Functional Impairment in Middle-Aged Adults

项目摘要/摘要 功能障碍的流行--定义为在执行一个或多个任务时有困难或需要帮助 日常生活活动(ADL)-在美国8000万中年人中，ADL正在增加 45岁至的美国人中，超过16%的人表示执行一种或多种ADL有困难，这一比例 在过去的15年里增长了3个百分点。中年功能状况恶化的原因分析 目前还没有完全了解。然而，这是这个年龄段健康状况恶化的更大趋势的一部分。自.以来 1990年以来，中年人的慢性病患病率有所上升，包括糖尿病、肥胖症、 心血管疾病和抑郁症。过早死亡的风险也有所增加，特别是在 那些高中以下教育程度的人。这些发现引发了人们的担忧，即美国中年人 经历加速衰老，导致过早的功能障碍。如果是这样的话，中间- 有功能障碍的老年人可能会经历持续性的功能问题和相关的贫困 健康结果，类似于老年人。然而，研究表明，功能性心脏病的患病率越来越高。 中年障碍有连续的横断面设计，不评估功能或运动轨迹 对健康结果的长期影响。我们需要知道的是功能轨迹是否在恶化 在中年，什么是不利轨迹的风险因素，哪些轨迹预示着健康状况不佳？ 在以后的生活中的结果。需要一项从中年到老年观察人们的纵向研究 以弥补这些差距。拟议项目的目标是：(1)检查功能 美国中年人的损害；(2)确定风险和保护因素以解释差异 功能轨迹；以及(3)测量中年功能轨迹对晚年健康的影响 和经济结果。我们将使用以下具有全国代表性的纵向数据来实现这些目标 NIA资助的健康和退休研究与身体和社会的丰富背景测量相联系 环境、客观的体能指标和实验室数据，以及管理数据。这项研究将 有两个影响：通过提供数据支持来预防中年功能障碍 下一步制定和测试干预措施，以改善功能结果；并为政策提供信息 计划减轻预计的功能损害负担和相关不良后果。

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.