This application is a five-year competitive continuation of a NIA-sponsored project entitled """"""""Physical Frailty in Urban African Americans,"""""""" funded from 1991-7 (RO1 AG10436). In pursuit of its long range goal of identifying strategies for improving the active life expectancy of this population, the investigators investigated 646 African Americans living in a five-square mile, poor inner-city area of St. Louis who were aged 70-99 years at baseline evaluation in 1992-94. They identified increased disability and risk for functional decline among inner-city dwelling African Americans compared to Anglo Americans and to national samples of age- and gender-matched African Americans. They also demonstrated specific problems (e.g., obesity, high nutritional risk, dehydration, and renal insufficiency) that appear to contribute significantly to this excess disability. The present project proposes to continue pursuit of the stated long-term goal by extending investigation of the consequences and causes of the demonstrated disability in two directions. The first direction involves continued follow up of the original cohort using short telephone contacts in years 1, 3, and 4; longer contacts in 2 and 5; and yearly death searches. These data will address the project's first specific aim, i.e., to evaluate the effects of obesity, weight loss, fear of falling, lack of walking, and lower instrumental activities of daily living (ADL) functioning on subsequent fall, excess hospitalization, and increased basic ADL dependencies; and the impact of these factors on mortality. The second direction involves the recruitment and evaluation of a new cohort of 1200 younger African Americans from metropolitan St. Louis stratified by socioeconomic status. Data collection will involve in-home evaluations at waves 1 and 4, telephone follow-ups at waves 2, 3, and 5, and will also involve detailed evaluations of body composition and muscle strength in a 25% at waves 1 and 4. The investigators state that data from this new cohort will allow pursuit of specific Aims 2 and 3, i.e., the time of development, precursors and consequences of sarcopenia (Aim 2) and subclinical disability (Aim 3). Extensive data verification and internal reliability and validity studies will be performed. Primary analytic methods involve event history models predicting falls, incident basic ADL dependencies, hospitalization, and mortality in the original cohort as well as incident subclinical disability and functional limitation in the new cohort, adjusting for important covariates. Secondary analyses (e.g., studies involving fear of falling, bone mineral metabolism, adverse effects of dehydration and renal insufficiency, and supine-to-stand transfers) will also be pursued.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG010436-07
Application #
6168117
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Yancik, Rosemary
Project Start
1991-09-30
Project End
2005-04-30
Budget Start
2001-05-01
Budget End
2002-04-30
Support Year
7
Fiscal Year
2001
Total Cost
$1,300,721
Indirect Cost
Name
Saint Louis University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Saint Louis
State
MO
Country
United States
Zip Code
63103
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Chode, S; Malmstrom, T K; Miller, D K et al. (2016) Frailty, Diabetes, and Mortality in Middle-Aged African Americans. J Nutr Health Aging 20:854-859
Ribeiro, S M L; Morley, J E; Malmstrom, T K et al. (2016) Fruit and Vegetable Intake and Physical Activity as Predictors of Disability Risk Factors in African-American Middle-Aged Individuals. J Nutr Health Aging 20:891-896
Hawkins, Misty A W; Miller, Douglas K; Stewart, Jesse C (2015) A 9-year, bidirectional prospective analysis of depressive symptoms and adiposity: the African American Health Study. Obesity (Silver Spring) 23:192-9
Wolinsky, Fredric D; Ayyagari, Padmaja; Malmstrom, Theodore K et al. (2014) Lower extremity function trajectories in the African American Health Cohort. J Gerontol A Biol Sci Med Sci 69:1004-10
Kelly, Cheryl; Wilson, Jeffrey S; Schootman, Mario et al. (2014) The built environment predicts observed physical activity. Front Public Health 2:52
Malmstrom, Theodore K; Miller, Douglas K; Morley, John E (2014) A comparison of four frailty models. J Am Geriatr Soc 62:721-6
Bruchas, Robin R; de Las Fuentes, Lisa; Carney, Robert M et al. (2013) The St. Louis African American health-heart study: methodology for the study of cardiovascular disease and depression in young-old African Americans. BMC Cardiovasc Disord 13:66
Talantova, Maria; Sanz-Blasco, Sara; Zhang, Xiaofei et al. (2013) A? induces astrocytic glutamate release, extrasynaptic NMDA receptor activation, and synaptic loss. Proc Natl Acad Sci U S A 110:E2518-27

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