Changes in Multimorbidity and Disability Among Race/Ethnic Older Adults

项目摘要/摘要 老年人中多种并存的慢性病(多发病)非常普遍，致残， 代价不菲。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 确定推动重要健康结果的疾病组合，如残疾、与健康相关的质量 对于脆弱的老年人来说，这是一项非常重要的工作。拟议的工作将增加我们对 多发病组合及其在残疾发展中的重要作用：(1)提供 不同老年人流行多发病人群的直接比较，(2)量化关联性 多发病组合和残疾发病之间的关系，以及(3)确定不断变化的护理需求和 老年多发病患者的医疗费用。拟议的工作将提供重要的见解 关于哪些疾病组合对残疾发作的风险最大，这反过来可能导致 独立、制度化和过早死亡。虽然我们的初步工作发现更大的 多发病负担累积在年长的非裔美国人身上，并检查哪些疾病构成最多 在美国老年人中频繁出现的多病组合，我们建议的研究使 全国代表性两年期资料20余年多病长期影响研究 (健康和退休研究中约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： 目的1.确定老年人多发病的纵向发展和进展。 目的2.确定患有多发病的老年人残疾的发生和变化。 目的3.评估患有不同多发病的老年人的医疗保健和死亡率的变化 残疾档案。

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.