Persistent, consistent, widespread, and robust? Another look at recent trends in old-age disability

Abstract

Objective. The purpose of this study was to provide new evidence on disability trends among elderly persons from 1982 to 1996. Methods. The sample includes 124,949 participants aged 70 and older in the 1982-1996 National Health Interview Surveys. Logistic analysis was used to estimate the trend in disability prevalence after controlling for various sociodemographic factors. Results. We found that: (a) the prevalence of disability has declined, but the gains did not persist throughout the entire period or accelerate over time; (b) only routine care disability has declined, whereas more severe personal care disability shows no improvements; (c) estimates are robust to the exclusion of the nursing home population but may be sensitive to growth in the assisted living population; (d) estimates of decline in disability prevalence are fairly consistent across five national surveys; (e) gains have been concentrated among the most educated elderly persons; and (f) gains in education appear to be an important confounder of the improvements. Discussion. Evidence from several surveys using various measures indicates that disability has declined among elderly persons. Determining the causes of the improvements should be a high priority in future research efforts.