Project Grant K01AG083059

THE EFFECT OF THE HOME ENVIRONMENT ON HEALTH AND WELLBEING OF LOW-INCOME OLDER ADULTS - PROJECT ABSTRACT IN THE FACE OF A CHANGING CLIMATE, THERE EXISTS AN URGENT NEED TO STUDY THE EFFECTS OF THE SUMMERTIME HOME THERMAL ENVIRONMENT ON THE HEALTH AND WELLBEING OF LOW-INCOME OLDER ADULTS. WE RECENTLY DEVELOPED A PLATFORM FOR CONTINUOUS MEASUREMENTS OF HOME THERMAL ENVIRONMENT AND DAILY MEASUREMENTS OF SLEEP, GAIT, AND SUBJECTIVE WELLBEING-ALL OF WHICH ARE EITHER DIRECTLY OR INDIRECTLY INFLUENCED BY THERMAL ENVIRONMENT. OUR FIRST AIM IS TO DETERMINE COHORT-LEVEL RELATIONSHIPS BETWEEN AMBIENT TEMPERATURE AND OUTCOMES RELATED TO SLEEP, GAIT, AND COMFORT, AND EXAMINE THE EXTENT TO WHICH THESE RELATIONSHIPS VARY AT THE INDIVIDUAL LEVEL. OUR SECOND AIM IS TO EXPLORE FRAILTY AND SEX AS POTENTIAL EFFECT MODIFIERS OF THE RELATIONSHIPS BETWEEN HOME AMBIENT TEMPERATURE AND OUTCOMES RELATED TO SLEEP, GAIT, AND WELL-BEING IN OLDER ADULTS LIVING IN SUBSIDIZED HOUSING. BOTH AIMS WILL BE COMPLETED BY CONTINUOUSLY MEASURING THE HOME THERMAL ENVIRONMENT OF 50 LOW-INCOME OLDER ADULTS LIVING IN SUBSIDIZED HOUSING FACILITIES IN BOSTON FOR FOUR SUMMERTIME MONTHS. PARTICIPANTS WILL USE A VALIDATED WEARABLE DEVICE TO MEASURE OUTCOMES RELATED TO SLEEP, COMPLETE PERIODIC SMARTPHONE-BASED ASSESSMENTS OF GAIT, AND COMPLETE DAILY QUESTIONNAIRES TO REPORT THEIR PRESENT SUBJECTIVE COMFORT. THE PROPOSED STUDY WILL ESTABLISH THAT THE HOME THERMAL ENVIRONMENT HAS A SUBSTANTIAL IMPACT ON HEALTH AND WELLBEING OF LOW-INCOME OLDER ADULTS AND WILL ENABLE US TO DEVELOP CLINICAL INTERVENTIONS, PUBLIC HEALTH MEASURES, AND ENGINEERING SOLUTIONS THAT MINIMIZE THE IMPACTS OF HOT WEATHER ON THIS VULNERABLE POPULATION. THE CAREER DEVELOPMENT PLAN BUILDS UPON THE APPLICANT'S KNOWLEDGE ABOUT THE BUILT ENVIRONMENT AND HELPS HIM 1) ADVANCE HIS CLINICAL AND PRACTICAL KNOWLEDGE OF THE EFFECTS OF AGING AND AGE-RELATED CONDITIONS (E.G., FRAILTY) ON PHYSIOLOGY AND SYSTEM FUNCTION, ESPECIALLY AS THEY RELATE TO SENSITIVITY OF SLEEP, PHYSICAL FUNCTION, AND OTHER MEANINGFUL PATIENT-REPORTED OUTCOMES TO ENVIRONMENTAL FACTORS; 2) GAIN EXPERIENCE IN THE CONDUCT OF RESEARCH INVOLVING LOW-INCOME AND/OR UNDERSERVED OLDER ADULTS AND UNDERSTAND THEIR SPECIFIC NEEDS; 3) GAIN STATISTICAL, PROFESSIONAL, AND LEADERSHIP SKILLS TO DEVELOP AND LEAD AN INDEPENDENT RESEARCH PROGRAM FOCUSED ON AGING AND THE BUILT ENVIRONMENT. THE APPLICANT WILL BE WORKING WITHIN A WELL-FUNDED INFRASTRUCTURE THAT PROVIDES THE RESOURCES OF NUMEROUS NIH- AND FOUNDATION-FUNDED GRANTS. THE RESOURCES AVAILABLE AT THE MARCUS INSTITUTE FOR AGING RESEARCH PROVIDE THE INTELLECTUAL EXPERTISE AND SUPPORT NEEDED TO CONDUCT LONG-TERM AT-HOME MONITORING OF OLDER ADULTS, SUBJECT RECRUITMENT, AND STATISTICAL ANALYSIS THAT ARE NEEDED FOR THE SUCCESSFUL COMPLETION OF AIMS. ADDITIONALLY, HARVARD MEDICAL SCHOOL PROVIDES NUMEROUS RESOURCES FOR CAREER DEVELOPMENT, INCLUDING CAREER DEVELOPMENT SEMINARS AND COUNSELING, GRANT-WRITING COURSES, THE SCIENTIFIC CORES OF CLINICAL TRANSLATIONAL SCIENCE CENTER (HARVARD CATALYST); ONE OF THE WORLD'S LARGEST MEDICAL LIBRARIES, AND OPPORTUNITIES TO APPLY FOR PILOT GRANTS AND SPECIAL COURSES TO ENABLE JUNIOR FACULTY TO EXPAND THEIR EXPERTISE.