PREDICTORS OF FUNCTIONAL ABILITY

这项提案概述了一个五年计划，以准备一个训练有素的 临床医生--在老年医学领域富有成效的学术生涯的教育者。 该计划的目标包括临床研究方面的专业知识和先进的 老年人临床护理的实践和教学技巧。 将通过精心规划的流行病学研究来实现研究目标 老年人功能能力的可能预测因素的研究 由一个杰出的多学科团队赞助进行 四位老龄化领域的学者。建议的临床和教育 目标将通过正式的课程开发活动来实现 和多层次的临床教学与实践。 拟议的三个研究项目序列将评估几个 集体功能能力的可能决定因素和后果 未来的美国老年人口。纵向健康和功能性 来自NIA-NCHS中具有代表性的美国老年人样本的数据 老龄化纵向研究(n=7541)将用于： 1.评估累积泛函的假设预测因子的可能性 通过构建四年制特定性别的数学模型来提高能力 转换的概率(在功能能力水平之间)和 以下协变量：年龄、发病率、身体损伤、活动水平 和健康信念。 2.评估功能能力与随后死亡率之间的关系 通过构建按种族和性别划分的六年数学模型 死亡率和以下协变量：年龄和功能能力。 然后将使用(1)和(2)的结果来模拟 美国老年人在功能上的依赖，这是可以预见的 1994-2044年，根据对未来四年流行情况的一系列假设 功能依赖和死亡的危险因素：发病率、身体状况 损伤、不活动和健康信念。这些研究的结果 将协助针对修改最有效的预测因子 老年人的功能能力。模拟还将指导 为照顾受扶养人制定有效的政策和计划 未来的老年人。

This proposal outlines a five-year plan for preparing a well-trained clinician-educator for a productive academic career in geriatric medicine. The goals of the plan include expertise in clinical research and advanced skills in the practice and teaching of clinical care of the elderly. Research goals will be met through a carefully planned epidemiologic investigation of possible predictors of functional ability in the elderly, conducted under the sponsorship of an outstanding multidisciplinary team of four scholars in the field of aging. Proposed clinical and educational goals will be addressed through formal curriculum development activities and multilevel clinical teaching and practice. The proposed sequence of three research projects will evaluate several possible determinants and consequences of the collective functional ability of future U.S. elderly populations. Longitudinal health and functional data from a representative sample of U.S. elders in the NIA-NCHS Longitudinal Study of Aging (n=7541) will be used to: 1.assess the potencies of hypothesized predictors of cumulative functional ability by constructing gender-specific mathematical models of four-year probabilities of transition (between levels of functional ability) and the following covariates: age, morbidity, physical impairment, activity level and health beliefs. 2.assess the relation between functional ability and subsequent mortality by constructing race- and gender-specific mathematical models of six-year mortality and the following covariates: age and functional ability. The results of (1) and (2) will then be used to simulate the number of functionally dependent U.S. elders that can be anticipated during the years 1994-2044 under a range of assumptions about future prevalences of four risk factors for functional dependency and death: morbidity,, physical impairment, inactivity, and health beliefs. The results of these studies will assist in targeting for modification the most potent predictors of functional ability in the elderly. The simulations will also guide the development of effective policies and plans for the care of the dependent elderly of the future.