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UAB Study of Aging

(Mobility Among Older African Americans and Whites)

Sponsor:
National Institute on Aging (R01-AG15062)

Description:
The hypothesis underlying this research is that potentially modifiable factors predict mobility (life-space) trajectories associated with aging among community-dwelling African Americans (AAs) and whites. This is prospective, observational study of a population-based sample of 1000 community-dwelling Medicare beneficiaries, stratified by sex, race, and urban/rural residence. Participants were age 65 years and older at baseline. Baseline in-home assessments were completed between December 1999 and February 2001.

Specific aims included:

  1. Assess the predictors of life-space trajectories;
  2. Identify predictors of transitions to restricted life-space, homebound status, and nursing home placement;
  3. Examine proximate causes of life-space transitions;
  4. Evaluate changes in hypothesized risk factors as predictors of life-space trajectories;
  5. Determine the relationship of nutritional status with subsequent life-space trajectories;
  6. Evaluate specific markers of inflammation as potential predictors of life-space.

Telephone follow-up interviews every 6 months were used to ascertain subsequent life-space, nursing home placement, and vital status with outcomes known on N=921 at year 6 of follow-up. Repeat in-home assessments (N=624) 48-months after the baseline assessment permitted documentation of changes in disease and geriatric syndrome status, neuropsychological factors, nutritional status, health behaviors, and medication use over four years. Fasting blood specimens (N=408) were scheduled and obtained after the 48-month in-home assessment to assess nutrition-related lab tests, measures of inflammation, and other lab tests reflecting disease severity or management. Three 24-hour recall dietary intakes were also obtained within 3 weeks of the 48-month in-home assessment. Year 8 interviews on surviving participants were completed in April 2009.

Multivariable, hierarchical mixed model growth curve analyses and a generalized estimating equation (GEE) approaches are being used for analyses to permit identification of predictors of life-space trajectories and of specific life-space transitions. The results of this research will lead to interventions that will foster independence of older AAs and whites.

Papers (Published 2003-2012)

  1. Baker, P.S., Bodner, E.V., and Allman, R.M., 2003. Measuring life-space mobility in community-dwelling older adults. J. Am. Geriatr. Soc., 51:1610-1614. doi:10.1046/j.1532-5415.2003.51512.x
  2. Parker, M., Roff, L.L., Klemmack, D.L., Koenig, H.G., Baker, P.S., and Allman, R.M., 2003. Religiosity and mental health in southern, community-dwelling older adults. Aging Mental Hlth., 7(5), 390-397. DOI: 10.1080/1360786031000150667
  3. Crowther, M.R., Baker, P. S., Larimore, W.L., Koenig, H.G., Parker, M.W., 2003. Spiritual and emotional well-being: emotional tasks associated with elder care. J. Geriatr Care Management, 13(1): 15-21.
  4. Fuller, G.F., Baker, P.S., Larimore, W.L., Parker, M.W., Allman, R.M., and Martin, J.A., 2003. Helping families establish a medical care plan for an elderly parent. J. Geriatr Care Management, 13(1): 22-28.
  5. Roff, L.L, Klemmack, D.L, Parker, M.W., Koenig, C.G., Crowther, M., Baker, P., Allman, R.M. 2004. Depression and religiosity in African American and White community-dwelling older adults. J Human Behav. Soc. Environ. 10: 175-189.
  6. Allman, R.M., Sawyer Baker, P., Maisiak, R.M., Sims, R.V., and Roseman, J.M., 2004. Racial similarities and differences in predictors of mobility change over eighteen months. J Gen Intern Med. 19: 1118-1126. doi:10.1111/j.1525-1497.2004.30239.x.
  7. Roff, L.L., Klemmack, D.L., Koenig, H.G., Parker, M., Sawyer Baker, P., and Allman, R.M. 2005. Religiosity, smoking, exercise, and obesity among southern, community-dwelling older adults. 2005. J Appl Gerontol. 24: 337-354.
  8. Locher, J.L., Ritchie, C.S., Roth, D.L., Sawyer Baker, P., Bodner, E.V., and Allman, R.M., 2005. Social isolation, support, capital and nutritional risk in an older sample: ethnic and gender differences. Soc Sci Med. 60: 747-761. doi:10.1016/j.socscimed.2004.06.023
  9. Goode, P.S., Burgio, K.L., Halli, A.D., Jones, R.W., Richter, H.E., Redden, D.T., Baker, P.S., Allman, R.M. 2005. Prevalence and correlates of fecal incontinence in community-dwelling older adults. J Am Geriatr Soc. 53:629-635. doi:10.1111/j.1532-5415.2005.53211.x
  10. Peel, C., Sawyer Baker, P., Roth, D.L., Brown, C.J., Bodner, E.V., Allman, R.M. 2005. Assessing mobility in older adults: The UAB Study of Aging life-space assessment. Physical Therapy 85(10): 1008–1019.
  11. Williams, B. R., Sawyer Baker, P., Allman, R.M. 2005. Nonspousal family loss among community-dwelling older adults. Omega 51: 125-142.
  12. Allman, R.M., Sawyer, P., Roseman, J.M. 2006. The UAB Study of Aging: background and prospects for insights into life-space mobility among older African-Americans and Whites in rural and urban settings. Aging Health, 2(3): 417-428.
  13. Sawyer, P., Bodner, E.V., Ritchie, C.S., Allman, R.M. 2006. Pain and pain medication use in community-dwelling older adults. Am J Geriatr Pharmacotherap 4:316-324. doi:10.1016/j.amjopharm.2006.12.005.
  14. Roff, L.L., Klemmack, D.L., Simon, C., Cho, G.W., Parker, M.W., Koenig, C.G., Sawyer Baker, P., Allman, R.M. 2006. Functional limitations and religious service attendance among African American and White elders. Hlth Soc Work 31:246-255.
  15. Makhija, S.K., Gilbert, G.H., Boykin, M.J., Litaker, M.S., Allman, R.M., Sawyer Baker, P., Locher, J.L., Ritchie, C.S. 2006. The relationship between sociodemographic factors and oral health-related quality of life in dentate and edentulous community-dwelling older adults. J Am Geriatr Soc 54:1701-1712. doi:10.1111/j.1532-5415.2006.00923.x

