FLORIDA/CLEVELAND ARTHRITIS DISABILITY CASCADE STUDY

拟议的竞争更新研究旨在测试一个全面的模式 残疾的缓冲和社区生活质量的下降- 居住患有和不患有关节炎的老年人。我们将检查质量如何 由老年人承担的医疗保健和主动适应 (80+)减轻关节炎对其功能的不利影响 并帮助他们最大限度地提高生活质量。医生和病人都是 被视为护理方面的合作伙伴，具有患者响应的医疗护理 医生加强主动适应(体力活动和 环境修改)。拟议的研究将 在时间和时间上扩展我们先前由NeOMAMDC资助的纵向研究 太空。我们将获得对我们最初的长期纵向跟踪 总部设在佛罗里达州的老年队列。此外，我们将扩大我们的研究范围 来自生活在阳光地带退休的相对健康和富裕的成年人 社区现在还包括更广泛的城市老年人 和少数族裔，因此考虑到关节炎的过程- 在日益虚弱的社区人口中相关的残疾- 生活在不同种族和社会经济背景的长辈。我们会 根据对一位客户的家庭访谈收集三波年度数据 据估计，佛罗里达州有419名受访者，克利夫兰有3865名受访者。一个 预计第三年的综合样本为658名老年人。 后续行动。此外，我们将使用最小二乘回归、结构性 方程和潜在增长曲线分析来测试我们的综合 关于残疾级联缓冲的因果模型。更多 具体地说，我们将检查患者反应的缓冲效应 医疗护理和主动适应从关节炎进展到 残疾和生活质量下降。建议的调查结果 研究将对临床医生、服务提供商、政策制定者和 其他人则试图将关节炎导致的残疾降至最低，并提高 老年人的生活质量。

The proposed competitive renewal study seeks to test a comprehensive model of buffers of disability and diminished quality of life for community- dwelling elderly with and without arthritis. We will examine how quality of medical care and proactive adaptations undertaken by old-old adults (80+) lessen the adverse impact of arthritis on their ability to function and help maximize the quality of their lives. Physicians and patients are seen as partners in care, with the patient-responsive medical care of physicians enhancing the proactive adaptations (physical activity and environmental modifications) of patients. The proposed research will extend our prior NEOMAMDC-funded longitudinal study in both time and space. We will obtained a long term longitudinal follow-up of our original Florida-based elderly cohort. In addition, we will extend our research from relatively healthy and affluent adults living in sunbelt retirement communities to now also include a broader cross-section of urban elderly and racial minorities, and thereby consider the process of arthritis- related disablement in an increasingly frail population of community- living elders of diverse racial and socioeconomic backgrounds. We will collects three annual waves of data based on in-home interviews of an estimated 419 respondents in Florida and 3865 respondents in Cleveland. A combined sample of 658 elderly persons is projected for the third year follow-up. Additionally, we will use least squares regression, structural equations, and latent growth curve analysis to test our comprehensive causal model regarding buffers of the disability cascade. More specifically, we will examine the buffering effect of patient-responsive medical care and proactive adaptation on the progression from arthritis to disability and diminished quality of life. Findings from the proposed study will be useful to clinicians, service providers, policy makers, and others attempting to minimize arthritis-induced disability and enhance quality of life among the elderly.