HIP FRACTURE AND STROKE TRENDS IN AN AGING POPULATION

这项建议是越来越多的研究的一部分，旨在 了解死亡率、发病率、存活率和残疾水平的趋势 关于老年人中选定的主要疾病，以及 卫生保健利用的调查结果。具体地说，该提案包括 对一口井中年长成员的连续队列进行了回顾研究- 为下列目的界定并有充分记录的老年人口： 界定和解释髋部骨折发病率的趋势， 男性和女性的死亡率、长期存活率和功能结果 1967-1992年这25年间的女性。 定义和解释中风发病率、死亡率、 1981至1992年间的存活率和严重性，作为之前 研究中风的趋势。 研究人群由四个连续时期的老年人队列组成 以下五年期间确定的人：1967-71,1974- 78,1981-85,1988-92。前三个队列已经定义好了， 而第四个将被定义为当前提案的一部分。 假设如下： 1967-1992年间发生的髋部骨折： 人中髋部骨折的年龄别发病率&GT； 65岁有所增加。 短期和长期髋关节的比例有所增加。 骨折存活率。 骨折后功能有增加 急性髋部骨折幸存者的独立性。 1981-92年间的笔划： 65岁人群中中风的年龄别发病率 年龄增加了。 中风的临床严重程度和病死率有所下降。 可归因于发病率的增加和严重程度的降低 部分是由于疾病自然历史的改变，部分是因为 使用较新的成像技术确定较轻的病例。

This proposal constitutes part of a growing body of research designed to understand trends in mortality, morbidity, survival, and disability levels for selected major diseases among older persons, and implications of the findings for health care utilization. Specifically, the proposal consists of a retrospective study of successive cohorts of older members of a well- defined and well-documented elderly population for the following purposes: Defining and explaining the trends in hip fracture incidence, mortality, long-term survival, and functional outcomes among males and females during the 25 year period 1967-1992. Defining and explaining changes in stroke incidence, mortality, survival, and severity between 1981 and 1992, as an extension of a previous study of stroke trends. The study population consists of four successive period cohorts of elderly people identified for the following five-year periods: 1967-71,1974- 78,1981-85,1988-92. The first three cohorts 'have already been defined, while the fourth will be defined as part of the current proposal. Hypotheses are as follows: A Hip Fracture That during the period 1967-1992: Age-specific incidence of hip fracture among persons > 65 years of age has increased. There has been an increase in short- and long-term hip fracture survival. There has been an increase in post-fracture functional independence among survivors of acute hip fracture. Stroke That during the period 1981-92: Age-specific incidence of stroke among persons > 65 years of age has increased. Clinical severity and case fatality of stroke has decreased. Increased incidence and decreased severity are attributable in part to change in the natural history of disease and in part to ascertainment of milder cases using newer imaging technology.