Among community-living older persons, disability in bathing (i.e. washing and drying one's whole body) is highly prevalent, is a strong predictor of morbidity and mortality, and is a primary indication for home aide services. Yet, the evidence base to help guide the prevention and remediation of bathing disability is relatively scant. The long-term objective of this research is to rigorously evaluate targeted and clinically sensible intervention strategies to enhance safe and independent bathing among community-living older persons.
The Specific Aims of the research proposed in the current application, which has been extensively revised in response to the prior review, are: (1) to determine the burden and patterns of disability in bathing among community-living older persons; (2) to determine whether disability in bathing is associated with subsequent adverse outcomes, such as nursing home admission and death, independent of potential confounders, including disability in other basic activities of daily living (ADLs); (3) to evaluate the relationship between potential risk factors that are intrinsic to the individual, especially those that may be modifiable, and disability in bathing; and (4) to identify potential environmental impediments to independent bathing. To accomplish these aims, we will use high quality data from an ongoing prospective study of 754 community-living older persons, including monthly assessments of ADL function for 7 years and comprehensive home-based assessments at 18-month intervals. The proposed research addresses a fundamental problem in geriatric medicine and rehabilitation, builds upon a large body of previously completed work, including epidemiologic studies related to ADL disability and the home environment, and takes advantage of the most comprehensive and complete set of bathing related data on such a large cohort of community-living older persons, with an excellent participation rate and remarkably low attrition. By rigorously evaluating the epidemiology of bathing disability, the research proposed in this revised application will facilitate the development of subsequent interventions directed at the prevention and remediation of disability in bathing. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG022993-02
Application #
6935830
Study Section
Epidemiology of Clinical Disorders and Aging Study Section (ECDA)
Program Officer
Yancik, Rosemary
Project Start
2004-08-15
Project End
2008-06-30
Budget Start
2005-07-01
Budget End
2006-06-30
Support Year
2
Fiscal Year
2005
Total Cost
$500,427
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Miner, Brienne; Gill, Thomas M; Yaggi, H Klar et al. (2018) Insomnia in Community-Living Persons with Advanced Age. J Am Geriatr Soc 66:1592-1597
Han, Ling; Gill, Thomas M; Jones, Bobby L et al. (2016) Cognitive Aging Trajectories and Burdens of Disability, Hospitalization and Nursing Home Admission Among Community-living Older Persons. J Gerontol A Biol Sci Med Sci 71:766-71
Buurman, Bianca M; Han, Ling; Murphy, Terrence E et al. (2016) Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission. J Am Med Dir Assoc 17:225-31
Gill, Thomas M; Allore, Heather G; Gahbauer, Evelyne A et al. (2015) The role of intervening illnesses and injuries in prolonging the disabling process. J Am Geriatr Soc 63:447-52
Gill, Thomas M; Gahbauer, Evelyne A; Han, Ling et al. (2015) The role of intervening hospital admissions on trajectories of disability in the last year of life: prospective cohort study of older people. BMJ 350:h2361
Ferrante, Lauren E; Pisani, Margaret A; Murphy, Terrence E et al. (2015) Functional trajectories among older persons before and after critical illness. JAMA Intern Med 175:523-9
Levy, Becca R; Slade, Martin D; Chung, Pil H et al. (2015) Resiliency Over Time of Elders' Age Stereotypes After Encountering Stressful Events. J Gerontol B Psychol Sci Soc Sci 70:886-90
Gill, Thomas M; Allore, Heather G; Gahbauer, Evelyne A et al. (2015) Establishing a Hierarchy for the Two Components of Restricted Activity. J Gerontol A Biol Sci Med Sci 70:892-8
Gill, Thomas M (2014) Disentangling the disabling process: insights from the precipitating events project. Gerontologist 54:533-49
Barry, Lisa C; Soulos, Pamela R; Murphy, Terrence E et al. (2013) Association between indicators of disability burden and subsequent depression among older persons. J Gerontol A Biol Sci Med Sci 68:286-92

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