    See the following links for supplemental information about this paper:
  16. Martin, M.Y., Powell, M.P., Peel, C., Zhu, S., Allman, R.M., 2006. Leisure-time physical activity and health-care utilization in older adults. J. of Aging Physical Activity 14:392-410.
  17. Williams, B.R., Sawyer Baker, P., Allman, R.M., Roseman, J.M. 2006. The feminization of bereavement among community-dwelling older adults. J. Women Aging 18:3-18.
  18. Rahman, S., Sawyer Baker, P., Allman, R.M., Zamrini, E. 2007. Dietary factors and cognitive impairment in community-dwelling older adults. J. Nutr. Hlth. Aging 11: 49-54.
  19. Williams, B.R., Sawyer Baker, P., Allman, R.M., Roseman, J.M. 2007. Bereavement among African American and White older adults. J. of Aging Hlth. 19: 313-333. doi: 10.1177/0898264307299301
  20. Klemmack, D.L., Roff, L.L., Parker, M.W., Koenig, H.G., Sawyer Baker, P., Allman, R.M. 2007. A cluster analysis typology of religiousness/spirituality among older adults. Res. on Aging 29:163-183. doi: 10.1177/0164027506296757
  21. Sims, R.V., Ahmed, A., Sawyer, P., Allman, R.M. 2007. Self-reported health and driving cessation in community-dwelling older adults. J. Gerontol. A Biol. Sci. Med. Sci. 62: 89-793.
  22. Sawyer, P., Lillis, J.P., Bodner, E.V., Allman, R.M. 2007. Substantial daily pain among nursing home residents. J. Am. Med. Dir. Assoc. 8:158-165. doi:10.1016/j.jamda.2006.12.030.
  23. Schillerstrom, J.E., Sawyer Baker, P., Allman, R.M., Rungruang, B., Zamrini, E., Royall, D.R. 2007. Clock drawing phenotypes in community-dwelling African Americans and Caucasians: Results from the UAB Study of Aging. Neuroepidemiology 28:175-180. doi: 10.1159/000104095
  24. Makhija S.K., Gilbert G.H., Litaker M.S., Allman R.M., Sawyer P., Locher J.L., Ritchie C.S. 2007. Association between aspects of oral health-related quality of life and body mass index in community-dwelling older adults. J. Am. Geriatr. Soc. 55:1808-1816. doi:10.1111/j.1532-5415.2007.01391.x
  25. Markland, A.D., Goode, P.S., Burgio, K.L. Redden, D.T., Richter, H.E., Sawyer, P., Allman, R.M. 2007. Correlates of urinary, fecal, and dual incontinence among older, African- American and White men and women J. Am. Geriatr. Soc. 56 (2), 285–290 doi:10.1111/j.1532-5415.2007.01509.x
  26. Crowe, M., Clay O.J., Sawyer P., Crowther M.R., Allman R.M., 2008. Education and reading ability in relation to differences in cognitive screening between African American and Caucasian older adults. Int. J. Geriatr. Psychiatr. 23:222-223. doi:10.1002/gps.1902.
  27. Locher, J.L. Roth, D.L., Ritichie, C.S. Cox, K., Bodner, E.V., Sawyer, P., Allman, R.M. 2007. Body mass index, weight loss, and mortality in community-dwelling older adults. J. Gerontol. A Biol. Sci. Med. Sci. 62:1389-1392.
  28. Ritchie, C.S., Locher, J.L., Roth, D.L., McVie, T., Sawyer, P., Allman, R.M. 2008. Unintentional weight loss predicts decline in ADL function and life-space mobility over four years among community-dwelling older adults J. Gerontol. A Biol. Sci. Med. Sci. 63:67-75.
  29. Goode, P.S., Burgio K.L., Redden, D.T., Markland, A., Richter, H.E., Sawyer, P., Allman, R.M. 2008. Population-based study of incidence and predictors of urinary incontinence in African and White Older Adults. J. Urol. 179:1449-1453. doi:10.1016/j.juro.2007.11.069
  30. Crowe, M., Clay O.J., Sawyer P., Crowther M.R., Allman R.M., 2008. Education and reading ability in relation to differences in cognitive screening between African American and Caucasian older adults. Int. J. Geriatr. Psychiatr. 23:222-223. doi:10.1002/gps.1902.
  31. Park, N., Klemmack, D., Roff, L., Parker, M., Koenig, H., Baker, P., Allman, R. 2008. Religiousness and longitudinal trajectories in elders’ functional status. Research on Aging 279-298. doi:10.1177/0164027507313001.
  32. Williams, B.R., Sawyer, P., Roseman, J.M., Allman, R.M. 2008 Marital status and health:exploring pre-widowhood, Journal of Palliative Medicine. 11(6): 848-856. doi:10.1089/jpm.2007.0190.
  33. Crowe, M., Andel, R., Okonkwo, O.,Wadley, V., Sawyer, P., Allman, R.M. 2008. Life-space and cognitive decline in a community-based sample of African American and Caucasian older adults J. Gerontol. A Biol. Sci. Med. Sci. 63:1241-1245
  34. Brown, C.J., Roth, D.L., Allman, R.M., Sawyer, P., Ritchie, C.S. Roseman, J.M. Trajectories of life-space mobility after hospitalization. 2009. Ann Intern Med 150:372-378
  35. Makhija S.K., Gilbert G.H., Clay O.J., Matthews J.C., Sawyer P., Allman R.A. Oral health-related quality of life and life-space mobility in community-dwelling older adults 2010. J Am Geriatr Soc Accepted for publication

