Aging in place for older adults with cancer: The role of physical function and home environment

项目概要和摘要 该奖项将支持詹森-巴塔利亚博士的长期目标，即发展所需的专业知识和技能， 成为一名独立的研究者，探索身体功能和环境在 老年癌症患者的健康状况。到2050年，20%的新癌症诊断将发生在这些年龄段 80岁或以上，包括全球估计690万例病例。美国的大多数老年人 州（美国）当他们变老时更喜欢留在他们的家中（即，“年龄到位”），这与健康有关 效益相反，不支持的邻里环境和住宅搬迁是相关的 伴随着医疗保健利用的增加、存活率的降低和福尔斯。虽然身体功能的损伤 是常见的和高度可变的，我们还不知道老年癌症患者是否有更大的风险， 与那些没有癌症的人相比，由于这些缺陷而导致的住宅搬迁。无论是消极 与搬迁相关的健康结果，如医疗保健利用率、死亡率和福尔斯， 搬迁本身或相关的邻里环境变化仍不清楚。詹森-巴塔利亚博士 我将通过前瞻性地评估 美国社区居住老年人的身体功能障碍和住宅搬迁， 并研究癌症患者与非癌症患者之间的这种关联有何不同。 此外，她还将评估住宅搬迁如何改变邻里环境的影响， 癌症患者的未来健康对于F99阶段，Jensen-Battaglia博士将利用来自全国范围内的数据， 美国医疗保险受益人的代表性样本[国家健康和老龄化趋势研究（NHATS）]， 完善一种新的运动相关的身体功能的测量方法，评估这是否与增加的 居民搬迁的风险，并评估癌症诊断是否积极改变这种关系。她还将 探索与移动相关的身体功能和住宅搬迁之间的关系如何在不同的 家庭环境和癌症类型。对于K 00阶段，她将创建一个数据集，将NHATS与 医疗保险索赔和基于地区的措施，并评估是否住宅搬迁积极修改的影响 恶化（与稳定或改善相比）的邻里环境对癌症相关健康的支持 成果。詹森-巴塔利亚博士与她的赞助商密切合作，制定了一项培训计划， 支持博士前研究项目的顺利完成，并顺利过渡到一个有竞争力的， 以癌症为中心的博士后安置。这包括培训，以提高患者的癌症护理知识 经验，获得住宅搬迁动态分析的专业知识，并确定博士后导师。 总之，拟议的研究和培训计划为詹森博士提供了最佳的机会和结构- 巴塔利亚发展新的技能和进展，成为一个独立的癌症研究人员。

Project Summary and Abstract This award will support Dr. Jensen-Battaglia’s long-term goal of developing the expertise and skills needed to become an independent investigator exploring the overlapping roles of physical function and environment in health outcomes for older adults with cancer. By 2050, 20% of new cancer diagnoses will be among those age 80 or older, comprising an estimated 6.9 million cases worldwide. The majority of older adults in the United States (U.S.) prefer to remain in their homes as they age (i.e., ‘age in place’), which is associated with health benefits. Conversely, both unsupportive neighborhood environment and residential relocation are associated with increased healthcare utilization, decreased survival, and falls. Although impairments in physical function are common and highly modifiable, we do not yet know if older adults with cancer are at greater risk for residential relocation as a result of these impairments compared to those without cancer. Whether negative health outcomes such as healthcare utilization, mortality, and falls associated with relocation are due to relocation itself or associated changes in the neighborhood environment remains unclear. Dr. Jensen-Battaglia will address these gaps in her proposed project by prospectively evaluating the association between impairments in physical function and residential relocation among community dwelling older adults in the U.S., and examining how this association differs for those with cancer compared to those without cancer. Additionally, she will assess how residential relocation modifies the effect of neighborhood environment on future health for those with cancer. For the F99 phase, Dr. Jensen-Battaglia will leverage data from a nationally representative sample of U.S. Medicare beneficiaries [National Health and Aging Trends Study (NHATS)] to refine a novel measure of mobility-related physical function, assess whether this is associated with increased risk of residential relocation, and evaluate if cancer diagnosis positively modifies this relationship. She will also explore how the relationship between mobility-related physical function and residential relocation differs across home environments and cancer types. For the K00 phase, she will create a dataset linking the NHATS with Medicare claims and area-based measures, and evaluate if residential relocation positively modifies the effect of worsening (compared to stable or improving) neighborhood environment supports on cancer-related health outcomes. Dr. Jensen-Battaglia has worked closely with her sponsors to develop a training plan which supports successful completion of the predoctoral research project and smooth transition to a competitive, cancer-focused postdoctoral placement. This includes training to improve knowledge of the patient cancer care experience, obtain expertise in analysis of residential relocation dynamics, and identify a postdoctoral mentor. Together, the proposed research and training plan provide optimal opportunities and structure for Dr. Jensen- Battaglia to develop new skills and progress toward becoming an independent cancer researcher.