Geriatric Conditions and Disablement in the Older Adult Population

老年人口的老年病和残疾

• 批准号: 8044584
• 负责人: CHRISTINE T CIGOLLE
• 金额: $ 12.77万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8044584
• 关键词: Geriatric; Conditions; Disablement; Older; Adult

DESCRIPTION (provided by applicant): Geriatric conditions, although frequently unrecognized and overlooked, are important contributors to the health status of older adults. However, geriatric conditions as a group, in contrast to diseases, have not been clearly located within current models of disability development and progression. Rather, conditions appear to operate and interact at multiple points in these models. Christine Cigolle, M.D., M.P.H. proposes to investigate the place of geriatric conditions in the disablement pathway in older adults for the Mentored Clinical Scientist Research Career Development Award (K08). Dr. Cigolle is an Assistant Professors in the Departments of Family Medicine and Internal Medicine at the University of Michigan (UM) Medical School, with appointments in the Institute of Gerontology (UM) and the VA Ann Arbor Healthcare System Geriatrics Research, Education and Clinical Center (GRECC). Her previous cross-sectional research has demonstrated the prevalence and the disability association of geriatric conditions among older adults. Funded by a NIH-NCRR KL2 Mentored Clinical Scholars Award (UM), she investigated how geriatric conditions and chronic diseases group together in older adults using latent class analysis. Her research for the KL2 Award lays the foundation for the research aims and methodologies in her K08 proposal. The overall goal of the proposed research for the K08 Award is to investigate the place of geriatric conditions in the disablement pathway in the older adult population. The research will examine five geriatric conditions: dementia, falls, urinary incontinence, poor nutrition, and multisensory impairment. The research will propose a conceptual model in which geriatric conditions share common risk factors, have an accelerated trajectory of accumulation in older adults, and result in common outcomes (e.g., disability). The research will test this model, --first, by examining the incidence and longitudinal course of geriatric conditions (individually and in aggregate), beginning with adults in middle age and extending to the oldest old; and --second, by examining geriatric conditions as a predictor of disability (taking mortality into account as a competing outcome). By investigating how geriatric conditions begin, accumulate, and co-occur in older adults over time, the proposed research aims to add new knowledge about the place of geriatric conditions in the disablement pathway and thus to contribute to ongoing efforts to link the conditions theoretically. The proposed research will utilize unique longitudinal data from the Health and Retirement Study (HRS), a nationally-representative health interview survey, and data from the HRS supplemental Aging, Demographics, and Memory Study (ADAMS). It will also make use of newly available Medicare administrative data linked to the HRS and ADAMS to further specify conditions and diseases (diagnosis codes). Dr. Cigolle's career goal is to become an independent researcher in academic Family Medicine, focusing on older adult health status, especially geriatric conditions and syndromes and disability. Her future research methods will focus on implementation and analysis of large epidemiologic studies of older adults. The research and career development training in the K08 Award proposal are designed to support both (1) the acquisition of advanced methodological skills and expertise in the epidemiology of geriatric conditions and (2) training in the design and implementation of primary data collection for large epidemiologic studies of older adults. Her mentorship team for the K08 Award proposal includes: Primary Mentor Jersey Liang, Ph.D., Professor, Department of Health Management and Policy, School of Public Health; Co-Mentor Caroline S. Blaum, M.D., M.S., Professor, Division of Geriatrics, Department of Internal Medicine; and Co-Mentor Kenneth Langa, M.D., Ph.D., Professor, Division of General Internal Medicine, Department of Internal Medicine. Specific career development training activities include: --training in advanced statistical methodologies, including longitudinal analysis, latent trajectory analysis, hierarchical linear modeling, and survival analysis via tutorials with mentors and classwork through the Institute for Social Research and School of Public Health at the University of Michigan, --training in the use of Medicare administrative data via tutorials with mentors and course attendance at CMS 101: Introduction to the Use of Medicare Data for Research (Basic Workshop in Medicare Administrative Data) through the Research Data Assistance Center (ResDAC) at the University of Minnesota, and --training in primary data collection for large epidemiologic studies of older adults via participation in the NIA- funded ADAMS pilot study (National Trends in Brain Health) (Mentor: Langa), development of an experimental module on geriatric conditions to be submitted for consideration for fielding in the 2014 wave of the HRS (Mentor: Langa), and involvement in the Comparative Aging Research Program (Mentor: Liang). PUBLIC HEALTH RELEVANCE: This research investigates how older adults acquire geriatric conditions, such as falls and urinary incontinence, and how these conditions cause older adults to become disabled. Understanding the early development of geriatric conditions can lead to interventions to prevent or delay them.