    See the following links for supplemental information about this paper:
  36. Crowe, M., Sartori, A., Clay, O. J., Wadley, V. G., Andel, R., Wang, H. -X., Sawyer, P., & Allman, R. (2010). Diabetes and cognitive decline: Investigating the potential influence of factors related to health disparities. Journal of Aging and Health, 22, 292-306.
  37. Crowe, M., Allman, R. M., Triebel, K., Sawyer, P., & Martin, R. (2010). Normative performance on an executive clock drawing task (CLOX) in a community-dwelling sample of older adults. Archives of Clinical Neuropsychology, 25, 610-617.
  38. Clay O.J., Roth D.L., Safford M.M., Sawyer P.L., Allman R.M. Predictors of Overnight Hospital Admission in Older African American and Caucasian Medicare Beneficiaries 2011. J Gerontol A Biol Sci Med Sci. 2011 August;66A(8):910–916. doi:10.1093/gerona/glr082.

Opportunities for Faculty Involvement:
Data from this study are available for investigators to analyze for publications and for use as preliminary data for new grant applications.

Procedures for Requesting Data Sets

Primary Contact Person:

, Ph.D.
(tel) (205) 975-5372
(fax) (205) 934-7354

Leaders and Key Staff:

  • Richard M. Allman, M.D. (PI)
  • Patricia Sawyer, Ph.D. (Co-PI)
  • Eric V. Bodner, BS
  • Cynthia Brown, M.D.
  • Julie Locher, Ph.D.
  • Christine S. Ritchie, M.D.
  • Jeffrey R. Roseman, M.D.
  • David Roth, Ph.D.

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