Epidemiology of Bathing Disability in Elderly Persons

老年人沐浴障碍的流行病学

• 批准号: 7253956
• 负责人: Thomas Michael Gill
• 金额: $ 23.49万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-15 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7253956
• 关键词: Activities of Daily Living; Address; Admission activity; Bathing; Cessation of life; Clinical Trials; Cognitive; Condition; Data; Data Quality; Databases; Dependence; Development; Devices; Disabled Persons; Eating; Elderly; Elements; Environmental Hazards; Environmental Risk Factor; Epidemiologic Studies; Epidemiology; Equilibrium; Equipment; Event; Feces; Funding; Geriatrics; Gills; Grooming; Guide prevention; Hand; Home environment; Impairment; Independent Living; Individual; Injury; Intervention; Measures; Modeling; Morbidity - disease rate; Numbers; Nursing Homes; Outcome; Outcome Measure; Parents; Patient Self-Report; Pattern; Performance; Persons; Policy Maker; Population; Porifera; Positioning Attribute; Prevalence; Prevention; Prospective Studies; Purpose; Quality of life; Rate; Recurrence; Rehabilitation therapy; Research; Research Personnel; Risk; Risk Factors; Role; Self-Help Devices; Series; Services; Social Environment; Sterile coverings; Testing; Vision; Walking; Weight-Bearing state; Work; base; cohort; community living; cooking; day; disability; falls; hazard; instrumental activity of daily living; mortality; muscle strength; programs; psychologic; remediation; response; skills; therapy design

DESCRIPTION (provided by applicant): Among community-living older persons, disability in bathing (i.e. washing and drying one's whole body) is highly prevalent, is a strong predictor of morbidity and mortality, and is a primary indication for home aide services. Yet, the evidence base to help guide the prevention and remediation of bathing disability is relatively scant. The long-term objective of this research is to rigorously evaluate targeted and clinically sensible intervention strategies to enhance safe and independent bathing among community-living older persons. The Specific Aims of the research proposed in the current application, which has been extensively revised in response to the prior review, are: (1) to determine the burden and patterns of disability in bathing among community-living older persons; (2) to determine whether disability in bathing is associated with subsequent adverse outcomes, such as nursing home admission and death, independent of potential confounders, including disability in other basic activities of daily living (ADLs); (3) to evaluate the relationship between potential risk factors that are intrinsic to the individual, especially those that may be modifiable, and disability in bathing; and (4) to identify potential environmental impediments to independent bathing. To accomplish these aims, we will use high quality data from an ongoing prospective study of 754 community-living older persons, including monthly assessments of ADL function for 7 years and comprehensive home-based assessments at 18-month intervals. The proposed research addresses a fundamental problem in geriatric medicine and rehabilitation, builds upon a large body of previously completed work, including epidemiologic studies related to ADL disability and the home environment, and takes advantage of the most comprehensive and complete set of bathing related data on such a large cohort of community-living older persons, with an excellent participation rate and remarkably low attrition. By rigorously evaluating the epidemiology of bathing disability, the research proposed in this revised application will facilitate the development of subsequent interventions directed at the prevention and remediation of disability in bathing.

描述（申请人提供）：在社区生活的老年人中，洗澡（即清洗和擦干全身）残疾非常普遍，是发病率和死亡率的一个强有力的预测因素，也是家庭护理服务的一个主要指标。然而，帮助指导预防和补救洗澡残疾的证据基础相对较少。这项研究的长期目标是严格评估有针对性和临床上合理的干预策略，以提高社区生活的老年人的安全和独立洗澡。目前申请中提出的研究的具体目标是：（1）确定社区生活的老年人在洗澡方面的负担和残疾模式;（2）确定洗澡时的残疾是否与随后的不良后果有关，如入住疗养院和死亡，独立于潜在的混杂因素，包括其他基本日常生活活动（ADL）中的残疾;（3）评估个体固有的潜在风险因素（尤其是那些可以改变的因素）与洗澡残疾之间的关系;（4）识别独立洗澡的潜在环境障碍。为了实现这些目标，我们将使用754名社区老年人正在进行的前瞻性研究的高质量数据，包括7年的ADL功能每月评估和18个月间隔的全面家庭评估。拟议的研究解决了老年医学和康复的一个基本问题，建立在以前完成的大量工作，包括与ADL残疾和家庭环境相关的流行病学研究的基础上，并利用了最全面和完整的一套洗浴相关的数据，对这样一个大的队列社区生活的老年人，具有良好的参与率和显着低的磨损。通过严格评估洗澡残疾的流行病学，在此修订后的应用程序中提出的研究将促进后续干预措施的发展，旨在预防和治疗洗澡残疾。