# Presentation: 248187

## The Second

**Longitudinal Study of Aging**

**Julie Dawson Weeks, Ph.D.**
**LSOAs Project Director**

## LSOA II Staff

**Survey Team**
**	****	****Sylvia Ellison**
**	****	****Cordell Golden**
**	****	****Keith Zevallos**
**Data Linkage Team**
**	****	****Chris Cox**
**	****	****Donna Miller**
**	****	****Jim 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.

- 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

- Complex, multistage area probability design
- Civilian, non-institutionalized population
- Persons 70 years of age and over in 1995
- N = 9,447 persons

**LSOA II**
**Sample Characteristics**

## SOA II Design

**Supplements**

**Immunization**

**Year 2000**
** ****objectives**

**AIDS**

**Family**
** ****resources**

- Non-disabled
- Age <70

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

**Disability Supplement Phase 2**

**DFS-1**
- Age <18
- (n~4,200)

**DFS-2**

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

- Age 70+
- (n=4,928)

- Disabled

- 1994 NHIS Core
- (n=116,179)

- Second Supplement
- On Aging (DFS-3)
- Age 70+
- (n=4,519)

- Non-disabled, age 70+

**SOA II Sample**
- (n=9,447)

## LSOA II

**Methodological 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 IIResponse 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/a**

**94.1 %**

**NHIS Core**

**Cumulative**

**Conditional**
**on Eligibility**

**Interview**

- 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 II**

**1994 NHIS Supplements:**
**Family Resources**
**Disability Supplement**

**1999-2000**
**Wave 3 Interview**

**1994 NHIS:**
**Core Questionnaire**

**Survivors**

**Decedents**

**NDI**

**CMS**

**SSA**

**1997-1998**
**Wave 2 Interview**

**Administrative**
**Record 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 Content

**Baseline 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 IIAdministrative Record LinkagesChristine S. CoxNCHS Special Assistant for Record Linkage

## LSOA II

**Data 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 II

**CMS 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 II

**CMS 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 II

**SSA 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 II

**SSA 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 II

**NDI 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)**

## NCHS

**Research 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**

## NCHS

**Research Data Center (RDC)**

**User procedures**** **
**Submit a research *****proposal *****for review and**
**receive approval**
**Sign an *****affidavit of confidentiality***
**Submit (in advance) data files to be linked**
**with NCHS internal data (*****all***** linkages occur**
**at NCHS)**
**Subject all output and/or materials removed**
**from the RDC to a *****disclosure limitation review***

## NCHS

**Research Data Center (RDC)**
**Contact Information**

**For general questions**** **
_**[rdca@cdc.gov](mailto:rdca@cdc.gov)**_**	****	****(301) 458-4732**
**For on-site access information**
**Negasi Beyene**
_**[nbeyene@cdc.gov](mailto:nbeyene@cdc.gov)**_**	****(301) 458-4097**
**For remote access information**
**Vijay Gambhir**
_**[vgambhir@cdc.gov](mailto:vgambhir@cdc.gov)**_**	****(301) 458-4226**

## Additional Information

**Survey Website**
- Documentation and data files
- _[http://www.cdc.gov/nchs/lsoa.htm](http://www.cdc.gov/nchs/lsoa.htm)_
**Survey Email**
- lsoa@cdc.gov

**on the LSOA II**