The major research project is the first prospective study of fall related factors in a sample of independently living elderly persons. The study, which involves an initial evaluation, a fall diary, bimonthly phone contact, and a partial reevaluation will examine the relative roles of chronic disabilities, acute stresses, and environmental hazards in fall etiology. Two other future fall related projects include a fall intervention trial based on the results of the upcoming study and a project addressing the problem of fear of falling. Substudies from the data generated in the major project are also anticipated. Examples of other age related research projects at Yale University include: the Yale Health and Aging Project (Drs. Ostfeld and Berkman), development of resource utilization groups for LTC (Drs. Cooney and Smits), and an observational study of indwelling catheters in nursing homes (Dr. Miller). Also, Dr. Feinstein, with the help of the geriatric group, will be applying his clinimetric skills to the area of functional assessment. Clinical and teaching opportunities (which are coexistent in large part) include, but are not limited to: the acute rehabilitation unit at Yale New Haven Hospital, the geriatric evaluation clinic, medical consultation at a LTC facility, and attending at several Yale affiliated hospitals. Plans for the next few years include expansion of the geriatric clinic into a multidisciplinary evaluation clinic, development of a geriatric fellowship, and increased collaboration with other university and community people interested in aging from ethical, medical, economic, nursing, social, and basic science perspectives. The applicant's strength lies in the association with, and support from, the excellent clinical epidemiology group (including the sponsor Dr. A. Feinstein), the Public Health and Epidemiology faculty interested in aging (Drs. Ostfeld, L. Berkman, and H. Smits), and the small but strong geriatric subdivision within the General Medicine Section (Drs. L. Cooney, R. Miller, and applicant). The applicant completed a geriatric and clinical epidemiology fellowship at the University of Rochester before joining the Yale faculty. During that fellowship she designed and conducted a preliminary fall study. In addition, geriatrics at Yale has a strong commitment from Dr. Thier, chairman of the Department of Medicine.
