Relationship of Frailty to Multimorbidity and Disability

描述（由申请人提供）：拟议研究的总体目标是使用具有全国代表性的健康访谈调查数据，即2004年健康与退休研究（HRS）浪潮，调查老年人的虚弱状况。利用HRS中最新提供的物理性能测量，该研究将使Fried等人开发的脆弱表型操作化。然后，研究将把弗里德模型与其他虚弱模型进行比较；检查虚弱与老年人其他临床特征（多病、认知障碍、残疾）的关系；并检查与这些特征相关的使用模式和成本结果。提出的研究将评估三个假设：(1)HRS中虚弱的患病率与心血管健康研究（CHS）中的患病率相似，CHS是首次操作Fried虚弱表型的人群样本。(2)自我报告度量可以代替绩效度量作为定义弱点的标准。(3)体弱多病人群与多病人群、残障人群虽然存在重叠，但三者具有明显的差异性，其医疗保健利用模式和成本也各不相同。拟议的研究将是一个更全面的研究的第一步，该研究将纳入相关的医疗保险索赔数据和纵向调查数据。

DESCRIPTION (provided by applicant): The overall goal of the proposed research is to use nationally representative health interview survey data, the 2004 wave of the Health and Retirement Study (HRS), to investigate frailty in older adults. Using physical performance measures newly available in the HRS, the research will operationalize the frailty phenotype developed by Fried et al. The research will then compare the Fried model to other models of frailty; examine the association of frailty with other defining clinical characteristics of older adults (multimorbidity, cognitive impairment, disability); and examine utilization patterns and cost outcomes associated with these characteristics. The proposed research will evaluate three hypotheses: (1) the prevalence of frailty in the HRS is similar to that in the Cardiovascular Health Study (CHS), the population sample in which the Fried frailty phenotype was first operationalized. (2) Self-report measures may substitute for performance measures as frailty-defining criteria. (3) Although the frail population overlaps with populations with multimorbidity and with disability, nonetheless, the three are distinct, with distinct health care utilization patterns and costs. The proposed research will be an initial step to a more comprehensive study that will incorporate linked Medicare claims data and longitudinal survey data.