Physical disability is the most prevalent major health problem of aging populations, and the associated needs for medical services are large. Yet, while longitudinal studies of risk factors for cardiovascular disease have identified major modifiable risk factors and have led to strategies for reduction of morbidity and mortality, such studies in musculoskeletal disease remain in their infancy. This 20 year longitudinal study of 961 individuals studied from an average age of 58 in 1984 and due to reach age 78 in 2004 will (1) identify risk factors for physical disability, radiologic osteoarthritis, and associated use of medical services, (2) assess changes in exercise and other risk factors in terms of cumulative lifetime disability and cumulative health care utilization over time, and (3) establish risk factor models for osteoporotic fractures. The role of physical exercise is particularly emphasized. The investigators will assess development of disability, progression of disability, and risk factor models in minority as compared with predominately white non-Hispanic populations. The investigators state that this project is enabled by extensive previous work and a unique data set. They point out that the application extends their investigations into important new questions of cumulative morbidity and costs, analysis of costs and benefits, long-term disability and cost outcomes, risk factors in minority populations, and effects of changes in risk factor status upon disability, cost, and mortality outcomes. The application proposes to continue data acquisition into the eighth and ninth decades, the age when this cohort will experience the greatest degrees of disability, decline in health, and use of health services. The investigators state that the results will suggest public policy initiatives directed at decreasing lifetime morbidity and medical care costs through preventive mechanisms which reduce modifiable risk factors. They further state that the overall project objective is to understand how improvements in exercise and other risk factor status may retard functional decline and reduce the need for medical care.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG015815-04
Application #
6650374
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Patmios, Georgeanne E
Project Start
2000-09-30
Project End
2005-08-31
Budget Start
2003-09-01
Budget End
2004-08-31
Support Year
4
Fiscal Year
2003
Total Cost
$372,527
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Bruce, Bonnie; Fries, James F (2009) Rheumatologist perceptions of sources of health care disparities in minority rheumatoid arthritis patients. J Clin Rheumatol 15:145-7
Chakravarty, Eliza F; Hubert, Helen B; Lingala, Vijaya B et al. (2008) Long distance running and knee osteoarthritis. A prospective study. Am J Prev Med 35:133-8
Bjorner, Jakob Bue; Chang, Chih-Hung; Thissen, David et al. (2007) Developing tailored instruments: item banking and computerized adaptive assessment. Qual Life Res 16 Suppl 1:95-108
Hays, Ron D; Liu, Honghu; Spritzer, Karen et al. (2007) Item response theory analyses of physical functioning items in the medical outcomes study. Med Care 45:S32-8
Reeve, Bryce B; Hays, Ron D; Bjorner, Jakob B et al. (2007) Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care 45:S22-31
Berk, David R; Hubert, Helen B; Fries, James F (2006) Associations of changes in exercise level with subsequent disability among seniors: a 16-year longitudinal study. J Gerontol A Biol Sci Med Sci 61:97-102
Fries, James F (2005) Frailty, heart disease, and stroke: the Compression of Morbidity paradigm. Am J Prev Med 29:164-8
Bruce, Bonnie; Fries, James F; Lubeck, Deborah P (2005) Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14 year prospective, longitudinal study. Arthritis Res Ther 7:R1263-70
Bruce, Bonnie; Fries, James (2004) Longitudinal comparison of the Health Assessment Questionnaire (HAQ) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Arthritis Rheum 51:730-7
Fries, James F (2003) Measuring and monitoring success in compressing morbidity. Ann Intern Med 139:455-9

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