Changes in Multimorbidity and Disability Among Race/Ethnic Older Adults

项目总结/摘要 老年人中的多种慢性病（多发病）非常普遍，致残， 很贵。对疾病之间复杂相互作用的更高认识激发了拟议项目目标 确定导致重要健康结果的疾病组合，如残疾、健康相关质量 脆弱的老年人的生命和死亡率。拟议的工作将增加我们对以下问题的理解： （1）通过以下方式，以多种形式的组合及其在残疾发展中的作用： 直接比较不同老年人的流行多发病组，（2）量化协会 多种疾病组合与残疾发作之间的关系，以及（3）确定不断变化的护理需求， 老年人的医疗保健支出与多发性硬化症。拟议的工作将提供重要的见解 哪些疾病组合对残疾发作构成最大风险，这反过来又可能导致丧失 独立、制度化和过早死亡。虽然我们的初步研究发现， 老年非裔美国人的多重负担，并检查哪些疾病构成最多， 在美国老年人中经常发生的多发病组合，我们提出的研究使 用20多年的全国代表性两年期数据研究多台风的长期影响 （健康与退休研究中约37，000人），以及5年的年度数据（全国约8，000人） 健康与老龄化趋势研究）。我们提出三个目标： 目标1。确定老年人中多发性硬化症的纵向发展和进展。 目标2.确定多发性硬化老年人残疾的发生和变化。 目标3。评估不同多发性硬化症的老年人的医疗保健和死亡率的变化， 残疾概况。

Project Summary/Abstract Multiple co-occurring chronic diseases (multimorbidity) among older adults are highly prevalent, disabling, and costly. Greater awareness of the complex interactions between diseases motivates the proposed project aims to identify disease combinations that drive important health outcomes such as disability, health-related quality of life, and mortality for vulnerable older adults. The proposed work will add to our understanding of multimorbidity combinations and their role in the development of disability in important ways by: (1) providing direct comparisons of prevalent multimorbidity groups for diverse elders, (2) quantifying the association between multimorbidity combinations and disability onset, and (3) identifying the changing care needs and health care expenditures of older adults with multimorbidity. The proposed work will provide important insights on which disease combinations pose the greatest risks for disability onset, which in turn may lead to loss of independence, institutionalization, and premature death. While our preliminary work finds that greater multimorbidity burdens accrue to older African Americans, and examines which diseases comprise the most frequently occurring multimorbidity combinations among older Americans, our proposed research enables the study of long-term influences of multimorbidity in over 20 years of nationally-representative biennial data (~37,000 people in the Health & Retirement Study), and 5 years of annual data (~8,000 people in the National Health & Aging Trends Study). We propose three aims: Aim 1. Determine the longitudinal development and progression of multimorbidity among older adults. Aim 2. Determine the onset of and changes in disability for older adults with multimorbidity. Aim 3. Evaluate changes in health care and mortality for older adults with varying multimorbidity and disability profiles.