Arthritis pervades all facets of older people's health --it is their most prevalent and symptomatic chronic condition, the first or second rank cause of social limitations for them, and a common reason for ambulatory care. A progressive nonfatal condition with persistent or flare-up symptoms, arthritis accompanies many years of later life. It is thus central to older people's health and quality of life. This application comes from a social demographer with knowledge in sex and social differentials in health and mortality, and technical skills in health survey design and analysis. The SERCA goals are: (1) to gain scholastic and practical training in biomedical, clinical, and epidemiological facets of arthritic diseases, and more broadly the rheumatic diseases, and (2) to design and conduct collaborative research projects by social and biomedical scientists interested in the impact of arthritis on people's physical and social functioning and in strategies of medical and personal care that relieve discomfort and improve functioning. The training component will focus on: the pathology of osteoarthritis and other arthropathies; chronic back disorders, connective tissue diseases, and gout; differential diagnosis of rheumatic diseases; clinical procedures for diagnosis and functional assessment; how medical teams determine strategies of patient care and monitor outcomes; epidemiology and nosology of musculoskeletal conditions; and selected epidemiological research methods. The P.I.'s personal research aim is to bring together social and medical perspectives of arthritis into population based surveys in a brand-new way. A nascent plan is to conduct a state or regional survey of middle- aged and older noninstitutional people, focusing on arthritis and one or two nonfatal chronic conditions. The arthritis protocol would include questions about symptoms, disability, and routines of care, interviewer-conducted functional assessments, and health diaries for a month or longer. The survey would reveal (i) physical bases for social disabilities (esp. activities of daily living) and (ii) the short term dynamics of arthritis symptoms and care aimed at them. Design extensions to include medical diagnoses of arthropathy, and to resurvey respondents after 1-2 years to capture longer dynamics of the disease and disability, will be considered. This and other topics with genuinely sociomedical perspectives will be developed during the SERCA period with the preceptors/advisor (rheumatology, geriatric medicine, epidemiology) and their colleagues.
| Verbrugge, L M; Jette, A M (1994) The disablement process. Soc Sci Med 38:1-14 |
| Verbrugge, L M (1990) Disability. Rheum Dis Clin North Am 16:741-61 |
| Verbrugge, L M (1989) Recent, present, and future health of American adults. Annu Rev Public Health 10:333-61 |
| Verbrugge, L M; Balaban, D J (1989) Patterns of change in disability and well-being. Med Care 27:S128-47 |
| Boscia, J A; Kobasa, W D; Abrutyn, E et al. (1986) Lack of association between bacteriuria and symptoms in the elderly. Am J Med 81:979-82 |
