PHYSICAL FRAILTY IN URBAN AFRICAN AMERICANS

描述：(改编自《调查者摘要》)此应用程序是一个 NIA赞助的一个项目的五年竞争性延续 《城市非裔美国人的身体虚弱》，1991年至2007年资助(RO1 AG10436)。为实现其确定战略的长期目标， 提高这一人群的活动预期寿命，研究人员 调查了646名非洲裔美国人，他们生活在5平方英里的贫困地区 基线评估时年龄在70-99岁之间的圣路易斯市中心地区 在1992-94年间。他们发现更多的残疾和功能性疾病的风险 与盎格鲁美国人相比，居住在市中心的非裔美国人的比例有所下降 以及年龄和性别匹配的非裔美国人的全国样本。他们也 表现出特定的问题(例如，肥胖、高营养风险、 脱水和肾功能不全)，这些似乎对 对于这种过度的残疾。本项目建议继续追求 通过扩大对后果的调查和 被证明残疾的原因有两个方面。第一个方向 包括使用短电话对原始队列进行持续跟踪 第一年、第三年和第四年接触时间较长；第二年和第五年接触时间较长；每年死亡 搜查。这些数据将解决该项目的第一个具体目标，即 评估肥胖，体重减轻，害怕摔倒，不走路， 和较低的日常生活(ADL)功能 随后的跌倒、过度住院和增加基本的ADL依赖； 以及这些因素对死亡率的影响。第二个方向涉及 招募和评估1200名年轻非裔美国人的新队列 从圣路易斯大都会根据社会经济地位分层。数据收集 将涉及第1和第4波的家庭评估，电话跟进： 第2、3和5波，还将涉及对身体的详细评估 在波1和波4中，25%的成分和肌肉力量。研究人员 声明来自这一新队列的数据将允许追求具体目标2和 3，即骨质疏松症的发生时间、先兆和后果 (目标2)和亚临床残疾(目标3)。广泛的数据核查和 将进行内部信度和效度研究。主要分析 方法包括预测跌倒的事件历史模型、事件基本ADL 原始队列中的依赖性、住院率和死亡率 新队列中发生的亚临床残疾和功能受限， 对重要协变量进行调整。二次分析(例如，涉及 对跌倒的恐惧，骨矿物质代谢，脱水和 肾功能不全和仰卧位到立位转位)也将继续进行。

DESCRIPTION: (Adapted from Investigator's Abstract) This application is a five-year competitive continuation of a NIA-sponsored project entitled "Physical Frailty in Urban African Americans," funded from 1991-7 (RO1 AG10436). In pursuit of its long range goal of identifying strategies for improving the active life expectancy of this population, the investigators investigated 646 African Americans living in a five-square mile, poor inner-city area of St. Louis who were aged 70-99 years at baseline evaluation in 1992-94. They identified increased disability and risk for functional decline among inner-city dwelling African Americans compared to Anglo Americans and to national samples of age- and gender-matched African Americans. They also demonstrated specific problems (e.g., obesity, high nutritional risk, dehydration, and renal insufficiency) that appear to contribute significantly to this excess disability. The present project proposes to continue pursuit of the stated long-term goal by extending investigation of the consequences and causes of the demonstrated disability in two directions. The first direction involves continued follow up of the original cohort using short telephone contacts in years 1, 3, and 4; longer contacts in 2 and 5; and yearly death searches. These data will address the project's first specific aim, i.e., to evaluate the effects of obesity, weight loss, fear of falling, lack of walking, and lower instrumental activities of daily living (ADL) functioning on subsequent fall, excess hospitalization, and increased basic ADL dependencies; and the impact of these factors on mortality. The second direction involves the recruitment and evaluation of a new cohort of 1200 younger African Americans from metropolitan St. Louis stratified by socioeconomic status. Data collection will involve in-home evaluations at waves 1 and 4, telephone follow-ups at waves 2, 3, and 5, and will also involve detailed evaluations of body composition and muscle strength in a 25% at waves 1 and 4. The investigators state that data from this new cohort will allow pursuit of specific Aims 2 and 3, i.e., the time of development, precursors and consequences of sarcopenia (Aim 2) and subclinical disability (Aim 3). Extensive data verification and internal reliability and validity studies will be performed. Primary analytic methods involve event history models predicting falls, incident basic ADL dependencies, hospitalization, and mortality in the original cohort as well as incident subclinical disability and functional limitation in the new cohort, adjusting for important covariates. Secondary analyses (e.g., studies involving fear of falling, bone mineral metabolism, adverse effects of dehydration and renal insufficiency, and supine-to-stand transfers) will also be pursued.