Migrating the National Long Term Care Survey to the MedRIC Health and Aging Data Enclave

将国家长期护理调查迁移到 MedRIC 健康和老龄化数据飞地

• 批准号: 10827579
• 负责人: P.J. ERIC STALLARD
• 金额: $ 24.15万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10827579
• 关键词: Acceleration; Address; Administrative Supplement; Administrator; Adult; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Arthritis; Benchmarking; Blood Vessels; Characteristics; Chronic; Chronic Disease; Cognitive; Complex; Computer software; Constitution; Constitutional; Data; Data Analyses; Data Set; Dementia; Elderly; Ensure; Environment; Epigenetic Process; Equilibrium; Evaluation; Fracture; Frontotemporal Dementia; Future; Genetic; Goals; Health; Health trends; Home; Impaired cognition; Impairment; Incidence; Individual; Individual Differences; Information Centers; Infrastructure; Internet; Joints; Lewy Bodies; Life Expectancy; Link; Location; Long-Term Care; Malignant Neoplasms; Medicaid; Medicare/Medicaid; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Paper; Population Study; Prevalence; Process; Productivity; Provider; Publications; Quality of life; Recommendation; Recovery; Research; Research Activity; Research Personnel; Research Project Grants; Resolution; Resources; Risk; Risk Factors; Security; Stroke; Surveys; System; Testing; United States; United States National Institutes of Health; Universities; Update; Work; chronic infection; comparative; cost; data access; data enclave; data infrastructure; data management; data resource; design; disability; experience; genetic analysis; health assessment; health data; health record; human old age (65+); improved; instrumental activity of daily living; loss of function; migration; mortality; multiple chronic conditions; negative affect; non-genetic; parent grant; systems research; task analysis

TITLE Migrating the National Long-Term Care Survey to the MedRIC Health and Aging Data Enclave ABSTRACT As life expectancy at age 65 continues to increase in the U.S., chronic diseases alone and in combination are placing an increasingly heavy burden on U.S. older adults and continue to be leading causes of disability and mortality. Alzheimer’s disease (AD) and related dementias (ADRD) have become important focal points for efforts to reduce the burden of chronic diseases on older adults. This is with good cause, as together with stroke, these conditions are the leading causes of cognitive impairment and associated loss of function and quality of life. However, AD/ADRD is but one aspect of unhealthy aging and operates in concert with other high impact adverse health conditions. Many of these conditions are leading causes of non-cognitive disability, and there is significant overlap of risk where one chronic illness imposes increased risk for the onset of others. An important aspect of preparing for the current and future burdens associated with chronic morbidity/multimorbidity in older ages is acquiring an understanding of whether these health trends are accompanied by a reduction in total lifetime days of chronic morbidity/disability—reflecting a balance between morbidity/disability incidence rates and case- continuance rates—generated by case-fatality and case-recovery rates. This is termed morbidity/mortality compression and is the primary focus of this Supplement’s parent grant (R01AG063971: 03/15/2020– 02/28/2025) which seeks to test two major hypotheses across three complementary Aims: [H1] that modifiable non-genetic risk factors account for the recent temporal changes in the incidence, prevalence, and continuance of cognitive and physical impairments; and [H2] that constitutional genetic and epigenetic factors modulate individual differences in lifetime morbidity/disability incidence, prevalence, and continuance of cognitive and physical impairments. To achieve these Aims, joint access to multiple CMS-linked data in a single location is necessary; but regulatory changes have made this challenging. These same regulatory changes also created unexpected opportunities: (1) to make the National Long Term Care Survey (NLTCS) available to NIA researchers on the Medicare & Medicaid Resource Information Center (MedRIC) Health and Aging Data (HaAD) Enclave—the future home of all NIA-sponsored CMS-linked studies—as a new CMS-linked data resource; and (2) to use the MedRIC HaAD enclave for the joint analysis of the CMS-linked datasets listed in the parent grant, thereby accelerating the rate of progress on its Aims. Exploiting both opportunities, with enhanced data analysis and comparative assessment of the HaAD enclave, is the goal of this Supplement. It presents a unique opportunity for formal review, evaluation, and recommendations for enhancement of the efficiency of the MedRIC HaAD enclave from the point of view of users and administrators of the NLTCS, with comparison of HaAD-based productivity gains to those achieved with two other CLOUD-based solutions at Duke University. All improvements in the efficiency of the HaAD enclave will benefit NIH/NIA researchers because the distribution of CMS data through the MedRIC HaAD enclave is expected to be the sole mode of distribution of these data in the future.

标题 将国家长期护理调查迁移到 MedRIC 健康和老龄化数据飞地 抽象的 随着美国 65 岁的预期寿命持续增长，慢性病单独或综合作用 给美国老年人带来越来越沉重的负担，并且仍然是导致残疾和残疾的主要原因 死亡。阿尔茨海默病（AD）和相关痴呆症（ADRD）已成为重要的工作重点 减轻老年人的慢性病负担。这是有充分理由的，就像中风一样，这些 疾病是导致认知障碍以及相关功能和生活质量丧失的主要原因。 然而，AD/ADRD 只是不健康老龄化的一个方面，并且与其他高影响不利因素共同作用。 健康状况。其中许多情况是非认知障碍的主要原因，并且有显着的影响 风险重叠，其中一种慢性病会增加其他慢性病的发病风险。一个重要方面 为当前和未来与老年人慢性发病/多重发病相关的负担做好准备是 了解这些健康趋势是否伴随着总生命天数的减少 慢性发病率/残疾率——反映发病率/残疾发生率和病例之间的平衡 持续率——由病死率和病例康复率产生。这称为发病率/死亡率 压缩，是本补充文件母基金的主要关注点（R01AG063971：03/15/2020– 02/28/2025）旨在测试三个互补目标的两个主要假设：[H1] 非遗传风险因素导致了近期发病率、患病率和持续时间的变化 认知和身体障碍； [H2] 体质遗传和表观遗传因素调节 终生发病率/残疾发生率、患病率以及认知能力和持续性的个体差异 身体损伤。为了实现这些目标，需要在单个位置联合访问多个 CMS 链接的数据 必要的;但监管变化使这一点变得具有挑战性。这些相同的监管变化也创造了 意想不到的机会：(1) 向 NIA 提供国家长期护理调查 (NLTCS) 医疗保险和医疗补助资源信息中心 (MedRIC) 健康与老龄化数据 (HaAD) 的研究人员 Enclave——所有 NIA 赞助的 CMS 相关研究的未来家园——作为一种新的 CMS 相关数据资源；和 (2) 使用 MedRIC HaAD enclave 对父资助中列出的 CMS 链接数据集进行联合分析， 从而加快其目标的进展速度。通过增强数据分析来利用这两个机会 对 HaAD 飞地进行比较评估是本补充文件的目标。它呈现出一种独特的 进行正式审查、评估和提出提高 MedRIC 效率的建议的机会 从 NLTCS 用户和管理员的角度来看 HaAD enclave，与基于 HaAD 的比较 杜克大学的生产力提高程度与使用另外两个基于云的解决方案所取得的成果相当。所有改进 HaAD enclave 效率的提高将使 NIH/NIA 研究人员受益，因为 CMS 数据的分布 通过 MedRIC HaAD enclave 预计将成为未来分发这些数据的唯一模式。