National Study of Disability Trends and Dynamics

描述(由申请人提供)：本申请建议设计、测试、实地和传播一项新的全国残疾趋势和动态研究(NSDTD)，以：(I)促进对晚年残疾趋势和动态、其前因和相关性以及其中差异的科学调查，以及(Ii)推进晚年残疾对个人、家庭和社会的社会和经济后果的研究。为了实现这些目标，一个在残疾测量、调查设计和操作以及传播方面有经验的多学科联盟将：(1)使用最先进的调查方法设计和测试：(A)一个全面、有效的残疾测量方案，其中包括自我报告和基于绩效的功能测量；允许将活动限制分解为损害、环境和补偿战略；并包括社会参与的测量；(B)评估残疾与健康状况治疗和自我护理战略的相互作用的问题；(C)关于残疾的主要经济和社会后果的问题，包括生活和护理安排、医疗和长期护理支出以及经济福祉和生活质量的其他方面；(D)与现有调查基本协调一致的措施，以便于调查种族/族裔和社会经济差异以及其他关键风险因素在趋势和轨迹中的干预作用；(E)将随机分配给受访者分组的单元，以便在全国残疾调查和其他主要调查中确定残疾衡量标准。(2)亲自从1.2万名65岁及以上的联邦医疗保险参保人中收集数据，每年重新调查一次，并每隔5年更新一次样本。(3)开展方法学研究，以验证增强残疾议定书，为补充生物标志物奠定基础，并提高数据收集的质量和效率。(4)执行外部调查员提出新的数据收集模块的程序。(5)提供与死亡率数据和外部数据库的链接，以便能够分析与残疾和长期护理相关的公共方案支出、医疗和长期护理系统的流动情况、医疗和长期护理的供应和质量以及公共长期护理政策的作用。(6)清理、记录和传播公共使用和受限数据文件。将高度重视及时分发高质量、方便用户和文件齐全的数据文件，并建立广泛的用户基础。公共卫生相关性NSDTD将成为科学研究的平台，以指导减少残疾、最大限度地发挥功能和提高老年人的生活质量的努力。它将促进设计多因素干预措施以减少晚年残疾的研究，并将支持对残疾进程的结果进行全面建模，包括生活和护理安排、支出、经济福祉和生活质量。

DESCRIPTION (provided by applicant): This application proposes to design, test, field, and disseminate a new National Study of Disability Trends and Dynamics (NSDTD) to: (I) promote scientific inquiry into late-life disability trends and dynamics, their antecedents and correlates, and disparities therein, and (II) advance study of the social and economic consequences of late-life disability for individuals, families, and society. To achieve these aims, a multidisciplinary consortium with experience in disability measurement, survey design and operations, and dissemination will: (1) Design and test, using state-of-the-art survey methodology: (a) a comprehensive, validated disability measurement protocol that includes self-report and performance-based measures of functioning; allows disaggregation of activity limitations into impairments, the environment, and compensatory strategies; and includes measures of social participation; (b) questions to assess the interplay of disablement with treatment of health conditions and self-care strategies; (c) questions on key economic and social consequences of disability including living and care arrangements, medical and long-term care expenditures, and other aspects of economic well-being and quality of life; (d) measures, largely harmonized with existing surveys, to allow investigation of racial/ethnic and socioeconomic disparities and the intervening role of other key risk factors in trends and trajectories; and (e) modules that will be randomly assigned to subgroups of respondents that will allow cross-walks to disability measures in the NLTCS and other major surveys. (2) Collect data in person from a sample of 12,000 Medicare enrollees ages 65 and older, resurvey them at annual intervals, and refresh the sample at 5-year intervals. (3) Conduct methodological studies to validate the enhanced disability protocol, lay the groundwork for a biomarker supplement, and improve the quality and efficiency of data collection. (4) Implement a process whereby external investigators propose new data collection modules. (5) Provide linkages to mortality data and external databases that enable analyses of disability and long-term care related public program expenditures, movement through the medical and long-term care system, the supply and quality of medical and long-term care, and the role of public long-term care policies. (6) Clean, document, and disseminate public use and restricted data files. A high priority will be placed on timely distribution of high-quality, user-friendly, and well-documented data files and on building a broad user base. PUBLIC HEALTH RELEVANCE The NSDTD will be a platform for scientific inquiry to guide efforts to reduce disability, maximize functioning, and enhance older adults' quality of life. It will foster research to design multi-factor interventions to reduce late-life disability, and will support comprehensive modeling of outcomes of the disablement process including living and care arrangements, expenditures, economic well-being, and quality of life.