Exploring Paths to Differential Disability Trajectories

描述（由申请人提供）：本研究的目的是研究导致晚年长期残疾轨迹的因果途径。该项目将增强我们对老年人如何随着时间的推移而经历残疾的理解，并将探索在美国这一年龄组中观察到的残疾下降的机制。人口和社会经济因素对残疾水平和过渡都有很高的预测作用。此外，个体内部特征和个体外因素被假设可以减轻这些关系，尽管这些影响很少被测试。使用以生命历程为中心的方法和已知的残疾过程理论，我将首先使用潜在类别分析来确定最能预测老年人不同残疾轨迹的慢性疾病。接下来，我将结合潜在生长曲线的使用来测试从疾病到残疾的途径中个体内特征和个体外因素的影响。最后，我将使用事件历史分析来探索死亡率作为一种选择性和竞争性力量的作用，与残疾相比，随着时间的推移。在这个项目中，队列的影响将是最重要的，因为这些影响说明了助长残疾下降趋势的因素。

DESCRIPTION (provided by applicant): The objective of this research is to examine the causal pathways leading to long term disability trajectories in later life. The project will enhance our understanding of how older adults experience disability differentially over time and will explore the mechanisms at work in the observed disability declines in the U.S. among this age group. Demographic and socioeconomic factors are highly predictive of both disability level and transition. In addition, intra-individual characteristics and extra-individual factors are hypothesized to mitigate these relationships, although these effects have rarely been tested. Using a life course centered approach and known theory on the disablement process, I will first use latent class analysis to determine the chronic conditions most predictive of differential disability trajectories in older adulthood. Next, I will incorporate the use of latent growth curves to test the effects of intra-individual characteristics and extra-individual factors in the pathway from disease to disability. Finally, I will use event history analysis to explore the role of mortality both as a selective and competing force in comparison to disability over time. The effects of cohort will be of primary importance in this project, since these effects speak to factors fueling trends in disability decline.