The Study of Women's Health Across the Nation (SWAN): The Impact of Midlife and the Menopause Transition on Health and Functioning in Early Old Age

全国妇女健康研究 (SWAN)：中年和更年期过渡对早年健康和功能的影响

• 批准号: 10263894
• 负责人: SHERRI-ANN M BURNETT-BOWIE
• 金额: $ 1114.51万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263894
• 关键词: Adopted; Affect; Age; Aging; American; Biological Assay; Blood Pressure; Blood Vessels; Body Composition; Body Weight; Bone Density; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Characteristics; Chinese People; Chronic; Clinic Visits; Clinical; Cognitive; Cohort Studies; Communities; Data; Data Collection; Data Set; Early Intervention; Elderly; Enrollment; Ensure; Event; Follow-Up Studies; Fracture; Future; Genitourinary system; Goals; Gonadal Steroid Hormones; Health; Health Personnel; Hemorrhage; Hispanics; Hormonal Change; Inflammation; Infrastructure; Japanese Population; Knowledge; Laboratories; Leadership; Life Expectancy; Life Experience; Life Style; Link; Lipids; Longitudinal cohort; Longitudinal cohort study; Measures; Medical; Menopause; Menstruation; Mental Depression; Mental Health; Methods; Musculoskeletal; Natural History; Osteoporosis; Outcome; Pattern; Personal Satisfaction; Physical Function; Physiological; Physiology; Population; Positioning Attribute; Postmenopause; Premenopause; Prevention program; Quality of life; Research; Resources; Risk; Risk Factors; Role; Site; Sleep; Structure; Study of Women' s Health Across the Nation; Symptoms; Time; Translating; Visit; Woman; Women' s Health; age related; aged; body system; bone; bone strength; cardiometabolic risk; cardiometabolism; cardiovascular disorder risk; clinical practice; cognitive disability; cognitive performance; cohort; data management; depressive symptoms; design; disability; disorder prevention; enhancing factor; ethnic difference; falls; health disparity; human old age (65+); indexing; insight; men; middle age; mortality; multi-racial; physical conditioning; preservation; prospective; psychosocial; public health priorities; racial and ethnic; racial and ethnic disparities; socioeconomics; treatment program

PROJECT SUMMARY This U19 application, referred to as SWAN-Aging, is designed to determine the extent to which midlife health, and specifically the menopause transition (MT), affects successful aging in women. This proposal capitalizes on the rich resources of the Study of Women's Health Across the Nation (SWAN), a longitudinal cohort study initiated in 1994 to characterize the physiological and psychosocial changes that occur during the MT. A total of 3302 Black, Chinese, Japanese, Hispanic and White women were enrolled at seven sites, with 74% of still- living women completing up to 16 visits spanning the pre-menopause to post-menopause. SWAN has described the natural history of the MT -- its timing, patterns of hormonal changes, and symptoms – and their relation to midlife health indicators. In SWAN-Aging, we will extend follow-up of the SWAN cohort into early old age (66-75 years) and will prospectively link comprehensive longitudinal characterization of both the MT and midlife health indicators to functioning and health across multiple domains in early old age, a pivotal time of transition into old age when adverse changes in health and functioning begin to accumulate. The global specific aims of this U19 application are to: 1) determine the impact of MT characteristics and trajectories of midlife health indicators on the preservation of cognitive, physical, genitourinary, sexual, and psychosocial function and sleep in early old age; 2) determine the impact of MT characteristics and trajectories of midlife health indicators on risk of adverse health outcomes, including falls, osteoporosis and fractures, poor cardiometabolic function, cardiovascular events and early mortality; 3) determine if racial/ethnic disparities in health and functioning in early old age are attributable to midlife racial/ethnic differences in MT characteristics and midlife health indicators; and 4) translate the SWAN and SWAN-Aging findings for women and their health care providers. These aims will be achieved through three integrated scientific Projects that are organized around key health domains (functioning, cardiometabolic health and musculoskeletal health) and linked by a common focus on MT characteristics and midlife changes in health indicators as key exposures. The three Projects will be supported by three Cores which will a) provide the necessary organizational infrastructure to conduct this study and to disseminate results to the research and medical communities; b) conduct accurate, high volume assays, adopting new methods as needed to provide state-of-the-art laboratory data, and c) oversee the design and conduct of the core clinic visit, data collection and data management, and the creation of the analytic datasets. SWAN-Aging will include one clinic visit and a National Death Index search to ensure complete mortality ascertainment for the cohort. SWAN-Aging is uniquely positioned to fill important scientific gaps in understanding of the impact of the MT and midlife indicators on women's health and functioning in early old age and to facilitate the application of new knowledge to clinical practice. This study will provide valuable insights into modifiable factors relevant to the design of future prevention and treatment programs.

项目摘要 该U19应用程序被称为天鹅，旨在确定中年健康的程度， 特别是更年期过渡（MT）会影响女性的成功衰老。该提案资本化 关于全国妇女健康研究的丰富资源（天鹅），一项纵向人群研究 于1994年开始表征MT期间发生的身体和社会心理变化。总共 在3302个黑色，中国，日本，西班牙裔和白人妇女中，有7个地点，仍有74％ 跨越少年前往少年前期的活着的妇女完成了多达16次访问。天鹅有 描述了MT的自然历史 - 其时机，激素变化的模式以及符号 - 与中年健康指标有关。在天鹅上，我们将把天鹅队列的后续行动扩展到早期 年龄（66-75岁），可能会将MT和MT的全面纵向表征联系起来 年龄较小的多个领域的中年健康指标 当健康和功能不良变化开始积累时，过渡到老年。全球 该U19应用的具体目的是：1）确定MT特征和轨迹的影响 中年健康指标有关保存认知，身体，泌尿生殖器，性和社会心理的指标 老年时的功能和睡眠； 2）确定MT特征和中年轨迹的影响 健康指标有不良健康结果的风险，包括瀑布，骨质疏松和骨折，差 心脏代谢功能，心血管事件和早期死亡率； 3）确定种族/种族差异是否 老年的健康和功能归因于中年的种族/种族差异MT特征 和中年健康指标； 4）翻译妇女及其健康的天鹅和天鹅的发现 护理提供者。这些目标将通过三个综合科学项目实现 围绕关键健康领域（功能，心脏代谢健康和肌肉骨骼健康），并与 对MT特征和健康指标的中年变化的共同关注作为关键暴露。三个 项目将得到三个核心的支持，这些核心将为a）提供必要的组织基础设施 进行这项研究并将结果传播给研究和医疗社区； b）进行准确， 大量测定，根据需要采用新方法来提供最先进的实验室数据，c） 监督核心诊所访问，数据收集和数据管理的设计和行为以及创建 分析数据集。天鹅及将包括一次诊所访问和全国死亡指数搜索以确保 对队列的完全死亡率确定。天鹅的衰老位置是填补重要科学的独特位置 了解MT和中年指标对妇女健康的影响的差距 早年，并促进将新知识应用于临床实践。这项研究将提供 对与未来预防和治疗计划的设计有关的可修改因素的有价值的见解。