The SecondLongitudinal Study of

Aging

Julie Dawson Weeks, Ph.D.

LSOAs Project Director

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and PreventionNational Center for Health Statistics

LSOA II Staff

Survey TeamSylvia EllisonCordell

GoldenKeith

Zevallos

Data Linkage TeamChris CoxDonna MillerJim Brittain

Presentation Topics

LSOA II background and purpose

Review the Longitudinal Studies of Aging

LSOA II methodology

•Sample selection

•Survey design

•Interview data source & structure

LSOA II interview data file contents

Linkage activities & data file contents

Sponsors

A collaborative project of the…

•National Institute on Aging, NIH

•National Center for Health Statistics, CDC

With additional funding from…

•Office of the Assistant Secretary for Planning and Evaluation, DHHS

•Robert Wood Johnson Foundation

The LSOA II was designed to…

•Describe the continuum from functional, community-dwelling independence through dependence, including institutionalization, to death;

•Describe the covariates associated with changes in functional status;

•Replicate the first LSOA in order to determine whether there have been changes in the disability and impairment process across the decades.

Objectives

The Longitudinal Studies of Aging(LSOAs)

A family of surveys…

• 1984 Supplement on Aging (SOA)

• 1984-1990 Longitudinal Study of Aging (LSOA)

• 1994 Second Supplement on Aging (SOA II)

• 1994-2000 Second Longitudinal Study of Aging

(LSOA II)

Relationship Between the Surveys

LSOA

LSOA II

1984

1986

1988

1990

SOA

SOA II

1994-96

1997-98

1999-2000

W2 W3 W4

W2 W3

•Based on the 1994 NHIS

•Complex, multistage area probability design

•Civilian, non-institutionalized population

•Persons 70 years of age and over in 1995

•N = 9,447 persons

LSOA IISample Characteristics

SOA II Design

SupplementsImmunization

Year 2000 objectives

AIDSFamily

resources

Non-disabledAge <70

DisabilitySupplement

Phase I (HIS-2)(n=107,469)

Disability Supplement Phase 2DFS-1

Age <18(n~4,200)

DFS-2Age 18-70(n=11,102)

Age 70+(n=4,928)

Disabled

1994 NHIS Core(n=116,179)

Second SupplementOn Aging (DFS-3)

Age 70+(n=4,519)

No

n-disab

led, ag

e 7

0+

SOA II Sample(n=9,447)

LSOA IIMethodological Characteristics

Baseline interview: 1994-1996•In-person, SP’s home•Census Bureau

Follow-up interviews: 1997-98 and 1999-2000

•Telephone•NORC•Institutionalized & decedent IWs

conducted

Self-response (unless SP incapacitated)

LSOA IIResponse Rates

56.6 %76.3 %LSOA II Wave 3

74.2 %84.9 %LSOA II Wave 2

87.4 %92.9 %SOA II Baseline

n/a94.1 %NHIS Core

Cumulative

Conditional

on EligibilityInterview

Note: Response rates may change slightly once final LSOA II Version 3.0 data files are released for public use.

LSOA II Data Sources

SOA II1994 NHIS Supplements:

Family ResourcesDisability Supplement

1999-2000Wave 3 Interview

1994 NHIS:Core Questionnaire

SurvivorsDecedents

SurvivorsDecedents

NDICMSSSA

1997-1998Wave 2 Interview

AdministrativeRecord Linkages

LSOA II Content

NHIS Core

• Sex

• Age (DOB)

• Race / Ethnicity

• Marital status

• Veteran status

• Education

• Family income

Other Baseline Data Sources

Family Resources

• Access to care

• Reasons for no care

Disability Supplement

• Mental health

• Depression

• RA Disability

LSOA II Content

•Housing characteristics

•Transportation

•Social activities

•Family structure

•Family interactions

•Living arrangements

•Employment history

•Community services

Baseline SOA II

LSOA II ContentBaseline SOA II, continued

•Health behaviors

•Chronic conditions

•Assistive devices

•Physical functioning

•Personal assistance

•Health insurance

•Prescription use

•LTC Utilization

LSOA II Content

•Migration and reasons for moves

•Cognitive functioning (HRS)

