Mg. Ory et Dm. Cox, FORGING AHEAD - LINKING HEALTH AND BEHAVIOR TO IMPROVE QUALITY-OF-LIFE IN OLDER-PEOPLE, Social indicators research, 33(1-3), 1994, pp. 89-120
This chapter will focus on conceptual and methodological issues relate
d to health promotion/disability prevention for older people. The firs
t section will begin with a discussion of why older people, as compare
d to younger persons, are not traditionally seen as targets of health
promotion efforts. In recent years several national working groups hav
e been established to examine how older people's health and functionin
g can be improved. Their objectives and recommendations for older Amer
icans will be reviewed. The second section will address the conceptual
framework underlying health and behavior research supported by the Na
tional Institute on Aging. Tle movement from correlational studies to
studies of basic mechanisms linking health and behaviour will be discu
ssed, with particular attention to interactions with aging processes.
Examples of health and behavior research representing these processes
will be presented as well as methodological issues in the measurement
of health and functional outcomes for older people. Measurement of qua
lity of life in the cognitively impaired is seen as especially difficu
lt. The third section will review several common themes emanating from
these research studies. These include attention to a life course pers
pective, variability in aging processes, alternative research approach
es, and intervention strategies for both initiating and maintaining re
commended behavioral changes. A fourth section will review current are
as of investigation at the National Institute of Aging. Successful int
ervention strategies in both community and institutional settings will
to presented. These include: (1) a comprehensive behavioral and envir
onmental falls prevention program which has been shown to reduce falls
in the community; (2) a health education program to increase older wo
men's use of cancer-related health practices; and (3) behavioral strat
egies for reducing incontinence in nursing homes. A new NIA initiative
on special care units for persons with dementia will also be discusse
d. The fifth and final section will deal with issues involved in the t
ranslation of research into policy and practice. Approaches for increa
sing the relevance of research to policymakers will be discussed.