PHYSICAL FRAILTY IN URBAN AFRICAN AMERICANS

城市非洲裔美国人的身体虚弱

• 批准号: 6629785
• 负责人: DOUGLAS K. MILLER
• 金额: $ 133.62万
• 依托单位: SAINT LOUIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6629785
• 关键词: African American; accidental falls; clinical research; disease /disorder proneness /risk; exercise; frail elderly; functional ability; hospital utilization; human mortality; human population study; human subject; interview; longevity; obesity; socioeconomics; urban poverty area; weight loss

DESCRIPTION: (Adapted from Investigator's Abstract) This application is a five-year competitive continuation of a NIA-sponsored project entitled "Physical Frailty in Urban African Americans," funded from 1991-7 (RO1 AG10436). In pursuit of its long range goal of identifying strategies for improving the active life expectancy of this population, the investigators investigated 646 African Americans living in a five-square mile, poor inner-city area of St. Louis who were aged 70-99 years at baseline evaluation in 1992-94. They identified increased disability and risk for functional decline among inner-city dwelling African Americans compared to Anglo Americans and to national samples of age- and gender-matched African Americans. They also demonstrated specific problems (e.g., obesity, high nutritional risk, dehydration, and renal insufficiency) that appear to contribute significantly to this excess disability. The present project proposes to continue pursuit of the stated long-term goal by extending investigation of the consequences and causes of the demonstrated disability in two directions. The first direction involves continued follow up of the original cohort using short telephone contacts in years 1, 3, and 4; longer contacts in 2 and 5; and yearly death searches. These data will address the project's first specific aim, i.e., to evaluate the effects of obesity, weight loss, fear of falling, lack of walking, and lower instrumental activities of daily living (ADL) functioning on subsequent fall, excess hospitalization, and increased basic ADL dependencies; and the impact of these factors on mortality. The second direction involves the recruitment and evaluation of a new cohort of 1200 younger African Americans from metropolitan St. Louis stratified by socioeconomic status. Data collection will involve in-home evaluations at waves 1 and 4, telephone follow-ups at waves 2, 3, and 5, and will also involve detailed evaluations of body composition and muscle strength in a 25% at waves 1 and 4. The investigators state that data from this new cohort will allow pursuit of specific Aims 2 and 3, i.e., the time of development, precursors and consequences of sarcopenia (Aim 2) and subclinical disability (Aim 3). Extensive data verification and internal reliability and validity studies will be performed. Primary analytic methods involve event history models predicting falls, incident basic ADL dependencies, hospitalization, and mortality in the original cohort as well as incident subclinical disability and functional limitation in the new cohort, adjusting for important covariates. Secondary analyses (e.g., studies involving fear of falling, bone mineral metabolism, adverse effects of dehydration and renal insufficiency, and supine-to-stand transfers) will also be pursued.

描述：（改编自研究者摘要）此应用程序是一个 继续开展一项为期五年的竞争性项目， “城市非裔美国人的身体虚弱”，1991-7年资助（RO 1 AG 10436）。为了实现其确定战略的长期目标， 提高这一人群的活跃预期寿命， 调查了646名生活在5平方英里的非洲裔美国人， 基线评价时年龄为70-99岁的圣路易斯市中心地区 在1992-94年。他们发现，功能障碍和风险增加， 与英裔美国人相比， 以及年龄和性别匹配的非裔美国人的全国样本。他们还 已证明的具体问题（例如，肥胖，高营养风险， 脱水和肾功能不全），似乎有助于显着 这种过度的残疾。本项目建议继续努力， 通过扩大对后果的调查来实现所述的长期目标， 从两个方面说明残疾的原因。第一方向 包括使用简短的电话继续随访原始队列 第1、3和4年的接触;第2和5年的长期接触;以及每年的死亡 搜索.这些数据将解决该项目的第一个具体目标，即，到 评估肥胖、体重减轻、害怕摔倒、缺乏行走的影响， 和较低的工具性日常生活活动（ADL）功能， 随后的跌倒、过度住院和基础ADL依赖性增加; 以及这些因素对死亡率的影响。第二个方向涉及 招募并评估了一批新的1200名年轻的非裔美国人 来自圣路易斯大都市的人数据收集 将包括第1和第4波的家庭评估， 波2，3和5，还将涉及身体的详细评估 在波1和波4时，组合物和肌肉强度为25%。调查人员 声明来自这一新队列的数据将允许追求特定目标2， 3，即，肌肉减少症的发展时间、前兆和后果 (Aim 2）和亚临床残疾（目标3）。广泛的数据验证和 将进行内部可靠性和有效性研究。初级分析 方法包括预测福尔斯的事件历史模型、事件基本ADL 依赖性、住院率和死亡率，以及 在新队列中发生亚临床残疾和功能限制， 调整重要协变量。次要分析（例如，研究涉及 害怕跌倒，骨矿物质代谢，脱水的不良影响， 肾功能不全和仰卧至站立转移）也将继续进行。