VARIATIONS IN FUNCTIONING IN AN AGING POPULATION

随着人口的增长和寿命的延长， 美国老年人，医疗保健和社会服务的提供者， 遇到越来越多的人，他们的功能是 受损 制定有效的干预措施， 在处理这些限制的实际需要彻底 了解他们的决定因素。 虽然越来越多的 随着年龄的增长，慢性病的患病率肯定是一个主要的 之前的研究表明，无论是疾病还是年龄， 完全决定了老年人的日常生活 活动或他们的总体福祉。 社会和心理 这些因素可能起着重要作用，但这些因素如何解释 与年龄相关的功能状态和幸福感差异 会理解的。 原因在于，解释性社会研究 和心理因素没有充分控制 存在慢性医学和精神疾病，或 其严重程度的差异。 我们建议分析正在收集的数据， 研究，医学结局研究（MOS），以探索 老年人健康状况个体差异的原因 以及患有一种或多种慢性疾病的中年人。 四 将研究健康状况的各个方面：临床状况， 在日常活动中发挥作用，一般福祉， mortality. 我们假设某个时间点的健康状况 以及在以下时间段内向更好或更坏状态转变的概率 一年和两年的间隔受到可识别和 可测量的社会环境和心理因素。 多元回归方法将被用来检验这一假设 同时控制社会人口和经济 特征、个人健康实践和医疗状况 （诊断、疾病严重程度和合并症） 基线。 MOS具有测量和隔离主要 影响结果的社会和心理因素， 优势：健康成果计量的广度和深度; 主要结局和解释性的有效措施 变量; 2年内重复测量;以及 对医疗状况进行全面的基线评估。 大 横截面（N-22，785）和纵向（N-2546）样本 可供分析。 研究参与者的年龄范围从18- 108岁; 75%的纵向样本为45岁及以上; 37% 65岁及以上。

With the growth and increasing longevity of the population of older Americans, providers of health care and social services will encounter increasing numbers of persons whose functioning is impaired. Development of interventions that are effective and practical in dealing with these limitations requires thorough understanding of their determinants. Although the increasing prevalence of chronic disease with age is certain to be a major factor, prior research suggests that neither disease nor age completely determines how well the elderly function in everyday activities or their general well-being. Social and psychological factors may play an important role, but how well these explain age-related differences in functional status and well-being is not will understood. The reason is that studies of explanatory social and psychological factors have not adequately controlled for the presence of chronic medical and psychiatric conditions, or for differences in their severity. We propose to analyze data being collected for an ongoing investigation, the Medical Outcomes Study (MOS), to explore the reasons for individual variations in health status among elderly and middle-aged adults with one or more chronic conditions. Four aspects of health status will be studied: clinical status, functioning in everyday activities, general well-being, and mortality. We hypothesize that health status at a point in time and the probability of transitions to better or worse states over one and two-year intervals are affected by identifiable and measureable social circumstances and psychological factors. Multiple regression methods will be used to test this hypothesis while controlling for sociodemographic and economic characteristics, personal health practices, and medical condition (diagnosis, disease severity, and comorbidity) measured at baseline. The MOS has the capability to measure and isolate the principal social and psychological factors affecting outcome because of its strengths: breadth and depth of measures of health outcomes; well-validated measures of major outcome and explanatory variables; repeated measurements over a 2-year period; and thorough baseline assessments of medical conditions. Large cross-sectional (N-22,785) and longitudinal (N-2546) samples are available for analysis. Study participants range in age from 18- 108 years; 75% of the longitudinal sample are 45 and older; 37% are 65 and older.