National Study of Disability Trends and Dynamics

描述（由申请人提供）：本申请旨在设计、测试、实地考察和传播一项新的国家残疾趋势和动态研究（NSDTD），以：(1)促进对老年残疾趋势和动态、其前因和相关性以及其中的差异的科学探究；(2)推进对个人、家庭和社会的老年残疾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具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)一个全面的、经过验证的残疾测量方案，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伤、环境和补偿策略；包括社会参与的衡量标准；(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，包括生活和照料安排、医疗和长期照料支出以及经济福利和生活质量的其他方面；(d)与现有调查大体一致的措施，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)随机分配给回答者小组的模块，这些模块将允许在NLTCS和其他主要调查中采取残疾措施。(2)对12000名年龄在65岁及以上的医保参保人进行抽样调查，每隔一年进行一次问卷调查，每隔5年进行一次问卷更新。(3)开展方法学研究，验证增强的残疾方案，为生物标志物补充奠定基础，提高数据收集的质量和效率。(4)实施外部调查人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联系，以便分析残疾和长期护理相关的公共项目支出，医疗和长期护理系统的流动，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限制数据文件。将高度优先考虑及时分发高质量、用户友好和记录良好的数据文件，并建立广泛的用户基础。NSDTD将成为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。它将促进设计多因素干预措施的研究，以减少晚年残疾，并将支持对残疾过程的结果进行综合建模，包括生活和护理安排、支出、经济福利和生活质量。

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.