This application proposes to design, test, field, and disseminate a new National Study of Disability Trends and Dynamics (NSDTD) to: (I) promote scientific inquiry into late-life disability trends and dynamics, their antecedents and correlates, and disparities therein, and (II) advance study of the social and economic consequences of late-life disability for individuals, families, and society. To achieve these aims, a multidisciplinary consortium with experience in disability measurement, survey design and operations, and dissemination will: (1) Design and test, using state-of-the-art survey methodology: (a) a comprehensive, validated disability measurement protocol that includes self-report and performance-based measures of functioning;allows disaggregation of activity limitations into impairments, the environment, and compensatory strategies;and includes measures of social participation;(b) questions to assess the interplay of disablement with treatment of health conditions and self-care strategies;(c) questions on key economic and social consequences of disability including living and care arrangements, medical and long-term care expenditures, and other aspects of economic well-being and quality of life;(d) measures, largely harmonized with existing surveys, to allow investigation of racial/ethnic and socioeconomic disparities and the intervening role of other key risk factors in trends and trajectories;and (e) modules that will be randomly assigned to subgroups of respondents that will allow cross-walks to disability measures in the NLTCS and other major surveys. (2) Collect data in person from a sample of 12,000 Medicare enrollees ages 65 and older, resurvey them at annual intervals, and refresh the sample at 5-year intervals. (3) Conduct methodological studies to validate the enhanced disability protocol, lay the groundwork for a biomarker supplement, and improve the quality and efficiency of data collection. (4) Implement a process whereby external investigators propose new data collection modules. (5) Provide linkages to mortality data and external databases that enable analyses of disability and long-term care related public program expenditures, movement through the medical and long-term care system, the supply and quality of medical and long-term care, and the role of public long-term care policies. (6) Clean, document, and disseminate public use and restricted data files. A high priority will be placed on timely distribution of high-quality, user-friendly, and well-documented data files and on building a broad user base.

Public Health Relevance

The NSDTD will be a platform for scientific inquiry to guide efforts to reduce disability, maximize functioning, and enhance older adults'quality of life. It will foster research to design multi-factor interventions to reduce late-life disability, and will support comprehensive modeling of outcomes of the disablement process including living and care arrangements, expenditures, economic well-being, and quality of life.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HOP-Y (51))
Program Officer
Patmios, Georgeanne E
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
Zip Code
Freedman, Vicki A; Spillman, Brenda C (2014) The residential continuum from home to nursing home: size, characteristics and unmet needs of older adults. J Gerontol B Psychol Sci Soc Sci 69 Suppl 1:S42-50
Wolf, Douglas A (2014) Getting help from others: the effects of demand and supply. J Gerontol B Psychol Sci Soc Sci 69 Suppl 1:S59-64
Skolarus, Lesli E; Burke, James F; Freedman, Vicki A (2014) The role of accommodations in poststroke disability management. J Gerontol B Psychol Sci Soc Sci 69 Suppl 1:S26-34
Burke, James F; Freedman, Vicki A; Lisabeth, Lynda D et al. (2014) Racial differences in disability after stroke: results from a nationwide study. Neurology 83:390-7
Freedman, Vicki A; Agree, Emily M; Cornman, Jennifer C et al. (2014) Reliability and validity of self-care and mobility accommodations measures in the National Health and Aging Trends Study. Gerontologist 54:944-51
Elliot, Ari J; Mooney, Christopher J; Douthit, Kathryn Z et al. (2014) Predictors of older adults' technology use and its relationship to depressive symptoms and well-being. J Gerontol B Psychol Sci Soc Sci 69:667-77
Davydow, Dimitry S; Zivin, Kara; Langa, Kenneth M (2014) Hospitalization, depression and dementia in community-dwelling older Americans: findings from the national health and aging trends study. Gen Hosp Psychiatry 36:135-41
Choi, Namkee G; DiNitto, Diana M; Kim, Jinseok (2014) Discrepancy between chronological age and felt age: age group difference in objective and subjective health as correlates. J Aging Health 26:458-73
Freedman, Vicki A; Kasper, Judith D; Spillman, Brenda C et al. (2014) Behavioral adaptation and late-life disability: a new spectrum for assessing public health impacts. Am J Public Health 104:e88-94
Skolarus, Lesli E; Burke, James F; Brown, Devin L et al. (2014) Understanding stroke survivorship: expanding the concept of poststroke disability. Stroke 45:224-30

Showing the most recent 10 out of 23 publications