The major focus of this exploratory study is on nutritional programs and support, and their effects on risks of institutionalization, hospitalization and mortality. The analyses will use the National Long Term Care Survey (NLTCS), linked Medicare records, and additional data to characterize available nutritional support programs at the local and state level. The NLTCS is a large nationally representative longitudinal survey of health and disability of the US population aged 65 years and older. Questions on nutritional status (participation in Elderly Nutritional Programs, weight and physical activities) were added in 1994. A food frequency questionnaire (FFQ), a series of questions about patterns of food consumption, was added in 1999. This study will focus on the last two waves of the NLTCS, which contain this nutritional information, to pursue the following specific aims:
Aim 1. To model participation in Elderly Nutrition Programs (ENPs: home delivered meals, and congregate meals), and the food stamp program among those eligible for such programs. We will estimate probit models that will be used to adjust for the propensity to participate in these programs.
Aim 2. To model whether those participating in the ENPs and/or receiving food stamps in 1994, compared with those in other nutritional support arrangements, have reduced risks of institutionalization, hospitalization and mortality between 1994 and 1999. We will use hazard models to estimate the risk of these health outcomes.
Aim 3. To model patterns of dietary intake in 1999, using a modified short FFQ, to explore the impact of current receipt of ENP services. Models of dietary intake will be estimated in two ways: k-means clustering, and grade of membership clustering. Regression models will be used to estimate the effects of receipt of nutritional services, health, sociodemographic and location correlates. This study will generate important hypotheses to be examined in future research on the effect of nutritional programs on elderly health outcomes, and the role of nutritional support programs as a significant factor in the provision of community based long-term care.
| Manton, Kenneth G; Lamb, Vicki L; Gu, XiLiang (2007) Medicare cost effects of recent U.S. disability trends in the elderly: future implications. J Aging Health 19:359-81 |
