Risk and Resilience Factors in Memory Aging Among Older Cancer Survivors: A Cross Country Comparison of the US and England

老年癌症幸存者记忆老化的风险和弹性因素：美国和英国的跨国比较

基本信息

批准号：
10589206
负责人：
Ashly C Westrick
金额：
$ 11.24万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-01 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10589206
关键词：
Acceleration Accounting Acute Address Age Aging Alzheimer&apos s disease related dementia Cancer Patient Cancer Survivor Cancer Survivorship Clinic Cognitive Complex Comprehensive Health Care Country Data Data Analyses Diabetes Mellitus Diagnosis Diagnostic Economics Education Elderly England Environment Equity General Population Goals Government Health Health and Retirement Study Healthcare Systems Hypertension Income Individual Inequality Intervention Interview Knowledge Leadership Longitudinal Studies Malignant Neoplasms Measurement Memory Memory Loss Mental Depression Mental Health Mentorship Neighborhoods Obesity Older Population Persons Phase Physical activity Policies Politics Population Positioning Attribute Process Proxy Research Research Personnel Risk Risk Factors Role Sampling Short-Term Memory Social support Socioeconomic Factors Survivors Symptoms Training United Kingdom United States Variant cancer diagnosis cancer epidemiology cardiovascular health career cohort comorbidity dementia risk experience health care availability health difference healthy aging high risk population human old age (65+)individual variation long term memory modifiable risk multilevel analysis neighborhood disadvantage older women population based prevent recruit resilience resilience factor safety net sex social social determinants social epidemiology social vulnerability socioeconomic disparity socioeconomics survivorship

项目摘要

Memory loss is a hallmark symptom of Alzheimer’s disease and related dementias (ADRD). By identifying its early stages, interventions could be developed to prevent or slow ADRD progression. While previous research has examined memory aging among the general population, the long-term memory aging of older cancer survivors is under-studied. This is a critical evidence gap, as >26 million people in the United States (US) and >5 million people in the United Kingdom (UK) will be cancer survivors by 2040, and >70% of cancer survivors will be over age 65. The US and UK have different health care systems, government social safety net policies, and magnitudes of income inequality. Hence, older cancer survivors are aging in different social, political, and economic environments across these two high-income countries. A cross-national comparison of the US and UK is an opportunity to identify drivers of both individual-level variation and population-level differences in the memory aging of older cancer survivors. Understanding the long-term memory aging of older cancer survivors in a cross-national framework will enhance our knowledge of what factors matter most for the memory aging of older cancer survivors and could be targets for interventions. This K99/R00 proposal leverages longitudinal pre- and post-cancer diagnosis data from two nationally representative cohorts, the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), to investigate long-term memory trajectories of N=2,500 older cancer survivors from 2002 to 2018. The specific aims are to: (1) identify and compare memory trajectories of cancer survivors in the HRS and ELSA, overall and by age and sex (K99 phase); (2) identify and compare individual, neighborhood, and macro-level socioeconomic inequalities in memory aging of cancer survivors in the HRS and ELSA (R00 phase); and, (3) identify the roles of modifiable risk and resilience factors (hypertension, diabetes, obesity, depression, physical activity, social support) across countries, as these may be intervention targets to promote healthy memory aging among older cancer survivors (R00 phase). The training plan will build on the applicant’s prior training in social and cancer epidemiology to include: (1) ADRD research among cancer survivors; (2) the measurement and analysis of multi-level socioeconomic exposures; (3) and complex longitudinal data analyses in a cross-national framework. This integrated training will prepare the applicant for a successful independent research career focused on the social determinants of healthy aging among older cancer survivors. The applicant is supported by a cohesive and interdisciplinary mentorship team, including HRS and ELSA leadership. Identifying country-level differences in risk and resilience for cancer-related memory aging is important for informing population-level interventions and will support the exploration of policy- relevant determinants in future research. The proposed research will unite the fields of cancer survivorship and ADRD research by using a cross-national, population-based approach to identify high-risk groups of older cancer survivors for accelerated memory decline, as well as identify modifiable risk factors as intervention targets.

记忆丧失是阿尔茨海默氏病和相关痴呆症（ADRD）的标志性症状。通过识别它早期阶段，可以制定干预措施以防止或减缓addd的进展。同时研究已经检查了一般人群中的记忆衰老，旧癌症的长期记忆衰老幸存者研究不足。这是一个关键的证据差距，美国（美国）和到2040年，英国（英国）的500万人将成为癌症幸存者，> 70％的癌症幸存者将超过65岁。美国和英国具有不同的医疗保健系统，政府社会安全网政策，和收入不平等的幅度。因此，在不同的社会，政治和这两个高收入国家的经济环境。美国和英国的跨国比较是确定个人级别差异和人群级别差异的驱动因素的机会旧癌症存活的记忆衰老。了解旧癌症存活的长期记忆衰老在跨国框架中，将增强我们对哪些因素对哪些因素对记忆老化最重要的知识较旧的癌症存活，可能是干预措施的目标。此K99/R00提案利用纵向前以及来自两个国家代表人群的后癌后诊断数据，美国卫生和退休研究（HRS）和英语衰老纵向研究（ELSA），以研究的长期记忆轨迹 n = 2002年至2018年的2,500个较老的癌症存活。具体目的是：（1）识别和比较记忆 HRS和ELSA中癌症存活的轨迹，总体上以及年龄和性别（K99期）；（2）识别和比较癌症记忆衰老中的个人，邻里和宏观社会经济不平等现象 HRS和ELSA的幸存者（R00阶段）；（3）确定可修改风险和弹性因素的作用（高血压，糖尿病，肥胖，抑郁，体育锻炼，社会支持），因为这些可能是促进较老的癌症存活（R00期）健康记忆衰老的干预靶标。培训计划将基于申请人先前在社会和癌症流行病学上的培训，包括：（1）ADRD研究在癌症存活中；（2）多级社会经济暴露的测量和分析；（3）和复杂的纵向数据分析在跨国框架中。这种集成的培训将为成功的独立研究职业的申请人专注于健康衰老的社会决定者在较老的癌症存活中。申请人得到了一个凝聚力和跨学科的心态团队的支持，包括HRS和ELSA领导。确定国家级别的风险和弹性差异与癌症有关记忆老化对于告知人口级干预措施很重要，并将支持探索政策 - 相关的确定未来的研究。拟议的研究将团结癌症生存领域和 ADRD研究通过使用跨国，基于人群的方法来识别高风险的老年癌组可加速记忆下降的幸存者，并确定可修改的危险因素是干预目标。