Project 1: Influence of Midlife on Functioning and Psychological Well-being in Early Old Age

项目1：中年对早年功能和心理健康的影响

• 批准号: 10471456
• 负责人: Sioban D Harlow
• 金额: $ 142.69万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10471456
• 关键词: Address; Affect; Age; Age of Onset; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Black race; Bone Density; Characteristics; Chinese; Clinical; Cognition; Cognitive; Data; Data Analyses; Data Collection; Dementia; Elderly; Endocrine; Environment; Ethnic group; Functional disorder; Future; Genitourinary system; Gonadal Steroid Hormones; Health; Health Personnel; Hispanic; Impaired cognition; Independent Living; Japanese; Knowledge; Life; Life Experience; Lipids; Maintenance; Menopause; Menstruation; Modeling; Musculoskeletal; Outcome; Pattern; Personal Satisfaction; Physical Function; Population; Prevention; Prospective Studies; Quality of life; Resources; Risk; Role; Sex Functioning; Sexual Health; Site; Sleep; Sleep disturbances; Social Well-Being; Study of Women' s Health Across the Nation; Symptoms; Translating; Vasomotor; Well in self; Woman; Women' s Health; age related; cardiovascular health; cognitive change; cognitive function; cohort; computerized data processing; design; disability; ethnic difference; falls; family structure; health disparity; health related quality of life; healthy aging; human old age (65+); inflammatory marker; insight; men; middle age; mild cognitive impairment; mortality; multiple chronic conditions; physically handicapped; preservation; prospective; psychosocial; psychosocial wellbeing; racial and ethnic; racial and ethnic disparities; racial diversity; reproductive senescence; sleep health; socioeconomics; stressor; therapy design

Women live longer with disability than men and constitute a disproportionate share of the population receiving assistance with daily activities. Cognitive decline (including age-related mild cognitive impairment, Alzheimer’s disease and Alzheimer’s disease related dementia), disrupted sleep, genitourinary symptoms and activity limitations increasingly affect women’s health and well-being as they age. Studies on aging highlight the midlife (age 40-65 years) as a critical life stage for prevention of cognitive impairment, dementia, Alzheimer’s disease, physical disability and multi-morbidity in old age. In women, the midlife encompasses the menopause transition (MT), characterized by significant changes in women’s endocrine environment, alterations in health indicators (e.g., bone mineral density, lipids, inflammatory markers), changes in family structure and social roles, and new stressors, all of which can affect cognition, functioning and well-being in later life. The 22-year multi-site Study of Women’s Health Across the Nation (SWAN) is the most comprehensive prospective study describing characteristics of the MT and elucidating relationships between the MT and change in numerous domains of health and cognitive, physical and psychosocial function in a diverse racial/ethnic cohort (Black, Chinese, Hispanic, Japanese and White women). This U19 application is designed to assess the extent to which midlife health and the MT affect risk for cognitive decline/mild cognitive impairment and physical disability, or promote psychosocial well-being and successful aging. Building on SWAN’s comprehensive midlife assessments, Project 1 will evaluate the impact of MT characteristics and MT/midlife-aging-related changes in health indicators on multiple domains of functioning in early old age (ages 66-75 years). Specific Aims of this Project are to: 1) Evaluate the impact of MT characteristics and trajectories of midlife health indicators on preservation of cognitive function (avoiding cognitive decline and onset of mild cognitive impairment), sleep health, genitourinary and sexual function, and ability for independent living in early old age; 2) Evaluate the impact of MT characteristics and trajectories of health indicators on the preservation of psychological well-being and HRQL in early old age; 3) Determine the extent to which racial/ethnic health disparities in functioning and well-being in early old age are attributable to racial/ethnic differences in MT characteristics and midlife health trajectories; and 4) Translate for women and their health care providers findings regarding the relation of the MT/midlife health to cognition, functioning and well-being in early-old age. Integrating across Projects, we will examine associations of cognitive, physical and psychosocial functioning with cardiovascular health and mortality (Project 2) and with musculoskeletal health and falls (Project 3). Resources of the three Cores are essential to the data collection, data processing and analyses proposed. Knowledge gained from Project 1 will facilitate identification of midlife prevention targets to delay or avoid mild cognitive impairment, preserve functioning, maintain independence, and optimize quality of life in early old age.

女性的残疾寿命比男性长，并且在接受日常活动帮助的人群中所占比例过高。认知能力下降（包括与年龄相关的轻度认知障碍、阿尔茨海默病和阿尔茨海默病相关的痴呆）、睡眠中断、泌尿生殖症状和活动限制日益增多。随着年龄的增长，衰老会影响女性的健康和福祉。有关衰老的研究强调，中年（40-65 岁）是预防认知障碍、痴呆、阿尔茨海默氏病、身体残疾和老年痴呆症的关键生命阶段。对于女性来说，中年期包括更年期过渡期（MT），其特征是女性内分泌环境的显着变化、健康指标的改变（例如骨矿物质密度、血脂、炎症标志物）、家庭结构的变化。社会角色和新的压力源，所有这些都会影响晚年的认知、功能和福祉。为期 22 年的全国妇女健康多地点研究 (SWAN) 是最全面的。前瞻性研究描述了 MT 的特征，并阐明了 MT 与不同种族/民族群体（黑人、中国人、西班牙裔、日本人和白人女性）的健康和认知、身体和心理社会功能的许多领域的变化之间的关系。项目 1 旨在评估中年健康和 MT 对认知衰退/轻度认知障碍和身体残疾风险的影响程度，或促进社会心理健康和成功老龄化。项目 1 将评估中年健康和 MT 的影响。早期老年（66-75 岁）多个功能领域的 MT 特征和 MT/中年衰老相关的健康指标变化该项目的具体目标是： 1) 评估 MT 特征和轨迹的影响。中年健康指标包括认知功能的保持（避免认知能力下降和轻度认知障碍的发生）、睡眠健康、泌尿生殖和性功能以及早年独立生活的能力；2）评估MT 特征和健康指标轨迹对老年早期心理健康和 HRQL 的影响 3) 确定老年早期功能和福祉方面的种族/族裔健康差异在多大程度上归因于种族/ MT 特征和中年健康轨迹的种族差异；以及 4) 为女性及其医疗保健提供者翻译关于 MT/中年健康与认知、功能和福祉之间关系的调查结果；整合各个项目，我们将研究认知、身体和心理社会功能与心血管健康和死亡率（项目 2）以及肌肉骨骼健康和跌倒（项目 3）的关联。这三个核心的资源对于数据至关重要。从项目 1 中获得的知识将有助于确定中年预防目标，以延迟或避免轻度认知障碍、保持功能、保持独立性并优化老年早期的生活质量。