体验开放性和外向性因素的结构稍差。然而，因素一致性的总体指数支持规范结构的复制远远超出了机会水平，即使在识字率较低的人中也是如此。尽管面临识字率低的挑战，但目前的研究结果表明，可以在社会经济多样化的人群（包括生活在贫困中的人群）中可靠地评估人格特征。 非法药物会增加发病和死亡的风险，并对社会产生重大影响。人格特质与吸毒有关；我们测试这些关联是否因社会经济地位而异。来自“一生中多样性社区健康老龄化”(HANDLS) 研究的参与者 (N=412) 完成了修订版 NEO 人格量表并自我报告了阿片类药物和可卡因的使用情况。 50% 的参与者生活在联邦贫困线 125% 以下。比较了从未、以前和当前阿片/可卡因使用者的平均水平人格差异。逻辑回归比较了从未使用过的用户与当前用户，以及性格特征和贫困状况之间的相互作用，测试了这些关联是否因社会经济地位而异。高神经质和低宜人性增加了吸毒的风险。低尽责性与吸毒之间的关联因贫困而减弱，因此对于社会经济地位相对较高的人来说，低尽责性是非法药物使用的更强风险因素。尽责性标准差每降低一次，非法药物使用风险就会增加 2 倍以上（OR=2.15，95% CI=1.45-3.17）。生活在联邦贫困线 125% 以下的参与者的责任心与吸毒无关。在有利的经济条件下，有组织、有纪律和深思熟虑的倾向可以防止吸毒。然而，当财政资源稀缺时，这些趋势就不那么重要了。相比之下，那些容易情绪困扰和对抗的人，无论其经济状况如何，目前吸毒的风险都更大。