The Second

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The Second Longitudinal Study of Aging
Julie Dawson Weeks, Ph.D. LSOAs Project Director
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LSOA II Staff
Survey Team Sylvia Ellison Cordell
Golden Keith Zevallos Data Linkage
Team Chris Cox Donna Miller Jim Brittain
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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

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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

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Objectives

• 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.

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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)

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Relationship Between the Surveys
LSOA
1984
1986
1988
1990
SOA
W2
W3
W4
LSOA II
1994-96
1997-98
1999-2000
SOA II
W2
W3
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LSOA II Sample Characteristics

• 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

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SOA II Design
1994 NHIS Core (n116,179)
Supplements
Immunization
Year 2000 objectives
AIDS
Non-disabled, age 70
Family resources
Disability Supplement Phase I (HIS-2) (n107,469)
Non-disabled Age lt70
Disabled
Disability Supplement Phase 2
Second Supplement On Aging (DFS-3) Age
70 (n4,519)
DFS-2
DFS-1 Age lt18 (n4,200)
Age 18-70 (n11,102)
Age 70 (n4,928)
SOA II Sample (n9,447)
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LSOA II Methodological Characteristics

• Baseline interview 1994-1996
• In-person, SPs home
• Census Bureau
• Follow-up interviews 1997-98 and 1999-2000
• Telephone
• NORC
• Institutionalized decedent IWs conducted
• Self-response (unless SP incapacitated)

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LSOA IIResponse Rates
Cumulative
Conditional on Eligibility
Interview
n/a
94.1
NHIS Core
87.4
92.9
SOA II Baseline
74.2
84.9
LSOA II Wave 2
56.6
76.3
LSOA II Wave 3
Note Response rates may change slightly once
final LSOA II Version 3.0 data files are
released for public use.
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LSOA II Data Sources
1994 NHIS Supplements Family Resources Disability
Supplement
1994 NHIS Core Questionnaire
SOA II
1999-2000 Wave 3 Interview
1997-1998 Wave 2 Interview
Administrative Record Linkages
Survivors
NDI
Decedents
CMS
SSA
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LSOA II Content
Other Baseline Data Sources

• NHIS Core
• Sex
• Age (DOB)
• Race / Ethnicity
• Marital status
• Veteran status
• Education
• Family income

• Family Resources
• Access to care
• Reasons for no care
• Disability Supplement
• Mental health
• Depression
• RA Disability

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LSOA II Content
Baseline SOA II

• Housing characteristics
• Transportation
• Social activities
• Family structure
• Family interactions
• Living arrangements
• Employment history
• Community services

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LSOA II Content
Baseline SOA II, continued

• Health behaviors
• Chronic conditions
• Assistive devices
• Physical functioning
• Personal assistance
• Health insurance
• Prescription use
• LTC Utilization

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LSOA II Content
Additions at Waves 2 and 3

• 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

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LSOA II Content
Decedent Interviews

• 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

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LSOA II Content
Decedent Interviews

• 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

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LSOA IIAdministrative Record LinkagesChristine
S. CoxNCHS Special Assistant for Record Linkage
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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

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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

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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

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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)

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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)

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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)

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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 - Users remote location

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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

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NCHS Research Data Center (RDC) Contact
Information

• For general questions
• rdca_at_cdc.gov [phone]
• For on-site access information
• Negasi Beyene
• nbeyene_at_cdc.gov [phone]
• For remote access information
• Vijay Gambhir
• vgambhir_at_cdc.gov [phone]

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Additional Information
on the LSOA II

• Survey Website
• Documentation and data files
• http//www.cdc.gov/nchs/lsoa.htm
• Survey Email
• lsoa_at_cdc.gov