This study aims to examine cross-cultural differences of persons age 65 and older in North Manhattan with respect to (1) Active Life Expectancy, (2) Frailty-related subjective and objective function and expanded qualities of life, (3) Transitions between non-frail and frail states, in predictors, determinants and sequences, (4) The course and outcome of frailty in relation to general and condition-specific frailty, (5) Service utilization, access to care, compliance, caregiver arrangements for the frail elderly over time. Among (1) The elderly (65 years and older), (2) From a defined geographic area (North Manhattan), (3) Consisting of representative samples of Hispanics, Blacks, and Whites, a majority of whom are women, (4) In large samples (between 1,000 and 2,000 in each of the three groups). Hypotheses to be tested are: The Hispanic and Black elderly have relative to white elderly (1) A shorter active life expectancy, (2) More impairments in objective (but not necessarily subjective) function and quality of life), A different distribution of frequencies of patterns of transitions between frail and non-frail status, (4) A different distribution of condition-specific frailty, (5) More restricted access to institutional and specialist care. We will: 1) Conduct follow-up assessments of previously identified representative samples, Hispanic, Black and White elderly, (2) One year and three years following their initial assessment by the NMAP Project 3) Using structured interviews, an established assessment team familiar with the community, (5) An established reporting network of health providers, (6) Measures of active life expectancy, and other frailty-related variables over time.
