This application will support the research and training of Dr. Tsenkova, a health psychologist committed to developing a career in aging-related morbidities such as type 2 diabetes and cardiovascular disease. Using a national longitudinal study of aging adults (MIDUS, Midlife in the U.S.), the proposed aims will investigate the extent to which sociodemographic and psychosocial factors modulate the impact of traditional risk factors (e.g., obesity) on preclinical glucose metabolism. A didactic plan includes development of: 1) a strong grounding in geriatric endocrinology and metabolism, and 2) expertise in epidemiology and statistical methodology. Training objectives will be accomplished through multidisciplinary mentorship, along with targeted coursework in epidemiology, nutritional sciences, and aging. The research plan will focus initially on data from MIDUS I and II (9- 10 years) to create cumulative profiles of SES advantage or disadvantage as well as cumulative profiles of psychosocial resources and vulnerabilities to test their combined influence on glucose metabolism and subsequent morbidity. Cumulative SES disadvantage and minority status are hypothesized to amplify the effects of traditional risk factors, resulting in por glycemic control. Similarly, cumulative psychosocial vulnerabilities are hypothesized to exacerbate the effects of traditional risk factors, resulting in poor glycemic control. Alternativey, persistent SES advantage and persistent psychosocial resources are predicted to buffer the effects of traditional risk factors on glycemic control. In the final years of this CDA, data from MIDUS III (9- 10 years post MIDUS II) will be used to predict morbidity (type 2 diabetes and cardiovascular disease) and mortality two decades after post-baseline assessments, using combinations of traditional risk factors, cumulative SES and psychosocial measures, and glucose metabolism as the mediating mechanism. A key question is whether the combined presence of risk factors from multiple areas translates to accelerated aging (i.e., compromised glycemic control earlier in the adult life course). Glucose metabolism will be indexed with multiple indicators known to operate on different timelines and reflect related yet distinct physiological processes. The central significance of the proposed research is the focus on integrative biopsychosocial pathways (some illustrating vulnerability, others illustrating resilience) to explicit health outcomes, assessed over a 20-year period. Findings from the above aims have implications for prevention of type 2 diabetes, a public health epidemic of striking proportions, particularly among older adults.

Public Health Relevance

Using a national longitudinal sample of aging adults (MIDUS), this research will examine the ways in which sociodemographic and psychosocial factors moderate relationships between traditional risk factors (e.g., obesity) and multiple indicators of glucose metabolism. In the final years of this CDA, MIDUS III data (covering 20 years) will be used to predict morbidity and mortality using combinations of risk factors, cumulative SES and psychosocial measures. The goal of my proposed training is to learn about aging processes involved in glucoregulation, with the ultimate research objective of identifying modifiable factors that could become the focus of prevention efforts related to type 2 diabetes and cardiovascular disease.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Scientist Development Award - Research & Training (K01)
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National Institute on Aging Initial Review Group (NIA)
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Nielsen, Lisbeth
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University of Wisconsin Madison
Other Health Professions
Other Domestic Higher Education
United States
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Lee, Chioun; Tsenkova, Vera; Carr, Deborah (2014) Childhood trauma and metabolic syndrome in men and women. Soc Sci Med 105:122-30
Tsenkova, Vera K; Carr, Deborah; Coe, Christopher L et al. (2014) Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II. J Behav Med 37:37-46
Tsenkova, Vera; Pudrovska, Tetyana; Karlamangla, Arun (2014) Childhood socioeconomic disadvantage and prediabetes and diabetes in later life: a study of biopsychosocial pathways. Psychosom Med 76:622-8
Tsenkova, Vera; Boylan, Jenifer Morozink; Ryff, Carol (2013) Stress eating and health. Findings from MIDUS, a national study of US adults. Appetite 69:151-5