Cardiovascular and Cerebrovascular Risk Factors for Mobility Limitation in the Jackson Heart Study

杰克逊心脏研究中导致活动受限的心脑血管危险因素

基本信息

批准号：
10359113
负责人：
Michelle Christina Odden
金额：
$ 39万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-01 至 2024-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10359113
关键词：
Affect African American population Age Aging Ancillary Study Biology Blood Pressure Brain Cardiac health Cardiovascular Diseases Cardiovascular system Categories Cerebrovascular Disorders Clinical Cognitive Cohort Studies Communities Data Dementia Development Elderly Ethnic Origin Event Exposure to Gait speed Goals Health Heart failure Human Human Activities Hypertension Impaired cognition Inflammation Intervention Jackson Heart Study Kidney Kidney Diseases Knowledge Life Link Measures Mediating Mediation Mediator of activation protein Methods Microvascular Dysfunction Mississippi Myocardial Infarction Obesity Outcome Study Participant Pathway interactions Patient Self-Report Persons Physical Performance Physical activity Population Prevalence Prevention strategy Race Research Resources Risk Factors Schedule Seminal Smoking Socioeconomic Status Stroke Testing Underrepresented Populations Vascular Diseases Walking White Matter Hyperintensity Work brain health brain magnetic resonance imaging cardiovascular health cerebrovascular cognitive testing critical period dementia risk depressive symptoms design disability disadvantaged population fasting glucose high risk population middle age novel preservation prevent psychosocial racial health disparity sex vulnerable community

项目摘要

ABSTRACT Walking is a core activity of human life. Mobility limitation, or difficulty or inability to walk, can limit a person's ability to work, live independently, and participate in the community. Heart and brain health are two of the strongest modifiable pathways to mobility limitation. African Americans have a disproportionate burden of cardiovascular disease (CVD), cerebrovascular disease (CBVD), cognitive impairment, and mobility limitation, but the majority of research on the relationship between these conditions has been conducted in predominantly white populations. The biology and optimal prevention strategies for mobility limitation may differ by race/ethnicity, highlighting a critical need for research in underrepresented populations. The proposed research will add validated measures of mobility, disability, and physical performance to the Jackson Heart Study (JHS), a cohort study of African Americans, designed to investigate causes of CVD in a high-risk population. JHS participants have undergone three exams (Exam 1, 2000-2004, Exam 2, 2005-2008, Exam 3, 2009-2013); Exam 4 is scheduled on the 3,500 remaining participants (mean age = 65 years) beginning in 2020. The exam will include extensive CVD measures, socioeconomic status, psychosocial health, cognitive testing, and brain MRI. We propose an ancillary study to add established measures of mobility limitation: gait speed <0.6 m/s, and self-reported difficulty/inability to walk a quarter of a mile or climb 10 stairs. We will leverage the nearly 20 years of data on CVD/CBVD risk factors and newly collected data on subclinical vascular disease and brain health to better understand the timing of exposure to risk factors and mediating pathways to mobility limitation in African Americans. We hypothesize that exposure to high blood pressure, high fasting glucose, and adiposity in midlife will have stronger associations with mobility limitation in older adults than exposure to these risk factors in late life. We will use novel statistical mediation methods to quantify the extent to which potential mediators explain the relationship between CVD/CBVD risk factors and mobility limitation, while allowing us to test for potential interactions by these mediators. This research will support our long-term goal to enhance functional health among African Americans, in order to preserve independence and participation in the community. Understanding the link between heart and brain health and mobility limitation is critical to reduce racial disparities in health. Moreover, the addition of the functional measures will help expand JHS into a contemporary study cardiovascular health and aging in African Americans.

抽象的步行是人类生活的核心活动。行动受限，或者行走困难或无法行走，会限制一个人的活动能力。工作、独立生活和参与社区的能力。心脏和大脑健康是其中两个限制行动能力的最强可修改途径。非裔美国人承受着不成比例的负担心血管疾病（CVD）、脑血管疾病（CBVD）、认知障碍和活动受限，但大多数关于这些条件之间关系的研究主要是在白人人口。行动受限的生物学和最佳预防策略可能因以下原因而有所不同：种族/族裔，强调对代表性不足的人群进行研究的迫切需要。拟议的研究将在杰克逊心脏研究 (JHS) 中添加经过验证的活动能力、残疾和身体表现测量指标，一项针对非裔美国人的队列研究，旨在调查高危人群中 CVD 的病因。 JHS 参与者已经参加了三场考试（考试1，2000-2004年，考试2，2005-2008年，考试3，2009-2013年）；考试 4 计划于 2020 年开始对剩余的 3,500 名参与者（平均年龄 = 65 岁）进行。考试将包括广泛的 CVD 测量、社会经济状况、社会心理健康、认知测试和大脑核磁共振成像。我们提出一项辅助研究，添加已建立的移动限制措施：步态速度 <0.6 m/s，以及自我报告的困难/无法行走四分之一英里或爬 10 级楼梯。我们将利用近20 多年关于 CVD/CBVD 危险因素的数据以及新收集的关于亚临床血管疾病和大脑的数据健康，以更好地了解暴露于危险因素的时间和调节行动受限的途径在非裔美国人中。我们假设暴露于高血压、高空腹血糖和与接触这些物质相比，中年肥胖与老年人行动受限的关系更强晚年的危险因素。我们将使用新颖的统计中介方法来量化潜在的程度调解员解释了 CVD/CBVD 风险因素与行动限制之间的关系，同时允许我们测试这些中介者的潜在相互作用。这项研究将支持我们的长期目标，以增强非裔美国人的功能健康，以保持独立和参与社区。了解心脏和大脑健康与行动限制之间的联系对于减少健康方面的种族差异。此外，功能措施的增加将有助于将 JHS 扩展为当代研究非裔美国人的心血管健康和衰老。