EPIDEMIOLOGY OF CHRONIC DISEASE IN THE OLDEST OLD

高龄老年人慢性病的流行病学

• 批准号: 3118502
• 负责人: DOROTHY P. RICE
• 金额: $ 15.8万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-07-15 至 1994-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3118502
• 关键词: cardiovascular disorder epidemiology; chronic disease /disorder; disease /disorder prevention /control; epidemiology; health care service utilization; human morbidity; human mortality; human old age (65+); human very old age (85+); longitudinal human study; musculoskeletal disorder; neoplasm /cancer epidemiology; patient /disease registry

Declining mortality over the past several decades has contributed to an increase in the proportion of persons over 64 in the US population, especially of persons over 84, the "oldest old." Since aging is associated with an increased incidence and prevalence of chronic disease, it is likely that the demand for medical care will steadily increase in the years ahead. However, improvements in health care and reductions in risk factors may be delaying the onset of chronic disease to ages closer to death; if this is so, the interval between onset of disease and death may be compressed, resulting in a decreased demand for medical care services. Increased survival may also be leading to increases in multiple diagnoses. Comorbidity affects treatment, survival and progression of disease. It is strongly associated with changes in functional status and mortality. Comorbidity is a central fact in understanding the epidemiology of chronic diseases in the elderly. The research includes nine-year mortality, incidence and prevalence of chronic disease, and health services use in two cohorts each composed of 3,000 Kaiser members aged 65 and over in 1971 and 1980. Only members who took the Multiphasic Health Checkup (MHC) within 5 years of the baseline date can be included in the study. Information on chronic disease diagnoses, causespecific mortality, physiological and socio-demographic risk factors, and health services utilization is being obtained from computerized hospitalization and Multiphasic Health Checkup records and from medical charts. The original study hypothesis is that the period of morbidity from onset of chronic disease to death is shorter in the 1980 cohort. Duration of morbidity is shorter because the age at onset of disease is occurring later, at ages closer to death. This hypothesis will be examined for specific conditions, especially including cardiovascular diseases and cancers. In addition, the influence of cohort differences in comorbidity on survival with chronic disease win be examined. Cohort differences in the risk of additional comorbidities among those with cardiovascular or musculoskeletal diagnoses will be examined. This continuation is being requested to allow completion of the original study analyses which have been delayed by significant budget cuts and an increase in work scope. As originally proposed, this research did not include assessment of the influence of comorbidity on cohort differences.

过去几十年来死亡率的下降导致了 美国人口中 64 岁以上人口的比例增加， 尤其是84岁以上的人，即“最年长的老人”。既然衰老是 与慢性病发病率和患病率增加有关， 预计未来几年医疗需求将稳步增长 未来的岁月。 然而，医疗保健的改善和医疗费用的减少 危险因素可能会将慢性病的发病年龄推迟到更接近的年龄 至死；如果是这样，则疾病发作和死亡之间的时间间隔 可能会被压缩，导致医疗需求减少 服务。 生存率的提高也可能导致 多次诊断。 合并症影响治疗、生存和 疾病的进展。 它与以下方面的变化密切相关 功能状态和死亡率。 合并症是一个核心事实 了解老年人慢性病的流行病学。 该研究包括九年死亡率、发病率和患病率 慢性病和卫生服务使用分为两个队列，每个队列由 1971 年和 1980 年，有 3,000 名 65 岁及以上的 Kaiser 会员。 基线后 5 年内接受了多相健康检查 (MHC) 日期可以包含在研究中。 慢性病信息 诊断、特定原因死亡率、生理和社会人口统计学 风险因素和卫生服务利用情况是从 电脑化住院和多阶段健康检查记录以及 从医疗图表。 最初的研究假设是 1980 年从慢性病发病到死亡的发病率较短 队列。 发病时间较短，因为发病年龄 疾病发生的时间较晚，接近死亡的年龄。 这个假设 将检查特定条件，特别是包括 心血管疾病和癌症。 此外，影响 慢性病生存期合并症的队列差异 检查了。 其他合并症风险的队列差异 在患有心血管或肌肉骨骼疾病的患者中 检查了。 请求继续这样做是为了完成 最初的研究分析因大量预算而被推迟 削减和扩大工作范围。 正如最初提议的那样，这 研究不包括评估合并症的影响 队列差异。