EPIDEMIOLOGY OF CHRONIC DISEASE IN THE OLD

老年人慢性病的流行病学

• 批准号: 3118501
• 负责人: DOROTHY P. RICE
• 金额: $ 29.83万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-07-15 至 1992-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3118501
• 关键词: chronic disease /disorder; disease /disorder prevention /control; disease /disorder proneness /risk; epidemiology; health care service utilization; human morbidity; human mortality; longevity; managed care; patient /disease registry

Declining mortality over the past several decades has contributed to an increase in the proportion of persons over 64 in the US population, especially of persons over 84, the "oldest old." This aging trend is expected to continue for the foreseeable future. Since aging is associated with an increased incidence and prevalence of chronic disease, many health scientists predict that the demand for medical care will steadily increase in the years ahead. Others, however, believe that improvements in health care and reductions in risk factors are delaying the onset of chronic disease more than they are delaying death; thus, the interval between onset of disease and death is being compressed, resulting in a decreased demand for medical care services. The proposed research will compare the nine-year mortality, incidence and prevalence of chronic disease, and health services of a 1971 cohort that of a 1980 cohort. Each cohort will consist of 3000 randomly selected members of the Northern California Kaiser Permanente Medical Care Program aged 65 and over who have had at least one prior Multiphasic Health Checkup. Approximately one-third of each cohort will be 80 or older. Information on chronic disease diagnosis, cause-specific mortality, physiological and socio-demographic risk factors, and health services utilization will be obtained from computerized hospitalization and Multiphasic Health Checkup records and from medical charts. We will examine the hypotheses that in the 1980 cohort mortality is lower, chronic disease morbidity is lower, reductions in morbidity exceed reductions in mortality, and use of health services is lower. The study will be done by a team of experienced investigators on a sample of members of the largest HMO in the United States, with a high level of organizational commitment.

过去几十年来死亡率的下降促成了 美国64岁以上人口比例增加 人口，特别是84岁以上的人，即“最年长的老人”。 这 预计老龄化趋势在可预见的未来仍将持续。 由于衰老与发病率增加有关 随着慢性病的流行，许多健康科学家预测 医疗需求逐年稳步增长 前面。 然而，其他人则认为，健康状况的改善 护理和减少危险因素正在推迟发病 慢性病比延迟死亡更重要；因此， 发病与死亡之间的间隔正在被压缩， 导致医疗服务需求减少。 拟议的研究将比较九年死亡率， 慢性病的发病率和患病率以及卫生服务 1971 年队列 1980 年队列。 每个队列将包括 北加州随机抽取的 3000 名成员 Kaiser Permanente 医疗护理计划 65 岁及以上人士 之前至少进行过一次多阶段健康检查。 每个队列中大约有三分之一的人年龄在 80 岁或以上。 有关慢性病诊断、特定原因的信息 死亡率、生理和社会人口危险因素，以及 卫生服务利用情况将通过计算机化获得 住院和多阶段健康检查记录以及 医疗图表。 我们将检验以下假设：1980 年队列死亡率 较低，慢性病发病率较低， 发病率超过死亡率和卫生保健利用的降低 服务较低。 该研究将由经验丰富的研究人员团队完成 美国最大的 HMO 成员样本， 具有高水平的组织承诺。