A large proportion of deaths in the U.S. involve the very old: people aged 80+ comprise 44% of deaths and people 85+ 29%. Yet little population-based data are available to describe dying, health care choices, and clinical trajectories in persons who have reached very old age. The overriding goal of the proposed study is to provide information on a broad-based sample of elders aged 85+ in order to improve care at the end of life in advanced age. To accomplish this goal, we propose to continue follow-up of participants in the Health, Aging, and Body Composition cohort (Health-ABC), a bi-racial population-based sample that currently numbers about 1600 with an average age of 85. Our prospective study will follow the clinical course of these participants with an in-person baseline assessment and quarterly telephone assessments with participants and their substitute decision makers (SDMs) over 4 years, as well as a follow-back interview with SDMs after respondent deaths. The objectives of the research are to (i) characterize clinical trajectories and risk of death in very old age, (ii) assess participant and SDM decision-making in late life in the presence of very high risk of dying, and (iii) examine predictors of hospitalization and emergency department care in very old age. Expected outcomes and impact include clarification of choices and determinants of levels of care in older people at high risk of dying.

Public Health Relevance

Little population-based data are available to describe dying, health care choices, and clinical trajectories in persons who have reached very old age. The overriding goal of the proposed study is to provide information on a broad-based sample of elders aged 85+ in order to improve care at the end of life in advanced age. To accomplish this goal, we propose to continue follow- up of participants in the NIH Health, Aging, and Body Composition cohort (Health-ABC) over an additional 3 years. Health ABC is a bi-racial community-based sample from Pittsburgh, PA and Memphis, TN that currently numbers about 1600 with an average age of 85.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR012459-03
Application #
8394580
Study Section
Special Emphasis Panel (ZRG1-NRCS-B (01))
Program Officer
Mccloskey, Donna J
Project Start
2010-12-23
Project End
2015-11-30
Budget Start
2012-12-01
Budget End
2013-11-30
Support Year
3
Fiscal Year
2013
Total Cost
$487,292
Indirect Cost
$88,382
Name
University of Pittsburgh
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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