This application is to continue the Study of Women's Health Across the Nation (SWAN) for a second five year funding cycle. SWAN II is poised to contribute substantive new knowledge on the menopause transition through its prospective design, multi-ethnic/racial composition, representativeness of defined populations, and comprehensive measurement and power. No other recent or ongoing study is in a position to respond to the breadth of identified gaps in scientific knowledge on the menopause transition, either because sample sizes or follow-up data are insufficient, the multidisciplinary data are lacking or are restrictive, or because the samples are homogeneous. This application serves as the primary scientific application for SWAN. There are also companion applications being submitted by the Coordinating Center (NERI) and the Central Endocrine Laboratory (CLASS). This executive summary serves as the overall summary and progress report for SWAN I and as an introduction to the four substantive project applications which follow. The four project applications each provide a detailed proposal to address one of four major objectives originally identified in the RFA (number AG-94-002), from which the Study of Women's Health Across the Nation (SWAN I), was funded in September 1994 by the National Institute on Aging with support from the National Institute of Nursing Research and the Office of Research on Women's Health. The objectives from the original RFA and the project applications which follow this executive summary are: 1) To collect and analyze data on demographics, health and social characteristics, race/ethnicity, reproductive history, pre-existing illness, physical activity (includes activity limitations), health practices (includes diet, smoking, use of OTC) as potential predictor variables and to describe the multiethnic community-based samples of mid-life women. (Risk Factor Project); 2) To elucidate factors that differentiate symptomatic from asymptomatic women during the [menopausal] transition. (Risk Factor Project); 3) To identify and utilize appropriate markers of ovarian aging or aging of the ovarian-hypothalamo-pituitary axis and relate these markers to alterations in menstrual characteristics as women approach and traverse menopause. (Ovarian Aging Project); 4) To elucidate factors that differentiate women most susceptible to long-term pathophysiological consequences of ovarian hormone deficiency from those who are protected. (Cardiovascular Project and Bone Project)
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