MEASURING COGNITIVELY ACTIVE LIFE EXPECTANCY

描述(申请人摘要)：描述认知的方法论 使用二级和行政数据集的老年人落后于 评估身体机能的措施。然而，由于相互关联， 身体活动预期寿命(P-ALE)和认知完好寿命 预期(C-ALE)，很难调查导致 差异总预期寿命(T-ALE)未改善 C-ALE的应对措施。使用二次数据评估认知表现 在物理评估方面提出了前所未有的挑战 限制。在这项研究中，我们将定义和验证C-ALE的衡量标准。至 为此，我们将使用两个基于人口的数据集，这两个数据集都由 国家老龄研究所(NIA)，一个开发适合的认知测量方法 用于分析二次数据，并用于验证这些数据。第一 人口，由1984年以来的10,887名社区居民组成， 1989年或1994年全国长期护理调查与其各自的 医疗保险索赔，将被用来制定措施。初步措施将重点放在 关于可能包含直接或间接的三类调查问题 有关认知状态的信息：痴呆症、“衰老”或 阿尔茨海默病；认知筛查测试的表现；以及其他 包含与内存相关的信息的问题。使用Medicare ICD-9-CM 关于NLTCS人口的代码，我们将创建与Medicare派生的变量 保持临床相关性和变量与适当的折叠类别 用于检查与临床上不太详细的NLTCS调查数据的一致性。 第二个人口，包括大约2,200个原始人口的数据 哥伦比亚华盛顿高地因伍德博物馆的参与者和2,000名新参与者 老龄化项目(WHICAP)将用于验证认知测量 在NLTCS人群上开发，有和没有他们各自的医疗保险 诊断。WHICAP是一项纵向的、基于社区的、多种族的研究 痴呆症和老龄化与年度随访，包括一组 神经心理测试.对有异常者的医学检查 认知；实验室，核磁共振和尸检数据。我们将发展多元化 预测基线认知状态、C-ALE和认知衰退的模型 在跟踪调查人口统计、社会经济、功能、合并症 条件和疾病风险变量。我们经过验证的痴呆症测量方法和 认知将被用来评估基线认知之间的关系 功能，C-ALE，以及随后的卫生保健使用和支出模式。 我们将报告可用于通知设计和数据的调查结果 未来预期进行的认知相关变量的收集 调查。

DESCRIPTION (Applicant's abstract): Methodologies to characterize cognition in the elderly using secondary and administrative data sets lag behind those for measures assessing physical function. However, because of the inter-relatedness of physically active life expectancy (P-ALE) and cognitively-intact life expectancy (C-ALE), it is difficult to investigate mechanisms contributing to differential total active life expectancy (T-ALE) without having improved measures for C-ALE. Assessing cognitive performance using secondary data presents challenges that are unparalleled in assessments of physical limitations. In this study, we will define and validate measures for C-ALE. To do this, we will employ two population-based data sets, both funded by the National Institute on Aging (NIA), one to develop cognitive measures suitable for use in analyses of secondary data and one to validate them. The first population, consisting of 10,887 community-dwelling participants from the 1984, 1989, or 1994 National Long Term Care Surveys linked to their respective Medicare claims, will be used to develop measures. Initial measures will focus on three categories of survey questions that may contain direct or indirect information on cognitive status: Rank reports of dementia, "senility," or Alzheimer's disease; performance on cognitive screening tests; and other questions that contain memory-related information. Using Medicare ICD-9-CM codes on the NLTCS population, we will create Medicare-derived variables that maintain clinical relevance and variables with collapsed categories suitable for examining correspondence with less clinically-detailed NLTCS survey data. The second population, consisting of data on approximately 2,200 original participants and 2,000 new enrollees of the Washington Heights Inwood Columbia Aging Project (WHICAP), will be used to validate the cognitive measures developed on the NLTCS population, with and without their respective Medicare diagnoses. WHICAP is a longitudinal, community-based, multiethnic study of dementia and aging with annual follow-up, including a battery of neuropsychological tests; medical examinations for those with abnormal cognition; laboratory, MRI, and autopsy data. We will develop multivariate models for predicting baseline cognitive status, C-ALE, and cognitive decline during follow-up investigating demographic, socioeconomic, function, comorbid conditions, and disease risk variables. Our validated measures of dementia and cognition will be used to assess the relation between baseline cognitive function, C-ALE, and subsequent patterns of health care use and expenditures. We will report findings that could be used to inform the design and data collection of cognitively-related variables in future prospectively conducted surveys.