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.

项目概要 这个 U19 应用程序被称为 SWAN-Aging，旨在确定中年健康的程度， 特别是更年期过渡 (MT)，会影响女性的成功老龄化。 全国妇女健康研究 (SWAN) 的丰富资源，这是一项纵向队列研究 1994 年发起，旨在描述 MT 期间发生的生理和心理变化。 共有 3302 名黑人、中国人、日本人、西班牙裔和白人女性在 7 个地点注册，其中 74% SWAN 已完成多达 16 次绝经前至绝经后就诊的在世女性。 描述了 MT 的自然史——它的时间、荷尔蒙变化的模式和症状——及其 在 SWAN-Aging 中，我们将 SWAN 队列的随访范围延伸至老年早期。 年龄（66-75岁），并将前瞻性地将MT和MT的综合纵向特征联系起来 中年健康指标反映了老年早期多个领域的功能和健康状况，这是一个关键时期 当健康和功能的不利变化开始累积时，就会过渡到老年。 该 U19 应用程序的具体目标是： 1) 确定 MT 特征和轨迹的影响 关于保持认知、身体、泌尿生殖、性和心理社会的中年健康指标 早年的功能和睡眠；2) 确定 MT 特征和中年轨迹的影响 关于不良健康结果风险的健康指标，包括跌倒、骨质疏松和骨折、贫困 心脏代谢功能、心血管事件和早期死亡率；3) 确定种族/民族差异是否存在 早年的健康和功能归因于中年 MT 特征的种族/民族差异 和中年健康指标；4) 将 SWAN 和 SWAN-Aging 研究结果转化为女性及其健康 这些目标将通过组织的三个综合科学项目来实现。 围绕关键健康领域（功能、心脏代谢健康和肌肉骨骼健康）并通过 共同关注MT特征和中年健康指标变化作为关键暴露点。 项目将由三个核心支持，这将 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界和医学界 b) 进行准确、 大容量测定，根据需要采用新方法来提供最先进的实验室数据，以及 c) 监督核心门诊就诊的设计和实施、数据收集和数据管理以及创建 SWAN-Aging 分析数据集将包括一次诊所就诊和一项全国死亡指数搜索，以确保 SWAN-Aging 队列的完整死亡率确定具有独特的地位，可以填补重要的科学空白。 对 MT 和中年指标对妇女健康和功能的影响的理解存在差距 这项研究将提供早期老年并促进新知识应用于临床实践。 对与未来预防和治疗计划设计相关的可改变因素的宝贵见解。