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Assessment of Frailty Phenotype and Functional Limitations to Improve Prediction of Subsequent Health Care Utilization in Older Community-Dwelling Adults

Award Number: R01AG067973
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Health care burden as manifested by greater health care utilization rises markedly with advancing age due in part to increasing prevalence of multiple chronic medical conditions (multimorbidity). While multimorbidity is a robust risk factor for higher health care burden, current multimorbidity measures explain only a modest proportion of the variation in subsequent health care costs. In order to constrain health care burden without negatively impacting health outcomes, improved understanding of key determinants of health care utilization among older adults is essential. Risk factors from other domains (including potentially modifiable determinants) would enhance identification of older community-dwelling adults likely to require costly care. Thus, models of health care utilization including the potentially modifiable (but not routinely measured in clinical settings) domains of the frailty phenotype and self-reported functional limitations may improve characterization of patient risk profiles and therefore improve targeting and design of interventions to reduce subsequent health care burden. The overarching objective of this proposal is to construct interpretable, generalizable and validated models of health care costs and utilization among older community dwelling adults that identify clinical risk factors amenable to targeted interventions to reduce risk of subsequent extensive and costly health care. We will take advantage of the linkage between community-dwelling participants in four cohort studies of older adults (Study of Osteoporotic Fractures [SOF]; Osteoporotic Fractures in Men Study [MrOS]; Health Aging and Body Composition Study [Health ABC]; and National Health and Aging Trends Study [NHATS]) and their Medicare claims data. We will perform a comprehensive evaluation of key potential clinical risk factors (frailty phenotype, self-reported functional limitations and components of frailty phenotype and functional limitations) for higher health care costs and utilization, after accounting for demographics and claims-based indicators of multimorbidity and frailty. Our application is consistent with the NIA mission to conduct biological, clinical, behavioral, social, and economic research related to the diseases and conditions associated with the aging process. Our study combines a wide range of data from four large epidemiologic studies leveraging the value of these cohorts in an efficient manner. If our hypotheses are confirmed, findings from our analyses will more accurately characterize subsets of older community-dwelling adults at risk for intense, costly health care; benefit health care systems/payers estimating costs vs. benefits of interventions aimed at delaying progression to frailty and disability; support assessment of the frailty phenotype, functional status, or specific individual components of these domains in the outpatient primary care practice setting; and direct the design of future targeted intervention trials aimed at reducing health care costs and utilization among the aged population.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $710,477 )
2023	2023	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	3	3/21/2023	SUPPLEMENT FOR EXPANSION	$262,220
2023	2023	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	001	4	6/6/2023	NON-COMPETING CONTINUATION	$448,257
														Subtotal = $710,477

Issue Date FY: 2022 ( Subtotal = $479,990 )
2022	2022	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	3	6/15/2022	NON-COMPETING CONTINUATION	$479,990
														Subtotal = $479,990

Issue Date FY: 2021 ( Subtotal = $484,763 )
2021	2021	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	2	5/21/2021	NON-COMPETING CONTINUATION	$484,763
														Subtotal = $484,763

Issue Date FY: 2020 ( Subtotal = $493,889 )
2020	2020	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	1	8/19/2020	NEW	$493,889
														Subtotal = $493,889

Grand Total All Awards = $2,169,119

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Assessment of Frailty Phenotype and Functional Limitations to Improve Prediction of Subsequent Health Care Utilization in Older Community-Dwelling Adults

Award Number: R01AG067973

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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