Project 7: IUGR and Chronic Disease in Later Life in China, a supplemental application to the program project (IPO1 AG 17937-01) """"""""Population Models of Factors Affecting Health Trends"""""""", directed by Ken Manton. We will computerize the exceptionally detailed obstetric records of 12,097 persons born 1921 to 1954, available at Peking Union Medical College Hospital. Data include weight, length, head circumference at birth, placental weight, length of umbilical cord, and duration of gestation, as well as mother's height, weight, nutritional and health status, etc. at delivery and during the pregnancy. Of the 12,097 persons, 2,500 aged 48-82 in 2002-2003 will voluntarily participate in an extensive clinical examination to determine chronic disease, focusing on coronary heart disease, diabetes, hypertension and dementia. Interviews with each subject include assessments of family structure, childhood conditions, ADL, IADL, MMSE, lifestyle, diet, disposition, economics and use of medical services, etc. We will use the Random Walk stochastic process model and the Grade of Membership (GoM) model developed at CDS/Duke to more adequately measure IUGR (intrauterine growth retardation) using obstetric data on both birth outcome and maternal status, in contrast to previous studies that used birth outcome data only. Based on more adequately measured IUGR and the clinical examination/interview data, we will use a multivariate logistic model to estimate the relation of IUGR and chronic diseases in later life, controlling for social, behavioral risk factors and unobserved (possibly genetic) heterogeneity. We will also use the Fixed Attribute Dynamics (FAD) method to investigate the impact of IUGR on survival and healthy survival (i.e., survival without major diseases) to older ages. We will pay particular attention on how early and later life factors interact and on possible explanations and mechanisms underlying the relation between IUGR and chronic disease in later life.
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