Department of Sociology, University of Utah, 380 S 1530 E, Room 301, Salt Lake City, Utah, USA.
National University of Singapore, Singapore, Singapore.
BMC Public Health. 2019 Oct 23;19(1):1351. doi: 10.1186/s12889-019-7680-6.
Survivors of war throughout the world experience illnesses and injuries that are crucial to understand, given the ongoing treatment and adaptation they demand. In developing countries like Vietnam, where population aging and chronic disease burdens are rapidly rising, aging populations have seen a disproportionate share of armed conflict and related casualties. This paper describes the Vietnam Health and Aging Study (VHAS), a unique resource for investigating mechanisms of association between diverse exposures to armed conflict during the Vietnam War and multiple dimensions of older adult health among survivors of that war.
The VHAS utilizes a longitudinal design, the first wave of data collection conducted in 2018 among 2447 older adults. A second wave of follow-up data collection, scheduled to take place in 2021, will examine life course, social relational and health and mortality transitions. The VHAS was conducted in four northern Vietnamese districts purposively selected to represent a spectrum of war exposure as indicated by intensity of bombings. Additionally, VHAS uses random sampling within gender and military service subdomains to permit unique gender-specific analyses of military service, trauma exposure and health. The VHAS' face-to-face interviews include modules detailing war and military service experiences; warzone stressors; and multiple dimensions of health such as chronic disease, functional limitation, disability, health behaviors, cognition and psychological health. Biomarker data collected for the full VHAS sample includes anthropometric and functional tests such as grip strength and blood pressure, hair samples for cortisol assay, and capillary blood samples to assay C-reactive protein, cholesterol, HbA1c, and other markers of interest for cardiovascular and other disease risks and for testing the impact of early life stressors on later life health. Blood samples will also permit epigenetic analysis of biological aging.
Future VHAS investigations will examine dynamic linkages between war exposure, mortality and morbidity, while taking into account the selective nature of each of these processes. Longitudinal analyses will examine late-life health transitions and war-related resiliency.
世界各地的战争幸存者都经历着各种疾病和伤害，这些疾病和伤害对于理解他们所需要的持续治疗和适应至关重要。在越南等发展中国家，人口老龄化和慢性病负担迅速增加，老年人口经历了不成比例的武装冲突和相关伤亡。本文描述了越南健康与老龄化研究（VHAS），这是一个独特的资源，用于研究在越南战争期间多样化的武装冲突暴露与战争幸存者的老年健康的多个维度之间的关联机制。
VHAS 采用纵向设计，在 2018 年对 2447 名老年人进行了第一轮数据收集。第二轮随访数据收集计划于 2021 年进行，将研究生命历程、社会关系和健康与死亡的转变。VHAS 在四个越南北部地区进行，这些地区是根据轰炸强度有目的地选择的，代表了一系列的战争暴露。此外，VHAS 在性别和兵役子领域内进行随机抽样，以便对兵役、创伤暴露和健康进行独特的性别特定分析。VHAS 的面对面访谈包括详细描述战争和兵役经历、战区压力源以及健康的多个维度的模块，如慢性病、功能受限、残疾、健康行为、认知和心理健康。为整个 VHAS 样本收集的生物标志物数据包括人体测量和功能测试，如握力和血压，皮质醇测定的头发样本，以及毛细血管血样，以测定 C 反应蛋白、胆固醇、HbA1c 和其他心血管和其他疾病风险的标志物，并测试早期生活压力源对晚年健康的影响。血液样本还将允许对生物衰老进行表观遗传分析。
未来的 VHAS 研究将研究战争暴露、死亡率和发病率之间的动态联系，同时考虑到这些过程各自的选择性。纵向分析将研究晚年健康的转变和与战争有关的恢复力。
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