BUFFERS OF THE ARTHRITIS DISABILITY CASCADE IN THE OLD OLD

老年人关节炎残疾级联的缓冲剂

• 批准号: 3727972
• 负责人: KYLE KERCHER
• 金额: --
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3727972
• 关键词: arthritis; chronic disease /disorder; disease /disorder prevention /control; gender difference; health care model; health education; human morbidity; human subject; human very old age (85+); longitudinal human study; mathematical model; model design /development; pathologic process; psychological adaptation; psychological stressor; quality of life; self concept; social support network; socioeconomics

There is increasing recognition that efforts to reduce disability among the elderly must be based on a better understanding of factors that slow the cascade from chronic illness to organ-level physical impairment to disability. Progression along this cascade is not inevitable, but may be buffered by personal and social resources, preventive adaptations, and impairment-relevant ameliorative adaptations. Arthritis is the most prevalent chronic medical condition for older people, and is one of the most common causes of physical impairment and disability. The factors that buffer the progression from arthritis-induced musculoskeletal impairments to personal and social disabilities have not been well studied. The propose study seeks to test a comprehensive model of buffers of disability and diminished quality of life for community-living elderly with and without arthritis. Our model also takes into account the important effects of comorbid conditions and potential gender differences in adapting to arthritis and attendant disability. The study sample consists of approximately 700 community-living old-old (age 75+) subjects who are enrolled in an ongoing NIA-funded MERIT-award study of Florida retirees. Fifty-four percent of the sample report having arthritis. Data collection for the proposed project will commence following four annual waves of the ongoing MERIT-award study. A three- wave longitudinal design will be used. The proposed study will take advantage of existing measures of chronic illness, personal (ADL/IADL) disability, health-promotion activities, social, psychological, and economic resources, and quality of life that we are gathering as part of our ongoing MERIT-award study. The proposed new study will introduce additional self-report data on arthritis, physical impairments, ameliorative adaptations, social disability and quality of life. Because our proposed study will be nested within the ongoing MERIT-award study, it can be feasibly performed within the budget constraints of the center grant proposal. We will use descriptive analyses to characterize the range of arthritis symptomatology and comorbid conditions and impairment, and their association with personal and social disability and diminished quality of life. We will also use standard uni-variate statistics and regression to test hypotheses about (10 the association of musculoskeletal impairment with specific disabilities, and (2) gender differences in effect of arthritis-related impairments on disability. Additionally, the proposed study will include multi-variate analyses of variance, least squares regression, and structural equations to test our comprehensive causal model regarding buffers of the disability cascade. More specifically, we will examine the buffering effect of preventive and ameliorative adaptations and general resources on the progression from arthritis to disability and diminished quality of life. Findings from the proposed study will be useful to clinicians, service providers, policy markers, and others attempting to minimize arthritis- induced disability and enhance quality of life among the elderly.

人们越来越认识到减少残疾的努力 老年人必须基于对减缓因素的更好理解 从慢性疾病到器官水平的身体损伤的级联 残疾。 沿着这一级联的进展并非不可避免，但可能 通过个人和社会资源、预防性适应进行缓冲，以及 与损伤相关的改善性适应。 关节炎是最常见的 老年人普遍存在的慢性疾病，也是其中之一 身体损伤和残疾的最常见原因。因素 缓冲关节炎引起的肌肉骨骼疾病的进展 对个人和社会残疾的损害尚未得到很好的解决 研究过。 本研究旨在测试一个综合模型 残疾和社区生活质量下降的缓冲 患有或不患有关节炎的老年人。 我们的模型还考虑了 合并症和潜在性别的重要影响 适应关节炎和随之而来的残疾方面的差异。 研究样本由约 700 名社区老年人组成 （75 岁以上）正在参加 NIA 资助的 MERIT 奖的受试者 对佛罗里达州退休人员的研究。 百分之五十四的样本报告 患有关节炎。 拟议项目的数据收集将开始 继每年四波正在进行的 MERIT 奖研究之后。 一个三- 将采用波浪纵向设计。 拟议的研究将采取 现有个人慢性病衡量标准（ADL/IADL）的优势 残疾、健康促进活动、社会、心理和 我们正在收集的经济资源和生活质量 我们正在进行的优异奖研究。 拟议的新研究将介绍 关于关节炎、身体损伤的额外自我报告数据， 改善适应、社会残疾和生活质量。 因为 我们提出的研究将嵌套在正在进行的优异奖研究中， 它可以在中心的预算限制内可行 拨款提案。 我们将使用描述性分析来描述关节炎的范围 症状和合并症和损伤及其 与个人和社会残疾以及质量下降有关 的生活。 我们还将使用标准的单变量统计和回归 检验关于（10 肌肉骨骼的关联）的假设 特定残疾的损害，以及（2）性别差异 关节炎相关损伤对残疾的影响。 此外， 拟议的研究将包括多变量方差分析，至少 平方回归和结构方程来测试我们的综合能力 关于残疾级联缓冲的因果模型。 更多的 具体来说，我们将检查预防和预防措施的缓冲效果 改进的适应和一般资源的进展 关节炎导致残疾和生活质量下降。 拟议研究的结果将对临床医生、服务机构有用 提供者、政策制定者和其他试图尽量减少关节炎的人 致残，提高老年人的生活质量。