NATIONAL HEALTH AND AGING TRENDS STUDY

说明(申请人提供)：本申请建议继续进行国家健康和老龄化趋势研究(NHATS)，其目的是(1)促进对晚年残疾趋势和动态、其前因性和相关性以及其间差异的科学研究，以及(2)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，在下一个五年周期(2014-2018年)，我们将：(A)每年亲自从原来的NHATS队列中收集数据，包括：继续收集增强的残疾议定书和关于后果的补充问题，包括主观和经济福祉、生活和护理安排以及生命终结的质量；收集干血点，其中一些将进行化验，以促进对残疾进展的生物风险的研究，其他将储存以供未来使用；在可能日益重要的未充分研究的关键领域--旨在从残疾中恢复的康复服务的使用，以及促进退休和老年社区独立运作的服务环境和相关便利设施的使用--以及纳入更广泛的研究界提交的新模块方面，对NHATS访谈进行了改进。(B)在第五轮(2015年)补充样本。补充将以这样一种方式实施，即NHATS保持生成5年年龄估计(包括90岁以上)和黑白比较的能力。(C)在网上清理、记录和传播公共使用档案，并继续利用既定程序提供医疗保险索赔和其他敏感和受限档案。(D)开展方法学研究，以提高今后几轮的数据收集效率，包括测试关键估计数对不同后续行动期的敏感性，并将项目反应理论等现代衡量方法应用于能力衡量。NHATS的总体目标是成为一个科学研究平台，指导减少残疾、最大限度地发挥功能并提高老年人的生活质量的努力。使用NHATS的研究将促进设计多因素干预措施以减少晚年残疾的研究，并将支持对残疾过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 continue the National Health and Aging Trend Study (NHATS), which aims (1) to promote scientific inquiry into late-life disability trends and dynamics, their antecedents and correlates, and disparities therein and (2) to advance study of the social and economic consequences of late-life disability for individuals, families, and society. To achieve these aims, in the next 5-year cycle (2014-2018) we will: (a) Collect data in person from the original NHATS cohort annually, including: continued collection of the enhanced disability protocol and supplemental questions on consequences including subjective and economic wellbeing, living and care arrangements, and quality of end of life; collection of dried blood spots, some to be assayed to foster study of the biologic risk for disability progression, and others to be stored for future use; enhancements to the NHATS interview in key understudied areas of potentially growing importance-use of rehabilitation services aimed at recovery from disability, and the service environment and related amenities that promote independent functioning in retirement and senior community settings-and incorporating new modules submitted by the broader research community. (b) Replenish the sample in Round 5 (2015). Replenishment will be implemented in such a way that NHATS maintains the ability to produce 5-year age estimates (including 90+) and Black-White comparisons. (c) Clean, document and disseminate public use files online and continue to make Medicare claims and other sensitive and restricted files available using established procedures. (d) Undertake methodological studies to improve the efficiency of data collection in future rounds, including testing the sensitivity of key estimates to differential follow-up periods and applying modern measurement approaches such as Item Response Theory (IRT) to measures of capacity. The overarching goal of NHATS is to be a platform for scientific inquiry to guide efforts to reduce disability, maximize functioning, and enhance older adults' quality of life. Research using NHATS will foster research to design multi-factor interventions to reduce late-life disability, and will support comprehensive modeling of outcomes of the disability process including living and care arrangements, expenditures, economic well-being, and quality of life.