Long-term retention of older adults in the Cardiovascular Health Study: implications for studies of the oldest old.
OBJECTIVE
To describe retention according to age and visit type (clinic, home, telephone) and to determine characteristics associated with visit types for a longitudinal epidemiological study in older adults.


METHODS
Longitudinal cohort study.


METHODS
Four U.S. clinical sites.


METHODS
Five thousand eight hundred eighty-eight Cardiovascular Health Study (CHS) participants aged 65 to 100 at 1989/90 or 1992/93 enrollment (58.6% female; 15.7% black). CHS participants were contacted every 6 months, with annual assessments through 1999 and in 2005/06 for the All Stars Study visit of the CHS cohort (aged 77-102; 66.5% female; 16.6% black).


METHODS
All annual contacts through 1999 (n=43,772) and for the 2005/06 visit (n=1,942).


RESULTS
CHS had 43,772 total participant contacts from 1989 to 1999: 34,582 clinic visits (79.0%), 2,238 refusals (5.1%), 4,401 telephone visits (10.1%), 1,811 home visits (4.1%), and 740 other types (1.7%). In 2005/06, the All Stars participants of the CHS cohort had 36.6% clinic, 22.3% home, and 41.1% telephone visits. Compared with participants aged 65 to 69, odds ratios of not attending a CHS clinic visit were 1.82 (95% confidence interval (CI)=1.54-2.13), 2.94 (95% CI=2.45-3.57), 4.55 (95% CI=3.70-5.56), and 9.09 (95% CI=7.69-11.11) for those aged 70 to 74, 75 to 79, 80 to 84, and 85 and older, respectively, in sex-adjusted regression. In multivariable regression, participants with a 2005/06 clinic visit were younger, more likely to be male and in good health, and had had better cognitive and physical function 7 years earlier than participants with other visit types. Participants with home, telephone, and missing visits were similar on characteristics measured 7 years earlier.


CONCLUSIONS
Offering home, telephone, and proxy visits are essential to optimizing follow-up of aging cohorts. Home visits increased in-person retention from 36.5% to 58.8% and diversified the cohort with respect to age, health, and physical functioning.
Strotmeyer
Elsa S
ES
Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Room 515, Pittsburgh, Pennsylvania 15213, USA. strotmeyere@edc.pitt.edu
Arnold
Alice M
AM
Boudreau
Robert M
RM
Ives
Diane G
DG
Cushman
Mary
M
Robbins
John A
JA
Harris
Tamara B
TB
Newman
Anne B
AB
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016009:Chi-Square Distribution; D016021:Epidemiologic Studies; D005260:Female; D015577:Geriatric Assessment; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010352:Patient Dropouts / Q000706:statistics & numerical data; D018579:Patient Selection; D035842:Research Subjects / Q000600:supply & distribution; D013689:Telephone / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
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