Researchers from multiple medical, nursing, and social/behavioral science specialties from three major research institutions propose to establish a coordinated mechanism for present and future research to identify and measure the modifiable factors affecting health status and health care of chronically ill elders. The research being currently proposed focuses on a wide range of potentially modifiable factors including: hormonal predispositions for hip fracture; changes in renal and cognitive functions among older diabetics; metabolism of nonsteroidal drugs used in arthritis; identification of sleep disorders among nursing home residents; cognitive training of mildly demented nursing home residents; and nursing requirements of patient care in nursing homes. Current research (TNH) sites to be shared by these studies include one free-standing nursing home, two continuum-of-care residential facilities including skilled nursing units, and a community health service with a large number of older members; acute care hospital patients will also be used for individual proposals. Recruitment of subjects and other research sites, liaison with staff and resident councils, centralized storage of basic standardized information and data management/analysis functions will be performed by center core staff. Future research will be developed by soliciting and reviewing proposals, utilizing Pilot Projects and other funding support. A research advisory committee will assist in the review of subsequent proposals. A clinical care advisory committee will assist with future clinical issues. A plan for analyzing shared data will be designed. TNH Council will make policy; weekly seminars will share findings.
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