Women's Health Study: Infrastructure support for continued cohort follow-up

妇女健康研究：为持续队列随访提供基础设施支持

• 批准号: 10117507
• 负责人: Julie E. Buring
• 金额: $ 44.68万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117507
• 关键词: Accelerometer; Acute; Administrative Supplement; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Aspirin; Beta Carotene; Biological Assay; Blood specimen; Cardiovascular Diseases; Data; Dementia; Diagnosis; Diagnostic Services; Disease; Follow-Up Studies; Funding; Future; Genetic; Geographic Distribution; Geography; Goals; High Prevalence; Impaired cognition; Individual; Influentials; Infrastructure; Intervention; Investigation; Life; Life Expectancy; Life Style; Literature; Malignant Neoplasms; Measurement; Measures; Medical History; Morbidity - disease rate; Participant; Pathology; Persons; Physical activity; Primary Cancer Prevention; Questionnaires; Randomized; Research; Risk Factors; Sample Size; Sampling; Science; Social Security Number; Testing; Time; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Vitamin E; Woman; Women' s Health; aged; cohort; cost effective; dementia risk; design; exome; experience; follow-up; genetic risk factor; genome wide association study; lifetime risk; men; middle age; mortality; novel; prevent; randomized trial; symposium; virtual

ABSTRACT Alzheimer's disease and related dementias (AD/RD) are pervasive and debilitating diseases currently affecting over 5 million Americans. At age 65, the lifetime risk of developing dementia is 21.1% among women compared to 11.6% among men. Although age is the most influential risk factor for dementia, the greater life expectancy of women compared to men does not entirely explain the higher prevalence of dementia among women. Given the higher burden of AD/RD, it is particularly important to identify risk factors for AD/RD among women. In addition, a growing body of research underscores the need to examine midlife risk factors for dementia, especially since dementia pathology often begins decades before diagnosis. Our overarching goal is to leverage data from the existing Women's Health Study (WHS) to explore a large range of risk factors for AD/RD among women followed from middle age into old age. The goal of this proposal is to expand the infrastructure of the WHS to allow us to assess AD/RD in a cohort that was not originally designed to evaluate these important and timely questions. The WHS began in 1992 as a randomized trial testing aspirin, beta- carotene, and vitamin E for the primary prevention of cancer and cardiovascular disease in 39,876 apparently healthy women aged ≥45 years. The women have been followed observationally since the end of the trial in 2004. As of the end of December 2018, average mean follow-up was almost 24 years, with morbidity follow-up still close to 90% and mortality follow-up virtually 100%. An extensive body of data is available, with decades of yearly follow-up questionnaires on a wide range of demographic, lifestyle, and medical history variables. Since the mean age of the participants is currently 77.1 years (range 67.3 to 106.3 years), social security numbers are available on virtually all participants, and Centers for Medicare & Medicaid Services (CMS) data are available even for participants unwilling or unable to return study questionnaires, we propose to obtain and assess data from CMS to identify dementia diagnoses among WHS participants from 2011 to 2018. There is no other feasible and cost-effective strategy to assess dementia in a geographically diverse cohort the size of the WHS. We will also assess the association between established demographic, lifestyle, medical history, and genetic risk factors for dementia using previously collected data from WHS questionnaires and dementia data from CMS, and compare our findings to the current literature. These aims are feasible to accomplish within the one-year time frame of this administrative supplement and will provide us with important information on the feasibility of using CMS data to obtain information on AD/RD diagnoses in the WHS. In the future, we will apply for funding to explore novel risk factors for dementia among women, leveraging from the WHS the broad range of risk factor data collected over 24 years, the large sample size of women, and the availability of genetic data. The WHS has made substantial contributions to our understanding of cancer and cardiovascular disease, and we believe that the WHS can be effectively leveraged to understand AD/RD risk factors among women.

抽象的 阿尔茨海默氏病和相关痴呆症（AD/RD）目前是普遍的疾病 影响超过500万美国人。在65岁时，女性患痴呆症的终生风险为21.1％ 男性为11.6％。尽管年龄是痴呆症的最具影响力的风险因素，但寿命更大 与男性相比，女性的期望并不能完全解释痴呆症的较高患病率 女性。鉴于AD/RD的燃烧较高，确定AD/RD的风险因素尤其重要 女性。此外，越来越多的研究强调了检查中年风险因素的需求 痴呆症，尤其是因为痴呆症病理通常在诊断前几十年开始。我们的总体目标是 利用现有妇女健康研究（WHS）的数据来探索各种风险因素 从中年到老年，女性的广告/路。该提议的目的是扩大 WHS的基础架构使我们能够在最初旨在评估的队列中评估AD/RD 这些重要及时的问题。 WHS始于1992年，是一项随机试验测试阿司匹林，β- 胡萝卜素和维生素E主要预防癌症和心血管疾病，显然是39,876 ≥45岁的健康女性。自审判结束以来，妇女就在观察中受到关注 2004年。截至2018年12月底，平均平均随访近24年，发病率随访 仍然接近90％，死亡率随访实际上是100％。有大量数据，数十年 每年有关广泛的人口，生活方式和病史变量的随访问卷。自从 参与者的平均年龄目前为77.1岁（67.3至106.3岁），社会安全号码 几乎所有参与者都可以使用，医疗保险和医疗补助服务中心（CMS）数据是 即使对于不愿意或无法返回学习问卷的参与者，我们都建议获得和 评估CMS的数据以识别2011年至2018年WHS参与者之间的痴呆诊断。 没有其他可行且具有成本效益的策略来评估地理上不同的队列中的痴呆症的大小 WHS。我们还将评估既定人口，生活方式，病史和 使用先前收集的WHS问卷和痴呆数据的数据的痴呆症遗传危险因素 从CMS，将我们的发现与当前文献进行比较。这些目标是可行的 此行政补充的一年时间范围，将为我们提供有关 使用CMS数据获取WHS中的AD/RD诊断信息的可行性。将来，我们将申请 为了探索女性痴呆症的新型危险因素，从广泛范围内利用 在24年内收集的危险因素数据，女性的样本大小和遗传数据的可用性。 WHS为我们对癌症和心血管疾病的理解做出了重大贡献，以及 我们认为，可以有效利用WH来了解女性的AD/RD风险因素。