Risk and Resilience Factors in Memory Aging Among Older Cancer Survivors: A Cross Country Comparison of the US and England

老年癌症幸存者记忆老化的风险和弹性因素：美国和英国的跨国比较

基本信息

批准号：
10589206
负责人：
Ashly C Westrick
金额：
$ 11.24万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-01 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10589206
关键词：
Acceleration Accounting Acute Address Age Aging Alzheimer&apos s disease related dementia Cancer Patient Cancer Survivor Cancer Survivorship Clinic Cognitive Complex Comprehensive Health Care Country Data Data Analyses Diabetes Mellitus Diagnosis Diagnostic Economics Education Elderly England Environment Equity General Population Goals Government Health Health and Retirement Study Healthcare Systems Hypertension Income Individual Inequality Intervention Interview Knowledge Leadership Longitudinal Studies Malignant Neoplasms Measurement Memory Memory Loss Mental Depression Mental Health Mentorship Neighborhoods Obesity Older Population Persons Phase Physical activity Policies Politics Population Positioning Attribute Process Proxy Research Research Personnel Risk Risk Factors Role Sampling Short-Term Memory Social support Socioeconomic Factors Survivors Symptoms Training United Kingdom United States Variant cancer diagnosis cancer epidemiology cardiovascular health career cohort comorbidity dementia risk experience health care availability health difference healthy aging high risk population human old age (65+)individual variation long term memory modifiable risk multilevel analysis neighborhood disadvantage older women population based prevent recruit resilience resilience factor safety net sex social social determinants social epidemiology social vulnerability socioeconomic disparity socioeconomics survivorship

项目摘要

Memory loss is a hallmark symptom of Alzheimer’s disease and related dementias (ADRD). By identifying its early stages, interventions could be developed to prevent or slow ADRD progression. While previous research has examined memory aging among the general population, the long-term memory aging of older cancer survivors is under-studied. This is a critical evidence gap, as >26 million people in the United States (US) and >5 million people in the United Kingdom (UK) will be cancer survivors by 2040, and >70% of cancer survivors will be over age 65. The US and UK have different health care systems, government social safety net policies, and magnitudes of income inequality. Hence, older cancer survivors are aging in different social, political, and economic environments across these two high-income countries. A cross-national comparison of the US and UK is an opportunity to identify drivers of both individual-level variation and population-level differences in the memory aging of older cancer survivors. Understanding the long-term memory aging of older cancer survivors in a cross-national framework will enhance our knowledge of what factors matter most for the memory aging of older cancer survivors and could be targets for interventions. This K99/R00 proposal leverages longitudinal pre- and post-cancer diagnosis data from two nationally representative cohorts, the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), to investigate long-term memory trajectories of N=2,500 older cancer survivors from 2002 to 2018. The specific aims are to: (1) identify and compare memory trajectories of cancer survivors in the HRS and ELSA, overall and by age and sex (K99 phase); (2) identify and compare individual, neighborhood, and macro-level socioeconomic inequalities in memory aging of cancer survivors in the HRS and ELSA (R00 phase); and, (3) identify the roles of modifiable risk and resilience factors (hypertension, diabetes, obesity, depression, physical activity, social support) across countries, as these may be intervention targets to promote healthy memory aging among older cancer survivors (R00 phase). The training plan will build on the applicant’s prior training in social and cancer epidemiology to include: (1) ADRD research among cancer survivors; (2) the measurement and analysis of multi-level socioeconomic exposures; (3) and complex longitudinal data analyses in a cross-national framework. This integrated training will prepare the applicant for a successful independent research career focused on the social determinants of healthy aging among older cancer survivors. The applicant is supported by a cohesive and interdisciplinary mentorship team, including HRS and ELSA leadership. Identifying country-level differences in risk and resilience for cancer-related memory aging is important for informing population-level interventions and will support the exploration of policy- relevant determinants in future research. The proposed research will unite the fields of cancer survivorship and ADRD research by using a cross-national, population-based approach to identify high-risk groups of older cancer survivors for accelerated memory decline, as well as identify modifiable risk factors as intervention targets.

记忆丧失是阿尔茨海默病和相关痴呆症 (ADRD) 的标志症状。在早期阶段，可以制定干预措施来预防或减缓 ADRD 的进展。对一般人群的记忆老化进行了检查，老年癌症的长期记忆老化对于幸存者的研究还不够充分，这是一个关键的证据缺口，因为美国和美国有超过 2600 万人。到 2040 年，英国将有超过 500 万人成为癌症幸存者，其中超过 70% 的癌症幸存者年龄将超过 65 岁。美国和英国有不同的医疗保健系统、政府社会安全网政策、因此，老年癌症幸存者在不同的社会、政治和环境中都在老龄化。美国和英国这两个高收入国家的经济环境的跨国比较。是一个机会来确定个体水平差异和人口水平差异的驱动因素老年癌症幸存者的记忆老化了解老年癌症幸存者的长期记忆老化。在跨国框架中将增强我们对哪些因素对记忆老化最重要的认识老年癌症幸存者可能成为干预措施的目标。以及来自两个全国代表性队列（美国健康与退休研究）的癌症后诊断数据 (HRS) 和英国纵向衰老研究 (ELSA)，研究长期记忆轨迹 N=2002 年至 2018 年期间的 2,500 名老年癌症幸存者。具体目标是：(1) 识别和比较记忆 HRS 和 ELSA 中癌症幸存者的总体轨迹以及按年龄和性别划分的轨迹（K99 阶段）(2) 识别和比较癌症记忆老化中的个人、社区和宏观层面的社会经济不平等 HRS 和 ELSA（R00 阶段）的幸存者；(3) 确定可改变的风险和复原力因素的作用；（高血压、糖尿病、肥胖、抑郁、体力活动、社会支持），因为这些可能是促进老年癌症幸存者健康记忆老化的干预目标（R00 阶段）。该计划将以申请人之前在社会和癌症流行病学方面的培训为基础，包括：(1) ADRD 研究癌症幸存者；(2) 多层次社会经济暴露的测量和分析；(3) 和这种综合培训将为跨国框架中的复杂纵向数据分析做好准备。成功独立研究职业的申请人，重点关注健康老龄化的社会决定因素申请人得到了一个有凝聚力的跨学科指导团队的支持，包括 HRS 和 ELSA 的领导力确定国家层面癌症相关风险和复原力的差异。记忆老化对于为人口层面的干预措施提供信息非常重要，并将支持政策探索未来研究中的相关决定因素。拟议的研究将联合癌症生存和癌症领域。 ADRD 研究采用跨国、基于人群的方法来识别老年癌症的高危人群幸存者记忆加速衰退，并确定可改变的风险因素作为干预目标。