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: 6887744
• 负责人: LAURA P. SANDS
• 金额: $ 12.69万
• 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 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6887744
• 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）：该项目将确定在现存的老年人社区中功能损失进展的发病率，模式，时机和风险，其现有功能依赖性和合并症使他们对额外功能损失的风险很高。额外的损失将降低他们的生活质量，给护理人员带来额外的负担，并大大增加了需要养老院护理的风险。第一个目的是确定渐进式功能丧失的发病率，模式和时间。第二个具体目标是：1）使用基线风险因素开发功能下降的预后指数，2）检查基线风险因素如何与降水事件（例如住院）相互作用，以增加这些事件后经历的功能损失的幅度，并开发出这些事件后的功能损失的幅度，3）3）3）3）3）3），用于在心理健康，身体健康，身体上的身体健康，机能和身体机能和身体机能和身体机能和身体机能和身体机能和身体机能和身体机能和身体机能和身体机能和身体上的功能性和身体机能和身体上的功能性和功能性和功能性和功能性和功能性和功能性和功能性和功能性和功能性和功能性和功能性和功能性和性能性作用为性和性能性作用。对老年人（PACE）的所有包容性护理计划（PACE）的计划为居住具有功能依赖性和多种合并症的老年人的社区提供了照顾。 DataPace包含来自12个速度站点的3,700多名摄入量的季度健康，功能和社会心理评估。数据序列的分析将包括：1）使用混合模型来确定现场调整的渐进功能损失的发病率，2）功能性原理组件分析，以确定2年内进行性功能下降的模式，3）事件分析的时间，以描述功能中其他损失的时间，4）逻辑回归的时间，以发展社会的兴奋性，并在预测索引中进行了更改，并描述了如何使用混乱的模型，并描述了混乱的模型，并描述了如何使用混乱的模型，并描述了混乱的模型。功能和健康状况有助于一年和两年内ADL功能的逐步丧失。政策制定者，临床医生和家庭成员需要计划照顾有功能依赖性和多种合并症的社区老年人。很少研究这些老年人。该项目将描述在需要疗养院护理的风口浪尖的老年人中进行性功能损失的范围。此外，它将确定具有现有功能依赖性和多种合并症的社区老年人的渐进式功能损失的健康，功能，心理和社会风险。