Alexander D. Deev

Dmitri A. Jdanov

Evgueni M. Andreev

James W. Vaupel

Maria A. Shkolnikova

Svetlana A. Shalnova

Victoria A. Metelskaya

Vladimir M. Shkolnikov

English

Research Papers in Economics

Study protocol 
 
Biological mechanisms of disease and death in Moscow: rationale and design of 
the survey on Stress Aging and Health in Russia (SAHR) 
 
Maria Shkolnikova
1,3, Svetlana Shalnova
2, Vladimir M. Shkolnikov
3 §, Viktoria 
Metelskaya
2, Alexander Deev
2, Evgueni Andreev
3, Dmitri Jdanov
3 and James W. 
Vaupel
3  
 
1 Moscow Institute of Pediatry and Surgery, Federal Arrhythmia Centre, Moscow, 
Russia 
2 National Research Centre for Preventive Medicine, Moscow, Russia 
3 Max Planck Institute for Demographic Research, Rostock, Germany
 
 
 
§ Corresponding author  
 
E-mail addresses: 
Shkolnikova, Maria: shkolnikova@demogr.mpg.de 
Shalnova, Svetlana: sshalnova@gnicpm.ru 
Shkolnikov, Vladimir: shkolnikov@demogr.mpg.de 
Metelskaya, Victoria: vmetelskaya@gnicpm.ru 
Vaupel, James: JWV@demogr.mpg.de 
 Abstract 
Background: Prior research has revealed large differences in health and mortality 
across countries, socioeconomic groups, and individuals. Among the industrialized 
countries, Russia experiences one of the world’s highest levels of all-cause and 
cardiovascular mortality, great mortality differences within the population, and a 
heavy burden of ill health. Psychological stress has been suggested as a likely 
explanation of health loss and premature death in Russia and Eastern Europe. 
However, physiological mechanisms connecting stress with health in Russia remain 
unclear since existing epidemiological data are scarce and limited to conventional risk 
factors.  
 
Method and Design: The survey on Stress Aging and Health in Russia (SAHR) is 
addressing this knowledge gap by collecting an unusually rich database that includes a 
wide range of reported information, physical and cognitive health outcomes, and 
biomarkers in a sample of Muscovite men and women aged 55 and older. The total 
planned sample size is 2,000 individuals. The sample was randomly selected from 
epidemiological cohorts formed in Moscow between the mid-1970s and the 1990s and 
from medical population registers. The baseline data collection was carried out from 
December 2006 to June 2009. Interviews and medical tests were administered at 
hospital or at home according to standardized protocol. Questionnaire information 
includes health, socio-demographic characteristics, economic well-being, cognitive 
functioning, and batteries on stress and depression. Biomarkers include 
anthropometry, grip strength, resting ECG, conventional cardiovascular factors risk 
such as cholesterol lipid profile and blood pressure, and other biochemical parameters 
such as those related to inflammation, glucose and insulin resistance, coagulation, 
fibrinolysis, and stress hormones. In addition to these measurements, SAHR includes 
dynamic biomarkers provided by 24-hour ECG (Holter) monitoring . This method 
continuously registers the beat-to-beat heart rate in naturalistic conditions without 
restrictions on normal daily activities. It provides information about heart functioning, 
including heart rate variability and ischemic and arrhythmic events. 
Re-examination of the study subjects will be conducted in 2009–2011 and will focus 
on health, functional status, economic conditions, behaviors, and attitudes towards 
aging. The subjects are also followed up for mortality and non-fatal health events.  
 Discussion: The SAHR will produce a valuable set of established and novel 
biomarkers combined with self-reported data for the international research community 
and will provide important insights into factors and biological mechanisms of 
mortality and health losses in Russia.  

Biological mechanisms of disease and death in Moscow: rationale and design of the survey on Stress Aging and Health in Russia (SAHR)

http://www.demogr.mpg.de/papers/working/wp-2009-016.pdf

Biological mechanisms of disease and death in Moscow: rationale and design of the survey on Stress Aging and Health in Russia (SAHR)

Abstract

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