Progressive Functional Loss in Elders with Dependencies

有依赖性的老年人的渐进性功能丧失

• 批准号: 7069983
• 负责人: LAURA P. SANDS
• 金额: $ 17.72万
• 依托单位: PURDUE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7069983
• 关键词: African American; Asian Americans; Hispanic Americans; behavior prediction; behavioral /social science research tag; behavioral medicine; caregivers; caucasian American; clinical research; cognition disorders; comorbidity; functional ability; gender difference; human data; human old age (65+); mental disorders; meta analysis; outcomes research; physical fitness; quality of life; racial /ethnic difference; self care; socioeconomics; socioenvironment; statistics /biometry

DESCRIPTION (provided by applicant): The project will determine the incidence rates, patterns, timing and risks for progression of functional loss in community living older adults whose existing functional dependencies and co-morbidities put them at high risk for additional functional losses. Additional losses would decrease their quality of life, place additional burdens on their caregivers and substantially increase their risk for needing nursing home care. The first aim is to determine the incidence rates, patterns and timing of progressive loss of functioning. The second specific aim is to: 1) develop a prognostic index for functional decline using baseline risk factors, 2) examine how baseline risk factors interact with precipitating events (e.g. hospitalization) to increase the magnitude of functional loss experienced after these events, and 3) develop prognostic models for progressive functional decline that incorporates baseline values of and changes in psychological health, social functioning, sensory functioning and physical health. The Program for All Inclusive Care of the Elderly (PACE) provides care for community residing older adults who have functional dependencies and multiple co-morbidities. DataPACE contains quarterly health, functional and psychosocial assessments for more than 3,700 PACE enrollees from 12 PACE sites. Analyses of DataPACE will include: 1) the use of mixed models to determine site adjusted incidence rates of progressive functional loss, 2) functional principle components analysis to determine patterns of progressive functional decline over 2 years, 3) time to event analyses to describe the timing of additional losses in functioning, 4) logistic regression to develop a prognostic index, and 5) the use of repeated mixed models to describe how precipitating events and changes in psychological, social, functional, and health status contribute to progressive loss of ADL functioning over one and two years. Policy makers, clinicians and family members need to plan for the care of community living older adults with functional dependencies and multiple co-morbidities. Little research is focused on these older adults; this project will describe the scope of progressive functional loss in older adults who are on the cusp of needing nursing home care. Further, it will determine the health, functional, psychological and social risks of progressive functional loss in community living older adults with existing functional dependencies and multiple co-morbidities.

描述（由申请人提供）：该项目将确定社区老年人功能丧失进展的发生率、模式、时间和风险，这些老年人现有的功能依赖性和合并症使他们面临额外功能丧失的高风险。额外的损失会降低他们的生活质量，给他们的护理人员带来额外的负担，并大大增加他们需要疗养院护理的风险。第一个目标是确定渐进性功能丧失的发生率、模式和时间。第二个具体目标是：1) 使用基线风险因素制定功能衰退的预后指数，2) 检查基线风险因素如何与诱发事件（例如住院）相互作用，以增加这些事件后功能丧失的程度，以及 3 ）开发进行性功能衰退的预后模型，其中包含心理健康、社会功能、感觉功能和身体健康的基线值和变化。老年人全包护理计划 (PACE) 为社区居住的患有功能依赖和多种合并症的老年人提供护理。 DataPACE 包含来自 12 个 PACE 站点的 3,700 多名 PACE 参与者的季度健康、功能和社会心理评估。 DataPACE 的分析将包括：1) 使用混合模型来确定进行性功能丧失的部位调整发生率，2) 功能主成分分析，以确定 2 年内进行性功能丧失的模式，3) 事件发生时间分析，以描述额外功能丧失的时间，4) 逻辑回归以制定预后指数，以及 5) 使用重复混合模型来描述心理、社会、功能和健康状况的突发事件和变化如何导致 ADL 功能的逐渐丧失超过一年和两年。政策制定者、临床医生和家庭成员需要为患有功能依赖和多种合并症的社区老年人的护理制定计划。针对这些老年人的研究很少。该项目将描述即将需要疗养院护理的老年人渐进性功能丧失的范围。此外，它将确定具有现有功能依赖和多种合并症的社区老年人进行性功能丧失的健康、功能、心理和社会风险。

项目成果

Disparities between black and white patients in functional improvement after hospitalization for an acute illness.

黑人和白人患者因急性疾病住院后功能改善存在差异。

• 发表时间: 2005-10
• 影响因子: 6.3
• 作者: Sands, Laura P;Landefeld, C Seth;Ayers, Sandra Moody;Yaffe, Kristine;Palmer, Robert;Fortinsky, Richard;Counsell, Steven R;Covinsky, Kenneth E
• 通讯作者: Covinsky, Kenneth E

Predicting change in functional status over quarterly intervals for older adults enrolled in the PACE community-based long-term care program.

预测参加 PACE 社区长期护理计划的老年人每季度的功能状态变化。

• 发表时间: 2008-10
• 影响因子: 4
• 作者: Sands, Laura P;Xu, Huiping;Craig, Bruce A;Eng, Catherine;Covinsky, Kenneth E
• 通讯作者: Covinsky, Kenneth E

Comparison of resource utilization for Medicaid dementia patients using nursing homes versus home and community based waivers for long-term care.

使用疗养院与基于家庭和社区的长期护理豁免的医疗补助痴呆患者的资源利用率比较。

• 发表时间: 2008-04
• 影响因子: 3
• 作者: Sands, Laura P;Xu, Huiping;Weiner, Michael;Rosenman, Marc B;Craig, Bruce A;Thomas 3rd, Joseph
• 通讯作者: Thomas 3rd, Joseph

Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs.

满足与未满足日常生活需求的体弱老年人的急症护理入院率。

• 发表时间: 2006-02
• 影响因子: 6.3
• 作者: Sands, Laura P;Wang, Yun;McCabe, George P;Jennings, Kristofer;Eng, Catherine;Covinsky, Kenneth E
• 通讯作者: Covinsky, Kenneth E