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Disability trends among older Americans: National Health and Nutrition Examination surveys, 1988-1994 and 1999-2004

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  • Seeman, T.E.
  • Merkin, S.S.
  • Crimmins, E.M.
  • Karlamangla, A.S.

Abstract

We investigated trends in disability among older Americans from 1988 through 2004 to test the hypothesis that more recent cohorts show increased burdens of disability. Methods. We used data from 2 National Health and Nutrition Examination Surveys (1968-1994 and 1999-2004) to assess time trends in basic activities of daily living, instrumental activities, mobility, and functional limitations for adults aged 60 years and older. We assessed whether changes could be explained by sociodemographic, body weight, or behavioral factors. Results. With the exception of functional limitations, significant increases in each type of disability were seen over time among respondents aged 60 to 69 years, independent of sociodemographic characteristics, health status, relative weight, and health behaviors. Significantly greater increases occurred among non-Whites and persons who were obese or overweight (2 of the fastest-growing subgroups within this population). We detected no significant trends among respondents aged 70 to 79 years; in the oldest group (aged ≥80 years), time trends suggested lower prevalence of functional limitations among more recent cohorts. Conclusions. Our results have significant and sobering implications: older Americans face increased disability, and society faces increased costs to meet the health care needs of these disabled Americans.

Suggested Citation

  • Seeman, T.E. & Merkin, S.S. & Crimmins, E.M. & Karlamangla, A.S., 2010. "Disability trends among older Americans: National Health and Nutrition Examination surveys, 1988-1994 and 1999-2004," American Journal of Public Health, American Public Health Association, vol. 100(1), pages 100-107.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2008.157388_8
    DOI: 10.2105/AJPH.2008.157388
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    1. Sandra Albrecht & Ana Diez Roux & Allison Aiello & Amy Schulz & Ana Abraido-Lanza, 2013. "Secular trends in the association between nativity/length of US residence with body mass index and waist circumference among Mexican-Americans, 1988–2008," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 573-581, August.
    2. Craig Gundersen & David R. Just & Jason M. Fletcher & David E. Frisvold, 2017. "The Relationship between the School Breakfast Program and Food Insecurity," Journal of Consumer Affairs, Wiley Blackwell, vol. 51(3), pages 481-500, November.
    3. Ang, Shannon, 2019. "Intersectional cohort change: Disparities in mobility limitations among older Singaporeans," Social Science & Medicine, Elsevier, vol. 228(C), pages 223-231.
    4. Newton, Nicky J. & Ryan, Lindsay H. & King, Rachel T. & Smith, Jacqui, 2014. "Cohort differences in the marriage–health relationship for midlife women," Social Science & Medicine, Elsevier, vol. 116(C), pages 64-72.
    5. Dana A Glei & Maxine Weinstein, 2021. "Disadvantaged Americans are suffering the brunt of rising pain and physical limitations," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-18, December.
    6. Clarke, Philippa J. & Ailshire, Jennifer A. & Nieuwenhuijsen, Els R. & de Kleijn - de Vrankrijker, Marijke W., 2011. "Participation among adults with disability: The role of the urban environment," Social Science & Medicine, Elsevier, vol. 72(10), pages 1674-1684, May.
    7. Maaike van der Noordt & Johan J. Polder & Marjanne H. D. Plasmans & Henk B. M. Hilderink & Dorly J. H. Deeg & Theo G. van Tilburg & Suzan van der Pas & Fons van der Lucht, 2022. "Exploring Health Trends Prior to State Pension Age for The Netherlands up to 2040," IJERPH, MDPI, vol. 19(7), pages 1-13, April.
    8. Anthony R. Bardo & Jason L. Cummings, 2023. "Life, Longevity, and the Pursuit of Happiness: The Role of Disability in Shaping Racial and Sex Disparities in Living a Long and Happy Life," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-26, August.
    9. Hyokyoung Grace Hong & Jianhui Zhou, 2013. "A multi-index model for quantile regression with ordinal data," Journal of Applied Statistics, Taylor & Francis Journals, vol. 40(6), pages 1231-1245, June.
    10. Zajacova, Anna & Montez, Jennifer Karas, 2018. "Explaining the increasing disability prevalence among mid-life US adults, 2002 to 2016," Social Science & Medicine, Elsevier, vol. 211(C), pages 1-8.
    11. Joelle H. Fong, 2017. "Old-age Frailty Patterns and Implications for Long-term Care Programmes," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(1), pages 114-128, January.
    12. Aïda Solé-Auró & Hiram Beltrán-Sánchez & Eileen Crimmins, 2015. "Are Differences in Disability-Free Life Expectancy by Gender, Race, and Education Widening at Older Ages?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 34(1), pages 1-18, February.
    13. Nicholas J. Bishop & Natalie D. Eggum-Wilkens & Steven A. Haas & Jennie J. Kronenfeld, 2016. "Estimating the Co-Development of Cognitive Decline and Physical Mobility Limitations in Older U.S. Adults," Demography, Springer;Population Association of America (PAA), vol. 53(2), pages 337-364, April.
    14. Zheng, Hui & Choi, Yoonyoung & Dirlam, Jonathan & George, Linda, 2022. "Rising childhood income inequality and declining Americans’ health," Social Science & Medicine, Elsevier, vol. 303(C).
    15. Margie E Lachman & Stefan Agrigoroaei, 2010. "Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-9, October.

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