• Income questions (HRS)

•Home health care utilization

•Preventive services

• Information on the spouse

•Symptomatic conditions

•Nutrition and use of supplements

Additions at Waves 2 and 3

LSOA II Content

•EOL and LYOL transitions

•Eligibility: deaths subsequent to SOA II

•Conducted at Waves 2 and 3

•Respondent rule

•Wave 2 n = 938 Wave 3 n = 906

Decedent Interviews

LSOA II Content

•Most of the Survivor questions repeated

•Reference periods changed

•Cognitive functioning for proxies (HRS)

•Place of death, prior living arrangements

•Changes in functioning prior to death

•Directives and durable POA

Decedent Interviews

LSOA IIAdministrative Record

Linkages

Christine S. CoxNCHS Special Assistant for Record

Linkage

LSOA IIData Linkage Activities

Centers for Medicare & Medicaid Services (CMS)•Medicare-covered utilization & expenditures•Enrollment status

Social Security Administration (SSA)•SSDI & SSI eligibility•Disabling condition

National Death Index (NDI) •Date of death•Cause of death

LSOA IICMS File Linkage

Medicare Enrollment File•Match methodology•Two sample issues:

eligibility vs. match success

Standard Analytic Files (1991-2000)•Hospital inpatient and outpatient•Physician / supplier•Durable medical equipment•Home health agency•Hospice

LSOA IICMS Variables

Annual payment & utilization data •Inpatient hospital care & outpatient services•Skilled nursing facility care•Physician services•Durable medical equipment•Home health care•Hospice care

For each hospital stay•Date of admission & length of stay•Diagnoses & procedures•ICU, CCU, and DRG codes

LSOA IISSA File Linkage

Master Beneficiary Record•Enumeration Verification System•Additional matching algorithms•SSN verification status•Two sample issues:

eligibility vs. match success

Supplemental Security Income Record (SSI)

Disability Control File (SSDI)

LSOA IISSA Variables

For both SSDI & SSI beneficiaries (1991-2000)

•Disability determination date•Primary disabling condition•Whether R ever applied for benefits•Whether R was ever denied benefits

For SSDI beneficiaries (1991-2000)•Type of SSDI claim (worker, disabled, widow / widower, adult disabled as child)

LSOA IINDI File Linkage

Death certificate data (1994-2002)•Probabilistic match process •Outcome statuses:

presumed dead, presumed alive, ineligible

File variables•NDI match status, score and class•Date (mm/dd/yyyy) of birth and death•Age at death / age last known alive•Underlying cause of death (ICD & recodes)•Multiple causes of death (record & entity)

NCHSResearch Data Center (RDC)

Purpose •To provide access to internal data

files (those restricted from public use)

Accessibility •On-site access - NCHS, Hyattsville,

MD•Off-site access - User’s remote

location

NCHSResearch Data Center (RDC)

User procedures •Submit a research proposal for review andreceive approval•Sign an affidavit of confidentiality•Submit (in advance) data files to be linkedwith NCHS internal data (all linkages occurat NCHS)•Subject all output and/or materials removedfrom the RDC to a disclosure limitation

review

NCHSResearch Data Center (RDC)

Contact Information

For general questions •rdca@cdc.gov (301) 458-4732

For on-site access information•Negasi Beyene•nbeyene@cdc.gov (301) 458-4097

For remote access information•Vijay Gambhir•vgambhir@cdc.gov (301) 458-4226

Additional Information

Survey Website

•Documentation and data files•http://www.cdc.gov/nchs/lsoa

.htm

Survey Email

•lsoa@cdc.gov

on the LSOA II