The hypotheses underlying the proposed research are that potentially modifiable factors predict mobility (life-space) trajectories associated with aging among community-dwelling African Americans (AAs) and whites. Moreover, there are racial differences in these trajectories and in risk factors for life-space changes. The research team proposes to continue a prospective, observational study of a population-based sample of 1000 community-dwelling older adults (251 African American (AA) males, 249 AA females, 250 white males and 250 white females; 54 percent rural) for a total of 7 years of follow-up.
New specific aims i nclude: (1) Assess the predictors of life-space trajectories; (2) Identify predictors of transitions to restricted life-space, homebound status, and nursing home placement; (3) Examine proximate causes of life-space transitions; 4) Evaluate changes in hypothesized risk factors as predictors of life-space trajectories; (5) Determine the relationship of nutritional status with subsequent life-space trajectories; (6) Evaluate specific markers of inflammation as potential predictors of life-space. Repeat in-home assessments (N=780) 48-months after the baseline (1999-2001) in-home assessment will permit documentation of changes in disease and geriatric syndrome status, europsychological factors, nutritional status, health behaviors, and medication use since baseline. Fasting blood specimens (N=662) will be obtained within one month of the 48-month in-home assessment to assess nutrition-related lab tests, measures of inflammation, and other lab tests reflecting disease severity or management. Three 24-hour recall dietary intakes also will be obtained within 3 weeks of the in-home assessment. Telephone follow-up interviews every 6 months will be used to ascertain subsequent life-space. Multivariable, hierarchical mixed model growth curve analyses and generalized estimating equation (GEE) approaches will be used for analyses to permit identification of predictors of life-space trajectories and of specific life-space transitions. The results of this research will lead to interventions that will foster independence of older AAs and whites.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG015062-07
Application #
6803007
Study Section
Special Emphasis Panel (ZRG1-EDC-3 (01))
Program Officer
Stahl, Sidney M
Project Start
1998-09-30
Project End
2008-07-31
Budget Start
2004-08-01
Budget End
2005-07-31
Support Year
7
Fiscal Year
2004
Total Cost
$516,262
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Buys, David R; Kennedy, Richard E; Williams, Courtney Phillips et al. (2018) Social and Demographic Predictors of Nutritional Risk: Cross-sectional Analyses From the UAB Study of Aging II. Fam Community Health 41 Suppl 2 Supp:S33-S45
Clay, Olivio J; Perkins, Martinique; Wallace, Gail et al. (2018) Associations of Multimorbid Medical Conditions and Health-Related Quality of Life Among Older African American Men. J Gerontol B Psychol Sci Soc Sci 73:258-266
Wells, Elina U; Williams, Courtney P; Kennedy, Richard E et al. (2018) Factors That Contribute to Recovery of Community Mobility After Hospitalization Among Community-Dwelling Older Adults. J Appl Gerontol :733464818770788
Garrett, Stephanie L; Kennedy, Richard E; Sawyer, Patricia et al. (2018) Association Between Executive Dysfunction and Instrumental Activities of Daily Living: Racial and Ethnic Differences Among Community-Dwelling Older Adults in the Southeastern US. J Natl Med Assoc :
Kennedy, Richard E; Sawyer, Patricia; Williams, Courtney P et al. (2017) Life-Space Mobility Change Predicts 6-Month Mortality. J Am Geriatr Soc 65:833-838
Dermody, Gordana; Sawyer, Patricia; Kennedy, Richard et al. (2017) ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults. J Emerg Nurs 43:57-69
Vaughan, C P; Tangpricha, Vin; Motahar-Ford, N et al. (2016) Vitamin D and incident urinary incontinence in older adults. Eur J Clin Nutr 70:987-9
Lo, Alexander X; Rundle, Andrew G; Buys, David et al. (2016) Neighborhood Disadvantage and Life-Space Mobility Are Associated with Incident Falls in Community-Dwelling Older Adults. J Am Geriatr Soc 64:2218-2225
Brown, Cynthia J; Kennedy, Richard E; Lo, Alexander X et al. (2016) Impact of Emergency Department Visits and Hospitalization on Mobility Among Community-Dwelling Older Adults. Am J Med 129:1124.e9-1124.e15
McCaskill, Gina M; Sawyer, Patricia; Burgio, Kathryn L et al. (2015) The Impact of Veteran Status on Life-Space Mobility among Older Black and White Men in the Deep South. Ethn Dis 25:255-62

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