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Geriatric Conditions and Disablement in the Older Adult Population

老年人口的老年病和残疾

基本信息

批准号：
8716623
负责人：
CHRISTINE T CIGOLLE
金额：
$ 12.77万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8716623
关键词：
Accounting Adult Age Aged, 80 and over Aging Appointment Award Basic Science Brain Chronic Disease Clinical Clinical assessments Code Cognition Cognitive Data Data Collection Data Sources Dementia Demographic Aging Development Disabled Persons Disease Doctor of Medicine Doctor of Philosophy Education Educational workshop Elderly Epidemiologic Studies Epidemiology Family Practice Foundations Funding Geriatrics Gerontology Goals Health Health Status Healthcare Systems Impaired cognition Impairment Incidence Individual Institutes Internal Medicine Intervention Interview K-Series Research Career Programs Knowledge Lead Linear Models Link Master of Public Health Measures Medicare Medicare claim Memory Mentors Mentorship Methodology Methods Michigan Minnesota Modeling National Center for Research Resources National Institute on Aging National Research Service Awards Outcome Pathway interactions Pattern Performance Persons Pilot Projects Policies Population Prevalence Principal Investigator Public Health Schools Records Research Research Personnel Respondent Retirement Risk Factors Role Sampling Scientist Specific qualifier value Subgroup Surveys Survival Analysis Syndrome Testing Time Training Training Activity United States Centers for Medicare and Medicaid Services United States National Institutes of Health Universities Urinary Incontinence career career development comparative design disability disease diagnosis falls frailty longitudinal analysis longitudinal course longitudinal design medical schools middle age mortality multisensory nutrition population based prevent professor programs prospective public health relevance research and development skills social trend

项目摘要

DESCRIPTION (provided by applicant): Geriatric conditions, although frequently unrecognized and overlooked, are important contributors to the health status of older adults. However, geriatric conditions as a group, in contrast to diseases, have not been clearly located within current models of disability development and progression. Rather, conditions appear to operate and interact at multiple points in these models. Christine Cigolle, M.D., M.P.H. proposes to investigate the place of geriatric conditions in the disablement pathway in older adults for the Mentored Clinical Scientist Research Career Development Award (K08). Dr. Cigolle is an Assistant Professors in the Departments of Family Medicine and Internal Medicine at the University of Michigan (UM) Medical School, with appointments in the Institute of Gerontology (UM) and the VA Ann Arbor Healthcare System Geriatrics Research, Education and Clinical Center (GRECC). Her previous cross-sectional research has demonstrated the prevalence and the disability association of geriatric conditions among older adults. Funded by a NIH-NCRR KL2 Mentored Clinical Scholars Award (UM), she investigated how geriatric conditions and chronic diseases group together in older adults using latent class analysis. Her research for the KL2 Award lays the foundation for the research aims and methodologies in her K08 proposal. The overall goal of the proposed research for the K08 Award is to investigate the place of geriatric conditions in the disablement pathway in the older adult population. The research will examine five geriatric conditions: dementia, falls, urinary incontinence, poor nutrition, and multisensory impairment. The research will propose a conceptual model in which geriatric conditions share common risk factors, have an accelerated trajectory of accumulation in older adults, and result in common outcomes (e.g., disability). The research will test this model, --first, by examining the incidence and longitudinal course of geriatric conditions (individually and in aggregate), beginning with adults in middle age and extending to the oldest old; and --second, by examining geriatric conditions as a predictor of disability (taking mortality into account as a competing outcome). By investigating how geriatric conditions begin, accumulate, and co-occur in older adults over time, the proposed research aims to add new knowledge about the place of geriatric conditions in the disablement pathway and thus to contribute to ongoing efforts to link the conditions theoretically. The proposed research will utilize unique longitudinal data from the Health and Retirement Study (HRS), a nationally-representative health interview survey, and data from the HRS supplemental Aging, Demographics, and Memory Study (ADAMS). It will also make use of newly available Medicare administrative data linked to the HRS and ADAMS to further specify conditions and diseases (diagnosis codes). Dr. Cigolle's career goal is to become an independent researcher in academic Family Medicine, focusing on older adult health status, especially geriatric conditions and syndromes and disability. Her future research methods will focus on implementation and analysis of large epidemiologic studies of older adults. The research and career development training in the K08 Award proposal are designed to support both (1) the acquisition of advanced methodological skills and expertise in the epidemiology of geriatric conditions and (2) training in the design and implementation of primary data collection for large epidemiologic studies of older adults. Her mentorship team for the K08 Award proposal includes: Primary Mentor Jersey Liang, Ph.D., Professor, Department of Health Management and Policy, School of Public Health; Co-Mentor Caroline S. Blaum, M.D., M.S., Professor, Division of Geriatrics, Department of Internal Medicine; and Co-Mentor Kenneth Langa, M.D., Ph.D., Professor, Division of General Internal Medicine, Department of Internal Medicine. Specific career development training activities include: --training in advanced statistical methodologies, including longitudinal analysis, latent trajectory analysis, hierarchical linear modeling, and survival analysis via tutorials with mentors and classwork through the Institute for Social Research and School of Public Health at the University of Michigan, --training in the use of Medicare administrative data via tutorials with mentors and course attendance at CMS 101: Introduction to the Use of Medicare Data for Research (Basic Workshop in Medicare Administrative Data) through the Research Data Assistance Center (ResDAC) at the University of Minnesota, and --training in primary data collection for large epidemiologic studies of older adults via participation in the NIA- funded ADAMS pilot study (National Trends in Brain Health) (Mentor: Langa), development of an experimental module on geriatric conditions to be submitted for consideration for fielding in the 2014 wave of the HRS (Mentor: Langa), and involvement in the Comparative Aging Research Program (Mentor: Liang).

