This proposal constitutes part of a growing body of research designed to understand trends in mortality, morbidity, survival, and disability levels for selected major diseases among older persons, and implications of the findings for health care utilization. Specifically, the proposal consists of a retrospective study of successive cohorts of older members of a well- defined and well-documented elderly population for the following purposes: Defining and explaining the trends in hip fracture incidence, mortality, long-term survival, and functional outcomes among males and females during the 25 year period 1967-1992. Defining and explaining changes in stroke incidence, mortality, survival, and severity between 1981 and 1992, as an extension of a previous study of stroke trends. The study population consists of four successive period cohorts of elderly people identified for the following five-year periods: 1967-71,1974- 78,1981-85,1988-92. The first three cohorts 'have already been defined, while the fourth will be defined as part of the current proposal. Hypotheses are as follows: A Hip Fracture That during the period 1967-1992: Age-specific incidence of hip fracture among persons > 65 years of age has increased. There has been an increase in short- and long-term hip fracture survival. There has been an increase in post-fracture functional independence among survivors of acute hip fracture. Stroke That during the period 1981-92: Age-specific incidence of stroke among persons > 65 years of age has increased. Clinical severity and case fatality of stroke has decreased. Increased incidence and decreased severity are attributable in part to change in the natural history of disease and in part to ascertainment of milder cases using newer imaging technology.
| Barker, W H; Mullooly, J P; Linton, K L (1998) Trends in hypertension prevalence, treatment, and control: in a well-defined older population. Hypertension 31:552-9 |
