Goal B: Better understand the effects of personal, interpersonal, and societal factors on aging, including the mechanisms through which these factors exert their effects
Behavioral and psychological factors—for example, physical activity, smoking, and other health behaviors, cognitive and social engagement, personality, and psychosocial stress—play a critical role in health across the lifespan. For example, studies have shown that up to 50 percent of preventable deaths in the United States can be attributed to adverse health behaviors such as smoking and unhealthy diet that results in obesity. Likewise, social factors—including social relationships and socioeconomic circumstances—have a similarly important impact on health and well-being. For example, subjective feelings of loneliness are known to be a risk factor for serious functional declines and even death, and converging lines of evidence from multiple cross-national epidemiological studies indicate that social isolation is a major risk factor for morbidity and premature mortality. Behavioral and social factors interact with genetic, molecular, and cellular mechanisms to influence health at older ages.
Basic research in the biological, neurological, social, and behavioral sciences has revolutionized our understanding of healthy aging. New findings about genetic, molecular, and cellular factors and processes that affect the course of aging are providing valuable insights about aging, longevity, and the pathogenesis of disease. Basic behavioral science is uncovering individual level psychological, social, and behavioral factors that predict adaptive and healthy aging or confer risk for age-related decline. Similarly, population studies are uncovering potential risk and protective factors such as environmental exposures, health related behaviors, and social relationships, as well as the influence of co-existing conditions across the lifespan and their relationship to health and the progression of disease.
Evidence suggests that these factors and their interplay are critical to minimizing disease and achieving full potential and vitality as people age. NIA will support and conduct research to verify the linkages and to better understand their underlying mechanisms.
Research supported and conducted by NIA is helping to identify lifestyle factors and health behaviors that directly influence physical, cognitive, sensory, and emotional health and risk of disease as people age, such as research linking work and social engagement to cognition. Scientists are developing and refining recommendations for people of all ages regarding optimal diet, use of dietary supplements, mental stimulation, physical exercise, quality sleep, social engagement, stress reduction, and other practices to increase their likelihood of enjoying healthy old age. NIA will conduct and support research to lay the groundwork for a unified science of behavior change that capitalizes on advances in basic behavioral and social science research to better characterize mechanisms of change at all levels of description, from molecular to social. We anticipate that this research will ultimately enable us to build upon the progress we have already made and facilitate development of effective behavioral interventions in specific disease areas.
Still other researchers are looking for better ways to enhance the physical, mental, and social capacities of older people and to expand opportunities for them to achieve personal goals and contribute to society in meaningful ways. As investigators more precisely identify the psychological, behavioral, and social processes that influence health and quality of life, we will be able to reinforce prevention efforts, enhance symptom management, and conserve function among older people.
Our objectives in this area are to:
- B-1: Understand the basic behavioral, social, and psychological aspects of aging and well-being.
- B-2: Illuminate the pathways by which social, psychological, economic, and behavioral factors affect health in middle-aged and older adults.
- B-3: Identify developmental, prenatal, early life, and environmental processes that affect individual differences in aging and risk of disease.
- B-4: Explore the mechanisms that account for the effects of disadvantage, including research that focuses on critical periods for reversing such effects and/or the optimal timing of intervention.
- B-5: Identify, analyze, and track changing patterns of disability and mortality for older adults and better understand factors contributing to these patterns.
Along with new physical, social, and emotional challenges, increasing age brings changes in cognition and emotion that have impacts on subjective well-being, social relationships, decision making, and self-control. How individuals respond to these challenges has implications for their independence, cognitive function, social relationships, mental health, physical function, and economic well-being.
NIA will continue to conduct and support basic research in cognition, emotion, and motivation in normal aging, including their neurobiological and genetic bases. We will also explore these factors' relationships to individual differences, social processes, and contextual factors. Finally, NIA will continue research on the interrelationships among emotion, cognition, and brain function; this information will guide the development of new biobehavioral interventions.
B-2: Illuminate the pathways by which social, psychological, economic, and behavioral factors affect health in middle-aged and older adults.
Research is needed to help fully establish the pathways through which genes, environments, and behavior interact. For example, research on the impact of social relationships on health has shown that loneliness and social isolation are associated with risk for illness and premature mortality through different biological and behavioral pathways. NIA-supported investigators are also exploring the roles of behavior and biology, including genetics, in mediating the link between stress and disease. We will encourage multi-level and interdisciplinary research on the interactive effects of genes, behavior, biology, and social and physical environments on health and well-being as people age. Finally, we will work to identify important biomarkers that are linked to aging-relevant social and behavioral phenomena, including the integration of neuroimaging data in large-scale surveys and laboratory-based studies with representative samples.
B-3: Identify developmental, prenatal, early life, and environmental processes that affect individual differences in aging and risk of disease.
Exposure to harmful substances can exert profound and long-lasting physical effects on a developing fetus, and childhood exposure to environmental agents such as infections or drugs can greatly limit adult physical and cognitive health and longevity. Contextual factors such as residential segregation and socioeconomic status may greatly determine exposure to these agents. NIA will continue to support mechanistic and epidemiological studies to identify such factors and participate in translational studies to find ways to minimize their effects in adults.
B-4: Explore the mechanisms that account for the effects of disadvantage, including research that focuses on critical periods for reversing such effects and/or the optimal timing of intervention.
Many old-age outcomes and behaviors are influenced by events, social relationships, non-cognitive character skills, environmental factors, and habits that begin relatively early in life. Subgroups of the population experience disadvantage throughout their lives or for extended periods in life that generate persistent stress, and their patterns of stress reactivity appear to hasten the progression of disease. It is therefore important to identify key behavioral and social factors associated with all forms of social adversity in order to identify opportunities for their amelioration. Life course data connecting childhood circumstances to mid-life/old-age outcomes will facilitate research that identifies such mechanisms.
B-5: Identify, analyze, and track changing patterns of disability and mortality for older adults and better understand factors contributing to these patterns.
The current pattern of increased "active life expectancy," the average number of years an individual will live without a limiting disease or disability in parallel with increased length of life, is threatened by increases in obesity and disability rates among younger Americans. Likewise, longevity rates in the United States are lagging relative to other developed nations. Research supported and conducted by NIA will address disability dynamics at several levels, including longitudinal research to understand the determinants of onset, severity, and recovery from disabling conditions. At the population level, we will foster research to understand the pathways to disability and the causes of change in mobility and function over time as well as subgroup disparities. We will also invest in research on more sensitive measures of functional disability that are needed to better track these changes. Finally, we will identify and address the factors that account for worsening trends in mortality in midlife and at older ages in the U.S.