Among community-living older persons, disability in essential activities of daily living (ADLs), such as bathing,dressing, and walking, is common and highly morbid. During the first 44 months of the current 5-year funding cycle, we have have published or submitted more than two dozen original reports that are directly relevant to the overall objective of the MERIT Award, which is to further elucidate the epidemiology of disability and recovery among older persons. For the MERIT extension, we plan to build on what we have learned about disability and recovery during the pa4idecade, while expanding the scope of this research by incorporating detailed participant-level data on health care utilization in. acute care hospitals, rehabilitation and long-term care facilities, ambulatory and home settings, and hospice through linkages with Medicare and Medicaid claims. For this 5-year extension, we propose 3 distinct sets of specific aims and hypotheses. The first set will retain our focus on essential ADLs. The second set will expand our focus to include higher-level functional tasks, including community mobility and instrumental activities of daily living (lADLs). The third set will take advantage of administrative data on health care utilization that will be newly integrated into our primary database.
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