Women's Health Study: Infrastructure support for continued cohort follow-up

妇女健康研究：为持续队列随访提供基础设施支持

• 批准号: 10117507
• 负责人: Julie E. Buring
• 金额: $ 44.68万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117507
• 关键词: Accelerometer; Acute; Administrative Supplement; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Aspirin; Beta Carotene; Biological Assay; Blood specimen; Cardiovascular Diseases; Data; Dementia; Diagnosis; Diagnostic Services; Disease; Follow-Up Studies; Funding; Future; Genetic; Geographic Distribution; Geography; Goals; High Prevalence; Impaired cognition; Individual; Influentials; Infrastructure; Intervention; Investigation; Life; Life Expectancy; Life Style; Literature; Malignant Neoplasms; Measurement; Measures; Medical History; Morbidity - disease rate; Participant; Pathology; Persons; Physical activity; Primary Cancer Prevention; Questionnaires; Randomized; Research; Risk Factors; Sample Size; Sampling; Science; Social Security Number; Testing; Time; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Vitamin E; Woman; Women' s Health; aged; cohort; cost effective; dementia risk; design; exome; experience; follow-up; genetic risk factor; genome wide association study; lifetime risk; men; middle age; mortality; novel; prevent; randomized trial; symposium; virtual

ABSTRACT Alzheimer's disease and related dementias (AD/RD) are pervasive and debilitating diseases currently affecting over 5 million Americans. At age 65, the lifetime risk of developing dementia is 21.1% among women compared to 11.6% among men. Although age is the most influential risk factor for dementia, the greater life expectancy of women compared to men does not entirely explain the higher prevalence of dementia among women. Given the higher burden of AD/RD, it is particularly important to identify risk factors for AD/RD among women. In addition, a growing body of research underscores the need to examine midlife risk factors for dementia, especially since dementia pathology often begins decades before diagnosis. Our overarching goal is to leverage data from the existing Women's Health Study (WHS) to explore a large range of risk factors for AD/RD among women followed from middle age into old age. The goal of this proposal is to expand the infrastructure of the WHS to allow us to assess AD/RD in a cohort that was not originally designed to evaluate these important and timely questions. The WHS began in 1992 as a randomized trial testing aspirin, beta- carotene, and vitamin E for the primary prevention of cancer and cardiovascular disease in 39,876 apparently healthy women aged ≥45 years. The women have been followed observationally since the end of the trial in 2004. As of the end of December 2018, average mean follow-up was almost 24 years, with morbidity follow-up still close to 90% and mortality follow-up virtually 100%. An extensive body of data is available, with decades of yearly follow-up questionnaires on a wide range of demographic, lifestyle, and medical history variables. Since the mean age of the participants is currently 77.1 years (range 67.3 to 106.3 years), social security numbers are available on virtually all participants, and Centers for Medicare & Medicaid Services (CMS) data are available even for participants unwilling or unable to return study questionnaires, we propose to obtain and assess data from CMS to identify dementia diagnoses among WHS participants from 2011 to 2018. There is no other feasible and cost-effective strategy to assess dementia in a geographically diverse cohort the size of the WHS. We will also assess the association between established demographic, lifestyle, medical history, and genetic risk factors for dementia using previously collected data from WHS questionnaires and dementia data from CMS, and compare our findings to the current literature. These aims are feasible to accomplish within the one-year time frame of this administrative supplement and will provide us with important information on the feasibility of using CMS data to obtain information on AD/RD diagnoses in the WHS. In the future, we will apply for funding to explore novel risk factors for dementia among women, leveraging from the WHS the broad range of risk factor data collected over 24 years, the large sample size of women, and the availability of genetic data. The WHS has made substantial contributions to our understanding of cancer and cardiovascular disease, and we believe that the WHS can be effectively leveraged to understand AD/RD risk factors among women.

抽象的 阿尔茨海默病和相关痴呆（AD/RD）是目前普遍存在且使人衰弱的疾病 影响超过 500 万美国人，65 岁时，女性终生患痴呆症的风险为 21.1%。 尽管年龄是痴呆症最有影响力的危险因素，但男性的这一比例为 11.6%。 女性与男性相比的预期并不能完全解释痴呆症患病率较高的原因 鉴于 AD/RD 的负担较高，识别 AD/RD 的危险因素尤为重要。 此外，越来越多的研究强调有必要检查女性的中年危险因素。 痴呆症，特别是因为痴呆症病理学通常在诊断前几十年就开始了。 利用现有女性健康研究 (WHS) 的数据来探索多种风险因素 该提案的目标是扩大女性从中年到老年的AD/RD。 WHS 的基础设施使我们能够在最初并非旨在评估的队列中评估 AD/RD 这些重要而及时的问题始于 1992 年，作为一项测试阿司匹林、β- 的随机试验。 胡萝卜素和维生素 E 显然对 39,876 例癌症和心血管疾病有一级预防作用 自试验结束以来，对年龄≥45岁的健康女性进行了观察性随访。 2004年。截至2018年12月底，平均随访时间近24年，发病率随访 仍接近 90%，死亡率随访率几乎为 100%，有数十年的大量数据可供使用。 自此以来，每年对各种人口、生活方式和病史变量进行跟踪调查。 目前参与者的平均年龄为 77.1 岁（范围为 67.3 至 106.3 岁），社会保障号码 几乎所有参与者都可以获取医疗保险和医疗补助服务中心 (CMS) 的数据 即使参与者不愿意或无法返回研究问卷，我们建议获取并 评估 CMS 的数据，以确定 2011 年至 2018 年 WHS 参与者的痴呆诊断情况。 没有其他可行且具有成本效益的策略来评估规模大小不同的地理上的痴呆症 我们还将评估已确定的人口、生活方式、病史和疾病之间的关联。 使用之前从 WHS 调查问卷和痴呆症数据中收集的数据确定痴呆症的遗传风险因素 来自 CMS 的研究结果，并将我们的研究结果与当前文献进行比较，这些目标在 该行政补充文件的期限为一年，将为我们提供有关 使用 CMS 数据获取 WHS 中 AD/RD 诊断信息的可行性 将来我们将申请。 为探索女性痴呆症的新风险因素提供资金，利用 WHS 的广泛范围 24 年来收集的危险因素数据、女性样本量大以及遗传数据的可用性。 WHS 为我们对癌症和心血管疾病的理解做出了重大贡献，并且 我们相信，可以有效利用 WHS 来了解女性 AD/RD 风险因素。