Changes in Multimorbidity and Disability Among Race/Ethnic Older Adults

项目概要/摘要 多种同时发生的慢性疾病（多重发病）在老年人中非常普遍、致残，并且 成本高昂。对疾病之间复杂相互作用的更多认识激发了拟议的项目目标 识别导致重要健康结果（例如残疾、健康相关质量）的疾病组合 弱势老年人的生命和死亡率。拟议的工作将增加我们对 多种疾病组合及其在残疾发展中的重要作用：(1) 提供 直接比较不同老年人普遍存在的多发病群体，(2) 量化关联 多种疾病组合和残疾发作之间的关系，以及 (3) 确定不断变化的护理需求和 患有多种疾病的老年人的医疗保健支出。拟议的工作将提供重要的见解 哪些疾病组合对残疾发生的风险最大，进而可能导致丧失能力 独立、制度化和过早死亡。虽然我们的初步工作发现更大 老年非裔美国人承受的多种疾病负担，并检查哪些疾病构成最严重 老年人中经常出现的多种疾病组合，我们提出的研究使得 通过 20 多年的全国代表性双年度数据研究多种疾病的长期影响 （健康与退休研究中约有 37,000 人），以及 5 年的年度数据（全国研究中约有 8,000 人） 健康与老龄化趋势研究）。我们提出三个目标： 目标 1. 确定老年人多种疾病的纵向发展和进展。 目标 2. 确定患有多种疾病的老年人的残疾发生和变化。 目标 3. 评估患有不同多种疾病和疾病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.