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: 6235658
• 负责人: KYLE KERCHER
• 金额: $ 10.85万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-07-01 至 1998-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6235658
• 关键词: arthritis; behavioral /social science research tag; chronic disease /disorder; comorbidity; disease /disorder prevention /control; gender difference; health care model; health education; 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.

人们日益认识到，减少残疾人的努力 老年人必须在更好地了解减缓因素的基础上 从慢性疾病到器官水平的身体损伤， 残疾。 沿着这条瀑布的发展不是不可避免的，但可能 通过个人和社会资源、预防性调整和 与损伤相关的改善性适应。 关节炎是最 老年人普遍存在的慢性疾病，是其中之一， 身体损伤和残疾的最常见原因。的因素 可以缓冲关节炎引起的肌肉骨骼 对个人和社会残疾的损害 研究了 这项研究旨在测试一个全面的模型， 缓冲残疾和社区生活质量下降 有和没有关节炎的老年人。 我们的模型还考虑到 合并症和潜在性别的重要影响 在适应关节炎和随之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， (age 75+）受试者参加了正在进行的NIA资助的MERIT奖 对佛罗里达退休人员的研究。 54%的样本报告 患有关节炎。 将开始为拟议项目收集数据 在四次年度MERIT奖研究浪潮之后。 一个三- 将采用波浪纵向设计。 拟议的研究将采取 现有慢性病指标的优势，个人（ADL/IADL） 残疾、健康促进活动、社会、心理和 经济资源和生活质量，我们收集的一部分， 我们正在进行的优秀奖研究 这项新研究将引入 关于关节炎，身体损伤， 改善适应、社会残疾和生活质量。 因为 我们提出的研究将嵌套在正在进行的MERIT奖研究中， 在中心的预算限制范围内， 赠款提案。 我们将使用描述性分析来描述关节炎的范围 糖尿病和共病状况和损害，以及 与个人和社会残疾和素质下降的关联 生命 我们还将使用标准的单变量统计和回归 为了检验关于（10）肌肉骨骼系统与 具体残疾的障碍，和（2）性别差异， 关节炎相关损伤对残疾的影响。 另夕h 拟议的研究将包括多变量方差分析，最少 平方回归和结构方程来检验我们的综合 关于残疾级联缓冲区的因果模型。 更 具体而言，我们会研究预防及 改善适应和一般资源的进展， 关节炎导致残疾和生活质量下降。 从拟议的研究结果将是有用的临床医生，服务 供应商、政策制定者和其他试图最大限度地减少关节炎的人- 提高老年人的生活质量。