Prognostic Significance of Family Caregiver Factors for Older Adult Health Events

家庭照顾者因素对老年人健康事件的预后意义

• 批准号: 9519773
• 负责人: Jennifer L. Wolff
• 金额: $ 33.03万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9519773
• 关键词: Adverse event; Affect; Age; Aging; American; Bathing; Budgets; Calibration; Clinical; Cognitive; Communities; Complement; Computer software; Computerized Medical Record; Consequentialism; Data Collection; Data Set; Demographic Aging; Diffusion; Disabled Persons; Discrimination; Eating; Economics; Elderly; Event; Family Caregiver; Family Characteristics; Future; Gender; Health; Health Status; Healthcare; Home environment; Hospitalization; Individual; Inpatients; Intervention; Knowledge; Light; Link; Long-Term Care; Measures; Medicare claim; Medicare/Medicaid; Nursing Homes; Outcome; Performance; Play; Policies; Policy Developments; Population; Predictive Factor; Predictive Value; Preventive service; Public Health; Reporting; Rewards; Risk; Risk Factors; Role; Self Care; Services; Sterile coverings; Surveys; Time; Translating; Vital Statistics; Work; base; care delivery; caregiving; clinical decision-making; clinical practice; disability; economic value; electronic data; experience; high risk population; improved; indexing; insight; mortality; novel; nursing home length of stay; payment; population based; predictive modeling; prognostic; prognostic significance; programs; public health relevance; social; targeted treatment; tool; trend

 DESCRIPTION (provided by applicant): Growing numbers of disabled older adults with extensive health needs and persistent concerns about the sustainability of health care entitlement programs make efficient targeting of services to those who will most benefit a high priority. Most disabled older adults live at home and receive assistance from family caregivers. There is strong evidence that family caregivers play an instrumental role to disabled older adults' risk for a range of adverse health events. Although specific characteristics of family caregivers are likely to affect the extent to which adverse events among disabled older adults are experienced, robust evidence is lacking. Because disabled older adults have exceedingly high rates of adverse health events, such evidence could illuminate a potentially powerful but under-recognized domain of risk for a high-risk population. Risk prediction tools ("prognostic models") are widely used to identify individuals who are at risk for adverse health events, and in turn, to guide clinical decision-making and targeting of therapeutic and preventive services. Existing tools incorporate extensive measures of biomedical risk but do not include information reported by family caregivers. In this study, we will draw on national surveys of disabled older adult-family caregiver dyads to comprehensively and systematically elucidate the potential significance of family caregiver factors to disabled older adults' risk for diverse and consequential adverse health events that are of both fiscal and public health importance. In Aim 1, we determine whether and which family caregiver factors predict disabled older adults' future risk of all-cause hospitalization, long-stay nursing home entry, and mortality, controlling for disabled older adult risk factors. In Aim 2, we identify a reduced set of measures that could be efficiently used for risk prediction. We develop two prognostic models for each outcome that include: (1) disabled older adult factors only, and (2) disabled older adult and family caregiver factors. By comparing performance of the two prognostic indices, we will identify the predictive benefit of incorporating information from family caregivers to complement traditional assessments of disabled older adults. To accomplish this work we will construct a unique population-based dataset with information on social, economic, cognitive, health, and interpersonal domains of risk reported by 3,023 disabled older adult-family caregiver dyads who responded to linked nationally representative disability and family caregiver surveys (the 1999 and 2004 National Long-Term Care Surveys, and 2011 National Health and Aging Trends Study). All three survey waves will be linked to Medicare claims, Minimum Data Set assessments, and mortality/vital statistics files, which will contribute longitudinal information o older adults' health events. Together, these study aims will fill provide new knowledge regarding the relevance of family caregiver factors to diverse and consequential events among disabled older adults, as well as develop practical tools to translate this knowledge into clinical practice

 描述（由适用提供）：越来越多的残疾老年人拥有广泛的健康需求，并且对医疗保健权利计划的可持续性的持续关注，使服务有效地针对那些最优先的人的服务。大多数残疾人的老年人住在家里，并获得家庭护理人员的帮助。有充分的证据表明，家庭护理人员在残疾老年人对家庭护理人员的特定特征的风险中发挥了重要作用，可能会影响残疾老年人不良事件的经历，缺乏强大的证据。由于残疾老年人的健康事件发生率极高，因此这种证据可能会阐明潜在的强大但被识别的高风险人群风险领域。风险预测工具（“预后模型”）被广泛用于识别有不良健康事件风险的人，进而指导临床决策和靶向热服务和预防服务。现有工具包含广泛的生物医学风险措施，但不包括家庭护理人员报告的信息。在这项研究中，我们将借鉴对残疾老年人家庭护理人员二元组的全国调查，以全面，系统地阐明家庭护理人员因素因残疾老年人对潜水员的风险和后果不良健康事件的潜在意义，这些事件具有财政和公共卫生的重要性。在AIM 1中，我们确定哪些家庭护理人员是否可以预测残疾老年人的未来住院，长期护理房屋入境和死亡率的未来风险，控制着残疾的老年人危险因素。在AIM 2中，我们确定了一组可有效用于风险预测的措施集。我们为每个结果开发了两个预后模型，其中包括：（1）仅残疾老年人因素，以及（2）残疾的老年人和家庭护理人员因素。通过比较两个预后指数的表现，我们将确定将家庭护理人员的信息纳入传统评估残疾老年人的预测好处。为了完成这项工作，我们将构建一个基于人群的独特数据集，其中包含有关3,023家残疾人报告的社会，经济，认知，健康和人际风险领域的信息，使老年人与家庭护理人员二手体能够回应有关国家代表性的残疾和家庭护理人员的纽带（1999年和2004年的《国家长期护理》和《国家长期护理Surves》和2011年国民健康和2011年国家健康和艾格林趋势。所有三个调查浪潮都将与Medicare索赔，最低数据集评估以及死亡率/重要统计文件有关，这将为老年人的健康事件提供纵向信息。这些研究的目标将填充有关家庭护理人员因素与潜水员和残疾人老年人的后果事件的相关性的新知识，并开发了将这些知识转化为临床实践的实用工具

项目成果

Corrigendum: Change Over Time in Caregiving Networks for Older Adults With and Without Dementia.

勘误表：患有和不患有痴呆症的老年人的护理网络随时间的变化。

• DOI: 10.1093/geronb/gbz105
• 发表时间: 2020
• 期刊: The journals of gerontology. Series B, Psychological sciences and social sciences
• 作者: Spillman,BrendaC;Freedman,VickiA;Kasper,JudithD;Wolff,JenniferL
• 通讯作者: Wolff,JenniferL