The hypotheses underlying the proposed research are that potentially modifiable factors predict mobility (life-space) trajectories associated with aging among community-dwelling African Americans (AAs) and whites. Moreover, there are racial differences in these trajectories and in risk factors for life-space changes. The research team proposes to continue a prospective, observational study of a population-based sample of 1000 community-dwelling older adults (251 African American (AA) males, 249 AA females, 250 white males and 250 white females; 54 percent rural) for a total of 7 years of follow-up.
New specific aims i nclude: (1) Assess the predictors of life-space trajectories; (2) Identify predictors of transitions to restricted life-space, homebound status, and nursing home placement; (3) Examine proximate causes of life-space transitions; 4) Evaluate changes in hypothesized risk factors as predictors of life-space trajectories; (5) Determine the relationship of nutritional status with subsequent life-space trajectories; (6) Evaluate specific markers of inflammation as potential predictors of life-space. Repeat in-home assessments (N=780) 48-months after the baseline (1999-2001) in-home assessment will permit documentation of changes in disease and geriatric syndrome status, europsychological factors, nutritional status, health behaviors, and medication use since baseline. Fasting blood specimens (N=662) will be obtained within one month of the 48-month in-home assessment to assess nutrition-related lab tests, measures of inflammation, and other lab tests reflecting disease severity or management. Three 24-hour recall dietary intakes also will be obtained within 3 weeks of the in-home assessment. Telephone follow-up interviews every 6 months will be used to ascertain subsequent life-space. Multivariable, hierarchical mixed model growth curve analyses and generalized estimating equation (GEE) approaches will be used for analyses to permit identification of predictors of life-space trajectories and of specific life-space transitions. The results of this research will lead to interventions that will foster independence of older AAs and whites.
Showing the most recent 10 out of 74 publications
