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Functional Impairment in Middle-Aged Adults

中年人的功能障碍

基本信息

批准号：
10363429
负责人：
Rebecca Tyler Brown
金额：
$ 34.21万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-30 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10363429
关键词：
Activities of Daily Living Address Admission activity Adult Age Age of Onset Aging American Cardiovascular Diseases Chronic Data Development Diabetes Mellitus Disability Insurance Education Elderly Employment Enrollment Environmental Risk Factor Epidemiology Funding Health Health and Retirement Study Health behavior Hospitalization Hospitals Impairment Incidence Individual Intercept Intervention Life Life Cycle Stages Link Long-Term Effects Longitudinal Studies Measures Mediating Mental Depression Modeling Nursing Homes Obesity Outcome Participant Pattern Physical Performance Physical environment Policies Population Attributable Risks Premature Mortality Prevalence Prevention Public Health Reporting Research Risk Risk Factors Social Environment Subgroup Testing Time Visit Work acute care adverse outcome age group base built environment design disability economic outcome experience functional decline functional disability functional outcomes functional status health care service utilization health economics high school improved low socioeconomic status middle age modifiable risk mortality neighborhood safety nursing home length of stay premature protective factors theories trend

项目摘要

PROJECT SUMMARY/ABSTRACT The prevalence of functional impairment – defined as having difficulty or needing help to perform one or more activities of daily living (ADLs) – is increasing among middle-aged adults in the U.S. Of the 80 million Americans ages 45-64, more than 16% report difficulty performing one or more ADLs, and this percentage has grown 3 percentage points over the past 15 years. The reasons for worsening functional status in middle age are not yet fully understood. However, it is part of a larger trend of worsening health in this age group. Since 1990, the prevalence of chronic conditions has increased in middle-aged people, including diabetes, obesity, cardiovascular disease, and depression. The risk of premature mortality has also increased, particularly among those with less than a high school education. These findings raise the concern that middle-aged Americans are experiencing accelerated aging that is causing premature functional impairment. If this is the case, middle- aged adults with functional impairment could experience persistent functional problems and associated poor health outcomes, similar to older adults. However, studies showing the growing prevalence of functional impairment in middle age have serial cross-sectional designs and do not evaluate trajectories of function or long-term effects on health outcomes. What we need to know is whether functional trajectories are worsening in middle age, what the risk factors are for adverse trajectories, and which trajectories predict poor health outcomes later in life. A longitudinal study that observes people from middle age through older age is needed to address these gaps. The aims of the proposed project are to: (1) examine the trajectories of functional impairment among middle-aged adults in the U.S.; (2) identify risk and protective factors to explain differences in functional trajectories; and (3) measure the impact of functional trajectories in middle age on later-life health and economic outcomes. We will complete these aims using longitudinal nationally representative data from the NIA-funded Health and Retirement Study linked to rich contextual measures of the physical and social environment, objective physical performance measures and lab data, and administrative data. This study will have two impacts: informing prevention of functional impairment in middle age by providing data to support next-step development and testing of interventions to improve functional outcomes; and informing policy planning to mitigate the projected burden of functional impairment and associated adverse outcomes.