Racial Disparities in Mobility Disablility Among Older Men

描述（由申请人提供）：本申请旨在继续国家健康与老龄化趋势研究（NHATS），其目的是(1)促进对晚年残疾趋势和动态，其前因后果和相关性以及其中的差异的科学探究；(2)推进对个人，家庭和社会的晚年残疾的社会和经济后果的研究。为了实现这些目标，在接下来的5年周期（2014-2018）中，我们将：(a)每年亲自从原始的NHATS队列中收集数据，包括：继续收集增强的残疾协议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，以及生命结束的质量；收集干燥的血斑，一些用于分析以促进残疾进展的生物学风险研究，另一些用于储存以备将来使用；在潜在日益重要的未被充分研究的关键领域加强NHATS访谈——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环境中独立运作的服务环境和相关设施——并纳入更广泛的研究团体提交的新模块。(b)在第5轮（2015年）补充样品。补充资金的实施方式将使NHATS保持产生5年寿命估计（包括90年以上）和黑白比较的能力。(c)在线清理、记录和传播公共使用文件，并继续使用既定程序提供医疗保险索赔和其他敏感和受限文件。(d)进行方法研究，以提高今后几轮数据收集的效率，包括测试关键估计数对不同后续期间的敏感性，并将项目反应理论等现代衡量方法应用于能力衡量。NHATS的首要目标是成为一个科学探索的平台，以指导减少残疾，最大限度地发挥功能，提高老年人的生活质量。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，并将支持残疾过程结果的综合建模，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 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.