CORE--EPIDEMIOLOGY CORE

HRCA/哈佛RNH的流行病学核心将是该方案项目的基础，因为它将汇集和维持一批老年人，他们将在赠款期间参与所有3个项目。在过去的四个5年周期的赠款，项目已招募方便样本从我们的志愿者主题登记，报纸广告，疗养院和社区住房网站。我们现在正在采取一种更普遍的办法，设计一种以人口为基础的征聘战略。我们将与波士顿马萨诸塞州大学调查研究中心合作，从HRCA周围有限的地理半径范围内挨家挨户招募样本。哈佛/HRCA RNH的流行病学核心将招募样本，进行基线和 在家庭和HRCA进行的两次年度随访评估将为所有三个项目提供受试者，并将使用所有可用的策略在项目期间最大限度地保留队列。该核心的具体目标是（1）从波士顿HRCA周围的特定地理区域招募多样化的老年人（70岁及以上），以人口为基础的样本。这将通过人口普查区抽样和挨家挨户征聘来实现。使用家庭和中心访问，核心将描述参与者的基线临床，功能和认知状况;测量他们的步态，平衡，脑血管反应性，直立性血压， 疼痛、感觉功能和福尔斯风险。三个项目中的每一个都将涉及适当的主题。将使用跌倒日记法随访所有受试者2年以上的福尔斯发生率。将使用所有可用的保留技术实现最大随访，直至受试者死亡或研究期结束。(2)该中心还将继续维持和扩大对实验室研究感兴趣的主题的登记册，并将通过其通讯和研讨会向公众传播信息。这是一个重要的项目，有几个原因，包括使用门到门技术的人口招募，评估新的风险因素和福尔斯机制，对HRCA周围社区的潜在好处，以及创建一个有价值的数据库，以促进本提案范围以外的未来研究。

The Epidemiology Core of the HRCA/Harvard RNH will be the foundation for the program project in that it will assemble and maintain a cohort of older persons who will be involved in all 3 of the projects during the grant period. Over the previous four 5-year cycles of this grant, projects have recruited convenience samples from our volunteer subject registry, newspaper advertisements, nursing homes, and community housing sites. We are now undertaking a more generalizable approach by designing a population-based recruitment strategy. We will use door-to-door recruitment of a sample from a limited geographic radius surrounding the HRCA in collaboration with the University of Massachusetts, Boston, Center for Survey Research. The Epidemiology Core of the Harvard/HRCA RNH will recruit the sample, perform baseline and two annual follow up assessments conducted in the home and at the HRCA, will provide subjects for all three projects, and will use all available strategies to maximize retention of the cohort during the duration of the project. The specific aims of this Core are (1) to recruit a diverse, elderly (70 years of age and older), population-based sample from a defined geographic area surrounding the HRCA in Boston. This will be accomplished using census block sampling and door-to-door recruitment. Using both in-home and center-based visits, the core will characterize participants' baseline clinical, functional, and cognitive conditions; measure their gait, balance, cerebrovascular reactivity, orthostatic blood pressure, presence and features of pain, sensory function, and falls risk. Appropriate subjects will be referred to each of the three projects. All subjects will be followed for the occurrence of falls over 2 years of follow up using fall diary methods. Maximal follow up until death of participants or the end of the study period will be achieved using all available retention techniques. (2) This core will also continue to maintain and expand a registry of subjects interested in laboratory-based research, and will disseminate information to the population through its newsletter and seminars. This is a significant project for several reasons including the population based recruitment using door to door techniques, the assessement of novel risk factors and mechanisms of falls, the potential benefits to the community surrounding the HRCA and the creation of a valuable database to foster future research beyond the scope of this proposal.