描述（由申请人提供）：老年疾病虽然常常未被认识和忽视，但却是老年人健康状况的重要影响因素。然而，与疾病相比，老年病作为一个群体，在当前的残疾发展和进展模型中尚未明确定位。相反，条件似乎在这些模型的多个点上运行和相互作用。 Christine Cigolle，医学博士、公共卫生硕士提议调查老年疾病在老年人残疾途径中的地位，以获得指导临床科学家研究职业发展奖（K08）。 Cigolle 博士是密歇根大学 (UM) 医学院家庭医学和内科系的助理教授，并在老年学研究所 (UM) 和 VA 安娜堡医疗系统老年病学研究、教育和临床中心 (GRECC) 任职。她之前的横断面研究表明，老年人中老年疾病的患病率及其与残疾的关联。在 NIH-NCRR KL2 指导临床学者奖 (UM) 的资助下，她利用潜在类别分析研究了老年疾病和慢性疾病如何在老年人中组合在一起。她为 KL2 奖所做的研究为她的 K08 提案中的研究目标和方法奠定了基础。 K08 奖拟议研究的总体目标是调查老年疾病在老年人群残疾途径中的地位。该研究将检查五种老年疾病：痴呆、跌倒、尿失禁、营养不良和多感觉障碍。该研究将提出一个概念模型，其中老年疾病具有共同的危险因素，在老年人中具有加速的积累轨迹，并导致共同的结果（例如残疾）。该研究将测试这个模型，首先，通过检查老年疾病的发病率和纵向病程（单独的和总体的），从中年成年人开始一直延伸到最年长的老年人；其次，通过检查老年状况作为残疾的预测因素（将死亡率作为竞争结果考虑在内）。通过调查老年病如何随着时间的推移在老年人中开始、累积和共同发生，拟议的研究旨在增加关于老年病在残疾途径中的位置的新知识，从而为在理论上将这些疾病联系起来的持续努力做出贡献。 拟议的研究将利用来自健康与退休研究 (HRS)（一项全国代表性健康访谈调查）的独特纵向数据，以及来自 HRS 补充老龄化、人口统计和记忆研究 (ADAMS) 的数据。它还将利用与 HRS 和 ADAMS 关联的新可用医疗保险管理数据来进一步指定病情和疾病（诊断代码）。 Cigolle 博士的职业目标是成为学术家庭医学的独立研究员，专注于老年人的健康状况，特别是老年疾病、综合症和残疾。她未来的研究方法将侧重于老年人大型流行病学研究的实施和分析。 K08 奖提案中的研究和职业发展培训旨在支持 (1) 获得老年疾病流行病学方面的先进方法技能和专业知识，以及 (2) 设计和实施大型老年人流行病学研究的主要数据收集的培训。她的K08奖提案导师团队包括：首席导师梁泽西博士，公共卫生学院卫生管理与政策系教授；共同导师 Caroline S. Blaum，医学博士、硕士、内科老年病科教授；联合导师 Kenneth Langa，医学博士、哲学博士、内科普通内科教授。 具体的职业发展培训活动包括： - 通过密歇根大学社会研究所和公共卫生学院的教程和课堂作业，进行高级统计方法的培训，包括纵向分析、潜在轨迹分析、分层线性建模和生存分析， - 通过导师的教程和参加 CMS 101 课程，进行医疗保险行政数据的使用培训：医疗保险数据用于研究的简介（基本） 通过明尼苏达大学研究数据援助中心 (ResDAC) 举办的医疗保险管理数据讲习班），以及 - 通过参加 NIA 资助的 ADAMS 试点研究（脑健康国家趋势）（导师：Langa），对老年人大型流行病学研究的主要数据收集进行培训，开发老年疾病实验模块，以供考虑在 2014 年 HRS 浪潮中部署 （导师：Langa），并参与比较衰老研究计划（导师：Liang）。 公共健康相关性：本研究调查了老年人如何患上跌倒和尿失禁等老年疾病，以及这些疾病如何导致老年人残疾。了解老年病的早期发展可以采取干预措施来预防或延缓它们。