1. The Second Longitudinal Study of Aging Julie Dawson Weeks, Ph.D. LSOAs Project Director U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics

2. LSOA II Staff Survey Team Sylvia Ellison Cordell Golden Keith Zevallos Data Linkage Team Chris Cox Donna Miller Jim Brittain

3. 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

4. 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

5. 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

6. 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)

7. Relationship Between the Surveys LSOA LSOA II 1984198619881990 SOA SOA II 1994-961997-981999-2000 W2W3W4 W2W3

8. 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 II Sample Characteristics

9. 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)

10. 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)

11. 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/a94.1 %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.

12. LSOA II Data Sources SOA II 1994 NHIS Supplements: Family Resources Disability Supplement 1999-2000 Wave 3 Interview 1994 NHIS: Core Questionnaire Survivors Decedents Survivors Decedents NDI CMS SSA 1997-1998 Wave 2 Interview Administrative Record Linkages

13. 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

14. LSOA II Content Housing characteristics Transportation Social activities Family structure Family interactions Living arrangements Employment history Community services Baseline SOA II

15. LSOA II Content Baseline SOA II, continued Health behaviors Chronic conditions Assistive devices Physical functioning Personal assistance Health insurance Prescription use LTC Utilization

16. 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

17. LSOA II Content EOL and LYOL transitions Eligibility: deaths subsequent to SOA II Conducted at Waves 2 and 3 Respondent rule Wave 2 n = 938Wave 3 n = 906 Decedent Interviews

18. 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

19. LSOA II Administrative Record Linkages Christine S. Cox NCHS Special Assistant for Record Linkage

20. 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

21. 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

22. 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

23. 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)

24. 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)

25. 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)

26. 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

27. 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

28. NCHS Research Data Center (RDC) Contact Information For general questions rdca@cdc.gov(301) 458-4732 rdca@cdc.gov For on-site access information Negasi Beyene nbeyene@cdc.gov(301) 458-4097 nbeyene@cdc.gov For remote access information Vijay Gambhir vgambhir@cdc.gov(301) 458-4226 vgambhir@cdc.gov

29. Additional Information Survey Website Documentation and data files http://www.cdc.gov/nchs/lsoa.htm Survey Email lsoa@cdc.gov on the LSOA II