BUFFERS OF THE ARTHRITIS DISABILITY CASCADE IN THE OLD OLD

老年人关节炎残疾级联的缓冲剂

• 批准号: 3769950
• 负责人: KYLE KERCHER
• 金额: --
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3769950
• 关键词: arthritis; chronic disease /disorder; disease /disorder prevention /control; gender difference; health care model; health education; human morbidity; human subject; human very old age (85+); longitudinal human study; mathematical model; model design /development; pathologic process; psychological adaptation; psychological stressor; quality of life; self concept; social support network; socioeconomics

There is increasing recognition that efforts to reduce disability among the elderly must be based on a better understanding of factors that slow the cascade from chronic illness to organ-level physical impairment to disability. Progression along this cascade is not inevitable, but may be buffered by personal and social resources, preventive adaptations, and impairment-relevant ameliorative adaptations. Arthritis is the most prevalent chronic medical condition for older people, and is one of the most common causes of physical impairment and disability. The factors that buffer the progression from arthritis-induced musculoskeletal impairments to personal and social disabilities have not been well studied. The propose study seeks to test a comprehensive model of buffers of disability and diminished quality of life for community-living elderly with and without arthritis. Our model also takes into account the important effects of comorbid conditions and potential gender differences in adapting to arthritis and attendant disability. The study sample consists of approximately 700 community-living old-old (age 75+) subjects who are enrolled in an ongoing NIA-funded MERIT-award study of Florida retirees. Fifty-four percent of the sample report having arthritis. Data collection for the proposed project will commence following four annual waves of the ongoing MERIT-award study. A three- wave longitudinal design will be used. The proposed study will take advantage of existing measures of chronic illness, personal (ADL/IADL) disability, health-promotion activities, social, psychological, and economic resources, and quality of life that we are gathering as part of our ongoing MERIT-award study. The proposed new study will introduce additional self-report data on arthritis, physical impairments, ameliorative adaptations, social disability and quality of life. Because our proposed study will be nested within the ongoing MERIT-award study, it can be feasibly performed within the budget constraints of the center grant proposal. We will use descriptive analyses to characterize the range of arthritis symptomatology and comorbid conditions and impairment, and their association with personal and social disability and diminished quality of life. We will also use standard uni-variate statistics and regression to test hypotheses about (10 the association of musculoskeletal impairment with specific disabilities, and (2) gender differences in effect of arthritis-related impairments on disability. Additionally, the proposed study will include multi-variate analyses of variance, least squares regression, and structural equations to test our comprehensive causal model regarding buffers of the disability cascade. More specifically, we will examine the buffering effect of preventive and ameliorative adaptations and general resources on the progression from arthritis to disability and diminished quality of life. Findings from the proposed study will be useful to clinicians, service providers, policy markers, and others attempting to minimize arthritis- induced disability and enhance quality of life among the elderly.

人们越来越认识到，减少残疾的努力在 老年人必须基于对减缓因素的更好理解 从慢性病到器官层面的身体损害，再到 残疾。沿着这个瀑布前进并不是不可避免的，但可能 通过个人和社会资源、预防性适应和 与损伤相关的改善性适应。关节炎是最多的 老年人普遍存在的慢性疾病，是 身体损伤和残疾的最常见原因。影响因素 它可以减缓关节炎引起的肌肉骨骼疾病的进展 对个人和社会残疾的损害一直不太好 学习。拟议的研究旨在测试一个全面的模型 社区生活中残疾和生活质量下降的缓冲 患有和不患有关节炎的老年人。我们的模型还考虑到 合并症和潜在性别的重要影响 在适应关节炎和伴随而来的残疾方面的差异。 研究样本包括大约700名社区生活的老年人 (75岁以上)登记参加NIA资助的持续优异奖的受试者 对佛罗里达州退休人员的研究。54%的样本报告 得了关节炎。拟议项目的数据收集工作将开始 在进行中的四次年度优秀奖研究之后。A三- 将采用波浪式纵向设计。拟议的研究将需要 个人慢性病现有措施的优势(ADL/IADL) 残疾、健康促进活动、社会、心理和 我们聚集在一起的经济资源和生活质量 我们正在进行的功绩奖励研究。拟议的新研究将引入 有关关节炎、身体损伤、 改善适应、社会残疾和生活质量。因为 我们建议的研究将嵌套在正在进行的功绩奖励研究中， 它可以在中心的预算限制内可行地执行 格兰特提案。 我们将使用描述性分析来描述关节炎的范围 症状和合并症和损害，以及他们的 与个人和社会残疾和质量下降的联系 生活的一部分。我们还将使用标准的单变量统计和回归 检验有关肌肉骨骼的关联性的假设 有特定残疾的残疾，以及(2)性别差异 关节炎相关损害对残疾的影响。此外， 建议的研究将包括多变量的方差分析，最小 平方回归和结构方程来测试我们的综合 关于残疾级联缓冲的因果模型。更多 具体地说，我们将研究预防性和 改进性的适应和关于从 关节炎导致残疾和生活质量下降。 拟议的研究结果将对临床医生和服务人员有所帮助 提供者、政策标记者和其他试图将关节炎降至最低的人- 减少老年人的残疾，提高老年人的生活质量。