The purpose of this research is to develop methods to forecast life expectancy, active life expectancy and health status changes among the U.S. elderly and oldestold population. To produce such projections it will be necessary to conduct both a.) select substantive studies to examine mortality and morbidity patterns at advanced ages and the potential for modifying those patterns, and b.) methodological studies to integrate stochastic process models of human morbidity, disability and mortality processes into comprehensive forecasting models. In the substantive studies, use will be made of extensive data holdings of: a.) longitudinal studies (e.g., Framingham, Evans County, Albany Civil Servant Study, First and Second Duke Aging Studies, multiple data sets from the WHO ERICA Archiving Project); b.) vital statistics data (e.g., 1962 to 1984 underlying cause of death mortality files, 1968 to 1984 multiple cause mortality files), and c.) national health and disability surveys (e.g., 1982 and 1984 National Long Term Care Surveys; 1969-1977 National Nursing Home Surveys; 1969-1981 Health Interview Surveys). These data sets represent several different types of observational plans and degrees of individual information and will be analyzed with different appropriate models of stochastic processes; i.e., multivariate Gaussian stochastic process model; fuzzy set models of complex discrete state processes, discrete state models of partially observed processes estimated from multiple data sources, and stochastic compartment models. The development of those models will be taken from the stage of theoretical specification where the model is structured to represent the underlying processes of human physiological aging and mortality to the development of practical statistical estimation and forecasting procedures. Projections will be developed for a variety of health and disability endpoints. These projections will be sufficiently detailed to be useful for planning for such programs as the development of geriatric and other ancillary health professional manpower to better meet the increasing volume of health and LTC needs of the elderly and extremely elderly populations. Projections will be made for a series of time horizons and the uncertainty of different endpoints will be assessed.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
4R37AG007025-06
Application #
3480197
Study Section
Special Emphasis Panel (NSS)
Project Start
1987-08-01
Project End
1997-07-31
Budget Start
1992-09-30
Budget End
1993-07-31
Support Year
6
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Organized Research Units
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Manton, K G; Stallard, E (1996) Changes in health, mortality, and disability and their impact on long-term care needs. J Aging Soc Policy 7:25-52
Manton, K G; Stallard, E; Corder, L (1995) Changes in morbidity and chronic disability in the U.S. elderly population: evidence from the 1982, 1984, and 1989 National Long Term Care Surveys. J Gerontol B Psychol Sci Soc Sci 50:S194-204
Manton, K G; Woodbury, M A; Stallard, E (1995) Sex differences in human mortality and aging at late ages: the effect of mortality selection and state dynamics. Gerontologist 35:597-608
Manton, K G; Stallard, E; Woodbury, M A et al. (1994) Time-varying covariates in models of human mortality and aging: multidimensional generalizations of the Gompertz. J Gerontol 49:B169-90
Manton, K G; Stallard, E; Woodbury, M A (1994) Home health and skilled nursing facility use: 1982-90. Health Care Financ Rev 16:155-86
Potthoff, R F (1994) Telephone sampling in epidemiologic research: to reap the benefits, avoid the pitfalls. Am J Epidemiol 139:967-78
Manton, K G; Corder, L; Stallard, E (1993) Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NLTCS. Gerontologist 33:168-76
Manton, K G; Vertrees, J C; Clark, R F (1993) A multivariate analysis of disability and health, and its change over time in the National Channeling Demonstration data. Gerontologist 33:610-8
Manton, K G (1992) Forecasting health: data needs and implications for model structure. World Health Stat Q 45:80-8
Pekkanen, J; Manton, K G; Stallard, E et al. (1992) Risk factor dynamics, mortality and life expectancy differences between eastern and western Finland: the Finnish Cohorts of the Seven Countries Study. Int J Epidemiol 21:406-19

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