RC2 - The Vulnerable Aging Research Core (VARC)

项目摘要-脆弱老龄化研究核心(VARC) 脆弱老龄化研究核心(VARC)支持OAIC调查人员进行初步数据收集 包括脆弱的老年人在内的研究。老年人在研究中的比例严重偏低。这 对于有医疗脆弱性(例如，认知能力)的老年人来说，代表性不足的情况更加明显 损害和复杂的多种疾病)和/或社会脆弱性(例如，孤立、贫穷、有限的健康 识字、无家可归)。这些医疗和社会脆弱性往往共存并相互作用，从而产生 对疾病的发病率、进展、结果和对卫生干预措施的反应产生深远影响。然而，年龄更大了 有这些弱点的成年人往往很难招募和留住，对他们的代表性产生了不利影响 在研究和损害我们的知识，如何最好地优化他们的护理。加州大学洛杉矶分校的胡椒中心有一个 在招募、保留和保护医疗和社会方面的专业知识方面享有国际声誉 研究中的弱势老年人，包括社区参与的研究、前瞻性研究和 随机试验。自VARC成立以来，OAIC调查人员从事初级工作的人数 医疗和社会弱势老年人的数据收集继续呈指数级增长，情况也是如此 我们为调查人员提供的服务。我们提出以下目标：(1)为以下方面提供专家咨询 主要数据收集研究的设计，侧重于患有医疗和/或社会疾病的老年人 脆弱性，包括人的主体考虑；(2)支持OAIC附属调查人员的方法 招募、同意、登记和留住弱势老年人，包括召集和维持 社区咨询委员会；(3)支持OAIC调查员制定和测试干预措施的方法 对弱势老年人的需求和优先事项作出反应；(4)就纳入 医疗和社会脆弱性的预测因素和结果衡量标准(例如，认知障碍、虚弱、健康 识字、贫穷、社会孤立)，与数据和分析核心合作；和(5)支持 在我们核心的主题领域推进新方法开发的开发项目。我们 提出一个新的开发项目，以开发融合定性和混合的创新方法 方法通过涉及残疾老年人及其护理伙伴和临床医生的研究获得数据。这个 VARC还将支持星级外部调查人员，他们的研究涉及招聘和留住 脆弱的老年人。拟议的外部项目包括由NIA资助的探索长期障碍的研究 老年阿尔茨海默病及相关痴呆症患者的社会支持服务及其影响 新的决策支持工具，帮助老年人与临床医生讨论糖尿病药物停药。

PROJECT SUMMARY ABSTRACT — Vulnerable Aging Research Core (VARC) The Vulnerable Aging Research Core (VARC) supports OAIC investigators conducting primary data collection studies that include vulnerable older adults. Older adults are vastly underrepresented in research. This underrepresentation is even more pronounced for older adults with medical vulnerability (e.g., cognitive impairment and complex multi-morbidity) and/or social vulnerability (e.g., isolation, poverty, limited health literacy, homelessness). These medical and social vulnerabilities often coexist and interact to produce profound effects on disease incidence, progression, outcomes, and response to health interventions. Yet, older adults with these vulnerabilities are often difficult to recruit and retain, adversely affecting their representation in research and impairing our knowledge of how best to optimize their care. The UCSF Pepper Center has an international reputation for expertise in the recruitment, retention, and protection of medically and socially vulnerable older adults in research including in community-engaged research, prospective studies, and randomized trials. Since the VARC's inception last cycle, the number of OAIC investigators engaged in primary data collection of medically and socially vulnerable older adults has continued to grow exponentially, as have the services we provide to investigators. We propose the following aims: (1) Provide expert consultation for the design of primary data collection studies that focus on older adults with medical and/or social vulnerabilities, including human subject considerations; (2) Support OAIC-affiliated investigators on methods for recruiting, consenting, enrolling, and retaining vulnerable older adults, including convening and maintaining community advisory boards; (3) Support OAIC investigators on methods to develop and test interventions that are responsive to the needs and priorities of vulnerable older adults; (4) Advise on the incorporation of predictor and outcome measures of medical and social vulnerability (e.g., cognitive impairment, frailty, health literacy, poverty, social isolation) in collaboration with the Data and Analysis Core; and (5) Support Development Projects that advance the development of new methodologies in our Core's theme area. We propose a novel Development Project to develop innovative methods for merging qualitative and mixed methods data across studies involving older adults with disability and their care partners and clinicians. The VARC will also support stellar external investigators whose research involves recruiting and retaining vulnerable older adults. Proposed external projects include NIA-funded studies exploring barriers to long-term social support services for older adults with Alzheimer's Disease and Related Dementias and the effects of a novel decision support tool to help older adults discuss diabetes medication deprescribing with clinicians.