描述（由申请人提供）：老年疾病，虽然经常被忽视和忽视，是老年人健康状况的重要贡献者。然而，与疾病相比，老年疾病作为一个群体，尚未在目前的残疾发展和进展模型中得到明确定位。相反，在这些模型中，条件似乎在多个点上运行和交互。Christine Cigolle, m.d.， M.P.H.为获得指导临床科学家研究职业发展奖（K08），建议调查老年疾病在老年人残疾途径中的地位。Cigolle博士是密歇根大学（UM）医学院家庭医学和内科学系的助理教授，在老年学研究所（UM）和VA安娜堡医疗保健系统老年病学研究、教育和临床中心（GRECC）任职。她之前的横断面研究已经证明了老年人中老年疾病的患病率和残疾关联。在NIH-NCRR KL2指导临床学者奖（UM）的资助下，她使用潜在分类分析研究了老年人的老年疾病和慢性疾病如何组合在一起。她对KL2奖的研究为K08提案的研究目标和方法奠定了基础。K08奖拟议研究的总体目标是调查老年人口中老年疾病在残疾途径中的地位。这项研究将检查五种老年疾病：痴呆、跌倒、尿失禁、营养不良和多感官障碍。该研究将提出一个概念模型，其中老年疾病具有共同的风险因素，在老年人中具有加速积累的轨迹，并导致共同的结果（例如残疾）。该研究将检验这一模型——首先，通过检查老年疾病的发病率和纵向病程（个体和总体），从中年成年人开始，延伸到最年长的老年人；其次，通过研究老年疾病作为残疾的预测因素（将死亡率作为一个竞争结果考虑在内）。通过调查老年疾病是如何随着时间的推移在老年人中开始、积累和共同发生的，本研究旨在增加关于老年疾病在残疾途径中的地位的新知识，从而为正在进行的将这些疾病从理论上联系起来的努力做出贡献。拟议的研究将利用来自健康与退休研究（HRS）的独特纵向数据，这是一项具有全国代表性的健康访谈调查，以及来自HRS补充老龄化，人口统计和记忆研究（ADAMS）的数据。它还将利用与HRS和ADAMS相关联的新获得的医疗保险管理数据，进一步具体说明条件和疾病（诊断代码）。Cigolle博士的职业目标是成为学术家庭医学的独立研究员，专注于老年人的健康状况，特别是老年疾病、综合征和残疾。她未来的研究方法将集中在老年人大型流行病学研究的实施和分析上。K08奖提案中的研究和职业发展培训旨在支持(1)获得老年疾病流行病学方面的先进方法技能和专业知识，以及(2)为老年人大型流行病学研究设计和实施主要数据收集的培训。她的K08奖提案的指导团队包括：主要导师梁泽，博士，公共卫生学院卫生管理与政策系教授；共同导师Caroline S. Blaum，医学博士，医学硕士，内科老年病科教授；联合导师Kenneth Langa，医学博士，内科内科综合内科教授。具体的职业发展培训活动包括：——通过密歇根大学社会研究所和公共卫生学院的导师辅导和课堂作业，对高级统计方法进行培训，包括纵向分析、潜在轨迹分析、层次线性建模和生存分析；——通过导师辅导和参加CMS 101课程，对医疗保险行政数据的使用进行培训；通过明尼苏达大学研究数据援助中心（ResDAC）介绍医疗保险数据用于研究（医疗保险管理数据基础研讨会），并通过参加NIA资助的ADAMS试点研究（国家脑健康趋势）培训老年人大型流行病学研究的主要数据收集(导师：Langa)，开发一个老年疾病的实验模块，提交考虑在2014年HRS浪潮中进行（导师：Langa），并参与比较老龄化研究项目（导师：Liang）。