Disability among the old-old leads to diminished quality of life and a disproportionate amount of health care resource use. There is increasing recognition that efforts to decrease disability among the elderly must be based on a better understanding of factors which slow down the cascade from chronic illness to organ-level physical impairment to disability. Progression along this cascade is not inevitable, but may be buffered by personal and social resources, preventive adaptations and impairment- relevant ameliorative adaptations. We have a unique opportunity to study a comprehensive model of this cascade and its buffers on a sample of the 660 elderly, age 75+, who are enrolled in an ongoing NIA-funded MERIT award study of Florida retirees. A three wave longitudinal design will be used in conjunction with data collection in the ongoing study. The proposed new study will introduce performance- based assessments of physical impairment, additional measures of specific adaptations to impairment, and time use measures of social disability. The study will take advantage of existing measures of chronic illness, personal (ADL/IADL) disability, health promotion activities, and social, psychological and economic resources. Descriptive analyses will characterize the illness - impairment -disability cascade and its effects on quality of life and health care use, and will identify the range of adaptations activated by the elderly to deal with their impairments. Least squares regression and structural equation modeling will be used to test a comprehensive model of buffers of this cascade. Findings from the proposed study will be useful to policy makers, service providers and others attempting to minimize disability and enhance quality of life among the elderly.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG010738-04
Application #
2051961
Study Section
Special Emphasis Panel (HSDG)
Project Start
1992-06-05
Project End
1996-08-31
Budget Start
1995-06-01
Budget End
1996-08-31
Support Year
4
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Family Medicine
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Lee, Jeong Eun; Kahana, Boaz; Kahana, Eva (2016) Social support and cognitive functioning as resources for elderly persons with chronic arthritis pain. Aging Ment Health 20:370-9
Choi, Moon; Adams, Kathryn Betts; Kahana, Eva (2013) Self-regulatory driving behaviors: gender and transportation support effects. J Women Aging 25:104-18
Choi, Moon; Adams, Kathryn Betts; Kahana, Eva (2012) The impact of transportation support on driving cessation among community-dwelling older adults. J Gerontol B Psychol Sci Soc Sci 67:392-400
Kahana, Eva; Kelley-Moore, Jessica; Kahana, Boaz (2012) Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life. Aging Ment Health 16:438-51
Zhang, Jian-Ping; Kahana, Boaz; Kahana, Eva et al. (2009) Joint modeling of longitudinal changes in depressive symptoms and mortality in a sample of community-dwelling elderly people. Psychosom Med 71:704-14
Kelley-Moore, Jessica A; Schumacher, John G; Kahana, Eva et al. (2006) When do older adults become ""disabled""? Social and health antecedents of perceived disability in a panel study of the oldest old. J Health Soc Behav 47:126-41
Kahana, Eva; Kahana, Boaz; Zhang, Jianping (2005) Motivational Antecedents of Preventive Proactivity in Late Life: Linking Future Orientation and Exercise. Motiv Emot 29:438-459
Covinsky, K E; Kahana, E; Kahana, B et al. (2001) History and mobility exam index to identify community-dwelling elderly persons at risk of falling. J Gerontol A Biol Sci Med Sci 56:M253-9