DISABILITY--RECOVERY AND IMPROVEMENT

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Dr. Caroline Blaum is an experienced clinical geriatrician who began a geriatrics fellowship at the University of Michigan in 1991 to develop research skills and begin a career in academic geriatrics. From 1991 to 11993, she pursued quantitive training in research methodology and worked with Dr. Jersey Liang to develop a research agenda concerning outcomes of chronic diseases. Funding from the University of Michigan Geriatrics Center, a NRSA Individual Postdoctoral Award, and a Brookdale National Fellowship allowed her to extend her research agenda to the longitudinal study of disability and the impact of clinical covariates on disability transitions. The Mentored Clinical Scientist Development Award (MCSDA) will give Dr. Blaum time and resources to establish herself as an independent physician scientist. Two experienced co-sponsors, Dr. Jeffrey Halter and Dr. Jersey Liang, and multiple University of Michigan resources are available for Dr. Blaum~s career development. Dr. Halter will assure her access to office space, secretarial help, and 75% protected time for research, and direct her career development within Geriatric Medicine. Dr. Liang will serve as her research mentor, and assist with all substantive and methodological aspects of her research. Other available resources include the faculty and seminars of the Geriatrics Center and Institute of Gerontology (IoG), consultation and coursework from the Institute for Social Research, and training in the responsible conduct of research from the IoG, Medical School, and University of Michigan. The proposed research will investigate disability recovery and improvement noted in health interview surveys. The research goals are to develop multi-wave models for disability recovery/improvement (R/I) as functions of clinically-related variables. The research will evaluate two specific hypotheses: (1) Disability (R/I) occurs mainly in early or mild disability; (2) Disability R/I is affected by measurable clinical covariates. The specific aims will: describe and model health transitions that result in disability outcomes, particularly R/I, in order to clarify the model of disability progression and investigate the concept of early disability; extend models of disability transitions to multi-wave data to examine the effects of time on the disability trajectory; examine the impact of clinically important covariates on disability R/I and the disability trajectory. The research strategy involves clarification of the conceptual framework and research terms; use of health interview survey data; and longitudinal data analysis. Consultation with researchers in survey research and biostatistics is planned.