National Study of Disability Trends and Dynamics

描述（由申请人提供）：本申请建议设计，测试，现场，并传播一个新的残疾趋势和动态（NSDTD）的国家研究：（一）促进科学探究晚年残疾的趋势和动态，其前因和相关因素，以及其中的差异，（二）推进研究晚年残疾对个人，家庭和社会的社会和经济后果。为实现这些目标，一个在残疾计量、调查设计和操作以及传播方面具有经验的多学科联合体将：（1）使用最先进的调查方法设计和测试：（a）全面、有效的残疾计量规程，其中包括自我报告和基于业绩的功能计量;允许将活动限制分解为障碍、环境和补偿策略;并包括社会参与措施;（B）评估残疾与健康状况治疗和自我保健战略之间相互作用的问题;（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，（d）基本上与现有调查相统一的措施，以便调查种族/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;以及（e）将随机分配给受访者分组的模块，这些模块将允许在NLTCS和其他主要调查中进行残疾测量。(2)从12，000名65岁及以上的医疗保险注册者中收集数据，每年重新调查一次，并每隔5年更新一次样本。(3)开展方法研究，以验证增强的残疾协议，为生物标志物补充奠定基础，并提高数据收集的质量和效率。(4)实施一个程序，由外部调查人员提出新的数据收集模块。(5)提供与死亡率数据和外部数据库的链接，以便分析残疾和长期护理相关的公共计划支出，通过医疗和长期护理系统的移动，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。将高度优先重视及时分发高质量、方便用户和记录良好的数据文件，并建立广泛的用户基础。公共卫生相关性NSDTD将是一个科学探究的平台，以指导减少残疾、最大限度地发挥功能和提高老年人生活质量的努力。它将促进研究，以设计多因素干预措施，以减少晚年残疾，并将支持残疾过程的结果，包括生活和护理安排，支出，经济福祉和生活质量的综合建模。

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.