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. 2014 Feb;104(2):e88-94.
doi: 10.2105/AJPH.2013.301687. Epub 2013 Dec 12.

Behavioral adaptation and late-life disability: a new spectrum for assessing public health impacts

Vicki A Freedman  1 , Judith D Kasper, Brenda C Spillman, Emily M Agree, Vincent Mor, Robert B Wallace, Douglas A Wolf
Affiliations

Behavioral adaptation and late-life disability: a new spectrum for assessing public health impacts

Vicki A Freedman et al. Am J Public Health. 2014 Feb.

Abstract

Objectives: To inform public health efforts to promote independent functioning among older adults, we have provided new national estimates of late-life disability that explicitly recognize behavioral adaptations.

Methods: We analyzed the 2011 National Health and Aging Trends Study, a study of Medicare enrollees aged 65 years and older (n = 8077). For 7 mobility and self-care activities we identified 5 hierarchical stages--fully able, successful accommodation with devices, activity reduction, difficulty despite accommodations, and receipt of help--and explored disparities and associations with quality of life measures.

Results: Among older adults, 31% were fully able to complete self-care and mobility activities. The remaining groups successfully accommodated with devices (25%), reduced their activities (6%), reported difficulty despite accommodations (18%), or received help (21%). With successive stages, physical and cognitive capacity decreased and symptoms and multimorbidity increased. Successful accommodation was associated with maintaining participation in valued activities and high well-being, but substantial disparities by race, ethnicity, and income existed.

Conclusions: Increased public health attention to behavioral adaptations to functional change can promote independence for older adults and may enhance quality of life.

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Figures

FIGURE 1—
FIGURE 1—
Percentage of older adults with participation restrictions and mean well-being scores by (a) stage in the late-life disability spectrum and (b) age: National Health and Aging Trends Study, United States, 2011.
See this image and copyright information in PMC

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