Health Mechanisms and Outcomes in an Epidemiological Cohort of Vietnam Era Women Veterans

越战时期女性退伍军人流行病学队列的健康机制和结果

• 批准号: 9091026
• 负责人: Brian N Smith
• 金额: $ 6.95万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9091026
• 关键词: Aging; Alcohol abuse; Alcohol consumption; Cohort Studies; Data; Early-life trauma; Elderly; Epidemiology; Equation; Exercise; Exposure to; Health; Health behavior; Lead; Life; Life Stress; Link; Literature; Longitudinal Studies; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental Health Services; Military Personnel; Modeling; Obesity; Older Population; Outcome; Pathway interactions; Personal Satisfaction; Population; Post-Traumatic Stress Disorders; Psychosocial Factor; Public Health; Quality of life; Research; Resources; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Services; Smoking; Social support; Staging; Stress; Testing; Tobacco use; Trauma; Veterans; Vietnam; Woman; biological adaptation to stress; cohort; follow-up; functional status; health care service; health related quality of life; healthy aging; high risk; male; men; modifiable risk; older women; physical conditioning; post-traumatic stress; psychosocial; public health relevance; stressor; tailored health care; traumatic event

 DESCRIPTION (provided by applicant): Trauma exposure and its mental health correlates - particularly posttraumatic stress disorder (PTSD) - can have negative implications for health-related outcomes, particularly in high-risk populations, such as military and veteran groups. Specific risk mechanisms, however, are understudied in older adults. While there is growing evidence for the association between traumatic stress and physical health, less is known about the role of modifiable psychosocial factors and risk behaviors in the relationships among trauma exposure, stress reactions, and physical health outcomes, including how these risk factors operate over the long term. Examinations of traumatic stress-associated health risk in older, high-risk populations are needed to elucidate potentially modifiable mechanisms by which traumatic stress undermines health-related quality of life and functioning over the long term. Further, to date, the vast majority of research on older veterans has been conducted on men, yet women veterans are the fastest growing group among the veteran population, and they have poorer mental and physical health as compared to their civilian and male veteran counterparts. The proposed research will overcome existing gaps in the literature related to representing women and examining potentially modifiable risk mechanisms in the wake of stress, and will also set the stage for further longitudinal study of risk associations, an important direction in tis research. The focus of the proposed study is to examine the impact of early life traumatic stress exposure and mental health sequelae on later life health in an epidemiological cohort of older women veterans (N=4219) using data from The Health of Vietnam Women's Study (HealthVieWS), which is the most comprehensive study of women Vietnam Era veterans to date. The roles of PTSD and depression will be examined explicitly, as will several potentially modifiable psychosocial factors including salient health-risk behaviors (tobacco use, alcohol abuse, lack of exercise) and perceived social support. The primary health outcomes examined are indicators of health-related quality of life and functional status, obesity, and health conditions. Results will provide valuable pilot data for a larger-scale follow-up with this cohort o investigate hypothesized longitudinal associations linking early life traumatic stress exposure (including military exposure) with health outcomes in later-life, to better understand the long-term impact of military service and early life stress on healthy aging among women veterans.

 描述（由申请人提供）：创伤暴露及其心理健康相关性 - 特别是创伤后应激障碍 (PTSD) - 可能会对健康相关结果产生负面影响，特别是在高危人群中，例如军人和退伍军人群体。然而，尽管越来越多的证据表明创伤性应激与身体健康之间存在关联，但人们对可改变的心理社会因素和危险行为在创伤暴露、应激反应和身体健康之间的关系中的作用知之甚少。结果，包括需要对老年高危人群中与创伤性应激相关的健康风险进行检查，以阐明创伤性应激长期损害与健康相关的生活质量和功能的潜在可改变机制。此外，迄今为止，绝大多数关于老年退伍军人的研究都是针对男性进行的，但女性退伍军人是退伍军人中增长最快的群体，与文职人员和男性退伍军人相比，她们的心理和身体健康状况较差。拟议的研究将克服现有的差距与代表女性和检查压力后潜在可改变的风险机制相关的文献，也将为风险关联的进一步纵向研究奠定基础，这是本研究的一个重要方向。拟议研究的重点是检查其影响。使用越南妇女健康研究 (HealthVieWS) 的数据，对老年女退伍军人 (N=4219) 的流行病学队列中的早期生活创伤性压力暴露和心理健康后遗症对晚年健康的影响进行研究，该研究是越南时代女性最全面的研究退伍军人创伤后应激障碍（PTSD）和抑郁症的作用将得到明确的研究，一些潜在的可改变的社会心理因素也将受到研究，包括显着的健康风险行为（吸烟、酗酒、缺乏运动）和感知的社会支持。健康相关的生活质量和功能状态、肥胖和健康状况将为该队列的更大规模随访提供有价值的试点数据，该队列调查了早期生命创伤应激暴露（包括军事暴露）与健康结果之间的关联。在以后的生活中，为了更好的了解服兵役和早期生活压力对女退伍军人健康老龄化的长期影响。