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Grant Name: Biodemography of Disease and Death in Moscow
Grant Number: R01 AG026786
Funding Agency: NIA (funded for 5 years)
PIs: James W. Vaupel, Maria Shkolnikova, Svetlana A. Shalnova
Investigators/Advisors: Alexander Deev, Noreen Goldman, Francesco Lagona, Heiner Maier, Vladimir Shkolnikov, Olga V. Vikhireva, Maxine Weinstein
Effective Dates: 2006/09-2011/08
Approximate Amount/Year: $350,000
Approximate Total: $1,750,000
Description: Biodemography of Disease and Death in Moscow
The purpose of the study is to investigate whether 24-hour Holter monitoring of the heart rate can feasibly be added to biodemographic surveys and whether the Holter information contributes to better measurement of physiological toll and understanding of the causal mechanisms that link individual characteristics and socio-economic conditions with health and survival. The study will provide a database that can be used to shed light on the impact of cumulated stress on the poor health and high mortality of middle-aged and elderly Russians. The aims of the study are: to conduct a demographic and health survey of 2000 men and women in Moscow of age 55+ that includes 24-hour Holter monitoring, to study all data obtained using statistical methods and regression analysis with a focus to determine the incremental value of the Holter data, to conduct follow-up interviews 2.5 years after the first interview/examination, to study the longitudinal data and prepare a dataset for further study by qualified researchers.
Research studies have identified socio-psychological circumstances contributing to stress buildup and correlations between self-perceived stress and health outcomes. Also studies show that repetitive stress reactions can lead to the suppression of the body’s adaptability. Stress is recognized as the main risk factor in multi-system damage. In trying to measure cumulated stress, scientists have used allostatic load markers to score multi-system physiological toll as well as conventional measures to score factors such as smoking, grip strength, lung capacity, and blood pressure. While these scores are valuable, a serious limitation can be seen in their static (single point in time) character. Point measurements of risk factors do not provide any information about changes due to physiological cycles, diurnal rhythms, and other fluctuations. This research study will try a new method to measure cumulated stress. The method will combine existing allostatic load biomarkers and other established biomarkers with biomarkers based on data from 24-hour Holter monitoring. By collecting a wide range of individual-level biodemographic data and biomarkers from a sample of the older population in Moscow, this study will provide unique data to the scientific community and new insights into the causes of premature disease and death. This study is linked to three types of prior empirical research: studies seeking the best ways to measure physiological toll and the biological mechanisms behind the differences in mortality and health, studies of inter-group and inter-country health differences, and clinical studies of heart rate and its connections with disease and death.
A small-scale pilot project, the Moscow Pilot Study, (funded by the Max Planck Institute for Demographic Research, Germany) was undertaken in 2002-03. The results demonstrated the practical applicability of Holter monitoring and highlighted the usefulness and value of the Holter variables when compared to conventional risk factors and the existing allostatic load score for the prediction of health outcomes. The proposed research and protocol builds upon the pilot project.
Holter monitoring has excellent potential for adding explanatory power to existing approaches and measures, and for detecting new aspects of physiological toll. It will provide a new toolkit for non-invasive measurement of biomarker trajectories in real-life conditions. Results of the study will potentially facilitate empirical research on health protection and the prevention of premature morbidity and mortality..