Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Mar;86(1):47-89.
doi: 10.1111/j.1468-0009.2007.00513.x.

Why is late-life disability declining?

Robert F Schoeni  1 , Vicki A Freedman, Linda G Martin
Affiliations

Why is late-life disability declining?

Robert F Schoeni et al. Milbank Q. 2008 Mar.

Abstract

Context: Late-life disability has been declining in the United States since the 1980s. This study provides the first comprehensive investigation into the reasons for this trend.

Methods: The study draws on evidence from two sources: original data analyses and reviews of existing studies. The original analyses include trend models of data on the need for help with daily activities and self-reported causes of such limitations for the population aged seventy and older, based on the National Health Interview Surveys from 1982 to 2005.

Findings: Increases in the use of assistive and mainstream technologies likely have been important, as have declines in heart and circulatory conditions, vision, and musculoskeletal conditions as reported causes of disability. The timing of the improvements in these conditions corresponds to the expansion in medical procedures and pharmacologic treatment for cardiovascular disease, increases in cataract surgery, increases in knee and joint replacements, and expansion of medications for arthritic and rheumatic conditions. Greater educational attainment, declines in poverty, and declines in widowhood also appear to have contributed. Changes in smoking behavior, the population's racial/ethnic composition, the proportion of foreign born, and several specific conditions were eliminated as probable causes.

Conclusions: The substantial reductions in old-age disability between the early 1980s and early 2000s are likely due to advances in medical care as well as changes in socioeconomic factors. More research is needed on the influence of health behaviors, the environment, and early- and midlife factors on trends in late-life disability.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age-Adjusted Prevalence of Disability among the Noninstitutionalized Population 70 and Older, 1983 to 2005. Source: Authors' tabulations using the National Health Interview Survey.
Figure 2
Figure 2
The Late-Life Disablement Process: Influences over the Life Course.
Figure 3
Figure 3
Trends in the Prevalence of Reported Causes of Disability for the Population 70 and Older, 1982 to 2005. Source: Authors' tabulations using the National Health Interview Survey.
Figure 3
Figure 3
Trends in the Prevalence of Reported Causes of Disability for the Population 70 and Older, 1982 to 2005. Source: Authors' tabulations using the National Health Interview Survey.
Figure 4
Figure 4
Percentage Who Ever Smoked, by Age: 1983, 1994, and 2005. Source: Authors' tabulations using the National Health Interview Survey.
Figure 5
Figure 5
Poverty and Disability Rates for Noninstitional Population 70 and Older, 1982 to 2004. Source: Disability rates are based on authors' tabulations using the National Health Interview Survey, and poverty rates are from the U.S. Bureau of the Census.
See this image and copyright information in PMC

References

    1. Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H. Walking and Dementia in Physically Capable Elderly Men. Journal of the American Medical Association. 2004;292(12):1447–53. - PubMed
    1. Adams P, Hurd M, McFadden D, Merrill A, Ribeiro T. Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status. Journal of Econometrics. 2003;112(1):3–56.
    1. Allaire SH, LaValley MP, Evans SR, O'Connor GT, Kelly-Hayes M, Meenan RF, Levy D, Felson DT. Evidence for Decline in Disability and Improved Health among Persons Aged 55 to 70 Years: The Framingham Heart Study. American Journal of Public Health. 1999;89(11):1678–83. - PMC - PubMed
    1. American Association of Retired Persons. Beyond 50.03: A Report to the Nation on Independent Living and Disability. Washington D.C.: AARP Public Policy Institute; 2003. [accessed December 4, 2007]. Available at http://research.aarp.org/il/beyond_50_il.html.
    1. Applegate WB, Miller ST, Elam JT, Freeman JM, Wood TO, Gettlefinger TC. Impact of Cataract Surgery with Lens Implantation on Vision and Physical Function in Elderly Patients. Journal of the American Medical Association. 1987;257(8):1064–66. - PubMed

Publication types