Our proposed study addresses the Program Announcement entitled 'Research on Mind-Body Interactions and Health' (PA-07-046). Specifically, we address the National Institute on Aging (NIA) interest in exploring associations between psychological well-being and functional ability in older adults hospitalized for acute illness.
The Specific Aims of the proposed application are to: 1. Examine change in functional status during hospitalization and up to one-year post hospital discharge. Functional status will be assessed by a battery of measures (a 4 meter walk, a test of grip strength, knee extensor strength and seven activities of daily living (ADLs)) at 5 time points: within 24 hours of hospital admission and discharge, and 1, 6 and 12 months post discharge. 2. Examine direct and indirect associations between psychological well-being and functional status during hospitalization and up to one-year post hospital discharge. Psychological well-being, assessed by a 6- domain psychological well-being instrument and a positive affect summary scale, will be used to examine patterns of association with functional status over the 5 time points outlined in aim 1. 3. Examine whether psychological well-being modifies ethnic health disparities associated with functional status during hospitalization and up to one-year post hospital discharge.
This aim will allow us to examine how ethnic group (non-Hispanic whites, non-Hispanic blacks and Hispanics) interacts with psychological well-being to influence functional status over the 5 time points outlined in aim 1. To explore our aims, we plan to follow up an ethnically diverse sample of 800 older patients (non-Hispanic whites, non-Hispanic blacks and Hispanics) admitted to the Acute Care for Elders (ACE) unit at the University of Texas Medical Branch. Older adults enrolled in the study will be assessed at five time points: within 24 hours of hospital admission, within 24 hours of hospital discharge and 1, 6 and 12 months post discharge. The five time points will allow us not only to examine overall patterns of effect between functional status and psychological well-being but it will also allow us to examine patterns of effect over distinct time periods including hospitalization and post discharge. The three post discharge follow up interviews will further allow us to examine and explain associations between functional status and psychological well-being in relation to short (1 month) and longer term (6 and 12 month) recovery patterns. A central goal of the current application is to examine whether psychological well-being can influence the risk for functional status decline associated with hospitalization in an ethnically diverse older patient population.
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