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Epidemiology, Demography and Biometry Program. National Institute on Aging, National Institutes of Health, USA. http://www.nih.gov./nia http://www.nih.gov/nia/research/intramural/. Richard Havlik, M.D., M.P.H. Associate Director. Learning Objectives:.
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Epidemiology, Demography and Biometry Program National Institute on Aging, National Institutes of Health, USA http://www.nih.gov./nia http://www.nih.gov/nia/research/intramural/ Richard Havlik, M.D., M.P.H. Associate Director
Learning Objectives: • To become familiar with the epidemiology programs of the National Institute on Aging (NIA) • To understand the investigations being conducted by the Epidemiology, Demography, and Biometry (EDBP) Program, part of the Intramural Research Program, (NIA) • To be aware of data resources available for the study of the epidemiology of aging and age-associated diseases
Performance Objectives: • Monitor appropriately and update knowledge regularly concerning epidemiology programs at the NIA • Become more knowledgeable about the epidemiology of aging and age-associated diseases by accessing information from the EDB Program, NIA • Begin to access data sets available at the National Archive of Computerized Data on Aging and use for relevant epidemiologic analyses
24 65,604,000 22 20 18 16 14 31,559,000 Percent 12 25,704,000 10 12,397,000 8 6,459,050 6 4 2 0 1900 10 20 30 40 50 60 70 80 90 2000 10 20 30 Projected
Epidemiology, Demography, and Biometry (EDB) Program Primary Mission: To conduct research on aging and age-associated diseases and conditions using population-based epidemiologic and biometric methods
EDP Program Part 1 • Epidemiology, and Demography Office • Chronic Diseases • Aging Processes • Environmental, Social, and Behavioral Factors • Neuroepidemiology of Aging Office • Dementing Processes • Risk Factors for Dementia • Other Neuropsychiatric Diseases
EDB Program Part 2 Biometry Office • Methods • Statistics • Data Management Geriatric Epidemiology Office • Gerontological Issues • Biomedical and Comorbidity Factors • Genetic and Metabolic Factors
Utility of EDB Program Studies • Elucidate the etiology of diseases by combining epidemiologic data with information from other disciplines. • Evaluate the consistency of epidemiologic data with etiologic hypotheses developed either clinically or experimentally. • Provide the basis for developing and evaluating preventive new procedures and public health practices.
Key Guiding Research Principles Studies should: • Be platforms for hypothesis –driven research • Be population based to minimize bias and maximize relevance • Be longitudinal in nature to minimize cross-sectional biases • Address a wide range of psychosocial and biomedical issues, including the incorporation of emerging biological and genetic opportunities • Attempt to secure data from earlier in life to assess long-term influences • Take advantage of racial diversity and unique populations for investigation • Include opportunities for addressing very applied questions
EDB Program Targets Behavior\ Environment Age-Associated Diseases & Conditions Cognitive Function & Dementia Physical Function & Disability Genetics
EPESE X HAAS X WHAS X X VSMA X HEALTH ABC X X ACT AGES - Hawaii (Diabetes) X AGES - Reykjavik (Iceland) X X EDB Program: Targets of Studies Physical Function & Disability Cognitive Function & Dementia Genetics/ Poly- morphisms Behavior/ Environ- ment Diseases & Conditions X X X X X X = Primary Focus = Secondary
EDB Program: Major Studies 1980 1990 2000 2010 1985 1995 2005 EPESE HAAS WHAS VSMA HEALTH ABC ACT AGES - Hawaii (Diabetes) AGES - Reykjavik (Iceland)
Established Populations for Epidemiologic Studies of the Elderly (EPESE) East Boston, 1982-83 Senior Health Project (N=3809) Iowa 1982 85+ Rural Health Study (N=3673) Epidemiology, Demography, and Biometry Program (EDBP) National Institute on Aging (NIA) New Haven 1982 Yale Health and Aging Project (N=2812) North Carolina 1986-87 Piedmont Health Survey of the Elderly (N=4163)
EPESE Study Design Sample: Total or random samples of community populations of men and women age 65 and over Number of Participants at Baseline: 14,450 Follow-up: In-home interview 3-year intervals,brief telephone contact intervening years. Blood work and performance measures. (Original sites 1982-83 to 1989) (Duke 1986-87 to 1993) Surveillance with Medicare and National Death Index
Women’s Health and Aging Study Focus: Causes and Course of Disability • Screened 5000 for 1002 Disabled Older Women in Community • Assessment of Baseline Disease-Disability Associations • Follow-up for Course and Outcome over 5 years
Honolulu-Asia Aging Study • A Study of Dementia in Honolulu Heart Program Participants • 3734 Japanese-American Men Aged 70-90 years • 25 Years of Prospective Data Available, Focused on Cardiovascular Disease and Other Risk Factors • Completed Dementia Re-examinations at 3, 5 and 7 Years; On-going Examination Cycle • Coordinate Methods with Studies in Japan, Seattle
Health, Aging and Body Composition(Health ABC) Design: Clinical research study 3,075 persons age 70-79 Comparable numbers of women and men Comparable numbers of whites and African-Americans Free of ADL disability Free of functional limitation Outcome: New onset of functional limitation Decline in performance, strength and endurance Follow-up: Seven years with yearly examinations
Country-to-Country Activities Collaboration with: • MRI Study in 10 European Communities (study of Cardiovascular Determinants of Dementia-CASCADE) • Honolulu-Asia Aging Study (dementia in Japanese-American men) and with similar studies in Seattle, Washington and Hiroshima, Japan (Ni-Hon-Sea Study) • Aging project of the Veneto Region (PROVA Study) using protocols similar to those of EDB Program • Italian Longitudinal Study on Aging (ILSA) has cohort under observation since 1991
Planned Collaboration with the Iceland Heart Association - Reykjavik Study Scientific strategy: Characterize study participants with detailed phenotypes for: Neurologic diseases (cognition, Alzheimer’s and Parkinson’s), atherosclerotic status, diabetes and hyperglycemia, obesity and body composition, and osteoporosis Collect DNA and other biologic specimens for molecular markers Add unique risk factors to the database: birthweight, childhood weight, and dietary factors Test relevant candidate genes for genetic susceptibility, gene-environment and gene-gene interaction
National Archive of Computerized Data on Aging (NACDA) • Mission is to advance research on aging by helping researchers gain access to archived data sets. • Located at the University of Michigan and is a project of the Inter-university Consortium for Political and Social Research (ICPSR) • For further information: http://www.icpsr.umich.edu/NACDA