This research will test the hypothesis that subject-specific factors predict mobility among both African Americans (AAs) and whites, and there are racial differences in potentially modifiable risk factors. Cohort studies, simple in-home evaluations, and mobility assessments in terms of life space (the area in which subjects routinely and purposely move) will be used.
Specific aims are as follow: (1) determine racial differences in patterns of change in mobility over a short-term period of follow-up; (2) determine short-term predictors of mobility limitation for AAs and whites; (3) determine if the development of mobility limitation predicts nursing home placement and death; and (4) determine intermediate-term and long-term predictors of mobility limitation. A prospective, observational, cohort study of community dwelling older adults aged 66 and older (N = 648, 40% AAs, 30% rural) will address aims 1-3. In-home assessments of factors hypothesized to predict mobility will be conducted in 1999. Follow-up telephone interviews every 6 months for 3 years (1999 to 2003) are proposed to define subsequent mobility. Recruits will come from two groups of older adults who previously were evaluated in-home: (1) the Woodlawn/Greene County (WCG) group (N = 308, 72% AAs, 57% rural) studied between 1990 and 1993; and (2) the Statewide Survey of Alabama's Elderly (N = 1,058, 23.2% AAs, 10.8% rural) studied in 1967-87. Short-term patterns in mobility change, predictors of mobility, nursing home placement, and mortality (aims 1-3) will be defined using 1999 in-home assessments as the baseline and subsequent telephone interviews to define outcomes. Intermediate-term and long-term predictors of mobility (aim 4) will be defined using the 1990-1993 assessments of the WCG group and the 1986-1987 Statewide Survey as respective baselines, with 1999 assessments providing mobility outcomes. The investigators state that the results of this research will lead to interventions that will foster the independence of older AAs and whites.
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