This is the amended competing renewal application of the Study of Women's Health Across the Nation (SWAN), a 7-site longitudinal cohort study initiated in 1994 in response to RFA AG-94-002. SWAN was mandated """"""""to characterize the chronology of the biological and psychosocial antecedents and sequelae of the menopausal transition (MT) and the effect of this transition on subsequent health and risk factors for age- related disease"""""""", and to extend this information from White women to """"""""...the range of peri-menopausal experiences in women of other racial/ethnic background(s)."""""""" A total of 3302 Black, Chinese, Japanese, Hispanic and White women were enrolled, with 78% completing up to 13 visits spanning the premenopause to early post-menopause (PM). Thus far, SWAN has described the natural history of the MT -- its timing, patterns of hormonal changes, and symptoms and factors related to them - and their relation to disease risk indicators. During SWAN V, we will extend observations through the late PM, a necessary step to assess the impact of the MT on age-related diseases.
Our specific aims are to: 1) complete the characterization of the natural history of reproductive aging through the late PM;2) evaluate the impact of reproductive aging through the late PM on health outcomes clinically relevant to women in their 60s and 70s, including: cognitive and physical function, psychological well-being, sleep, bone and cardiometabolic health, urogenital symptoms, sexual function and vaginal health;and 3) identify potential underlying mechanisms linking reproductive aging and health by assessing the relation of inflammation, hemostasis and adipokines to the occurrence and progression of biological, functional and clinical outcomes and delineating the interrelationships of body size and composition, race/ethnicity and socioeconomic status with these outcomes. The SWAN V Core protocol will be completed at 7 study sites, with bone and cardiovascular studies at 4 sites and actigraphy studies in a subset of women at all sites. Longitudinal specimens from the SWAN Repository will enable characterization of skeletal markers, adrenal hormones, hemostasis, inflammation, and adipokines across the MT into PM. The Coordinating Center will provide the necessary organizational infrastructure, statistical resources, and timely dissemination of high quality SWAN data. The CLIA-certified Central Laboratory will perform or coordinate with other laboratories to provide accurate, high volume assays, adopting new methods as needed to provide state- of-the-art data. SWAN is uniquely positioned to fill important scientific gaps in understanding of the impact of the MT on women's health in their 60s and 70s and to facilitate the application of new knowledge to clinical practice. With 1.5 decades of both calendar time and """"""""menopause time"""""""", SWAN V can disaggregate the contributions of aging and the MT to women's health, address difficult and critical questions about the temporal nature of MT-disease associations, assess differences by race/ethnicity, and provide insights into modifiable factors relevant to the design of innovative prevention and treatment programs for aging women.

Public Health Relevance

SWAN will fill important gaps in understanding the impact of the menopausal transition and mid-life aging on women's health and functioning in the postmenopausal years. Accordingly, it will provide useful information to guide clinical decisions in mid-life and beyond in women who have diverse life experiences and socioeconomic and racial/ethnic characteristics.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01AG012535-21A1
Application #
8757829
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Rossi, Winifred K
Project Start
1994-09-30
Project End
2019-06-30
Budget Start
2014-09-15
Budget End
2015-06-30
Support Year
21
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Albert Einstein College of Medicine
Department
Neurology
Type
Schools of Medicine
DUNS #
City
Bronx
State
NY
Country
United States
Zip Code
10461
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Putman, Melissa S; Yu, Elaine W; Lin, David et al. (2017) Differences in Trabecular Microstructure Between Black and White Women Assessed by Individual Trabecular Segmentation Analysis of HR-pQCT Images. J Bone Miner Res 32:1100-1108
Wu, Xiangmei May; Basu, Rupa; Malig, Brian et al. (2017) Association between gaseous air pollutants and inflammatory, hemostatic and lipid markers in a cohort of midlife women. Environ Int 107:131-139
El Khoudary, Samar R; Shields, Kelly J; Janssen, Imke et al. (2017) Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study. J Am Heart Assoc 6:
Karlamangla, Arun S; Lachman, Margie E; Han, WeiJuan et al. (2017) Evidence for Cognitive Aging in Midlife Women: Study of Women's Health Across the Nation. PLoS One 12:e0169008
Bromberger, Joyce T; Schott, Laura L; Matthews, Karen A et al. (2017) Childhood socioeconomic circumstances and depressive symptom burden across 15 years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN). Arch Womens Ment Health 20:495-504
Appelhans, Bradley M; Baylin, Ana; Huang, Mei-Hua et al. (2017) Beverage Intake and Metabolic Syndrome Risk Over 14 Years: The Study of Women's Health Across the Nation. J Acad Nutr Diet 117:554-562
Paramsothy, Pangaja; Harlow, Siobán D; Nan, Bin et al. (2017) Duration of the menopausal transition is longer in women with young age at onset: the multiethnic Study of Women's Health Across the Nation. Menopause 24:142-149
Kravitz, Howard M; Janssen, Imke; Bromberger, Joyce T et al. (2017) Sleep Trajectories Before and After the Final Menstrual Period in The Study of Women's Health Across the Nation (SWAN). Curr Sleep Med Rep 3:235-250
Kim, Catherine; Harlow, Siobàn D; Zheng, Huiyong et al. (2017) Changes in androstenedione, dehydroepiandrosterone, testosterone, estradiol, and estrone over the menopausal transition. Womens Midlife Health 3:

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