The need to combine biomarker data with socioeconomic, health and well-being data in studies of older adults from general population samples is being increasingly recognized as a valuable research good, and such studies are being implemented in many countries around the world. Large scale longitudinal cohort studies to understand the epidemiology of population health and disease are also being considered as a mechanism to incorporate genetic measures to increase our understanding of the role of genes and environment in influencing human health and well-being. The proposed study addresses many of these issues by combining the collection of DNA samples along with richly textured phenotypes generated over two waves of data collection of the World Health Organization's Study on Global AGEing and Adult Health (SAGE), its accompanying studies in HIV affected respondents (the SAGE-HIV studies) and the studies on populations under health and demographic surveillance (the SAGE- INDEPTH studies). In total, these SAGE studies are currently collecting data on a cohort of about 25,000 community-dwelling older adults across countries in sub-Saharan Africa. Follow-up interviews for the SAGE cohorts in Waves 2 and 3 are taking place at two year intervals. Two waves of data from the SAGE HIV sub-study are available with another round of interviews planned for 2015 (Wave 3) and 2017 (Wave 4). The SAGE- INDEPTH sub-study follow-up (Wave 2) will be implemented in 2014. Comprehensive measures of health coupled with the inclusion of an array of biomarkers provide an unprecedented opportunity to study the complex nature of interactions between genes and the environment and resulting health and disease in non-clinical older African populations. Collaborations with the AWI-Gen Collaborative Centre under the Human Heredity and Health in Africa (H3A) programme in South Africa will bring synergies that combine expertise in state-of-the-art genetic analysis with expertise in epidemiology. Data from the proposed study will have direct implications for understanding the health and well- being of similar older adult populations in the US, especially those from lower socioeconomic classes and minority populations. Data from the study will use health measures that are comparable to other international studies of aging, like the US Health and Retirement Study. All anonymized microdata from the study will be archived according to international standards along with all metadata and made available to researchers.
The rich genetic diversity of Africa combined with a rapidly changing health profile driven by a range of lifestyle and other factors offers an unprecedented opportunity to combine genetic measures with measures of health and health related outcomes and their determinants. This becomes all the more relevant with increasing life expectancies and economic growth in Africa. Understanding the genetic and environmental underpinnings of health and well-being in these populations will provide insights to plan future health and social policy to provide the appropriate support required to maintain the health of these populations. The proposed studies would also help to improve our understanding the interrelationship between aging, non-communicable diseases, HIV/AIDS and ART. Data collected as part of the proposed study have been designed to be comparable to similar studies in higher income countries and the genetic information obtained would have invaluable lessons for understanding human health and aging everywhere.
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